Uricanorm Tablet

Why there is a need to control Uric acid?

If elevated levels of uric acid are not controlled, it may ultimately lead to problems related to hyperuricemia such as gout, hypertension, kidney disease and cardiovascular disease etc.

Reasons for increase in uric acid-

The buildup of uric acid in the bloodstream can be due to following conditions:

• Metabolic disorders can result in overproduction of uric acid.
• A kidney or thyroid problem, diabetes, or an inherited disorder, can make it harder for the body to remove out excess uric acid.
• Eating high purine food, such as red meats, organ meats and alcohol etc can also result in formation of excess uric acid.
• Medications like diuretics and cyclosporine can also results in increased levels of uric acid.
• Genetic factors can also be a reason of Gout.

URIC ACID METABOLISM 

he excess accumulation of uric acid may result from either over production or under excretion.

• Under excretion– Uric acid is eliminated via two mechanisms: two-thirds are excreted in the urine, and the remaining is excreted through the gastrointestinal tract. Hyperuricemia occurs when excretion becomes slower than the production of uric acid.
• Over production- Uric acid overproduction may be primary and due to enzyme deficiencies in the metabolic pathway of purines. It also may be secondary due to increased purine production as in hemolytic diseases. Uric acid levels also get increased in case of diminished uric acid elimination by the kidney and increased intake of dietary purines.
• The overproduction of uric acid can also be the result of abnormalities in the enzyme systems that regulate purine metabolism. For example: Xanthine oxidase is the main enzyme involved in uric acid formation.

When uric acid level increases it start getting precipitated. This precipitated urate crystals in joint fluid are able to stimulate an intense inflammatory reaction. Neutrophils infiltrate the joint space attempting to remove the foreign crystals. During this process they release bradykinin, proteases, interleukins and other inflammatory mediators that cause redness, pain and swelling in the joints.

Treatment of hyperuricemia according to modern:

Treatment of Hyperuricemia will depend on its cause.

1. Pain relievers such as Acetaminophen are the potent analgesics that are used to manage pain.
2. Anti-inflammatory agents:Nonsteroidal anti-inflammatory drugs (NSAIDS), colchicine, and corticosteroids are used to decrease joint inflammation.
3. Xanthine oxidase inhibitors:Xanthine oxidase inhibitorslimit the amount of uric acid that our body produce by inhibiting xanthine oxidasee.g. Febuxostat, allopurinol.
4. Uricosuric Drugs:Uricosurics inhibits the renal tubular reabsorption of uric acid and thereby increases the renal clearance of uric acid. For example: -Probenecid and sulfinpyrazone.

 

Uric Acid according to Ayurveda

In Ayurveda, imbalance of pitta dosh is known to be the responsible factor for raised levels of Uric acid or Hyperuricemia in the body. As Improper diet can be the reason of vata imbalance in the body. So, the person who eats more acidic, sour, oily and spicy food with lesserfibres can also have high levels of uric aciddue tovataimbalancing properties of these food items. If the vitiated pitta dosha is not balanced earlier, it can result into Gout. Gout is a type of arthritis which is also known as gouty arthritis.

Gout is a progressive disorder. In Ayurveda Gout is correlated to Vatarakta. VataDosha and RaktaDhatu get aggravated in Gout and start circulating in the body. The vitiated dosha get localized in the big toe of the foot or in the thumb of the hand. Due to subtle pervasive nature of Vata and Rakta it spreads to all the other joints of the body if left untreated.

Varities of Vatarakta: Uttana (Superficial) and Gambhira (Deep seated). Uttanavatarakta is residing in the skin and muscles and Gambhirvatarakta is spreading to all the tissues.

In Ayurveda, the treatment principle to treat gout is to balance the imbalanceddoshas mainly Vatadosha, the causative factor of gout. As vatarakta is the progressive disease so the use of Rasayana (Rejuvenators) herbs should also be done.

