Uric Acid
Uric acid is the end product of purine metabolism and is excreted mainly by the kidneys. Elevated levels can crystallize in joints to cause gout and in kidneys to form stones, and are associated with hypertension, metabolic syndrome, chronic kidney disease, and cardiovascular events. Diet, alcohol, fructose, and certain drugs influence levels.
Units: mg/dL; some labs report µmol/L (µmol/L = mg/dL × 59.5). Check the units on your report before comparing to any range here.
Optimal range: who says what
Institutions, researchers and practitioners draw the line in different places. Each position is listed with who holds it and, where a document states it, a link. How we verify ranges.
- Institution or study≤7.0 mg/dL (men)NHANES 2015-2016 hyperuricemia definition (Chen-Xu et al. 2019)Hyperuricemia defined as above 7.0 mg/dL in men; mean serum urate in US men was 6.0 mg/dL
- Institution or study≤5.7 mg/dL (women)NHANES 2015-2016 hyperuricemia definition (Chen-Xu et al. 2019)Hyperuricemia defined as above 5.7 mg/dL in women; mean serum urate in US women was 4.8 mg/dL
- Institution or study<6 mg/dL (treatment target in gout)American College of Rheumatology gout guideline (2020)A treat-to-target goal for people on urate-lowering therapy, not a screening cutoff
- Institution or study<6 mg/dL; <5 mg/dL in severe goutEULAR gout recommendations (2016 update)Target for people with gout on urate-lowering therapy
- Named practitioner<7-8 mg/dLChris Kresser · Which Lab Tests are Essential?
- Named practitioner<6 mg/dLLife Extension · Lab Testing Protocol (Suggested Optimal Ranges)Disclosure: Life Extension sells lab panels that appear in our blood-test comparisons.
- Lab reference intervalMen: 4.0-8.6 mg/dL, Women: 3.0-7.1 mg/dL (MedlinePlus)What a lab report flags against. A lab interval is not an optimal target.
Practitioner targets are individual positions, often tighter than guideline ranges. Each was checked against its article before publishing.
16 of 21 itemized panels
Metabolic Health / Glucose
What is Uric Acid?
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.
Uric acid is more than a waste product. High levels are associated with hypertension, fatty liver, insulin resistance, and heart disease. Whether uric acid causes these problems is still debated: allopurinol lowered blood pressure in a small trial of adolescents with new hypertension (Feig 2008), and in a meta-analysis hyperuricemia added only a small independent risk of coronary heart disease (Kim 2010).
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.
Why Uric Acid Matters for Longevity
- Cardiovascular disease: Uric acid >6 mg/dL increases CVD risk by 20-30% independent of other risk factors. High uric acid impairs endothelial function, raises blood pressure, promotes atherosclerosis, and predicts heart attacks and stroke.
- Hypertension: Uric acid >5.5 mg/dL doubles the risk of developing hypertension. Uric acid inhibits nitric oxide (a vasodilator), causing vasoconstriction and sodium retention. Lowering uric acid with allopurinol reduces blood pressure by 5-10 mmHg.
- Kidney disease: Uric acid crystals deposit in kidneys, causing inflammation and fibrosis. High uric acid is a major risk factor for chronic kidney disease (CKD) and kidney stones. Lowering uric acid slows CKD progression.
- Metabolic syndrome and insulin resistance: Uric acid promotes hepatic fat accumulation (fatty liver) and worsens insulin resistance. Elevated uric acid predicts development of metabolic syndrome and type 2 diabetes.
- Gout: Uric acid >7 mg/dL leads to crystal deposition in joints (especially big toe), causing excruciatingly painful gout attacks. Prevalence ~4% of US adults, increasing with obesity and metabolic syndrome.
- Longevity: Higher uric acid associated with increased all-cause mortality. Lower uric acid (4-5 mg/dL) associated with longer healthspan and reduced disease burden.
Interpretation bands (curated, PMID-backed)
Holder: OptimizeBiomarkers editorial synthesis of: Serum uric acid and risk of cardiovascular mortality: a systematic review and dose-response meta-analysis of cohort studies of over a million participants (Rahimi-Sakak et al., 2019); Association between serum uric acid levels and mortality: a nationwide community-based cohort study (Konta et al., 2020). No single paper sets these cutoffs; for attributed targets see who says what.
