High uric acid level Causes - Mayo Clinic References Uric acid. Lab Tests Online. Accessed Oct. 6, 2015. Questions and answers about gout. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Accessed Oct. 6, 2015. Kim SY, et al. Hyperuricemia and coronary heart disease: A systematic review and meta-analysis. Arthritis Care & Research. 2010;62:170. Ohno, I. Relationship between hyperuricemia and chronic kidney disease. Nucleosides, Nucleotides and Nucleic Acids. 2011;30:1039. Kanbay M, et al. Uric acid in hypertension and renal disease: The chicken or the egg? Blood Purification. 2010;30:288. Hochberg J, et al. Tumor lysis syndrome: Current perspective. Haematologica. 2008;93:9. So A, et al. Uric acid transport and disease. The Journal of Clinical Investigation. 2010;120:1791. Becker MA.

Asymptomatic hyperuricemia. Accessed Nov. 2, 2015. Wilkinson JM (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 29, 2015. Products and Services Hyperuricemia (High Uric Acid) - Managing Side Effects - Chemocare Managing Side Effects Care During Chemotherapy and Beyond Hyperuricemia (High Uric Acid) What is hyperuricemia? Hyperuricemia is an excess of uric acid in the blood. Uric acid passes through the liver, and enters your bloodstream. Most of it is excreted (removed from your body) in your urine, or passes through your intestines to regulate "normal" levels. Normal Uric acid levels are 2.4-6.0 mg/dL (female) and 3.4-7.0 mg/dL (male). Normal values will vary from laboratory to laboratory. Also important to blood uric acid levels are purines. Purines are nitrogen-containing compounds, which are made inside the cells of your body (endogenous), or come from outside of your body, from foods containing purine (exogenous).

Purine breaks down into uric acid. Increased levels of uric acid from excess purines may accumulate in your tissues, and form crystals. This may cause high uric acid levels in the blood. Uric acid formation may occur when the blood uric acid level rises above 7 mg/dL. Problems, such as kidney stones, and gout (collection of uric acid crystals in the joints, especially in your toes and fingers), may occur. What causes hyperuricemia? Causes of high uric acid levels (hyperuricemia) can be primary (increased uric acid levels due to purine), and secondary (high uric acid levels due to another disease or condition). Sometimes, the body produces more uric acid than it is able to excrete. Causes of high uric acid levels include: Primary hyperuricemia Increased production of uric acid from purine Your kidneys cannot get rid of the uric acid in your blood, resulting in high levels Secondary hyperuricemia Certain cancers, or chemotherapy agents may cause an increased turnover rate of cell death. This is usually due to chemotherapy, but high uric acid levels can occur before chemotherapy is administered.

After chemotherapy, there is often a rapid amount of cellular destruction, and tumor lysis syndrome may occur. You may be at risk for tumor lysis syndrome if you receive chemotherapy for certain types of leukemia, lymphoma, or multiple myeloma, if there is a large amount of disease present. Kidney disease - this may cause you to not be able to clear the uric acid out of your system, thus causing hyperuricemia. Medications - can cause increased levels of uric acid in the blood Endocrine or metabolic conditions -certain forms of diabetes, or acidosis can cause hyperuricemia Elevated uric acid levels may produce kidney problems, or none at all. People may live many years with elevated uric acid levels, and they do not develop gout or gouty arthritis (arthritis means "joint inflammation"). Only about 20% of people with elevated uric acid levels ever develop gout, and some people with gout do not have significantly elevated uric acid levels in their blood. What are some symptoms of hyperuricemia to look for? You may not have any symptoms.

If your blood uric acid levels are significantly elevated, and you are undergoing chemotherapy for leukemia or lymphoma, you may have symptoms kidney problems, or gouty arthritis from high uric acid levels in your blood. You may have fever, chills, fatigue if you have certain forms of cancer, and your uric acid levels are elevated (caused by tumor lysis syndrome) You may notice an inflammation of a joint (called "gout"), if the uric acid crystals deposit in one of your joints. (*Note- gout may occur with normal uric acid levels, too). You may have kidney problems (caused by formation of kidney stones), or problems with urination Things you can do about hyperuricemia: Make sure you tell your doctor, as well as all healthcare providers, about any other medications you are taking (including over-the-counter, vitamins, or herbal remedies). Remind your doctor or healthcare provider if you have a history of diabetes, liver, kidney, or heart disease. Follow your healthcare provider's instructions regarding lowering your blood uric acid level and treating your hyperuricemia. If your blood levels are severely elevated, he or she may prescribe medications to lower the uric acid levels to a safe range.

If you have an elevated blood uric acid level, and your healthcare provider thinks that you may be at risk for gout, kidney stones, try to eat a low purine diet. Foods that are high in purine include: All organ meats (such as liver), meat extracts and gravy Yeasts, and yeast extracts (such as beer, and alcoholic beverages) Asparagus, spinach, beans, peas, lentils, oatmeal, cauliflower and mushrooms Foods that are low in purine include: Refined cereals - breads, pasta, flour, tapioca, cakes Milk and milk products, eggs Lettuce, tomatoes, green vegetables Cream soups without meat stock Water, fruit juice, carbonated drinks Peanut butter, fruits and nuts Keep well hydrated, drinking 2 to 3 liters of water per day, unless you were told otherwise. Take all of your medications for hyperuricemia as directed Avoid caffeine and alcohol, as these can contribute to problems with uric acid and hyperuricemia. Avoid medications, such as thiazide diuretics (hydrochlortiazide), and loop diuretics (such as furosemide or Lasix®).

Also, drugs such as niacin, and low doses of aspirin (less than 3 grams per day) can aggravate uric acid levels. Do not take these medications, or aspirin unless a healthcare provider who knows your condition told you. If you experience symptoms or side effects, especially if severe, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems. Drugs or treatments that may be prescribed by your doctor to treat hyperuricemia: Your doctor or healthcare provider may prescribe medications if you have a high blood uric acid levels. These may include: Non-steroidal anti-inflammatory (NSAID) agents and Tylenol®- such as naproxen sodium and ibuprofen may provide relief of gout-related pain. Gout may be a result of a high uric acid level. If you are to avoid NSAID drugs, because of your type of cancer or chemotherapy you are receiving, acetaminophen (Tylenol() up to 4000 mg per day (two extra-strength tablets every 6 hours) may help.