Composition

Each tablet contains

Mass extract derived from: Guduchi 500mg, Triphala 300mg, Ashwagandha 200mg, Punarnava 200mg, Sariva 200mg

Powders of: Shudh guggulu 100mg, Shudhshilajit 75mg, Musta 45mg, Guduchi 45mg, Erandmool 45mg, Vidang 45mg, Trivrit 45mg, Dalchini 25mg,Sonth 25mg, Marich 20mg, Pippali 20mg

Features of Herbs

Guduchi (Tinosporacordifolia)

In Ayurveda Guduchi is a well-known rasayana drug with tridoshar properties. It helps in pacification of vitiated doshas. In a clinical study it was observed that Guduchikwatha was found very effective in Vatarakta due to its Rasayana (anti-oxidant), vaysthapan (anti-ageing), vatahara, ushna guna (hot in potency) and steroidal properties. ^{AyurpharmInt J AyurAlli Sci., Vol. 4, No. 11 (2015) Pages 206 – 213}

Another study showed that the aqueous extract of Tinosporacordifolia (AETC) has significant analgesic and anti-inflammatory activities.^{International Journal of Basic Medical Science – November 2011, Vol: 2, Issue: 5}

Ashwagandha (Withaniasomnifera)

Ashwagandha is a Rasayana drug and it provides strength to the body and helps to balance vatadosha the causative factor of hyperuricemia. According to a research study, the suppressive effect of withaniasomnifera root powder on gouty arthritis was observed. It also showed potent analgesic and antipyretic effect with the absence of gastric damage at different dose levels in experimental rats. The above results associate the anti-arthritic, analgesic and antipyretic actions of W. somnifera root powder with absence of gastric damage. ^{M. Rasool, P. Varalakshmi / Chemico-Biological Interactions 164 (2006) 174–180}

 

Guggulu(Commiphoramukul)

In Ayurvedic texts Guggulu is a well-known drug mentioned to be used in sandhishool (Joint pain) due to its vednasthapan (Analgesic) properties which helps to relief pain in the joints.The result of several studies also confirms anti-inflammatory and anti-arthritic activities of guggulu.

Triphala

Triphala has anti-inflammatory effects and helps in healing process, it provides nutrients which strengthen bones and detoxify toxins (uric acid) which may cause inflammation. Therefore, Triphala provides great relief in gout, arthritis and other problems related to joint pain.

In a study, an experimental model for gouty arthritis was treated with Triphala.The results obtained from the study clearly indicated that Triphala exerted a strong anti-inflammatory effect against gouty arthritis.^{E.P. Sabina, M. Rasool / Vascular Pharmacology 48 (2008) 14–20}

Musta(Cyperusrotundus)

Musta is used in Vatajvikar (vata disorders).In a study, the extract of Mustapossessed anti-inflammatory activity against carrageenan induced oedema and also found effective against formaldehyde induced arthritis in albino rats. It also possesses analgesic activity.

Shilajit

Shilajit has analgesic and anti-inflammatory effects and is thus useful for different painful conditions of the body. Shilajit is also found to be very beneficial in rheumatoid arthritis, osteoarthritis, and gout.

Erandmool(Ricinuscommunis)

It balances Vata and Kaphadosha. Therefore, it is effective in treating vata related disorders. The extract of the root was studied for anti-inflammatory activity in carrageenan induced hind paw edema model in which R. communis roots showed anti-inflammatory activity against carrageenan induced paw edema.^{A.N.Kalia et al /Int.J.PharmTech Res.2013,5(3)}

Vidang(Embeliaribes)

Embeliaribes possess wide range of medicinal properties due to its vatahar properties. It also has analgesic and antioxidant properties that help to provide relief from pain.

