Uric Acid: Key Facts, Levels and Health Risks

What Is Uric Acid?

Uric acid is a waste product that is created when the body breaks down substances called purines. Purines are found in certain foods, such as red meat, seafood, and even alcohol. After purines are broken down, uric acid forms and is mostly expelled from the body through urine.

Uric acid plays an important role in balancing chemicals in the body. However, too much or too little uric acid can lead to health problems.

It is often used as a biomarker to diagnose and monitor conditions like gout, kidney disease, and some forms of arthritis. Regular uric acid tests can help doctors determine if a patient is at risk of developing certain conditions related to high or low levels of uric acid.

When Is Uric Acid Testing Recommended?

Doctors may recommend a uric acid test in various situations. The test is not part of routine annual checkups, but it can be crucial in diagnosing specific health issues. Testing is often prescribed when patients experience symptoms linked to uric acid imbalances.

Here are common situations when uric acid testing might be necessary:

• Ongoing joint pain, swelling, or redness (possible signs of gout)
• Recurrent kidney stones
• Long-term discomfort or pain in the lower back or kidney area
• Monitoring the effectiveness of treatments for conditions like gout or kidney disease
• After chemotherapy or other cancer treatments that can increase uric acid levels

How Is Uric Acid Testing Conducted?

A uric acid test is usually conducted through a blood test. Sometimes, doctors may request a urine test to measure how much uric acid is being excreted by the kidneys. The test checks the amount of uric acid in the blood or urine to ensure levels are within a healthy range.

• Blood test: A small sample of blood is taken from a vein, typically from the arm, to measure the level of uric acid in the bloodstream.
• Urine test: A 24-hour urine collection is often used to measure uric acid in urine, giving insight into how well the kidneys are removing it.

Preparation for the Test:

• Fasting: Patients are often advised not to eat for at least 8 hours before the test. Clean water is allowed.
• Alcohol: Avoid alcohol consumption 24 hours before the test, as it can affect uric acid levels.
• Physical activity: Try to avoid intense physical activity just before the test.
• Stress and smoking: Avoid stress and smoking for at least 30 minutes before the test.

What Are the Normal Uric Acid Levels?

Normal uric acid levels can vary depending on age and gender. Here are the standard reference values:

Children (Males):

• Up to 10 years old: 2.4 - 5.4 mg/dL
• Up to 11 years old: 2.7 - 5.9 mg/dL
• Up to 12 years old: 3.1 - 6.4 mg/dL
• Up to 13 years old: 3.4 - 6.9 mg/dL
• Up to 14 years old: 3.7 - 7.4 mg/dL
• Up to 15 years old: 4.0 - 7.8 mg/dL
• Over 15 years old: 3.7 - 8.0 mg/dL

Children (Females):

• Up to 1 year old: 2.1 - 4.9 mg/dL
• Up to 6 years old: 2.1 - 5.4 mg/dL
• Up to 8 years old: 2.3 - 5.5 mg/dL
• Up to 10 years old: 2.3 - 5.7 mg/dL
• Up to 11 years old: 2.3 - 5.8 mg/dL
• Up to 12 years old: 2.3 - 5.9 mg/dL
• Over 12 years old: 2.7 - 6.1 mg/dL

Pregnant Women:

• Up to 12 weeks: 119 - 250 mcmol/L
• Up to 27 weeks: 143 - 292 mcmol/L
• Up to 42 weeks: 184 - 375 mcmol/L

Note: The units of measurement and the normal ranges can differ depending on the laboratory and the specific methods used.

What Do Abnormal Levels Mean?

Abnormal uric acid levels—whether high or low—can indicate various underlying health conditions. Here’s a breakdown of what each means.

Uric Acid High Levels

High uric acid levels, also called hyperuricemia, can lead to several health problems if left unmanaged. The body may produce too much uric acid or struggle to eliminate it, causing an accumulation in the bloodstream.

Common causes of high uric acid levels are:

• Purine-rich diet: Consuming foods like red meat, shellfish, and alcohol increases purine breakdown, leading to higher uric acid.
• Gout: This condition is directly related to high uric acid levels, leading to painful joint inflammation.
• Kidney disease: Impaired kidney function makes it harder for the body to eliminate uric acid.
• Obesity: Excess weight can increase the risk of hyperuricemia.
• Certain cancers: Leukemia and multiple myeloma can increase uric acid production.
• Chemotherapy: Some cancer treatments can cause a sudden rise in uric acid as cells break down rapidly.

To manage high uric acid, you can take the following steps:

• Maintain a healthy weight to reduce uric acid buildup.
• Drink plenty of water to help flush out uric acid through urine.
• Reduce consumption of purine-rich foods, such as red meat and seafood.
• Limit alcohol intake, especially beer, which is high in purines.
• Include more dairy products in your diet, as they may help lower uric acid levels.
• Add cherries to your diet; they have been linked to lower uric acid levels.
• Talk to your doctor about adding vitamin C supplements to your daily routine, as they may help reduce uric acid.

Uric Acid Low Levels

Low levels of uric acid, though less common, can also indicate health issues. Hypouricemia may result from a variety of causes, often linked to specific diseases or external factors.

Common causes of low uric acid levels are:

• Overconsumption of alcohol: Alcohol affects the body’s ability to produce uric acid.
• Lead poisoning: Long-term exposure to lead can decrease uric acid levels.
• Kidney failure: Severe kidney problems can prevent uric acid production.
• Medications or treatments: Some medications or medical treatments can reduce uric acid levels.

If you are diagnosed with low uric acid levels, the following lifestyle changes may help:

• Work with your doctor to determine the exact cause of low uric acid and follow their treatment recommendations.
• Adjust your diet to ensure balanced nutrient intake.
• If overconsumption of alcohol is a factor, reduce or eliminate alcohol from your routine.
• Increase water consumption to support kidney function.

Which Specialist Should You Consult?

If your uric acid levels are outside the normal range, you may need to consult a specialist. The type of doctor you should visit depends on the symptoms and underlying causes of your uric acid imbalance.

• General practitioner: Can assess your overall health and refer you to a specialist if needed.
• Rheumatologist: Specializes in joint-related conditions like gout that are often caused by high uric acid.
• Urologist: Focuses on kidney health and can help if kidney stones or other kidney issues are present.
• Oncologist: If your uric acid levels are high due to cancer or treatments like chemotherapy, an oncologist will monitor your condition.

By consulting the right specialist, you can effectively manage uric acid levels and the underlying health conditions associated with them.