?A high uric acid blood test can increase the likelihood of gout, but it does not automatically mean that you have gout.
And the reverse is also important: a normal uric acid result does not always exclude gout, particularly if the blood sample is taken during an acute flare.
This makes serum urate slightly more complicated to interpret than simply comparing one number with a reference range.
Uric acid is produced when the body breaks down substances called purines. Most uric acid circulates in the blood as urate before being removed mainly through the kidneys. When urate concentrations remain sufficiently high, monosodium urate crystals can form and deposit in joints, creating the intensely painful inflammation associated with gout.
For people who require a direct measurement, London Blood Tests offers a private Uric Acid Blood Test with clinic and home blood collection options.
What Is a Uric Acid Blood Test?
A uric acid blood test measures the amount of uric acid, usually reported as serum urate, circulating in your blood.
Uric acid is the final breakdown product of purine metabolism in humans.
Purines occur naturally within the body's cells and are also present in certain foods and drinks.
The kidneys remove much of the urate produced by the body. A smaller amount is eliminated through the digestive system.
Blood concentrations can therefore rise if:
the body produces more uric acid,
the kidneys remove less of it,
or both processes occur together.
You may see the laboratory test described as:
uric acid
serum uric acid
urate
serum urate
urate blood test
These terms are closely related and are often used interchangeably in routine clinical practice.
Is Uric Acid the Same as Urate?
Not exactly, although the terms are commonly used as though they are.
Uric acid is the chemical produced from purine breakdown.
At normal physiological pH, most of it exists in the blood in its ionised form, urate.
That is why UK clinical guidelines frequently refer to serum urate, while patients often search for a uric acid test or uric acid blood test.
In practical terms, both descriptions usually refer to the same laboratory investigation when assessing gout or hyperuricaemia.
What Does a High Uric Acid Result Mean?
A raised uric acid concentration is called hyperuricaemia.
It means there is more urate circulating in the blood than expected according to the laboratory's reference range.
One important consequence of persistent hyperuricaemia is an increased likelihood of monosodium urate crystal formation.
These crystals can accumulate in and around joints and trigger gout.
However:
High uric acid does not automatically mean gout.
Many people with hyperuricaemia never experience a gout attack.
The result therefore indicates a biochemical risk factor rather than diagnosing the joint condition by itself.
The concentration should be interpreted alongside symptoms, medical history, kidney function, medication and whether there has been a previous gout diagnosis.
Can You Have High Uric Acid Without Gout?
Yes. This is known as asymptomatic hyperuricaemia when serum urate is raised but the person has no gout symptoms or urate-related complications.
Not everyone with elevated urate develops gout.
The likelihood of crystal formation generally increases as serum urate remains higher for longer, but individual risk varies.
That means discovering a high result during an unrelated health screen does not automatically mean treatment for gout is required.
The next step depends on the degree of elevation, clinical history, medicines, kidney function and whether symptoms such as gout attacks or kidney stones have occurred.
A laboratory number should not be turned into a diagnosis without that context.
Can You Have Gout With a Normal Uric Acid Blood Test?
Yes. This is one of the most important limitations of a blood test for gout.
Serum urate can temporarily fall during an acute gout attack.
NICE therefore recommends that when gout is strongly suspected but the serum urate concentration is below 360 micromol/L during a flare, the test should be repeated at least two weeks after the flare has settled.
This means:
A normal urate result taken during an acute attack does not necessarily rule out gout.
Timing matters.
Someone who has a classic red, swollen, extremely painful joint should not simply be told that gout is impossible because their uric acid result happened to fall within range during the attack.
Can a Uric Acid Blood Test Diagnose Gout?
It can support the diagnosis, but it cannot always establish it on its own.
NICE recommends measuring serum urate in people with symptoms and signs suggestive of gout.
A level of 360 micromol/L or higher can support the clinical diagnosis.
But gout remains a clinical condition involving deposition of urate crystals in joints.
When the diagnosis remains uncertain, analysis of fluid taken directly from the affected joint can be more definitive.
Joint aspiration allows the laboratory to look for monosodium urate crystals under microscopy.
NICE describes joint aspiration and microscopy as the gold-standard investigation when the diagnosis remains uncertain.
Imaging such as ultrasound or dual-energy CT may also be used in selected situations when aspiration cannot be performed.
So the blood test is extremely useful.
It is not infallible.
What Does a Gout Attack Usually Feel Like?
Gout often causes a sudden episode of severe joint inflammation.
The affected joint may become:
very painful,
swollen,
red,
warm,
and extremely sensitive to touch.
