Uric Acid
Waste product that can indicate gout or kidney issues
15 of 22 providers
Metabolic Health / Glucose
metabolic syndrome
What is Uric Acid?
Uric acid is the end product of purine metabolism. Purines are nitrogen-containing compounds found in DNA, RNA, and certain foods (red meat, organ meats, seafood, alcohol). When cells break down or you consume purine-rich foods, purines are metabolized to uric acid, which is then excreted by the kidneys (70%) and gut (30%). Elevated uric acid (hyperuricemia) is best known for causing gout—painful crystallization of uric acid in joints—but it's also a powerful independent risk factor for metabolic syndrome, hypertension, kidney disease, cardiovascular disease, and all-cause mortality.
Here's the critical insight:uric acid is not just a byproduct—it's an active signaling molecule that drives metabolic dysfunction. High uric acid (>5.5 mg/dL) impairs nitric oxide production (worsening endothelial function and raising blood pressure), activates the NLRP3 inflammasome (promoting inflammation), stimulates fat storage in the liver (causing fatty liver), and worsens insulin resistance. Uric acid is a CAUSE, not just a marker, of metabolic disease. Lowering uric acid with diet, weight loss, or allopurinol improves blood pressure, insulin sensitivity, and cardiovascular outcomes.
Standard "normal"ranges for uric acid (3.5-7.2 mg/dL men, 2.6-6.0 mg/dL women) are far too high. For longevity optimization, target <5.5 mg/dL (ideally 4-5 mg/dL). Uric acid >5.5 mg/dL is associated with doubling of hypertension risk, 40% higher kidney disease risk, and 20-30% higher CVD mortality. Even within the "normal"range, lower is better for metabolic health.
Why Uric Acid Matters for Longevity
- Cardiovascular disease:Uric acid >6 mg/dL increases CVD risk by 20-30% independent of other risk factors. High uric acid impairs endothelial function, raises blood pressure, promotes atherosclerosis, and predicts heart attacks and stroke.
- Hypertension:Uric acid >5.5 mg/dL doubles the risk of developing hypertension. Uric acid inhibits nitric oxide (a vasodilator), causing vasoconstriction and sodium retention. Lowering uric acid with allopurinol reduces blood pressure by 5-10 mmHg.
- Kidney disease:Uric acid crystals deposit in kidneys, causing inflammation and fibrosis. High uric acid is a major risk factor for chronic kidney disease (CKD) and kidney stones. Lowering uric acid slows CKD progression.
- Metabolic syndrome and insulin resistance:Uric acid promotes hepatic fat accumulation (fatty liver) and worsens insulin resistance. Elevated uric acid predicts development of metabolic syndrome and type 2 diabetes.
- Gout:Uric acid >7 mg/dL leads to crystal deposition in joints (especially big toe), causing excruciatingly painful gout attacks. Prevalence ~4% of US adults, increasing with obesity and metabolic syndrome.
- Longevity:Higher uric acid associated with increased all-cause mortality. Lower uric acid (4-5 mg/dL) associated with longer healthspan and reduced disease burden.
Optimal vs Standard Ranges
Optimal (Longevity)3.5-5.0 mg/dL▼
- Target for optimal metabolic health, blood pressure, and longevity
- Lower uric acid within this range associated with lowest CVD and kidney disease risk
Acceptable5.0-5.5 mg/dL▼
- Upper end of optimal
- Acceptable for most people but consider lifestyle optimization if trending upward
Suboptimal (Elevated)5.5-7.0 mg/dL▼
- Increased risk of hypertension (2x), metabolic syndrome, kidney disease
- Intervene with diet, weight loss, hydration
- Consider allopurinol if >6.5 mg/dL
High (Hyperuricemia)7.0-9.0 mg/dL▼
- Frank hyperuricemia
- High risk of gout attacks (20-30% will develop gout)
- Significantly increased CVD and kidney disease risk
- Requires uric acid-lowering therapy (allopurinol or febuxostat)
Scientific Evidence
Uric acid >7 mg/dL=hyperuricemia, high risk of gout and metabolic complications. Uric acid >9 mg/dL=very high risk of acute gout attacks.
Low uric acid (<2.5 mg/dL) is rare and usually benign. May indicate:|SIADH (syndrome of inappropriate ADH):Dilutional hyponatremia and low uric acid.|Fanconi syndrome:Kidney tubular defect causing wasting of uric acid, glucose, amino acids, phosphate.|Xanthinuria:Rare genetic xanthine oxidase deficiency. Uric acid very low, xanthine high. Can cause xanthine kidney stones.|Wilson disease:Copper accumulation in liver causes Fanconi-like kidney defect with low uric acid.
