Our more common serious diseases, unlike those of yesteryear, are those of longevity and lifestyle. Consequently, they get a lot of attention, whether it be in the form of research dollars or media headlines. We all know the usual suspects, heart disease, cancer, diabetes. But there are other chronic diseases causing significant illness that don’t get the press coverage. Hyperuricemia should be tops on this list.

Like many others at this juncture, you may find yourself unfamiliar with the term. What is it and who the heck gets that? Although far more common than gout attacks, all those afflicted by that sudden and painful joint condition have hyperuricemia. In other words, gout is basically a very painful symptom of high uric acid levels in the bloodstream.

When someone eats any food which contains protein, wherever it comes from, uric acid is a product of its breakdown. We consume protein in varied forms. Vegetables can be an excellent source of protein, and they can provide one that is complete. Most Americans think of a good burger or steak as their primary source of protein, but there are many others besides animal sources, from dairy to fungal.

The term hyperuricemia literally means high levels of uric acid, this ever-present component of our blood. Its considered a metabolic disease, and leads to increased levels in the blood as well as in tissues throughout the body. As research has revealed, when the concentration of this common compound increases sufficiently, complications will commonly develop. The effect best known to the everyday individual is the infamous, acute gout attack.

The sudden development of a grossly swollen, painful big toe joint is synonymous with acute gouty arthropathy, the term for an acute attack. Often these attacks develop overnight, the afflicted waking up with a hot, red big toe joint. The sudden development of exquisite pain from a hot joint makes this an easy initial diagnosis, but the tougher question is why uric acid levels were high.

Early on, gout was associated with the consumption of a rich diet and excess alcohol. Studies have revealed it’s not simply the result of a sumptuous feast, but dietary intake can act to stimulate an attack. Still, there must be an underlying metabolic or pathologic condition at work. Numerous diseases are associated, although the relationship is not yet fully understood.

Alarming news has come forth on the potential consequences of hyperuricemia. High levels of uric acid in our blood appears to have an association with some serious health conditions, from an increased risk of heart disease and heart attacks, a greater tendency to have a stroke, and, of course, kidney disease. This latter issue should be understandable: a build-up of uric acid is most often due to an inability of the kidneys to filter this substance out of the blood and into the urine.

Rarely discussed are the many critical functions of uric acid in our bodies (at appropriate levels). They are multifaceted and include acting as an antioxidant, serving to stimulate the immune system. When it is too excess, this is not beneficial, leading to a pro-inflammatory state, the consequences of which we are only beginning to learn. But UA (uric acid for short) also aids in controlling nitric oxide levels and has anti-aging effects.

The big news on the topic is the latest findings on the consequences of hyperuricemia to other disease states. Apparently, some experts are convinced most of the major diseases, some of which are potentially deadly, are made much more likely when this substance is in excessive concentrations in our bodies. The association with hypertension is well-recognized but there seems to be one with heart attacks, heart disease, diabetes, metabolic syndrome, and more. And the evidence is mounting for many of these claims.

Hyperuricemia is not a rarity and gout attacks continue to be an attention-getting ailment for many. Data from 2020 stated over 20 percent of Americans have this condition and too few are treated. Many American healthcare providers believe the condition doesn’t need therapy if gout attacks are absent or rare. And only about half of those with gout attacks are adequately treated, the usual approach being the prescribing of allopurinol, a drug with a long and successful track record.

The key to treating hyperuricemia is to test repeatedly to determine the precise amount of allopurinol which will serve to maintain uric acid in the proper range. Everyone is different, a cliche also accurate on the subject of how much of the drug is needed. Overall, unless you are allergic to it (which is not a rarity), it is a very successful, inexpensive medication.

Some have compared the rising tide of hyperuricemia in the world as the next epidemic. Perhaps some would say this is hyperbole, yet the latest data indicates the long term consequences of this condition can be dramatic. Hyperuricemia, over time, seems able to significantly impair the quality of life for those affected. And the prevalence of hyperuricemia is trending upward globally, especially in the developed countries.

Public attention will oscillate, swayed in part by media coverage. Perhaps our gaze, as well as the funding for research, needs to be directed at this common condition, present in one out of five Americans. Is hyperuricemia killing us? The jury is out on this one, but many experts are convinced. A discussion of how you can deal with the condition is upcoming. Check back soon to learn more.

EDITORS NOTE: Dr. Conway McLean is a podiatric physician now practicing foot and ankle medicine in the Upper Peninsula, having assumed the practice of Dr. Ken Tabor. McLean has lectured internationally on surgery and wound care, and is board certified in both, with a sub-specialty in foot orthotic therapy. Dr. McLean welcomes questions, comments and suggestions at drcmclean@penmed.com.