Have you recently discovered you have high uric acid levels 1? Uric acid is a waste product formed when your body breaks down substances called purines. Purines are made naturally by your body, but they're also found in almost every food you eat.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Uric acid is normally carried in your blood, passed through your kidneys, and then removed from your body in your urine. High levels of uric acid — called hyperuricemia — occur when excessive amounts of uric acid accumulate in your blood 12.
There are a number of causes of hyperuricemia. Treating the underlying cause, making dietary changes and taking medications are some of the best ways to lower uric levels.
Address the Cause of High Uric Acid
- Thiazide diuretics — hydrochlorothiazide (Hydrodiuril, Microzide), chlorthalidone (Thalitone) and methyclothiazide
- Furosemide (Lasix)
- Low dose aspirin
- Some anti-rejection medications like cyclosporine (Sandimmune)
- Levodopa (Larodopa)
- Ethambutol (Myambutol)
- Nicotinic acid (Nicolar)
- Vitamin B12 supplements
:
Beware of What You Drink
How to Lower Uric Acid Levels Naturally
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Alcohol often increases uric acid levels. Alcohol-containing drinks — especially beer — have high amounts of purines. Alcohol can also increase purine production in your body and reduce uric acid excretion by your kidneys.
Fructose increases the production of purines by the body, raising uric acid levels. Limit or avoid drinks sweetened with high-fructose corn syrup, such as non-diet sodas and some sweetened juices, if your uric acid is high 1.
Coffee, water and low-fat milk can all reduce uric acid levels. They do so by increasing uric acid removal through your urine. Both regular and decaffeinated coffee have this effect.
- Alcohol often increases uric acid levels.
- Alcohol can also increase purine production in your body and reduce uric acid excretion by your kidneys.
Avoid High-Purine Foods
Most fruits and vegetables will not affect uric acid levels or may even help lower your uric acid. Some vegetables, however, contain moderate amounts of purines. These include:
- peas
- lentils
- beans
- cauliflower
- spinach
- asparagus
A 2017 review article in the Journal of Advanced Research notes that they can increase uric acid levels, but not much as purine-rich meats and seafood 12. Avoid large amounts of these vegetables if your uric acid is high 1.
Lose Weight and Consider Supplements
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If you're overweight, losing weight will often reduce uric acid levels. In fact, weight loss in an obese person is generally more effective than major reductions in dietary purines, according to an article in the November 2012 issue of Therapeutic Advances in Chronic Disease.
Vitamin C may reduce uric acid production in your body and increase uric acid excretion through your urine. A 2012 study in Arthritis Care and Research, which combined the results of several previous studies, found that vitamin C supplements — 500 milligrams per day on average — significantly decreased uric acid levels.
Folic acid supplements may also reduce uric acid production and thus decrease uric acid levels, according to a study published in a 2017 issue of American Journal of Clinical Nutrition.
- If you're overweight, losing weight will often reduce uric acid levels.
- In fact, weight loss in an obese person is generally more effective than major reductions in dietary purines, according to an article in the November 2012 issue of Therapeutic Advances in Chronic Disease.
Medications for High Uric Acid Levels
Several prescription medications are available to reduce high uric acid levels 1. The choice depends on a number of factors, including whether you have kidney problems. Some medications act by reducing the production of uric acid in your body.
These include allopurinol (Zyloprim or Lopurin) and febuxostat (Uloric). Another group of medications, called uricosuric agents, increase the removal of uric acid through your urine. They include probenecid (Probalan or Benemid), sulfinpyrazone (Anturane) and lesinurad (Zurampic).
Newer drugs — pegloticase (Krystexxa) and rasburicase (Elitek) — break down uric acid to allantoin, a substance that is more easily excreted by your kidneys. Unlike the other medications, which are available in pill form, pegloticase and rasburicase must be administered through a vein.
- Several prescription medications.
- Newer drugs — break down uric acid to allantoin, a substance that is more easily excreted by your kidneys.
