The spread of infection with the new coronavirus increases the risk of hyperuricemia leading to gout. This is because it is easy for people to lack exercise or have a disordered diet due to working from home or refraining from going out. The number of patients with gout is increasing year by year, but there are many "misunderstandings" about prevention and treatment methods. I want to suppress the onset and eliminate anxiety with accurate knowledge.
"Gout has often occurred in the spring when the seasons change and in the summer when alcohol consumption increases. Corona sickness is likely to require caution even after the fall." Ichiro Kurume, Vice President of the Japanese Society of Gout and Uric Acid Nucleic Acids (Professor, Faculty of Medicine, Tottori University) sounds a warning bell.
Dietary habits and lack of exercise are the most important points for patients with hyperuricemia. Working from home causes stress and makes it easier for people to drink more. I want to keep the daily guideline of 1 go of sake and 350 to 500 ml of beer as much as possible.
Many patients think that it is okay because they are drinking distilled liquor such as shochu, which is said to have zero purines. "It's a misunderstanding. Drinking a lot of alcohol still increases the risk of gout," Kurume points out.
The reason is that alcohol itself tends to increase uric acid in the blood. In fact, about 20% of the uric acid in the body depends on the intake of purines from food and drink. 80% is synthesized in the body, and when a certain amount is accumulated, it is excreted together with urine, sweat, and stool. Large amounts of alcohol can upset the balance of synthesis and excretion.
Purines are abundant in meat, internal organs, and seafood, but if you care too much, you will lose the enjoyment of eating. Masako Onoe, a registered dietitian, said, "We should prevent overeating and try to have a nutritionally balanced diet with staple foods, main dishes and side dishes. Then, the intake of purines derived from food will be appropriate." Give advice.
The key to preventing overeating is "If you actively incorporate vegetables, seaweed, and mushrooms and increase the volume, you will be more satisfied" (Mr. Onoe). If you drink enough water such as water or tea, the amount of urine will increase and you can promote the excretion of uric acid.
Weight loss is also essential for obese people. According to Mr. Kurume, uric acid levels decrease when visceral fat decreases by 15% or more due to weight loss. However, anaerobic exercise such as muscle training breaks down ATP (adenosine triphosphate) used when moving the body and increases uric acid in the body. Jogging and cycling are recommended for weight loss to lower uric acid levels.
Uric acid lowering medications prescribed by your doctor should be taken continuously. Hyperuricemia has no subjective symptoms unless a gout attack (arthritis) occurs, and many people stop taking the drug on the way. According to Mr. Kurume, the ratio is about 75%, which is significantly higher than that of hypertensive and diabetic patients (about 40%). In addition to making it difficult to go out due to the corona virus, there are also moves to refrain from going to the hospital for fear of infection.
However, when the drug is stopped, "the uric acid level returns to the original level in 2 weeks" (Japan Gout and Uric Acid Nucleic Acid Society). The chances of a seizure recurrence within 3 years also increase. If hyperuricemia is left untreated, it may adversely affect the kidneys and cardiovascular disease, leading to urinary stones and kidney disease. If it is difficult to get a medical examination at a hospital, I would like to utilize telephone medical treatment or telemedicine.
It is said that taking the drug should be continued for a lifetime, but if the uric acid level is stable, it may be stopped after consulting with a doctor. You should avoid quitting at your own discretion.
It has also been reported that some of the new corona therapeutic drug candidates raise uric acid levels and have adverse effects when used in combination with uric acid lowering drugs. The Japanese Society of Gout and Uric Acid Nucleic Acid Society says, "If you are infected with corona, it is important to inform your healthcare professionals that you are being treated for gout and hyperuricemia."
Reserve army patients over 10 million
Gout is said to have not existed in Japan before the Meiji era, but in recent years it has continued to increase due to the westernization of eating habits. According to a survey by the Ministry of Health, Labor and Welfare, the number of patients in 2016 was estimated at 1.1 million, which has quadrupled in 30 years. There is an image of middle-aged and elderly illness, but there are many cases of illness under 40s.
According to the Japan Lifestyle-related Disease Prevention Association, the number of hyperuricemia patients, who are considered to be "gout reserves," exceeds 10 million, and it is estimated that 30% of men in their 30s and 40s fall under this category.
Concerned about the increase in gout patients and worsening of symptoms due to corona illness, the Japan Society for Gout and Uric Acid Nucleic Acid has posted a notice on its website stating, "Especially for hyperuricemia and gout patients." Coronavirus also calls for the maintenance of proper lifestyle and the continuation of medication. The Japan Dietetic Association, a public interest corporation, also publishes advice to consumers regarding nutritional guidance in a Q & A format on its website.