It is important not to exceed the recommended daily dose of Tylenol, as it may cause liver damage. Discuss this with your healthcare provider. Uricosuric Drugs: These drugs work by blocking the reabsorption of urate, which can prevent uric acid crystals from being deposited into your tissues. Examples of uricosuric drugs include probenecid, and sulfinpyrazone. Xanthine oxidase inhibitors - Such as allopurinol, will prevent gout. However, it may cause your symptoms of gout to be worse if it is taken during an episode of painful joint inflammation. Allopurinol may also be given to you, if you have a certain form of leukemia or lymphoma, to prevent complications from chemotherapy and tumor lysis syndrome - and not necessarily to prevent gout. With high levels of uric acid in your blood, as a result of your disease, the uric acid will collect and form crystals in your kidneys. This may occur during chemotherapy, and may cause your kidneys to fail. When to call your doctor or health care provider: Localized joint pain (especially in a toe or finger joint), that is red and inflamed.

Shortness of breath, chest pain or discomfort; should be evaluated immediately. Feeling your heart beat rapidly (palpitations). Bleeding that does not stop after a few minutes. Any new rashes on your skin - especially if you have started any new medications. Return to list of Blood Test Abnormalities Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice. Chemocare.com is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit Symptoms of Gout Are Related to Excess Uric Acid 0 By Dr. Mercola Rates of gout have skyrocketed in the UK, rising 64 percent between 1997 and 2012. 1 That equates to about a four percent rise every year, and this painful condition now affects one in 40 people!

Unfortunately, many of the media outlets that picked up this story have been focusing on the researchers' finding that access to medication was a problem, and rates of people using uric-acid-lowering medications remained "suboptimal." If you struggle with gout, as increasing numbers of people do, the message to take home is that you don't need to take drugs to deal with this potentially excruciating condition. You can address the underlying cause of excess uric acid formation through all natural means, and very effectively at that. Gout is, after all, primarily a lifestyle-related disease. The Symptoms of Gout Are Related to Excess Uric Acid Uric acid is a normal waste product found in your blood. High levels of uric acid are associated with gout, which is a type of painful arthritis and inflammation, and about half the time, targets the base of the big toe. It has been known for some time that people with high blood pressure, overweight, and people with kidney disease often have high uric acid levels as well. Uric acid functions both as an antioxidant and as a pro-oxidant once inside your cells. So, if you lower uric acid too much, you lose its antioxidant benefits.

But if your uric acid levels are too high, it tends to increase to harmful levels inside your cells as well, where it acts as a pro-oxidant. When the metabolic processes that control the amount of uric acid in your blood fail to do their job effectively, gout occurs. The stiffness and swelling are a result of excess uric acid-forming crystals in your joints, and the pain associated with this condition is caused by your body's inflammatory response to the crystals. The symptoms associated with gout can be excruciating. In fact, gout is described as one of the most painful forms of arthritis. Most often, gout attacks the big toe first, with sufferers often describing it as being burned by a flame or skewered with a hot poker. Gout symptoms usually go away within three to 10 days, and the next attack may not occur for months, or even years, if at all. However, oftentimes, gout becomes a lifelong problem, with attacks occurring with increasing frequency and severity. In time, this can permanently damage your joints and surrounding areas, especially if you don't take steps to help reduce your uric acid levels.

Why Drugs Are Not the Long-Term Solution for Gout Conventional approaches to the treatment of gout typically involve the use of drugs like: Allopurinol, which works by reducing the amount of uric acid made by the body Colchicine, which blocks the inflammation caused by uric acid crystals Non-steroidal anti-inflammatory drugs (NSAIDs) These drugs may work in the short term, but they also may have very dangerous, long-term side effects. Because gout is frequently a lifelong condition, you may end up staying on these drugs for very long periods of time, which can wreak havoc with your health. Any time we're talking about reducing inflammation, please remember that your diet is your number one priority. This is especially true with gout, as it's known that meats and purine-rich foods can raise uric acid. Even more importantly, however, is the fact that one of the most potent ways to raise uric acid is by consuming large amounts of fructose! If You Have Gout, Carefully Limit Your Fructose Total Video Length: 43:35 Uric acid is a byproduct of fructose metabolism . In fact, fructose typically generates uric acid within minutes of ingestion.

I became fully aware of the dramatic and devastating impact fructose has on your uric acid levels when I interviewed Dr. Richard Johnson on this topic . You can watch that interview above. Dr. Johnson's research focuses on how fructose -- which is among the top sources of calories in the US diet – causes obesity, diabetes, and a number of other common diseases, including: Gout High cholesterol and high triglycerides Kidney disease and fatty liver disease Heart disease As it turns out, a major component of all of these diseases is elevated uric acid, and more recent research shows that fructose is the ONLY type of sugar that will raise your uric acid levels! Fructose is distinctly different from other sugars as it's metabolized through very specific pathways that differ from those of glucose, for example, and it is through this distinct metabolic action that uric acid is generated. According to Dr. Johnson's research, uric acid appears to take on a lead role in creating health problems when it reaches levels in your body of 5.5 mg per dl or higher. At this level, uric acid is associated with an increased risk for developing high blood pressure, as well as diabetes, obesity, and kidney disease.

The ideal range for uric acid lies between 3 to 5.5 mg per dl. The connection between fructose consumption and increased uric acid is so reliable that a uric acid level taken from your blood can actually be used as a marker for fructose toxicity. I now recommend that a uric acid level be a routine part of your blood screening. Interestingly and not commonly noted, low-carb diets that move one towards a nutritional ketosis can also cause a high uric acid level. It is unclear if uric acid elevation from this route can cause the same damage as that from a high fructose intake. This actually occurred to me and after discussing it with Dr. Johnson I have concluded that it is harmless in this scenario. Research Connects Fructose-Rich Beverages to Gout If you're still not convinced that fructose could be increasing your risk of gout , consider a JAMA study from 2010. 2 The analysis showed that women who drank more than two cans of soda per day were more than twice as likely to develop gout, compared with women who rarely drank soda. Drinking 12 ounces or more of orange juice daily had the roughly the same effect.

