Author
Bowtie Team
Updated on
2025-08-22
Disclaimer: This article is translated with the assistance of AI.
High uric acid is a common concern for many middle-aged men. Bowtie has invited Dr. Lau Wing Yan (Endocrinology & Diabetes Specialist) to explain the symptoms and diseases associated with high uric acid, along with essential dietary advice.
What is Uric Acid?
Uric acid is the final metabolite of purines in the human body. 80% of it is produced through internal metabolism, and 20% comes from diet. Purines are metabolized by the liver to form uric acid, which is finally excreted from the body through the kidneys in urine. If the body produces too much uric acid or the kidneys have poor metabolic capacity, it can lead to hyperuricemia, acute or chronic gouty arthritis, gout, kidney stones, joint deformities, and kidney stone disease.
Does Uric Acid Cause Gout and Foot Pain? What are the Symptoms?
Gout attacks occur when uric acid crystals in the blood deposit in the joints, causing inflammation, redness, swelling, and pain. Data shows that about 5% to 18% of people with hyperuricemia experience gout, so high uric acid levels are a warning sign for gout.
How to Interpret Uric Acid Levels? Causes of High Uric Acid
| High Uric Acid Levels | |
| Men | >7.0 mg/dl |
| Women | >6.0 mg/dl |
1. Increased Uric Acid Production (Overproduction)
- Diet : Seafood, organ meats, meat broths, and beer are very high in purines. Consuming these foods frequently can disrupt the body’s balance.
- Stress/Overwork : Excessive stress or overwork slows down the body’s cell metabolism, leading to cell accumulation and elevated uric acid levels.
- Sugary Drinks : When the body metabolizes the sugar in these drinks, it consumes a large amount of cellular energy, resulting in the production of significant amounts of uric acid.
- Intense Exercise : Over-exercising or rapid weight loss in a short period can lead to the breakdown of muscle and fat, producing creatinine and uric acid. Therefore, weight loss should be gradual, aiming for 1 to 2 kilograms per month.
2. Reduced Uric Acid Excretion (Under-excretion)
- High-Fat Diet, Acidic Foods : Fried foods and carbonated drinks can hinder uric acid excretion. Consuming too much seafood, meat, and processed foods can make urine acidic, making uric acid less soluble in urine and difficult to excrete.
- Obesity : Excess subcutaneous fat can interfere with uric acid metabolism.
- Alcohol Consumption : Alcohol not only stimulates the liver to produce more uric acid, but the lactic acid produced during metabolism also makes it harder for uric acid to be excreted. Furthermore, fermented alcoholic beverages themselves contain high purines, all of which contribute to a significant accumulation of uric acid in the body.
- Kidney Disease : High uric acid can damage the kidneys, and impaired kidney function can also reduce metabolic capacity, leading to elevated uric acid levels. This vicious cycle can worsen symptoms. Individuals with kidney disease must pay close attention to regular uric acid monitoring.
3. High-Risk Groups Prone to High Uric Acid
Middle-aged men have a higher incidence of gout, while women account for 5% to 10% of cases, typically occurring after menopause. Genetic factors, obesity, and excessive alcohol consumption also increase the risk of gout.
What Diseases Can High Uric Acid Cause?
- Gouty Nephropathy: Most uric acid in the blood is excreted by the kidneys. If uric acid levels repeatedly rise, it can lead to the precipitation of uric acid crystals in the kidneys, causing kidney damage.
- Uric Acid Stones Causing Urinary Tract Obstruction: High uric acid levels can lead to the formation of calcium urate stones, which can obstruct the urinary tract and affect kidney function.
- Typical Gout Symptoms: During a gout attack, most patients experience severe pain and burning. This type of acute onset in a single joint is the most typical presentation of gout.
What Medications Should Patients Take? Treatment Overview
- Uricosuric Drugs: These medications work by inhibiting the reabsorption of uric acid in the renal tubules, increasing uric acid excretion, and thereby lowering blood uric acid levels. A side effect is that while excreting more uric acid, other trace elements in the body are also excreted, potentially leading to hyponatremia, hypokalemia, and hypocalcemia.
- Uric Acid Production Inhibitors: This type of drug is a potent xanthine oxidase inhibitor that effectively reduces uric acid production and lowers uric acid levels in the body.
- Urine Alkalinizing Agents: Alkaline drugs like sodium bicarbonate do not directly lower uric acid but can alkalinize the urine. This increases the solubility of uric acid in the blood, making it less likely to crystallize in the urine.
Can a Low-Purine Diet Improve the Problem? Dietary Taboos and Recommendations
A low-purine diet is a dietary approach that is low in purines and provides adequate nutrients. It can help reduce uric acid levels in the blood and is suitable for patients with gout and hyperuricemia.
Here are the basic principles of a low-purine diet:
- Consume low-purine foods and moderate amounts of medium-purine foods.
- Drink 8 to 10 cups of water daily. Increased water intake helps excrete uric acid and reduces the risk of developing uric acid kidney stones. (Some patients with heart or kidney disease may need fluid restriction, so it’s essential to follow your doctor’s instructions).
- Maintain a standard body weight to reduce joint load and decrease the pain during gout attacks.
- Eat more whole grains and vegetables. Limit meat intake to no more than 4 to 6 taels per day.
- Avoid alcohol. Lactic acid, a metabolite of alcohol, inhibits uric acid excretion, thereby increasing uric acid levels in the blood.
- Avoid greasy foods. High fat intake can hinder uric acid excretion and lead to weight gain, increasing the load on joints.
- Avoid overeating, which can lead to excessive synthesis of purines in the body, metabolizing into uric acid.
- Avoid rapid weight loss, which can cause excessive breakdown of body tissues, leading to increased uric acid levels.
How to Prevent High Uric Acid?
- Maintain an ideal body weight: Overweight individuals should aim to lose weight, but not too quickly, to prevent uric acid from rising due to rapid tissue breakdown. If experiencing a gout flare-up, temporarily halt weight loss efforts.
- Drink plenty of water: Aim for 2,000 to 3,000 ml of water daily to help excrete uric acid. However, avoid alcohol, as it increases uric acid production.
- Pay attention to diet: Follow a low-purine diet.
- Avoid foods high in purines , such as chicken essence, animal offal, and soybeans.
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