Nutrihuang.com TCM and Gout for OEM
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Traditional Chinese Medicine for Gout and Uric Acid has Scientific Backing

Uric Acid is the chief end product of purine metabolism. Purines are constituents of nucleic acids. Most uric acid is synthesized in the liver, in a reaction requiring the enzyme xanthine oxidase. Uric acid travels through the blood to the kidneys, where filtration, absorption and secretion will affect uric acid excretion. Organ meats, legumes and yeast are especially high in purines. Those who suffers from gout and uric acid problems should avoid such type of food.

Uremia can be described as symptoms and physical abnormalities that result from the kidneys’ failure to remove nitrogenous waste products like uric acid normally excreted in the urine. The toxic effects of uremia because of excessive uric acid affect virtually all human organs e.g. renal failure. The most common symptoms are high blood pressure, swelling (edema) of the ankles, nausea, vomiting and weight loss. Anemia is almost always present because high blood levels of urea, one of the nitrogenous substances, shortens the life span of red blood cells. Other symptoms may include irritation of the heart sac (pericarditis), bleeding, muscle twitches and itching (pruritus). In the later stages, uremia causes agitation alternating with stupor, convulsions, coma, and ultimately death. Analysis of blood chemistries show elevated levels of urea, creatinine, uric acid, phosphorus and hydrogen ion.

The journey to our gout and uric acid problems begins with our consumption of synthetic materials that affect the health of our organs. For example gastrointestinal problems, liver toxicity, and renal complications can be caused by side effects of painkillers (including those for fevers). Pain killers also affect our blood. In ancient time people take herbs to reduce fever but these active herbal ingredients are synthesized to form synthetic chemical that left behind side effects. Synthetic willow bark sap is "aspirin." These synthetic particles settle in various organs or systems.

Renal symptoms such as renal hypertension or weak kidneys are caused by toxicity in the urine for example excessive uric acid which damages the kidneys. The kidneys' main mission is to filter impurities like uric acid from the blood. The kidneys keep the individual's water, urine and alkaline level balanced at a certain pH. When the kidneys become dysfunction and unable to work efficiently to filter our blood, it can cause our uric acid and other residues to remain in the kidney or unable to be expelled. Uric acid poisoning will damage the kidneys or cause urinary tract obstruction or kidney stones. In the clinic we will see these effects of uric acid problems manifest as edema, usually in the foot and ankle.

In the long run gout and uric acid will affect the liver function. The liver becomes thicker and sometimes develops inflammation. The liver produces bile. When the liver's ability to function is insufficient it will indirectly influence the gall bladder's bile secretion. Therefore the gall bladder system will also be damaged.

There is some evidence that anti-inflammatory chemicals obstruct the ability of cartilage cells to heal. Anti-inflammatory products only cover up the pain and at the same time impair the healing process. Symptomatic relief will eventually worsen the problem.

So painkillers can affect our digestive system, cause the dysfunction of our liver and kidney system.

Problems of High Uric Acid

Uric acid is a semisolid compound that is a nitrogenous end product of protein and purine metabolism and is a nitrogenous component of urine. Uric acid  is a white, odorless, tasteless crystalline substance. Uric acid is a very weak organic acid that is barely soluble in water and insoluble in alcohol and ether. Under normal circumstances uric acid is present in human urine only in extremely small amounts. Uric acid  can sometimes collects in the human kidneys or bladder in calculi, or stones. Uric acid levels can increased following excessive intake of food rich in purines (animal liver), primary synthesis in certain diseases (gout) and restricted renal excretion (renal diseases).

When the body has too much uric acid, it can cause problems like kidney stones or gout. Uric acid can also damages the kidneys and cause kidneys failure because humans do not possess the enzyme to digest it to a soluble form. Gout is the result of uric acid crystals depositing in the joints, especially feet and hands, causing a painful inflammatory response. Gout is a type of arthritis. If uric acid problem is left untreated, it can become chronic and result in deformity.

Primary gout occurs most frequently in middle-aged males and is passed as a familiar or hereditary trait which for some unknown reason does not appear as often in females. Gout and uric acid problem is nine times more common in men than in women. Approximately one million people in the United States suffer from attacks of gout.

