Blood lab results indicating gout
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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Uric acid is the end product of the breakdown of purines in food. Purines are found in a variety of food substances. An elevated level of uric acid in the blood may lead to gouty arthritis.
The level of uric acid in the blood is elevated by a diet rich in purines - foods such as kidney, liver, pancreas, and sweetbreads. Kidney disease, stress, alcohol and certain diuretics may also raise the level.
The serum uric acid test is helpful in monitoring the extent of hyperuricemia in patients with gout requiring treatment. The traditional cut-off is that a level of 7.0mg/dl or above is considered abnormal. With the obesity epidemic "normal" blood levels of uric acid are now set at 7.0mgs/dl. Normal doesn't mean normal good though.
The prevalence of asymptomatic hyperuricemia among men used to be 5%-8%, with about 1 in 3 people with hyperuricemia developing gout. However, that incidence appears to be dramatically rising concurrent with the increase in obesity and increased dietary consumption of high fructose containing beverages.
Serum uric acid testing is often ordered for the patient with acute monoarthritis. Unfortunately, this is not always helpful in the diagnosis because of the high prevalence of asymptomatic hyperuricemia and the fact that, in 10% of patients with acute gout, serum uric acid levels are normal.
A diagnosis of acute gout can only be made with certainty by needle aspiration of an affected joint to confirm the presence of urate crystals under polarized light.
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