How To Reduce Uric Acid Naturally and Manage Gout

Abstract

Uric Acid is a chemical which is created by the body and is removed via toxins from the body. This disease is commonly known as Disease of the Kings, High uric acid is known as Hyperuricemia which are usually diagnosed after Gout and Kidney stone problem in the body. Joint is the part of the body where more than 2 bones meet and allow movement. Due to high uric acid, they form crystal compounds which get settled in the joints and cause Gout which is a painful form of Arthritis. Joints come in many forms and sizes throughout the body and provide proper shape to the body to help in movement. Joints are mainly made up of bones and various connective tissues such as Cartilage, Tendons, Ligaments and Nerves. Joints are also known as articulation which forms the connection between bones. In this article, we will discuss various causes of high uric acid and its symptoms with its Ayurvedic view in detail.

Introduction

Hyperuricemia is high uric acid which is above the normal level in the body. Uric acid is a chemical created by the body and thus breaks down; that substance is known as Purines, commonly found in drinks and food. Uric acid is a heterocyclic compound that is made of carbon, hydrogen and oxygen with the formula of C5H4N4O3. The high level of uric acid in the blood clumps together in the form of sharp crystals leading to Gout and its associated conditions such as formation of the ammonium acid urate, Kidney stones and diabetes. This Uric Acid mainly dissolves in the blood and further travels to the kidney and thus leaves the body in urine.

Purines perform the most important function in the cells of the body and Uric Acid is the antioxidants which are found in the human body. The metabolism of Purine occurs mainly in the liver, kidney, Intestines and the vascular endothelium by using various endogenous and exogenous factors. About 70% of urate is excreted daily by the kidneys and the rest is eliminated by the intestines. Swedish chemist Carl Wilhelm Scheele discovered uric acid from kidney stones for the first time in 1776.

Pathophysiology Of Hyperuricemia

• In the human body, Uric acid is the final product of purine metabolism.
• This Uric Acid occurs mainly in the Liver and in small amounts in the parts of the Intestine.
• The ⅔ part is excreted in the Liver and ⅓ in the intestines.
• In the kidney, urate is filtered at the glomerulus, reabsorbed, secreted and then reabsorbed in the proximal tubule. Understanding the exact procedures by which urate is handled in the kidney and small intestines will be made easier by the replication of some urate transporters.
• An anion exchanger is well identified in the brush border membrane of the kidney and then inhibited by the Angiotensin 2 receptor.
• Hyperuricemia occurs due to decreased excretion and increased production or the combination mechanism.
• Underexcretion is the main cause of hyperuricemia as altered excretion of uric acid decreases the glomerular filtration, decreases tubular secretion and enhances the reabsorption.
• Overproduction can lead to hyperuricemia which can be due to exogenous (diet rich in purine) and endogenous (increased nucleotide breakdown) methods.
• Combined mechanisms can also lead to hyperuricemia which can be due to alcohol consumption. It leads to hepatic breakdown of ATP and enzymatic defects such as Glycogenoses type 1 and Aldolase B-Deficiency are the causes of hyperuricemia.

Etiology/Causes Of Hyperuricemia

Hyperuricemia is divided into 3 pathophysiological categories

1. Uric Acid Underexcretion – It leads to the following
• Idiopathic
• Familial juvenile gouty nephropathy (rare autosomal dominant condition)
• Kidney insufficiency
• Metabolic syndrome
• Hypertension
• Acidosis
• Preeclampsia and eclampsia
• Trisomy 21
• Sarcoidosis
• Hypothyroid-Hyperthyroid
2. Uric Acid Overproduction – It is idiopathic and includes the following
• Kelley Seegmiller syndrome
• Lesch Nyhan Syndrome
• Tumor Lysis Syndrome
• Lymphoma, Leukemia and Myeloma
3. Combined Causes – It includes the following
• Alcohol
• Fructose – sweetened soft drinks
• Exercise
• Glucose 6 – Phosphatase deficiency

Symptoms Of Hyperuricemia

About ⅓ of people experience hyperuricemia symptoms and this is known as Asymptomatic Hyperuricemia. This high Uric acid leads to various medical conditions such as