Additionally, as reported by CNN: 3 "Women who had just one soda or 6-ounce glass of OJ per day were at 74 percent and 41 percent greater risk, respectively, compared with women who rarely drank either. The culprit appears to be fructose, says the lead author of the study, Dr. Hyon Choi, M.D., a professor of medicine at Boston University School of Medicine." A similar study on men also revealed that men who drank two or more sugary soft drinks a day had an 85 percent higher risk of gout than those who drank less than one a month. 4 The risk significantly increased among men who drank five to six servings of sugary soft drinks a week. Fruit juice and fructose-rich fruits such as oranges and apples also increased the risk. As a general health rule, I recommend limiting your total fructose consumption to about 25 grams per day on average, and that includes fructose from fruit. However, if you have insulin resistance, heart disease, cancer, high blood pressure, or elevated uric acid levels, you may want to cut it down to 15 grams or less. For those who are particularly sensitive to fructose, Dr.

Johnson has developed a program to help people optimize their uric acid levels, and the key step in this program is complete elimination of fructose, until your levels are within the ideal range of 3-5.5 mg/dl. The chart below is excerpted from Dr. Johnson's book, The Sugar Fix, which contains more details on the fructose content of common foods. You can use it to help you cut back in your diet: Fruit 23.0 Top Lifestyle Changes for Fighting and Preventing Gout Limiting fructose in your diet is one of the most important parts of managing and preventing gout attacks, and you can find a simple guide for doing so using my nutrition plan . You'll want to be sure to cut out soda, fruit drinks, and other sweetened beverages, as these types of drinks are a primary source of excessive fructose. Instead, drink plenty of pure water, as the fluids will help to remove uric acid from your body. Other top tips include: • Limit Alcohol Consumption, Especially Beer: Gout is more likely if you drink too much alcohol but beer in particular may be problematic.

It turns out that the yeast and all that's used to make beer work together to make beer another powerful uric acid trigger. While this concept is still new, pilot studies support Dr. Johnson's findings, so beer consumption is also something to definitely consider when you're watching your weight and trying to improve your health. • Eat Tart Cherries in Moderation: Cherries contain powerful compounds like anthocyanins and bioflavonoids, which are known to fight inflammation and may help lower your uric acid levels. 5 If you eat cherries for their therapeutic value, 10 sweet cherries or 1 cup of sour cherries contain about 4 grams of fructose, so be sure to take that into account for your total daily fructose consumption. • Avoid Soy Milk: There is some research showing it may increase uric acid levels by about 10 percent. 6 • Consider Therapeutic Herbs: Certain herbs and spices, including ginger, 7 cinnamon , 8 and ashwaganda, 9 have been shown to potentially help relieve gout symptoms and its associated inflammation.

• Eat More Potassium-Rich Foods: Potassium deficiency is sometimes seen in people with gout, and potassium citrate preparations, which are known to alkalize your urine, may help your body to excrete uric acid. 10 A proper balance of potassium both inside and outside your cells is crucial for your body to function properly, but if you eat a highly processed diet (the same type often associated with gout), you may not be getting enough. Potassium is widely available in fruits and vegetables, but I've included some of the most beneficial sources below. If you want to supplement, consider using potassium bicarbonate, which is probably the best potassium source to use as a supplement. I personally use it every night in my dental irrigator.

✓ Swiss chard (960 mg of potassium per 1 cup) ✓ Avocado (874 mg per cup) ✓ Spinach (838 mg per cup) ✓ Crimini mushrooms (635 mg in 5 ounces) ✓ Broccoli (505 mg per cup) ✓ Brussels sprouts (494 mg per cup) ✓ Celery (344 mg per cup) ✓ Romaine lettuce (324 mg per 2 cups) 0 Uric Acid in Blood Uric Acid in Blood Test Overview The blood uric acid test measures the amount of uric acid in a blood sample. Uric acid is produced from the natural breakdown of your body's cells and from the foods you eat. Most of the uric acid is filtered out by the kidneys and passes out of the body in urine. A small amount passes out of the body in stool. But if too much uric acid is being produced or if the kidneys are not able to remove it from the blood normally, the level of uric acid in the blood increases. High levels of uric acid in the blood can cause solid crystals to form within joints. This causes a painful condition called gout .

If gout remains untreated, these uric acid crystals can build up in the joints and nearby tissues, forming hard lumpy deposits called tophi . High levels of uric acid may also cause kidney stones or kidney failure . Why It Is Done Help diagnose gout . Check to see if kidney stones may be caused by high uric acid levels in the body. Check to see if medicine that decreases uric acid levels is working. Check uric acid levels in people who are undergoing chemotherapy or radiation therapy . These treatments destroy cancer cells that then may leak uric acid into the blood. How To Prepare You do not need to do anything before you have this test. Some medicines can change the results of this test. Be sure to tell your doctor about all the nonprescription and prescription medicines you take. Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results may mean. To help you understand the importance of this test, fill out the medical test information form (What is a PDF document?). How It Is Done The health professional who takes a sample of your blood will: Wrap an elastic band around your upper arm to stop the flow of blood.

This makes the veins below the band larger so it is easier to put a needle into the vein. Clean the needle site with alcohol. Put the needle into the vein. More than one needle stick may be needed. Attach a tube to the needle to fill it with blood. Remove the band from your arm when enough blood is collected. Put a gauze pad or cotton ball over the needle site as the needle is removed. Put pressure on the site and then put on a bandage. Continued How It Feels The blood sample is taken from a vein in your arm. An elastic band is wrapped around your upper arm. It may feel tight. You may feel nothing at all from the needle, or you may feel a quick sting or pinch. Risks There is very little chance of a problem from having a blood sample taken from a vein. You may get a small bruise at the site. You can lower the chance of bruising by keeping pressure on the site for several minutes. In rare case, the vein may become swollen after the blood sample is taken. This problem is called phlebitis . A warm compress can be used several times a day to treat this. Ongoing bleeding can be a problem for people with bleeding disorders.

