What is uric acid?
Uric acid forms when your body breaks down purines. Purines sit in your own cells, which are renewed daily, and in what you eat: meat, offal, shellfish, and by a detour also fructose and alcohol, which drive the breakdown in your liver. What you do not need, your kidneys clear, with a small part leaving through the gut. The value in your blood is therefore the balance of two things: how much you make and how much you get rid of. The problem with uric acid is that it dissolves poorly. Above a concentration close to the upper limit of the normal range it precipitates as needle-shaped crystals, preferably in cool joints such as the big toe, and sometimes in the kidneys as a stone. As long as the value stays below that, nothing happens; it is a threshold effect, and that explains why most people with a high uric acid never get a gout attack and some do. Your report shows uric acid in mmol/l, with one range for men and one for women. Normal is 0.20 to 0.42 mmol/l in men and 0.12 to 0.34 mmol/l in women; women sit lower because oestrogen promotes excretion through the kidneys, and after the menopause their value shifts towards that of men. For anyone with gout a stricter limit applies: under 0.35 mmol/l crystals slowly dissolve.
Why is uric acid relevant?
Uric acid is the value behind gout, one of the most painful joint inflammations there is: a joint, often the big toe, that turns red, swollen and untouchable in a single night. The higher the value and the longer it stays high, the greater the chance that crystals settle somewhere. But a high value alone is not a disease, and most people with a high uric acid never get gout. The reason to know the value anyway is what sits behind it. A high uric acid is, in most people, a lifestyle value. It goes with belly fat and insulin resistance, because insulin slows excretion through the kidneys. It goes with soft drinks and fruit juice, because fructose drives production. It goes with beer and spirits, and with plenty of meat and little vegetables. That is why it often runs alongside high triglycerides, high blood pressure and high blood sugar, and it is one of the earliest values that point that way. Whether uric acid itself damages the vessels and kidneys or only runs alongside is not settled; lowering it with medication in people without gout has yielded little in research. What is settled: the lifestyle that lowers uric acid is the same one that improves the rest of that pattern. Kidney stones are the second reason to know the value: some of them consist of uric acid, and drinking plenty and a lower value help against them. For anyone with gout the question changes. Then 0.35 mmol/l is the limit the treatment steers by, well below what the labs still call normal in men, because crystals only dissolve below that concentration.
Uric acid decision limits
What counts beside the number:
- Your kidney function, creatinine and eGFR, because the kidneys are the exit
- What you drink: soft drinks, juice and alcohol are the fastest levers
- Your waist, triglycerides and blood sugar, the pattern uric acid often rises with
- Diuretics and low-dose aspirin, which slow excretion
- Whether you ever had a gout attack or kidney stones: then 0.35 mmol/l is the goal
- An attack itself, because during a gout attack the value can be temporarily normal
The lab bands above describe what is usual in healthy men and women. The 0.35 mmol/l below them is something else: the goal for anyone with gout, and for men that sits below what the labs still call normal, because crystals only dissolve below that concentration. For anyone without gout, the top of the lab range is the limit that counts.
What Dutch labs actually use
Unilabs and Star-shl publish exactly the same bands: 0.20 to 0.42 in men and 0.12 to 0.34 in women. Clinical Diagnostics sets both slightly higher, 0.21 to 0.43 and 0.15 to 0.36. The difference shows most at the lower end in women: someone landing on 0.13 is normal at two laboratories and below range at the third, with nothing about the blood having changed.
0.15 – 0.34mmol/l
Between 0.12 and 0.15 and between 0.34 and 0.36 it depends on the lab, because each sets its limits on its own method and population. Above 0.36 every lab calls it abnormal.
every lab calls 0.15 – 0.34 mmol/l normal. Between 0.12 and 0.15 and between 0.34 and 0.36 it depends on the lab.
Every age, per lab
| Laboratory | Group | Reference range |
|---|---|---|
| Unilabs(Saltro, Medlon, SHO, Atalmedial)2026 | Man | 0,20-0,42 mmol/l |
| Vrouw | 0,12-0,34 mmol/l | |
| Star-shl2026 | Vrouw vanaf 18 jaar | 0,12-0,34 mmol/l |
| Man vanaf 18 jaar | 0,20-0,42 mmol/l | |
| Clinical Diagnostics2026 | Man | 0,21-0,43 mmol/l |
| Vrouw | 0,15-0,36 mmol/l |
Each band as the lab publishes it, retrieved in 2026, unless marked otherwise.
Uric acid high or low: what it means
The usual causes of a high uric acid are the levers themselves: excess weight and insulin resistance, soft drinks and fruit juice, beer and spirits, plenty of red meat, offal and shellfish, and drinking too little. Then medication: diuretics such as hydrochlorothiazide and low-dose aspirin slow excretion. And the kidneys themselves: anyone filtering less holds on to more uric acid. Rarer are inherited predisposition, psoriasis and rapid cell breakdown, as after heavy exertion or chemotherapy. Rapid weight loss and fasting push the value up temporarily, because ketones slow excretion. A low uric acid is almost always favourable or harmless. In anyone who eats plant-based, is lean and drinks little alcohol it is the ordinary outcome, and in anyone treated for gout it is the goal. Very low values sometimes come from medication that drives excretion, or from a rare inherited trait of the kidneys, and those rarely call for anything. Uric acid responds within weeks to what you change. Soft drinks, juice and energy drinks out, because fructose is the strongest dietary lever. Cut down beer and spirits; wine weighs less. Less red meat, offal and shellfish, more vegetables, legumes and whole grains; the purines in plants barely raise uric acid. Low-fat dairy, coffee and vitamin C lower it a little. Losing weight around the middle works most strongly and longest, provided it is gradual. Plenty of water, certainly with kidney stones. With gout and repeated attacks or tophi, medication joins in, allopurinol first, and then 0.35 mmol/l is the goal. Read uric acid beside your kidney function, creatinine and eGFR, because the kidneys are the exit, and beside triglycerides, blood sugar and blood pressure, which it often rises with. One high value is not gout; gout is diagnosed on symptoms and where needed on crystals in the joint fluid, and during an attack uric acid can even be normal.
