Be Careful if Uric Acid Levels Exceed 7mg/dL; Why Treatment Must Continue Even Without Pain

Gout is a disease where crystals accumulate around joints as uric acid levels rise, causing extreme inflammation and pain. Recently, due to changes in dietary habits, the number of patients among the younger generation and even middle school students is increasing, necessitating caution. According to a video from Uihak Channel Biondwi, the goal of gout treatment is not simply to eliminate pain, but the core is long-term management to completely remove the uric acid crystals remaining in the body.

The 7mg/dL Uric Acid Standard and Causes of Gout

Gout and uric acid are inseparable. If uric acid levels in the blood remain high for a long time, crystals accumulate around the joints and cause inflammation. The video explains that when uric acid levels exceed the 'saturation concentration' of approximately 6.82mg/dL, crystals can form, and it stated that 7mg/dL is typically used as a standard during health checkups to determine whether levels are normal.

The cause of gout is not limited solely to food intake. Genetic factors play an important role; the presenter in the video mentioned that they are also a gout patient and that many family members are patients, explaining the genetic influence. Additionally, uric acid is excreted through the kidneys, so if kidney function is impaired, uric acid levels can rise. In particular, gout often occurs in old age in patients whose kidney function has worsened as a complication of diabetes or hypertension.

Body weight and uric acid levels have a direct proportional relationship. The presenter emphasized weight loss for gout patients, adding that they have often seen cases where uric acid levels drop when weight is lost. In addition, certain medications, such as taking tuberculosis medication (pyrazinamide), can also cause uric acid concentrations to rise.

Gout Diagnosis Using Ultrasound and 'asymptomatic hyperuricemia'

Not everyone who shows high uric acid levels in a health checkup is a gout patient. A diagnosis is not made based on a single value alone; one must comprehensively consider symptoms such as joints turning red or pain when pressed, walking impairment, and the location of occurrence (big toe, top of the foot, ankle, Achilles tendon, knee, elbow, etc.). A state where only uric acid levels are high without symptoms is called 'asymptomatic hyperuricemia,' and young people with good kidney function manage it through lifestyle corrections.

Ultrasound is used for accurate diagnosis. The video explains that through ultrasound, one can see the joint fluid being filled with inflammation. In particular, unlike normal cartilage lines, a typical ultrasound finding called the 'Double contour sign' appears in gout patients. During the diagnostic process, 'joint aspiration,' where joint fluid is directly drawn out, may be performed to both ensure an accurate diagnosis and perform injection therapy to reduce inflammation simultaneously. The video showed the process of confirming yellow inflammatory fluid accumulated in the joint through ultrasound, drawing it out through a needle, and then administering a steroid injection.

In cases where gout has progressed, findings suggesting that bones are being eroded can be confirmed through an X-ray, and various imaging tests such as dual-energy CT, which can directly confirm the deposition of uric acid crystals, can be utilized.

The Reason Why You Must Continue Taking Medication Even After Pain Disappears

Many patients mistakenly believe they are cured once the pain disappears, but this is a dangerous thought. This is because the pain has merely subsided as the inflammation went down, but uric acid crystals (seeds) may still remain within the joint. If treatment is not carried out steadily until the crystals completely disappear, recurrence is unavoidable. The presenter emphasized that if an attack occurs again within three months despite attempting lifestyle corrections (reducing alcohol, losing weight, sufficient water intake), consistent drug treatment is absolutely necessary.

Gout medications are largely divided into two purposes. The first is treatment to calm inflammation and pain during an acute attack, using colchicine , anti-inflammatory analgesics (such as the Moenside group, etc.), and steroids. It was explained that these acute-phase treatments are used to rapidly alleviate symptoms and are generally not used for long periods once symptoms improve, so there is no need to worry greatly about side effects. The second is treatment to lower the uric acid level itself, which includes febuxostat, allopurinol, and benzbromarone, and it was mentioned that a new drug that excretes uric acid through urine is in the final stages of development.

Uric acid-lowering treatment should treat gout as a chronic disease like hypertension. Just as one does not stop taking blood pressure medication just because blood pressure is controlled, gout must also be taken long-term to maintain uric acid levels at a constant level. The presenter urged, "You must start taking uric acid-lowering drugs with the intention of taking them for life," noting that if the medication is stopped, uric acid levels will rise again, making steady management essential. In fact, the presenter revealed that they themselves have been taking uric acid-lowering medication for 8 years and recommended monitoring progress while taking the medication for at least 3 years.