Why do I still get gout when I am healthy?
A few days ago, I met a young man in the outpatient clinic.
After diagnosis, it turned out to be a gout attack.
Asking the reasons carefully, it turned out to be the fault of fitness.
Exercise and fitness is a matter that is extremely beneficial to physical and mental health. Why is it related to gout, and how should gout patients do fitness exercises? Today I will talk about these things with you.
For gout sports is a "double-edged sword"
Before talking about the relationship between exercise and gout, let's first understand the basis of the onset of gout-elevated blood uric acid.
The first thing to be clear is that when the concentration of uric acid in the blood rises and exceeds its solubility saturation in the blood, it will precipitate in the joints or surrounding tissues and form urate crystals, which is the basis for the onset of gout.
Therefore, effectively controlling the blood uric acid level and preventing the formation of urate crystals is the key to preventing and treating gout.
In addition, the sharp and large fluctuations in blood uric acid levels can cause the instability of urate crystals in the tissues, which are often the predisposing factors for gout attacks.
A large amount of evidence has shown that exercise and fitness play an important role in disease prevention and treatment and maintenance of human health.
Proper exercise can not only exercise musculoskeletal and build a strong body, but also enhance cardiopulmonary function, improve body composition, regulate immune function, relieve mental stress, and promote the body's physical and mental health from many aspects.
So how does exercise have to do with ventilation?
In terms of blood uric acid levels and gout, exercise is a "double-edged sword".
On the one hand, proper exercise can improve the metabolic function of the human body, increase fat burning, reduce weight, lower blood sugar and blood pressure, and indirectly affect the production and excretion of blood uric acid, which is beneficial to the decrease of blood uric acid.
On the other hand, improper exercise can increase blood uric acid and increase the chance of gout attacks.
Excessive anaerobic exercise can induce gout
Studies have shown that the blood uric acid level of endurance athletes is significantly lower than that of those who lack exercise, and that blood uric acid levels will rise sharply after high-intensity exercise, but low- and medium-intensity exercise (aerobic exercise) of the same amount of exercise does not increase blood uric acid.
It can be seen that high-intensity, anaerobic exercise can increase blood uric acid and induce gout.
So, why does high-intensity or anaerobic exercise increase blood uric acid?
There are three main reasons for this:
The raw materials that produce uric acid increase the fitness friends who like to know that the energy supply in the body comes from a substance called adenine nucleoside triphosphate, which we often call ATP.
In fact, this is a purine-containing substance in the body. During high-intensity or anaerobic exercise, the energy demand is huge, and the ATP in the muscle will be broken down for energy, and a large amount of adenosine and hypoxanthine will be produced at the same time, the latter two It is further metabolized to produce uric acid, which leads to an increase in blood uric acid.
The excretion of uric acid in the urine decreases. Two-thirds of the uric acid in our body is excreted in the urine. Strenuous exercise causes an increase in sweating and a decrease in urine output. The excretion of uric acid in the urine is also reduced correspondingly, leading to the accumulation of uric acid in the body.
Increased lactic acid affects the excretion of uric acid. After high-intensity exercise or anaerobic exercise, a large amount of lactic acid is produced in the muscle tissue, which reduces the local PH value, which is not conducive to the dissolution of uric acid, and promotes the formation of urate crystals, thereby affecting the excretion of uric acid.
Based on the above-mentioned mechanism, the blood uric acid level often rises rapidly after strenuous exercise, and such large fluctuations in the blood uric acid level can lead to the onset of gout.
In addition, joint damage caused by strenuous exercise and overeating after exercise can also induce gout attacks.
It is best to choose aerobic exercise for gout patients
Patients with gout should not seek quick success and quick benefits during fitness exercises. They must choose appropriate exercise methods based on their own conditions and disease states, and formulate corresponding fitness plans.
In general, we must follow the principles of individualization, moderation, gradual progress, and perseverance.
Exercise principles for different disease states During the acute stage of gout attacks, you should rest in good time, avoid exercise, and seek medical treatment in time.
After the acute period, it enters the remission interval. This is the best time for exercise and fitness, but high-intensity, high-resistance exercise and long-term anaerobic exercise should be avoided.
For patients with chronic gout, since the blood uric acid level is high for a long time, and gouty arthritis persists or frequently attacks, it is necessary to be more cautious in the choice of exercise intensity and exercise method. Low intensity, short-term, and gradual exercise should be used. model.
The preferred exercise program for gout patients Moderate, regular and continuous aerobic exercise is the best exercise method for gout patients.
Patients with gout can choose a variety of aerobic exercise methods such as brisk walking, jogging, swimming, skipping rope, aerobics, Tai Chi, non-confrontational ball games and so on.
Make a reasonable choice based on your own conditions, personal preferences and physical strength.
When exercising, pay attention to the intensity not to be too high, and the upper limit should be no more than 80% of the individual's maximum heart rate (maximum heart rate=220-age).
For example, for a 40-year-old patient with gout, his heart rate during exercise should not exceed 144 beats per minute.
Of course, if the intensity is too low (less than 60% of the maximum heart rate), the effect of exercise will not be achieved.
Exercise time should be 30-60 minutes, it is best to choose four or five in the afternoon is better, maintain the exercise frequency 3-4 days a week, perseverance.
Physical labor and fitness exercise are two different things
Patients with gout should also pay attention to the following issues during exercise and fitness:
The occurrence of gout and hyperuricemia cannot be replaced by fitness exercises due to multiple factors. Most patients require long-term drug treatment to control blood uric acid levels. Physical fitness alone has very limited uric acid-lowering effects.
Physical labor cannot replace fitness exercise. The physical labor exercises the limitations of the tissues, and the body and mind are under work tension and pressure, which is incomparable with fitness exercise.
Sufficient water should be added during or after exercise to ensure sufficient urine output and increase the excretion of uric acid.
Avoid overeating after exercise, especially reduce the intake of high-purine foods to avoid large fluctuations in blood uric acid.
Do not take a bath or drink cold drinks immediately after exercise. This will cause a sharp drop in the temperature of the skin or stomach, vasoconstriction, and unstable urate crystals in the tissues, which may induce gout.
In short, life lies in exercise, and exercise is good for health.
Patients with gout should formulate scientific and reasonable fitness plans under the guidance of professional doctors to promote overall physical and mental health.
Text/Zhao Yi (Xuanwu Hospital, Capital Medical University)