Q&A 3/2/23 Arthritis and Uric Acid


Coming Soon


00:00 Introduction

04:25 Uric Acid blood test

05:58 Uric acid and cardiovascular disease connection

10:01 Physiological effects of uric acid

11:23 Foods that increase uric acid

11:54 Alopurinol medication

14:28 Colchicine

16:42 4 Stages of high uric acid

20:29 Vitamin C

21:45 Quercetin

24:44 Luteolin

27:09 Tart Cherry

28:00 Celery Seed

29:17 Apply Polyphenols

Transcript from Webinar:

Before we get started, I just want to remind everyone. Please invite your friends, family, enemies, whoever, to everybody to check in with us here on the webinar. The more, the merrier. We’re getting good questions. And, you know, I love getting the word out to as many people as possible. So. Uh, please let people know. Contact someone today or tomorrow and say, hey, you know, you might want to check this out because obviously the vast majority of people don’t know we’re on the air. Uh, 99.999% at least.

So here we are on another Thursday afternoon, and I’m going to talk about some stuff that’s very important to me. It’s the kind of thing that isn’t generally important to other people until they have a problem with it. And then it’s like, oh my goodness, what can I do? So, what I want to do is talk to you about. Catching things early. Always. And this is the whole point of Chinese medicine. Well, not the whole point, but a key critical point of Chinese medicine is to treat. The illness that is unmanifest or to treat the unmanifest illness. Meaning? Well, there are several apocryphal stories. I’m assuming apocryphal, but they’re accurate.


Were a doctor in China to be brought up to get some awards for being such a great doctor. And they’re, you know, they’re doing speeches about him and how great he is. And he says, “Oh, you know, I don’t deserve all of this attention.” He’d say, “I treat, you know, of me because I treat people who are sick and help them get well. But my father was a much greater physician because he would treat people at the very first sign of possible illness. But he paled in comparison to my grandfather, whose patients never got sick.” And so, in our culture, we are an illness based medical culture. You know, there are many groups that kind of pay lip service to preventive medicine. In my experience, most of them are not very preventive.


Our book is now getting closer and closer to coming out, you know, there’s always more stuff, but it’s in formatting right now, which means there’s only two more steps formatting in a cover and it will be out in that we go into this, you know, how do you look at your own blood tests and with just a basic knowledge, you can look at it and see if you’re in the best possible ranges for long term good health.  You can’t get that by looking at a standard blood test unless it has the functional medical ranges because the ranges are far too large. They extend well outside of the sweet spot of maximum health. So that’s really the point. And so that’s why I’m doing this particular talk today. I’ve had several questions about these issues and so I want to do try to do service to the issue of uric acid.


Kathryn sent out a newsletter last week. So, we got from that quite a few. Questions. Then she sent out another newsletter today that went into a little more depth. So, I’m going to go through her newsletter and talk about uric acid and gout.


One of the problems. Is that most people only become concerned about uric acid after they develop kidney stones that are debilitating or gout, which is horrible condition. It’s just talk about painful. It is really excruciatingly painful, and most people never look at or are concerned with uric acid until those happen. We run a uric acid as a standard test on most of over 50% of the blood tests that we run. It’s a very inexpensive test to add on and it’s a very, very important thing to understand and to know your levels.


Now, if someone comes back with a perfect level the first time, we may not run it again, because if you’re in a great level, it means you probably don’t have the genetic issues that will lead to high uric acid and gout.  If you come out anywhere near high or low, then we’re going to run that every time we run a blood test. So, I’m going to share my screen with you. And we’ve got a couple of questions that came in that I probably am not going to have a chance to get to because I really want to get any questions on this particular issue.


Everybody. Please give a big cheer and a round of applause. Today is Kathryn’s birthday. 29 going on 30. Please wish her a happy birthday.


