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High uric acid level in the blood

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High uric acid level in the blood

What is high uric acid in the blood called?

  • Hyperuricemia

What is the normal uric acid level in the blood?

If you need to know which are the uric acid reference ranges or you require more information about the role of uric acid in the blood you can visit: Normal uric acid level in the blood

What does a high uric acid level in the blood mean?

High uric acid level in the blood, called hyperuricemia, requires follow-up.

Uric acid is the final product of the purines metabolism present in the food. Uric acid is excreted in the urine after being filtrated in the kidneys. There are two types of hyperuricemia.

  • Primary hyperuricemia
  • Secondary hyperuricemia (it is a consequence of another disease or cause)

Primary hyperuricemia can be idiopathic (with not known reason) or hereditary. In many cases, it is caused because the renal excretion of uric acid is lower than normal. A 1% of the people with primary hyperuricemia have an enzymatic disorder related to the purines metabolism that increase the uric acid production.

Secondary hyperuricemia can be caused by an excessive purine intake, kidney failure, myeloproliferative diseases, hemolytic diseases, psoriasis, polycythemia vera, alcohol abuse, lead poisoning, starvation or chemotherapy.

The uric acid excess in the blood can create crystals. If these crystals are accumulate in the joints may cause gout, a painful disease related to the inflammation of the joints. Gout attacks occur suddenly and are very painful. The big toe, the knee or the ankle are the most commonly joints involved.

These crystals may also formed kidney stones, especially if the pH of the urine is low (pH < 5).

Uric acid values are usually given in mg/dl but sometimes you can see those values in nmol/l following the International System of Units (SI). In case your values are in nmol/l you can convert them using this tool:

µmol/l
  • Mild hyperuricemia (7.2 - 9 mg/dl in adult men and 6 - 9 mg/dl in adult women) :

    Your uric acid level is a bit high. The possibility of suffering a gout attack is low. Only about 0.5 to 3.5% of people with this level of uric acid in the blood will suffer a gout attack in the following years.

    It is advisable to follow a balanced diet to reduce the uric acid level avoiding food rich in purines and cut down on alcohol intake, including wine and beer.

  • Moderate hyperuricemia (9 - 10 mg in adults) :

    Your uric acid level in the blood is moderately high. About 7 or 8 % of the people with moderate hyperuricemia will experiment a gout attack in the following years if the level is not reduced.

    It is advisable to follow a low-purine diet, avoid alcohol drinking and increase the water intake to excrete more acid uric in the urine.

  • Marked hyperuricemia (> 10 mg/dl in adults) :

    Your uric acid level in the blood is very high. More than 90% of people with marked hyperuricemia will experiment a gout attack in the following 5 years. For that reason, you should visit your doctor. He will give you a strict diet that you must follow and maybe medication to reduce your uric acid level.

    Medication is usually given when there is a previous gout attack or kidney stones or if the uric acid level in the blood is above 13 mg/dl in men and 10 mg/dl in women.

Which factors can raise the uric acid level in the blood?

There are some health circumstances or drugs than can raise your uric acid in the blood:

  • Alcohol
  • Nicotinamida (vitamin B3) excess
  • Radiocontrast agent
  • Purine-rich diet
  • Stress
  • Excessive exercising
  • Starvation
  • Lead poisoning
  • Burns
  • Chemotherapy
  • Injury
  • Drugs
    • Antibiotics
      • Ethambutol
    • Antituberculars
      • Pyrazinamide
    • Low dose aspirin theraphy (1-2 g/day)
    • Diuretics
      • Etacrynic acid
      • Furosemide
      • Thiazides
    • L-DOPA
    • Theophylline

Which diseases can raise your uric acid level in the blood?

There are different diseases why the uric acid level in the blood can be higher than normal:

  • Gout
  • Metabolic acidosis
  • Lactic acidosis
  • Diabetes mellitus
  • Eclampsia
  • Hypoparathyroidism
  • Leukemia
  • Nephrolithiasis
  • Polycythemia vera
  • Rheumatoid arthritis
  • Multiple myeloma
  • Sarcoidosis
  • Hypothyroidism
  • Lesch–Nyhan syndrome
  • Von Gierke disease
  • Kidney failure
  • Psoriasis

What can I do to lower the uric acid level in the blood?

If your uric acid level in the blood is too high you can consider the next tips:

  • Avoid alcohol consumption, especially beer
  • Drink more water (drink at least 2 liter of water every day)
  • Reduce purine intake. High-purine foods that you should not eat are:
    • Meat: Brains, liver, kidneys, red meat (beef, pork), meat extracts
    • Fish: Anchovies, trout, salmon, sardines, herring, mackerel, cod.
    • Seafood: Scallops, mussels, prawns, oysters, lobster, etc.
    • Vegetables: Mushrooms, asparagus, peas, kale, spinach, green beans
    • Legumes: Lentils, beans
  • Avoid overweight and obesity
  • Avoid prolonged fasting

Where can I find more information about uric acid level in the blood?