While an elevated blood level of uric acid (hyperuricemia) may indicate an increased risk of gout, the relationship between high uric acid in the blood and gout is unclear. Many patients with high uric acid in the blood do not develop gout, while some patients with repeated gout attacks have normal or low blood uric acid levels. Among the male population in the United States, approximately ten percent have high uric acid in the blood. However, only a small portion of those with high uric acid in the blood will actually develop gout or uric acid problems.
 

Causes and Symptoms of Gout and Uric Acid Problems

As a result of high levels of uric acid in the blood, needle-like uric acid (urate) crystals gradually accumulate in the joints. Uric acid (urate) crystals may be present in the joint for a long time without causing symptoms. Infection, injury to the joint, surgery, drinking too much, or eating the wrong kinds of foods may suddenly bring on the symptoms, which include pain, tenderness, redness, warmth, and swelling of the joint. In many cases, the gout attack begins in the middle of the night. The pain can be very excruciating. The inflamed skin over the joint may be red, shiny, and dry and the inflammation may be accompanied by a mild fever. These symptoms may go away in about a week and disappear for months or years at a time. However, over the course of time, attacks of gout recur more and more frequently, last longer, and affect more joints. Eventually, stone-like deposits known as tophi may build up in the joints, ligaments, and tendons, leading to permanent joint deformity and decreased motion. (In addition to causing the tophi associated with gout, hyperuricemia can also cause kidney stones, also called renal calculi or uroliths.)

Source of Uric Acid

Foods rich in uric acid are shellfish, organ meats, red meat, certain types of fish and vegetables. Certain products like alcohol can aggravate uric acid or gout problems

Treatment for Gout and Uric Acid Problems

The goals of treatment for gout and uric acid problem consist of alleviating pain, avoiding severe attacks in the future, and preventing long-term joint damage. In addition to taking pain medications as prescribed by their doctors, people having gout attacks are encouraged to rest and to increase the amount of fluids that they drink.

Acute attacks of gout can be treated with nonaspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen sodium (Aleve), ibuprofen (Advil), or indomethacin (Indocin). In some cases, these drugs can aggravate a peptic ulcer or existing kidney disease and cannot be used. Doctors sometimes also use colchicine (Colbenemid), especially in cases where nonsteroidal anti-inflammatory drugs cannot be used. Colchicine may cause diarrhea, which tends to go away once the patient stops taking it. Corticosteroids such as prednisone (Deltasone) and adrenocorticotropic hormone (Acthar) may be given orally or may be injected directly into the joint for a more concentrated effect. While all of these drugs have the potential to cause side effects, they are used for only about 48 hours and are not likely to cause major problems. However, aspirin and closely related drugs (salicylates) should be avoided because they can ultimately worsen gout.

Once an acute attack has been successfully treated, doctors try to prevent future attacks of gout and long-term joint damage by lowering uric acid levels in the blood. There are two types of drugs for correcting hyperuricemia. Uricosuric drugs, such as probenecid (Benemid) and sulfinpyrazone (Anturane), lower the levels of uric acid (urate) in the blood by increasing uric acid removal from the body (excretion) through the urine. These drugs may promote the formation of kidney stones, and they may not work for all patients, especially those with kidney disease. Allopurinol (Zyloprim), a type of drug called a xanthine-oxidase inhibitor, blocks the production of uric acid in the body, and can dissolve kidney stones as well as treating gout. The potential side effects of allopurinol include rash, a skin condition known as dermatitis. vascular, kidney and liver dysfunction. Once people begin taking these medications, they must take them for life or the gout will continue to return.

So your taking more uric acid and gout "treatment" products only further aggravate the uric acid problems in our body.

For TCM the treatment involves improving the functions of the kidneys, liver and blood circulation, stop the inflammation (reduce the pain) as well as removing the blood toxicity (high uric acid).

Herbs: Herbs rich in flavonoid compound have been found to help lower uric acid levels in the body. Flavonoids are effective in decreasing inflammation and preventing and repairing the destruction of joint tissue. Herbs have been proven to be able to reduce uric acid levels and to relieve joint pain. High uric acid level in the blood represents a serious strain on the kidneys. Herbs can be used to support kidney functions.

Using herbal formulation is the best alternative to treating uric acid and gout problems as they are designed to be holistic in nature: pain caused by gout has to be treated, uric acid has to be removed, blood circulation, gall bladder, kidneys and liver functions have to be improved. Chinese medicinal herbs have more advantages in treating uric acid problems as they provide holistic treatment and restoration and have no toxic side effects. Using Chinese medicinal herbs for the treatment of uric acid disorder has been done for centuries.  

