High Uric Acid

Uric acid is a waste product formed when the body breaks down purines. High levels in the blood (hyperuricemia) are the underlying driver of gout, though not everyone with elevated uric acid develops symptoms.

What Causes High Uric Acid

• The body producing too much — sometimes related to genetics, certain foods, or other medical conditions
• The kidneys not excreting enough — the more common cause, influenced by genetics, kidney function, certain medications (including some diuretics), and alcohol use
• Diet — foods high in purines (organ meats, certain seafood, red meat) and alcohol, particularly beer, contribute in many people

How It's Tested

A simple blood test measures uric acid levels. However, a single high reading doesn't automatically mean gout, and some people with gout have normal uric acid levels at the time of testing — the diagnosis of gout itself typically relies on the clinical picture and sometimes joint fluid analysis, not the blood level alone.

Why Not Everyone With High Uric Acid Gets Gout

Many people have elevated uric acid without ever developing a gout attack — this is called asymptomatic hyperuricemia. Whether and when crystals form and trigger inflammation varies by individual, and not everyone with high levels needs treatment specifically for that reason alone.

This guide draws on clinical guidance from the American College of Rheumatology (ACR) and NIH/NIAMS.