The illness is defined by an overwhelming and unrelenting fatigue that does not improve with rest, often coupled with pain, cognitive difficulties, and post-exertional malaise—a sudden worsening of symptoms after even small amounts of physical or mental activity. Despite its impact, there has been no diagnostic test, no clear biological explanation, and no proven cure.

Now, a major genetic study is beginning to change that narrative. The DecodeME project, launched in 2022 and led by scientists at the University of Edinburgh with support from patient advocacy groups, has provided the strongest evidence yet that biology—rather than behavior or psychology—plays a central role in ME/CFS.

Eight Genetic Signals—What They Reveal

Researchers examined DNA samples from more than 15,000 people with the illness and compared them to over 250,000 individuals without it. What they found was striking: eight regions of DNA where genetic differences were far more common among patients than in the general population.

These differences, often referred to as “genetic signals,” appear to cluster around two key biological systems—the immune system and the nervous system. Some of the genes identified are known to influence how the body responds to infection, a finding that echoes the experiences of many patients who report that their illness began after a viral or bacterial illness.

Others are linked to pathways involved in pain regulation, which may help explain why chronic pain is such a common feature of the condition.

Importantly, the study also showed that these genetic differences are not associated with psychiatric conditions such as depression or anxiety, helping to counter the long-standing misconception that ME/CFS is primarily psychological in nature.

Implications

The implications of these findings are significant, though researchers caution that they are only the beginning. The genetic associations discovered by DecodeME cannot yet be used to diagnose the illness, nor do they immediately translate into treatment.

What they do provide, however, is a roadmap for future research—clues that point scientists toward the biological processes most likely driving ME/CFS. By focusing on immune and neurological pathways, researchers may be able to develop targeted studies and, eventually, new therapies that address the underlying mechanisms rather than just the symptoms.

For patients, the study represents more than just scientific progress—it is also a moment of validation. ME/CFS has historically been misunderstood, with many sufferers facing disbelief from clinicians, employers, and even friends or family. The discovery that the illness is written, at least in part, into the genome underscores that it is not imagined, but rooted in biology. As Professor Chris Ponting, who leads the DecodeME study, has noted, these results mark a turning point in how the illness is perceived within the medical and research communities.

Future Directions

The DecodeME team is continuing its work, expanding the study to include participants from more diverse backgrounds and conducting deeper analyses of genetic variation. They have also made their dataset available to scientists around the world in the hope that collaboration will accelerate discoveries.

While it may take years to translate these findings into practical treatments, the momentum is now firmly on the side of progress. For a patient community that has long waited for recognition and solutions, this study offers both a clearer biological foundation and a renewed sense of hope.

[Source]

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1. Green Tea (and Black Tea):

Rich in catechins and gallic acid, green and black teas can block xanthine oxidase, thereby reducing uric acid production. In fact, gallic acid in tea has one of the strongest XO-inhibiting effects, outperforming even other tea polyphenols. Enjoy 2–3 cups of unsweetened green or black tea daily (hot or iced). For example, have a cup in the morning instead of sugary beverages, or use cooled green tea as a base for smoothies. This provides a steady intake of XO-inhibiting compounds and can be a simple, soothing addition to your routine.

2. Coffee:

Moderate coffee consumption is associated with lower uric acid levels. Coffee contains chlorogenic acid (a polyphenol) and low doses of caffeine, which together inhibit xanthine oxidase and increase uric acid excretion. Essentially, chlorogenic acid in coffee acts similarly to allopurinol by occupying XO’s active site, thus preventing the formation of uric acid. If you tolerate caffeine, one or two cups of coffee a day (preferably black or low-sugar) can be beneficial. For instance, you might replace a mid-morning snack with a cup of black coffee or have it with breakfast. The diuretic effect of coffee’s polyphenols also helps flush out uric acid, but be sure to stay hydrated.

