Uric Acid: A Guide to How It Impacts Your Joints, Kidneys, and Heart Health

You have likely heard about the importance of managing conditions like high blood pressure, cholesterol, and blood sugar for optimal health and longevity. However, there is another critical factor that often gets overlooked but can significantly impact your wellbeing over the long run: uric acid.

Uric acid is a normal waste product in the body, but high levels of it in the blood, known as hyperuricemia, can lead to gout and kidney stones. More concerning, research now shows that elevated uric acid may be an independent risk factor for high blood pressure, type 2 diabetes, metabolic syndrome, heart disease, and other life-threatening conditions.

For those seeking healthspan in addition to lifespan, monitoring and managing your uric acid levels is essential.

TLDR: Uric acid is essential for your joints, kidney, and overall health.

• High uric acid levels (hyperuricemia) can cause health issues like gout, kidney stones and increase risk of diabetes, heart disease and hypertension.
• Regular monitoring and managing uric acid levels is important for health and longevity.
• Lifestyle changes and medications can help optimize uric acid levels.

What Is Uric Acid?

Uric acid is a waste product produced when the body breaks down purines. Purines are naturally present in some foods like red meat, seafood, and beer, and are also produced by the body during cell turnover. As the body breaks down purines, uric acid is created as a byproduct and excreted in the urine. However, in some people, uric acid builds up in the bloodstream instead of being properly excreted, leading to conditions like hyperuricemia, gout and kidney stones.

The Role of Uric Acid in Health and Disease

Uric acid is a compound produced in the body as a byproduct of purine metabolism. While historically viewed as primarily waste, uric acid may play an important role in health and longevity.

Antioxidant Effects

Uric acid acts as an antioxidant in the body, helping to prevent cell damage from free radicals. High levels of uric acid have been linked to a lower risk of developing Parkinson's and Alzheimer's disease. Uric acid may help protect nerve cells in the brain from oxidative damage and death.

Inflammation Regulation

Uric acid helps regulate inflammation in the body. At normal levels, uric acid may have anti-inflammatory effects and help prevent excess inflammation. However, high levels of uric acid, known as hyperuricemia, can lead to gout and kidney stones due to increased inflammation and crystal formation.

Relationship to Other Markers

Uric acid levels tend to rise with age and often in parallel with declining kidney function. Elevated uric acid is also linked to high blood pressure, insulin resistance, metabolic syndrome and cardiovascular disease. While uric acid may have some benefits at normal levels, it is often a marker of poor health and longevity when elevated.

High Uric Acid Symptoms and Potential Complications

High uric acid levels, known as hyperuricemia, can lead to painful conditions like gout attacks and kidney stones if left untreated. As uric acid builds up in the blood, it can crystallize and deposit in the joints and kidneys, causing inflammation and damage over time. The symptoms and complications associated with hyperuricemia include:

Gout attacks

Excess uric acid causes needle-like uric acid crystals to form in the joints, often the big toe. This results in sudden burning pain, swelling, redness, and joint inflammation known as a gout attack. Gout attacks tend to become more frequent and severe without treatment.

Kidney stones

Uric acid crystals may accumulate in the kidneys, eventually forming kidney stones. Kidney stones can block the flow of urine and cause severe back pain, nausea, or blood in the urine. They may require medical procedures to break up or remove.

Kidney disease

Elevated uric acid levels over time put extra stress on the kidneys. This can lead to chronic kidney disease, reducing kidney function and the ability to filter waste from the blood. Symptoms include changes in urine, swelling, and fatigue.

Cardiovascular disease

High uric acid has been linked to high blood pressure, coronary artery disease, stroke, and other cardiovascular problems. While uric acid does not directly cause these conditions, it may contribute to artery damage and blockages over time. Managing uric acid levels may help reduce the risks.

The potential complications associated with untreated hyperuricemia underscore the importance of regular screening for high uric acid, especially for those over age 40. Early diagnosis and proper treatment and management of uric acid levels can help prevent irreversible joint and organ damage, ensuring better health and longevity.

Monitoring Your Uric Acid Levels: When and How Often to Test

As you age, monitoring your uric acid levels becomes increasingly important for maintaining health and longevity. Testing your uric acid levels regularly allows you to catch high levels early and make necessary lifestyle changes and interventions to bring levels back to an ideal range.

How Often Should You Test Your Uric Acid Levels?

For most adults, testing uric acid levels once every 12-24 months is recommended. However, more frequent testing may be needed if:

• You have a family history of gout or kidney stones.
• You have a medical condition like kidney disease, diabetes, or high blood pressure that can impact uric acid levels.
• You are making significant changes to your diet, exercise routine, or medication regimen.
• Your last test result showed borderline or high uric acid levels.

