My wife had bypass surgery. Now uric acid in her blood is elevated. What are purines?

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My wife is 43 years old. She is 54 kilograms (199 pounds) and 158 centimeters (5 feet 2 inches). She had bypass surgery in September 1997. She is quite fine now, except that uric acid level in her blood is slightly elevated (7.2 milligrams). She exercises very regularly and maintains a strict diet, especially with regard to cooking oil, salt, fatty food, etc. What food should she avoid in order to decrease her uric acid level? We read somewhere that she should avoid purines. What are purines? I hope u will be able to help.

If your wife’s blood uric acid level is elevated above 7.0 milligrams/deciliter (mg/dL), then she probably has gout.

Purines break down in the body to uric acid, but food sources of purines only account for 50% of uric acid produced in the body. Uric acid crystals then lodge in and around joints which is what causes the pain, most often in feet. If left untreated, gout can cause permanent joint damage. Some doctors feel that gout is a pre-diabetic condition, but can also lead to rheumatoid arthritis. Xanthine oxidase which is an enzyme is responsible for the uric acid formation and drugs to control gout lower xanthine oxidase.

Prescribed drugs to lower uric acid levels are the preferred mode of treatment (allopurinol). Your wife should ask her doctor what drugs he/she would recommend to lower uric acid and reduce joint pain. She should not take aspirin without her doctor’s advice if she is on blood thinners after her bypass surgery as aspirin is also a blood thinner. Also, aspirin can increase potassium levels if she also has kidney disease.

Low purine diets can be helpful in addition to drug therapy. Food sources of purines are organ meats like liver, kidney, sweetbreads, brains, meat gravies and extracts, sardines, anchovies, herring, mackerel, scallops and most wild game. The following foods are allowed once per day: meat; fish; poultry; dried beans and peas; asparagus; mushrooms; cauliflower; spinach. Alcohol is not recommended because it causes dehydration and results in increased blood uric acid levels. While organ meats are not recommended for low cholesterol / low saturated fat diets, even lean meat (poultry and fish) contains purines. Cooking oils, salt and fatty food influence blood cholesterol levels and high blood pressure, not uric acid levels tho high cholesterol and high blood pressure often go hand in hand with high uric acid levels.

Unless her fluid intake is restricted by her doctor because of fluid retention in her feet or lungs or kidney disease. encourage your wife to drink around twelve 8 ounce glasses of water a day (3 liters) to ensure adequate hydration. If after her first voided urine in the morning, her urine should be colorless and odorless, then she is drinking enough water.

Considering your wife has several diet restrictions, I would recommend she talk to a dietitian in Bangladesh. According to my Healthy Body Calculator on Ask the Dietitian, your wife is in a healthy weight range for her height (45.2 to 55.2 Kg), so weight loss is not necessarily recommended.