Uric acid and gout: which blood value gives insight

Anyone who has had a gout attack does not forget it: a suddenly red, swollen and painful joint, often the big toe. Gout is linked to a high uric acid in your blood, and that is the value that gives insight. Yet not everyone with a high uric acid actually develops gout (Dalbeth 2021).

This article expands on the overview about your kidney function, focusing on uric acid and gout.

What is uric acid?

Uric acid is a breakdown product of purines, which sit in your own cells and in certain foods like organ meat, some fish and alcohol. Your body breaks purines down into uric acid, which is mostly passed out via your kidneys. When production and excretion are balanced, the value stays stable. Make too much or excrete too little, and it rises. That is where the link with your kidneys comes in.

How does uric acid relate to gout?

With a lasting high uric acid, small crystals can form in a joint. Those crystals can trigger a fierce inflammatory reaction, felt as a gout attack. The classic spot is the big toe. A high uric acid is a risk factor, not a guarantee: many people carry a raised value for years without an attack. During an attack, uric acid can even look normal, so one measurement does not tell the whole story.

Which values are relevant?

Because your kidneys help set excretion, it makes sense to read uric acid next to your kidney values. See high creatinine and eGFR explained.

What influences your uric acid?

Several things influence uric acid: purine-rich food, alcohol (especially beer), excess weight, certain medicines and reduced kidney function (Dalbeth 2021). Diet is not the whole story, though. Genetics play a large role, and some people naturally have a higher uric acid. See also uric acid.

What can you do?

You can include uric acid in a blood test at Vitalcheck. If your value is raised, discuss it with your GP, who combines it with your symptoms and kidney values. If you have had an attack, repeating the measurement on a calm day is wise, as uric acid can be misleadingly normal during an attack. To map your kidney function too, you can have a kidney function test.

References

• Dalbeth N, et al. Gout. Lancet. 2021. PMID: 33798500.
• Webster AC, et al. Chronic Kidney Disease. Lancet. 2017. PMID: 27887750.
• Thuisarts.nl. About gout.

Every blood test result includes a professional assessment from a BIG-registered doctor. For treatment decisions, discuss your results with your GP.