Risks of High Uric Acid: How to Reduce It

Elevated levels of uric acid are associated with gout, an excruciating form of arthritis.

More recent evidence demonstrates powerful correlations between high uric acid levels and some of the most deadly conditions of our time, including metabolic syndrome, diabetes, kidney failure, and cardiovascular disorders.^1-5

In 2016-2017, a group of studies appeared linking uric acid elevations to bipolar disorder.^6-9

Many people don’t realize that it is possible to have high uric acid without having gout. About 21% of Americans have elevated levels of uric acid (hyperuricemia), but only 4% suffer from gout.¹⁰

A 2016 study highlighted a natural plant extract, called Terminalia bellerica, that can effectively lower uric acid blood levels without the side effects associated with prescription drugs.¹¹

Let’s look at how lowering uric acid blood levels is an important step not only in addressing gout, but also in helping prevent life-shortening diseases.¹¹

Terminalia Bellerica Lowers Uric Acid

Terminalia bellerica is a tree native to lower elevations in Southeast Asia, whose fruit has been used for centuries in Indian traditional medicine to treat a variety of diseases, particularly diabetes.¹²

In 2011, a component of the T. bellerica fruit rind, gallic acid, was shown to promote antidiabetic activity in a study of diabetic rats.¹² In that study, the extract lowered blood sugar levels, and, in a surprising finding, the animals’ pancreases showed regeneration of their insulin-producing islet cells.

Additional beneficial effects noted in that study included reductions in serum total cholesterol, triglycerides, LDL, urea, creatinine (a measure of kidney dysfunction when elevated)—and also uric acid.¹²

Other studies have shown that T. bellerica has protective properties against oxidative stress, which in turn are thought to directly inhibit the action of an enzyme involved in the synthesis of uric acid.^11,13

Human Studies

These findings in diabetic rats led a group of Indian researchers to perform a randomized, controlled clinical trial to determine the efficacy and tolerability of a standardized extract of T. bellerica at lowering uric acid levels in humans.¹¹

For the study, 110 people with elevated uric acid received one of the following: a placebo, 40 mg daily of the uric-acid lowering drug febuxostat, 500 mg of T. chebula extract twice daily, or either 250 mg or 500 mg of T. bellerica standardized extracts twice daily.

After 24 weeks, the uric acid levels in the placebo recipients had risen significantly compared to baseline levels. In contrast, all non-placebo groups showed a reduction in uric acid levels compared to baseline and to placebo subjects.¹¹

The most effective dose of T. bellerica was at 500 mg twice daily, which reduced uric acid levels by nearly twice as much as the lower dose.

And while the T. bellerica treatment was only about 60% as effective as the prescription drug febuxostat at reducing uric acid levels, it achieved these results without the side effects associated with this drug,¹¹ which include liver function abnormalities, rash, nausea, and joint pain.¹⁴

Because the other common uric acid-lowering drug, allopurinol, also carries a wide range of side effects—including a potentially life-threatening hypersensitivity syndrome¹⁵—T. bellerica supplementation offers a leap forward in safely lowering high uric acid levels while reducing risks of the conditions associated with them.

Why is it Important to Lower Uric Acid Levels?

Our bodies naturally produce uric acid when we break down and recycle the molecules that constitute DNA and RNA. An enzyme called xanthine oxidase is responsible for conversion of those compounds into uric acid, which is then normally excreted in the urine.

But age-related declines in kidney function lead to impaired excretion and gradual buildup of uric acid in the blood, accounting for the elevated serum uric acid levels in up to 25% of adults.¹⁶

Making matters worse, a diet rich in red meats and sugars, especially fructose—in other words, the typical American diet—can sharply increase uric acid production, further exacerbating the problem.^17,18 In fact, gout has historically been called “the disease of kings” because of its association with rich diets.¹⁹

While gout was the original disorder associated with high uric acid, more recent evidence reveals that it is associated with conditions that are far worse.

Uric acid blood levels above 8.6 mg/dL in men or 7.1 mg/dL in women are classified as hyperuricemia (although some laboratories and research groups use different limits).^20,21 High uric acid levels have now been found to be significantly associated with risks for:

• Decreasing kidney function²²
• Chronic low-level inflammation, itself a major risk factor for many chronic disorders²³
• Metabolic syndrome^18,24,25
• Type II diabetes^26-28
• A wide array of cardiovascular risks, including elevated blood pressure, heart arrhythmias, and risk of death from heart attacks and strokes.^1,29-35

TABLE: Risk Elevations Associated with High Uric Acid Levels
Condition	Risk Increase With Elevated Uric Acid
Kidney failure	7% per 1 mg/dL increase22
Chronic inflammation as measured by hs-CRP	52%23
Metabolic syndrome	410%25
Diabetes	18% per 1 mg/dL increase26
Unstable lipid-rich arterial plaques	143%36
Prehypertension	44%34
Atrial fibrillation (cardiac arrhythmia)	67%35
Heart muscle enlargement	96% in highest vs. lowest uric acid levels; 26% increase per 1 mg/dL elevation of uric acid31
In-Hospital death from heart attack	432%32
Major adverse cardiac event (death, congestive heart failure, repeat heart attack, stroke)	184%33

 

The Table above shows elevations in risks associated with high uric acid levels in blood.