What lowers it
Usually simply healthy, sometimes the goal of a treatment.
| Cause | How often |
|---|---|
| Plant-based eating and little alcoholFew purines from meat and no beer or fructose means little production; the ordinary outcome of a plant-based pattern | Often |
| Urate-lowering treatmentAllopurinol and related drugs slow production or drive excretion; with gout a value under 0.35 mmol/l is the goal | Often |
| Medication that drives excretionLosartan, fenofibrate, high doses of vitamin C and some diabetes medicines make the kidneys lose more uric acid | Sometimes |
What raises it
More production or less excretion, and usually both at once.
| Cause | How often |
|---|---|
| Excess weight and insulin resistanceInsulin slows excretion through the kidneys; belly fat is therefore the strongest lever, and the value runs with triglycerides and blood sugar | Often |
| Soft drinks, juice, beer and spiritsFructose and alcohol drive the breakdown in your liver, and alcohol also slows excretion | Often |
| Reduced excretion by the kidneysThe kidneys are the main exit; anyone filtering less or drinking too little holds on to more | Often |
| Medication that raises the levelDiuretics such as hydrochlorothiazide, low-dose aspirin and ciclosporin slow excretion | Sometimes |
| More purine coming inRed meat, offal and shellfish; also rapid cell breakdown in psoriasis, after heavy exertion or after chemotherapy | Sometimes |
How does an uric acid blood test work?
- Referral
- Not needed. You can have uric acid measured without going through your GP.
- Fasting
- Not needed, but an evening of plenty of beer or meat beforehand lifts the value; have blood drawn on an ordinary day.
- The draw
- One tube of blood from a vein in your arm.
- The result
- A single number in mmol/l, with one range for men and one for women; usually available the same day.
- Repeating
- Uric acid responds within weeks; measure again after two to three months of eating and drinking differently. During treatment for gout the value is checked every four weeks at first until it sits under 0.35 mmol/l.
- Which test
- Uric acid is in the comprehensive test (€229) and in .
- Where to draw
- You can draw at 250+ locations near you, no referral needed. See the locations
Frequently asked questions
What is uric acid?
Uric acid is the waste product formed when your body breaks down purines, building blocks found in your own cells and in your food. Your kidneys clear most of it. If too much remains, it no longer dissolves and forms crystals in a joint, often the big toe. That is the mechanism behind gout.
What is a normal uric acid level?
From 0.20 to 0.42 mmol/l in men and from 0.12 to 0.34 mmol/l in women; one lab sets the edges a fraction higher. Women sit lower because oestrogen promotes excretion. Anyone with gout steers for a lower value: under 0.35 mmol/l crystals dissolve. For anyone who wants to stay healthy, a value at the high end of normal is mainly a sign to look at soft drinks, alcohol and waist size.
Does a raised uric acid mean I have gout?
No. Most people with a high uric acid never get an attack; a high value makes gout more likely, no more than that. Gout is diagnosed on the symptoms, a joint that suddenly turns red, swollen and very painful, and where in doubt on crystals in the joint fluid. During an attack uric acid can even be normal.
What does a low uric acid mean?
Usually something favourable: little production in anyone who eats plant-based, is lean and drinks little alcohol, or the goal in anyone treated for gout. Very low values sometimes come from medication that drives excretion or from a rare inherited trait of the kidneys, and rarely call for anything.
How do I lower my uric acid?
Start with what you drink: soft drinks, juice and energy drinks out, because fructose is the strongest dietary lever, and less beer and spirits. Then the plate: less red meat, offal and shellfish, more vegetables, legumes and whole grains; low-fat dairy and coffee help a little. Losing weight around the middle works most strongly, provided it is gradual, because rapid weight loss pushes the value up temporarily. Drink plenty of water. Count on weeks to a few months before you see it back. With gout and repeated attacks, medication joins in.
Why do I hear 0.35 as a limit when my lab quotes a higher number?
Because they are two different kinds of number. The lab range describes what is usual in healthy people. The 0.35 mmol/l is the goal for anyone with gout: below that concentration the crystals that cause the attacks dissolve. For men that goal sits below the lab's upper limit, so a man with gout can have a normal result and still be above his goal.
When is medication for gout needed?
With repeated attacks, with tophi, or with kidney stones of uric acid. Allopurinol is then usually the first choice; it slows production, and the value is checked every four weeks at first until it sits under 0.35 mmol/l. With a single attack and a high value without symptoms, medication is usually not needed, and lifestyle is often enough.
Do I need to fast?
No. An evening of plenty of beer or meat beforehand does lift the value, so have blood drawn on an ordinary day, and mention which medicines you take, because diuretics and low-dose aspirin raise the level.
Which tests include uric acid?
Uric acid is in the Blood sugar & metabolism test (€59, also as an add-on for €15) and in .
Related biomarkers
Read on
Sources
- 1.NHG guideline on arthritis (M90), Dutch College of General Practitioners. 2026. richtlijnen.nhg.org
- 2.Unilabs, Bepalingenklapper: urinezuur. 2026. bepalingenklapper.nl
- 3.Star-shl, Labbepalingen: urinezuur. 2026. star-shl.nl
- 4.Clinical Diagnostics, Labgids: urinezuur. 2026. clinicaldiagnostics.nl
Educational information only, not medical advice. Consult a healthcare professional for clinical decisions.
Read about our scientific approachShare