Aspirin , warfarin ( Coumadin ), and other blood-thinning medicines can make bleeding more likely. If you have bleeding or clotting problems, or if you take blood-thinning medicine, tell your doctor before your blood sample is taken. Results Low uric acid values may be caused by: Severe liver disease, Wilson's disease , or some types of cancer. The syndrome of inappropriate antidiuretic hormone (SIADH), a condition that causes large amounts of fluid to build up in the body. Not eating enough protein. Sulfinpyrazone , large amounts of aspirin (1,500 mg or more daily), probenecid (such as Probalan ), and allopurinol (such as Zyloprim ). What To Think About Having a high uric acid level does not mean that you have gout . If your uric acid level is high and you do not have any other symptoms, you will not need to take any medicine to decrease your uric acid level. A high level of uric acid in the blood does not always mean that a person with a painful joint has gout .

Testing the fluid taken from an affected joint for the presence of uric acid crystals is the only sure method to diagnose gout . To learn more, see the topic Joint Fluid Analysis . Uric acid may also be measured in urine. If your blood uric acid level is high, a 24-hour urine collection may help your doctor find out whether your body is producing too much uric acid or your kidneys are not getting rid of enough of it. To learn more, see the topic Uric Acid in Urine . Uric acid blood levels vary from day to day. The level is usually higher in the morning and lower in the evening. Blood uric acid levels that increase during pregnancy , even if the levels remain within the normal range, may help diagnose preeclampsia . Continued What Is Gout - Causes, Symptoms and Treatment Credit: Alice Day | shutterstock Also called "gouty arthritis," gout is a painful form of arthritis caused by too much uric acid in the body. The painful flare-ups may be concentrated in the big toe (a symptom known as podagra), as well as swelling and pain in the ankles, knees, feet, wrists or elbows.

Flare-ups last days in the beginning, but can become progressively longer. Left untreated, gout can cause permanent damage to joints and kidneys, according to the National Institutes of Health (NIH). Gout is most commonly seen in men, particularly those between the ages of 40 and 50. It is a very common disease. Six million adults age 20 and older have reported being diagnosed with gout according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). "Gout is the most common form of inflammatory arthritis. It is caused by an elevation of serum uric acid levels that cause crystals to accumulate in the joints, which bring on a gout flare," Dr. N. Lawrence Edwards, professor of medicine, rheumatology and clinical immunology at the University of Florida and chairman and CEO of the Gout & Uric Acid Education Society, told Live Science. Causes Uric acid is a waste product created during the normal breakdown of purines, naturally occurring substances found in foods such as liver, mushrooms, anchovies, mackerel and dried beans according to the NIAMS .

Uric acid is normally cleaned out of the blood by the kidneys, and passes out of the body along with urine. However, high levels of uric acid can accumulate in the body, either when the kidneys excrete too little uric acid or when the body produces too much uric acid. This condition is known as hyperuricemia, according to the NIH. The high concentration of uric acid in the blood will eventually convert the acid into urate crystals, which can then accumulate around the joints and soft tissues. Deposits of the needle-like urate crystals are responsible for the inflammation and the painful symptoms of gout. There are several factors that can make a person more susceptible to gout, according to the NIH. A few are: Having a family history of gout Being overweight Taking certain medications like diuretics or niacin Symptoms According to the Mayo Clinic , common symptoms of gout are: Intense joint pain that is most severe in the first 12 to 24 hours Joint pain that lasts a few days to a few weeks and spreads to more joints over time Redness, tenderness and swelling of the joints Gout vs.

rheumatoid arthritis Gout and rheumatoid arthritis (RA) both cause bumpy, painful joints, but they couldn't be more different. Rheumatoid arthritis is a disease in which the body's immune system attacks itself, causing damage to tissue and organs while gout has nothing to do with the immune system. "Unfortunately, when chronic, it can involve many joints making it difficult to distinguish from rheumatoid arthritis," Dr. Nathan Wei, a rheumatologist and director of the Arthritis Treatment Center in Frederick, Maryland, told Live Science. "Obviously, if the patient has a high level of rheumatoid factor and anti-CCP, that helps. However, a few patients may have concomitant RA and gout." Gout vs. Pseudogout Gout and pseudogout closely resemble each other, but they each have very different characteristics. "The amount of pain suffered by a patient with pseudogout is usually less than is experienced by a gout patient," Edwards said.

"The main difference between gout and pseudogout are the types of crystals that deposit into the joints and cause inflammation." Edwards went on to point out that monosodium urate (MSU) crystals cause gout, while pseudogout is caused by calcium pyrophosphate crystals. Test and diagnosis While gout has painful and distinctive symptoms during flare-ups, its symptoms can be vague during other times. A doctor may extract a sample of joint fluid so it can be examined under a microscope for any presence of urate crystals, according to the NIAMS. Certain joint infections can produce symptoms similar to gout. If an infection is suspected, the doctor may check joint fluid for bacteria. Blood tests can reveal the concentration of uric acid in the blood and further confirm the diagnosis. However, according to the Mayo Clinic , blood tests can be misleading, because some gout patients do not have an unusual level of uric acid in their blood, and some people with high levels of uric acid do not go on to develop gout. Treatment and prevention "A patient’s gout will not get better until they start taking uric-acid-lowering drugs.

Patients need to know that their serum uric acid level should be below the target of 6 milligrams per deciliter (mg/dL). While gout cannot be cured, it can be better managed, or even controlled completely, with the right medications and lifestyle choices," Edwards said. In most cases, long-term medications for lowering uric acid will be used to treat gout and prevent flares gout. "Generally, patients with gout will need to be on these drugs for life. If they stay on them over time, their gout symptoms and risk of deformity or disability will be greatly decreased," Edwards added. The painful symptoms of gout can be alleviated by nonsteroidal anti-inflammatory drugs (NSAIDs), which can reduce both pain and inflammation around the joints, according to the University of Maryland . Depending on the severity of the flare-ups, patients can be treated with over-the-counter NSAIDs such as ibuprofen (Advil or Motrin), or naproxen (Aleve) or with prescription-strength painkillers such as indomethacin (available under the trade name Indocin).