3. Tart Cherries (and Cherry Juice):

Tart cherries are famed as a home remedy for gout – and for good reason. They are high in anthocyanins, which not only have anti-inflammatory effects but may also inhibit xanthine oxidase. Studies have observed that regular tart cherry intake is linked to reduced serum uric acid and fewer gout flares. Cherry compounds can increase urate excretion and even showed a synergistic effect with allopurinol in research. You can drink an 8-ounce glass of 100% tart cherry juice daily (for example, in the morning or post-dinner), or eat a handful of fresh or frozen tart cherries as a snack. Alternatively, concentrated tart cherry capsules are available online. This sweet-tart fruit is an easy dessert swap that may help control uric acid levels.

4. Apples and Onions (Quercetin-Rich Foods):

Apples (especially with skins) and onions are high in quercetin, a flavonoid that inhibits xanthine oxidoreductase – the final step of uric acid synthesis. Quercetin has been shown in human studies to lower blood uric acid; for example, 500 mg of quercetin daily (equivalent to the quercetin in about one large red onion or several apples) significantly reduced serum urate in pre-hyperuricemic men. To get quercetin through diet, try eating an apple a day (as a snack or chopped into oatmeal) and use onions generously in cooking (soups, salads, stir-fries, etc.). Red onions, in particular, are very high in quercetin. By incorporating these foods regularly, you’ll get a consistent dose of this natural XO inhibitor alongside vitamins and fiber.

5. Celery and Celery Seeds:

Celery has long been used as a folk remedy for gout. Luteolin, a flavonoid abundant in celery (particularly in celery seeds), is a potent xanthine oxidase inhibitor. Research confirms that celery seed extracts can lower uric acid and block XO activity in animal models of hyperuricemia. You can integrate this by sprinkling celery seeds (about ¼ teaspoon) into soups, stews, or even smoothies – they have a mild, earthy flavor. Alternatively, steep celery seeds in hot water to make a tea, or take a celery seed extract supplement (readily available online). Eating fresh celery stalks is healthy too (as snacks or in salads), though the seeds have a higher concentration of luteolin. For example, you might add a pinch of ground celery seed to a vegetable juice or morning eggs for an extra anti-gout boost.

6. Ginger:

Common ginger root contains bioactive compounds (gingerols and shogaols) that have XO-inhibiting and anti-inflammatory properties. Notably, 6-gingerol in ginger has been shown to inhibit xanthine oxidase, thus interfering with the formation of uric acid. While ginger is often used to ease nausea or arthritis, it may also help keep uric acid in check by reducing production and oxidative stress. You can easily use fresh ginger in your diet: grate it into stir-fries, steep slices in hot water for a soothing ginger tea, or add it to smoothies and marinades. Even ginger powder can be used in curries or sprinkled on roasted vegetables. For instance, try drinking a cup of ginger tea after meals – not only is it calming for digestion, but it also provides those XO-inhibiting compounds in a warm, caffeine-free beverage.

7. Turmeric:

Turmeric (the golden-yellow spice) contains curcumin, which emerging research suggests can inhibit xanthine oxidase and also act as a uricosuric, helping the kidneys excrete uric acid. This dual action means turmeric might reduce uric acid both by producing less of it and by getting rid of it faster. In one clinical trial, curcumin supplements lowered serum urate about 7% (though results were comparable to placebo, indicating more research is needed). Regardless, turmeric’s anti-inflammatory benefits are well known and can be useful if you have any gouty joint pain. To incorporate turmeric, add ½–1 teaspoon of turmeric powder to your cooking daily – for example, stir it into soups, stews, or rice, or use it to make “golden milk” (turmeric latte) with milk/non-dairy milk and a pinch of black pepper (which boosts curcumin absorption). You can also take curcumin capsules available online for a concentrated dose. Be consistent; using a bit of turmeric every day – such as in scrambled eggs or a smoothie – can provide a steady supply of curcumin. (Tip: combine with black pepper and a healthy fat like olive oil when cooking, to enhance absorption of curcumin.)

Practical Tips: Aim to incorporate several of these options in your daily diet for a combined effect. For instance, you might start your day with a cup of green tea or coffee, enjoy an apple as a snack, use onions and ginger in your lunch/dinner recipe, and have a glass of tart cherry juice in the evening. Sprinkle in turmeric and celery seeds while cooking your meals. By using these natural xanthine oxidase inhibitors regularly, you can gradually lower uric acid levels.

