Hyperuricemia (High Uric Acid Level)

What is hyperuricemia?

“Hyperuricemia” is the medical term for having high uric acid levels in your body.

Uric acid is a waste product that’s created when your body breaks down chemicals called purines in food and drinks. Most uric acid dissolves in your blood, passes through your kidneys and leaves your body in your pee (urine). Hyperuricemia happens if too much uric acid stays in your body.

Hyperuricemia causes uric acid to clump together in sharp crystals. These crystals can settle in your joints and cause gout, a painful form of arthritis. They can also build up in your kidneys and form kidney stones.

Hyperuricemia is very treatable. You might need to change some aspects of your daily routine (like tweaking your diet or drinking more water). A healthcare provider might prescribe you medicine to lower your uric acid levels or treat any symptoms you’re experiencing.

How common is hyperuricemia?

Hyperuricemia is very common. One in 5 people has hyperuricemia.

Around 5% of people in the U.S. have gout. Men and people assigned male at birth are four times more likely to develop gout than women and people assigned female at birth.

How does hyperuricemia affect my body?

You might not notice you have hyperuricemia, especially if your levels are only slightly elevated. But over time, the buildup of uric acid in your blood can lead to pain and other symptoms. It can also cause damage throughout your body.

Untreated high uric acid levels can eventually lead to permanent damage in your:

• Bones.
• Joints.
• Tendons.
• Ligaments.

Research has also shown a link between high uric acid levels and other health conditions, including:

• Kidney disease.
• Heart disease.
• High blood pressure.
• Diabetes.
• Fatty liver disease.
• Metabolic syndrome.

What are the symptoms of hyperuricemia?

Hyperuricemia itself doesn’t usually cause symptoms. Most people don’t know they have it until their uric acid levels are high enough to cause gout or kidney stones.

Symptoms of a gout attack in one of your joints include:

• Intense pain.
• Discoloration or redness.
• Stiffness.
• Swelling.
• Tenderness, even to light touch (like your bedsheet covering it).
• Warmth, or a feeling like the joint is “on fire.”

Symptoms of kidney stones include:

• Pain in your lower back or side.
• Nausea or vomiting caused by the pain.
• Fever or chills.
• Blood in your pee.
• Pain while you’re peeing.
• Being unable to pee.
• Feeling the need to pee more often.
• Pee that smells bad or looks cloudy.

What causes hyperuricemia?

Extra uric acid in your blood causes hyperuricemia.

Your body creates uric acid after breaking down purines. Purines occur naturally and aren’t harmful in small amounts. But by regularly eating high-purine foods, you can raise your uric acid levels over time. Food and drinks high in purines include:

• Red meat.
• Organ meats like liver.
• Seafood (especially salmon, shrimp, lobster and sardines).
• Food and drinks with high fructose corn syrup.
• Alcohol (especially beer, including nonalcoholic beer).

Some medications can increase your uric acid levels as a side effect, including:

• Diuretics (sometimes referred to as water pills).
• Immunosuppressants.

Hyperuricemia risk factors

Hyperuricemia can affect anyone. Some groups of people are more likely to develop hyperuricemia, including people who:

• Were assigned male at birth.
• Have obesity.
• Regularly drink alcohol.
• Regularly eat high-purine foods.
• Have family members with hyperuricemia or gout.
• Have hypothyroidism.

How is hyperuricemia diagnosed?

A healthcare provider will diagnose hyperuricemia with a blood test to measure the uric acid in your blood.

If you pass a kidney stone or have one surgically removed, the stone itself might be tested.

Does having high uric acid levels mean I have gout?

Having hyperuricemia doesn’t mean you’ll develop gout. To diagnose gout, your provider will take a sample of your joint fluid during an attack of gout symptoms to look for uric acid crystals. They might also use imaging tests on your joints, including:

• Ultrasound.
• CT (computed tomography) scan.
• X-rays.

How is hyperuricemia treated?

If you have high uric acid levels but aren’t experiencing any symptoms, you might not need treatment for hyperuricemia. Your provider will tell you how often you should get blood tests to track any changes in your uric acid levels.

What should I eat or drink with hyperuricemia?

The best way to help lower your uric acid is to avoid high-purine foods and drinks as often as you can. Try to limit how often you eat or drink:

• Red meat and organ meats.
• Alcohol.
• Drinks sweetened with high fructose corn syrup (like soda).
• Fish (especially shellfish like lobster and shrimp).

Following a low-purine diet can help lower uric acid levels. Talk to your provider about which specific foods or drinks you should avoid. They can help you develop a healthy diet and exercise plan that’s customized to your needs.

Which medications are used to treat hyperuricemia?

Which medications you need depends on how high your uric acid levels are. If you have gout or kidney stones, you might need medicines that specifically treat those conditions.

Your provider might prescribe medications that help your kidneys excrete any extra uric acid or dissolve the deposits of uric acid crystals that have already formed in your body.

Gout treatment

Gout is usually treated with a combination of over-the-counter NSAIDs when you’re experiencing symptoms and prescription medication to help lower your uric acid levels. You might need colchicine (a prescription that prevents gout attacks) or corticosteroids (prescription anti-inflammatory medications).

Kidney stone treatment

Kidney stones may eventually pass out of your body in your pee. Drinking more fluid is important. Try to drink at least 64 ounces of water every day.

Your provider might prescribe medications that help stones pass by relaxing the muscles in your ureter — the duct pee passes through to get from your kidneys to your bladder.

If a kidney stone is too large to pass, blocks your pee or causes an infection, you might need it surgically removed.

How can I prevent hyperuricemia?

The best way to prevent hyperuricemia is by following a diet and exercise plan that’s healthy for you. Limiting how often you eat or drink foods and beverages high in purines will help you keep your uric acid levels low. It will also help you maintain good overall health.

Talk to your provider about which kinds of foods or drinks you should avoid, and how often it’s OK to have certain high-purine foods or drinks.

What can I expect if I have hyperuricemia?

If you have hyperuricemia, you should expect to monitor your uric acid levels with blood tests. Some people only have temporarily high uric acid levels.

You might need to make some changes to your diet and daily routine to help lower the amount of uric acid levels in your blood.

If you have gout, kidney stones or any other symptoms, your provider will tell you what to expect and which treatments you’ll need.

How do I take care of myself?

Following a healthy diet and exercise plan can help you maintain a healthy weight and lower your uric acid levels. Even if you do have hyperuricemia, tweaking your diet, drinking more water and getting plenty of exercise can reduce the chances that you experience gout flares and other symptoms in the future.

When should I see my healthcare provider?

Visit your provider if you have any new symptoms, including:

• Swelling.
• Discoloration or redness.
• A feeling of warmth or a joint that feels hot.
• Trouble peeing.
• Pain while you’re peeing.
• Pain after you pee.

What questions should I ask my healthcare provider?

• How high are my uric acid levels?
• Will I need treatment?
• What type of low-purine diet should I follow?
• Will I need any medication?

A note from Cleveland Clinic

You might not even know you have hyperuricemia until gout or a kidney stone cause pain or other symptoms. Making some minor changes to your usual diet and exercise routine can help lower your uric acid levels, prevent any future symptoms and improve your overall health.

Talk to a healthcare provider if you’re experiencing any new symptoms, especially if it hurts when you pee or you have any swelling.