From the Guidelines
Uric acid levels increase due to a combination of factors including diet, medications, and underlying medical conditions, with chronic kidney disease, overweight, and excess alcohol consumption being significant risk factors, as highlighted in the 2018 updated European League Against Rheumatism evidence-based recommendations for the diagnosis of gout 1. When considering the factors that contribute to elevated uric acid levels, it's essential to look at both the production and excretion of uric acid. The body produces uric acid as a byproduct of the breakdown of purines, which are found in various foods and are also produced by the body. However, certain dietary factors can increase uric acid production, such as:
- Consumption of excess alcohol, particularly beer and spirits
- High intake of non-diet sodas, meat, and shellfish
- Foods high in purines, such as red meat, organ meats, and seafood Medications can also play a role in increasing uric acid levels, including:
- Diuretics, such as those used to treat high blood pressure
- Low-dose aspirin
- Cyclosporine and tacrolimus, which are immunosuppressants Underlying medical conditions can affect the body's ability to excrete uric acid, including:
- Chronic kidney disease (CKD)
- Overweight and obesity
- Certain genetic factors can also influence uric acid levels, as some people may inherit enzymes that affect uric acid production or elimination 1. It's crucial to identify and address these risk factors, as some are modifiable, and managing them can help reduce uric acid levels and prevent gout flare-ups 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