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What Causes High Uric Acid Level?

Where does uric acid come from? Uric-Acid.jpg

Firstly, we have to understand where uric acid comes from. Animal cells (including human cells) have structures called DNA, which reside with the nucleus of the cell. This DNA is broken down into its constituents, called amino acids, when a cell dies through the action of the immune system. Some of these amino acids are called purines, which in turn are converted into other chemicals. Our body recycles some of these chemicals with those left over proceeding to become uric acid, which is in some ways a waste product that is then excreted by our kidneys into the urine.

It is a very complicated process but with this concept in mind you may understand why certain diseases are associated with high levels of uric acid. For example, if a person has a high burden of dying cells, such as occurs in certain cancers or in those undergoing chemotherapy for the treatment of cancer, then more DNA is broken down to purines, resulting in excess uric acid production.

Conversely, when the uric acid cannot be efficiently excreted, such as is the case with many kidney diseases or due to many medications that interfere with this process of excretion.  This is particularly a concern with diuretics, which remove water from our body at the expense of other products such as uric acid. Rarely, a person is born with a defective step in uric acid metabolism, whereby gout develops at a young age, sometimes associated with a very strong family history of early and aggressive gout.

When the uric acid level is high in the circulation it is termed Hyperuricaemia.  This situation is also strongly associated with obesity. It is believed that fatty tissue enhances the production of uric acid. Hyperuricaemia is part of the ‘metabolic syndrome’, which is associated with an increased risk of heart attacks and strokes.

We also obtain purine amino acids from our diet. It is estimated that 10-15% of our purine load is dietary in origin. Foods that are high in purine include offal, seafood (in particular crustaceans), red meat, and alcohol.