Table of ContentsView AllTable of ContentsNormal Uric Acid LevelsHow It Builds UpCauses of High Uric AcidRelated ConditionsSymptomsDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Normal Uric Acid Levels
How It Builds Up
Causes of High Uric Acid
Related Conditions
Symptoms
Diagnosis
Treatment
Uric acid is the final waste product ofpurines, which are chemical compounds found naturally inside cells and in certain foods and drinks (e.g., red meat and alcohol).
Elevated uric acid levels in the body may develop due to increased production or decreased removal of uric acid from within the body. Excess uric acid has the potential to formuric acid crystals, which can accumulate within joints and kidneys and cause disease.
This article defines a normal uric acid level and explores potential causes of an elevated level. It will also review conditions related to high uric acid levels, such asgoutand uric acidkidney stones, and their treatment.
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What Are Normal Uric Acid Levels?
Normal serum uric acid levels in people assigned male at birth typically range from 2.4 to 7.4 milligrams per deciliter of blood (mg/dL), and in people assigned female at birth, they typically range from 1.4 to 5.8 mg/dL.Experts suspect that the sex hormoneestrogencontributes to these differences among the sexes.
Estrogen Improves Uric Acid Clearance
How Uric Acid Can Build Up in the Body
Uric acid is the final product of purine metabolism. The two types of purines are:
Next, the kidneys and intestines remove uric acid from the body—the kidneys remove two-thirds via urine, and the intestines remove the other one-third via stool.
A disruption in the balance of producing or clearing uric acid within the body can cause it to build up, an abnormality known ashyperuricemia.
What Causes a High Uric Acid Level?
Increased uric acid production may be seen with the following:
Decreased removal of uric acid may be seen with the following;
Examples of Related Medical Conditions
Hyperuricemia is not a health condition itself but can increase the risk of developing gout, kidney stones, and kidney disease.
Hyperuricemia can also occur as a result of cancer treatment, andhypouricemia(low uric acid) may occur from a rare kidney disorder calledFanconisyndrome.
Gout
Kidney stones are another complication of gout, as is an uncommon form of chronic kidney disease called chronic uric acidnephropathy.
Symptoms and Complications of Gout
Kidney Stones and Disease
Increased blood uric acid levels are associated with a higher risk of developing kidney stones, specifically stones composed of uric acid. This risk exists regardless of whether a person has high uric acid levels, like those seen with gout, or is asymptomatic.
Although not a direct cause, hyperuricemia is also associated with chronic kidney disease. (It may be a direct cause of chronic uric acid nephropathy seen in gout, however.)
The precise link between hyperuricemia and chronic kidney disease is complex. It involves other factors like underlying health conditions such asdiabetesand genetic (hereditary) factors.
Cancer Treatment
Cancer treatments, like chemotherapy and radiation, can lead to a potentially fatal condition calledtumor lysis syndrome.
With this syndrome, the rapid rate of cancer cell death leads to the spilling of extremely high levels of uric acid into the bloodstream. This can suddenly damage the kidneys and other organs, namely the heart and nervous system.
In addition to high uric acid levels, tumor lysis syndrome is associated withhigh potassium, highphosphate, andlow calciumlevels.
Keep in mind that tumor lysis syndrome can happen on its own in blood cancers (e.g., leukemia orlymphoma), even if a person is not undergoing treatment at the time.
Fanconi Syndrome
Fanconi syndrome is a rare kidney disease that causes excessive removal of substances from the urine. These substances include uric acid,glucose, bicarbonate, phosphate, andamino acids.
The syndrome can be hereditary (runs in families) or acquired (develops during a person’s lifetime).
Symptoms of High and Low Uric Acid Levels
A person may not necessarily experience symptoms with high or low uric acid levels unless there is an underlying cause like gout, kidney stones, tumor lysis syndrome, or Fanconi syndrome.
Symptoms of these disorders include:
How Is a High Uric Acid Level Diagnosed?
Hyperuricemia is diagnosed through auric acid blood test.
The American College of Rheumatology defines hyperuricemia as a blood uric acid level greater than 6.8 mg/dL.
