Uric acid – that’s behind the laboratory value!

Uric acid - that's behind the laboratory value!

Uric acid accumulates in our body when it breaks down purines. Uric acid levels are essential when diagnosing gout so that elevated levels can be a clue to the disease. The average values ​​for uric acid vary depending on age and gender. What are normal levels, what does it mean when uric acid levels are too high and what can be done to lower them? Read that here.

What is uric acid?

Uric acid – not to be confused with Urea – is formed when purines are broken down. Purines are building blocks of our DNA but can also be ingested through food. On the other hand, Urea is formed when the nitrogen contained in the amino acids of proteins is broken down. In both cases, it is a matter of degradation products, which have a completely different meaning in the body.

Uric acid could be better soluble in water. Usually, there is a balance between the supply of uric acid through the breakdown of purines and its excretion, mainly through the kidneys and the intestines. Due to the poor solubility of uric acid in water, this balance is very fragile and susceptible to disruption. If the uric acid levels in the blood rise above the solubility limit, uric acid crystals can form – especially in the joints – which can cause inflammation there and trigger the metabolic disorder gout.

 

What do the uric acid levels in the blood mean?

A typical abbreviation for the laboratory value of uric acid is HS, and UA (uric acid) is also occasionally used. The uric acid concentration in the blood can be measured as part of a blood test . The uric acid values ​​can then be related to the other blood values ​​of the blood count, depending on whether a specific disease is suspected and, if so, which one.

Uric acid levels can be too high or too low. Elevated levels can promote gout attacks. Values ​​that are too low, on the other hand, are scarce but can be an indication of a disease or an overdose of uric acid-inhibiting agents. In addition to diseases and medication, diet can influence uric acid levels.

Why and how is uric acid measured?

The uric acid level is usually measured in the blood (plasma or serum). This can be done routinely as part of a blood test but also when gout is suspected or to check existing gout, in kidney failureleukaemia, or cancer therapy. You should not eat or drink anything before taking your blood as this could affect the values.

In rare cases, the uric acid in the urine can also be measured, with the 24-hour urine collection being decisive. The value depends, among other things, on the pH value of the urine. The uric acid level in the urine can be critical in some instances when it comes to dosing medication, for example, as part of chemotherapy.

In addition to determining uric acid in the laboratory, you can buy test strips for measuring devices for home use in the drugstore to determine the values ​​in the blood yourself. This works similar to a blood glucose test. The uric acid concentration is determined using a small drop of blood. In case of doubt, however, these measuring devices are not as accurate as the laboratory determination at the doctor’s.

 

What uric acid levels are normal?

The average values ​​for uric acid differ according to gender and age. The table shows the standard values ​​in mg/dl (milligrams per deciliter):

In adults, the uric acid value in urine should be up to 0.8 g/24h (grams in 24-hour urine) per 10 millilitres.

Decreased levels of uric acid in the blood

Too low uric acid levels (hypouricemia) are instead a rarity. A possible cause for this can be too much treatment with uric acid-lowering drugs such as allopurinol. However, the uric acid deficit can also be caused by a disorder in the purine metabolism (xanthinuria) or by liver disease.

Increased uric acid in the blood – what can be the cause?

.Experts speak of hyperuricemia if uric acid levels exceed the limit values ​​. Translated, this means that there is too much uric acid in the blood. Hyperuricemia is a common symptom that, depending on the available data, affects 15 to 25 per cent of all people in the Western world. An elevated uric acid level does not mean that gout is present. It only promotes the development of a gout attack.

The cause of high uric acid levels in the blood is either too many purines, which are broken down into uric acid, or impaired excretion. Conditions or situations in which elevated uric acid levels may occur include:

  • gout
  • kidney diseases
  • Fasting or zero diet: The formation of ketone bodies during fasting inhibits uric acid excretion
  • excessive consumption of purines, for example, in meat
  • in the context of tumour diseases Here, the cells disintegrate, and more uric acid is formed
  • when taking ASA, the excretion of uric acid in the kidneys is inhibited

 

What are the symptoms of high uric acid levels in the blood?

Too high uric acid levels in the blood initially cause no symptoms. The typical symptoms of a gout attack appear only when the uric acid crystallizes and is deposited in the joints in the form of urate crystals ( salt of uric acid). The inflammatory reaction triggered by the body leads to severe redness, swelling of the respective joint, and severe pain.

Therefore, Elevated uric acid levels mean a risk of an acute gout attack. For this reason, there are different ways to lower the blood levels.

What can be done against high uric acid levels?

Medicine has some drugs available to reduce uric acid. Not every elevated uric acid level in the blood must be treated with tablets. The general practitioner best judges this.

The drugs are usually used in prophylaxis for gout. These drugs are not given in acute cases because they worsen the symptoms.

A popular active ingredient in the prophylactic therapy of gout attacks is allopurinol. This drug interferes with uric acid metabolism and ensures that the precursors of uric acid are metabolized more slowly. On the one hand, this ensures that less uric acid is produced, and, on the other hand, the purines are increasingly excreted via the precursors of uric acid.

However, an immediate reduction in uric acid is rarely possible. If large amounts of uric acid accumulate in the body, as happens in tumour patients, another drug comes from the animal kingdom. Most mammals use the enzyme rasburicase to convert uric acid into a second compound: allantoin. Allantoin is more soluble in water and does not form crystals quickly. This trick is used to lower these patients’ high uric acid levels.

Which foods should you avoid if you have high uric acid levels?

In addition to medication to lower uric acid, there are alternatives that you can use to help reduce uric acid levels in the blood.

One way is to watch your diet. Foods containing purines should only be consumed in moderation if uric acid levels are too high. This includes meat, shellfish, offal and many other foods. Alcohol should also be avoided as much as possible. You can find an overview of low-purine diets here.

Another way of lowering uric acid is to ensure that you drink enough water so that the uric acid can dissolve better. It doesn’t matter whether it‘s tea or water.

If you want to lower the uric acid value with plants, try black poplar or birch preparations, but the effect here has not been scientifically proven. The same goes for taking baking soda to lower uric acid levels. It is easier and more effective with a change in diet and – if necessary – the appropriate medication.

 

 

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