The joint at the base of the big toe is a classic location, although gout can affect other joints including the ankle, knee, wrist, fingers and elbow.
Symptoms can begin rapidly, sometimes overnight.
But a painful red joint is not automatically gout.
Septic arthritis, calcium pyrophosphate crystal disease and other inflammatory joint conditions can produce overlapping symptoms.
A hot, swollen joint accompanied by fever or significant systemic illness requires urgent medical assessment because joint infection must be considered.
Private uric acid testing should never delay assessment of a potentially infected joint.
Uric Acid vs Urea: Are They the Same Blood Test?
No. Uric acid and urea are completely different waste products.
Uric acid comes primarily from the breakdown of purines.
Urea is produced when the body processes nitrogen from proteins and amino acids.
Both are influenced by kidney function, but they answer different clinical questions.
Urea is commonly measured as part of a kidney-function or Urea & Electrolytes profile.
Uric acid is measured separately when assessing conditions such as gout, hyperuricaemia or certain metabolic and renal problems.
London Blood Tests offers a Urea & Electrolytes Blood Test for kidney and electrolyte assessment, while Uric Acid can be measured as a separate biomarker.
So if your laboratory report contains "urea", do not assume your uric acid has also been tested.
Why Can Uric Acid Become High?
Raised serum urate can develop for several reasons.
Reduced Kidney Excretion
The kidneys are responsible for removing much of the body's urate.
If the kidneys excrete less urate than expected, blood concentrations can rise.
This does not necessarily mean someone has severe kidney disease. Genetic differences, medicines and other physiological factors can also affect renal urate handling.
However, kidney function is an important part of the wider assessment.
Certain Medicines
Some medicines can increase serum urate.
Diuretics used for conditions such as high blood pressure or fluid retention are an important example.
Medication should therefore be considered when interpreting an unexpectedly high result.
Do not stop prescribed medication simply because urate is elevated.
Discuss it with the clinician responsible for your treatment.
Alcohol
Alcohol can contribute to elevated urate and gout risk.
Beer and spirits are particularly associated with gout risk, although individual susceptibility varies.
Heavy alcohol intake can also affect hydration, kidney function, liver health and metabolic risk, making the relationship more complex than one single food or drink.
Dietary Purines
Purine-rich foods can contribute to urate production.
Examples include certain red meats, organ meats and some seafood.
However, gout should not be reduced to a simple list of "bad foods".
Genetics, kidney handling of urate, body weight, medicines and metabolic health can be equally or more important.
Metabolic Health
Hyperuricaemia commonly occurs alongside obesity, hypertension, insulin resistance and other metabolic risk factors.
This does not mean uric acid itself explains every aspect of metabolic disease.
It means the conditions frequently coexist and may share underlying physiological factors.
Can Diet Alone Cause Gout?
Diet can influence gout risk, but gout is not simply the result of eating too much purine-rich food.
Some people develop gout despite eating a relatively balanced diet.
Others consume high-purine foods without ever developing the condition.
Genetics and renal urate excretion play major roles.
This is important because people with gout are sometimes made to feel that the condition is purely a consequence of lifestyle choices.
Modern gout management considers the whole clinical picture.
Diet can help.
But dietary restriction alone may not be enough to control serum urate in someone with established gout requiring urate-lowering treatment.
Uric Acid and Kidney Function
Kidneys and urate are closely connected.
Reduced renal excretion can cause urate concentrations to rise.
At the same time, people with gout frequently have other health conditions, including chronic kidney disease, that influence treatment decisions.
This makes kidney assessment particularly useful when gout or persistent hyperuricaemia is being investigated.
The London Blood Tests Advanced Kidney Profile includes uric acid alongside creatinine, eGFR, cystatin C, urea and key electrolytes.
That may provide more context than uric acid alone when the clinical question involves both gout risk and renal function.
However, a comprehensive kidney panel is not automatically necessary for everyone wanting a repeat urate level.
The test should match the reason for investigation.
Uric Acid and Kidney Stones
Uric acid is also relevant to certain kidney stones.
Some urinary stones are composed predominantly of uric acid.
High uric acid production, acidic urine and other metabolic factors can contribute to their formation.
A blood uric acid result alone cannot determine what type of kidney stone someone has.
People with recurrent kidney stones may require urine analysis, imaging and broader metabolic investigation.
London Blood Tests also offers a separate uric acid urine measurement where urinary uric acid assessment has specifically been requested.
Persistent flank pain, blood in the urine, fever or severe urinary symptoms should be medically assessed rather than managed through blood testing alone.