Always remember to monitor your levels and consult with a healthcare provider for personalized guidance, but these additions are safe, accessible steps that leverage nature’s own XO inhibitors.

The post 7 Natural Dietary Xanthine Oxidase Inhibitors to Reduce Uric Acid appeared first on Medical Journal Daily.

Highest in Purines (400 mg uric acid/100 g and higher)

Moderately High in Purines (100 to 400 mg uric acid/100 g)

Lowest in Purines (100 mg uric acid/100 g and lower)

It is essential to note that food typically accounts for only about 30% of the uric acid content in the blood serum. While diet is crucial for those wishing to lower their uric acid levels, other factors such as physical exertion and traumatic injuries can also contribute to the occurrence of gout. Additionally, foods that elevate blood acidity may aggravate gout, even if they have low purine content. These include spicy and greasy foods, coffee, alcohol, excess tea, and deeply fried foods.

Low Purine, Whole Foods Vegetarian Diet Plan for Hyperuricemia

Breakfast

1. Smoothie Bowl
   • Ingredients: Bananas, blueberries, almond milk, chia seeds, and a handful of almonds.
   • Preparation: Blend the bananas, blueberries, and almond milk. Pour into a bowl and top with chia seeds and almonds.
2. Avocado and Tomato Slices
   • Ingredients: Avocado, cherry tomatoes, salt, and pepper.
   • Preparation: Slice the avocado and cherry tomatoes. Sprinkle with salt and pepper.
3. Skimmed Cow Milk
   • Ingredients: Skimmed cow milk.
   • Preparation: Drink a glass of chilled skimmed cow milk alongside your breakfast.

Snack

• Apple Slices with Almond Butter
  • Ingredients: Apple, almond butter.
  • Preparation: Slice the apple and dip it in almond butter.

Lunch

1. Quinoa Salad
   • Ingredients: Quinoa, cucumber, cherry tomatoes, bell peppers, red onion, olive oil, lemon juice, and fresh herbs (like parsley or cilantro).
   • Preparation: Cook the quinoa and let it cool. Mix with chopped vegetables, olive oil, lemon juice, and herbs.
2. Vegetable Soup
   • Ingredients: Carrots, celery, tomatoes, garlic, vegetable broth, and your choice of spices.
   • Preparation: Sauté garlic and vegetables in a pot. Add vegetable broth and spices. Simmer until vegetables are tender.
3. Curd (Yogurt)
   • Ingredients: Plain curd (yogurt).
   • Preparation: Enjoy a bowl of plain curd as a side with your lunch.

Snack

• Mixed Berries
  • Ingredients: Strawberries, blueberries, raspberries.
  • Preparation: Mix and enjoy.

Dinner

1. Stuffed Bell Peppers
   • Ingredients: Bell peppers, cooked quinoa, black beans, corn, diced tomatoes, onion, garlic, and spices (such as cumin and paprika).
   • Preparation: Sauté onion and garlic, add black beans, corn, diced tomatoes, and spices. Mix with cooked quinoa. Stuff the mixture into bell peppers and bake until peppers are tender.
2. Stir-Fried Vegetables with Brown Rice
   • Ingredients: Broccoli, cauliflower, carrots, bell peppers, snap peas, garlic, soy sauce, and brown rice.
   • Preparation: Stir-fry the vegetables and garlic in a bit of olive oil. Add soy sauce to taste. Serve over cooked brown rice.
3. Curd (Yogurt)
   • Ingredients: Plain curd (yogurt).
   • Preparation: Enjoy a bowl of plain curd as a side with your dinner.

Dessert

• Fresh Fruit Salad
  • Ingredients: Mixed fruits like watermelon, cantaloupe, kiwi, and berries.
  • Preparation: Chop and mix the fruits.

Additional Tips

• Hydrate: Drink plenty of water throughout the day.
• Limit Alcohol and Sugary Beverages: Stick to water, herbal teas, and diluted fruit juices.
• Maintain a Balanced Diet: Include a variety of fruits, vegetables, whole grains, and nuts.
• Regular Physical Activity: Engage in moderate exercise regularly to help maintain a healthy weight and overall well-being.