1. GOUT – This is known as Gouty Arthritis which is seen in 20% of the people. The rapid drop of Uric acid level in the body is the trigger of gout and can lead to Flares and Isolated attacks. This occurs suddenly which is more often seen at night and the intensity of pain reaches in about 12-14 hours. Gout commonly affects Toe joints, Knees and Ankles. It may include various symptoms-
• Severe joint Pain
• Stiffness in each joint
• Redness and swelling
• Difficulty in moving the joint
• Misshapen joints (leads to Osteoarthritis)
• Tenderness
2. TOPHACEOUS GOUT – If Hyperuricemia is present for many years, the crystals of Uric acid can lead to clump formations which are known as Tophi. These hard lumps are found under the skin, around joints and at the curve of the ear. This clump can lead to worsening of the pain which further damages joints and compresses the nerve.
3. KIDNEY STONES – The crystals of Uric Acid build up stones in the kidney. The small stones can pass in urine and the large stone is difficult to pass and can obstruct the pathway of the urinary tract. It includes various symptoms-
• Aching Pain in the lower back, abdomen and Groin region
• Nausea
• Pain during urination
• Blood in urination
• The foul smell of urine
• Increased urge to pass urine 

Differential Diagnosis

• Alcoholic ketoacidosis
• Diabetic ketoacidosis
• Hodgkin Lymphoma
• Hypothyroidism and Hyperparathyroidism
• Preeclampsia
• Hemolytic anemia
• Nephrolithiasis

Diagnosis And Tests

• Ultrasound
• CT (Computed tomography)
• X-Rays
• Blood and Urine Tests to check Creatinine level and determine kidney function along with Uric Acid level.

Treatment

The medications which are used to treat hyperuricemia are divided into two categories-

1. Xanthine oxidase inhibitors – Such as Allopurinol, febuxostat and decrease the production of uric acid 
2. Uricosuric agents – Such as Benzbromarone and Lesinurad increase the excretion of uric acid and reduce the reabsorption of uric acid thus filtering out of the blood through the kidney.

Ayurvedic View

Hyperuricemia can be correlated with VataRakta, it is the involvement of Vata doshas which affects Rakta dhatu (blood tissue). Due to the intake of Excessive food and disturbed lifestyle activities, Vata doshas get aggravated along with Rakta dhatu (due to intake of Lavana, Amla and Katu). Due to this vitiated Vata doshas, the vitiated blood burns the whole body, leaves its place and starts moving towards the foot. This vitiated Vata and Rakta is known as Vatarakta. Later, Pitta and Kapha get involved in this which causes more complications. This symptoms are first seen in small joints of the foot.

NIDANA (Etiological factors)

1. Aharaja Nidana – It is related to dietary habits such as
• Excess intake of Lavana, Amla and Katu ras
• Incompatible food
• Intake of food without digestion of earlier meals
• Intake of Anupa Mamsa, Masha, Sura and Aasava
2. Viharaja Nidana – It is related to environmental factors-
• Krodha, Divaswapana, Ratrijagrana
• Riding on elephant, horse and Camel
• Excessive swimming
• Excessive sexual activities
3. Mansika Nidana – Related to Psychological Factors
• Akrodha, Achinta and Harshanityatva lead to the accumulation of Kapha doshas and leads to VataRakta.
4. Aguntuja Nidana – Exogenous Factors
• It is due to the vitiation of Doshas and Dhatus which lead to the occurrence of the disease.

Types Of Vatarakta

1. Vata Pradhana Vatarakta – It is due to the vitiation of Vata doshas which causes symptoms like Pain, twitching, Swelling, cold and numbness.
2. Rakta Pradhana Vatarakta – When the Rakta dhatu is severely vitiated it causes symptoms of Swelling, Severe pain, Itching and moistening.
3. Kapha Pradhana Vatarakta – When Kapha is severely affected it causes symptoms such as Numbness, Heaviness and coldness.

