Hyperuricemia (High Uric Acid) - Managing Side Effects (2022)

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What Is Hyperuricemia?

Hyperuricemia is an excess of uric acid in the blood. Uric acid passes through the liver, and enters your bloodstream. Most of it is excreted (removed from your body) in your urine, or passes through your intestines to regulate "normal" levels.

Normal Uric acid levels are 2.4-6.0 mg/dL (female) and 3.4-7.0 mg/dL (male). Normal values will vary from laboratory to laboratory.
Also important to blood uric acid levels are purines. Purines are nitrogen-containing compounds, which are made inside the cells of your body (endogenous), or come from outside of your body, from foods containing purine (exogenous). Purine breaks down into uric acid. Increased levels of uric acid from excess purines may accumulate in your tissues, and form crystals. This may cause high uric acid levels in the blood.
Uric acid formation may occur when the blood uric acid level rises above 7 mg/dL. Problems, such as kidney stones, and gout (collection of uric acid crystals in the joints, especially in your toes and fingers), may occur.

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What Causes Hyperuricemia?

Causes of high uric acid levels (hyperuricemia) can be primary (increased uric acid levels due to purine), and secondary (high uric acid levels due to another disease or condition). Sometimes, the body produces more uric acid than it is able to excrete.

Causes of High Uric Acide Levels:

  • Primary hyperuricemia
    • Increased production of uric acid from purine
    • Your kidneys cannot get rid of the uric acid in your blood, resulting in high levels
  • Secondary hyperuricemia
    • Certain cancers, or chemotherapy agents may cause an increased turnover rate of cell death. This is usually due to chemotherapy, but high uric acid levels can occur before chemotherapy is administered.
    • After chemotherapy, there is often a rapid amount of cellular destruction, and tumor lysis syndrome may occur. You may be at risk for tumor lysis syndrome if you receive chemotherapy for certain types of leukemia, lymphoma, or multiple myeloma, if there is a large amount of disease present.
    • Kidney disease - this may cause you to not be able to clear the uric acid out of your system, thus causing hyperuricemia.
    • Medications - can cause increased levels of uric acid in the blood
    • Endocrine or metabolic conditions -certain forms of diabetes, or acidosis can cause hyperuricemia
    • Elevated uric acid levels may produce kidney problems, or none at all. People may live many years with elevated uric acid levels, and they do not develop gout or gouty arthritis (arthritis means "joint inflammation"). Only about 20% of people with elevated uric acid levels ever develop gout, and some people with gout do not have significantly elevated uric acid levels in their blood.

Symptoms of Hyperuricemia:

  • You may not have any symptoms.
  • If your blood uric acid levels are significantly elevated, and you are undergoing chemotherapy for leukemia or lymphoma, you may have symptoms kidney problems, or gouty arthritis from high uric acid levels in your blood.
  • You may have fever, chills, fatigue if you have certain forms of cancer, and your uric acid levels are elevated (caused by tumor lysis syndrome)
  • You may notice an inflammation of a joint (called "gout"), if the uric acid crystals deposit in one of your joints. (*Note- gout may occur with normal uric acid levels, too).
  • You may have kidney problems (caused by formation of kidney stones), or problems with urination

Things You Can Do About Hyperuricemia:

  • Make sure you tell your doctor, as well as all healthcare providers, about any other medications you are taking (including over-the-counter, vitamins, or herbal remedies).
  • Remind your doctor or healthcare provider if you have a history of diabetes, liver, kidney, or heart disease.
  • Follow your healthcare provider's instructions regarding lowering your blood uric acid level and treating your hyperuricemia. If your blood levels are severely elevated, he or she may prescribe medications to lower the uric acid levels to a safe range.

If you have an elevated blood uric acid level, and your healthcare provider thinks that you may be at risk for gout, kidney stones, try to eat a low purine diet.
Foods that are high in purine include:

  • All organ meats (such as liver), meat extracts and gravy
  • Yeasts, and yeast extracts (such as beer, and alcoholic beverages)
  • Asparagus, spinach, beans, peas, lentils, oatmeal, cauliflower and mushrooms

Foods that are low in purine include:

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  • Refined cereals - breads, pasta, flour, tapioca, cakes
  • Milk and milk products, eggs
  • Lettuce, tomatoes, green vegetables
  • Cream soups without meat stock
  • Water, fruit juice, carbonated drinks
  • Peanut butter, fruits and nuts
  • Keep well hydrated, drinking 2 to 3 liters of water per day, unless you were told otherwise.
  • Take all of your medications for hyperuricemia as directed
  • Avoid caffeine and alcohol, as these can contribute to problems with uric acid and hyperuricemia.
  • Avoid medications, such as thiazide diuretics (hydrochlorotiazide), and loop diuretics (such as furosemide or Lasix®). Also, drugs such as niacin, and low doses of aspirin (less than 3 grams per day) can aggravate uric acid levels. Do not take these medications, or aspirin unless a healthcare provider who knows your condition told you.
  • If you experience symptoms or side effects, especially if severe, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Drugs or Treatments That May Be Prescribed by Your Doctor:

