Complete Testing & Optimization Guide
Optimal ranges, provider comparison, and strategies to improve your Uric Acid levels
Included in 8 of 10 major testing providers
Metabolic Health / Glucose
metabolic syndrome
Abnormal Uric Acid levels can indicate underlying health issues that may go undetected without proper testing. Regular monitoring helps catch problems early when they're most treatable.
Understanding your Uric Acid levels enables targeted interventions, tracks treatment effectiveness, and helps optimize your overall health and performance.
Uric acid is the end product of purine metabolism. Purines are nitrogen-containing compounds found in DNA, RNA, and certain foods (red meat, organ meats, seafood, alcohol). When cells break down or you consume purine-rich foods, purines are metabolized to uric acid, which is then excreted by the kidneys (70%) and gut (30%). Elevated uric acid (hyperuricemia) is best known for causing gout—painful crystallization of uric acid in joints—but it's also a powerful independent risk factor for metabolic syndrome, hypertension, kidney disease, cardiovascular disease, and all-cause mortality.
Here's the critical insight:uric acid is not just a byproduct—it's an active signaling molecule that drives metabolic dysfunction. High uric acid (>5.5 mg/dL) impairs nitric oxide production (worsening endothelial function and raising blood pressure), activates the NLRP3 inflammasome (promoting inflammation), stimulates fat storage in the liver (causing fatty liver), and worsens insulin resistance. Uric acid is a CAUSE, not just a marker, of metabolic disease. Lowering uric acid with diet, weight loss, or allopurinol improves blood pressure, insulin sensitivity, and cardiovascular outcomes.
Standard "normal"ranges for uric acid (3.5-7.2 mg/dL men, 2.6-6.0 mg/dL women) are far too high. For longevity optimization, target <5.5 mg/dL (ideally 4-5 mg/dL). Uric acid >5.5 mg/dL is associated with doubling of hypertension risk, 40% higher kidney disease risk, and 20-30% higher CVD mortality. Even within the "normal"range, lower is better for metabolic health.
Bottom line: TSH and Free T4 alone miss people with conversion problems. Free T3 is the only way to know if you have enough active thyroid hormone at the tissue level.
| Range Type | Level | Clinical Significance |
|---|---|---|
| Optimal (Longevity) | 3.5-5.0 mg/dL | Target for optimal metabolic health, blood pressure, and longevity. Lower uric acid within this range associated with lowest CVD and kidney disease risk. |
| Acceptable | 5.0-5.5 mg/dL | Upper end of optimal. Acceptable for most people but consider lifestyle optimization if trending upward. |
| Suboptimal (Elevated) | 5.5-7.0 mg/dL | Increased risk of hypertension (2x), metabolic syndrome, kidney disease. Intervene with diet, weight loss, hydration. Consider allopurinol if >6.5 mg/dL. |
| High (Hyperuricemia) | 7.0-9.0 mg/dL | Frank hyperuricemia. High risk of gout attacks (20-30% will develop gout). Significantly increased CVD and kidney disease risk. Requires uric acid-lowering therapy (allopurinol or febuxostat). |
Standard lab range:metabolic syndrome
>9.0 mg/dL
Low (Rare)
Low uric acid is rare. May indicate SIADH (syndrome of inappropriate ADH secretion), Fanconi syndrome (kidney tubular defect), or xanthinuria (rare genetic disorder). Generally not harmful.
Limit high-purine foods:Red meat (beef, lamb, pork), organ meats (liver, kidney), shellfish (shrimp, lobster, mussels), sardines, anchovies, mackerel. Reducing intake lowers uric acid by 0.5-1.0 mg/dL.
Avoid beer and spirits:Alcohol (especially beer) significantly raises uric acid by increasing production and decreasing excretion. Beer contains purines from yeast. Limit to ≤1 drink/day or avoid.
Moderate seafood:Salmon, tuna are lower in purines than shellfish but still contribute. Limit to 2-3x/week.
Fructose is THE dietary driver of uric acid production. Fructose metabolism in the liver generates uric acid as a byproduct (ATP depletion → AMP → uric acid).
Eliminate sugary drinks:Soda, fruit juice, sweetened beverages. Each daily serving of sugar-sweetened beverage raises uric acid by 0.3-0.5 mg/dL and increases gout risk by 75%.
Limit high-fructose corn syrup:Found in processed foods, desserts, sweetened yogurt.
Whole fruit is OK:Fiber in whole fruit mitigates fructose's uric acid-raising effect. Berries, cherries (especially tart cherries) may even lower uric acid.
Note: Lose 5-10% body weight:Obesity strongly correlates with high uric acid. Weight loss lowers uric acid by 1-2 mg/dL. | Caution:Rapid weight loss or fasting can TEMPORARILY raise uric acid and trigger gout (ketone bodies compete with uric acid for kidney excretion). Lose weight gradually (1-2 lbs/week). | Exercise regularly:Improves insulin sensitivity and helps maintain healthy weight. Moderate intensity (walking, cycling) is best;excessive exercise can raise uric acid acutely.
