Uric acid is a chemical that is released in the body when it breaks down substances. Once it is produced, it travels to the kidneys and is eliminated from the body in our urine. However, uric acid levels need to be balanced for a healthy life. High levels of uric acid can result in arthritis as well as kidney stones or kidney dysfunction. In case, your uric acid levels are low, you can get Wilson’s disease, a condition that leads to a build-up of copper in the body or Fanconi syndrome, a kidney tube disorder. There are various tests to check uric acid levels.

What is uric acid?

Uric acid is a waste product found in the blood, created when the body breaks down chemicals called purines. “Purines are found in certain foods and drinks, such as red meat, seafood, and alcoholic beverages. After formation, uric acid dissolves in the blood and travels to the kidneys, where it is excreted in urine,” says urologist Dr Avanish Arora. Maintaining balanced uric acid levels is crucial, as both excess and deficiency can lead to health issues. The normal blood uric acid level is 2.5–6 mg/dL for women and 3.4–7 mg/100 mL of blood for men, states this study, published in Protocols in Biochemistry and Clinical Biochemistry.

Why is it important to get uric acid tested?

Testing for uric acid is essential for diagnosing and monitoring various medical conditions. Uric acid tests help to determine how our bodies are using the uric acid that is produced and how efficiently it is being disposed of as well. “High levels of uric acid can lead to gout, a form of arthritis characterised by severe pain, redness, and swelling in joints. Elevated uric acid levels may also indicate kidney stones or kidney dysfunction, and chronic conditions like metabolic syndrome,” says Dr Arora. Conversely, low uric acid levels, although less common, can suggest issues such as Wilson’s disease or Fanconi syndrome. Regular monitoring helps in managing these conditions and preventing complications.

The uric acid tests also help to determine how well our kidneys are functioning, and the cause of kidney stones, as well as to monitor people who are undergoing chemotherapy and radiation therapy.

When should you get uric acid tests?

There are a few symptoms and conditions that you should be careful of which will can indicate a need to get your uric acid levels tested. These include:

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1. Symptoms of high uric acid (Hyperuricemia)

The symptoms include severe joint pain, often starting in the big toe, swelling and redness in the affected joints, limited range of motion in the joints, kidney stones presenting as severe back pain, blood in the urine, or frequent urination. This condition is fairly common. A paper published in Arthritis and Rheumatism states that nearly 43.3 million Americans suffer from Hyperuricemia.

2. Symptoms of low uric acid (Hyperuricemia)

The symptoms include general fatigue and weakness, frequent urination, and Symptoms specific to underlying conditions, such as muscle weakness in Wilson’s disease. “Chronic hyperuricemia can lead to gout and is characterised by sudden and intense joint pain, swelling, and redness. Without treatment, gout attacks can become more frequent and severe, potentially causing permanent joint damage,” says Dr Arora.

Tests to check uric acid levels

There are several tests used to measure uric acid levels in the body:

1. Serum Uric Acid Test

This blood test measures the amount of uric acid in the blood. It’s the most common method for diagnosing hyperuricemia, and high uric acid levels and monitoring treatment efficacy for gout and other related conditions. The test involves drawing blood from a vein, usually from the arm.

2. Urine Uric Acid Test

This test measures the amount of uric acid in the urine, usually over 24 hours. It’s useful for determining whether the body is producing too much uric acid or if the kidneys are not excreting it properly. Patients collect all urine produced in a 24-hour period, which is then analysed in a laboratory.

3. Joint Fluid Test

In cases of suspected gout, a joint fluid test (arthrocentesis) can be performed. This involves extracting a small amount of fluid from the affected joint and examining it for urate crystals under a microscope. The presence of these crystals confirms a diagnosis of gout.

Are there any further tests required?

If abnormal uric acid levels are detected, additional tests may be required to understand the underlying cause and extent of complications. “These include blood tests like serum creatinine and blood urea nitrogen (BUN) to evaluate how well the kidneys are filtering waste products. Ultrasound, X-rays, or CT scans may be used to detect kidney stones or joint damage caused by gout,” says Dr Arora, adding, “In cases of hyperuricemia, liver function tests can help diagnose conditions like Wilson’s disease. For inherited conditions affecting uric acid levels, such as Lesch-Nyhan syndrome, genetic testing may be recommended.”

How often should you get your uric acid levels checked?

Blood tests to check uric acid levels should be done once a year to ensure kidney function is efficient. Also, extra care must be given in case of a history of gout or kidney disease. There are some natural ways to reduce uric acid as well, besides medication.

Summary

Uric acid levels must be maintained for our kidneys to function efficiently. There are blood tests and urine tests to determine uric acid levels, and prompt action must be taken if the levels are higher or below the recommended range. Dietary changes and medication can help you.