Q. I have elevated homocysteine and uric acid levels. Please suggest the treatment.

Hi,

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• I have seen your reports (attachment removed to protect patient's identity). You have low vitamin B12, low vitamin D and slightly high uric acid levels.

• A high value of homocysteine could be due to the low level of vitamin D. The possible cause can be nutrition related.

• The probable reason can be any of the following:

1. High intake of alcohol.
2. Vitamin D deficiency.

• Treatment should be done if you have joint pain or any other problems. My suggestion is as follows:

1. Torflash sachet (Cholecalciferol), once a week for 10 weeks, before breakfast with milk, then once a month for five months.
2. Tablet Neurobion forte (multivitamin tablets) once daily for two months. Consult with your specialist doctor, discuss with him or her and take the medicines with their consent.

• Keep the serum level of 25(OH)D (25-hydroxyvitamin D) more than 30 ng/dL, which is considered to be the optimal level.

• Two months of follow-up may be required.

• There are two important strategies in the long term management to reduce the high uric acid level. The first one is losing weight and the second one is reducing the consumption of alcoholic drinks (mainly beer) and purine-rich foods (such as red meat, offal, and dark fish).

• A small amount of research evidence supports the consumption of dairy products such as low-fat yogurts, skimmed milk, and cherries to specifically reduce uric acid levels.

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