Are hyperuricemia and high uric acid the same thing?

Written by Li Jing
Rheumatology
Updated on February 20, 2025
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Firstly, hyperuricemia and high uric acid levels refer to the same concept, defined as blood uric acid levels greater than 420. This condition is described as asymptomatic hyperuricemia, which does not require special treatment at this stage, but it does necessitate changes in lifestyle habits such as abstaining from alcohol, avoiding eating animal organs, seafood, and high-protein foods, not drinking carbonated beverages, and losing weight if obese, to help control body weight. After changing these lifestyle habits, a recheck of the uric acid levels should be done in two weeks to see if there has been a decrease. If the levels have not decreased at that time, sodium bicarbonate tablets can be used to alkalinize the urine. Additionally, increasing water intake to promote the excretion of uric acid and monitoring the dynamic changes in uric acid levels are needed. Once joint pain occurs, which indicates an acute gout attack, proper uric acid-lowering medication is required. (Please undergo medication under the guidance of a professional physician, and do not self-medicate blindly.)

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Causes of hyperuricemia

Hyperuricemia is divided into primary hyperuricemia and secondary hyperuricemia. Primary hyperuricemia is mainly due to a disorder in the metabolism of purines in the body, leading to excessive production of uric acid, which in turn causes hyperuricemia. Prolonged duration can greatly increase the risk of gout. Secondary hyperuricemia refers to hyperuricemia caused by excessive production or excretion obstacles due to some common diseases, the most common being chronic renal failure or some tumors, etc.

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Written by Li Jing
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What should be noted for hyperuricemia?

Firstly, hyperuricemia is just found during routine physical examinations or blood tests, showing an increase in blood uric acid levels without the occurrence of gout attacks, meaning there are no symptoms of joint pain. At this time, there is no need for special medication, which means uric acid-lowering drugs are not required. However, you need to be cautious and change your lifestyle habits. For example, abstaining from alcohol, controlling the intake of animal organs, seafood, and barbecued foods. Additionally, drinking more water is necessary, and for overweight individuals, controlling weight and losing weight are important considerations. Also, you should avoid intense physical activities as they can trigger gout attacks, but this doesn't mean no exercise at all; slow walking and swimming are fine.

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Written by Luo Juan
Endocrinology
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Hyperuricemia treatment agent

Currently, the main treatments for hyperuricemia in clinical practice include the following types. One category is drugs that inhibit uric acid synthesis, primarily allopurinol and febuxostat. Allopurinol is a xanthine oxidase inhibitor, which mainly works by preventing the conversion of hypoxanthine and xanthine into uric acid through the inhibition of xanthine oxidase. Febuxostat, on the other hand, is a newer xanthine oxidase inhibitor and may be more effective than allopurinol in lowering blood uric acid levels. Another category includes drugs that promote the excretion of uric acid, suitable for patients with normal renal function and hyperuricemia. These mainly include probenecid, benzbromarone, and some use of thiazide diuretics, though their effectiveness for hyperuricemia is somewhat controversial. (Specific medications should be taken under the guidance of a physician.)

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Written by Chen Xie
Endocrinology
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How is hyperuricemia treated?

The treatment of hyperuricemia mainly includes the following points: 1. Improve lifestyle primarily, including a low-purine diet, appropriate exercise, smoking cessation, and increased water intake. 2. Alkalize urine using sodium bicarbonate to maintain urine pH value between 6.2 and 6.9, which facilitates the excretion of uric acid. 3. Avoid drugs that increase uric acid levels, such as diuretics, corticosteroids, and insulin. 4. Use medications that lower uric acid levels; drugs that increase uric acid excretion mainly include probenecid and sulfinpyrazone, and drugs that inhibit uric acid synthesis mainly include febuxostat and allopurinol. However, the treatment with these drugs has specific indications, contraindications, and related side effects. It is advised to use medication under the guidance of a doctor and avoid choosing drugs for treatment arbitrarily.

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Treatment of Hyperuricemia with Medication

The treatment of hyperuricemia primarily involves dietary control, focusing on low-purine foods, increasing water intake, and maintaining regular exercise. Additionally, alkalizing the urine using sodium bicarbonate to keep the urine pH between 6.2 and 6.9 can help facilitate the excretion of uric acid. It's also important to avoid medications that can increase uric acid levels. For reducing uric acid, treatments mainly include probenecid, which can increase the excretion of uric acid, and febuxostat, an alternative to allopurinol, though side effects of these medications should be noted. Therefore, it is advised for patients with hyperuricemia to consult a doctor at a reputable hospital before taking any medications.