Hidden Dangers

Reasons Why High Uric Acid is Often Overlooked

What are the dangers?

How is it diagnosed?

Can it be treated?

People with poor diet, obesity, or kidney issues are more vulnerable.

Untreated high uric acid can lead to gout, kidney stones, and increased heart disease risk.

1. The "Gout-Only" Paradigm: For decades, the primary focus of elevated uric acid has been its role in causing gout—a painful form of arthritis. Many physicians, especially in busy primary care settings, may not order a uric acid test unless a patient presents with classic gout symptoms (e.g., a red, hot, swollen joint, often in the big toe). If a patient is asymptomatic, the high level might be noted but not actively treated.

2. Asymptomatic Nature: High uric acid often has no symptoms for years or even decades. During this "silent" period, it can cause damage (like crystal deposition in joints or kidneys) without the patient feeling anything. In a healthcare system often driven by symptom complaints, asymptomatic conditions are prone to being deprioritized.

3. Lack of Unified Treatment Guidelines: Unlike high blood pressure or cholesterol, which have clear, universally accepted treatment thresholds and guidelines, the management of asymptomatic hyperuricemia is controversial.

   • There is no consensus on when to start medication for someone with high uric acid but no history of gout.

   • The decision is often left to individual physician judgment, leading to inconsistent practices.

4. Competing Priorities in Primary Care: A primary care physician often has 15-20 minutes with a patient who may have multiple, more pressing issues like diabetes, hypertension, heart disease, and depression. Screening for an asymptomatic condition like high uric acid can fall by the wayside.

5. Focus on "Traditional" Risk Factors: The focus for cardiovascular and kidney disease has traditionally been on "the big ones": high LDL cholesterol, hypertension, diabetes, and smoking. Uric acid is often still considered a "non-traditional" or emerging risk factor, so it doesn't always make the standard preventive care panel.

The Shifting Perspective: Why It Shouldn't Be Overlooked

Medical research is increasingly showing that high uric acid is not just a cause of gout but is independently linked to several serious health conditions:

• Chronic Kidney Disease (CKD): Uric acid can form crystals in the kidneys and also damage the delicate blood vessels and filtering units, accelerating kidney decline.

• Hypertension (High Blood Pressure): Studies have shown a strong association between high uric acid and the development of hypertension, particularly in adolescents and young adults.

• Cardiovascular Disease: Hyperuricemia is linked to an increased risk of heart attack, stroke, and heart failure. It's thought to contribute to endothelial dysfunction (damage to blood vessel linings), inflammation, and oxidative stress.

• Metabolic Syndrome and Type 2 Diabetes: High uric acid is frequently found alongside insulin resistance, obesity, and abnormal cholesterol levels.

• Nonalcoholic Fatty Liver Disease (NAFLD): There is a growing body of evidence linking uric acid to the development and progression of NAFLD.

• Depression: There are several biological theories that explain how elevated uric acid could contribute to or worsen depression

• Low Testosterone levels: Low testosterone can slow down your kidneys' ability to remove uric acid from your blood.

• Low Thyroid Hormone Levels: Low thyroid hormone can slow your kidneys, making them less efficient at removing uric acid from your blood.

  
  

The Current State in the US Healthcare System

• Awareness is Growing: Specialists like rheumatologists, nephrologists, and cardiologists are increasingly aware of these broader implications and are slowly starting to test for and manage high uric acid.

• The Gap is in Primary Care: The biggest area for improvement is in routine primary care screening. It is not currently part of the standard "wellness" blood panel (like a metabolic panel or lipid panel) unless the doctor has a specific reason to order it.

• Patient Advocacy: Patients are becoming more informed. Those with a family history of gout, kidney stones, or cardiovascular disease are increasingly asking their doctors to check their uric acid levels.

What You Can Do?

If you are concerned about high uric acid, you can be proactive:

1. Know Your Risk Factors: Obesity, a diet high in purines (red meat, organ meats, some seafood), sugary drinks (especially high-fructose corn syrup), alcohol consumption (particularly beer), kidney disease, and certain medications (like diuretics) increase your risk.

2. Ask us for the Test: During your annual physical or check-up, you can specifically ask your doctor, "Given my risk factors, would it be appropriate to check my uric acid level?"

3. Understand the Number: If your level is high (generally >7.0 mg/dL for men and >6.0 mg/dL for women), discuss with your doctor what it means for you.

4. Focus on Lifestyle: Regardless of medication, lifestyle modifications are the first line of defense: maintain a healthy weight, stay hydrated, limit alcohol and sugar-sweetened beverages, and eat a balanced diet.

Conclusion:

High uric acid has historically been overlooked in the US, trapped in the "gout-only" mindset and overshadowed by other health priorities. However, the medical understanding is evolving. It is now recognized as a significant player in kidney, cardiovascular, and metabolic health. While systemic change in screening practices is slow, individual awareness and proactive conversations with your doctor are key to ensuring this potential risk factor is not overlooked in your personal health.

What Can We Do?

If you're concerned about high uric acid, you've likely experienced how the traditional healthcare system often focuses only on treating painful gout attacks. The bigger picture—the silent, long-term risks to your kidneys, heart, and metabolism—frequently gets overlooked because you don't have symptoms yet.

That's where we are different. We don't operate on the "Gout-Only Paradigm." We specialize in the proactive management of high uric acid as a key indicator of your overall metabolic health.

As your dedicated virtual health provider, here’s how we add value where primary care falls short:

• We Close the "Silent Risk" Gap: We don't wait for a painful gout flare to act. We understand that high uric acid can silently damage your body for years. We will actively monitor your levels and work with you to lower them, protecting your joints, kidneys, and heart before damage occurs.

• We Provide Specialized, Consistent Expertise: Unlike a busy primary care doctor who may have 15 minutes for all your concerns, we focus deeply on this one area. We cut through the controversy around treatment guidelines and create a clear, personalized, and consistent plan for you based on the latest evidence, not just on whether you're in pain.

• We Look at the Whole Picture: We know high uric acid is linked to your kidneys, blood pressure, heart disease risk, liver health, and even mood and hormones like testosterone and thyroid. We connect these dots for you, creating a holistic plan that addresses the root causes and related conditions, not just a single number.

• We Make Proactive Management Easy:

  • Convenient Testing: We'll help you get the right lab tests (uric acid, kidney function, etc.) easily, even if you never had symptoms.

  • Personalized Treatment Plans: We create a clear plan that may include diet, lifestyle, and if necessary, medication to safely reach and maintain your target uric acid level.

  • Ongoing Support & Education: We are your partners for the long term. We help you understand your numbers, adjust your plan, and stay motivated to protect your health.

Stop wondering if your uric acid level is being overlooked. Let us give you the focused, proactive care you deserve.

Ready to take control? Schedule you free discovery call today.

Yes, lifestyle changes and medication can effectively manage uric acid levels.