Corticosteroids, such as prednisone, can be injected directly into the affected joints for relief within a few hours, according to Mayo Clinic . However, despite their effectiveness, corticosteroids must be used sparingly, because they can weaken bones or poor wound healing. Another pain reliever commonly used to reduce gout pain is colchicine. It is most effective when taken within the first 12 hours of symptoms, according to NIAMS. Once the flare-up subsides, the doctor may prescribe low, daily doses of colchicine to ward off future attacks. Beyond medications, patients can also control the frequency of flare-ups through exercise and diet adjustments. Because uric acid is created during the digestion and breakdown of purines, patients can reduce the concentration of uric acid in the blood by avoiding high-purine foods such as anchovies, asparagus, dried beans and peas, mushrooms and organ meats (such as livers and kidneys). The Mayo Clinic also suggests that patients should drink more water and less alcohol, because alcohol can raise the level of uric acid in the blood. This article is for informational purposes only, and is not meant to offer medical advice.

Uric acid urine test: MedlinePlus Medical Encyclopedia DO NOT stop taking any medicine before talking to your provider. Be aware that alcoholic drinks, vitamin C, and x-ray dye can also affect test results. How the Test will Feel The test involves only normal urination. There is no discomfort. Why the Test is Performed This test may be done to help determine the cause of a high uric acid level in the blood. It may also be done to monitor people with gout, and to choose the best medicine to lower the uric acid level in the blood. Uric acid is a chemical created when the body breaks down substances called purines. Most uric acid dissolves in blood and travels to the kidneys, where it passes out in urine. If your body produces too much uric acid or does not remove enough of it, you may get sick. A high level of uric acid in the body is called hyperuricemia and it can lead to gout or kidney damage. This test may also be done to check whether a high uric acid level is causing kidney stones. Normal Results Normal values range from 250 to 750 milligrams per 24 hours. Normal value ranges may vary slightly among different laboratories.

Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test results. What Abnormal Results Mean A high uric acid level in the urine may be due to: Body not being able to process purine ( Lesch-Nyhan syndrome) Certain cancers that have spread (metastasized) Disease that results in breakdown of muscle fibers ( rhabdomyolysis ) Disorders that affect the bone marrow (myeloproliferative disorder) Uric acid crystals References Burns CM, Wortmann RL. Clinical features and treatment of gout. In: Firestein GS, Budd RC, Gabriel SE, et al., eds. Kelly's Textbook of Rheumatology. 9th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 95. Inker LA, Fan L, Levey AS. Assessment of renal function. In: Johnson RJ, Feehally J, Floege J. Comprehensive Clinical Nephrology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 3. Landry DW, Bazari H. Approach to the patient with renal disease.

In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 114. McPherson RA, Ben-Ezra J. Basic examination of urine. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 28. Read More Diseases and Conditions Gout Gout Fast Facts Intensely painful, swelling joints (most often in the big toe or other part of the foot) and/or bouts of arthritis that come and go may indicate gout. Finding the characteristic crystals in the fluid of joints allows health care providers to correctly diagnose gout. Gout treatments exist, but therapy should be tailored for each person. Treatment choices depend on kidney function, other health problems, personal preferences and other factors. Patients may need medications to lower their elevated blood uric acid levels that predispose to gout. The goal is a uric acid level less than 6 milligrams per deciliter (mg/dL). There are two types of medicine for gout.

For control of acute attacks of joint pain, there are NSAIDs , colchicine and corticosteroids. After gout flares have resolved, there are medications that can lower the level of uric acid over time in order to prevent or lessen attacks. Lifestyle changes such as controlling weight, limiting alcohol intake and limiting meals with meats and fish rich in purines also can help control gout. Gout is a painful and potentially disabling form of arthritis that has been around since ancient times. It is sometimes referred to as the “disease of kings,” because people long have incorrectly linked it to the kind of overindulgence in food and wine only the rich and powerful could afford. In fact, gout can affect anyone, and its risk factors vary. The first symptoms usually are intense episodes of painful swelling in single joints, most often in the feet, especially the big toe. The swollen site may be red and warm. Fifty percent of first episodes occur in the big toe, but any joint can be involved. Fortunately, it is possible to treat gout and reduce its very painful attacks by avoiding food and medication triggers and by taking medicines that can help.

However, diagnosing gout can be hard, and treatment plans often must be tailored for each person. What causes gout? Gout occurs when excess uric acid (a normal waste product) collects in the body, and needle‐like urate crystals deposit in the joints. This may happen because either uric acid production increases or, more often, the kidneys cannot remove uric acid from the body well enough. Certain foods and drugs may raise uric acid levels and lead to gout attacks. These include: Shellfish and red meats Sugary drinks and foods that are high in fructose Some medications, such as: low-dose aspirin (but because it can help protect against heart attacks and strokes, we do not recommend that people with gout stop taking low-dose aspirin) certain diuretics (“water pills”) such as hydrochlorothiazide (Esidrix, Hydro‐D) and Lasix immunosuppressants used in organ transplants such as cyclosporine (Neoral, Sandimmune) and tacrolimus (Prograf) Over time, increased uric acid levels in the blood may lead to deposits of urate crystals in and around the joints.

These crystals can attract white blood cells, leading to severe, painful gout attacks and chronic arthritis. Uric acid also can deposit in the urinary tract, causing kidney stones. Who gets gout? Gout affects more than three million Americans. This condition and its complications occur more often in men, women after menopause, and people with kidney disease. Gout is strongly linked to obesity, hypertension (high blood pressure), hyperlipidemia (high cholesterol and triglycerides) and diabetes. Because of genetic factors, gout tends to run in some families. Gout rarely affects children. How is gout diagnosed? Some other kinds of arthritis can mimic gout, so proper diagnosis (detection) is key. Health care providers suspect gout when a patient has joint swelling and intense pain in one or two joints at first, followed by pain‐free times between attacks. Early gout attacks often start at night. Diagnosis depends on finding the distinguishing crystals. The physician may use a needle to extract fluid from an affected joint and will study that fluid under a microscope to find whether urate crystals are present. Crystals also can be found in deposits (called tophi) that can appear under the skin. These tophi occur in advanced gout.

