From the Guidelines
Uric acid levels increase due to a combination of factors including chronic kidney disease, overweight, certain medications, and excessive consumption of alcohol, non-diet sodas, meat, and shellfish. These factors contribute to either the overproduction or inadequate elimination of uric acid in the body. According to the 2018 updated European League Against Rheumatism evidence-based recommendations for the diagnosis of gout 1, identifying person-specific risk factors for hyperuricaemia is crucial as some of these factors are modifiable. Key factors to consider include:
- Chronic kidney disease (CKD) which impairs the kidneys' ability to remove uric acid from the bloodstream
- Overweight, which can be addressed through gradual weight loss to lower serum uric acid (SUA) levels and reduce the likelihood of gout flare
- Medications such as diuretics, low-dose aspirin, cyclosporine, and tacrolimus, which can increase uric acid levels
- Excessive consumption of alcohol, particularly beer and spirits, non-diet sodas, meat, and shellfish, which are high in purines and can contribute to elevated uric acid levels. Implementing lifestyle modifications, such as limiting alcohol consumption and maintaining a healthy weight, is recommended not only for managing uric acid levels but also for preventing cardiovascular disease and other comorbidities associated with gout 1.
From the FDA Drug Label
Hyperuricemia may be primary, as in gout, or secondary to diseases such as acute and chronic leukemia, polycythemia vera, multiple myeloma, and psoriasis It may occur with the use of diuretic agents, during renal dialysis, in the presence of renal damage, during starvation or reducing diets, and in the treatment of neoplastic disease where rapid resolution of tissue masses may occur. The etiology of this hyperuricemia is the overproduction of uric acid in relation to the patient's ability to excrete it
Causes of High Uric Acid Levels:
- Overproduction of uric acid
- Reduced ability to excrete uric acid
- Certain diseases, such as:
- Gout
- Acute and chronic leukemia
- Polycythemia vera
- Multiple myeloma
- Psoriasis
- Use of diuretic agents
- Renal damage or dialysis
- Starvation or reducing diets
- Rapid resolution of tissue masses during treatment of neoplastic disease 2
From the Research
Factors Contributing to High Uric Acid Levels
- Diet: Consuming purine-rich foods, such as meat and seafood, can increase uric acid levels 3, 4
- Obesity: Excess weight can lead to higher uric acid levels, and weight gain can increase the risk of gout 3, 4
- Dehydration: Inadequate fluid intake can cause a rise in uric acid levels 4
- Strenuous exercise: Intensive physical activity can lead to adenine nucleotide degradation, increasing uric acid levels 4
- Starvation: Severely restricting calorie intake can decrease uric acid excretion, leading to higher levels 4
- Heavy alcohol drinking: Excessive alcohol consumption can raise uric acid levels through adenine nucleotide degradation and lactate production 3, 4
- Fructose intake: Consuming high amounts of fructose, found in sweet fruits and soft drinks, can increase uric acid production and decrease excretion 3, 4
Lifestyle Changes to Reduce Uric Acid Levels
- Weight reduction through daily exercise and limiting excess calorie intake 3, 4
- Moderating intake of purine-rich foods, such as meat and seafood 3, 4
- Increasing consumption of dairy products, vegetables, nuts, legumes, and whole grains 3, 4
- Avoiding heavy alcohol drinking and limiting sugary beverages 3, 4
- Considering coffee and vitamin C supplementation as preventive measures to lower uric acid levels 3, 4