Why Is Uric Acid Sometimes Included in Rheumatology Profiles?
Joint pain has many possible causes.
Gout is only one.
Rheumatoid arthritis, other inflammatory arthritides and crystal-related conditions can produce overlapping symptoms.
For this reason, uric acid may sometimes be interpreted alongside autoimmune and inflammatory markers.
The London Blood Tests Rheumatology Extended Profile includes uric acid together with Anti-CCP antibodies, rheumatoid factor, ANA, ESR and smooth muscle antibodies.
These biomarkers do not all test for the same condition.
Uric acid helps assess a possible crystal-related cause of joint symptoms.
Anti-CCP and rheumatoid factor relate more closely to rheumatoid arthritis.
ESR measures inflammation.
For more detail on inflammatory blood markers, see our guide to CRP and ESR Blood Tests.
What Is the Normal Uric Acid Range?
There is no single universal reference interval that should be copied from an unrelated website.
Reference ranges differ between laboratories and can vary according to sex and analytical method.
For example, Cambridge University Hospitals currently lists adult serum urate reference intervals of:
200–430 micromol/L for men
140–360 micromol/L for women
Other UK laboratories use slightly different intervals.
Use the reference range printed alongside your own result.
There is also an important difference between a general laboratory reference interval and a treatment target for someone with diagnosed gout.
A result may technically sit inside a laboratory population range but still be above the target recommended for long-term gout management.
What Uric Acid Level Is Used When Assessing Gout?
NICE uses 360 micromol/L as an important clinical threshold when gout is suspected.
In someone with symptoms and signs of gout, a serum urate concentration of 360 micromol/L or more can support the clinical diagnosis.
However, interpretation depends on timing.
If the level is below this during an acute flare but gout remains strongly suspected, NICE advises repeating it at least two weeks after the attack has settled.
This is different from saying:
"Anything over 360 means gout."
That would be incorrect.
Hyperuricaemia can occur without gout, while gout can sometimes be present despite a lower result during a flare.
Uric Acid Targets When Gout Is Already Diagnosed
Once gout has been diagnosed and urate-lowering treatment is used, serum urate becomes useful for monitoring whether treatment is achieving its target.
Long-term management commonly follows a treat-to-target approach.
The treatment goal is different from simply asking whether the result falls inside the laboratory's general reference interval.
This is why someone taking allopurinol or another urate-lowering medicine may have their serum urate checked repeatedly.
The purpose is to assess treatment effectiveness, not repeatedly prove that they have gout.
Medication doses should only be altered in consultation with the clinician managing treatment.
Should Uric Acid Be Tested During a Gout Flare?
It can be tested, but the result requires caution.
Serum urate may fall during an acute attack.
A high result can support the diagnosis in an appropriate clinical setting, but a normal or lower result during the flare does not necessarily exclude it.
If gout remains strongly suspected, NICE recommends repeating serum urate at least two weeks after the flare has settled.
This is one of the best examples of why timing can change the meaning of a blood-test result.
Do You Need to Fast for a Uric Acid Blood Test?
A standalone serum urate test generally does not require fasting.
UK NHS laboratory directories commonly list no special preparation for routine serum urate measurement.
You can normally eat and drink before the test.
Normal hydration is sensible.
However, if uric acid is being collected as part of a larger metabolic or health profile, other biomarkers within that panel may require fasting.
Always follow the preparation instructions supplied for the complete test order.
Can Dehydration Affect Uric Acid?
Hydration can influence blood concentrations and kidney handling of waste products.
Significant dehydration may contribute to temporary changes in laboratory results and may also affect gout risk in susceptible individuals.
There is no need to drink excessive amounts of water immediately before testing.
Normal hydration is preferable.
The aim is to obtain a representative result rather than manipulate the laboratory value.
What Happens After a High Uric Acid Result?
The next step depends on whether symptoms are present.
High Uric Acid but No Gout Symptoms
The result may represent asymptomatic hyperuricaemia.
Medication history, kidney function, blood pressure, metabolic health and the degree of elevation may need consideration.
A high number alone does not automatically establish gout.
High Uric Acid With Typical Gout Attacks
The result adds support to the clinical diagnosis.
Medical assessment can then determine whether treatment for acute attacks, long-term urate lowering or additional investigations are appropriate.
Normal Uric Acid During a Suspected Flare
If gout remains strongly suspected, repeat serum urate after the flare has resolved.
NICE recommends waiting at least two weeks.