Uric acid levels in the blood are important to measure but can sometimes be misleading, especially if measured at the time of an acute attack. Levels may be normal for a short time or even low during attacks. Even people who do not have gout can have increased uric acid levels. X-rays may show joint damage in gout of long duration. Ultrasound and dual energy computed tomography (commonly called dual energy CT) can show early features of gouty joint involvement. These imaging techniques also can help suggest the diagnosis. How is gout treated? Treatment of acute attacks One treatment for active gout flares is colchicine. This medicine can be effective if given early in the attack. However, colchicine can cause nausea, vomiting, diarrhea and other side effects. Side effects may be less frequent with low doses. Patients with kidney or liver disease, or who take drugs that interact (interfere) with colchicine, must take lower doses or use other medicines. Colchicine also has an important role in preventing gout attacks (see below). Nonsteroidal anti‐inflammatory drugs – commonly called NSAIDs – are aspirin‐like medications that can decrease inflammation and pain in joints and other tissues.

NSAIDs, such as indomethacin (Indocin) and naproxen (Naprosyn), have become the treatment choice for most acute attacks of gout. There is no proof that any one NSAID is better than others. High doses of short‐acting NSAIDs give the fastest relief of symptoms. These medicines may cause stomach upset, ulcers or diarrhea, but they are well tolerated by most people when used for the short term. Some people cannot take NSAIDs because of health conditions such as ulcer disease or impaired kidney function or the use of blood thinners. The fact sheet on NSAIDs lists the types of patients who cannot take NSAIDs. In patients with chronic undertreated gout crystals can be found in uric acid deposits (called tophi) that can damage joints & can appear under the skin. Corticosteroids such as prednisone and triamcinolone are useful options for patients who cannot take NSAIDs. Given orally (by mouth) or by injection (shot) into the muscle, these medicines can be very effective in treating gout attacks. If only one or two joints are involved, your doctor can inject a corticosteroid directly into your joint.

Health care providers may prescribe anakinra (Kineret) , an “interleukin 1 beta antagonist,” for very severe attacks of gout. Though this rheumatoid arthritis drug is not approved by the Food and Drug Administration (FDA), for gout treatment, it can quickly relieve gout symptoms for some patients. Some home remedies may help ease gout pain. Rest the affected joint and apply ice packs or cold compresses (cloths soaked in ice water and wrung out) to that spot. Treatment to remove excess uric acid Patients who have repeated gout flares, abnormally high levels of blood uric acid, or tophi or kidney stones should strongly consider medicines to lower blood uric acid levels. These medications do not help the painful flares of acute gout, so most patients should start taking them after acute attacks subside. The drug most often used to return blood levels of uric acid to normal is allopurinol (Lopurin, Zyloprim). It blocks production of uric acid. Another option, febuxostat (Uloric), also acts by blocking uric acid production. Probenecid (Benemid) helps the kidneys remove uric acid.

Only patients with good kidney function who do not overproduce uric acid should take probenecid. Pegloticase (Krystexxa) is given by injection and breaks down uric acid. This drug is for patients who do not respond to other treatments or cannot tolerate them. New drugs to lower uric acid levels and to treat gout inflammation are under development. Gout flares often can occur when you first start to use medications that lower blood uric acid levels. Patients can help prevent flares when starting these medications by also using low‐dose colchicine or NSAIDs. Often, doctors advise patients to keep taking colchicine in a low, preventive dose together with the uric acid-lowering medicine for at least six months. If you are taking a uric acid-lowering drug, your doctor should slowly raise the dose and keep checking your blood uric acid levels. Once your uric acid levels drop below 6 mg/dL (normal), crystals tend to dissolve and new deposits of crystals can be prevented. You probably will have to stay on this medicine long term to prevent gout attacks. What works well for one person may not work as well for another.

Therefore, decisions about when to start treatment and what drugs to use should be tailored for each patient. Treatment choices depend on kidney function, other health problems, personal preferences and other factors. What you eat can increase uric acid levels. Limit the amount of high-fructose drinks, such as non-diet soda. Also, do not drink alcohol, especially beer. Restrict eating foods that are rich in purines, compounds that break down into uric acid. These compounds are high in meat and certain types of seafood. New research has found purines in vegetables appear to be safe. Low‐fat dairy products may help lower uric acid levels. In almost all cases, it is possible to successfully treat gout and bring a gradual end to attacks. Treatment also can decrease the number and size of tophi (deposits of uric acid crystals). Broader health impacts of gout Gout often is associated with high blood pressure, heart and kidney disease, or the use of medications that increase uric acid levels. Therefore, health care providers should test for these related health problems. Researchers are studying whether lowering blood uric acid levels can help heart disease and kidney disease.

Living with gout Gout affects quality of life by both the intermittent attacks and the potential for chronic (lasting) arthritis. Compliance with your treatment plan is critical. Lifestyle changes may make it easier to manage this lifelong disease. Suggestions include gradual weight loss, avoidance of alcohol and reduced consumption of fructose‐containing drinks and foods high in purines. The rheumatologist's role in the treatment of gout Treatment of gout can be difficult because of coexisting illnesses and other medications. As experts in the treatment of arthritis, rheumatologists examine patients to learn whether gout is the cause of their arthritis and to educate them about the role and proper use of medications and other treatments for gout. They also act as a resource to primary care doctors. Written by H. Ralph Schumacher, MD, and reviewed by the American College of Rheumatology Committee on Communications and Marketing. This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.