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
Acceptable5.0-5.5 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)
- Serum uric acid and risk of cardiovascular mortality: a systematic review and dose-response meta-analysis of cohort studies of over a million participants.
- Increased cardiovascular mortality associated with gout: a systematic review and meta-analysis.
- Association between serum uric acid levels and mortality: a nationwide community-based cohort study.
What raises or lowers Uric Acid
Causes of high Uric Acid
- High-purine diet: Excessive red meat, organ meats, shellfish, alcohol (especially beer).
- Fructose consumption: Sugary drinks, high-fructose corn syrup, excessive fruit juice. Fructose metabolism generates uric acid.
- Obesity and metabolic syndrome: Insulin resistance impairs kidney uric acid excretion. Visceral fat promotes uric acid production.
- Kidney disease (CKD): Impaired kidney function reduces uric acid excretion, raising serum levels. Creates vicious cycle (high uric acid worsens kidney disease).
- Dehydration: Concentrates uric acid in blood and reduces kidney excretion.
- Medications: Diuretics (thiazides, loop diuretics) impair uric acid excretion. Low-dose aspirin (<1 g/day) reduces excretion. Niacin, levodopa, pyrazinamide.
- Genetic factors: 40-70% of uric acid variation is genetic. Some people are \overproducers\ (excess purine metabolism) or \underexcretors\ (kidney defect).
- Alcohol: Increases uric acid production (purine metabolism) and decreases excretion (lactic acid competes for kidney transporters). Beer is worst offender.
- Cell turnover diseases: Psoriasis, leukemia, lymphoma, chemotherapy (tumor lysis syndrome) release purines from dying cells.
Causes of low Uric Acid
- 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).
Symptoms when Uric Acid is high or low
When high
Symptoms of hyperuricemia and gout:
- Acute gout attack: Sudden, severe pain, redness, warmth, swelling in joint (usually big toe, ankle, knee). Excruciatingly painful, often starts at night. Lasts 3-10 days without treatment.
- Tophi: Chalky deposits of uric acid crystals under skin (elbows, fingers, ears) in chronic untreated gout.
- Kidney stones: Uric acid stones (10-15% of all kidney stones). Causes flank pain, hematuria (blood in urine).
- Often asymptomatic: Many people with high uric acid have no symptoms; high levels are associated with cardiovascular and kidney disease.
Uric acid >7 mg/dL = hyperuricemia, high risk of gout and metabolic complications. Uric acid >9 mg/dL = very high risk of acute gout attacks.
When low
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.
Low uric acid is rarely harmful unless due to underlying kidney or metabolic disorder.
How to move Uric Acid
Effect sizes (how much something moves the marker) appear only where the paper cited under the item states them. Talk to your clinician before starting or changing any medication or supplement.
Reduce Dietary Purines (Moderate Effect)
- 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 modestly.
- 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.
Eliminate Fructose and Sugary Drinks (High Impact)
- 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 is associated with higher uric acid and higher gout risk.
- 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.
Weight Loss and Exercise
- Lose 5-10% body weight: Obesity strongly correlates with high uric acid. Weight loss lowers uric acid.
- 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.
Hydration
- 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): Regular coffee drinking is associated with lower gout risk. Coffee compounds (not caffeine) may lower uric acid slightly.
Medications (if lifestyle insufficient or uric acid >7 mg/dL)
- Allopurinol: 100-300 mg daily. Xanthine oxidase inhibitor; blocks uric acid production. Lowers uric acid substantially. First-line for chronic hyperuricemia and gout prevention. Side effects: rash (5%), GI upset. Rare: Stevens-Johnson syndrome (more common in Asians with HLA-B*5801 allele).
- Febuxostat: 40-80 mg daily. Alternative xanthine oxidase inhibitor. More potent than allopurinol but higher cost. May have slightly higher CVD risk.
- Probenecid: 500-1000 mg twice daily. Increases kidney uric acid excretion. Less effective than allopurinol; avoid if kidney disease (GFR <50).
- Losartan (ARB blood pressure med): Uniquely lowers uric acid among ARBs by increasing renal excretion. Consider for hypertensive patients with high uric acid.
When to retest
- 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. Life Extension suggests below 6 mg/dL (see who says what above).
- If starting allopurinol/febuxostat: Retest after 4-6 weeks, then every 3 months until uric acid is below 6 mg/dL, the American College of Rheumatology treat-to-target goal (EULAR sets below 5 mg/dL in severe gout). 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.