Dalchini(Cinnamomumzeylanicum)

Dalchini has kaphavatahar properties that help in balancing the increased vata dosh. In an experimental study administration of cinnamomum extract significantly reduced the elevation of uric acid in urine.^{D.A. Mohamed & S.Y. Al-Okbi.Pol. J. Food Nutr. Sci. 2008, Vol. 58, No. 3, pp. 389-395}

Sonth(Zingiberofficinale)

Sonth has vata balancing properties and it also effective in relieving pain. Therefore, Sonth can be used in case of hyperuricemia. A study also revealed that Ginger flavonoids are able to reduce uric acid levels in hyperuricemic rats with no effects on the level of this biological metabolite in normal animals and prevent oxidative stress. ^{International Journal of Advanced Research (2015), Volume 3, Issue 10 , 1033 – 1039}

 

Marich(Piper nigrum) and Pippali(Piper longum)

Pippali and Marich works as a detoxifier of amadosh (toxins) and also act as yogvahi (Increase bioavailability of the other herbs). They also possesssothahar (Anti-inflammatory) properties by virtue of which they are helpful in conditions like hyperuricemia.

According to a study,the anti-inflammatory effect of piperine was investigated on an experimental model for gouty arthritis and the study clearly indicated that piperine inhibit the monosodium urate crystal induced inflammation and can be regarded as therapeutic drug for the treatment of acute gouty arthritis^{. Piperine Inhibits Gouty Arthritis. Inflammation, Vol. 34, No. 3, June 2011}

 

Punarnava(Boerhaviadiffusa)

Punarnava is a plant of rasayana category drug. Studies approving anti-inflammatory action along with diuretic properties have been observed by various authors. The anti-inflammatory action of Punarnava helps to reduce the inflammation in the joints.The extracts of the roots of B.diffusa showed significant anti-inflammatory activity and anti-arthritis in albino rats. ^{Asian J. Applied Sci.4 (7):663- 684, 2011}

In another study author found significant diuretic activity of Punarnava root extract in which he observed 90.3% increase in the volume of urine with the extract whereas extract of leaves and flower showed 67.22% increase in the volume of urine. Through its diuretic effect it increases the uric acid excretion and hence lowering blood serum levels of uric acid. ^{PlantaMedica, vol 28, no 1, pp 62-66, 1975.}

 

Sariva(Hemidesmusindicus)

Sariva has kaphavatahar properties so it is utilized in Gout.In the study, the protective effects of Hemidesmusindicus on arthritis models were seen. The fraction of H. indicus showed significantly higher anti-arthritic activity.^{Alka Mehta et al./Asian Pacific Journal of Tropical Medicine (2012)130-135}

Trivrit(Operculinaturpethum)

In Ayurveda the roots of Trivrit are used in Rheumatism and in painful conditions. In a study, the anti-inflammatory potential of different extracts of O. turpethum has been reported in arthritis model. The aqueous extract was reported more potent fraction in all three animal models. ^{Journal of Pharmacognosy and Phytochemistry 2017; 6(1): 23-26}

Justification and Rationale of the Combination

Hyperuricemia is the presence of excess uric acid in the blood. High levels of uric acid may lead to attacks of gout or the development of kidney stones if it is not regulated on time.

Uricanorm tablets are prepared from the combination of potent herbs and minerals which are highly beneficial in conditions like hyperuricemia and gout. It is a blend of anti-inflammatory, analgesic, and anti-hyperuricemic drugs.

• Ingredients such as Guggulu, Musta, Shilajit, Erandmool and Trivrit helps in decreasing the inflammation.
• Guduchi, Ashwagandha, Sariva and Dalchini provide anti-gout action.
• Triphala, Sonth, Marich and Pipali helps in controlling Uric acid levels.
• Punarnva as a diuretic helps in removal of uric acid out of the body through urine.

These drugs in combination help to normalize the levels of uric acid, prevent the inflammation and pain in the joints. It also works as a rejuvenating and anti-oxidant to defy free radicals. Therefore, Uricanorm tablet helps to prevent the gouty arthritis.