How Your Uric Acid Level Changes

Uric acid level is the most important number you must know to be able to manage your gout.

Rather than a single number, you really need to think of a range.

Your uric acid level will fluctuate naturally during the day, and other factors can also cause temporary changes.
The best advice for gout sufferers is never let blood uric acid concentration rise above 5 mg/dL (0.30mmol/L) ^[1]. But does this mean you should worry if it falls below, or rises slightly above? How precise does it have to be?

We know from the gout and lifestyle articles that high purine meals and strenuous exercise can temporarily raise uric acid levels. In testing blood uric acid, these variations can often be avoided, but others are not so obvious.

In particular, it is known that uric acid level fluctuates naturally through the day. We have known for a long time that uric acid excretion is higher at night ^[2-3]. Though interesting, this is not truly helpful, as it is the uric acid level of blood that determines the risk of gout attacks.

More recent analysis tells us that uric acid production also increases at night, though no explanation is offered. This means that uric acid is generally higher after sleep, though only around 0.5 mg/dL (0.03mmol/L).

The natural daily fluctuation in uric acid levels means that the exact figure from your test result, though vitally important, may not tell the full story. A small difference up or down should not cause alarm, and it is best to look at the average of a few results for a clearer picture.

The other significant factor is the stage of your gout treatment program. During the first year or so, most gout patients will benefit from a significantly lower uric acid level. This allows uric acid crystals to dissolve quicker – see the Gout Treatment pages for more details, or search for faster lower in the search box at the top of each page.