Target Uric Acid Range for Healthy Adult Males
For a healthy adult male without comorbidities, the normal reference range for serum uric acid is approximately 3.5-7.2 mg/dL, though emerging evidence suggests maintaining levels below 6.0 mg/dL may be optimal for long-term health. 1
Standard Laboratory Reference Ranges
- Traditional normal range: 3.5-7.2 mg/dL for adult males and postmenopausal women 1
- Upper limit of normal: Approximately 7 mg/dL for men 2
- These ranges were historically defined based on absence of clinical gout in healthy populations 1
Emerging Evidence for Lower Targets
The concept of "normal" uric acid is being reconsidered based on newer understanding of subclinical tissue damage and cardiovascular-metabolic effects:
- Recommended threshold: <6.0 mg/dL (<360 µmol/L) may better identify truly healthy subjects 1
- This lower threshold accounts for silent monosodium urate crystal deposition that can occur below the saturation point of 6.8 mg/dL, leading to early skeletal changes even without gout symptoms 1
- Uric acid appears to play a pathophysiological role in cardiovascular, renal, and metabolic disorders independent of crystal formation 1
Optimal Range Based on Cardiometabolic Risk
For men specifically, serum uric acid <5 mg/dL is associated with the lowest risk of developing hypertension, dyslipidemia, and chronic kidney disease:
- A 5-year Japanese cohort study found that each 1 mg/dL decrease in serum uric acid was independently protective against hypertension (OR 1.153), dyslipidemia (OR 1.164), and CKD (OR 1.226) in men 3
- The optimal range associated with lowest cardiometabolic disease development was <5 mg/dL for men 3
Avoiding Excessive Lowering
Serum uric acid should not be maintained below 3 mg/dL long-term:
- A U- or J-shaped association exists between uric acid levels and mortality in epidemiologic studies 4
- Patients with congenital hypouricemia are prone to exercise-induced renal failure 4
- Available evidence suggests a reasonable target range of 5.0-6.0 mg/dL balances benefits and potential risks 4
Clinical Context and Caveats
Important considerations for interpretation:
- Serum uric acid levels have been rising in populations over time, with mean levels increasing from below 5.5 mg/dL in the 1960s to above 6.5 mg/dL by the late 1970s 5
- This secular trend may artificially shift "normal" ranges toward higher values that may not represent optimal health 1
- For a truly healthy adult male without kidney disease, diabetes, hypertension, or other comorbidities, maintaining levels in the 3.5-6.0 mg/dL range appears most appropriate based on current evidence 1, 4
The absence of gout symptoms does not necessarily indicate absence of uric acid-related tissue damage, particularly at levels above 6.0 mg/dL. 1