Uric acid is high, do you want to take medicine?

Rheumatologists or endocrinologists often meet patients who come to consult with physical examination reports in outpatient clinics, and a large part of this is due to the increase of uric acid in blood biochemical indexes.

Some patients may ask: Doctor, my uric acid is high, is it gout? Do you want to take medicine?

Some people will ask: Doctor, my uric acid has always been high, but I have never had arthralgia. Do you want to treat it?

Then, this article will introduce to you the relationship between hyperuricemia and gout, and whether hyperuricemia should be treated or not.

Is what hyperuricemia?

Excessive production of uric acid in the body or decreased uric acid excretion function in the kidney may lead to an increase in blood uric acid, i.e. Hyperuricemia.

Hyperuricemia is the basis of gout, and is also closely related to type 2 diabetes, hypertension, cardiovascular diseases, chronic kidney disease, etc.

Is hyperuricemia equal to gout?

Not equal to.

Many people first think of whether they have gout after the physical examination found that the blood uric acid has increased. In the impression of many friends, [hyperuricemia equals gout].

In fact, only a small number of patients with hyperuricemia will develop gout. Therefore, the number of hyperuricemia patients around us is far greater than that of gout patients.

Does hyperuricemia need treatment?

The treatment plan needs to be decided according to the specific situation.

Everyone knows that high blood sugar, high blood pressure and high blood lipid should be treated, so should high uric acid be treated or not?

First of all, we need to clarify two concepts. Hyperuricemia is divided into the following two categories according to whether there are symptoms or not:

    Asymptomatic hyperuricemia: That is, hyperuricemia without symptoms such as acute arthritis, tophus, kidney stones or renal insufficiency. Symptomatic hyperuricemia: Once gout attacks, of course, it needs immediate treatment and is beyond the scope of this article.

[asymptomatic hyperuricemia] How to do?

[Asymptomatic hyperuricemia] in the eyes of the common people should be [my other what are good, that is, the physical examination found high uric acid]. For this part of the patients, it is recommended to deal with it as follows:

1. Comprehensive health assessment

It is suggested to do a more detailed examination first, which should include: blood pressure, blood lipid, blood sugar, liver and kidney function and kidney B-ultrasound to comprehensively evaluate your health status, because many [I am good in what] are not really [good].

2. Better lifestyles

All [asymptomatic hyperuricemia] patients need to improve their lifestyle first, including diet, exercise, weight loss, etc.

3. Specialist treatment (rheumatology or endocrinology)

Whether the true [asymptomatic hyperuricemia] patient needs treatment, At present, there is a great debate in the academic circle. European and American countries do not recommend the treatment of [asymptomatic hyperuricemia], while China currently has only one expert consensus on [asymptomatic hyperuricemia complicated with cardiovascular diseases] for reference. On the basis of referring to domestic and foreign studies, we suggest:

No matter any age or sex, as long as the blood uric acid > 420 mol/L, one should seek medical treatment from a specialist.

For all patients with [asymptomatic hyperuricemia], treatment should start with improving lifestyle.

Does what Need Uric Acid Reduction Treatment?

1. Cardiovascular risk factors (such as hypertension, diabetes, etc.)

  • Serum uric acid > 480 mol/L, uric acid reduction therapy should be started on the basis of improving lifestyle.

2. No cardiovascular risk factors (assessed by doctors)

  • Serum uric acid > 540 mol/L, uric acid reduction therapy should be started on the basis of improving lifestyle.

For patients who are not within the above range [asymptomatic hyperuricemia], what they need to do at present is to actively improve their lifestyle and regularly monitor indicators such as blood uric acid. Just because they have not reached the uric acid value that requires drug intervention, they must not think that they are [easy to rest].


High uric acid does not necessarily mean that you will get gout.

However, hyperuricemia also needs your attention, and improving lifestyle is the primary treatment.

For some people, it is not only you who drink less wine and eat less seafood that can achieve the goal of reducing uric acid. Whether to use uric acid-reducing drugs needs to be comprehensively judged by doctors according to the blood uric acid level of patients and the conditions of other diseases.