We’re going to talk a little bit about arthritic pain in general, but primarily arthritic pain caused by high uric acid levels. So, in the previous newsletter, we talked about the importance of doing your uric acid test and the correlation with arthritic pain. I’m going to go into a little more detail about that.  It was over a century ago, the Scottish physician Haig spoke about the connection between uric acid levels in the body and cardiovascular health. Okay, so he’s not saying gout and he’s not saying kidney problems and he’s not saying kidney stones. He’s saying cardiovascular health. The cardiovascular damage done by uric acid is occurring long before someone gets the symptoms of gout. Gout is the more extreme case of this.


About 3 million people in the United States, I believe about 3 million, test positive for gout, but I think it’s a much higher percentage because most people are not getting their uric acid tested.  So even though I see it at 4 to 6%, I think it would probably turn out to be over 10% if people actually got their uric acid level checked. So anyway, it doesn’t just cause kidney stones, it doesn’t just cause gout. It’s also involved in cardiovascular and kidney disorders. So uric acid is an end product of a whole string of metabolic processes.


When Kathryn first put this in here, she had them all kind of laid out, and you’d have to be a biochemist really to understand a lot of them. But it has to do with the inability to process purines properly. Purines are found in many foods that are found in alcohol, but things like organ meats are very high. Meat in general is pretty high, high fructose corn syrup. So quite a few foods that are rich in purines though certain seafoods. So those purines should get broken down and they’ll break down into xanthine oxidase and that should be cleared from the system. But with certain genetic problems, that process of breaking down purines and getting rid of xanthine oxidase isn’t carried out properly and we get a buildup of uric acid in the body.


Uric acid, as its name implies, is an acid. So, you’ll basically your bloodstream and your tissues will become more acidic, which is pretty much always bad, right? You don’t want an extremely acidic environment. You would like it to be more alkaline than acidic. Again, as we point out here with most as with most blood tests, there’s a sweet spot, right? So, a ‘U-shaped curve’. So, you take the letter U and in mortality tables. The lowest level of mortality will be in the sweet spot right at the bottom of the U. Then as you go up on either side, which means as you go lower or you go higher, either way, the mortality curve kicks in and the death rate is higher.


When you start looking at the sweet spot, which is where people are the healthiest versus the so-called standard ranges, you can have a massive increase in deaths and still be within the standard ranges. So, it’s very important and low. Uric acid is also a problem. There’s a higher dementia risk, higher some other risks than a perfect uric acid level. And then as we get higher, then we get all the problems with cardiovascular disease, kidney disease, kidney stones, gout. ET cetera.


Now uric acid has a whole bunch of physiological effects: it modulates or regulates immune responses. It regulates blood pressure. Now, there are many factors affecting everything. I’m listening here, but uric acid will affect all of these. Controlling the balance between antioxidants and pro-oxidants in the body. Antioxidants, of course, are cleaning up the inflammatory molecules where pro-oxidants are creating more inflammatory molecules.


So basically, either by excessive intake of foods that lead to high uric acid, again, those are the purine rich foods, or by the body’s inability to excrete significant levels of uric acid you can develop uric acid-related problems. Generally, it’s both. You don’t process purines well and you can’t pee them out. And most of these are eliminated through urine, some of them through feces, some of it’s through pieces. But the kidneys have to filter a lot of this. And so again, generally it’s a problem of both of those factors. Now, red meat can increase purines organ meats a lot more even than red meat, some seafood, high fructose corn syrup. One of the worst I’ve seen for that is beer. A beer is… I have patients that if they have one beer, they can’t walk because it kicks up their gout so much.


Let’s talk about some treatment options and we’re going to look at some pharmaceuticals and then some natural supplements and foods. If you go to your doctor, basically they will give one of two options. The most common is allopurinol. Allopurinol works on that xanthine oxidase system and helps clear the xanthine oxidase from the system which keeps the uric acid levels down. And this is very common. Some people take this daily. Some only take it when they have symptoms of gout. If one is taking it, I think it’s probably better to take it more regularly. It’s a relatively safe medication, although there is no perfectly safe pharmaceutical, they don’t exist, so there are some adverse effects that can occur.