Methods of Testing Uric Acid Levels

The two most common ways to test your uric acid levels are:

1. Blood Test: A blood draw is the most accurate way to determine your uric acid level. A blood sample is taken and analyzed to measure the amount of uric acid in your bloodstream. For most adults, a normal uric acid range is 3.5 to 7.2 milligrams per deciliter (mg/dL).
2. Urine Test: A 24-hour urine test can also be used to determine if your uric acid levels are elevated. Urine is collected over a 24-hour period and analyzed to determine how much uric acid is being excreted. A normal result for a 24-hour uric acid urine test is 250 to 750 milligrams (mg). Urine testing may be less accurate than a blood test but can still provide useful information about your uric acid excretion.

Knowing your uric acid levels and testing regularly gives you the power to take control of your health. By catching high uric acid early, you have the opportunity to make lifestyle changes and manage levels through natural means before medication becomes necessary. Your uric acid level is an important biomarker of health that should not be overlooked.

Recommended Uric Acid Levels Across Age Groups

As you age, maintaining healthy uric acid levels is key to overall wellness and longevity. The normal range of uric acid levels varies depending on your age and sex. The following are the generally accepted target levels to aim for:

Age 20-40

For most adults in their 20s through 40s, a uric acid level between 3.4 to 7.2 mg/dL is considered normal for men, and 2.4 to 6.0 mg/dL is the normal range for women. At this stage of life, the kidneys are functioning at peak performance, so uric acid is typically well-regulated. However, lifestyle factors like diet, alcohol consumption, and excess body weight can begin to impact levels. It is a good idea to have your uric acid levels tested at your annual physical exam to establish a baseline and make sure you remain in the normal range.

Age 40-60

In middle age, the normal ranges are slightly lower, between 3.9 to 7.2 mg/dL for men and 3.0 to 6.0 mg/dL for women. Kidney function may start to decrease slightly during this time, so uric acid levels need to be monitored more closely. Have your levels checked at least once every 2-3 years to ensure they remain in the target zone. Make any necessary lifestyle adjustments to keep uric acid in balance.

Over Age 60

For older adults over 60, the normal range is 3.4 to 7.2 mg/dL for men and 3.0 to 6.0 mg/dL for women. Kidney function continues to decline with age, so testing uric acid levels annually is recommended. Levels that are too high (hyperuricemia) or too low (hypouricemia) require medical intervention to prevent health issues like gout, kidney stones, or impaired kidney function.

Mito Health's flagship package, priced at $499, offers testing for uric acid as well as 66 other carefully curated biomarkers that provide insight into various aspects of your health - this comprehensive suite of tests allows for early detection of cancer, heart disease, neurodegenerative disorders, diabetes and more. 

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Achieving Optimal Uric Acid Levels Through Diet and Lifestyle

To achieve optimal uric acid levels, making targeted lifestyle changes and dietary adjustments is key. By closely monitoring your uric acid levels and working to keep them in the ideal range of 3.5 to 7.2 mg/dL, you can significantly improve your health and longevity.

Dietary Changes

The foods you consume can have a significant impact on uric acid levels. Limit intake of purine-rich foods like red meat, organ meats, seafood, and alcohol which tend to increase uric acid production.

• Red meat: Reduce red meat consumption to 2-3 times per week. Choose lean cuts and smaller portions.
• Organ meats: Avoid organ meats like liver, kidney and sweetbreads which are high in purines.
• Seafood: Limit high-purine seafood like anchovies, sardines, scallops and mussels to 1-2 times per week. Opt for lower purine fish like salmon and tilapia.
• Alcohol: Limit alcohol intake, especially beer and liquor. Alcohol increases uric acid production and impairs excretion.

Instead, base your diet around plant-based foods such as:

• Fruits: Berries, citrus fruits and cherries are high in vitamin C which helps lower uric acid levels. Aim for 2-3 servings per day.
• Vegetables: Cruciferous vegetables like broccoli, cauliflower and cabbage contain compounds that inhibit uric acid production. Eat 3-4 servings per day.
• Whole grains: Choose whole wheat bread, oats, brown rice and quinoa. They provide fiber to support kidney function.
• Legumes: Beans, lentils and peas are rich in antioxidants and B vitamins to aid uric acid excretion. Include 3-4 servings per week.
• Nuts: Almonds, walnuts and pistachios are a healthy snack. But limit portions to 1/4 cup per day due to their high fat and calorie content.

Stay hydrated by drinking plenty of water and unsweetened beverages. Avoid sugar-sweetened drinks and fruit juices which are high in fructose, a sugar that can increase uric acid levels.

Exercise Regularly

Exercise improves circulation and helps remove uric acid from the bloodstream.

Engage in at least 30 minutes of moderate activity most days of the week. Walking, jogging, biking, and swimming are excellent options.

Strength or resistance training 2-3 times a week also provides benefits.

The key is to start slow and build up your endurance over time. Be sure to stay well hydrated before, during and after exercise.

Maintain a Healthy Weight

Losing excess pounds can help achieve normal uric acid levels.

Fat tissue produces uric acid, so less fat means less uric acid in your body. Aim for losing 1-2 pounds per week through diet and exercise.

Losing weight steadily and sustainably is the key. Extreme or fad diets may temporarily lower uric acid but the effects do not last.

