Q. My dad has pain and swelling on the big toe with high uric acid levels. Please help.

Answered by
Dr. Kaushal Bhavsar
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Aug 17, 2020

Hello doctor,

I am writing this on behalf of my father. He has lately been experiencing a bump and some inflammation at the base of his big toe (only the right foot). I have also attached some photos of the same. This has occurred on several occasions throughout the past years and he is wondering what might be causing this and what is the best way of managing the pain would be? He is currently on Perindopril arginine.



Welcome to icliniq.com.

I can understand your concern. I have gone through the images you have attached (attachment removed to protect patient identity).

This looks like skin and subcutaneous tissue infection with inflammation. I want to know a few more things first.

Let me know is he having diabetes? Is that area on toe soft on touch or hard? Does it pain when touched? Any pain while moving the toe? Please reply with answers to the above-asked questions so that I can guide you better.

Thank you doctor,

My father had run some tests and it turned out he had a very high uric acid concentration. He was put on some medication and the problem subsided nicely.

The doctors were not quite sure what might have caused this. I have attached some other blood test results (unfortunately, he did not get a printout of the uric acid numbers. Plus the values are written in Estonian, so I do not know if they are of much help but hopefully the words are more or less similar to English). Are there any known factors that contribute to high uric acid and what should he generally do to avoid a repeat of this kind of situation?



Welcome back to icliniq.com.

Most common cause for high uric acid is high protein intake. So please restrict the protein intake. Another reason is high cholesterol and borderline diabetes. Is he taking any lipid-lowering drug? Is he taking anything for diabetes?

Thank you doctor,

He is currently only on Perindopril to lower his blood pressure. He has not been tested for diabetes but as per your suggestion is going to as soon as possible. Blood tests for cholesterol came back as follows:

Cholesterol: 4.8 mmol/l.

LDL: 2.7 mmol/l.

HDL: 1.1 mmol/l.

Triglycerides: 3.22 mmol/l.

The high triglycerides numbers seemed to be the most concerning. Is it generally something to be worried about? And if so, what could be done to lower it?



Welcome back to icliniq.com.

Yes, triglycerides are high. The best and natural way to reduce triglycerides are diet and exercise. Is he able to do any sort of exercise like walking or cycling?

Another option is lipid-lowering drug (Rosuvastatin). And also get done fresh HbA1c (glycated hemoglobin) because previous one was just below the upper limit of normal.

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