Uric Acid

What it is

Uric acid is produced when the body breaks down purines (from nucleic acids, certain foods, and de novo synthesis). It is excreted mainly by the kidneys. Humans evolved to produce more uric acid than most mammals because we lack functional uricase.

Reference ranges

• Men: 3.4–7.0 mg/dL (200–420 μmol/L).
• Women: 2.4–6.0 mg/dL (140–360 μmol/L) (lower premenopausally).
• Optimal for longevity considerations: keep below the upper end of reference; many practitioners aim for <5.5–6.

Why it matters

• Gout: monosodium urate crystallises at high serum levels causing acute arthritis.
• Cardiovascular: elevated uric acid associates with hypertension and cardiovascular events (causality debated).
• Kidney: high levels accelerate CKD progression.
• Metabolic: associated with insulin resistance and metabolic syndrome; high-fructose intake raises it.

What raises it

• Fructose intake, especially as sugar-sweetened beverages.
• Alcohol (especially beer).
• Red meat and shellfish (modest).
• Dehydration.
• Diuretics (thiazides, loop).
• Low-dose aspirin (modest).
• Genetic variation in SLC2A9 and ABCG2.

What lowers it

• Weight loss, lower-fructose diet, more water.
• Coffee (associated with lower levels).
• Cherries (modest evidence).
• Allopurinol, febuxostat, uricosurics (for gout).
• SGLT2 inhibitors lower uric acid as a side benefit.

Related entries

Type 2 diabetes, Cardiovascular disease, Chronic kidney disease.