High uric acid can lead to gout and kidney stones. It can come from diet, alcohol, kidney problems, or medicines.
Normal range
About 3.4 to 7.0 mg/dL for men and 2.4 to 6.0 mg/dL for women. Above 6.8 mg/dL, urate can form crystals.
Causes
- Diet high in red meat, shellfish and sugary drinks.
- Alcohol, especially beer.
- Kidney disease.
- Obesity.
- Diuretics.
- Genetics.
Risks
Gout and kidney stones.
Treatment
Lifestyle, allopurinol or febuxostat.
See a doctor
If you have joint pain or swelling. Many people with high levels have no symptoms.
Reference ranges
Typical serum uric acid is about 3.5 to 7.2 mg/dL in men and 2.6 to 6.0 mg/dL in women. Hyperuricemia is generally defined as above 6.8 mg/dL, the level at which urate crystals can form. Many people with high levels never develop gout.
- Causes include a diet high in red meat, shellfish, alcohol (especially beer) and sugary drinks with fructose, kidney disease, obesity, and drugs such as thiazide diuretics and low-dose aspirin.
- Genetics matter: variants in transporter genes such as SLC2A9 and ABCG2 reduce excretion.
- Tumor lysis and psoriasis can raise levels through increased cell turnover.
Risks and treatment
Gout affects about 9.2 million US adults, according to CDC-based estimates. High uric acid is also linked to kidney stones and chronic kidney disease. Treatments include allopurinol or febuxostat, with a target serum urate under 6 mg/dL for gout, per the American College of Rheumatology. Lifestyle steps include weight loss, less alcohol and fluids. See a doctor for sudden joint pain, redness and swelling, especially in the big toe.
Reference ranges
Normal serum uric acid is about 3.5 to 7.2 mg/dL in men and 2.6 to 6.0 mg/dL in women. Hyperuricemia is commonly defined as above 6.8 mg/dL. High uric acid can result from diet (red meat, seafood, fructose, alcohol), kidney disease, certain drugs, obesity and genetics. About 4 percent of US adults have gout.
Risks and treatment
High uric acid can cause gout and kidney stones. Treatment for gout includes allopurinol or febuxostat to lower uric acid, and colchicine or NSAIDs for flares. Many people with high levels never get gout. Lifestyle changes include weight loss, limiting alcohol and sugary drinks, and staying hydrated.
Diet and lifestyle drivers
Foods high in purines include organ meats, anchovies, sardines, beer and sugary drinks with fructose. A 2004 NEJM study of 47,000 men found the risk of gout was 41 percent higher for those with the highest meat intake and 51 percent higher with high seafood intake. Dairy lowered risk. Obesity increases production of uric acid.
Treatment targets
Gout treatment aims for serum urate below 6 mg/dL (360 micromol/L), per ACR guidelines. Allopurinol is started low and increased. Febuxostat has cardiovascular warnings. Hydration helps prevent kidney stones. Cherry juice has limited evidence. Asymptomatic hyperuricemia is usually not treated with drugs.
Based on data from the American College of Rheumatology and the New England Journal of Medicine
