Three months of measuring my uric acid level
It has been more than three months since I received my uric acid meter and started using it every day. I wrote about how to use it when I got it, and I followed up with a post about what I had learned about using it after two weeks. Now it has already been three months and I wanted to follow up how I have used it and what I have learned in the process.
The trusty UASure uric acid meter that I have been using for two months now.
The past three months have been a bit of a revelation. I had no idea my uric acid was so high - or that I could get it to be so low. I have had days when it was above 11, and days when it was below 6. I have had tinglings in my fingers and my toes, despite the efforts of my Sixpad Footfit Plus to give me massages from the inside of my feet. But I have escaped flare-ups and gout attacks thanks to being able to check when I need to lower my uric acid.
The biggest discovery, however, has been the effect of diet. When I eat a low-purine diet, my uric acid level goes down to 6 mg/dL or less. One hamburger, and it moves to 9. The second discovery is how many days I am above 6.8. This is important, since it tells me that I probably have some crystals aggregated in my cartilage, as I have not been lower than 6.8 for more days than I was above.
The third discovery is related to the importance of diet. The researchers say that uric acid is 30 % dependent on diet. There is only one way it can be consistent with having a reading of 6 one day and 10 another, and that is if the increase is cumulative. That would mean that one day, it is 6. The next day, it increases by 30 % to 7.8. The next day it increases with 30% again, to 10.14. The next step would be over 13, but I do not want to go there. It sounds too much like a gout attack to me. There must also be some kind of roof level, otherwise people would have uric acid levels which were completely destructive.
That would actually be consistent with the liver not being able to produce infinite amounts of glucose, but switching off after a while. Unless you are diabetic, that is.
The biggest discovery, however, has been the effect of diet. When I eat a low-purine diet, my uric acid level goes down to 6 mg/dL or less. One hamburger, and it moves to 9. The second discovery is how many days I am above 6.8. This is important, since it tells me that I probably have some crystals aggregated in my cartilage, as I have not been lower than 6.8 for more days than I was above.
The third discovery is related to the importance of diet. The researchers say that uric acid is 30 % dependent on diet. There is only one way it can be consistent with having a reading of 6 one day and 10 another, and that is if the increase is cumulative. That would mean that one day, it is 6. The next day, it increases by 30 % to 7.8. The next day it increases with 30% again, to 10.14. The next step would be over 13, but I do not want to go there. It sounds too much like a gout attack to me. There must also be some kind of roof level, otherwise people would have uric acid levels which were completely destructive.
That would actually be consistent with the liver not being able to produce infinite amounts of glucose, but switching off after a while. Unless you are diabetic, that is.
A chart of my UA variation over time, with the average and 6.8 mg/dL added.
This is also aligned with the different roles uric acid plays in our bodies. Uric acid does not just clump up on the ligaments and form sharp, needle-like crystals (which actually are monosodium urate). It is an important antioxidant, balancing the dangerous hydroxyl radicals formed by various processes in your body. Uric acid is also involved in creating nitrous oxide, which signals to your heart how it should beat. This is the reason people with heart problems get nitroglycerin.
But at the same time, uric acid is an oxidant, destroying the cells that capture it, and has to be controlled by vitamn C (which it oxidizes so the vitamin can be used as an input into the biochemic cycle that produces energy in your cells).
Uric acid is also an important signalling substance, telling your muscles when to grow and counteracting the anaerobic energy production which happens when you do rapid excercise. This is the lactic acid production you feel in your muscles when you for instance run long distance; and this is of course why my body feels it is more important to raise the level of uric acid when I get more excercise.
But at the same time, uric acid is an oxidant, destroying the cells that capture it, and has to be controlled by vitamn C (which it oxidizes so the vitamin can be used as an input into the biochemic cycle that produces energy in your cells).
Uric acid is also an important signalling substance, telling your muscles when to grow and counteracting the anaerobic energy production which happens when you do rapid excercise. This is the lactic acid production you feel in your muscles when you for instance run long distance; and this is of course why my body feels it is more important to raise the level of uric acid when I get more excercise.
Why create uric acid?
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But why, if I am not exercising more than normal and do not eat a lot of sweet things, does my body feel a need to first suck up a lot of purines from the food, and then use those purines to make uric acid - whether I need the extra energy or or not?
The uric acid is produced as a byproduct when your liver turns sugar into glucose. The enzymes doing it are derived from recycled material in your cells or from the purines in your food. Your body normally produces between 5 and 7 mg/dL of uric acids from those purines, and the purines in your food are added on top. The uric acid that can not be excreted through urine and poop is stored in your body as uric acid crystals. I have tried to explain more about this in my little book, "Gout Simply Explained", without technical terms as far as I could. You can get the book from one of many online stores directly to your computer by clicking on the link. |
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Storage conditions for uric acid
If you are hyperuricemic (has very high level of uric acid, above 10) for a long time, the uric acid will be stored in the connective tissue, especially in your feet because the temperature is often slightly lower there and it makes uric acid crystal formation easier.
When the concentration has been high enough, or there is a trigger event such as a blow or dehydration (or stress), the crystals spill out into the fluid in the joint and irritates the cells there so they think there is foreign matter or a virus, and that starts an inflammation to remove it. You experience that as a gout attack.
So the answer is "it depends". If you eat a purine-rich meal, it takes the same time as for you to metabolize the food, which can be from 30 min to 6 hours depending on your metabolism. But unless you were already hyperuricemic, that is had a high level of uric acid level for a long time, the spike will quickly go down.
