What Is Uric Acid?
Uric acid is a waste product your body makes when it breaks down substances called purines. Purines are found naturally in your cells and in certain foods.
Uric acid normally dissolves in the blood. Your kidneys filter most of it out, and it leaves the body through urine. If your body makes too much uric acid or your kidneys remove too little, it builds up in the blood.
How is uric acid linked to heart health?
High uric acid may contribute to cardiovascular disease by increasing oxidative stress, promoting inflammation, and reducing nitric oxide, a molecule that helps blood vessels relax and maintain healthy blood flow.1 These changes can impair blood vessel function, promote plaque formation, and increase the risk of high blood pressure, coronary artery disease, heart failure, atrial fibrillation, and stroke.
How is uric acid linked to metabolic health?
Because insulin resistance reduces the kidneys’ ability to eliminate uric acid, elevated uric acid often appears years before type 2 diabetes develops.2 High uric acid often appears with other signs of metabolic syndrome, including:
- High fasting insulin or blood sugar
- High triglycerides
- Low HDL cholesterol
- High blood pressure
- Excess abdominal fat
Why Does Uric Acid Matter?
- Associated with increased risk of heart disease. High uric acid is closely linked with a higher risk of heart disease, high blood pressure, and stroke3
- Flags a higher risk of future metabolic problems: Increases in uric acid are associated with a higher risk of developing metabolic syndrome.4
- Identifies if you are at a higher risk of gout: As uric acid rises, crystals are more likely to form in the joints and trigger pain, swelling, and redness. However, many people with high levels never develop gout.
- Offers clues about kidney function: The kidneys remove most uric acid. A high result may be related to reduced kidney clearance, dehydration, or medications that affect how the kidneys handle uric acid.
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How to Interpret Uric Acid Levels
(Ranges may vary slightly by lab)
Standard reference ranges represent the middle 95% of healthy individuals but don’t necessarily reflect levels associated with longevity. Optimal ranges are derived from clinical guidelines, peer-reviewed research, and real-world outcomes data, with an emphasis on levels associated with peak functioning and reduced disease risk.
Benefits of Optimizing Uric Acid
- Reduced risk of gout attacks and uric acid kidney stones
- Healthier blood vessel function and blood pressure
- Improved insulin sensitivity and overall metabolic health
- Healthy kidney function and uric acid clearance
- Reduced inflammation and oxidative stress
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Low Uric Acid Levels
Low uric acid levels are uncommon and are usually not a cause for concern. Rarely, they may reflect certain medications, inherited conditions, or kidney disorders and should be interpreted in the context of your overall health.
High Uric Acid Levels
High uric acid levels on a blood test mean that your body is making more uric acid than it can remove, your kidneys are not clearing enough, or both. Many people with elevated uric acid never develop gout, but higher levels still provide valuable information about long-term metabolic and cardiovascular health.
Symptoms:
- Usually causes no symptoms
Causes:
The most common problem is that the kidneys do not remove enough uric acid. Factors that may contribute include:
- Insulin resistance and high insulin levels
- Abdominal obesity
- High intake of sugar-sweetened drinks or fructose
- High alcohol intake, particularly beer and spirits
- Reduced kidney function
- Dehydration
- Genetics
- Diuretics and certain other medications
- Eating large amounts of organ meat, red meat, or certain seafood
- Metabolic dysfunction-associated steatotic liver disease (MASLD)
- Sleep apnea
Healthspan Impacts:
- Insulin resistance and metabolic syndrome
- A higher future risk of type 2 diabetes
- Fatty liver disease
- High blood pressure
- Chronic kidney disease
- Cardiovascular disease (coronary artery disease and stroke)
- Gout and uric acid kidney stones
- Heart failure
How Hone Treats Out of Range Uric Acid Levels
Your Hone physician evaluates uric acid alongside fasting insulin, fasting glucose, HbA1c, triglycerides, liver enzymes, kidney function, blood pressure, and body composition to determine whether elevated uric acid reflects insulin resistance, impaired kidney function, dietary factors, or another underlying cause. Treatment focuses on improving metabolic health while reducing long-term cardiovascular and kidney disease risk.
Yu W, Cheng JD. (2020) Uric Acid and Cardiovascular Disease: An Update From Molecular Mechanism to Clinical Perspective.
↑Lv Q, Meng XF, He FF, et al. (2013). High serum uric acid and increased risk of type 2 diabetes
↑Perez-Ruiz F, Aniel-Quiroga MA, Herrero-Beites AM, et al. (2015). Renal clearance of uric acid is linked to insulin resistance and lower excretion of sodium in gout patients.
↑Yuan H, Yu C, Li X, et al. (2015). Serum uric acid levels and risk of metabolic syndrome: A dose-response meta-analysis of prospective studies
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Reviewed for Accuracy by Our Medical Review Board
This biomarker information has been reviewed by a member of Hone’s medical review board. As part of the medical review team, physicians fact-check this content against the latest research and their own experience treating their patients.
Ashley Winter, M.D., is a board-certified urogynecologist trained at Weill Cornell and Cleveland Clinic. She specializes in female and male sexual dysfunction, urinary issues, genital pain, and hormone therapy.
James Staheli, D.O., is the Medical Director for Broad Health, Hone Health’s affiliated medical practice and a family medicine doctor in Atlanta, Georgia.