By following this diet plan and making healthy lifestyle choices, you can help manage hyperuricemia and reduce the risk of gout flare-ups.

References:

1. Elevate Health AZ. (n.d.). Purine Table. PDF.
2. National Center for Biotechnology Information. (2017). Clinical Methods: The History, Physical, and Laboratory Examinations. Book.

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Li Hua, often called China’s ‘folded man,’ suffered from a condition that deformed his spine. This story highlights Li’s life before a team of doctors in Shenzhen performed surgery that allowed him to stand straight again.

On a peaceful autumn morning in Hunan province, 47-year-old Li sits outside his home, enjoying the sunshine. After a while, he uses a walking frame to get inside and sits by the counter, scrolling through news on his phone.

What seems like a simple routine was once impossible for Li.

Li was diagnosed with ankylosing spondylitis, an autoimmune disease, at the age of 18. The disease causes the bones to fuse, forcing the spine to curve forward. Over time, his body bent completely, with his chin touching his chest, his breastbone meeting his pubic bone, and his face resting on his thighs.

His condition worsened until he could no longer straighten his body, lift his head, or lie flat. Li depended on his mother for full-time care.

Last year, everything changed when he underwent four complex surgeries at Shenzhen University General Hospital. It was the first time such an operation had been successfully done in China.

Li now has 20 metal pins in his body and cannot move his neck. He still needs his mother’s help to lie down, get out of bed, dress, and use the toilet. However, his condition has improved dramatically.

“I can now walk slowly with a walking frame, brush my teeth, wash my face, and sit at the table to eat like everyone else,” Li said. “I’m happy – I have hope.”

Li was born in a rural town in Qiyang county. His father worked at a military factory, while his mother was a local village committee member. He grew up with two brothers.

After completing secondary school, Li planned to leave his hometown and find work, but at 18, he started feeling pain in his feet, legs, and waist. His plans were put on hold. Doctors initially diagnosed him with arthritis and prescribed painkillers and anti-inflammatories to manage his symptoms.

However, his condition worsened. By the time he was 27, his neck had become stiff, and within two years, he couldn’t lift his head. His body gradually folded forward, and by 40, his face was nearly touching his thighs.

Li used a small wooden bench and a walking stick to get around. To eat, his mother positioned a bowl close enough for him to reach. Due to his deformed digestive system, he could only manage two small meals a day. His mother also had to dress him, though it was a difficult task.

Over the years, his mother, Tang Dongchen, tirelessly sought medical help. They visited doctors in different provinces, but none could offer more than pain relief. In 2017, they went to a hospital in Chengdu, where Li finally received a diagnosis: ankylosing spondylitis. Unfortunately, the doctors said his case was too severe to operate on and sent him home.

Tang, determined not to give up, said, “I brought him into this world, so I had to do my best to help him. If I didn’t, who would care for him when I’m gone?”

Li also refused to lose hope. He continued searching for possible treatments until he found Dr. Tao Huiren, head of spinal surgery at Shenzhen University General Hospital, in June 2019. Dr. Tao agreed to help.

The surgery was risky and involved breaking and reconstructing multiple bones. After four operations and six months of rehabilitation, Li returned home in June this year.

“When Li Hua came home, the entire street came to see if it was really him standing straight again,” Tang said. “People crowded our home, saying it was like a miracle, as if the doctors had performed magic.”

Li now has a daily routine of physiotherapy. He’s resumed playing the harmonica and practicing calligraphy, two hobbies he enjoyed before his condition worsened. He also helps his parents run a small tobacco stand in their village.

Additionally, elderly villagers often come to Li for help with their mobile phones since many young people have moved to the cities for work. Some even visit him for fortune-telling.

“I’ve read a few books on fortune-telling, and I’ve helped a few neighbors,” Li said. “It’s mentally tiring, so I don’t do it too often. For myself, I calculated that last year would bring me good luck. I think that prediction came true.”

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