When the concentration has been high enough, or there is a trigger event such as a blow or dehydration (or stress), the crystals spill out into the fluid in the joint and irritates the cells there so they think there is foreign matter or a virus, and that starts an inflammation to remove it. You experience that as a gout attack.
So the answer is "it depends". If you eat a purine-rich meal, it takes the same time as for you to metabolize the food, which can be from 30 min to 6 hours depending on your metabolism. But unless you were already hyperuricemic, that is had a high level of uric acid level for a long time, the spike will quickly go down.
Boring water matters
If your body is geared to take up all proteins and carbohydrates that passes through the lower intestine, that would explain why the purines you do not need are not just left in the intestine but absorbed into your body. It explains about 30% of all the purines in the blood. Because the uric acid meter does, of course, measure the concentration of uric acid in the blood at the moment you take the sample.
The uric acid concentration during the day goes up and down, as I have shown before. But it goes up and down over long periods of time too, and the only reasonble explanation is the diet. If you look at my blog, you can see my daily UA reading, and you can check diet and excercise. I decided against including water intake, because it is so boring, even if it is important. I do drink a great deal of water and coffee. And tea. And lemon water. But then I changed my mind and started including it anyway.
The uric acid concentration during the day goes up and down, as I have shown before. But it goes up and down over long periods of time too, and the only reasonble explanation is the diet. If you look at my blog, you can see my daily UA reading, and you can check diet and excercise. I decided against including water intake, because it is so boring, even if it is important. I do drink a great deal of water and coffee. And tea. And lemon water. But then I changed my mind and started including it anyway.
Normal life uric acid
So what happened to my uric acid during these three months? Well, first let me stress that even though I am measuring my UA level and taking supplements like apple cider vinegar (ACV) and tart cherries, I am trying to live as normally as I can. That only means a shift of diet, no changes otherwise. And I tend to be less strict with the diet on weekends.
The week when I started measuring, the average reading for that month (September 2020) was 8.25. For October 2020, it was 8.45. For November 2020 it was 7.79. For December (it is December 22 today) it was 8.09. So there are no really big changes, even if I had hoped that my diet would accomplish more. It is the peaks that throws the averages off, of course. The median values tell a slightly different story: September median 8.5, October median uric acid level 8.7, November uric acid median level 7.65, and December median uric acid level 7.8.
When I took cherry supplements, my average was actually quite high, 9.17 mg/dL. When I was drinking apple cider vinegar, it was 7.9 mg/dL. Before you call that a victory for the apple cider vinegar, consider that during the three weeks before, the average was 7.4 mg/dL.
The week when I started measuring, the average reading for that month (September 2020) was 8.25. For October 2020, it was 8.45. For November 2020 it was 7.79. For December (it is December 22 today) it was 8.09. So there are no really big changes, even if I had hoped that my diet would accomplish more. It is the peaks that throws the averages off, of course. The median values tell a slightly different story: September median 8.5, October median uric acid level 8.7, November uric acid median level 7.65, and December median uric acid level 7.8.
When I took cherry supplements, my average was actually quite high, 9.17 mg/dL. When I was drinking apple cider vinegar, it was 7.9 mg/dL. Before you call that a victory for the apple cider vinegar, consider that during the three weeks before, the average was 7.4 mg/dL.
Next steps for my uric acid
So what should I do next? Well, continue in the same way. I can control my uric acid level now. I will make sure to keep
it low enough not to get a gout attack. I am finding new and interesting foods in the vegetables department (it helps that vegetables in Japan are almost as amazing as the famous wagyu and seafood). And I am slowly losing weight. Could hardly get better.
Now that I have my uric acid under control, there are a few other things that I want to check. I already know wine and beer raise the UA with more than 20%, and meat with 30% or more. But how about sweets? And then there are a number of supplements I want tontry, to see if they have any effect on my uric acid. There is rooibos, which have been claimed to lower UA. There is vitamin C, which has a proven track record. There is milk and orotic acid, which have some intriguing results. Some people swear by celery seeds - do they have any effect on uric acid levels? And I always get good effects when I eat konjac, or konyakku. It is not easily available in many parts of the world, but the fibers are.
Sounds like I will have a busy 2021!
it low enough not to get a gout attack. I am finding new and interesting foods in the vegetables department (it helps that vegetables in Japan are almost as amazing as the famous wagyu and seafood). And I am slowly losing weight. Could hardly get better.
Now that I have my uric acid under control, there are a few other things that I want to check. I already know wine and beer raise the UA with more than 20%, and meat with 30% or more. But how about sweets? And then there are a number of supplements I want tontry, to see if they have any effect on my uric acid. There is rooibos, which have been claimed to lower UA. There is vitamin C, which has a proven track record. There is milk and orotic acid, which have some intriguing results. Some people swear by celery seeds - do they have any effect on uric acid levels? And I always get good effects when I eat konjac, or konyakku. It is not easily available in many parts of the world, but the fibers are.
Sounds like I will have a busy 2021!
Read more here:
My reflections when unboxing the UASure uric acid meter
Two weeks of using the UASure uric acid meter
What is uric acid?
Where does uric acid come from?
How much uric acid do you have in your body?
Can you affect the pH level of your urine, and does it matter?
My reflections when unboxing the UASure uric acid meter
Two weeks of using the UASure uric acid meter
What is uric acid?
Where does uric acid come from?
How much uric acid do you have in your body?
Can you affect the pH level of your urine, and does it matter?
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