One of the things that happens is when people first start taking the medications for gout, it will start breaking down the deposits. as those deposits become destabilized, some of the uric acid deposits. And so, I’m going to go into some more detail in a minute. If the uric acid builds up and gets too high, it will throw the PH of your blood off to the point that you could die. It could form stones or actually really, really sharp crystals of urate that get stuck in the joints, incredibly painful.  There’s also something else called tophi, which are the same chemical material, but they’ll just form something like little bumps. A lot of people will have bumps along their feet, those are tophi. When the uric acid goes back into solution there could be an increased incidence of acute gout flares, especially in the first few months.  It’s important to note too that allopurinol can also increase a thyroid-stimulating hormone which might result in subclinical hyperthyroidism. So, you need your thyroid checked if you’re going to be on allopurinol. You should also have your uric acid checked quite often.


Now colchicine is a much stronger drug and it’s for gouty prophylaxis prevention and usually only people that have are pretty serious along the gout spectrum. And then treatment of acute flares, it’s primarily anti-inflammatory, but it has quite a few toxic effects. Again, I’m not going to go into what this means necessarily, but it actually affects proliferating tissue or fast-growing tissue. It has an effect on them and changes how cell division occurs. The most common adverse reactions are GI problems, but there are some others also.  Though medications are the most common form of treatment, recent research has shown that there are some amazing herbs and supplements that have been shown to lower uric acid levels, and if it lowers uric acid levels, it will lower gout problems.


When we’re looking at. Gout. As the uric acid goes up, the crystals will form in solution, then the crystals will come out of solution and get into the joints. When that happens, the body sees that as a foreign invader, so it sends white blood cells out to attack it. The crystals then pop the cells actually, and the cells released proteins which are cytokines. Interleukins are chemicals that increase inflammation quite radically. And one of their purposes is it’s like a fire. You send out the first fire truck and they say, ‘Oh, we can’t handle this’. And so, they send in more alarms to the fire station. As a response more white blood cells are released, which causes more inflammation and more pain, which causes the pH level to go down, meaning it becomes more acidic, which causes more crystals to form.


So, it’s a really nice circular process or a really evil circular process if you wish. And so, what we see is there are basically four levels of gout. One is the increase in uric acid that is silent. You won’t know it. It’s damaging your blood vessels, damaging the kidneys, forming kidney stones, forming the crystals. But it has not risen to the point where you’re having pain from any of those. Then you get an acute attack, which is where you could get a gout attack. The most common location, about 50% of the time the attack is in the great toe in the joint. It’ll get hot and red and incredibly painful. But gouty deposits can happen anywhere. They can happen in your neck. They can happen in your wrists. They can happen in your ankles. I’ve had patients who had huge stones cut out of their thigh, which the doctor had no idea that was there. They just saw something, and they opened them up and there was this huge gout crystal so it can go anywhere.


But if you wake up with a red swollen toe, especially the big toe, assume you have gout and get some treatment for it. So, the third stage of gout is called inter critical. So that’s when you’re not having an acute attack. The uric acid is still high, but it’s not acute. You’re not having this huge inflammatory response. And then the fourth stage is chronic and that’s where you form the tophi, the little lumps, you form kidney stones, et cetera. So that’s kind of where that goes. Now, when I talked about those proteins that are getting released, they’re chemical messengers, cytokines, interleukins those can be tested for. I mentioned this in a couple of broadcasts. Those can be tested for and those are things that actually will cause inflammation.  Be aware, though, the gout itself may calm down, but you may still be releasing the Interleukins.


In my case, I have gout, I have stage three arthritis in my right foot, meaning the bones are somewhat decayed. But if I eat all the right things, don’t eat the wrong things and take a couple of supplements, I’m pain free. Okay. So, I’m living proof that this stuff actually works and I’m going to talk about what some of those supplements are. But first, get your uric acid tested. It should be on every test that’s run. It’s less than $5. Yeah, it’s very inexpensive.