© April 2015 American College of Rheumatology Español High uric acid level - Mayo Clinic High uric acid level By Mayo Clinic Staff A high uric acid level, or hyperuricemia, is an excess of uric acid in your blood. Uric acid is produced during the breakdown of purines, which are found in certain foods and are also formed by your body. Once produced, uric acid is carried in your blood and passes through your kidneys, where most of it is filtered out into the urine. About one in five people has a high uric acid level. It may be related to attacks of gout or the development of kidney stones. But most people with high uric acid levels don't have any symptoms or related problems. References Uric acid. Lab Tests Online. Accessed Oct. 6, 2015. Questions and answers about gout. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Accessed Oct. 6, 2015. Kim SY, et al. Hyperuricemia and coronary heart disease: A systematic review and meta-analysis. Arthritis Care & Research. 2010;62:170. Ohno, I.

Relationship between hyperuricemia and chronic kidney disease. Nucleosides, Nucleotides and Nucleic Acids. 2011;30:1039. Kanbay M, et al. Uric acid in hypertension and renal disease: The chicken or the egg? Blood Purification. 2010;30:288. Hochberg J, et al. Tumor lysis syndrome: Current perspective. Haematologica. 2008;93:9. So A, et al. Uric acid transport and disease. The Journal of Clinical Investigation. 2010;120:1791. Becker MA. Asymptomatic hyperuricemia. Accessed Nov. 2, 2015. Wilkinson JM (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 29, 2015. Products and Services Gout: A Detailed Discussion| Arthritis | Zina Kroner Gout: A detailed discussion Download this page in PDF format Gout What is gout?

Gout is a type of arthritis (inflammation of the joints) that mostly affects men age 40 and older. It is nearly always associated with an abnormally high concentration of uric acid in the blood. Uric acid is produced in the liver and enters the bloodstream. Under certain circumstances, the body produces too much uric acid or excretes too little. As uric acid concentrations increase, needlelike crystals of a salt called monosodium urate (MSU) form. In time, MSU crystals accumulate and cause inflammation and pain, symptoms typical of gout. People with chronically high blood levels of urate (commonly referred to as uric acid) may develop a condition known as gout. These high blood levels of uric acid may cause crystals to deposit in the body’s tissues, especially in joints. Deposition of the urate crystals and the attempts by white blood cells to consume the crystals appear to be a key factor in development of an acute gouty attack. An attack of gout manifests itself by a suddenly painful and inflamed joint. It most commonly affects a single joint at a time and most frequently will involve the large toe on initial presentation.

Urate crystals can be deposited in the kidney or urinary tract causing kidney stones and, occasionally, impairing kidney function. “Tophaceous” gout, which can develop in a patient with chronic gout, occurs when large aggregates of urate crystals collect in joints, bones and cartilage. The urate causes a nodule called a “tophus” (plural “tophi”) to form. The presence of a tophus can cause erosion of bone it is near. They often occur near the knuckles or small joints of the fingers and are usually not painful or tender. Occasionally, they can become inflamed and cause symptoms like those of an acute gouty attack. Patients with gout are at increased risk for developing kidney stones. Uric acid crystals can collect in the urinary tract and form a stone. The most important risk factor for uric acid crystallization and stone formation is a low urine pH (below 5.5), rather than an increased urinary uric acid excretion. Causes of low urine pH include chronic diarrhea, severe dehydration and renal tubular disorders. A small collection of uric acid crystals can be a nidus for the formation of larger calcium containing urinary stones and ultimately affect kidney function.

Hyperuricemia ( elevated blood uric acid levels) can be caused by genetic predisposition coupled with the wrong diet, or by either a) an increased production of uric acid such as seen in leukemia, hemolytic anemia, psoriasis, excessive exercise or b) decreased excretion of uric acid as seen in chronic renal disease, lead induced nephropathy (kidney damage) or diabetic ketoacidosis. Nutrition plays a significant role in contributing to a gouty attack. Certain foods can cause an elevation of uric acid levels thereby provoking a gouty attack. They include excessive amounts of alcohol, coffee, soft drinks, anchovies, asparagus, legumes, mushrooms and meats, especially organ meats, and shellfish. Some other instigators of gout are surgery, injury, use of antibiotics, vitamin B5 deficiency and chemotherapy. Any cause of potassium loss, such as surgery, fasting and diuretic use, may trigger gout as well. Rapid weight loss or fasting can cause excess lactic acid buildup, which hinders uric acid excretion by the kidneys thereby triggering a gout attack. Dieting also may cause a loss of potassium, which can increase urate levels in the blood.

Some dieters also use diuretics which can deplete the body of potassium and other minerals, triggering a gout attack. An elevated uric acid level as diagnosed by blood test only indicates that a patient is at risk for gout but does not necessarily have it. It can take 20-30 years for a patient with elevated uric acid levels to actually develop gout. The typical age of onset is 45. If one has an acute attack of gout, the drug of choice is indomethacin, but other NSAIDs can be tried. Colchicine can be used in the event of an acute attack but is often times poorly tolerated due to diarrhea, abdominal pain and nausea. One treatment that has an immediate effect is intra-articular (into the joint) steroid injection. The physician, however, has to be certain that there is no element of infection in the joint as the steroid can exacerbate it. Certain medications can decrease the blood level of uric acid. Probenecid and sulfinpyrazone are two such medications, called uricosuric agents, and cause the uric acid to be disposed of in the urine.

These medications are not given to patients with impaired kidney function, because in order for the uric acid to pass in the urine, it must first pass through the kidneys. The majority of patients with gout who excrete less than 800 mg [4.76 mmol] of uric acid per day on a standard diet are potential candidates for uricosuric drug therapy Another drug, allopurinol, prevents the formation of uric acid. It works by inhibiting an enzyme called xanthine oxidase and therefore decreasing the synthesis of uric acid. It is prescribed for the treatment of chronic gout and is not to be started in the event of acute gout, but continued if already on it. It is especially indicated for patients with overproduction of urate, kidney stones, tophaceous deposits or if the patient is older than 60. For treatment with either class of medications to be effective and lasting, patients generally must take them regularly and on a long-term basis. Among adverse reactions occurring in 3 to 5 percent of patients are rash, leukopenia or thrombocytopenia, diarrhea, and drug fever.

