1, gout patients only need to control the mouth can be? As we all know, gout is a metabolic-related rheumatism, since it is metabolic-related, many people think that gout is eaten out, so many gout patients think that since they have high uric acid, then lowering uric acid can be. The same reason is to lower uric acid as long as you keep your mouth shut, you don’t need to exercise, and you don’t need to take drugs, and the side effects of drugs are so big, such as “colchicine inhibits bone marrow, allopurinol hurts the liver, benzbromarone hurts the kidneys, and sodium bicarbonate hurts the stomach” and so on. Some gout sufferers even live a “vegetarian” life like “a simple meal” and “asceticism” every day in order to bring down uric acid, but in the end, the uric acid may not drop much and they end up with a “malnutrition and weakness”. Obviously, it is a wrong viewpoint to lower uric acid just by avoiding the mouth Gout patients, of course, need to control the diet properly. But only by controlling diet, it is often difficult to make blood uric acid reach the target value. Scientific research has shown that avoiding eating is not the whole story of gout treatment. Strict control of the mouth usually can only reduce the overall uric acid by about 20%, and it is unlikely that the uric acid can be reduced to the “target value” simply by avoiding the mouth. Therefore, a multi-pronged approach of diet control, exercise and weight control is needed to reduce uric acid. Some gout patients need to take uric acid-lowering drugs (such as allopurinol, febuxostat, benzbromarone, etc.) as prescribed by their doctors. 2. Is it true that all you need to do to lower uric acid is to lower it to a normal value? Since gout patients need to lower uric acid, and we all know that the normal upper limit of blood uric acid for male patients is 420 μmol/L, is it true that gout patients only need to lower uric acid to the normal value of 420 μmol/L to be successful? Ladies and gentlemen, have you ever heard of a target value for lowering uric acid in the medical field? (1) The target value of uric acid reduction for gout patients without gout stones The 2016 Chinese Gout Guidelines recommend that gout patients without gout stones should lower their blood uric acid value to below 360 μmol/L. In outpatient clinics, gout patients often ask, “Since the upper limit of the normal reference value of blood uric acid is 420 μmol/L, why is it not sufficient to control to the normal value of 420 μmol/L, but below 360 μmol/L? The answer is here: Because our body temperature is 37℃, the saturation of blood uric acid in blood at this temperature is about 410 μmol/L. In fact, our normal blood uric acid value has already exceeded the saturation value of blood uric acid, so if a gout patient wants to prevent the continued release of uric acid crystals, or to let those uric acid crystals deposited in the joint cavity dissolve back into the blood to prevent gout attacks, then he needs to This is what the medical community calls the “target value” for blood uric acid control. In patients with gout without gout stones, controlling the blood uric acid below 360 μmol/L will keep the blood uric acid below the solubility of urate crystals and promote the dissolution of existing or potentially existing urate crystals. Therefore, for gout patients without gout stones, 360 μmol/L should be the treatment target for lowering uric acid. (2) Target value of uric acid lowering for gout patients with gout stones The 2016 Chinese gout treatment guidelines recommend that: i.e. gout patients with gout stones, it is recommended to lower blood uric acid to below 300 μmol/L. The rationale is that studies have shown that the lower the blood uric acid level in uric acid-lowering therapy, the faster the gout stones dissolve, with a significant negative correlation between the two. In addition, it is recommended that 300 μmol/L should be the final target value of uric acid-lowering therapy for patients with combined gout and kidney damage, because controlling the primary gout disease and lowering blood uric acid can reduce urate crystals deposited in the kidney and protect kidney function. To conclude, the key to the treatment of gout is to control the uric acid to reach the standard consistently, as has been said many times. Gout patients and rheumatologists must pay attention to this long-term project of lowering uric acid, so that as many early and less severe gout patients as possible can reach the uric acid standard consistently, and even “cure” gout one day.