Depending on the clinical scenario, other diagnostic tests may be performed:
How High and Low Uric Acid Levels Are Treated
Hyperuricemia, in the absence of symptoms, usually requires no treatment.
An exception would be if a person has a blood uric acid level that is very high—typically greater than 8 mg/dL. In such cases, the following lifestyle behaviors are generally recommended, such as:
Keep in MindThere is limited research on the treatment of hyperuricemia in asymptomatic individuals. Healthcare providers may have different opinions or unique approaches and will consider factors like patient preference and severity of hyperuricemia.
Keep in Mind
There is limited research on the treatment of hyperuricemia in asymptomatic individuals. Healthcare providers may have different opinions or unique approaches and will consider factors like patient preference and severity of hyperuricemia.
The treatment of symptomatic hyperuricemia or hypouricemia (in the case of Fanconi syndrome) involves the following.
In individuals with agoutflare,an anti-inflammatory medication is taken, such as:
In individuals with frequent, severe, or debilitating gout flares, a urate-lowering medication like Lopurin or Zyloprim (allopurinol) is often advised. While taking this medication, a healthcare provider monitors blood uric acid levels, often aiming for less than 6.0 mg/dL.
Regardless of the severity of a person’s gout, the American College of Rheumatology recommends the following lifestyle interventions:
Foods to Eat and Avoid With Gout
Uric Acid Kidney Stones
In individuals with hyperuricemia who experience auric acid kidney stone, the following therapies are usually recommended:
Tumor Lysis Syndrome
Tumor lysis syndromeis treated in an hospitalintensive care unit (ICU), as it requires aggressive hydration with intravenous (IV) fluids and close heart andelectrolyte(e.g., potassium, phosphate, calcium) monitoring.
A “loop diuretic” called Lasix (furosemide) and a drug to lower uric acid levels called Elitek (rasburicase)may also be given. In some cases,dialysisis required.
Summary
Consuming too many foods and drinks rich in purines (e.g., alcohol, red meat, and seafood) or high fructose corn syrup (e.g., soda) can increase uric acid production. Chronic kidney disease or taking certain medications like diuretics (“water pills”) can impair uric acid clearance from the body.
High uric acid levels can lead to the development of gout (a type of inflammatory arthritis), kidney stones, or a medical emergency related to cancer called tumor lysis syndrome.
Treatment of hyperuricemia is generally only indicated when an underlying condition manifests from the high uric acid levels.
For example, in individuals with gout, medication is prescribed to treat acute flares and, sometimes, for prevention. Lifestyle interventions like maintaining a healthy weight and limiting alcohol, purines, and high-fructose corn syrup are also advised for all individuals with gout.
If your blood uric acid level is abnormal, talk with a healthcare provider. A medical history, physical exam, and other diagnostic tests may be performed to determine the next steps.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Khan A, Shah MH, Khan S, Shamim U, Arshad S.Serum uric acid level in the severity of congestive heart failure (CHF).Pak J Med Sci. 2017;33(2):330-334. doi:10.12669/pjms.332.11779Halperin Kuhns VL, Woodward OM.Sex differences in urate handling.Int J Mol Sci. 2020;21(12):4269. doi:10.3390/ijms21124269Yin H, Liu N, Chen J.The role of the intestine in the development of hyperuricemia.Front Immunol. 2022;13:845684. doi:10.3389/fimmu.2022.845684Mount DB.Asymptomatic hyperuricemia. In:UpToDate, Dalbeth N (Ed), UpToDate, Waltham, MAAihemaitijiang S, Zhang Y, Zhang L, et al.The association between purine-rich food intake and hyperuricemia: a Cross-Sectional Study in Chinese Adult Residents.Nutrients. 2020;12(12):3835. doi:10.3390/nu12123835Lubawy M, Formanowicz D.High-fructose diet-induced hyperuricemia accompanying metabolic syndrome-mechanisms and dietary therapy proposals.Int J Environ Res Public Health. 2023;20(4):3596. doi:10.3390/ijerph20043596Hainer BL, Matheson E, Wilkes RT.Diagnosis, treatment, and prevention of gout.Am Fam Physician. 2014;90(12):831-836.Kim S, Chang Y, Yun KE, et al.Development of nephrolithiasis in asymptomatic hyperuricemia: a cohort study.Am J Kidney Dis. 2017;70(2):173-181. doi:10.1053/j.ajkd.2017.01.053Kim GH, Jun JB.Altered serum uric acid levels in kidney disorders.Life (Basel). 2022;12(11):1891. doi:10.3390/life12111891Mirrakhumov AE, Voore P, Khan M, Ali AM.Tumor lysis syndrome: a clinical review.World J Crit Care Med. 2015;4(2):130-38. doi:10.5492/wjccm.v4.i2.130Hechanova LA (2024).Fanconi syndrome. InMerck Manual Professional Version. Merck & Co., Inc.MedlinePlus.Kidney stones.FitzGerald JD, Dalbeth N, Mikuls T, et al.2020 American College of Rheumatology guideline for the management of gout.Arthritis Care Res (Hoboken). 2020;72(6):744-760. doi:10.1002/acr.24180Mount Sinai.Kidney stones self-care.