Herbs like Poria Cocos Wolf, Radix Gentiana, Radix Ledebouriella, Herba Lysimachia Christinae, Herba Artemisa Scoparia, Uncaria Rhynchophylla, Folium Taraxacum Mongolicum, Salvia Miltiorrhiza and Panax Notoginseng have been traditionally used for uric acid and gout problems, improve the function of the liver and protect the kidneys from uric acid damage.

Poria Cocos Wolf:

1) Clinical research by western scientists from Japan has shown that Poria cocos has anti-inflammatory functions. 20314

2) Research by western scientists from Spain has shown that Poria cocos is effective in treating  chronic and acute inflammation. 25140

3) Clinical research by western scientists has shown that Poria Cocos Wolf has   immune-enhancing activity. 65424

4) Clinical research by western scientists has shown that Poria cocos has strong anti-tumor effect (antioxidant). 84472

5) Clinical research by western scientists have shown that Poria Cocos have anti-inflammatory functions, high scavenging activity and protects liver and red blood cells from lipid peroxidation. 60151

6) Clinical research by western scientists has shown that Poria cocos has anti-inflammatory functions and protects red blood cells from AAPH-induced hemolysis (affected by microorganisms). 160 - 162

7) Clinical research by western scientists has shown that Poria cocos improves kidney functions. This would protect the kidneys from being damage by uric acid. 07662

Lysimachia Christinae: Clinical research by western scientists has shown that aqueous extract of Lysimachia christinae possesses potent hypouricemic (meaning removing uric acid) effects on models of hyperuricemia in mice pretreated with oxonate. 41944 

Artemisia Scoparia:

1) Clinical research by western scientists has shown that Artemisiae species were proven to have immunosuppressive principles, some of them were now used clinically for the treatment of rheumatoid arthritis. 41992

2) Clinical research by western scientists has shown that this herb is effective for treating liver diseases. Research showed that scoparone from Artemisa Scoparia decreases the production of the inflammatory mediators such as NO and PGE2 in macrophages by inhibiting iNOS and COX-2 expression. 203-8 

3) Another group of scientists wrote "these data indicate that the plant artemisia scoparia is hepatoprotective and validate the folkloric use of this plant for treating liver problems". Research showed the protective action of the plant extract against CCl4-induced liver damage. 41001

4) Clinical studies by western scientists have shown that Artemisia Scoparia has strong anti-inflammatory function. Research demonstrate that the inhibition of scoparone on LPS-induced TF expression in HUVECs may mediate by the mechanisms suppressing superoxide anion formation and TF transcription.  72379

5) Clinical studies by western scientists have shown that Artemisia Scoparia  has strong hepatoprotective function against alcohol-induced hepatotoxicity (protects the liver). 75739

6) Clinical studies by western scientists have shown that the flavonoid rutin from Artemisia Scoparia  has strong hepatoprotective function against drug-induced (paracetamol) hepatotoxicity (protects the liver). 90212

7) Clinical studies by western scientists have shown that Artemisia Scoparia  has strong hepatoprotective function against drug-induced (Acetaminophen) hepatotoxicity (protects the liver). 12519

8) Clinical studies by western scientists have shown that Artemisia Scoparia  has strong hepatoprotective function against chemical-induced (carbon tetrachloride) hepatotoxicity. Research showed that Artemisia Scoparia inhibited fibrosis and lipid peroxidation induced by carbon tetrachloride (protects the liver). 33139

9) Clinical studies by western scientists have shown that Artemisia Scoparia  has strong antioxidative and cytoprotective actions. Clinical studies showed that the strong antioxidative functions of Artemisia Scoparia effectively protected liver tissues against the dimethylnitrosamine-induced hepatic fibrosis (protects the liver).  06248

Uncaria Rhynchophylla: Clinical research by western scientists have shown that Uncaria rhynchophylla can be used to lower blood pressure and to protect and relieve various neurological symptoms. Research showed that U. rhynchophylla extract inhibited TNF-alpha and nitric oxide production in BV-2 mouse microglial cells in vitro. These anti-inflammatory actions of U. rhynchophylla extract may contribute to its neuroprotective effects. 28929

Folium Taraxacum Mongolicum: Herbs like Folium Taraxacum Mongolicum is rich in vitamins and minerals. The leaves have a very high content of vitamin A as well as moderate amounts of vitamin D, vitamin C, various B vitamins, iron, silicon, magnesium, zinc, and manganese.

