What is uric acid?
Uric acid is produced in the body through breaking down nucleic acids and purines, which develop in the process of breaking down food (e.g. meat). After the nucleic acids and purines are broken down into uric acid, it is removed via the kidneys.
What is a normal uric acid level?
Some purines develop through normal processes in the body and are converted into 300 to 400 mg of uric acid per day. Further purines enter the body through food intake and are also converted into uric acid (300 to 600 mg/day). A healthy person's body contains around 1 g of uric acid. Interestingly, the level of uric acid in the blood is usually higher in the morning and lower in the evening. A normal uric acid level is below 6 mg/dl, or 360 µmol/l. A higher than normal uric acid level is called "hyperuricaemia".
How are uric acid levels tested?
Uric acid concentrations are measured through laboratory tests of blood and urine samples. In gout patients, the measurements are usually above 7 mg/dl of uric acid in the blood, often even higher than 8 mg/dl. By contrast, uric acid levels in the urine are lower than normal. During an acute gout attack, elevated uric acid levels are often not detectable in the blood; levels of pointers to inflammation are usually high.
Why is the uric acid level high?
A higher than normal uric acid level in the blood is caused either by overproduction of uric acid in the body or by decreased removal of uric acid by the kidneys. There are several possible reasons as to why the uric acid levels can be increased, for example:
- A diet high in foods containing purines, which are broken down into uric acid;
- Increased production of uric acid due to the breaking down of many cells;
- Insufficient filtering and removal of uric acid by the kidneys.
What should a gout patient know about uric acid levels?
In patients with gout, blood uric acid concentrations should be lower than 6 mg/dl (even below 5 mg/dl in patients with severe gout). To achieve this goal, uric acid-lowering medications should be considered.
How can you lower your uric acid level?
There are a number of possibilities to reduce the level of uric acid – most importantly, switching to a low-purine diet.
- Avoid very rich meals, fasting and dehydration.
- Drink at least two litres of fluid per day.
- Stop drinking alcohol.
- Slowly reduce obesity and overweight through a healthy diet and plenty of exercise. Physical activity helps to lower uric acid levels. Uric acid-lowering therapy is also necessary. These drugs must be prescribed by a physician.