How come the gout is not under control even though I don’t eat this or that?

  With the improvement of people’s living standard in China, the incidence of gout is on the rise due to the diversification and over-quantification of diet. However, many gout patients do not eat this or that in their diets, and end up eating only some vegetables at each meal, which seriously affects their quality of life, but the control of gout is still not ideal, and the uric acid is still high in the hospital.  Gout is a disease caused by disorder of purine metabolism and/or impaired uric acid excretion. It is characterized clinically by hyperuricemia, recurrent acute arthritis, gout stone formation and chronic arthritis caused by gout stones, urinary stones and renal parenchymal lesions. The causes include excessive uric acid production and/or decreased uric acid excretion, with the latter predominating. Uric acid is the end product of purine metabolism in the body, the average uric acid pool in normal human body is 1200mg, about 750mg is produced and 500-1000mg is excreted every day, about 2/3 is excreted by urine and the other 1/3 is excreted by intestine, the two are basically in balance. Therefore, it can be seen that if gout patients simply control their diet and reduce the intake of purine, it can only reduce the production of uric acid to a certain extent, but some foods do not contain high purine, such as yogurt, but the lactic acid it contains can greatly reduce the excretion of uric acid, which makes the uric acid pool in the body gradually increase, and when it reaches the saturation amount, uric acid crystals can be deposited in joints, cartilage, kidneys and other tissues and organs.  Therefore, it is not enough for gout patients to go to the hospital to simply test the uric acid in the blood, they should check both blood uric acid and uric acid, the more ideal result is that both can be controlled in the normal range, if the uric acid is elevated, while the blood uric acid is normal, it means that the total amount of uric acid in your body is still more, but due to their normal kidney function, the excess uric acid can still be excreted through the urine, but it will increase the burden on the kidneys, and eventually one day If the blood uric acid is elevated and the uric acid is not high, it means that the elevated uric acid in your body is not enough to be excreted through the kidneys, which means that the kidney function has been damaged to some extent. In addition to reducing the intake of high purine diet such as alcohol (especially beer), we can take some medications to increase the excretion of uric acid to reduce the burden on the kidneys and thus lower the level of uric acid in the blood, which can greatly reduce the risk of acute attacks of gout and joint destruction. Drugs to promote uric acid excretion include: benzbromarone tablets once a day, 50mg each time; sodium bicarbonate tablets three times a day, 0.5g each time. It is also recommended to drink some soda water regularly, which has a similar function to sodium bicarbonate tablets and is a weak alkaline drink that can improve the acidic environment in the body, alkalize the urine and promote uric acid excretion. Research shows that urine PH5.0 free uric acid only 15%, PH6.6 almost all uric acid is in the free state, only the free state of uric acid can be excreted through the kidneys, so we can see that alkalinization of urine can greatly improve the excretion rate of uric acid.  In summary, if you can insist on drinking more than 2000ml of water every day and improve the acid-base environment in your body, you can excrete uric acid in your body effectively, and you can follow up with your blood uric acid and uric acid in hospital every 2 months. The quality of life of gout patients can also be restored to a certain degree.