Are you used to experiencing sudden pain in bones and joints, out of nowhere? Seeing inflammation in the joints of hands and legs that were never before? And when you underwent the blood tests prescribed by your physician, have you noticed an elevation in the uric acid levels? If yes, it is time to know what is happening inside your body and what its relevance is.

What is hyperuricemia?

Hyperuricemia is a condition that shows increased uric acid levels in the blood. Uric acid is a common by-product of purine disintegration, a substance obtained through food materials like beer, liver, kidney, animal protein, peas, etc, or synthesized in the body itself. Uric acid formed as a result of this purine metabolism is usually eliminated through urine, making it a very normal component of your pee. But if the body produces more of it or fails to eliminate it completely, we call the condition hyperuricemia which can impact your health negatively. Hyperuricemia can be diagnosed through blood or urine screening.

Causes of hyperuricemia

As we saw before, the reason for the increased blood uric acid levels could be its increased production or inadequate elimination. Based on this, the etiological factors of hyperuricemia can be functionally classified into three-

1.Factors that cause increased uric acid formation- due to excess dietary purines and errors in purine metabolism

2.Factors that cause improper uric acid removal- due to kidney malfunction and certain medications

3.Factors that cause both- high sugar diet (especially fructose), alcoholism, malnutrition, or starvation

Additionally, factors like heredity, hypothyroidism, insulin resistance, chronic hypertension, faulty diet or unsupervised dieting, obesity, long-standing kidney diseases, etc can trigger hyperuricemia.

Commonly presented symptoms

Normally hyperuricemia stays symptomless and wouldn’t require particular medication. But in chronic conditions, it may present with two symptoms-

1.Gout

2.Kidney stones

Gout is a type of acute arthritis characterized by uric acid crystal accumulation that causes joints to swell up along with being tender. The joint at the base of the big toe is affected primarily in most cases, but the joints such as fingers, wrists, etc are also vulnerable to gouty arthritis. Joint pain that increases during the night, especially after 24 hours is the main symptom. Fever and burning sensation may also be experienced as a part of inflammatory reactions. Chronic gout may lead to tophi, the nodule-like eruptions in bones, joints, and cartilage, caused by the deposition of uric acid derivatives such as monosodium urate. A kidney stone can be considered a secondary disease to gouty arthritis.

High levels of uric acid in the blood reach the kidneys and start to crystallize from there, which lays the foundation for uric acid kidney stone formation. If hyperuricemia persists, the rate of accumulation may increase, forming larger stones that are impossible to pass through the urine normally.

Hyperuricemia and Ayurveda

In Ayurveda, hyperuricemia in the form of gout can be termed Vatarakta. The classically mentioned symptoms of Vatarakta match that of gouty arthritis, so it might be safe to correlate them. The word vatarakta is a derivative of two Sanskrit terms vata and rakta, citing their involvement in the disease manifestation. Some of the causative factors for the disease mentioned in Charaka Samhita are the intake of lavana (salty), amla (sour), kshara (sharp), dry food, overuse of meat from aquatic and marshy land animals like mutton, excessive indulgence in different types of madya (alcoholic/fermented beverages), incompatible food, vegetables and pulses like radish, black gram, and horse gram, curd, sugarcane, etc. Activities like long-distance travel, improper sleep-wake cycle, sedentary lifestyle, etc are also pointed as the reasons. All these factors tend to vitiate either rakta or vata, and thereby cause the disease.

Ayurvedic management of Vatarakta

The curability of vatarakta is heavily dependent on the stage of the disease and the doshas involved in it, and that is up to the physician’s verdict. But the treatment protocol can be broadly divided into common treatment and special treatment.

The common management option in the vatarakta condition is Shodhana chikitsa (body purification by using Panchakarma therapies). As vata and rakta are involved, the therapies to pacify them such as virechana (purgation), vasti (herbal enema), and raktamoksha (bloodletting). For virechana and vasti, the medicines should be selected only after assessing the patient’s body type. If the patient’s body is oily, medicines with hot, mild potency can be used, and in the patient with dry skin type, oily substances can be used as medicines. Vasti is indicated only after virechana. Raktamoksha can be done in different ways- be it with a needle or with a leech, the type of bloodletting is to be decided after observing the symptoms of the disease. All these procedures are to be carried out only after doing proper oleation and fomentation. For all procedures, the indications and contra-indications are to be carefully followed by the physician.

Though vata and rakta are the main culprits here, other doshas may also claim their fair share sometimes. Special treatments are done in such conditions. For example-

• Vata-pradhana vatarakta – Oleation is a mode of pacifying aggravated vata. Here, oleation is thoroughly done with ghrita (ghee), taila (oil), vasa (fat), or majja (marrow). Vasti can also be done using them.
• Pitta-pradhana vatarakta- medicines and substances with cold potency and mildness are used (eg- milk, ghee). Mild virechana (purgation) pacifies pitta without increasing vata. Pouring medicated liquid over the affected site and applying cold ointments there may benefit the patient.
• Kapha-pradhana vatarakta- Mild vamana (emesis/induced vomiting) without causing vata aggravation is preferred. Warm medicated pastes can be applied. Oleation should be done wisely as it may increase kapha.

Pathya and Apathya in vatarakta

Some Pathya-

• Barley
• Newly harvested rice
• Wheat
• Dairy products like milk of cow, sheep, buffalo, and butter
• Leafy vegetables such as spinach in limited quantity
• Raisins
• Gooseberry
• Ginger
• The meat of birds in limited quantity

A few apathya-

• Alcohol
• Pulses such as horse gram
• Fermented beverages
• Sesame
• Sugarcane
• Curd
• Day sleep
• Excess sexual activities
• Long distance travel

Several medicines in the form of kashaya, arishta, churna, ghrita, lehya, taila, etc are mentioned in classical textbooks such as Sahasrayoga in the context of Vatarakta. Yet, the best step is to eliminate the chances of getting affected. By practicing a genuine Ayurvedic routine and avoiding the above-said causative factors, one can surely lead a pain-free life.

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