Uric Acid

July 21, 2020

What is Uric Acid?

​Uric acid, also known as urate, is a waste product from the breakdown of nitrogen-containing proteins called purines. Purines are found in substances like nucleic acids (DNA and RNA). Uric acid can be produced when food which contains nitrogen is digested. Uric acid is removed from the body in the urine after it has been removed from circulation by the kidneys. Unremoved uric acid leaves the body in the faeces.[1]

Why take a Uric Acid blood test?

A uric acid test is used to diagnose gout because high levels are indicative of the condition. Its levels can also be measured in urine to diagnose the cause of recurrent kidney disease.

If the body is failing to remove uric acid, then it is often a result of the loss of kidney function due to kidney disease.

Uric acid levels can be elevated in pre-eclampsia, a serious condition affecting pregnant women.

You can check your level of uric acid together with 50 other biomarkers integral to good health within Forth’s Ultimate blood test.

What function does Uric Acid have in the body?

Uric acid is a waste product formed when purines are broken down in the body. Nitrogen is a major constituent of purines and they are found in many foods and drinks, including alcohol.

When cells reach the end of their lifespan they are broken down and removed from the body and this process releases uric acid. During digestion or cell breakdown, the uric acid produced travels in the bloodstream to the kidneys where it is filtered out of the blood and excreted from the body in urine. However, some individuals produce too much uric acid or the kidneys don’t remove enough and this leads to a build up in the body, resulting in hyperuricemia. The build up of uric acid may signal kidney disease or lead to conditions such as gout.

How do changes in Uric Acid affect health and wellbeing?

Hyperuricaemia is caused by the overproduction of uric acid in the body or the kidney’s inability to remove uric acid. When uric acid levels increase, small crystals form in the joints which cause painful symptoms. Hyperuricaemia is the biggest risk factor for developing gout. However, not everyone who has hyperuricaemia goes on to develop gout and equally, during a gout attack serum uric acid levels may not be elevated.

High levels of uric acid may also form crystals or kidney stones.

If you are worried about your uric acid level or just want to check where you fall on the range, you can test your uric acid with Forth’s leading blood test service.

What can cause Uric Acid to change?

Hyperuricaemia can result in the development of kidney stones. Small kidney stones may not cause any problems or symptoms and may pass through the body via the urine. However, larger stones can get stuck in the urinary tract, particularly in the ureter (the tube which attaches the kidney to the bladder) and can cause infection.

Gout is a type of arthritis which develops because of high uric acid levels in the body. Uric acid crystals form and are deposited in the joints. A common place for these crystals to occur is in the ankle. Individuals who drink alcohol or are overweight are at an increased risk of developing gout, so too are postmenopausal women and individuals who use diuretic medication.[2]

What are the most common symptoms of high or low Uric Acid?

The symptoms of kidney stones include:

  • A constant ache in the lower back
  • Intense pain in the back, abdomen or groin
  • Nausea
  • Pain when passing water
  • Blood in urine
  • Needing to urinate more often
  • Feeling restless[3]

Any joint in the body can be affected by gout, but it is more common in the toes, ankles, knees and fingers. Symptoms of gout include:

  • Extreme pain in one or more joints
  • Heat and tenderness around the affected joint
  • Swelling in an around the affected joint
  • Red, shiny skin over the joint

How to keep Uric Acid in the healthy range

A combination of a healthy diet and regular exercise is a good way to keep your weight under control which in turn can reduce uric acid levels in the body. Alcohol can leave you more susceptible to developing gout. Beer is most likely to cause gout than wine. However, you should keep your intake of alcohol low to reduce uric acid levels.

If your uric acid levels are high, it is recommended that you avoid foods such as:

  • offal
  • oily fish
  • seafood
  • marmite
  • bovril
  • game

These foods are all high in purines which when broken down produce uric acid. Instead, you should eat low to moderate purine containing foods, such as:

Moderate:

  • beef
  • lamb
  • chicken
  • pork
  • baked beans
  • kidney beans
  • mushrooms
  • spinach
  • asparagus
  • wholegrains

Low:

  • dairy products
  • eggs
  • pasta
  • noodles
  • bread
  • cereals[4]

Although protein is an important aspect of our diet, a high intake of meat can increase the risk of gout. We need approximately 1gof protein per kilogram of body weight daily.

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References

[1] Lab Tests Online UK. (2013). Uric Acid Test. Available at: https://labtestsonline.org.uk/tests/uric-acid-test

[2] NHS Inform. (2019).  Gout. Available at: https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions/gout

[3] NHS. (2016). Kidney Stones. Available at: https://www.nhs.uk/conditions/kidney-stones/symptoms/

[4] UK Gout Society. (2018). All About Gout and Diet. Available at: http://www.ukgoutsociety.org/docs/goutsociety-allaboutgoutanddiet-0113.pdf

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This information has been medically reviewed by Dr Nicky Keay

Nicola has extensive clinical and research experience in the fields of endocrinology and sport and exercise medicine. Nicky is a member of the Royal College of Physicians, Honorary Fellow in the Department of Sport and Exercise Sciences at Durham University and former Research Fellow at St. Thomas' Hospital.

Dr Nicky Keay

Dr Nicky Keay

BA, MA (Cantab), MB, BChir, MRCP.