Note: Drink 2-3 liters water daily:Adequate hydration increases uric acid excretion by kidneys. Dehydration concentrates uric acid in blood and promotes crystal formation. | Coffee (moderate benefit):2-4 cups/day associated with 20-30% lower gout risk. Coffee compounds (not caffeine) lower uric acid by ~0.2-0.3 mg/dL.
Low uric acid (<2.5 mg/dL) is rare and usually benign. May indicate:|SIADH (syndrome of inappropriate ADH):Dilutional hyponatremia and low uric acid.|Fanconi syndrome:Kidney tubular defect causing wasting of uric acid, glucose, amino acids, phosphate.|Xanthinuria:Rare genetic xanthine oxidase deficiency. Uric acid very low, xanthine high. Can cause xanthine kidney stones.|Wilson disease:Copper accumulation in liver causes Fanconi-like kidney defect with low uric acid.
Source:Low uric acid is rarely harmful unless due to underlying kidney or metabolic disorder.
leukemia
Source:lymphoma
Kidney disease causing uric acid wasting (Fanconi syndrome, proximal tubular defects).|Medications:Allopurinol, febuxostat (xanthine oxidase inhibitors), probenecid, losartan.|SIADH:Dilutional hyponatremia lowers uric acid.|Genetic:Xanthinuria (xanthine oxidase deficiency).|Low-purine diet:Vegetarian/vegan diet with minimal fructose (rare to cause clinical low uric acid).
Source:Baseline:Check uric acid if gout, kidney stones, hypertension, metabolic syndrome, or obesity.|After lifestyle intervention:Retest 3-6 months after dietary changes (reduce purines, eliminate fructose/alcohol), weight loss, increased hydration. Expect 0.5-2 mg/dL drop with successful intervention. Goal:<5.5 mg/dL (ideally 4-5 mg/dL).|If starting allopurinol/febuxostat:Retest after 4-6 weeks, then every 3 months until uric acid <6 mg/dL (goal <5 mg/dL for gout patients). Adjust dose as needed.|Annual screening:For patients with hypertension, CKD, metabolic syndrome, or history of gout.|If active gout:During acute attack, uric acid may paradoxically be normal or low (inflammation drives uric acid into tissues). Retest 2-4 weeks after attack resolves.
Uric acid >5.5 mg/dL is associated with 2x higher risk of developing hypertension. Uric acid inhibits nitric oxide production (causing vasoconstriction) and activates renin-angiotensin system (sodium retention). Allopurinol (uric acid-lowering drug) reduces systolic BP by 5-10 mmHg in hypertensive patients with hyperuricemia.
Source:Feig DI, et al. Effect of allopurinol on blood pressure of adolescents with newly diagnosed essential hypertension. JAMA. 2008;300(8):924-932.
Meta-analyses show each 1 mg/dL increase in uric acid associated with 20% higher CVD mortality and 15% higher all-cause mortality. Uric acid >6 mg/dL independently predicts heart attacks, stroke, and heart failure. Uric acid promotes endothelial dysfunction, inflammation, and atherosclerosis.
Source:Kim SY, et al. Hyperuricemia and coronary heart disease:a systematic review and meta-analysis. Arthritis Care Res. 2010;62(2):170-180.
| Provider | Includes Test | Annual Cost | Total Biomarkers |
|---|---|---|---|
 Superpower | ✓ | $199 | 100+ |
 WHOOP Advanced Labs | ✓ | $349 | 65 |
 Labcorp OnDemand | ✓ | $398 | 30+ |
| ✓ | $486 | 40+ | |
| — | $468 | 83 | |
| ✓ | $798 | 100+ | |
 InsideTracker | — | $680 | 48 |
 Function Health | ✓ | $499 | 100+ |
| ✓ | $900 | 70+ | |
| ✓ | $1150 | 110 | |
| — | $Varies | 75+ |
Choose from 8 providers that include this biomarker in their panels
Uric Acid is a metabolic health / glucose biomarker that Waste product that can indicate gout or kidney issues The normal reference range is metabolic syndrome. Regular testing helps track changes and identify potential health issues early.
8 out of 10 major blood testing providers include Uric Acid in their standard panels. These include Superpower, Blueprint, Mito Health and others.
For most people, testing Uric Acid 2-4 times per year is recommended to establish baseline levels and track trends. If you have abnormal results or are actively working to optimize this biomarker, more frequent testing (quarterly) may be beneficial. Always consult with your healthcare provider for personalized testing frequency recommendations.
The standard laboratory reference range for Uric Acid is metabolic syndrome. However, many functional medicine practitioners recommend tighter "optimal" ranges for peak health and performance. Your ideal range may vary based on your age, sex, health goals, and other individual factors. Work with a healthcare provider familiar with optimal ranges to determine your target levels.
Most direct-to-consumer blood testing services that include Uric Acid provide the physician order as part of their service. However, some states have restrictions on direct-to-consumer testing. Check with your chosen provider about availability in your state and whether they provide the necessary physician authorization.
Elevated levels cause gout (painful joint inflammation). Also linked to kidney disease
This information is for educational purposes only and is not medical advice. Always consult with a qualified healthcare provider about your specific health needs and before making decisions about blood testing.