Your doctor or healthcare provider may prescribe medications if you have a high blood uric acid levels. These may include:

  • Non-steroidal anti-inflammatory (NSAID) agents and Tylenol®- such as naproxen sodium and ibuprofen may provide relief of gout-related pain. Gout may be a result of a high uric acid level.
  • If you are to avoid NSAID drugs, because of your type of cancer or chemotherapy you are receiving, acetaminophen (Tylenol) up to 4000 mg per day (two extra-strength tablets every 6 hours) may help.
  • It is important not to exceed the recommended daily dose of Tylenol, as it may cause liver damage. Discuss this with your healthcare provider.
  • Uricosuric Drugs: These drugs work by blocking the reabsorption of urate, which can prevent uric acid crystals from being deposited into your tissues. Examples of uricosuric drugs include probenecid, and sulfinpyrazone.
  • Xanthine oxidase inhibitors - Such as allopurinol, will prevent gout. However, it may cause your symptoms of gout to be worse if it is taken during an episode of painful joint inflammation.
  • Allopurinol may also be given to you, if you have a certain form of leukemia or lymphoma, to prevent complications from chemotherapy and tumor lysis syndrome - and not necessarily to prevent gout. With high levels of uric acid in your blood, as a result of your disease, the uric acid will collect and form crystals in your kidneys. This may occur during chemotherapy, and may cause your kidneys to fail.

When to Contact Your Doctor or Health Care Provider:

  • Localized joint pain (especially in a toe or finger joint), that is red and inflamed.
  • Shortness of breath, chest pain or discomfort; should be evaluated immediately.
  • Feeling your heart beat rapidly (palpitations).
  • Bleeding that does not stop after a few minutes.
  • Any new rashes on your skin - especially if you have started any new medications.

Return to list of Blood Test Abnormalities

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

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FAQs

How do you manage hyperuricemia? ›

Allopurinol and febuxostat decrease uric acid synthesis by inhibiting xanthine oxidase and are commonly used for treating hyperuricemia. The usual adult daily maintenance dose is 200 to 300 mg and 40 to 80 mg orally for allopurinol and febuxostat, respectively.

What is the side effect if your uric acid is high? ›

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.

Does high uric acid need treatment? ›

Having a high uric acid level is not a disease or a condition that necessarily needs to be treated or searched for in the absence of other symptoms. But if you have an attack of gout or have a certain type of kidney stone, your doctor may check for high levels of uric acid.

What is the most common cause of hyperuricemia? ›

Most of the time, a high uric acid level occurs when your kidneys don't eliminate uric acid efficiently. Things that may cause this slow-down in the removal of uric acid include rich foods, being overweight, having diabetes, taking certain diuretics (sometimes called water pills) and drinking too much alcohol.

How long is treatment for hyperuricemia? ›

Indomethacin and other nonsteroidal anti-inflammatory drugs (NSAIDs) are the drugs of choice. NSAIDs are prescribed for approximately a 7- to 10-day course or until 3-4 days after all signs of inflammation have resolved.

Can hyperuricemia be cured permanently? ›

There is no cure for gout, and the condition can worsen over time without proper treatment. Treatments focus on reducing symptom severity during a flare-up and preventing future flare-ups. Doctors typically aim to reduce the amount of uric acid in the blood, which contributes to gout symptoms.

What removes uric acid from the body? ›

This article reviews natural ways to help lower uric acid levels.
  • Limit purine-rich foods. ...
  • Eat more low purine foods. ...
  • Avoid medications that raise uric acid levels. ...
  • Maintain a healthy body weight. ...
  • Avoid alcohol and sugary drinks. ...
  • Drink coffee. ...
  • Try a vitamin C supplement. ...
  • Eat cherries.
29 Jun 2022

What are the first symptoms of uric acid? ›

Symptoms
  • Intense joint pain. Gout usually affects the big toe, but it can occur in any joint. ...
  • Lingering discomfort. After the most severe pain subsides, some joint discomfort may last from a few days to a few weeks. ...
  • Inflammation and redness. ...
  • Limited range of motion.

