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A plant extract shown to reduce excessive uric acid in kidneys

Fruit Extract Protects Kidneys in People with High Uric Acid

Excess uric acid contributes to gout, kidney stones, and kidney disease. A human study showed that a plant extract lowered uric acid blood levels by 28.4% and improved measures of kidney health.

Scientifically reviewed by: Amanda Martin, DC, in February 2024. Written by: Mark Fulton.

Uric acid is a waste product that is normally produced by the body in small amounts.

When uric acid blood levels get too high, this is associated with problems including gout, kidney stones, and certain types of kidney disorders.1

Data from 2007–2016 show that roughly 20% of U.S. adults had elevated uric acid levels, and about 4% were diagnosed with gout.2   

Up to two-thirds of people with high uric acid levels don't show any symptoms.3

Medications to lower uric acid levels come with potential side effects.3

Scientists have discovered that an extract of the fruit of the Terminalia bellerica tree can safely reduce elevated uric acid levels in humans.4

In a study of patients with chronic kidney disease and elevated uric acid, a dosage regimen of Terminalia bellerica extract reduced uric acid by nearly 20% and improved markers of kidney health.5

In the same study, elevated creatinine levels, a marker of impaired kidney function, decreased by over 11.5%.5

In a clinical study, Terminalia bellerica offered kidney protection for individuals with high uric acid levels.

Causes of Elevated Uric Acid

Uric acid is a normal product of metabolism.

In a healthy body, the small amount of uric acid that is produced is easily filtered by the kidneys and removed from the body in urine.

High levels of uric acid, called hyperuricemia, can lead to a painful arthritic condition known as gout.

Risk factors for gout include, high blood pressure and obesity, as well as excess intake of alcohol and certain foods (including organ meats, bacon, turkey, and sardines).3

Individuals with impaired kidney function are not able to properly filter waste products from the blood, and this results in buildup of those waste products. This includes uric acid. Even in people without kidney disease, kidney function wanes with age, so less uric acid is eliminated.6

Dangers of Hyperuricemia

Only about 4% of the population suffers from gout, but at least 21% of adults have high uric acid levels.2

Even asymptomatic hyperuricemia has been found to be significantly associated with risk of health-related issues including hypertension, chronic kidney disease, cardiovascular disease, and insulin resistance syndrome.7

Uric acid tends to crystalize when its concentration is too great. The formation of solid crystals in the joints between bones causes inflammation and pain, known as gout.

Crystals can also form in the urine, causing painful kidney stones.3

Reduce Uric Acid

High uric acid levels can lead to many other significant problems.

Long-term elevated uric acid can damage the linings of blood vessels and accelerate the development of cardiovascular disease.5,8,9

It is also associated with metabolic diseases, including metabolic syndrome and type II diabetes.5,8,9

A few medications help reduce uric acid, most notably allopurinol and febuxostat. However, they can lead to various side effects, including cardiovascular and liver function abnormalities and even renal failure. Incredibly, some gout medicines can precipitate gout symptoms.10

Scientists investigating ways to safely reduce uric acid levels focused on Terminalia bellerica, a tree native to Southeast Asia. Its fruit has been used for centuries in Indian Ayurvedic medicine to promote overall health.

Research suggested that the bioactive compounds in this Terminalia bellerica fruit provide anti-inflammatory effects.11 This tannin-rich extract is believed to inhibit xanthine oxidase, an enzyme involved in the synthesis of uric acid.4

In a pilot study on patients without chronic kidney disease but with hyperuricemia,4 groups receiving Terminalia bellerica extract had a significant reduction in serum uric acid levels starting at four weeks. Levels continued to drop for 16 weeks, then stabilized at a lower level.

On average, those receiving 500 mg of Terminalia bellerica extract twice a day had a 28.4% uric acid reduction.

This reduced uric acid levels below 6 mg/dL, which is the therapeutic target doctors aim for in treating patients with gout.12

Terminalia bellerica may help prevent many different kinds of health problems caused by elevated uric acid.

What You Need to Know

Reduce Uric Acid for Kidney Health

  • Uric acid is a metabolic waste product. High blood levels of uric acid are common in adults and can cause painful gout and kidney stones.
  • An extract of the fruit of the Terminalia bellerica tree safely and effectively reduced high uric acid levels in human studies.
  • A clinical trial in patients with chronic kidney disease and elevated uric acid levels found that one dosage of Terminalia bellerica extract improved markers of kidney function, reducing creatinine levels by over 11.5% and improving the kidneys' blood-filtering activity.

Clinical Trial Shows Additional Benefits

After early studies showed Terminalia bellerica's ability to lower uric acid, scientists decided to evaluate whether it could help patients who had both chronic kidney disease and elevated uric acid.5

In a trial of patients with chronic kidney disease and elevated uric acid, participants were randomized to receive:

  • the gout/uric acid medication febuxostat 40 mg, once daily, or
  • two different dosages of Terminalia bellerica extract.