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Khan A, Shah MH, Khan S, Shamim U, Arshad S.Serum uric acid level in the severity of congestive heart failure (CHF).Pak J Med Sci. 2017;33(2):330-334. doi:10.12669/pjms.332.11779Halperin Kuhns VL, Woodward OM.Sex differences in urate handling.Int J Mol Sci. 2020;21(12):4269. doi:10.3390/ijms21124269Yin H, Liu N, Chen J.The role of the intestine in the development of hyperuricemia.Front Immunol. 2022;13:845684. doi:10.3389/fimmu.2022.845684Mount DB.Asymptomatic hyperuricemia. In:UpToDate, Dalbeth N (Ed), UpToDate, Waltham, MAAihemaitijiang S, Zhang Y, Zhang L, et al.The association between purine-rich food intake and hyperuricemia: a Cross-Sectional Study in Chinese Adult Residents.Nutrients. 2020;12(12):3835. doi:10.3390/nu12123835Lubawy M, Formanowicz D.High-fructose diet-induced hyperuricemia accompanying metabolic syndrome-mechanisms and dietary therapy proposals.Int J Environ Res Public Health. 2023;20(4):3596. doi:10.3390/ijerph20043596Hainer BL, Matheson E, Wilkes RT.Diagnosis, treatment, and prevention of gout.Am Fam Physician. 2014;90(12):831-836.Kim S, Chang Y, Yun KE, et al.Development of nephrolithiasis in asymptomatic hyperuricemia: a cohort study.Am J Kidney Dis. 2017;70(2):173-181. doi:10.1053/j.ajkd.2017.01.053Kim GH, Jun JB.Altered serum uric acid levels in kidney disorders.Life (Basel). 2022;12(11):1891. doi:10.3390/life12111891Mirrakhumov AE, Voore P, Khan M, Ali AM.Tumor lysis syndrome: a clinical review.World J Crit Care Med. 2015;4(2):130-38. doi:10.5492/wjccm.v4.i2.130Hechanova LA (2024).Fanconi syndrome. InMerck Manual Professional Version. Merck & Co., Inc.MedlinePlus.Kidney stones.FitzGerald JD, Dalbeth N, Mikuls T, et al.2020 American College of Rheumatology guideline for the management of gout.Arthritis Care Res (Hoboken). 2020;72(6):744-760. doi:10.1002/acr.24180Mount Sinai.Kidney stones self-care.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Khan A, Shah MH, Khan S, Shamim U, Arshad S.Serum uric acid level in the severity of congestive heart failure (CHF).Pak J Med Sci. 2017;33(2):330-334. doi:10.12669/pjms.332.11779Halperin Kuhns VL, Woodward OM.Sex differences in urate handling.Int J Mol Sci. 2020;21(12):4269. doi:10.3390/ijms21124269Yin H, Liu N, Chen J.The role of the intestine in the development of hyperuricemia.Front Immunol. 2022;13:845684. doi:10.3389/fimmu.2022.845684Mount DB.Asymptomatic hyperuricemia. In:UpToDate, Dalbeth N (Ed), UpToDate, Waltham, MAAihemaitijiang S, Zhang Y, Zhang L, et al.The association between purine-rich food intake and hyperuricemia: a Cross-Sectional Study in Chinese Adult Residents.Nutrients. 2020;12(12):3835. doi:10.3390/nu12123835Lubawy M, Formanowicz D.High-fructose diet-induced hyperuricemia accompanying metabolic syndrome-mechanisms and dietary therapy proposals.Int J Environ Res Public Health. 