So, Ortho Molecular Products, which is one of my favorite companies, I think they have probably the best research arm. We have 3 or 4 companies that have very good research and science departments. However, I really like Ortho Molecular a lot and they’ve recently come out with a new supplement called UA-X Pro. And the thing I love about UA-X Pro is that because I’m like many of you and I don’t like taking a lot of capsules and pills, this one capsule, actually I usually take three, but this one thing replaces four other things that I used to give to people and very effectively. So, it’s much, much easier to use. The compliance is much higher and again, very effective. Now, there’s tons of science around this, each of these individual ingredients. 


In randomized controlled trials. They found that vitamin C supplementation as a very significant effect on lowering serum uric acid levels. Our old buddy vitamin C, right. There’s a 20-year-old study that was in the archives of Internal Medicine. 47,000 males found that those taking vitamin C had a 44% reduced incidence of uric acid. If you reduce uric acid by 44%, you’re pretty much guaranteed of never having a gout attack. That’s almost miraculous. And of course, vitamin C does so many other magnificent things and it’s so inexpensive. And I have to apologize. I’ve been recommending vitamin C for 50 years, and it’s kind of my assumption that people are taking it. So sometimes I forget to suggest that people take it. It’s just kind of assumed.  It’s like, don’t forget to drink water and breathe and then pee occasionally, right? It’s just so much a part of the background. So, vitamin C very effective at reducing uric acid.


Quercetin, we went through massive amounts of quercetin over the last three years with the pandemic. Quercetin is a very powerful zinc Ionophores. It pulls zinc into the cells, stops and or at least greatly limits the replication of viruses. But it does tons of other things. Now Quercetin is found in a lot of the foods that you eat onions, apples. ET cetera. But you’d have to eat a bushel of apples to get the amount of quercetin that you need to deal with the gout. Okay. We use massive amounts of quercetin. It inhibits advanced glycation end products. Cool, huh? Ages.


So, glycation end products. Glycation is a process where sugar gets attached to things and generally in the body, we worry about it when it gets attached to the red blood cells, but also to some other proteins and they are massively harmful. Create harmful oxidative byproducts and just really nasty.  Quercetin inhibits a lot of those. Quercetin has been shown to inhibit the actions of xanthine oxidase Reductase don’t need to remember that which is the limiting step in the body’s production of uric acid. So, when they say a limiting step, that means if this is present, it limits how much will be produced.


In one 2016 study daily Quercetin at 500mg resulted in significantly lowered uric acid levels. Now we typically during the pandemic have recommended 4 to 500mg of quercetin as an antiviral and for other reasons, the study of individuals at risk for cardiovascular challenges showed a statistically significant effect of quercetin in maintaining blood pressure. Okay. And the proper ranges. Now we know that uric acid in excess will contribute to high blood pressure and here we’re seeing that if we’re doing quercetin, it will help lower that blood pressure.


Here’s my new favorite. You know, every month I’ve got a new favorite. And like, my favorite inflammatory chemical is interleukin six. I find it everywhere. And it’s my pride. It’s what I have. And if I take supplements that limit interleukin six, I don’t have pain. If I get cocky or forget to take my supplements to keep my interleukin six levels down, then I suffer. So that’s my favorite. Um, interleukin inflammatory chemical for this month.


Luteolin is my favorite antioxidant and bioactive ingredient for this month. Now, Luteolin’s been known for a long time, but there’s been a surge in research lately. Again, it’s in fruits. It’s in vegetables, It’s all over the place. One of the richest sources is actually olive oil. I’ve recommended olive oil for a while, you know, decades. But now I’m recommending it even more because of the luteolin content of it. It’s one of the two major chemicals that we look for in olive oil. Additionally, the luteolin content is probably one of the major factors in the Mediterranean diet, extending lifespan and lowering inflammation and pain.


