| Marker | Gabriel optimal | Typical lab range | Functional range |
|---|---|---|---|
| Uric Acid Men | 3.5 to 5 mg/dL | 3.5 to 7.2 | 3.5 to 5.4 |
| Uric Acid Women | 2 to 4 mg/dL | 3.5 to 7.2 | 3 to 4.7 |
Why a uric acid test is ordered
- Joint pain and swelling, often in the big toe, to help diagnose gout.
- Kidney stone symptoms, sometimes with a 24-hour urine uric acid test.
- During cancer treatment, because breaking down cancer cells releases large amounts of purines.
- Kidney disease, including chronic kidney disease or a kidney injury.
Normal ranges differ between labs, so compare your result with the range on your own report. As one example of a typical lab range, MedlinePlus lists 3.0 to 7.1 mg/dL for women and 4.0 to 8.6 mg/dL for men. The table on this page shows a common lab range next to Gabriel's optimal range, which is lower. See the uric acid lab guide for more.
What high uric acid can mean
High uric acid (hyperuricemia) happens when the body makes too much or the kidneys clear too little. It often causes no symptoms on its own. Possible causes and links:
- Diet and drink: a purine-rich diet, alcohol and fructose.
- Body and lifestyle: obesity, dehydration and very hard exercise.
- Medicines: diuretics, low-dose aspirin, niacin, cyclosporine and tacrolimus.
- Conditions: kidney disease, an underactive thyroid, psoriasis, some blood cancers and their treatment, and preeclampsia in pregnancy.
- Family history of gout or high uric acid.
Metabolic syndrome and obesity are both risk factors for gout. Cleveland Clinic also links high uric acid with diabetes and metabolic syndrome, so if yours is high, it can be worth looking at blood sugar and insulin too; see how insulin resistance is tested.
Uric acid and gout
Gout is inflammatory arthritis caused by urate crystals in and around a joint. It is more common in men, usually starts in middle age, and is uncommon in women before menopause.
- A blood test alone can't confirm gout. Seeing urate crystals in fluid drawn from the joint is the definitive test.
- Uric acid can read lower during a flare. In pooled trial data, 14% of people having a gout attack had a level under 6 mg/dL, so American Family Physician advises against measuring it during an acute attack.
- For people treated for gout, your clinician sets the goal. One guideline cited by American Family Physician, from the British Society for Rheumatology, aims for under 5 mg/dL.
Diet and uric acid
| What to limit | What the guidance says |
|---|---|
| Red meat and organ meats such as liver | Purine-rich meats are a risk factor for high uric acid and gout. |
| Shellfish such as shrimp and lobster, and some fish such as sardines | Purine-rich seafood raises the risk too; smaller portions, less often. |
| Alcohol, especially beer (including nonalcoholic beer) | Beer carries more risk than wine or liquor; avoiding alcohol is advised for gout. |
| Soda and other drinks with high-fructose corn syrup | Two or more sugar-sweetened soft drinks a day are linked to higher gout risk in men. |
| What to add | Plenty of water; skim milk and low-fat yogurt; cherries are also suggested. |
A low-purine diet and drinking plenty of water can help lower uric acid. Obesity is a risk factor, so reaching a healthy weight may help too. For people with two or more gout flares a year, kidney stones or other complications, a clinician may add a medicine that lowers uric acid.
Low uric acid, and what to ask next
Low uric acid is uncommon and usually doesn't cause health problems. It can follow a very low-purine diet or some medicines, such as losartan, fenofibrate or atorvastatin, and can also point to a kidney or inherited condition.
- Ask whether your result fits your symptoms, and whether to repeat it when you are not in a flare.
- Bring your medicine and supplement list. Aspirin and niacin can affect the test; never stop a medicine without your prescriber.
- Check kidney function on the same panel; see creatinine and eGFR.
See a clinician the same day for a hot, red, very painful joint with fever, which can be an infection. Get urgent care for severe side or back pain with fever, vomiting, or blood in your urine.
Common questions
What is a normal uric acid level?
It depends on the lab. MedlinePlus gives one typical lab range of 3.0 to 7.1 mg/dL for women and 4.0 to 8.6 mg/dL for men, and your report shows your lab's own range. Gabriel's optimal range is lower and shown in the table on this page.
Does high uric acid mean I have gout?
No. Many people with high uric acid never develop gout. Gout is diagnosed from symptoms and, when needed, by finding urate crystals in joint fluid.
What foods raise uric acid?
Red and organ meats, shellfish and some other seafood, alcohol (especially beer), and drinks sweetened with high-fructose corn syrup.
Can uric acid be normal during a gout attack?
Yes. Levels can drop during a flare, so a normal result then does not rule out gout. American Family Physician advises against measuring it during an attack.
Do I need to fast for a uric acid test?
MedlinePlus says not to eat or drink for 4 hours before, unless your clinician says otherwise. Tell them about all medicines and supplements, since aspirin and niacin can affect the result.
Sources
- Uric Acid Test MedlinePlus, U.S. National Library of Medicine
- Uric acid - blood MedlinePlus, U.S. National Library of Medicine
- Hyperuricemia (High Uric Acid Level) Cleveland Clinic
- Gout: Rapid Evidence Review (2020) American Family Physician
- Gout National Institute of Arthritis and Musculoskeletal and Skin Diseases
This guide is general information, not medical advice. It does not replace a visit with a licensed clinician. Gabriel membership is not health insurance.