Uric acid (Urate)

What is uric acid?

Uric acid is a natural compound formed when the body breaks down purines. Purines are chemical building blocks found in the cells of your own body as well as in certain foods. They play an essential role in the construction of DNA and RNA, the genetic blueprints needed for virtually all bodily processes.

After purines have been broken down, the uric acid is eliminated from the body via the kidneys and intestines. As long as production and excretion are in balance, this causes no problems. If that balance is disrupted, uric acid can accumulate in the blood.

A blood test measures the urate level: the concentration of uric acid in the blood. This value provides an indication of how well the kidneys process the uric acid and whether there is overproduction or reduced elimination.

What are purines and where do they come from?

Purines come from both internal and external sources. Your body produces them itself as part of cellular metabolism, but you also ingest them through food. Foods containing relatively high levels of purines include liver, blood sausage, kidney, herring, anchovies, and fish roe.

It is good to know that purines are not harmful in themselves. In fact, they are essential for the functioning of cells. The key is what the body does with them after they have been broken down. With a healthy metabolism, the released uric acid is eliminated without problems. However, with excessive intake or impaired kidney function, the balance can be disrupted.

What do abnormal values ​​mean?

Uric acid too high: hyperuricemia

When the uric acid level is structurally too high, it is referred to as hyperuricemia. This can lead to the formation of small uric acid crystals in the joints. These crystals cause a severe inflammatory reaction accompanied by pain, swelling, and stiffness. We know this condition as gout.

Gout often occurs suddenly, in the form of attacks. Interestingly, the big toe joint is one of the most common sites for the first attack. The attacks can be extremely painful and last for days. Risk factors for gout include high alcohol intake and a purine-rich diet, but impaired kidney function also plays a role.

Elevated uric acid levels also occur in other conditions, such as psoriasis, high blood pressure, and heart failure. Therefore, it is not always directly linked to gout, but it does require attention and further assessment by a doctor.

Uric acid levels too low: hypouricemia

A blood uric acid level that is too low, hypouricemia, is rare. It may indicate a problem with the production or excretion of uric acid. In some cases, it is associated with inflammation in the gastrointestinal tract. Because it is rare, it is less frequently recognized, but it deserves medical attention nonetheless when it is detected.

When is it useful to have uric acid measured?

Measuring uric acid levels is useful in various situations. Do you suffer from sudden, severe joint pain, especially in the big toe, feet, or ankles? Then a uric acid test can help confirm or rule out gout as the cause. In cases of pre-existing gout, the value is also checked regularly to see if the treatment is working.

Furthermore, measurement is useful in cases of kidney problems, high blood pressure, psoriasis, or other conditions where the uric acid balance may become disrupted. People who consume a lot of purine-rich foods or drink alcohol regularly can also benefit from insight into their values.

A blood test for uric acid is often part of a broader health check, in which kidney function, blood pressure, and other markers are also assessed. This way, you get a more complete picture of your health, and abnormalities can be assessed in the proper context.

Always discuss abnormal uric acid levels with a doctor. Based on your complete health situation, they can determine whether further diagnostics or treatment are necessary.