So, just to review, the luteolin and again, this inhibits that enzyme that we talked about the xanthine oxidase reductase enzyme. So very powerful for that. This alone has been shown to have uric acid lowering properties that are comparable to traditional therapies, traditional not being actually traditional, but being drugs. It’s as good as the drugs. If you add these all together, they’re astonishingly effective and each one of them independently is good for you. Luteolin is good for you, Quercetin is good for you. Vitamin C is good for you. And they all help prevent gout and high uric acid. In one double blind placebo-controlled study from 2017 of people with uric acid problems. It found that if you ingested luteolin for four weeks it tremendously decreased serum uric acid levels. Flavonoids are really a hot topic because they help to maintain normal inflammatory balance and antioxidant properties and luteolin and specifically has shown to be liver protective against uric acid free radical stress.


So again, you should be hearing that uric acid damages everything. (emphasis added)


Another ingredient is tart cherry. Most people do tart cherry juice. They contain anthocyanins. So, any of those blue purple colors, blackberries, blueberries … Raspberries, even have high anthocyanin levels. That’s what gives them the color.  These have tons of health benefits, including lowering uric acid levels. One study showed that low dose of tart cherry powder decreases uric acid and supports kidney function. Another study in 2021, showed that tart cherry decreases uric acid, and a single capsule is very effective for lowering uric acid.


Then we get to one of our favorites here. Celery. Celery has been known to reduce pain for hundreds of years, and it’s probably primarily through lowering uric acid levels. And so, it helps maintain normal inflammatory balance. Specifically, celery seed has been shown to reduce levels of the xanthine oxidase issues. And so, I’ve been taking celery seed extract capsules for a while. Usually, you know, I’m, I’m just like my patients. I will forget it until I start feeling bad and then I’ll pump it up again. Um, celery seed you need to do as an extract. I’ve never found anybody that can actually eat celery seed. It’s so bitter. Eating a lot of celery is helpful. We know that celery is good for the heart. And again, part of that is because it lowers uric acid levels, so it also increases what’s called superoxide dismutase or SOD and glutathione peroxidase. Two of the major, major, very powerful antioxidants that reduce inflammation in the system. Okay. Cool words.


Okay. Apple polyphenols in a study here where they gave patients 300mg of Apple polyphenols they found. So, get this, a positive effect on vascular oxidative stress. Okay. Oxidative stress on your vascular system. Very bad. That leads to heart and cardiovascular and brain problems. It helped endothelium function. So that’s the lining of the blood vessels got healthier in a future show. I’m going to talk a little bit more about the glycol Calyx, which is now the hot new topic in cardiovascular stress, and it helps maintain healthy blood sugar again by the XOD issues now. It’s really important to do this. If you have gout or you have a tendency toward kidney stones, then see your natural practitioner.


Western medicine does not have totally safe treatments for any of these. Alternative medicine does. We have things that are effective and are very safe and our health giving beyond their benefits of lowering uric acid levels. Okay, so love to talk about this forever. It’s such a big issue. And again, there’s a Cyto-DX panel that can be run to see for a little over $200 that goes through many, many of these interleukins and cytokines to see if any of those are high in you in particular. Very good panel.


Anymore, I want to say about uric acid. Kathryn?


Kathryn: No, there is a comment that luteolin and quercetin are shockingly molecularly similar.


John: That’s correct. Yes!


Kathryn: They may not hear me.


John: Oh, there was a comment that luteolin and Quercetin were very, very similar, I think. I believe there’s only one spot where they actually differ. They’re extremely similar, but they are different enough that they have slightly different qualities, but both great. Yeah.


Kathryn: Yeah. And someone’s asking me, ‘what is that panel?’


