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It seems like many posts I read here include some sort of warning to check your SUA regularly, “or else.” Is that simply because insight on one's SUA can provide a warning of impending attack or is there more to it than that?
If one has no gout symptoms, is there any inherent health risks per se strictly due to elevated SUA alone?
The official line is that high uric acid without gout symptoms (asymptomatic hyperuricemia), should not be treated.
I have two issues with that.
The first is that high uric acid, though not harmful of itself, is associated with high risk of heart disease, stroke, etc. I do not mean to imply that lowering uric acid will reduce the risks of these other disease. However, knowing the risk should compel physicians to implement a regular monitoring procedure for associated diseases. This is way beyond the scope of my knowledge, but I would advise people with high uric acid to talk to their doctor about appropriate screening every year.
More importantly, recent research on imaging scans (specifically DECT) has revealed tissue damage in asymptomatic joints (Gouty Tophi & Bone Erosion). It is clear that there have been no long-term follow-up studies on so-called asymptomatic hyperuricemia (though I'm happy to be proved wrong). Given that asymptomatic high blood pressure is an immediate candidate for treatment, I fail to see why the same risks for gout patients are written off so lightly.
We know that uric acid crystal deposits can take years to develop to the point of causing gout flares. Why wait for that to happen when it is so easy to prevent?
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Bloody good question though
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