Uric acid is a waste product found in blood. It’s created when the body breaks down chemicals called purines. Most uric acid dissolves in the blood, passes through the kidneys and leaves the body in urine. Food and drinks high in purines also increase the level of uric acid. These include:
- Seafood (especially salmon, shrimp, lobster and sardines).
- Red meat.
- Organ meats like liver.
- Food and drinks with high fructose corn syrup, and alcohol (especially beer, including non-alcohol beer).
If too much uric acid stays in the body, a condition called hyperuricemia will occur. Hyperuricemia can cause crystals of uric acid (or urate) to form. These crystals can settle in the joints and cause gout, a form of arthritis that can be very painful. They can also settle in the kidneys and form kidney stones.
If untreated, high uric acid levels may eventually lead to permanent bone, joint and tissue damage, kidney disease and heart disease. Research has also shown a link between high uric acid levels and type 2 diabetes, high blood pressure, and fatty liver disease.
Uric acid is formed when purines break down in your body. Purines are chemicals found in certain foods. This typically includes:
- red meat
- organ meat
- seafood
- beans
Normally, your body rids itself of uric acid when you urinate. Hyperuricemia occurs when your body either makes too much uric acid or is unable to excrete enough of it. It usually happens because your kidneys aren’t eliminating it quickly enough.
Excess uric acid levels in your blood can lead to the formation of crystals. Although these can form anywhere in the body, they tend to form in and around your joints and in your kidneys. Your body’s defensive white blood cells may attack the crystals, causing inflammation and pain.
symptoms
Only about one-third of people with hyperuricemia experience symptoms. This is known as asymptomatic hyperuricemia.
Although hyperuricemia isn’t a disease, if uric acid levels remain high, over time they can lead to several diseases.
Diagnosis
Doctors usually diagnose gout based on your symptoms and the appearance of the affected joint. Tests to help diagnose gout may include:
- Joint fluid test. Your doctor may use a needle to draw fluid from your affected joint. Urate crystals may be visible when the fluid is examined under a microscope.
- Blood test. Your doctor may recommend a blood test to measure the levels of uric acid in your blood. Blood test results can be misleading, though. Some people have high uric acid levels, but never experience gout. And some people have signs and symptoms of gout, but don’t have unusual levels of uric acid in their blood.
- X-ray imaging. Joint X-rays can be helpful to rule out other causes of joint inflammation.
- Ultrasound. This test uses sound waves to detect urate crystals in joints or in tophi.
- Dual-energy computerized tomography (DECT). This test combines X-ray images taken from many different angles to visualize urate crystals in joints.
Treatment
Gout medications are available in two types and focus on two different problems. The first type helps reduce the inflammation and pain associated with gout attacks. The second type works to prevent gout complications by lowering the amount of uric acid in your blood.
Which type of medication is right for you depends on the frequency and severity of your symptoms, along with any other health problems you may have.
