Friends often show me their health reports asking, "All my other markers are normal, so why is my uric acid high? Is this serious?" or "I don't smoke or drink, and I exercise regularly—why is my uric acid elevated?"... In fact, hyperuricemia (HUA) is a disorder of purine metabolism, a chronic condition with insidious onset.Statistics show that nearly 90% of patients only experience fluctuating or persistently elevated blood uric acid levels without noticeable symptoms. Thus, many discover their high uric acid levels unexpectedly through health checkups. If left untreated due to perceived lack of symptoms, it can lead to serious consequences. HUA causes urate crystals to precipitate in the body, triggering conditions like atherosclerosis and renal insufficiency—essentially damaging both the heart and kidneys.Not to mention that once gout attacks occur, the joint pain and swelling severely impact quality of life! HUA can be considered the hidden fourth high beyond the "three highs" of elevated blood pressure, blood lipids, and blood sugar, demanding serious attention.
HUA is a metabolic disorder closely linked to spleen-stomach function and damp-heat pathogens as described in traditional Chinese medicine. So, what lifestyle factors contribute to elevated uric acid? How does TCM prevent HUA by regulating spleen-stomach function? Today, we'll explore these questions.
First, HUA stems from unhealthy lifestyle habits.
Uric acid is a byproduct of purine metabolism in the body.Under normal circumstances, the body maintains a balance between daily uric acid production and excretion. If production increases or excretion decreases due to certain factors, HUA occurs. Beyond secondary causes from other diseases, the most common trigger is poor dietary habits—such as consuming seafood, beef, lamb, alcohol, or tobacco—which all increase uric acid intake. Beyond diet, factors like life stress and lack of exercise can impair uric acid excretion. When this balance is disrupted, uric acid levels rise.Purin metabolism in the human body is interconnected with carbohydrate and lipid metabolism. An imbalance in one metabolic pathway often triggers a domino effect, affecting others. Once multiple metabolic disorders occur, management becomes challenging. Patients may need to take numerous medications daily to control various indicators, yet the success rate remains low—only about 5% of such patients achieve comprehensive metabolic control.Therefore, early intervention to modify poor dietary and lifestyle habits is crucial to prevent disease before it develops.
Does this mean active exercise guarantees immunity? Not necessarily. Athletes and fitness enthusiasts may also experience elevated blood uric acid due to unscientific training methods and dietary choices. Despite abstaining from tobacco and alcohol, maintaining regular exercise, and enjoying overall good health, these individuals often show elevated uric acid levels on their lab reports. Regular exercisers know that achieving a desirable physique typically involves a "high-protein, low-carbohydrate" diet.However, many "high-protein, low-carb" foods are also moderate to high in purines—such as fish, shellfish, beef, lamb, and chicken breast. If these dominate daily meals, or if carbohydrates like rice and wheat are strictly avoided, developing hyperuricemia is unsurprising. Excessive protein intake may even overload the kidneys, potentially triggering more severe health issues.
Additionally, exercise methods impact purine metabolism. Intense anaerobic workouts generate substantial lactic acid, which—like uric acid—is primarily excreted through urine. Excess lactic acid acidifies urine, preventing uric acid from fully dissolving and causing urate crystal deposits that hinder excretion.Simultaneously, profuse sweating during exercise depletes bodily fluids. Failure to replenish fluids promptly reduces urine output, further hindering uric acid excretion. Therefore, exercise must be approached scientifically—maintaining balanced nutrition and moderate activity levels avoids extremes that could prove counterproductive.
Secondly, restoring robust spleen function is central to preventing gout.
From a traditional Chinese medicine perspective, ingested food and drink are stored in the stomach. During digestion, the spleen transforms these into refined substances for absorption, which are further converted into qi and blood to nourish the organs. Thus, the essence of food and drink forms the material foundation for qi and blood. The spleen is the "root of acquired constitution" and the "source of qi and blood generation," with its functions encompassing material and energy metabolism in modern medicine.When spleen function is normal, the body's metabolism functions properly. The essence extracted from ingested food is absorbed and utilized, while waste products are expelled through the large intestine. When spleen and stomach function is impaired, or when nutrient intake exceeds the spleen's transformative capacity, the refined substances cannot be absorbed and utilized in a timely manner. Their accumulation then forms pathological products such as "phlegm-dampness," "damp-heat," and "turbid toxins."Substances like purines and proteins belong to the refined essence of food and drink. When consumed in excess or when spleen-stomach weakness impairs their transformation, surplus nutrients cannot be metabolized promptly. They accumulate in the meridians, obstructing the flow of qi and blood. This accumulation leads to increased uric acid levels.
Therefore, restoring the spleen's robust transport and transformation function is central to preventing gout, with lifestyle modification being key. Lifestyle changes involve correcting the aforementioned unhealthy habits, specifically including: healthy eating, quitting smoking and alcohol, maintaining regular sleep patterns, engaging in appropriate exercise, managing weight, and avoiding "exhaustion damaging the spleen" and "excessive thinking damaging the spleen."Individuals with impaired spleen function often experience reduced appetite, postprandial bloating, sticky stools, or loose stools. They may benefit from incorporating spleen-tonifying medicinal foods such as Codonopsis, Astragalus, Poria,Coix seed (Yiyiren) also effectively strengthens the spleen and dispels dampness. A traditional medicinal porridge called "Four Treasures Soup" (made by simmering Coix seed, lotus seed, euryale seed, and Poria cocos into a porridge) serves as an excellent spleen-strengthening dietary remedy.
For individuals with existing risk factors for hyperuricemia, gout, or metabolic cardiovascular diseases, as well as middle-aged and elderly populations, a low-purine diet should be prioritized. This includes various grains, fruits, vegetables, dairy products, and eggs.Limit high-purine foods including organ meats, sardines, anchovies, concentrated meat broths, beer, as well as seafood, beef, lamb, and chicken. Fitness enthusiasts should also manage purine intake when planning meal plans, ensuring balanced consumption of all six major nutrient groups—avoiding excessive protein intake at the expense of carbohydrates.Additionally, encourage increased water intake, ensuring at least 1500mL daily. For conditions like heart failure or renal insufficiency requiring fluid restriction, individualized comprehensive management plans should be developed by physicians. Consistent exercise and weight control offer significant metabolic benefits, but HUA patients should avoid strenuous activities. Maintaining 2-3 sessions per week of moderate-intensity exercise (30 minutes to 1 hour per session) is most appropriate.
Overall, HUA stems from unhealthy lifestyle choices, and its prevention and treatment hinge on correcting these habits while focusing on regulating the spleen and stomach. With consistent adherence to a scientifically sound lifestyle, supplemented by short-term medication, the overall prognosis is favorable.