Can uric acid cause permanent damage? ›

Untreated gout can lead to permanent joint damage. The buildup of uric acid in the joints and soft tissue is called tophus. Some people with gout can also develop other health problems, such as severe arthritis, kidney stones and heart disease. It's important to discuss your symptoms with a healthcare provider.

Which doctor is best for uric acid? ›

Primary care physician

A primary care doctor is usually the doctor who treats gout. They can order uric acid blood tests, perform joint aspirations, and prescribe medications to treat the disease.

What type of disease is hyperuricemia? ›

Hyperuricemia occurs when there's too much uric acid in your blood. High uric acid levels can lead to several diseases, including a painful type of arthritis called gout. Elevated uric acid levels are also associated with health conditions such as heart disease, diabetes, and kidney disease.

What foods to avoid if you have hyperuricemia? ›

Avoid meats such as liver, kidney and sweetbreads, which have high purine levels and contribute to high blood levels of uric acid. Red meat. Limit serving sizes of beef, lamb and pork. Seafood.

What drugs cause hyperuricemia? ›

Other drugs which can cause hyperuricaemia are salicylates, pyrazinamide, ethambutol, nicotinic acid, cyclosporin, 2-ethylamino-1,3,4-thiadiazole, fructose and cytotoxic agents. A special type of 'drug-induced gout' can follow the rapid lowering of serum uric acid by allopurinol or uricosuric drugs.

Can uric acid go back to normal? ›

It is thought that it can take up to two years for the body to get rid of all uric acid crystals. To prevent gout attacks during this time, low-dose colchicine is often also prescribed for the first six months. That effectively reduces the risk of those kinds of attacks.

Can hyperuricemia be cured naturally? ›

Nonpharmacological therapy including dietary poor in purine-rich food, sugars, alcohol, and rich in vegetables and water intake is necessary for hyperuricemia. However, it is not enough for patients with higher uric acid level. Pharmacological therapy is necessarily required.

Is uric acid medicine lifelong? ›

Allopurinol doesn't treat the immediate pain caused by attacks of gout. But it's a long-term treatment to get rid of the urate crystals which causes gout attacks. It is likely that you will need to take allopurinol for the rest of your life to manage your urate levels.

Which is the first line treatment for chronic hyperuricemia? ›

Xanthine oxidase inhibitors (XOIs) still remain the first line of treatment as recommended by all guidelines. Among these, allopurinol is the first-line agent in all but the ACR guidelines, which recommend allopurinol or febuxostat interchangeably.

How long does it take to recover from uric acid? ›

An attack of gout usually lasts 5 to 7 days, then gets better. It may not cause lasting damage to joints if you get treatment immediately. Ask for an urgent GP appointment or call 111 if: the pain is getting worse.

Is Egg good for uric acid? ›

Certain foods, such as red meat, are rich in purines. You should avoid such foods if you have gout or are at a high risk for it. This means you need to choose sources of protein that are low in purines. Eggs are a good option.

Which vegetables are good for uric acid? ›

prevent attacks by lowering uric acid levels and reducing inflammation ( 23 , 24 ). Vegetables: All vegetables are fine, including potatoes, peas, mushrooms, eggplants and dark green leafy vegetables. Legumes: All legumes are fine, including lentils, beans, soybeans and tofu.

Is milk good for uric acid? ›

Studies show that drinking low-fat milk and eating low-fat dairy can reduce your uric acid levels and risk of a gout attack. The proteins found in milk promote excretion of uric acid in the urine.

Can I check my uric acid at home? ›

Measure Your Uric Acid Level at Home with Industry-Proven Accuracy. Full Monitoring Tester Kit Includes Meter (Instrument), Lancing Device, 5 Test Strips, 5 Lancets, and More. UASure Invented the World's First Hand-Held Uric Acid Meter in 2001. Individually-Sealed Test Strips for Maximum Accuracy and Shelf Life.

Where is uric acid coming from? ›

Uric acid is a chemical created when the body breaks down substances called purines. Purines are normally produced in the body and are also found in some foods and drinks. Foods with high content of purines include liver, anchovies, mackerel, dried beans and peas, and beer.

Where is the pain in uric acid? ›

The main symptom of gout is a sudden attack of severe pain in one or more joints, typically your big toe. Other symptoms can include: the joint feeling hot and very tender, to the point of being unable to bear anything touching it. swelling in and around the affected joint.

Can you live a normal life with gout? ›

If diagnosed early, most people with gout can live a normal life. If your disease has advanced, lowering your uric acid level can improve joint function and resolve tophi. Medication and lifestyle or dietary changes can also help ease symptoms and reduce the frequency and severity of gout attacks.