The leaves are a rich source of potassium, which is interesting since they are used for their diuretic action. This may make Folium Taraxacum Mongolicum the only naturally occurring potassium-sparing diuretic, although its diuretic action is likely different from that of pharmaceuticals. At very high doses, the leaves have been shown to possess diuretic effects comparable to the prescription diuretic frusemide (Lasix).

Folium Taraxacum Mongolicum leaves and roots have been used for hundreds of years (since the 3rd century) to treat problems of the joints, liver, gallbladder, and kidneys. In some countries, Folium Taraxacum Mongolicum is considered a blood purifier and is used for ailments such as eczema and cancer. Folium Taraxacum Mongolicum has also been used historically to treat poor digestion and diseases of the liver. Folium Taraxacum Mongolicum has two particularly important uses: to promote the formation of bile and to remove excess water from the body. The root affects all forms of secretion and excretion from the body. It acts as a tonic and stimulant by removing toxins and poisons from the body and increases the flow of urine in patients with liver problems.

The principal constituents responsible for Folium Taraxacum Mongolicum’s effects are its bitter principles. Previously referred to as taraxacin, these constituents are:

Sesquiterpene lactones — eudesmanolide, and germacranolide types.
Triterpenes — taraxol, taraxerol, beta-amyrin
Phytosterols — taraxasterol, , stigmasterol, beta-sitosterol
Phenolic acids — caffeic and hydroxyphenylacetic acids
Fatty acids — myristic acid
Carbohydrates — glucans, mannans, inulin,
Sugars — fructose, glucose, sucrose
Carotenoids — lutein, violaxanthin
Flavonoids — apigenin, luteolin
Miscellaneous — choline, mucilage, pectin

Research scientists says: "Folium Taraxacum Mongolicum helps the liver and kidneys to do their work and keeps the bowels in a healthy condition. Aside from its efficacy in the treatment of kidney and liver disorders, it may also be used to treat inflammation and congestion of the liver and gall bladder by stimulating them. Because of its ability to reduce high uric acid levels, it is an effective treatment for gout. Because Folium Taraxacum Mongolicum is one of the best natural sources of potassium, it is a perfectly balanced and safe diuretic. Taraxacum root contains bitter elements that may stimulate digestion through the stimulation of gastric and salivary juices. Considered one of the best liver tonics, it stimulates the liver to create bile and stimulates the gall bladder to release the stored bile. This increased flow of bile, combined with the action of the triterpenes that may increase the solubility of the bile, makes Taraxacum a good herb for cleansing and removing of toxins. "

1) Susnik F. The present state of knowledge about the medicinal plant Taraxacum officinale Weber [in Slovak; English abstract]. Med Razgl. 1982;21:323–328.

2) European Scientific Cooperative on Phytotherapy. Taraxaci radix (dandelion). Exeter, UK: ESCOP; 1996–1997:2. Monographs on the Medicinal Uses of Plant Drugs, Fascicule 2.

3) Bohm VK. Studies on the choleretic action of some drugs [in German, English abstract]. Arzneimittelforschung. 1959;9:376–378.

Salvia Miltiorrhiza:

1) Clinical research by western scientists confirmed the validity of the historical use of the drug for improving liver functions.  566-572(7)

2) Clinical research by western scientists confirmed the validity of the historical use of the drug, Salvia Miltiorrhiza for improving liver functions by preventing liver damage and micro-circulation disorders. 41991.

3) Scientists confirmed the validity of the historical use of the drug to improve heart and kidneys functions, promoting coronary blood flow without affecting heart rate, inducing dilation of renal vascular system, an increase in renal blood flow and glomerular filtration rate, decreases blood urea nitrogen, serum creatinine, methylguanidine, guanidinosuccinic acid and inorganic phosphate (in rat studies), is a free radical scavenger, inhibits platelet aggregation and reduces accumulation of methylguanidine and guanidinosuccinic acid levels (methylguanidine and guanidinosuccinic acid have been reported to cause platelet dynfunction, hemolytic activity, glucose metabolism disturbance and inhibition of lymphocyte transformation). 1527-0661  

4) Clinical research by western scientists from Taiwan showed that