John: It’s called a Cyto-DX. We order that from a company called Rupa. And it’s very simple. If you want to run it, we just give them your contact information. They contact you with everything you need to have, and they handle everything from there. And then they send us the panel. We’ve found it very informative. We’ve had patients that were given very strong drugs … for example, TNF Alpha, which is one of the major inflammatory chemicals. Turns out they didn’t have high TNF alpha, they had high interleukin six. So, the drugs they were given would have been very potentially damaging and they wouldn’t have done any good. And we were able to give them supplements for interleukin six that were very powerful. I mean, CoQ10, Coenzyme Q10 and lithium orotate just kind of off the top, fish oil are all very powerful to lower interleukin six. So, once you find out what the problem is, there are treatments for it.


The company is called Diagnostic Solutions, but we order it through another company called Rupa, we love them. They’re very efficient, very effective at what they do. And they really work hard to keep costs down. These tests, I don’t know. I never priced them, actually but they would have been 5 or $6000. There was one panel that had 3 of them that was $600 just a few years ago. So, we’re talking thousands of dollars down to about 250, I think, huge difference. So anyway, get your uric acid tested. If you’re if you’re going to go to your medical doctor or your naturopath or anybody else who does a blood test, ask them to add on uric acid. If they give you a bad time, point out that it’s less than $5 and it can be very, very illustrative of a lot of health issues and have them do it.


We ordered them all the time. We can actually order any tests that you might need. The downside is if we order it, your insurance won’t pay for it. The upside is we get incredibly inexpensive tests. We belong to a couple of clubs where we can get huge panels done for about 50 to 60 dollars. In fact, we can get your common panels, the complete blood count and your metabolic panel done, including the blood draw for less than $30. So, you know, the price of testing has come down a lot. We pay a fee every year to get the cost down even further.


Any medical provider can order that test. You can actually order it yourself. There are a variety of online testing associations now. Life Extension has that and lab tests online. You can do it. So, it’s pretty easy to come by actually. Okay.


And a couple of announcements. Once again, Kathryn’s birthday. Yay. And two: For those of you that are our patients, we have hired a new really, really, really, really good acupuncturist who’s works in all areas. She does a lot of sports medicine. But again, fertility has a good experience in fertility and facial issues. She does a lot of facial needling, as Kathryn has done also. And we have a great setup for those things here. And the really fun thing, her name is Gabi. And Gabi will be starting work at the end of this month and she’s going to be available on Sundays as well as a few days during the week. It’s going to be really nice to get someone in here on Sundays because I know my Saturdays are full and often people can’t come during the week. So, we’re looking forward to having Gabi come on board.


Any other any other questions? I want to thank people for sending all their questions, but there were a couple other questions that would require a little bit too long an answer for me to go into today. All right. So I want to thank you. I’ll be back next Thursday. We’ve got a very exciting topic next Thursday. I’m giving you a little leader here, kind of a little tease. It’s a very important topic. Um, it’s something that literally affects every single human being and is critical for your health.

So how’s that for a tease, huh? So I’ll be back at 3:00 next Thursday. And please be happy. Be healthy.


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Dr. John Nieters L.Ac, DAOM, is an acupuncturist, Chinese herbalist, functional medicine, writer, teacher, and leader in the community. In this episode, John talks about his experience with the importance of finding your vision and purpose in life, in order to create the right goals for you.

Disclaimer: Dr. John Nieters received his Doctor of Oriental Medicine and Acupuncture degree from Five Branches. His use of “doctor” or “Dr.” in relation to himself solely refers to that degree. Dr. Nieters is a licensed acupuncturist in California. This video is for general informational purposes only. It should not be used to self-diagnose and it is not a substitute for a medical exam, cure, treatment, diagnosis, and prescription or recommendation. It does not create a doctor-patient relationship between Dr. Nieters and you. You should not make any change in your health regimen or diet before first consulting a physician and obtaining a medical exam, diagnosis, and recommendation. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. TheBalancingPoint.net, Alameda Acupuncture, and Dr. John Nieters L.Ac, DAOM are not liable or responsible for any advice, course of treatment, diagnosis or any other information, services or product you obtain through this video or site.

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