What is Uric Acid?
Key Takeaways
Uric acid is a natural waste product that’s created by the breakdown of many foods as well as by normal cellular metabolism.
High uric acid levels in our bodies may be caused by overproduction of uric acid due to dietary factors, alcohol consumption, or medical conditions.
They can also be caused by reduced clearance of uric acid from the blood, which may be due to kidney disease, obesity.
High uric acid levels can lead to complications like gout (a painful condition of the joints) and kidney stones, and is associated with heart disease, type 2 diabetes, and dementia.
Many people don’t know that they have high uric acid levels until they experience a painful complication.
High uric acid levels can be managed with lifestyle changes and, in some cases, medications.
Uric acid is a natural waste product. It’s produced when the body breaks down many foods, and is also a byproduct of normal cellular metabolism.
In most people, the liver and kidneys are able to keep uric acid levels under control. However, there are certain conditions that can cause uric acid levels to rise too high, which can cause issues such as gout.
For optimal health, it’s important to keep uric acid levels under control. This article will explain what uric acid is, why levels can rise, how to find out your levels, and ways that high uric acid levels can be lowered.
Where Does Uric Acid Come From?
Uric acid is created when the body processes organic compounds called purines. These are found in DNA and RNA, which are the information-storing molecules present in all cells. Purines are also found in the cell’s main energy-storing molecules.
Purines are found at varying levels in many foods, and are broken down as part of the normal digestive process. Because these compounds are so integral to cellular function, the breakdown of purines also occurs in each of your cells on a daily basis.
When purines are broken down, the liver converts them to uric acid. The kidneys then get rid of the uric acid in your urine. In most people, these processes are able to keep uric acid levels from rising too high.
What is Hyperuricemia and What Causes It?
Hyperuricemia is the medical term for higher than normal uric acid levels in the blood.
There are a variety of different possible causes of high uric acid levels. In some cases, too much uric acid is being consumed or produced in the body, while in other cases, the kidneys are not able to clear uric acid from the blood effectively.
Causes of high uric acid due to increased uric acid production
In some cases, uric acid levels are high because too much purine-rich foods are being consumed. Some of the possible causes in this category include:
Excessive intake of foods high in purines. These foods include red meat, organ meats, shellfish, and certain fish (e.g. tuna and mackerel)
High alcohol intake. When yeast are used to produce alcohol, they produce purines as a byproduct. As a result, alcoholic beverages generally contain high levels of purines, so drinking a lot of alcohol can lead to high purine levels in the bloodstream.
Excessive intake of foods high in fructose. Fructose is a sugar that’s naturally found in fruit and honey, and is found at much higher levels in sweetened foods and beverages (especially soda made with high-fructose corn syrup). When the liver processes fructose, this produces high levels of purines, which are then further processed into uric acid. People who drink sodas or other beverages made with HFCS are significantly more likely to develop high uric acid levels.
In other cases, uric acid levels are high because the body is producing too much uric acid. Possible causes in this category include:
Medical disorders involving high cell turnover. When the body breaks down damaged cells, purines are naturally released. Certain medical conditions create more damaged cells than usual, which releases high levels of purines. Examples include psoriasis (an inflammatory skin condition) and bone marrow disorders, and patients undergoing cancer treatment.
Genetic conditions. There are genetic conditions in which the body produces high purine levels, due to altered activity of certain enzymes.
Causes of high uric acid due to decreased uric acid clearance
There are also cases in which the body’s production of uric acid is normal, but the kidneys are unable to clear it normally. The uric acid builds up in the blood, leading to high levels. Some conditions in this category include:
Chronic kidney disease. When the kidneys are damaged, it’s difficult for them to clear uric acid from the bloodstream. As a result, around 60% of people with chronic kidney disease have high uric acid levels.
Dehydration. When the body is low on fluids, the kidneys actively work to conserve water so that it won’t be lost in the urine. As part of this process, uric acid is reabsorbed back into the bloodstream, which can raise uric acid levels.
Obesity and insulin resistance. Obesity is strongly associated with insulin resistance, and both of these factors change how the body metabolizes uric acid. These changes increase the amount of uric acid the body produces and also decrease the clearance of uric acid by the kidneys.
Medications. Medications such as diuretics can raise uric acid levels. These are medications that are used to treat high blood pressure, and they work by stimulating the kidneys to get rid of excess fluids. Certain diuretics also cause the kidneys to hold onto uric acid instead of releasing it into the urine, which can cause uric acid levels to rise.
Genetic conditions. Certain genetic conditions affect the ability of the kidneys to clear uric acid from the blood.
