Uric Acid
Serum Uric Acid
What this test measures
Uric acid is a waste product made when your body breaks down purines (found in some foods and drinks). High levels can cause gout, a painful type of arthritis.
Understanding the numbers
Typical range: Men: 210-480 µmol/L | Women: 150-390 µmol/L
High uric acid does not always cause gout. Some people have high levels without symptoms.
- Normal (women): 150–390 µmol/L
- Overlap (men): 390–480 µmol/L
- Raised: 480–600 µmol/L
- Markedly raised: 600–700 µmol/L
Key numbers
- 390 µmol/L — Women — upper limit
- 480 µmol/L — Men — upper limit
- 360 µmol/L — Urate-lowering therapy target for gout
- 300 µmol/L — Tighter target in tophaceous gout
British Society for Rheumatology: urate-lowering therapy target is <360 µmol/L for most gout patients, and <300 for people with tophi or frequent flares. Many people have raised uric acid without gout — screening asymptomatic hyperuricaemia is not recommended in primary care.
Ranges can vary slightly between laboratories — your report may show slightly different numbers. This page does not read or interpret your result; your GP looks at it alongside your history and other tests.
What a higher-than-normal result can mean
- You may be at risk of gout (painful joint inflammation)
- Can be raised by eating lots of red meat, shellfish, or drinking alcohol
- Kidney problems can raise uric acid
- Some medicines can also cause raised levels
Questions you could ask your GP
- Am I at risk of developing gout?
- What dietary changes would help lower my uric acid?
- Should I reduce my alcohol intake?
- Do I need medicine to prevent gout attacks?
Example stories
These are made-up examples to show how results are talked about in real appointments. They are not real patients.
Acute gout in the big toe
Barry woke with severe pain in his big toe. Uric acid 540. He drank beer most evenings.
What the GP said: “This sounds like gout — the uric acid crystals in the joint cause this pain. Naproxen now for the flare; once it settles, we'll talk about allopurinol to lower uric acid and prevent it coming back.”
What happened next: With naproxen the flare settled in four days. Allopurinol was started 2 weeks later; uric acid fell to 300 and he had no further attacks for two years.
Acute gout is not the time to start or change allopurinol — it can make flares worse. Treat the flare with NSAID or colchicine first, then start urate-lowering therapy once settled.
Recurrent gout on allopurinol
Nikhil is on allopurinol 300 mg for gout. Still getting flares. Uric acid 410.
What the GP said: “Your uric acid is below the standard upper limit but still above the gout target of 360. Let's increase allopurinol and recheck in a month.”
What happened next: At 500 mg daily, his uric acid was 320 and flares stopped.
For gout the target isn't 'normal lab range' — it's below 360 µmol/L. Allopurinol is often under-dosed; titrating up to target usually prevents further attacks.
Raised uric acid on diuretic — asymptomatic
Elaine's uric acid was 500 µmol/L on a routine check. She was on bendroflumethiazide. No joint symptoms ever.
What the GP said: “Your thiazide is raising uric acid but you have no symptoms. We don't need to start uric-acid medicine — but if you ever get joint pain, tell me, as it could be gout.”
Asymptomatic hyperuricaemia doesn't need treatment. Many medicines (thiazides, low-dose aspirin) raise uric acid without causing gout. Treat when symptoms appear, not before.
Tophaceous gout — need tighter target
Jaydeep had lumpy white deposits (tophi) on his ears and elbows, and frequent flares. Uric acid 620.
What the GP said: “Tophi mean crystals have been building for years. We need a tighter target — below 300 — to dissolve them. Let's titrate allopurinol up carefully and consider adding febuxostat if needed.”
What happened next: Over 18 months on allopurinol 700 mg plus dietary change, uric acid was 280 and his tophi shrank.
In severe (tophaceous) gout, the uric acid target is tighter — under 300 µmol/L — to dissolve existing crystals. Treatment takes months to years but works.
Before you act on anything here
This page is general information, written to help you understand — it is not personal medical advice and it cannot tell you what is right for you. Talk to your own GP, pharmacist or nurse about your own health.
- Need help now but it's not an emergency? Call NHS 111 or use 111.nhs.uk.
- Emergency? Call 999 or go to A&E.