Q: I am 36 years old weighing 70 kg and 168 cm tall. My uric acid is 6. I am a vegetarian, and as per my doctor's advice, I have limited taking purine-rich foods. Before starting the treatment, I had pain in my knee joints (both legs), for which I underwent a complete check-up including kidney stone levels and blood urea. The reports were normal. Currently, I am taking Zyloric 10 mg once in the night. In addition to this, I am talking a lot of water (approximately 3 litre/day) and taking light food in the night. My daily work involves too much walking, climbing stairs and standing for long hours (more than 6 hours). I have also consulted an orthopaedic surgeon, who checked my RA and took an X-ray of my knee joints. The reports were normal. How long should I take this tablet for uric acid? Also, who should I consult for further advice?

A:High uric acid is present in a proportion of normal people, mostly those who have a family history of being overweight, family history of high blood pressure, heart disease, diabetes and high cholesterol. In other words, high uric acid is a red flag warning to the person that unless the person takes care of his health, he may develop diabetes, high blood pressure, heart disease and high cholesterol levels. This combination of diseases has now been included in an over-all condition called metabolic syndrome. Good health practices include eating fresh fruits, salads and green vegetables, simple dal, chawal, roti, fat free milk and yoghurt, etc. but strictly avoiding high fatty food (fried food, rich food, refined food, sea food and red meat) and beer. Remember, uric acid does not increase by eating vegetarian food. You can eat as much dal, tomato, spinach, fruits or other vegetarian items as you like. In addition, doing regular exercise (at least 10,000 steps walk daily) would automatically bring down uric acid levels. It is important to mention that even if uric acid still remains high, it does not affect normal health and it does not require treatment with Zyloric, which achieves nothing. Zyloric is a drug to be given in a person who has had at least three episodes of acute gouty arthritis - a relatively uncommon disease with acute red-hot swelling at the base of the big toe that is so painful that one cannot even touch it with a piece of cloth (e.g. bed sheet). It is given to prevent further acute attacks. It is ironical that if by mistake Zyloric is given during acute attack of gouty arthritis, it makes it worse. The condition is so acute that the person usually rushes to the hospital with agonising pain. The only medicines that work at that stage are called non-steroid anti-inflammatory drugs. Your history does not say anything about acute gouty attack. Therefore, I do not see any reason for you to be given Zyloric. For the knee pain, please immediately contact any experienced, trained rheumatologist - physicians with special training in diagnosing and treating joint disease.