How to determine the cause of high uric acid
There are many potential causes of high uric acid levels. You will need to visit a qualified medical professional to get an accurate diagnosis.
Symptoms of High Uric Acid
In many cases, high uric acid levels don’t cause any symptoms. Many people are unaware that their uric acid levels are high until this is discovered on a blood test. However, high uric acid levels can potentially lead to complications like gout and kidney stones.
Gout: A Common Complication of High Uric Acid
Gout is a condition in which uric acid crystals form in the joints. The symptoms of gout generally come and go, with periods of intense symptoms (known as flares) interspersed with periods when there are no symptoms. During a gout flare, people can experience severe pain in the affected joint, along with intense redness, warmth, and swelling around the joint. This usually comes on suddenly, as uric acid crystals form in the joint.
Gout flares the big toe base joint (1st Metacarpal joint) most commonly, however. people may also experience gout in other joints, like the ankles and wrists.
Without treatment, the symptoms of a gout flare usually last for about 7 to 14 days. However, treatment with medication can help to reduce the duration of symptoms.
Gout flares may be triggered by any factor that raises uric acid levels, such as eating high-purine foods, drinking alcohol, or getting dehydrated.
Repeated gout flares can lead to destruction of the joints, and permanent formation of uric acid deposits called gouty tophi.
Uric Acid Urinary Stones
When uric acid levels in the urine are high, then uric acid crystals may form inside the kidney and/or along the urinary tract. This is known as a uric acid urinary stone.
When a small urinary stone forms, there may be no symptoms. The stone will simply pass through the system and be excreted in the urine. However, when the stone is larger, then it can damage the urinary system as it passes through. This can lead to symptoms like severe pain in the back or flank, blood in the urine, and the frequent urge to urinate (even though very little urine passes each time).
Similar to gout, urinary stones can be triggered by any factor that raises uric acid levels. When there’s more uric acid in the blood, then the uric acid levels in the urine will generally also rise.
Long-Term Risks of High Uric Acid
High uric acid levels have been associated with a variety of serious medical conditions, including high blood pressure, cholesterol imbalances, heart attacks, strokes, type 2 diabetes, and dementia.
We need more research to clarify the link between hyperuricemia and these conditions, and it’s still not clear whether high uric acid directly causes these risks or is simply associated with them. However, if your uric acid levels are high, taking steps to reduce uric acid levels would be beneficial to your health.
High Uric Acid Treatment Approaches
If you have high uric acid levels, then there are steps you can take to help lower your levels and reduce your risk of complications.
Dietary changes. Changing your diet can significantly reduce your uric acid levels. Reduce purine-rich foods, such as red meat, organ meats, and seafood. Reduce or eliminate alcohol and sugary (high fructose) beverages. Eat more vegetables, whole grains, and low-fat dairy products.
Increase hydration. Drinking more fluids helps your kidneys to eliminate uric acid more effectively. It also helps to dilute your urine, making it more difficult for uric acid crystals to form. For people with high uric acid levels, it’s usually recommended to drink more fluids per day, preferably plain water,as it’s important to avoid sugary beverages.
Weight management. Maintaining a healthy body weight helps your body to clear uric acid more effectively. Prioritize getting enough physical activity on a daily basis, which helps to maintain many aspects of your health as well as your body weight. For some people, weight loss medications may be a part of their weight loss journey.
Medications. There are a variety of prescription medications that can help to reduce the body’s production of uric acid, break down uric acid in the body, or increase the clearance of uric acid by the kidneys. For patients who still have high uric acid levels after making lifestyle changes, and already are experience the complications of high uric acid such as gout or urinary stones, these medications may be useful
If your uric acid levels have been high in the past, it’s a good idea to continue monitoring your levels with blood tests and to go to your doctor for check-ups regularly. This allows you to detect any increases in uric acid levels early, so you can take action to bring your levels down before complications arise.
Conclusion
High uric acid levels can cause painful complications like gout and urinary stones. However, with the right combination of lifestyle changes and, if needed, medical treatment, long-term management is achievable. It’s important to have regular tests and check-ups and to stick to your planned lifestyle changes, to minimize the risk of future complications.
Unfortunately, many people don’t know that their uric acid levels are high until they experience a painful episode of gout or a urinary stone. That's where health screening can help: to detect this problem before any complications arise.
Our NOVI Assessment Max clients receive testing for uric acid levels along with many other metabolic markers. Our experts can then help you create a tailored lifestyle plan to effectively manage any potential concerns, including any medical treatments that would be appropriate. Early detection is the key to preventing complications and maximizing your chances of living a long and healthy life.