On the Basis of Location

1. Uttana Vatarakta – It is a disease which occurs on the superficial layers that are skin and muscles. It is present on the skin with lesions and pain in the muscles. Includes-
• Kandu (Itching)
• Daha (Burning sensation)
• Ruja (Pain)
• Toda (Pricking type)
• Bheda (Spitting type of pain)
• Gourava (heaviness)
2. Gambhira Vatarakta – This involves blood and many other deeper tissues are involved such as Bones and Joints. This is a more complicated case. It includes-
• Daha (Burning sensation)
• Toda (pricking sensation)
• Paakavaan (suppuration)
• Shyavata (black discolouration)
• Deep Pain
3. Ubhayashrita Vatarakta – It contains the symptoms of Both Uttana and Gambhira Vatarakta. It includes-
• Sandhi, Asthi, Majja Chinndni
• Khanjatwa
• Pangutwa

Samprapti Ghatak

• Doshas – Vata, Rakta
• Dushya – Rakta, Twak, Mamsa
• Srotas – Raktavaha Srotas
• Adhisthana – Sandhi, Twak, Mamsa, Rasvaha Srotas
• Srotodushti – Sanga
• Swabhava – Chirkari

Chikitsa (Line Of Treatment)

1. Uttana Vatarakta
• Lepa (medicinal paste)
• Abhyanga (Oil massage)
• Parisheka (Pouring or sprinkling of medicinal liquids such as Decoction and medicated oils)
• Avagahana
• Upanaha (Poultice)
2. Gambhira VataRakta
• Snehapana (Internal use of medicated ghee Oil)
• Virechana (Therapeutic Purgation)
• Asthapana Basti (medicated enema)
• Anuvasana Basti (Ghee Enema)
• Ksheera Basti (Milk enema)

According To Doshas

1. Vata Vatarakta Chikitsa
• Snehana (External oleation)
• Swedana (Sudation)
• Virechana (Therapeutic purgation)
• Asthanapana Basti (Enemas with decoctions)
• Anuvasana Basti (Enemas with medicated oils)
2. Raktaja VataRakta Chikitsa
• Raktamokshana by the means of- Jalauka, Suchivedha, Alabu
• Virechana (Therapeutic purgation)
• Asthapana Basti (enema made of decoction)
• Ksheera Basti (milk decoction)
• Anuvasana Basti (Ghee Enema)
3. Pittaja VataRakta Chikitsa
• Virechana (therapeutic purgation)
• Raktamokshana (letting of blood)
• Asthapana Basti (Medicated enema)
• Anuvasana Basti (decoction of medicated ghee)
• Ksheera Basti (Milk enema)
4. Kaphaja VataRakta Chikitsa
• Vamana (Therapeutic Emesis)
• Swedana (Sudation)
• Virechana (Purgation)
• Asthapana Basti (Medicated decoction enema)
• Anuvasana Basti (medicated oil enema)

Classical Medications For High Uric Acid (Vatarakta)

1. Vasadi Kwath – Vasaka is helpful in reducing the level of high uric acid in the blood. This Kwath contains Vasa (Adhatoda vasica), Guduchi (Tinospora cordifolia) and Aragwadha (Cassia fistula) when mixed with Erand Oil is useful in Joint Pain caused due to high levels of Uric Acid.
2. Navkarshika Kwath – The Decoction which is prepared from Daruhardira (Berberis aristata), Haritaki (Terminalia chebula), Amalaki (Emblica officinalis) and more which are useful in VataRakta. This decoction is useful in Psoriasis and Psoriatic Arthritis.
3. Kasmaryadi Kwath – The Decoction which is prepared from Kasmarya (Gmelina arborea), Chandana (Sandalwood) and Yashtimadhu (Glycyrrhiza glabra) when mixed with honey is helpful in Pitta Pradhan Vatarakta.