Can uric acid cause heart attacks? ›

“Among patients who had gout at the beginning of the study or who developed it during follow-up, their risk of either dying of cardiovascular disease or having a heart attack or stroke was 15 percent higher than patients who never developed gout,” said the study's lead author, Dr.

Is hyperuricemia a kidney disease? ›

Hyperuricemia may be a major contributor to the development or progression of chronic kidney disease (CKD). Although there is no clear cutoff uric acid (UA) value associated to the risk for kidney damage, it appears to be an increased risk as UA rises.

Can hyperuricemia cause kidney failure? ›

Chronic urate nephropathy. A widely accepted belief is that the overproduction of uric acid and the presence of hyperuricemia can cause acute kidney failure; however, whether chronic hyperuricemia independently results in chronic interstitial nephritis and progressive kidney failure is less clear.

What is another name for hyperuricemia? ›

Definition. A high uric acid level, or hyperuricemia, is an excess of uric acid in your blood.

Is banana good for uric patient? ›

Bananas are low in purines and high in vitamin C, which makes them a good food to eat if you have gout. Changing your diet to include more low-purine foods, like bananas, can lower the amount of uric acid in your blood and reduce your risk of recurrent gout attacks.

Is chicken good for uric acid? ›

A high intake of purine-rich foods such as beef, seafood, and chicken is associated with high serum uric acid levels and increased gout risk16,35. Uric acid is the end-product of purine nucleotide metabolism. Purine bases are converted to hypoxanthine and xanthine by many enzymes.

Is Lemon is good for uric acid? ›

Lemon juice may help balance uric acid levels because it helps make the body more alkaline. This means it slightly raises the pH level of blood and other fluids. Lemon juice also makes your urine more alkaline.

What are the two main types of hyperuricemia? ›

Causes of high uric acid levels (hyperuricemia) can be primary (increased uric acid levels due to purine), and secondary (high uric acid levels due to another disease or condition). Sometimes, the body produces more uric acid than it is able to excrete.

How common is hyperuricemia? ›

Hyperuricemia is a common issue in daily clinical practice, estimated to occur in approximately 8.9% to 24.4% of the general population [1, 2].

What is the prevention of uric acid? ›

dietary changes, such as reducing dairy, meat, and alcohol intake or cutting those foods out altogether. nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and colchicine, all of which reduce pain and inflammation. xanthine oxidase inhibitors, which reduce the level of uric acid produced in the body.

What food helps you cut down on high uric acid? ›

Low-purine foods that may help reduce uric acid in the body include fruits (especially those high in vitamin C), vegetables, whole grains, legumes, nuts and low-fat dairy.

Which drug causes hyperuricemia? ›

Alcohol is well known to have this property and in recent years diuretic-induced hyperuricaemia has become a global phenomenon. Other drugs which can cause hyperuricaemia are salicylates, pyrazinamide, ethambutol, nicotinic acid, cyclosporin, 2-ethylamino-1,3,4-thiadiazole, fructose and cytotoxic agents.

Which fruit is best for uric acid? ›

Grapefruit, oranges, pineapples, and strawberries are all great sources of vitamin C, which lowers your uric acid levels and helps prevent gout attacks.

What is the best drink for uric acid? ›

At least half of what you drink should be water. Vitamin C (think orange juice) also can help lower uric acid, but studies also show that the high fructose in OJ may boost uric acid levels, so drink it in moderation. Caffeinated coffee can cut uric acid, too, as long as you don't overdo it.

Which fruits are not good for uric acid? ›

Researchers report a correlation between foods high in fructose and gout symptoms, which can include chronic pain. These fruits include apples, peaches, pears, plums, grapes, prunes, and dates.

What is the fastest way to lower uric acid? ›

This article reviews natural ways to help lower uric acid levels.
  1. Limit purine-rich foods. ...
  2. Eat more low purine foods. ...
  3. Avoid medications that raise uric acid levels. ...
  4. Maintain a healthy body weight. ...
  5. Avoid alcohol and sugary drinks. ...
  6. Drink coffee. ...
  7. Try a vitamin C supplement. ...
  8. Eat cherries.
29 Jun 2022

Videos

1. Gout Guideline Changes and Best Treatment
(Health Professional Radio)
2. 20 Foods That Reduce Your Uric Acid Levels
(Bestie)
3. How to reduce uric acid level and prevent Gout‎? - Ms. Sushma Jaiswal
(Doctors' Circle World's Largest Health Platform)
4. Hyperuricemia (Made Simple)
(Doctor Q's Family Medicine)
5. Know how to deal with Uric Acid and Gout (in Hindi) - Dr Suvrat Arya, Rheumatologist Jaypee Hospital
(Jaypee Hospital)
6. High uric acid in blood: Know the facts
(Professor Tushar)

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