What do fatty liver, diabetes, cancer, Alzheimer’s, heart attacks, cardiovascular disease, kidney disease, insulin resistance, obesity, high blood pressure, and gouty arthritis all have in common? Uric acid! For the last hundred years, uric acid has been largely ignored by the medical profession unless you showed up with the symptoms of gout. The classic gout patient will have exquisite pain in a big toe joint that will also be bright red and swollen. The slightest touch on this joint will send the person through the roof in pain. The belief was that this was caused by too much protein or sugar-rich food and alcohol. For sure an attack of gout is an undesirable experience, but only a few percent of the population ever has this, so uric acid was never a glamour molecule that got big research bucks to be looked into.
Interestingly, almost 130 years ago a lone researcher did spend a lifetime researching uric acid and wrote an entire book on its impact on all sorts of systems in the body. The book was even translated into several languages back in the 1890s. But this was back at the dawn of the new petroleum-based pharmaceutical industry, and this information just did not fit into the medical world being created at that time. It was largely forgotten until recently, with a lot of research being done by Dr. Richard Johnson at the University of Colorado. This research has shown that uric acid is in fact a central player in all the modern metabolic diseases that are everywhere today. For many years I have written about the health-destroying impact of a high-sugar diet, but the exact biochemical mechanisms behind much of this damage were not fully understood. The research on uric acid fills in those holes in our knowledge. Uric acid is far more than just a nice blood marker for tracing the progress of diseases. It’s actually a core cause of the diseases of modern life.
Let’s describe one simple way uric acid messes with our health. Nobody I know likes the idea of being obese. And yet at this point over 50% of the American population is obese. Over 80% of Americans have some sort of metabolic disease and are headed down the obesity pathway right now. How many of us would like to drop some excess body baggage in the form of fat? Well, there is a particular chemical switch that controls this way down at the energy production pathways inside each and every cell in the body. This switch is run by an enzyme called AMPK which triggers the burning of fats to make energy for us. Uric acid shuts down this switch and instead pushes the build-up of a different enzyme called AMPD, which tells our body to store fats and not burn them. This is the bottom line in the production of energy inside our cells. When our body believes either food or water is becoming scarce due to a change of seasons, this switch takes place and we store fat rather than burn it. The signal that food will become scarce is the availability of lots of ripe high fructose fruit in the late fall. Fructose basically turns into uric acid which stops fat burning and triggers fat storage. If you are an animal that hibernates for the winter, your blood will get thicker due to dehydration. This causes your liver to manufacture fructose which then turns into uric acid and bam, more energy conservation and fat storage. Uric acid is running this show.
A few years ago the critical role of fructose in the diseases of metabolism was uncovered. The research was solid, but exactly how it did its damage was unclear. Now the pathways of fructose conversion into uric acid are known and the full understanding is about there. Now understand, what I am telling you about will not likely be known by your average medical doctor for another 20 years. It generally takes that long for researchers to prove such basic science through argument and reproduction of results unless the initial research provides a new drug remedy from which lots of money can be derived. Then research can be accelerated and communication/education of the doctors is handled by drug reps pushing the new blockbuster medication. Sometimes that is a good thing, but more often unfortunate side effects are missed until many years later.
Normally your uric acid levels are controlled by your kidneys more than by the production of uric acid from the foods you eat. The kidneys are supposed to excrete excess acid as a part of their normal functioning. But our kidneys are not functioning as well as they need to these days. Three significant dietary changes are damaging the functioning of our kidneys – excess sugar, excess inflammatory seed oils, and excess grains. Excess sugar creates the whole insulin resistance thing which damages the kidneys. It is the damage to the kidneys that usually takes out diabetics. Excess inflammatory seed oils (think sunflower, corn, soy, etc..) damage the kidneys through the toxic and free radical oxidative stress on the kidney tissues. And excess grains damage the kidneys by promoting a highly acidic environment due to the lack of potassium in grains. If you like your starches, you are much better off eating root vegetables like sweet potatoes and regular potatoes which are high in potassium.
It was a decrease in my kidney function that got me started on this subject. I noticed the GFR (filtration rate) in my kidneys was down on my latest blood test. My uric acid level on my blood test was still in the “normal” region (just barely). Modern lab work will tell you that anything under 7.0 is normal. I was 6.9. But as my research on this subject has shown me, normal is not enough to be healthy. For males, a healthy reading is below 5.5, and for females below 4.5. If you have had any lab work done in the last couple of years, check the results to see what your levels have been. I am so engaged now that I bought a finger stick blood meter for testing uric acid levels. It works just like the ones I have for testing blood sugar and ketones. The levels of uric acid vary throughout the day, with the highest levels occurring at about 5 in the morning. This way I can see if different things in my diet are affecting my levels.
Okay, so what can we do about this? Obviously, the first step is to check your uric acid levels to see if anything even needs to be done. I may bring my test kit to the office for this purpose. If your uric acid levels are too high, the next step is to stop eating stuff that turns into uric acid. Basically, that means fructose, so no sugar-sweetened beverages, fruit juices, anything with HCFCs (high fructose corn sweetener) in it like agave syrup, and any obvious sources of sugar like candy, cookies, and so on. There are a number of vegetables, seafood, shellfish, organ meats, and red meats that are high in something called purines which are broken down to uric acid, but their impact seems to be small compared to fructose. Alcohol is a frequent problem, particularly beer. It seems the brewer’s yeast is a bigger issue than the alcohol itself. So stop the bad stuff.
The next step is to block the formation of uric acid chemically. Medically this is done with a drug called Allopurinol. Like most drugs, it has a list of side effects to watch out for. Fortunately, there are a bunch of natural compounds that do this same job. The classic I have always suggested to patients is tart cherry juice. Other plant compounds include quercetin, rutin, luteolin, vitamin C, and coffee! Yes, you read that right. Drink several cups of coffee each day to lower uric acid. Also, remember I mentioned uric acid can result from self-made fructose? Dehydration can trigger this so make sure you stay hydrated.
The third step is to increase your kidney’s excretion of uric acid. Obviously, you want to deal with any insulin insensitivity issues that might be damaging the kidneys in the first place. I mentioned that too much acid in the kidneys blocks the release of uric acid, so eating a diet that is more alkalizing is important. That means keeping the consumption of grains down and keeping protein consumption down to 70 to 120 grams per day. You can also specifically take things to alkalize the urine such as potassium citrate or possibly baking soda. I am also using kidney protomorphogens to rebuild my kidney function.
I will be tracking my progress with my uric acid monitor to see what is working for me and what is not. Like everything, we each respond differently to different remedies. We have to find what works best for us.
Take care,
David