High uric acid in the blood — a condition doctors call hyperuricemia — is more common than most people realize. It happens when your body produces too much uric acid or cannot remove it fast enough. Left untreated, it can lead to painful gout attacks, kidney stones, and other serious health problems. This article explains what causes high uric acid, what symptoms to watch for, and what you can do about it.
What Is High Uric Acid?
Uric acid is a natural waste product. Your body makes it when it breaks down substances called purines, which are found in many foods and in your own cells. Normally, uric acid dissolves in your blood, passes through your kidneys, and leaves your body in urine.
However, sometimes this process goes wrong. When your body makes too much uric acid, or your kidneys do not flush out enough of it, levels in the blood rise too high. This is called high uric acid, or hyperuricemia.
According to Mayo Clinic’s overview of gout and uric acid, uric acid levels above 360 micromoles per litre (µmol/L) in women and 420 µmol/L in men are generally considered elevated. Your doctor will interpret your specific results based on your full health picture.
What Causes High Uric Acid Levels?
There are two main reasons uric acid builds up in the blood. Either your body is producing too much of it, or your kidneys are not removing enough of it. Often, both factors play a role at the same time.
Genetic and Metabolic Causes
For many people, high uric acid runs in the family. A genetic tendency to process purines inefficiently can cause the body to produce excess uric acid. This type is called a metabolic disorder of purine metabolism, and it is often inherited.
Certain health conditions also raise uric acid levels. These include obesity, type 2 diabetes, high blood pressure, kidney disease, and an underactive thyroid. Furthermore, some medications — including diuretics (water pills) often prescribed for heart conditions — can also push uric acid levels higher.
Diet and Lifestyle Causes
What you eat plays a big role. Foods that are very high in purines cause your body to produce more uric acid as it digests them. The biggest dietary offenders include:
Organ meats such as liver, kidney, and brain
Game meats like venison
Certain seafood, especially sardines, herring, anchovies, and mussels
Alcohol, particularly beer and spirits
Sugary drinks sweetened with fructose (high-fructose corn syrup)
Red meat consumed in large amounts
Dehydration is another common trigger. When you do not drink enough water, uric acid becomes more concentrated in your blood and urine. In addition, crash dieting or fasting can temporarily spike uric acid levels because the body breaks down cells rapidly for energy.
Symptoms of High Uric Acid
Here is an important fact: many people with high uric acid have no symptoms at all. Their elevated levels are only discovered during routine blood work. This is called asymptomatic hyperuricemia.
However, when uric acid crystals do form and deposit in the body, symptoms can appear. The crystals tend to collect in joints, kidneys, and under the skin.
Gout
Gout is the most well-known complication of high uric acid. It causes sudden, severe joint pain — most often in the big toe, but also in the ankles, knees, wrists, and fingers. The affected joint becomes red, swollen, and extremely tender to the touch.
Gout attacks often strike at night and can last days to weeks. Over time, without treatment, attacks may become more frequent and more severe. Healthline’s guide to gout offers a helpful breakdown of how these attacks develop and how to manage them.
Kidney Stones
Uric acid crystals can also form in the kidneys, creating kidney stones. These stones cause sharp pain in the back and sides, pain when urinating, and sometimes blood in the urine. Kidney stones are a common and very painful complication of untreated high uric acid.
Tophi
In long-standing cases, uric acid crystals can build up under the skin. These deposits are called tophi (pronounced TOE-fy). They appear as firm, white or yellowish lumps, usually around the joints, ears, or fingers. Tophi are a sign that high uric acid has been unmanaged for a long time.
How Is High Uric Acid Diagnosed?
Diagnosing high uric acid is straightforward. Your doctor will order a simple blood test called a serum uric acid test. This measures the amount of uric acid in your blood. A urine test may also be done to check how much uric acid your kidneys are excreting over 24 hours.
In Canada, these tests are covered under most provincial health plans when ordered by a family doctor or specialist. If you have had a gout attack, your doctor may also order imaging — such as an ultrasound or X-ray — to check for crystal deposits in your joints.
It is important to note that a single elevated reading does not always mean you need treatment. Your doctor will look at your full health history, symptoms, and risk factors before deciding on next steps.
Treatment Options for High Uric Acid
The good news is that high uric acid is very treatable. Treatment usually combines dietary changes with medication, depending on how high your levels are and whether you have symptoms.
Dietary Changes
Reducing purine-rich foods is the first step. Focus on building a diet around low-purine foods such as vegetables, whole grains, low-fat dairy, eggs, and most fruits. Cherries, in particular, have been studied for their ability to lower uric acid and reduce gout flares.
Drinking plenty of water is equally important. Aim for at least eight glasses a day to help your kidneys flush out uric acid efficiently. Cutting back on alcohol — especially beer — and avoiding sugary soft drinks can also make a significant difference.