Source:Low uric acid is rarely harmful unless due to underlying kidney or metabolic disorder. (PubMed)
High-purine diet:Excessive red meat, organ meats, shellfish, alcohol (especially beer).|Fructose consumption:Sugary drinks, high-fructose corn syrup, excessive fruit juice. Fructose metabolism generates uric acid.|Obesity and metabolic syndrome:Insulin resistance impairs kidney uric acid excretion. Visceral fat promotes uric acid production.|Kidney disease (CKD):Impaired kidney function reduces uric acid excretion, raising serum levels. Creates vicious cycle (high uric acid worsens kidney disease).|Dehydration:Concentrates uric acid in blood and reduces kidney excretion.|Medications:Diuretics (thiazides, loop diuretics) impair uric acid excretion. Low-dose aspirin (<1 g/day) reduces excretion. Niacin, levodopa, pyrazinamide.|Genetic factors:40-70% of uric acid variation is genetic. Some people are \overproducers\"(excess purine metabolism) or \"underexcretors\"(kidney defect).|Alcohol:Increases uric acid production (purine metabolism) and decreases excretion (lactic acid competes for kidney transporters). Beer is worst offender.|Cell turnover diseases:Psoriasis
leukemia
Source: lymphoma (PubMed)
chemotherapy (tumor lysis syndrome) release purines from dying cells."
Kidney disease causing uric acid wasting (Fanconi syndrome, proximal tubular defects).|Medications:Allopurinol, febuxostat (xanthine oxidase inhibitors), probenecid, losartan.|SIADH:Dilutional hyponatremia lowers uric acid.|Genetic:Xanthinuria (xanthine oxidase deficiency).|Low-purine diet:Vegetarian/vegan diet with minimal fructose (rare to cause clinical low uric acid).
Source:Baseline:Check uric acid if gout, kidney stones, hypertension, metabolic syndrome, or obesity.|After lifestyle intervention:Retest 3-6 months after dietary changes (reduce purines, eliminate fructose/alcohol), weight loss, increased hydration. Expect 0.5-2 mg/dL drop with successful intervention. Goal:<5.5 mg/dL (ideally 4-5 mg/dL).|If starting allopurinol/febuxostat:Retest after 4-6 weeks, then every 3 months until uric acid <6 mg/dL (goal <5 mg/dL for gout patients). Adjust dose as needed.|Annual screening:For patients with hypertension, CKD, metabolic syndrome, or history of gout.|If active gout:During acute attack, uric acid may paradoxically be normal or low (inflammation drives uric acid into tissues). Retest 2-4 weeks after attack resolves.
Uric Acid and Hypertension
Uric acid >5.5 mg/dL is associated with 2x higher risk of developing hypertension. Uric acid inhibits nitric oxide production (causing vasoconstriction) and activates renin-angiotensin system (sodium retention). Allopurinol (uric acid-lowering drug) reduces systolic BP by 5-10 mmHg in hypertensive patients with hyperuricemia.
Source:Feig DI, et al. Effect of allopurinol on blood pressure of adolescents with newly diagnosed essential hypertension. JAMA. 2008;300(8):924-932.
Uric Acid and Cardiovascular Disease
Meta-analyses show each 1 mg/dL increase in uric acid associated with 20% higher CVD mortality and 15% higher all-cause mortality. Uric acid >6 mg/dL independently predicts heart attacks, stroke, and heart failure. Uric acid promotes endothelial dysfunction, inflammation, and atherosclerosis.
Source:Kim SY, et al. Hyperuricemia and coronary heart disease:a systematic review and meta-analysis. Arthritis Care Res. 2010;62(2):170-180.
Which Providers Test Uric Acid?
Full Provider Comparison
| Provider | Includes | Annual Cost | Biomarkers |
|---|---|---|---|
 Superpower | ✓ | $199 | 100+ (150 with ratios) |
 WHOOP Advanced Labs | ✓ | $349 | 65 |
 Labcorp OnDemand | ✓ | $398 | 30+ |
| ✓ | $486 | 40+ | |
| — | $444 | 288 | |
| ✓ | $349 | 100+ | |
| — | $761 | 54 | |
 Function Health | ✓ | $365 | 160+ |
| ✓ | $250 | 65 | |
| ✓ | $495 | 70+ | |
| ✓ | $895 | 100+ | |
| ✓ | $1950 | 150+ | |
| ✓ | $375 | 80+ | |
| — | $Varies | 75+ | |
| ✓ | $190 | 100+ | |
| — | $99 | 50 | |
| — | $124 | 60 | |
| — | $199 | 50 | |
| ✓ | $499 | 120+ | |
| ✓ | $4188 | 70-80+ | |
| — | $375 | 85 | |
| ✓ | $700 | 128 |
Frequently Asked Questions
What is Uric Acid?
Waste product that can indicate gout or kidney issues
What is the optimal range for Uric Acid?
The standard reference range for Uric Acid is metabolic syndrome. Optimal ranges may differ based on individual health goals and expert recommendations.
Which blood test providers include Uric Acid?
15 out of 22 blood testing providers include Uric Acid in their panels. This biomarker is widely available across major providers.
What category does Uric Acid fall under?
Uric Acid is categorized under Metabolic Health / Glucose. This category includes biomarkers that help assess related aspects of health and wellness.
Medical Disclaimer
This information is for educational purposes only and is not medical advice. Always consult with a qualified healthcare provider about your specific health needs.
Last reviewed:2026-02-20