After 24 weeks, reduced uric acid and creatinine levels were seen in all the groups along with beneficial increases in renal filtration rate.

The fruit extract lowered uric acid levels starting at just four weeks in all participants.

The higher dosage of 1,000 mg twice a day lowered uric acid by almost 20% by the end of the 24-week treatment period.5

People with chronic kidney disease have compromised kidney function – meaning their kidneys have difficulty keeping up with regular housekeeping and clearing out waste. Reducing uric acid production may have lowered the kidney workload in trial participants.

This may explain in part why in this trial, Terminalia bellerica extract improved measures of kidney function.

In those taking 1,000 mg twice a day of Terminalia bellerica, creatinine levels decreased by over 11.5% by the end of the study. Creatinine is a widely used marker of kidney function.

Terminalia bellerica also significantly lowered CRP (C-reactive protein), a marker of systemic inflammation, and led to improvements in endothelial function, a sign of blood vessel health.13

The estimated glomerular filtration rate (eGFR), a measure of the blood-filtering capacity of the kidneys, increased, indicating a significant boost in kidney function.

These data sets indicate potential benefits for those with kidney disease and high uric acid levels.

Summary

Elevated levels of uric acid in the blood are common in adults and tend to worsen with age.

This can lead to gout and kidney stones. Uric acid elevations are also associated with chronic kidney disease and other long-term health problems.

Studies show that extracts of the fruit of the Terminalia bellerica tree can be effective at reducing uric acid levels in humans.

In patients with kidney disease and elevated uric acid, Terminalia bellerica was able to improve multiple markers of kidney function.

If you have any questions on the scientific content of this article, please call a Life Extension Wellness Specialist at 1-866-864-3027.

References

  1. Available at: https://www.uptodate.com/contents/uric-acid-kidney-diseases. Accessed November 21, 2023.
  2. Chen-Xu M, Yokose C, Rai SK, et al. Contemporary Prevalence of Gout and Hyperuricemia in the United States and Decadal Trends: The National Health and Nutrition Examination Survey, 2007-2016. Arthritis Rheumatol. 2019 Jun;71(6):991-9.
  3. Available at: https://www.uptodate.com/contents/gout-beyond-the-basics. Accessed November 21, 2023.
  4. Usharani P, Nutalapati C, Pokuri VK, et al. A randomized, double-blind, placebo-, and positive-controlled clinical pilot study to evaluate the efficacy and tolerability of standardized aqueous extracts of Terminalia chebula and Terminalia bellerica in subjects with hyperuricemia. Clinical Pharmacology: Advances and Applications. 2016;8:51-9.
  5. Pingali U, Nutalapati C, Koilagundla N, Taduri G. A randomized, double-blind, positive-controlled, prospective, dose-response clinical study to evaluate the efficacy and tolerability of an aqueous extract of Terminalia bellerica in lowering uric acid and creatinine levels in chronic kidney disease subjects with hyperuricemia. BMC Complement Med Ther. 2020Sep 15;20(1):281.
  6. Wang Y, Zhang W, Qian T, et al. Reduced renal function may explain the higher prevalence of hyperuricemia in older people. Scientific Reports. 2021 2021/01/14;11(1):1302.
  7. Available at: https://www.uptodate.com/contents/asymptomatic-hyperuricemia?search=hyperuricemia%20causes&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1. Accessed November 21, 2023.
  8. Gliozzi M, Malara N, Muscoli S, Mollace V. The treatment of hyperuricemia. Int J Cardiol. 2016Jun 15;213:23-7.
  9. Nishizawa H, Maeda N, Shimomura I. Impact of hyperuricemia on chronic kidney disease and atherosclerotic cardiovascular disease. Hypertens Res. 2022 Apr;45(4):635-40.
  10. Available at: https://www.uptodate.com/contents/pharmacologic-urate-lowering-therapy-and-treatment-of-tophi-in-patients-with-gout?search=gout%20medicine%20side%20effect&source=search_result&selectedTitle=4~150&usage_type=default&display_rank=4#H2830779235. Accessed November 21, 2023.
  11. Xu Y, Tang G, Zhang C, et al. Gallic Acid and Diabetes Mellitus: Its Association with Oxidative Stress. Molecules. 2021 Nov 24;26(23).
  12. Perez‐Ruiz F, Lioté F. Lowering serum uric acid levels: What is the optimal target for improving clinical outcomes in gout? Arthritis Care & Research. 2007 Oct 15;57(7):1324-8.
  13. Pingali U, Nutalapati C, Koilagundla N, Taduri G. A randomized, double-blind, positive-controlled, prospective, dose-response clinical study to evaluate the efficacy and tolerability of an aqueous extract of Terminalia bellerica in lowering uric acid and creatinine levels in chronic kidney disease subjects with hyperuricemia. BMC Complementary Medicine and Therapies. 2020 Sep 15;20(1):281.