2023;20(4):3596. doi:10.3390/ijerph20043596Hainer BL, Matheson E, Wilkes RT.Diagnosis, treatment, and prevention of gout.Am Fam Physician. 2014;90(12):831-836.Kim S, Chang Y, Yun KE, et al.Development of nephrolithiasis in asymptomatic hyperuricemia: a cohort study.Am J Kidney Dis. 2017;70(2):173-181. doi:10.1053/j.ajkd.2017.01.053Kim GH, Jun JB.Altered serum uric acid levels in kidney disorders.Life (Basel). 2022;12(11):1891. doi:10.3390/life12111891Mirrakhumov AE, Voore P, Khan M, Ali AM.Tumor lysis syndrome: a clinical review.World J Crit Care Med. 2015;4(2):130-38. doi:10.5492/wjccm.v4.i2.130Hechanova LA (2024).Fanconi syndrome. InMerck Manual Professional Version. Merck & Co., Inc.MedlinePlus.Kidney stones.FitzGerald JD, Dalbeth N, Mikuls T, et al.2020 American College of Rheumatology guideline for the management of gout.Arthritis Care Res (Hoboken). 2020;72(6):744-760. doi:10.1002/acr.24180Mount Sinai.Kidney stones self-care.
Khan A, Shah MH, Khan S, Shamim U, Arshad S.Serum uric acid level in the severity of congestive heart failure (CHF).Pak J Med Sci. 2017;33(2):330-334. doi:10.12669/pjms.332.11779
Halperin Kuhns VL, Woodward OM.Sex differences in urate handling.Int J Mol Sci. 2020;21(12):4269. doi:10.3390/ijms21124269
Yin H, Liu N, Chen J.The role of the intestine in the development of hyperuricemia.Front Immunol. 2022;13:845684. doi:10.3389/fimmu.2022.845684
Mount DB.Asymptomatic hyperuricemia. In:UpToDate, Dalbeth N (Ed), UpToDate, Waltham, MA
Aihemaitijiang S, Zhang Y, Zhang L, et al.The association between purine-rich food intake and hyperuricemia: a Cross-Sectional Study in Chinese Adult Residents.Nutrients. 2020;12(12):3835. doi:10.3390/nu12123835
Lubawy M, Formanowicz D.High-fructose diet-induced hyperuricemia accompanying metabolic syndrome-mechanisms and dietary therapy proposals.Int J Environ Res Public Health. 2023;20(4):3596. doi:10.3390/ijerph20043596
Hainer BL, Matheson E, Wilkes RT.Diagnosis, treatment, and prevention of gout.Am Fam Physician. 2014;90(12):831-836.
Kim S, Chang Y, Yun KE, et al.Development of nephrolithiasis in asymptomatic hyperuricemia: a cohort study.Am J Kidney Dis. 2017;70(2):173-181. doi:10.1053/j.ajkd.2017.01.053
Kim GH, Jun JB.Altered serum uric acid levels in kidney disorders.Life (Basel). 2022;12(11):1891. doi:10.3390/life12111891
Mirrakhumov AE, Voore P, Khan M, Ali AM.Tumor lysis syndrome: a clinical review.World J Crit Care Med. 2015;4(2):130-38. doi:10.5492/wjccm.v4.i2.130
Hechanova LA (2024).Fanconi syndrome. InMerck Manual Professional Version. Merck & Co., Inc.
MedlinePlus.Kidney stones.
FitzGerald JD, Dalbeth N, Mikuls T, et al.2020 American College of Rheumatology guideline for the management of gout.Arthritis Care Res (Hoboken). 2020;72(6):744-760. doi:10.1002/acr.24180
Mount Sinai.Kidney stones self-care.
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