For External Use

1. Prapaundarikadi Lepa
2. Til Lepa
3. Shatadhouta Lepa
4. Sek
5. Avgahana
6. Upnaha – Tilpinda Upnaha

Herbs Useful In Vatarakta

• Shallaki – Shallaki (Boswellia serrata) is an herbal anti-dote for various musculoskeletal disorders, bones and joints. The alkaloids and resins which are present in this plant are Boswellic acid and triterpenoids which have anti-inflammatory properties which manage Gouty arthritis. This herb is useful in reducing excessive joint pain, inflammation and the pains which are due to menopause. Maintains the health of the heart and boosts the functioning of the heart which prevents anti-coagulation.
• Hadjod – Hadjod (Cissus quadrangularis) is a perennial shrub that are the parts of Hadjod are used, the stem and leaves are more useful in cooking and in therapeutic conditions. It contains Calcium, Magnesium and Resveratrol anti-oxidant which is useful in proper growth and has anti-microbial properties. Hadjod has Vitamin C, Triterpenoids and Beta-sitosterol which has anti-inflammatory properties thus useful in liver problem.
• Nirgundi – Nirgundi (Vitex negundo) It is commonly known as the Five-chaste tree which heals various ailments in the body. This plant has an alkaloid which is nishindine has anti-oxidant and anti-inflammatory properties. Terpenoids and various fatty acids have analgesic properties thus relieving joint pain, Muscle aches and stress.  
• Haritaki – Haritaki (Terminalia chebula) is known as the king of medicine, which is known as the Indian Walnut. Haritaki contains various constituents which include Chebulin, Tannins and organic fatty acids which have anti-oxidant properties and thus act as an analgesic which decreases discomfort and manages gout. It has anti-inflammatory properties so useful in various respiratory troubles and loosens the accumulation of phlegm from the chest region.

Herbal Remedies For High Uric Acid By Planet Ayurveda

According to Ayurveda High uric acid (Hyperuricemia) leads to “gout disease” (vata-rakta roga). Vata means (wind), rakta means (blood) and roga means (disease). The line of treatment is the same for Hyperuricemia and gout. Planet Ayurveda provides the best combination of effective herbal remedies such as the Gout Care Pack for the ayurvedic treatment of high uric acid (Hyperuricemia). These herbal remedies are prepared by using best quality herbs and strictly follow the principles of Ayurveda. All these herbal remedies of Planet Ayurveda are 100 per cent pure, natural and vegetarian. These are free from chemicals, additives and preservatives. These are safe to use as they are free from side effects.

Products List

1. GILOY CAPSULES
2. KAISHORE GUGGUL
3. NAVKARSHIK CHURNA
4. PUNARNAVA CAPSULES
5. DASHMULARISHT

Dosage

1. Giloy Capsules – 1 capsule twice daily, after meals, with warm water.
2. Kaishore Guggul – 2 tablets twice daily, after meals, with warm water.
3. Navkarshik Churna – 1 teaspoonful twice daily, after meals, with warm water.
4. Punarnava Capsules – 2 capsules twice daily, after meals, with warm water.
5. Dashmularisht – 2 teaspoonfuls twice daily with an equal amount of water, after meals.

Products Description

1. Giloy Capsules

Giloy capsules are prepared single herbal capsules from planet ayurveda and are the pure extracts of Giloy (Tinospora cordifolia). It has anti-inflammatory, analgesic & antipyretic properties. The Giloy capsule reduces swelling, pain, inflammation and fever associated with Hyperuricemia. Giloy has various Detoxifying properties which are helpful in cleaning blood and kidney thus bringing the uric acid level down and resolving Gout.

2. Kaishore Guggul

Kaishore guggul is a classical tablet which is manufactured by the planet ayurveda using a mixture of herbs like Amalaki (Emblica officinalis), Bibhitaki (Terminalia bellirica), Haritaki (Terminalia chebula), Guggul resin (Commiphora mukul), Ginger (Zingiber officinale), Black pepper (Piper nigrum), Long piper (Piper longum), Vidanga (Embelia ribes), Red physic nut (Baliospermum montanum) and Indian Jalap (Ipomoea turpethum) that treats inflammation & pain condition. These tablets remove excess toxins from the body and maintain Hyperuricemia condition. Kaishore Guggul balances the vitiated Vata and Pitta doshas in muscles and joints which makes muscles and joints function normally.

3. Navkarshik Churna

Navkarshik Churna is a classical herbal blend of Ayurvedic herbs which is prepared by Planet Ayurveda using Amla (Emblica officinalis), Vacha (Acorus calamus), Katuki (Picrorhiza kurroa), Giloy (Tinospora cordifolia) and many more. It is well known for correcting the metabolism and is a good cleanser of blood. This churna has Antibacterial and Anti-inflammatory property which is useful in healing and strengthening of the joints and ligaments. Is a wonderful liver detoxifier which removes toxins from the body and clears uric acid from the blood.