If recent findings are any indication, these conditions may represent only the tip of the uric acid iceberg.

For example, in 2016 and 2017, a group of Italian researchers published several papers demonstrating that elevated uric acid levels play a role in bipolar disorder,^6-8 while a 2015 study related high uric acid with depression in adolescents.³⁷

Several drugs can be effective for many cases of major depression. Yet very few drugs are helpful with bipolar disorder, a condition that’s possibly even more heartbreaking than depression.

Together, the evidence that uric acid plays a major role in so many human disorders presents an opportunity for intervention with a safe, effective, plant extract, T. bellerica.

Summary

Levels of uric acid rise with age, exacerbated by declining kidney function and our meat- and sugar-rich diets.

Formerly associated mostly with painful gout, we now know that uric acid elevations threaten millions more people with elevated risks for kidney disease, diabetes, metabolic syndrome, and a wide range of cardiovascular disorders.

Exciting research has revealed the potent uric acid-lowering effect of extracts from the fruits of the Terminalia bellerica tree, a South Asian shade tree long used in traditional medicine.

These findings suggest one more natural way to combat the risks of so many age-related disorders—and they make T. bellerica an important weapon in our arsenal against premature aging and death.

Uric acid is included in Life Extension®’s CBC/Chemistry blood test that costs only $35. Page 62 shows the many health markers included in this ultra-low-priced blood test that you can order by calling 1-800-208-3444 (24 hours).

If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.

