High Uric Acid Levels (Hyperuricemia)

Uric acid is a waste product found in urine. If your body makes too much or doesn't eliminate enough of it, uric acid levels can become too high—a condition known as hyperuricemia. High uric acid levels can lead to symptoms and eventually conditions like gout and kidney disease.

Most uric acid is produced naturally in your body. The rest is converted from substances in certain foods called purines. If you're diagnosed with hyperuricemia, changes to what you eat and drink may help you bring your uric acid levels back down to normal.

This article looks at hyperuricemia, its causes, and symptoms. It also discusses possible treatment.

What Uric Acid Level Indicates Hyperuricemia?

A uric acid level of 6.8 mg/dl or higher means you have hyperuricemia. A normal serum urate level for assigned females is 1.5 to 6.0 mg/dL. For assigned males, it is 2.5 to 7.0 mg/dL.

Most uric acid dissolves in the blood. From there, it travels to the kidneys to be excreted in urine. A serum uric acid blood test measures the amount of uric acid in your blood. Your uric acid level can also be checked with a urine sample.

Symptoms of Hyperuricemia 

Hyperuricemia itself is not a disease. In some cases, it does not cause symptoms or problems. Still, long-term hyperuricemia may lead to the development of uric acid crystals. These can be problematic.

High uric acid levels can result in gout or kidney disease. These are the two most common conditions related to hyperuricemia.

Gout

With gout, uric acid crystals build up in the joints. This causes inflammation and the breakdown of joint cartilage.

Symptoms of gout include:

• Pain
• Swelling
• Redness
• Stiffness
• Deformity
• Inflammation
• Limited range of motion

Kidney Stones

Uric acid crystals can also be deposited in the kidneys. This causes kidney stones which can be very painful. If left untreated, they can block the urinary tract and cause infections.

Symptoms of kidney stones include:

• Pain or aching in your lower back, side, abdomen, or groin
• Nausea
• Increased urge to urinate
• Pain when urinating
• Difficulty urinating
• Blood in your urine
• Foul-smelling or cloudy urine

Kidney stones can also cause urinary tract infections (UTIs). This is because they harbor bacteria. Symptoms of a UTI are similar to those of kidney stones. There may also be fever or chills.

Over time, kidney stones and other forms of kidney damage can lead to chronic kidney disease. This makes it more difficult to get rid of uric acid.

Untreated kidney disease can lead to kidney failure or loss of kidney function.

What Causes High Uric Acid?

The primary risk factors for developing hyperuricemia include:

• Getting older
• Being an assigned male

Studies in the U.S. and New Zealand found that people of African, Maori, or Filipino ancestry are at higher risk than people of European ancestry.

Other risk factors include:

• Kidney disease
• Metabolic syndrome, a disorder that involves obesity, abnormal blood pressure, blood sugar disorders, and lipid disorders
• A diet that is high in alcohol, purines, protein, and carbohydrates
• Medications, including thiazides, loop diuretics, and low-dose aspirin
• Niacin
• Acidosis
• Chemotherapy
• Diabetes
• Hypoparathyroidism
• Psoriasis
• Lead poisoning
• Polycythemia vera
• Toxemia related to pregnancy
• Tumor lysis syndrome
• Family history of hyperuricemia
  

Hyperuricemia Treatment 

If you don't have symptoms, you don't necessarily need to treat your high uric acid levels. When hyperuricemia symptoms are present, a change in diet may help. Medication is typically prescribed for cases of gout.

Diet Changes

Eating foods low in purines may help regulate hyperuricemia levels.

Drink plenty of water each day. This will help the kidneys flush out uric acid. Some studies suggest drinking coffee on a regular basis can help prevent gout. If dietary changes don't control your hyperuricemia levels, your healthcare provider may prescribe medications.

High Uric Acid Medicine

Urate-lowering therapies are the preferred medication for most individuals with gout. Options include:

• Benemid (probenecid): This is a uricosuric medication. This drug increases excretion of uric acid in the urine.
• Zyloprin (allopurinol), Uloric (febuxostat): These drugs are called xanthine oxidase inhibitors (XOIs). They reduce the body’s production of uric acid.
• Zurampic (lenisurad): This is prescribed with an XOI to increase its effects.
• Krystexxa (pegloticase): Pegloticase is given by intravenous infusion. It changes uric acid into a substance called allantoin. Your body can easily eliminate allantoin. This drug is reserved for people who have not had success with other gout medications.

Summary

Hyperuricemia occurs when you produce too much uric acid or can't eliminate enough of it. Getting older and being an assigned male are the two major risk factors for this condition.

Hyperuricemia can lead to gout, when uric acid crystals build up in the joints. It can also cause uric acid crystals to form in the kidneys. Over time, this may lead to kidney disease.

A diet low in purines may help control uric acid levels. Foods that are low in purines include milk, eggs, nuts, and citrus fruits. If you can't control your hyperuricemia with diet, your healthcare provider may prescribe medication. 

A Word From Verywell

Knowing your uric acid level is just as important as knowing your cholesterol and blood glucose levels.

Talk to your healthcare provider if you have sore joints or frequent urinary tract infections. If you've had attacks of gout, you should have your uric acid levels tested. You'll need to test every six months to ensure that your levels stay under 6.0 mg/dl.

Gout Doctor Discussion Guide

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