A diet rich in fibre also supports healthy kidney function. Therefore, choosing whole grain breads, oats, and plenty of vegetables is a smart move for anyone managing high uric acid.
Medications
When diet alone is not enough, your doctor may prescribe medication. There are two main types used to treat chronically elevated uric acid:
Xanthine oxidase inhibitors (such as allopurinol and febuxostat): These drugs reduce how much uric acid your body produces. They are the most commonly prescribed long-term treatment in Canada.
Uricosuric agents (such as probenecid): These help your kidneys remove more uric acid from the blood.
For painful gout attacks, your doctor may also recommend anti-inflammatory medications such as colchicine, NSAIDs (like ibuprofen or naproxen), or corticosteroids to reduce pain and swelling quickly.
Always take medications as directed, and never stop them without speaking to your doctor first. Health Canada’s drug and health products resource provides trustworthy information about approved medications available in Canada.
Lifestyle Changes
Beyond diet and medication, certain lifestyle habits can help keep uric acid in check. Maintaining a healthy body weight reduces the metabolic load on your kidneys. Even modest weight loss — five to ten pounds — can meaningfully lower uric acid levels.
Regular, moderate exercise supports healthy metabolism. However, avoid very intense exercise during a gout flare, as it can worsen joint pain. Low-impact activities like walking, swimming, and cycling are excellent choices.
When to See a Doctor
You should speak with your family doctor if you experience sudden, severe joint pain — especially in the big toe, ankle, or knee. These could be signs of a gout attack linked to high uric acid. Early treatment prevents lasting joint damage.
You should also ask your doctor for a uric acid blood test if you have a family history of gout or kidney stones. This is especially important if you have other risk factors such as obesity, high blood pressure, or kidney disease.
If you do not have a family doctor, a walk-in clinic can order a basic blood panel that includes uric acid levels. Most provincial health plans cover this test when it is medically indicated. If your levels are high, you may be referred to a rheumatologist (a joint specialist) or nephrologist (a kidney specialist) for further care.
As always, this article is for general information only. Please consult your doctor or a qualified healthcare provider before making any changes to your diet, lifestyle, or medications.
Frequently Asked Questions About High Uric Acid
What is a dangerously high uric acid level?
A high uric acid level above 420 µmol/L in men and 360 µmol/L in women is considered elevated in most Canadian labs. Levels significantly above these thresholds — especially when combined with symptoms like joint pain — require prompt medical attention. Your doctor will determine what level is concerning based on your individual health history.
Can high uric acid go away on its own?
In some cases, mild high uric acid can improve with dietary and lifestyle changes alone, such as cutting back on purine-rich foods and drinking more water. However, if levels remain elevated or you experience gout attacks, medical treatment is usually needed. It is best to work with your doctor rather than waiting for it to resolve on its own.
What foods should I avoid if I have high uric acid?
If you have high uric acid, you should limit or avoid organ meats (liver, kidney, brain), certain seafood (sardines, herring, anchovies), red meat, alcohol — especially beer — and sugary drinks containing fructose. These foods are high in purines, which break down into uric acid in the body. Replacing them with vegetables, low-fat dairy, eggs, and whole grains can help bring your levels down.
Is high uric acid the same as gout?
No — high uric acid is not the same as gout, but it is the main cause of gout. Many people have elevated uric acid levels without ever developing gout. Gout occurs when uric acid crystals form and deposit in the joints, causing sudden, severe pain and inflammation.
How is high uric acid treated in Canada?
In Canada, high uric acid is typically treated with a combination of dietary changes and prescription medication such as allopurinol, which reduces uric acid production. These medications are available through a family doctor or specialist and are generally covered under provincial drug benefit programmes for eligible patients. Lifestyle changes like weight management and increased water intake are also recommended alongside medical treatment.
Can drinking more water lower uric acid levels?
Yes, staying well hydrated helps your kidneys filter and excrete high uric acid more efficiently. Drinking at least eight glasses of water per day can reduce uric acid concentration in the blood and lower the risk of kidney stones and gout attacks. Water is one of the simplest and most effective tools for managing uric acid levels.
Key Takeaways
High uric acid (hyperuricemia) occurs when the body produces too much uric acid or the kidneys remove too little of it.
Common causes include genetics, a diet high in purines, obesity, kidney disease, and certain medications.
Many people have no symptoms; however, high uric acid can lead to gout, kidney stones, and tophi if left untreated.
Diagnosis is done with a simple blood test, covered under most Canadian provincial health plans.
Treatment combines a low-purine diet, increased water intake, healthy weight management, and medication when needed.
See your family doctor or visit a walk-in clinic if you experience sudden joint pain or have known risk factors.
Always consult a healthcare professional before changing your diet or starting any new medication.