Limit Stress

Chronic stress causes inflammation in the body and elevates uric acid levels.

Engage in regular stress management techniques like yoga, meditation, mindfulness, massage therapy or deep breathing. Getting enough high-quality sleep every night is also essential for your health and managing stress. Most adults need 7 to 9 hours of sleep per night to feel well-rested.

Making positive lifestyle changes and staying within the normal range for uric acid levels provides significant benefits for your health, longevity and quality of life. By monitoring your uric acid levels regularly and making adjustments as needed, you can achieve optimal wellness for years to come.

Effective Supplements for Managing Uric Acid

Effective supplements can help lower uric acid levels and manage gout symptoms. Several supplements show promise for improving uric acid metabolism and kidney function.

Cherry Extract

Cherries, especially tart cherries, contain compounds called anthocyanins that may help lower uric acid levels. In one study, people with gout who took cherry extract for four months had significantly lower uric acid levels and inflammation. The recommended dosage is around 600 to 1,000 milligrams of cherry extract, one to two times per day.

Bromelain

Bromelain is an enzyme derived from pineapple stems that acts as an anti-inflammatory. Supplementing with bromelain may help reduce pain, swelling, and inflammation in people with gout.

The typical dosage for gout is around 500 to 1000 milligrams, two to three times per day between meals. Bromelain can interact with some medications, so check with your doctor first.

Turmeric or Curcumin

Turmeric, the bright yellow spice used in curries, contains curcumin, a compound with anti-inflammatory effects. Curcumin supplements may help lower uric acid levels and improve kidney function.

Studies show doses of 500 to 1000 milligrams of curcumin, two to three times per day, may benefit those with gout. However, curcumin is poorly absorbed, so look for formulations that contain piperine or nanoparticles to enhance absorption.

Milk Thistle

Milk thistle contains silymarin, a group of compounds that may help support liver health and improve uric acid metabolism. Some research shows milk thistle supplements may help lower uric acid levels, especially when used in combination with other supplements like turmeric.

A typical dosage for gout is 140 milligrams of silymarin, three times per day.

Vitamin C

Vitamin C acts as an antioxidant and helps support the excretion of uric acid from the kidneys. Supplementing with vitamin C may help lower uric acid levels. Most studies have used doses of around 500 milligrams of vitamin C, one to two times per day.

However, high doses of vitamin C can increase the risk of kidney stones in some people, so you may want to check with your doctor first, especially if you have a history of kidney stones.

Medications for Treating Elevated Uric Acid Levels

If lifestyle changes and diet are not enough to lower your uric acid levels, your doctor may prescribe medication. The most common medications for high uric acid are:

Allopurinol

Allopurinol works by reducing the production of uric acid in the body. It is usually the first-line treatment for chronic gout and can be used for both acute gout attacks and long-term prevention.

The starting dose is typically 100 mg per day, which can be increased incrementally every few weeks based on uric acid levels and tolerance. The target is to reduce uric acid levels below 6 mg/dL. Allopurinol is generally very well tolerated but can cause nausea or diarrhea in some people.

Febuxostat

Febuxostat is another xanthine oxidase inhibitor that works similarly to allopurinol but has a different chemical structure. It may be used if allopurinol is not tolerated or does not work. The typical dosage is 40 to 80 mg once daily.

Febuxostat can cause side effects such as nausea, joint pain, and rash. Liver function tests are recommended periodically while on this medication.

Probenecid

Probenecid works by increasing the excretion of uric acid in the urine. It is often used if allopurinol or febuxostat cannot be tolerated or do not work. The typical dosage is 250 to 500 mg twice daily.

Probenecid may not be suitable for people with kidney problems and can cause side effects such as nausea, headache, and rash. Uric acid levels and kidney function should be monitored regularly while on probenecid.

Corticosteroids

For acute gout attacks, corticosteroids such as prednisone are often used to help reduce inflammation and relieve symptoms like pain, swelling, and redness. Corticosteroids do not treat the underlying high uric acid levels but can be very effective for getting an acute attack under control.

The dosage depends on the severity of the attack but is typically around 30 to 60 mg per day for 3 to 5 days. Corticosteroids should only be used short-term due to potential side effects.

In summary, medication may be necessary to achieve target uric acid levels for some individuals. Work closely with your doctor to determine the most appropriate treatment based on your health conditions, medical history, and personal preferences. With the right management plan, you can get your uric acid under control and minimize gout attacks as well as related health risks.

Conclusion

In summary, uric acid is a crucial but often overlooked marker of health that deserves your attention. By understanding your uric acid levels and taking proactive steps to manage high or low levels, you are investing in your long term vitality and longevity. Don't wait for health issues to arise before making uric acid screening and management part of your wellness routine.

At Mito Health, we specialize in advanced health diagnostics to test your uric acid levels (along with 66 other biomarkers) - to form a science-based, personalized health plan to help you optimize your health. Sign up for our flagship package today to take control of your health and your future.