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Uric Acid, Metabolic Health, and Gout

  • 21 minutes ago
  • 3 min read


What it is

Uric acid is a natural compound produced in the body when purines, found in our cells and in foods such as red meat, liver, and seafood (lobster, sardines, shrimp), break down. But uric acid has many functions, from tissue healing to inflammatory response. At normal concentrations, uric acid can act as an antioxidant in the blood. And as a waste product, uric acid dissolves in the blood, travels to the kidneys, and leaves the body through urine. 


Levels can also vary with hydration, alcohol intake, diet, exercise, body weight, kidney function, medications, and time of day, so a single measurement should not be treated as a complete assessment of health. 


However, for some, when serum urate remains persistently elevated (~6.8 mg/dL), it can form monosodium urate crystals, deposit in joints and tissues, trigger inflammation, and result in the disease gout. 



What the science says


Your Uric acid levels play a central role in metabolic health. Uric acid is an antioxidant extracellularly, but intracellularly it is a pro-oxidant, meaning elevated levels can lead to oxidative stress. Oxidative stress occurs when there are too many unstable free radicals in the body, leading to damage. Antioxidants clear them up. 


Elevated levels of uric acid may rise as a consequence of obesity, insulin resistance, impaired kidney excretion, excess alcohol intake, ketogenic, high-protein, or high refined carbohydrate diets. There are real mechanisms involving oxidative stress, inflammation, and endothelial function, with numerous studies linking elevated urate to conditions such as weight gain, insulin resistance, hypertension, cardiovascular disease, and kidney dysfunction. Ensuring your levels are within range can help mitigate some of these risks. Especially diseases like gout.


Gout occurs when monosodium urate crystals activate the immune system, producing severe pain, swelling, redness, and heat in the affected joint. For people with established gout, lowering serum urate reduces crystal burden and helps prevent future flares. Clinical guidelines recommend a target below 6 mg/dL (ACR guide). Men are more likely to be diagnosed with gout, but incidence in women, especially after menopause, has increased. 


However, low levels (<3.2 mg/dL) of uric acid could indicate zinc, iron, or molybdenum deficiency, or low protein intake (i.e., a poorly planned vegan/vegetarian diet).


Fructose is often mentioned alongside gout because large, rapidly absorbed amounts can increase uric acid production. However, it is also often misunderstood to mean fruit, but the studies discuss higher fructose intake associated with highly processed items like high-fructose corn syrup. Whole fruit contains much-needed fiber, water, vitamins, minerals, and polyphenols. It is processed more slowly and is less concentrated than soda, juice, sweets, or processed foods containing high-fructose corn syrup. The most evidence-based dietary priority is to reduce concentrated sugars and excess alcohol rather than eliminate whole fruit. Diets high in fructose, particularly from sources like high-fructose corn syrup, can elevate uric acid, which inhibits nitric oxide production, leading to vasoconstriction (narrowing of blood vessels) and increased blood pressure.


Uric acid testing is most useful when there is suspected gout, a history of uric acid kidney stones, chronic kidney disease, relevant medication use, or a strong family history. But it can also add useful context to a broader metabolic assessment. Serum urate fluctuates with hydration, alcohol intake, diet, exercise, body weight, and time of day; therefore, the data is only relevant in the context of consistent observation. On the market, there are home finger-prick blood samplers that can provide a convenient way to measure uric acid levels, although accuracy can vary by device and sampling technique.


Functional reference ranges:

  • 3.7-6.0 mg/dL (men)

  • 3.2-5.5 mg/dL (women)


Home results may be useful for monitoring, but laboratory testing is more reliable. Uric acid is a valuable clinical marker but only within the context of your medical history and other drivers of health. Speak to your Client Advocate to learn more about whether Uric Acid testing is right for you.



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