High Uric Acid With Reduced Kidney Function
Kidney health becomes particularly relevant because renal urate clearance and treatment options may be affected.
A broader kidney profile may provide useful additional information.
High Uric Acid With Unexplained Joint Symptoms
Do not assume every joint problem is gout.
Other inflammatory or autoimmune causes may require consideration.
What Does the London Blood Tests Uric Acid Test Include?
The London Blood Tests Uric Acid Blood Test measures one biomarker:
Uric Acid / Serum Urate
The current test price is listed at approximately £38, excluding the applicable sample-collection charge.
Blood can be collected through an available clinic appointment or home phlebotomy service.
For people who need a wider renal assessment, the Advanced Kidney Profile includes uric acid alongside creatinine, eGFR, cystatin C, urea and electrolytes.
For joint symptoms where gout is only one of several possibilities, the Rheumatology Extended Profile includes uric acid alongside several rheumatological markers.
The larger panel is not automatically the better test.
Choose according to the question that needs answering.
Private Uric Acid Blood Testing in London
London Blood Tests provides private uric acid blood testing in London for people who require serum urate measurement for gout investigation, monitoring or another clinical reason.
The standalone Uric Acid Blood Test provides a direct urate measurement.
Where kidney function also needs assessment, the Advanced Kidney Profile provides a broader renal investigation.
Where persistent joint symptoms require wider investigation, the Rheumatology Extended Profile combines uric acid with autoimmune and inflammatory markers.
Private testing can make laboratory access more convenient.
But a severely painful red or swollen joint still requires appropriate clinical assessment, particularly because gout can resemble joint infection and other forms of inflammatory arthritis.
Frequently Asked Questions About Uric Acid Blood Tests
What does a uric acid blood test show?
A uric acid blood test measures serum urate, the circulating end product of purine metabolism. It can help assess hyperuricaemia and support the investigation or monitoring of gout.
Is uric acid the same as urate?
They are closely related. At normal blood pH, most uric acid circulates as urate, which is why laboratories and UK clinical guidance frequently use the term serum urate.
Does high uric acid mean gout?
No. High serum urate increases gout risk but does not automatically diagnose gout. Many people with hyperuricaemia never develop gout.
Can gout occur with normal uric acid?
Yes. Serum urate can be normal or lower during an acute gout flare.
When should uric acid be repeated after a gout attack?
If serum urate is below 360 micromol/L during a flare but gout remains strongly suspected, NICE recommends repeating it at least two weeks after the flare has settled.
What is hyperuricaemia?
Hyperuricaemia means the concentration of urate in the blood is elevated.
Is urea the same as uric acid?
No. Urea is a different waste product produced from protein metabolism. Uric acid results from purine breakdown.
Does a uric acid blood test require fasting?
Usually not when serum urate is being measured alone. Other tests collected at the same appointment may have different requirements.
Can high uric acid cause kidney stones?
Uric acid can contribute to certain types of kidney stones, although a blood uric acid result alone cannot diagnose the type or cause of a kidney stone.
Can diet raise uric acid?
Diet can influence urate, particularly through alcohol and purine-rich foods, but genetics, kidney excretion, medicines and metabolic factors are also important.
Can medication raise uric acid?
Yes. Some medicines, including certain diuretics, can increase serum urate. Prescribed medication should not be stopped without medical advice.
What other blood tests may be useful with uric acid?
Depending on the reason for testing, kidney function, CRP, ESR, rheumatoid factor and Anti-CCP antibodies may provide additional information.
Can normal uric acid rule out gout?
No, especially if the test was performed during an acute flare.
The Bottom Line
A uric acid blood test provides useful information, but the result is not a simple gout yes-or-no test.
A high serum urate result increases the likelihood of crystal formation but does not prove gout.
A normal result does not always rule gout out, particularly during an acute attack.
And uric acid is not the same measurement as urea, even though both are influenced by kidney function.
The most useful interpretation considers:
the urate concentration,
whether symptoms are present,
when the blood sample was taken,
kidney function,
medicines,
and whether gout has already been diagnosed.
For private testing in London, London Blood Tests offers a standalone Uric Acid Blood Test, the broader Advanced Kidney Profile and the Rheumatology Extended Profile where additional renal, inflammatory or autoimmune markers are relevant.
The objective is not simply to lower a number on a laboratory report.
It is to understand what that number means in the context of the person being tested.
Independent Medical Sources
NICE — Gout: diagnosis and management
Cambridge University Hospitals — Urate Blood Test
University Hospitals Sussex — Uric Acid (Serum)
London Blood Tests Services Mentioned