You can visit our pages about:

Which values are considered a high uric acid level in the blood?

The following values are considered to be above the normal range:

IMPORTANT: These levels are expressed in mg/dl They are an example of a healthy man of about 45 years old with no known disease and not taking any medication. The ranges can be different depending on the laboratory or on your personal circumstances.

Uric acid
Status
Mild hyperuricemia
7.3 mg/dl7.4 mg/dl7.5 mg/dl7.6 mg/dl7.7 mg/dl7.8 mg/dl7.9 mg/dl8 mg/dl
8.1 mg/dl8.2 mg/dl8.3 mg/dl8.4 mg/dl8.5 mg/dl8.6 mg/dl8.7 mg/dl8.8 mg/dl
8.9 mg/dl9 mg/dl      
Moderate hyperuricemia
9.1 mg/dl9.2 mg/dl9.3 mg/dl9.4 mg/dl9.5 mg/dl9.6 mg/dl9.7 mg/dl9.8 mg/dl
9.9 mg/dl10 mg/dl      
Marked hyperuricemia
10.1 mg/dl10.2 mg/dl10.3 mg/dl10.4 mg/dl10.5 mg/dl10.6 mg/dl10.7 mg/dl10.8 mg/dl
10.9 mg/dl11 mg/dl11.1 mg/dl11.2 mg/dl11.3 mg/dl11.4 mg/dl11.5 mg/dl11.6 mg/dl
11.7 mg/dl11.8 mg/dl11.9 mg/dl12 mg/dl12.1 mg/dl12.2 mg/dl12.3 mg/dl12.4 mg/dl
12.5 mg/dl12.6 mg/dl12.7 mg/dl12.8 mg/dl12.9 mg/dl13 mg/dl13.1 mg/dl13.2 mg/dl
13.3 mg/dl13.4 mg/dl13.5 mg/dl13.6 mg/dl13.7 mg/dl13.8 mg/dl13.9 mg/dl14 mg/dl
14.1 mg/dl14.2 mg/dl14.3 mg/dl14.4 mg/dl14.5 mg/dl14.6 mg/dl14.7 mg/dl14.8 mg/dl
14.9 mg/dl15 mg/dl15.1 mg/dl15.2 mg/dl15.3 mg/dl15.4 mg/dl15.5 mg/dl15.6 mg/dl
15.7 mg/dl15.8 mg/dl15.9 mg/dl16 mg/dl16.1 mg/dl16.2 mg/dl16.3 mg/dl16.4 mg/dl
16.5 mg/dl16.6 mg/dl16.7 mg/dl16.8 mg/dl16.9 mg/dl17 mg/dl17.1 mg/dl17.2 mg/dl
17.3 mg/dl17.4 mg/dl17.5 mg/dl17.6 mg/dl17.7 mg/dl17.8 mg/dl17.9 mg/dl18 mg/dl
18.1 mg/dl18.2 mg/dl18.3 mg/dl18.4 mg/dl18.5 mg/dl18.6 mg/dl18.7 mg/dl18.8 mg/dl
18.9 mg/dl19 mg/dl19.1 mg/dl19.2 mg/dl19.3 mg/dl19.4 mg/dl19.5 mg/dl19.6 mg/dl
19.7 mg/dl19.8 mg/dl19.9 mg/dl20 mg/dl    
foto de Dr. Javier Muga Bustamante
Written by

Dr. Javier Muga Bustamante

Last update: 06/04/2020

Bibliography

  • Concise Book of Medical Laboratory Technology: Methods and Interpretations. 2nd Edition. 2015. Ramnik Sood. ISBN: 978-93-5152-333-8. Pag. 492.
  • Painter PC, Cope JY, Smith JL. Reference information for the clinical laboratory. In: Burtis CA, Ashwood ER, eds. Tietz textbook of clinical chemistry. Philadelphia: WB Saunders Company, 1999;1838pp. ISBN 9780721656106.
  • Thomas L. Uric acid. In: Thomas L, Hrsg. Labor und Diagnose. Indikation und Bewertung von Laborbefunden für die medizinische Diagnostik. Frankfurt/Main: TH-Books Verlagsgesellschaft, 2005:280-289.
  • Common Terminology Criteria for Adverse Events (CTCAE). Version 5.0.Published: November 27, 2017. U.S. Department of health and human Services. Disponible en: https://ctep.cancer.gov

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