Talk to Your Doctor
High uric acid levels should not be ignored 1. The excess uric acid may accumulate in your kidneys, producing kidney stones or chronic kidney disease. Uric acid crystals can also collect in your joints, causing a type of arthritis called gout.
Your doctor will help determine the underlying cause of your high uric acid and the best treatment for you 1. Depending on the cause, it may not be possible to permanently cure your hyperuricemia, but appropriate treatment will help lower your uric acid levels 2.
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References
- Mayo Clinic: High Uric Acid Level
- Chemocare: Hyperuricemia (High Uric Acid)
- American Journal of Kidney Diseases: Management of Gout and Hyperuricemia in CKD
- American Family Physician: Gout and Hyperuricemia
- Therapeutic Advances in Chronic Disease: Latest Evidence on Gout Management: What the Clinician Needs to Know
- American Journal of Clinical Nutrition: Folic Acid Therapy Reduces Serum Uric Acid in Hypertensive Patients -- A Substudy of the China Stroke Primary Prevention Trial (CSPPT)
- StatPearls [Internet]: Tumor Lysis Syndrome
- Arthritis Care and Research: Effect of Oral Vitamin C Supplementation on Serum Uric Acid: A Meta-analysis of Randomized Controlled Trials
- Current Pharmaceutical Design: Chronic Hyperuricemia, Uric Acid Deposit and Cardiovascular Risk
- Frontiers in Medicine: Physiology of Hyperuricemia and Urate-Lowering Treatments
- Myrtue Medical Center: Low Purine Diet -- Gout Diet Treatment
- Journal of Advanced Research: Uric Acid in Plants and Microorganisms -- Biological Applications and Genetics -- A Review
- Arthritis Care and Research: Beer, Liquor, and Wine Consumption and Serum Uric Acid Level -- The Third National Health and Nutrition Examination Survey
- American Journal of Medicine: Update on the Importance of Diet in Gout
- Rheumatic Disease Clinics of North America: Gout -- A Review of Non-modifiable and Modifiable Risk Factors
- George C, Minter DA. Hyperuricemia. [Updated 2019 Jun 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
- American Association for Clinical Chemistry. Uric acid. Reviewed May 17, 2017.
- Benn CL, Dua P, Gurrell R, et al. Physiology of hyperuricemia and urate-lowering treatments. Front Med (Lausanne). 2018;5:160. doi:10.3389/fmed.2018.00160
- George C, Minter DA. Hyperuricemia. [Updated 2019 Jun 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
- Ramirez-Sandoval JC, Madero M. Treatment of hyperuricemia in chronic kidney disease. Contrib Nephrol. 2018;192:135-146. doi: 10.1159/000484288
- Wilson FP, Berns JS. Tumor lysis syndrome: new challenges and recent advances. Adv Chronic Kidney Dis. 2014;21(1):18–26. doi:10.1053/j.ackd.2013.07.001
- American Association for Clinical Chemistry. Uric acid. Reviewed May 17, 2017.
- Khanna D, Fitzgerald JD, Khanna PP, et al. 2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia. Arthritis Care Res (Hoboken). 2012;64:1431–46. doi: 10.1002/acr.21772
- Coburn BW, Bendlin KA, Sayles H, et al. Target serum urate: Do gout patients know their goal? Arthritis Care Res (Hoboken). 2016;68(7):1028-35. doi:10.1002/acr.22785
- Wiederkehr MR, Moe OW. Uric acid nephrolithiasis: a systemic metabolic disorder. Clin Rev Bone Miner Metab. 2011;9(3-4):207–217. doi:10.1007/s12018-011-9106-6
Writer Bio
Based in Houston, Texas, Dr. Mary D. Daley has been writing and editing health and medicine articles for more than 20 years. Daley holds an MD degree, as well as an MS in immunology and MS in biomedical writing. She is board-certified as an anesthesiologist in the United States and Canada.