References

1. Jin M, Yang F, Yang I, et al. Uric acid, hyperuricemia and vascular diseases. Front Biosci (Landmark Ed). 2012;17:656-69.
2. Ford ES, Li C, Cook S, et al. Serum concentrations of uric acid and the metabolic syndrome among US children and adolescents. Circulation. 2007;115(19):2526-32.
3. Lehto S, Niskanen L, Ronnemaa T, et al. Serum uric acid is a strong predictor of stroke in patients with non-insulin-dependent diabetes mellitus. Stroke. 1998;29(3):635-9.
4. Schretlen DJ, Inscore AB, Vannorsdall TD, et al. Serum uric acid and brain ischemia in normal elderly adults. Neurology. 2007;69(14):1418-23.
5. Siu YP, Leung KT, Tong MK, et al. Use of allopurinol in slowing the progression of renal disease through its ability to lower serum uric acid level. Am J Kidney Dis. 2006;47(1):51-9.
6. Bartoli F, Crocamo C, Dakanalis A, et al. Purinergic system dysfunctions in subjects with bipolar disorder: A comparative cross-sectional study. Compr Psychiatry. 2017;73:1-6.
7. Bartoli F, Crocamo C, Gennaro GM, et al. Exploring the association between bipolar disorder and uric acid: A mediation analysis. J Psychosom Res. 2016;84:56-9.
8. Bartoli F, Crocamo C, Mazza MG, et al. Uric acid levels in subjects with bipolar disorder: A comparative meta-analysis. J Psychiatr Res. 2016;81:133-9.
9. Machado-Vieira R, Salem H, Frey BN, et al. Convergent lines of evidence support the role of uric acid levels as a potential biomarker in bipolar disorder. Expert Rev Mol Diagn. 2017;17(2): 107-8.
10. Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008. Arthritis Rheum. 2011;63(10):3136-41.
11. Usharani P, Nutalapati C, Pokuri VK, et al. A randomized, double-blind, placebo-, and positive-controlled clinical pilot study to evaluate the efficacy and tolerability of standardized aqueous extracts of Terminalia chebula and Terminalia bellerica in subjects with hyperuricemia. Clin Pharmacol. 2016;8:51-9.
12. Latha RC, Daisy P. Insulin-secretagogue, antihyperlipidemic and other protective effects of gallic acid isolated from Terminalia bellerica Roxb. in streptozotocin-induced diabetic rats. Chem Biol Interact. 2011;189(1-2):112-8.
13. Hazra B, Sarkar R, Biswas S, et al. Comparative study of the antioxidant and reactive oxygen species scavenging properties in the extracts of the fruits of Terminalia chebula, Terminalia belerica and Emblica officinalis. BMC Complement Altern Med. 2010;10:20.
14. Love BL, Barrons R, Veverka A, et al. Urate-lowering therapy for gout: focus on febuxostat. Pharmacotherapy. 2010;30(6):594-608.
15. Lupton GP, Odom RB. The allopurinol hypersensitivity syndrome. J Am Acad Dermatol. 1979;1(4):365-74.
16. Vitart V, Rudan I, Hayward C, et al. SLC2A9 is a newly identified urate transporter influencing serum urate concentration, urate excretion and gout. Nat Genet. 2008;40(4):437-42.
17. Angelopoulos TJ, Lowndes J, Zukley L, et al. The effect of high-fructose corn syrup consumption on triglycerides and uric acid. J Nutr. 2009;139(6):1242S-5S.
18. Cirillo P, Sato W, Reungjui S, et al. Uric acid, the metabolic syndrome, and renal disease. J Am Soc Nephrol. 2006;17(12 Suppl 3):S165-8.
19. Giuffra V, Minozzi S, Vitiello A, et al. On the history of gout: paleopathological evidence from the Medici family of Florence. Clin Exp Rheumatol. 2017;35(2):321-6.
20. Schlesinger N, Norquist JM, Watson DJ. Serum urate during acute gout. J Rheumatol. 2009;36(6):1287-9.
21. Sun SZ, Flickinger BD, Williamson-Hughes PS, et al. Lack of association between dietary fructose and hyperuricemia risk in adults. Nutr Metab (Lond). 2010;7:16.
22. Tsai CW, Lin SY, Kuo CC, et al. Serum Uric Acid and Progression of Kidney Disease: A Longitudinal Analysis and Mini-Review. PLoS One. 2017;12(1):e0170393.
23. Raeisi A, Ostovar A, Vahdat K, et al. Association of serum uric acid with high-sensitivity C-reactive protein in postmenopausal women. Climacteric. 2017;20(1):44-8.
24. Choi H, Kim HC, Song BM, et al. Serum uric acid concentration and metabolic syndrome among elderly Koreans: The Korean Urban Rural Elderly (KURE) study. Arch Gerontol Geriatr. 2016;64:51-8.
25. Rubio-Guerra AF, Morales-Lopez H, Garro-Almendaro AK, et al. Circulating Levels of Uric Acid and Risk for Metabolic Syndrome. Curr Diabetes Rev. 2017;13(1):87-90.
26. Juraschek SP, McAdams-Demarco M, Miller ER, et al. Temporal relationship between uric acid concentration and risk of diabetes in a community-based study population. Am J Epidemiol. 2014;179(6):684-91.
27. Moleda P, Fronczyk A, Safranow K, et al. Is Uric Acid a Missing Link between Previous Gestational Diabetes Mellitus and the Development of Type 2 Diabetes at a Later Time of Life? PLoS One. 2016;11(5):e0154921.
28. Sun HL, Pei D, Lue KH, et al. Uric Acid Levels Can Predict Metabolic Syndrome and Hypertension in Adolescents: A 10-Year Longitudinal Study. PLoS One. 2015;10(11):e0143786.
29. Clarson LE, Hider SL, Belcher J, et al. Increased risk of vascular disease associated with gout: a retrospective, matched cohort study in the UK clinical practice research datalink. Ann Rheum Dis. 2015;74(4):642-7.
30. Singh JA. When gout goes to the heart: does gout equal a cardiovascular disease risk factor? Ann Rheum Dis. 2015;74(4):631-4.
31. Cuspidi C, Facchetti R, Bombelli M, et al. Uric Acid and New Onset Left Ventricular Hypertrophy: Findings From the PAMELA Population. Am J Hypertens. 2017.
32. Gazi E, Temiz A, Altun B, et al. The association between serum uric acid level and heart failure and mortality in the early period of ST-elevation acute myocardial infarction. Turk Kardiyol Dern Ars. 2014;42(6):501-8.
33. Kawabe M, Sato A, Hoshi T, et al. Gender differences in the association between serum uric acid and prognosis in patients with acute coronary syndrome. J Cardiol. 2016;67(2):170-6.
34. Lotufo PA, Baena CP, Santos IS, et al. Serum Uric Acid and Prehypertension Among Adults Free of Cardiovascular Diseases and Diabetes: Baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Angiology. 2016;67(2):180-6.
35. Tamariz L, Hernandez F, Bush A, et al. Association between serum uric acid and atrial fibrillation: a systematic review and meta-analysis. Heart Rhythm. 2014;11(7):1102-8.
36. Ando K, Takahashi H, Watanabe T, et al. Impact of Serum Uric Acid Levels on Coronary Plaque Stability Evaluated Using Integrated Backscatter Intravascular Ultrasound in Patients with Coronary Artery Disease. J Atheroscler Thromb. 2016;23(8):932-9.
37. Tao R, Li H. High serum uric acid level in adolescent depressive patients. J Affect Disord. 2015;174:464-6.