Allopurinol can cause potentiation of the immunosuppressive effects of the medication 6-mercaptopurine and azathioprine, which are partially metabolized by xanthine oxidase. Losartan, a drug used to treat high blood pressure, can actually reduce blood uric acid levels. It may provide a safe way of diminishing the diuretic-induced increase in uric acid levels and simultaneously potentiating the antihypertensive action of the diuretic. Fenofibrate, a fibric acid derivative, used for treatment of high cholesterol, also has uricosuric activity. A nutritional approach to gout: There is much one can do nutritionally to prevent gout. First, one should limit intake of foods rich in purines, which are the information molecules in genes and are used in the process of converting genes to proteins. They act as messengers in cellular signaling processes, such as nerve conduction and muscle contraction. After metabolism, these purines break down into uric acid, which is elevated in gout. Purine content is greater in red meats, so one should try to limit intake of organ meats and steaks, chops and corned beef.

Poultry has a significantly lower intake and is a better source of protein for gout patients for this reason. Shellfish, tofu, beans, peas and alcohol, especially beer and wine, also are high in purines. Meats and dairy products also contain a fatty acid known as arachidonic acid, which further contributes to the inflammatory process. It is converted into prostaglandins and leukotrienes, inflammatory proteins that are high in different types of arthritis conditions. Anti-inflammatory medications aim to decrease these markers, thereby mitigating symptoms. Based on this theory, a diet low in saturated fats, and therefore low in arachidonic acid, may be beneficial. Fish oils may work to decrease these inflammatory markers and thus can be very beneficial in gout. Cherries can lower plasma uric acid levels. They contain flavonoid compounds that may lower uric acid and reduce inflammation. Flavonoids called anthocyanins, often found in purple and blue colored berries, help to shut down the enzymes that cause tissue inflammation in the first place. Anthocyanins can therefore prevent and treat many kinds of pain. A study done at the University of California at Davis by Jacob et.

al entitled “Consumption of cherries lowers plasma urate in healthy women” proved just that and also showed that there was a decrease in plasma urate after cherry consumption. Bilberry , hawthorn and blueberries also are high in anthocyanosides. Quercetin , another flavonoid, can be added as a supplement to decrease uric acid levels. Quercetin can be taken with bromelain to improve its absorption. Bromelain, by itself, can act as an anti-inflammatory as well as contribute to the improved absorption of quercetin. Pantothenic acid , a type of B vitamin (B5), is needed to help with the excretion process of uric acid. Stress often depletes the body of this vitamin which may explain why gout flares during times of stress. Therefore, incorporating pantothenic acid into the treatment plan may be crucial. It is important to stay well-hydrated in order to prevent attacks of gout. This will prevent the uric acid from becoming too concentrated and inhibit uric acid crystallization. Uric acid crystallizes and forms stones in an acidic environment.

One was to prevent this is by alkalinizing the urine or making it more basic. Urine alkalinization can be achieved with administration of potassium citrate or sodium bicarbonate as directed by your physician. Lemon juice stimulates the formation of calcium carbonate, which neutralizes acids like uric acid. Therefore, drinking freshly squeezed lemon in a glass of water after meals can prevent a gouty attack. Baking soda also can help alkalinize the urine. Black cohosh also has been shown to moderate blood acidity, thereby making the urine more basic. Cayenne pepper, which can affect the substance P, expressed in pain syndromes, can be boiled in vinegar and water and applied onto the painful joint. It can also be mixed with wintergreen oil to make a paste and subsequently applied to the affected area. Alternatively, capsaicin cream is available at the drugstore. 106,347 total views, 3 views today Share: NiaCel can play a key role in healthy aging, weight management, and metabolic syndrome.

This nicotinamide riboside supplement: Supports cognitive function and provides neuroprotection Stimulates thermogenesis Enhances endurance and efficiency of skeletal and cardiac muscle Promotes healthy aging through sirtuin activation What Causes High Uric Acid Level | Gout | Gout Treatment What Causes High Uric Acid Level? Spondyloarthritis Info Sheet CONNECTED CARE INSIDER: Subscribe to BJC Health and stay up to date with all the latest medical breakthroughs regarding your health. SUBSCRIBE Spondyloarthritis Info Sheet CONNECTED CARE INSIDER: Subscribe to BJC Health and stay up to date with all the latest medical breakthroughs regarding your health. SUBSCRIBE What Causes High Uric Acid Level? Where does uric acid come from? Firstly, we have to understand where uric acid comes from. Animal cells (including human cells) have structures called DNA, which reside with the nucleus of the cell. This DNA is broken down into its constituents, called amino acids, when a cell dies through the action of the immune system. Some of these amino acids are called purines, which in turn are converted into other chemicals.

Our body recycles some of these chemicals with those left over proceeding to become uric acid, which is in some ways a waste product that is then excreted by our kidneys into the urine. It is a very complicated process but with this concept in mind you may understand why certain diseases are associated with high levels of uric acid. For example, if a person has a high burden of dying cells, such as occurs in certain cancers or in those undergoing chemotherapy for the treatment of cancer, then more DNA is broken down to purines, resulting in excess uric acid production. Conversely, when the uric acid cannot be efficiently excreted, such as is the case with many kidney diseases or due to many medications that interfere with this process of excretion. This is particularly a concern with diuretics, which remove water from our body at the expense of other products such as uric acid. Rarely, a person is born with a defective step in uric acid metabolism, whereby gout develops at a young age, sometimes associated with a very strong family history of early and aggressive gout. When the uric acid level is high in the circulation it is termed Hyperuricaemia. This situation is also strongly associated with obesity.

It is believed that fatty tissue enhances the production of uric acid. Hyperuricaemia is part of the ‘metabolic syndrome’, which is associated with an increased risk of heart attacks and strokes. We also obtain purine amino acids from our diet. It is estimated that 10-15% of our purine load is dietary in origin. Foods that are high in purine include offal, seafood (in particular crustaceans), red meat, and alcohol.

Question: An excess of which acid in the body causes 'gout'?
Answer: URIC ACID