4. Punarnava Capsules

The Punarnava capsule is a single herbal Capsule formulation which is prepared by Planet Ayurveda using the pure extract of the herb Punarnava (Boerhavia diffusa). Punarnava capsules give effective results in hyperuricemia as they remove toxins from the body as it has diuretic properties. These capsules have anti-oxidant properties which are effective in the management of various conditions. Punarnava is helpful in the overall health of the kidney and eliminates it through the urethra.

5. Dashmularisht

Dashmularisht is a classical decoction preparation which is manufactured by planet ayurveda using the process of natural fermentation. It has a group of ten herbs whose roots are specifically used along with other ingredients. The formulation has constituents like Bilva (Aegle marmelos), Sonapatha (Oroxylum indicum), Gambhari (Gmelina arborea), Patola (Stereospemum suaveolens) and many others. Dashmularisht is having very great results in anulomana of vata dosha in the body whose aggravation along with dushti of rakta by pitta dosha is responsible for swelling, redness and pain in areas like the greater toe, ankle joint, and knee joint etc. In addition, this is the best formulation for maintaining digestion and also bears analgesic properties.

Special Instructions To Be Taken

1. Drink lots of water, preferably 10 to 12 glasses (eight ounces) every day, to flush excess uric acid from your body.
2. Avoid high protein diets like red meat, poultry (especially turkey), shellfish, mackerel & sardines. It is advisable not to consume soybeans, tofu and other soy products.
3. The gym should avoid consuming high-protein artificial foods stuff.
4. High doses of Vitamin C and Vitamin E have been helpful in reducing uric acid levels naturally.
5. Cherries, strawberries & blueberries are excellent fruits to reduce uric acid naturally.
6. It is recommended that you should consume high-fibre food. Apples, pears & papaya are excellent. The vegetables growing on climbers are excellent natural remedies to reduce uric acid levels in the blood. These include round gourd, bottle gourd, ash gourd, pumpkin, zucchini & long gourd etc are all good for reducing high uric acid in the blood.
7. Asparagus, mushroom, spinach, soybeans, peas, cheese and other beans are also not recommended.
8. Apple juice is also recommended. Eating a lot of apples solves the purpose. Artificial fruit juices with additives and preservatives are not recommended.
9. Aloe vera juice and Amla juice also helps in keeping the fire element in control which is the main reason for increased uric acid level in the blood. Fire element imbalance should be restored to reduce uric acid naturally.
10. Fresh coconut water is also a good way to reduce uric acid naturally.
11. Ayurvedic medicine for uric acids like Kaishore Guggul, Giloy Capsules, Navkarshik Churna and Punarnava capsules are excellent natural remedies to reduce uric acid levels and are helpful in gout pain.
12. Try to consume as much natural diet to control uric acid. Avoid eating junk food. Soft drinks and frozen food are really bad and are big hurdles in reducing uric acid levels.
13. Remember if Gout is not properly treated the elevated uric acid can lead to severely damaged joints and kidney problems, which may be 2801-1462irreversible in nature.
14. Do not be anxious and stressed. Stress also plays an important role in aggravating gout attacks and causes more health disorders like Blood pressure and Diabetes.

Some Home Remedies For High Uric Acid

1. Neem – While preparing a paste of neem, apply it to the affected area such as swollen and painful joints.
2. Giloy – Drinking the Juice of Giloyis helpful in neutralizing the uric acid and reducing pain and stiffness.
3. Turmeric – Turmeric has anti-inflammatory properties which are helpful in improving joint health. Applying the paste of Turmeric reduces inflammation and soreness.

Conclusion

Hyperuricemia, often known as high uric acid, is typically identified following gout and kidney stone issues. Purines, which can be found in foods and drinks, constitute a chemical that the body creates and then breaks down into uric acid. With a chemical formula C5H4N4O3, uric acid is a heterocyclic substance comprised of carbon, hydrogen, and oxygen. Gout and other related disorders are caused by the uric acid in the blood clumping together in the form of sharp crystals. In ayurveda, it is known as VataRakta. For this Planet Ayurveda has its own products which are 100% natural, purely herbal, without any chemicals or synthetic preservatives. The natural Ayurvedic treatment for gout (Gout Care Pack) gives excellent results. It helps to relieve pain, inflammation and stiffness and reduce uric acid levels.