Scientific Evidence
Allopurinol and Blood Pressure in Adolescents
In a crossover trial of 30 adolescents with newly diagnosed stage 1 hypertension and uric acid of 6 mg/dL or higher, 4 weeks of allopurinol lowered casual systolic blood pressure by 6.9 mmHg versus 2.0 mmHg on placebo. 20 of 30 reached normal blood pressure on allopurinol versus 1 on placebo. The authors call the findings preliminary.
Uric Acid and Coronary Heart Disease
A meta-analysis of 26 prospective studies (402,997 adults) found hyperuricemia associated with a small rise in coronary heart disease after adjustment (relative risk 1.09 for incidence, 1.16 for mortality). Each 1 mg/dL higher uric acid carried 12% higher risk of coronary death, and the association was stronger in women.
Source: Hyperuricemia and coronary heart disease: a systematic review and meta-analysis.
Which Providers Test Uric Acid?
Cheapest: Empirical Health at $190/year. Most comprehensive: Function Health, 160+ biomarkers for $365/year.
16 panels that include it, cheapest first
| Provider | Annual Cost | Total Biomarkers | $/Biomarker |
|---|---|---|---|
| $190 | 100+ | $1.90 | |
| $250 | 65 | $3.85 | |
| $297 | 100+ | $2.97 | |
 Labcorp OnDemand | $338 | 50+ | $6.76 |
 Superpower | $349 | 100+ | $3.49 |
| $349 | 75+ | $4.65 | |
 WHOOP Advanced Labs | $349 | 65 | $5.37 |
 Function Health | $365 | 160+ | $2.28 |
| $365 | 100+ | $3.65 | |
| $495 | 80+ | $6.19 | |
| $499 | 100+ | $4.99 | |
| $700 | 138 | $5.07 | |
| $895 | 100+ | $8.95 | |
| $1188 | 70+ | $16.97 | |
| $1198 | 40+ | $29.95 | |
| $1950 | 130+ | $15.00 |
$/Biomarker is annual cost divided by the panel's advertised biomarker count, not the price of this one test. We track 23 blood test providers (32 plans); 21 of those plans are itemized marker by marker. Compare all of them.
5 itemized panels do not include Uric Acid
Everlywell · InsideTracker · Oura Health Panels · SiPhox Health · Vitality Blueprint Standard
11 providers not itemized in our matrix
We have not itemized these marker by marker (some sell tests one at a time), so this page cannot say whether they offer Uric Acid. Check with them directly.
Life Extension Standard · Quest Health · Ultrahuman Blood Vision · Lifeforce · Hundred Health · Personalabs · Walk-In Lab · HealthLabs · WHOOP Specialized Panels · Marek Health Essential · Vitality Blueprint Upload
Experts discussing Uric Acid
Podcast episodes where clinicians and researchers cover this marker in depth. Curated by hand; an episode is listed only when the marker is a substantial topic, not a passing mention.
- Are You Pre-Diabetic? Know Your NumbersDisclosure: Hyman co-founded Function Health, which appears in our blood-test comparisons.
Frequently Asked Questions
What is the optimal range for Uric Acid?
Published positions differ: ≤7.0 mg/dL (men) (NHANES 2015-2016 hyperuricemia definition (Chen-Xu et al. 2019)); ≤5.7 mg/dL (women) (NHANES 2015-2016 hyperuricemia definition (Chen-Xu et al. 2019)); <6 mg/dL (treatment target in gout) (American College of Rheumatology gout guideline (2020)); <6 mg/dL; <5 mg/dL in severe gout (EULAR gout recommendations (2016 update)). Named practitioners target: <7-8 mg/dL (Chris Kresser); <6 mg/dL (Life Extension). Lab reference interval: Men: 4.0-8.6 mg/dL, Women: 3.0-7.1 mg/dL (MedlinePlus). That is what a lab report flags against, not an optimal target.
Which blood test providers include Uric Acid?
16 of the 21 blood testing panels we itemize marker by marker include Uric Acid in their panels. This biomarker is widely available across major providers.
Related: YouBoost rates lifestyle and supplement interventions by evidence; HRV Zone tracks recovery trends.
Medical Disclaimer
This information is for educational purposes only and is not medical advice. Always consult with a qualified healthcare provider about your specific health needs.
Last reviewed Sep 23, 2026 · First published Sep 30, 2025