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Uric Acid Testing

Definition

Uric acid tests are tests that are done to measure the levels of uric acid in blood serum or in urine.

Purpose




When does arthritis appear? Rheumatoid arthritis -- one of the many forms of arthritis -- typically begins at 20 to 50 years of age, although it can develop in childhood.



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Description

The uric acid blood test is performed on a sample of the patient's blood, withdrawn from a vein into a vacuum tube. The procedure, which is called a venipuncture, takes about five minutes. The urine test requires the patient to collect all urine voided over a 24-hour period, with the exception of the very first specimen. The patient keeps the specimen container on ice or in the refrigerator during the collection period.

Increased production of uric acid may result from eating foods that are high in purine. Increased uric acid levels due to overproduction may also be caused by gout, by a genetic disorder of purine metabolism, or by metastatic cancer, destruction of red blood cells, leukemia, or cancer chemotherapy.

Abnormally low uric acid levels may indicate that the patient is taking allopurinol or probenecid for treatment of gout; may be pregnant; or suffers from Wilson's disease or Fanconi's syndrome.

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Risks

Risks for the blood test are minimal, but may include slight bleeding from the puncture site, a small bruise or swelling in the area, or fainting or feeling lightheaded.

There are pain syndromes like fibromyalgia and arthritis-related disorders, such as systemic lupus erythematosus, that involve every part of the body. There are relatively mild forms of tendinitis (as in 'tennis elbow') and bursitis to crippling systemic forms, such as rheumatoid arthritis. There are forms of the disease, such as gout, which almost nobody connects with this condition, and there are other conditions - like osteoarthritis, the misnamed 'wear and tear' arthritis - that a good many people think is the only form of the disease.

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Cherries have had a long history of being described as the "the healing fruit". Just as cranberries prevent urinary tract infections and an apple-a-day can keep the doctor away, tart cherries are known to stop gout and arthritis pain. But if tart cherries are so good, why haven't you heard more about them? Well first, the FDA doesn't want you to know.

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How do you know if you have arthritis? While symptoms and severity vary from person to person, the most common symptoms are: pain, swelling, stiffness, tenderness, redness and warmth. Osteoarthritis is characterized by progressive stiffness without swelling, chills or fever.

Precautions

Blood test

Patients scheduled for a blood test for uric acid should be checked for the following medications: loop diuretics (Diamox, Bumex, Edecrin, or Lasix); ethambutol (Myambutol); vincristine (Oncovin); pyrazinamide (Tebrazid); thiazide diuretics (Naturetin, Hydrex, Diuril, Esidrix, HydroDiuril, Aquatensen, Renese, Diurese); aspirin (low doses); acetaminophen (Tylenol); ascorbic acid (vitamin C preparations); levodopa (Larodopa); or phenacetin. These drugs can affect test results.

Rheumatoid arthritis is the painful swelling, inflammation and stiffness in the fingers, arms, legs and wrists, which are prevalent on both sides of the body and are usually worse in the morning. Children with on-off fever, loss of appetite, weight loss and a blotchy rash on the arms and legs might have juvenile rheumatoid arthritis. You should call the doctor if symptoms appear suddenly, or if they are accompanied by a fever or rash.

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Urine test

Patients should be checked for the following medications before the urine test: diuretics, aspirin, pyrazinamide (Tebrazid), phenylbutazone, probenecid (Benemid), and allopurinol (Lopurin). If the patient needs to continue taking these medications, the laboratory should be notified.

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The laboratory should also be notified if the patient has had recent x-ray tests requiring contrast dyes. These chemicals increase uric acid levels in urine and decrease them in blood.

For treatment, Methotrexate slows the progression of rheumatoid arthritis and restores some function. For osteoarthritis sufferers, NSAIDs like ibuprofen are good at relieving short term pain and stiffness. Disease modifiers like Methotrexate, Leflunomide, Adalimumab, Etanercept or Infliximab can help long term effects and reduce joint damage.

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Does arthritis affect more women than men? Rhemathoid arthritis is two to three times more common in women than men. Men, however, are at greater risk than women of developing gout.

Urine test

Reference values for 24-hour urinary uric acid vary from laboratory to laboratory but are generally found within the following range: 250-750 mg/24 hours.

There are several common misconceptions about arthritis. Myth # 1 is that every day is the same for patients. In reality, this form of chronic pain comes and goes, which makes it difficult for diagnosis. Myth # 2 is that only older people have arthritis. However, in some cases, even children have this type of pain. Myth # 3 is that arthritis is caused by cold, wet weather or a poor diet.

Normal results

Blood test

Reference values for blood uric acid vary from laboratory to laboratory but are generally found within the following range: Male: 2.1-8.5 mg/dL; female: 2.0-6.6 mg/dL. Values may be slightly higher in the elderly.

Tart cherry capsules are another way to get tart cherries. Tart cherry capsules are made with tart cherry powder. The tart cherry powder is made using the freeze-dried process. The freeze dried process is one of the best ways to get tart cherry powder. The reason is the freeze-dried process captures 100% of the nutritional value of the tart cherry.

The uric acid tests are used to evaluate the blood levels of uric acid for gout and to assess uric acid levels in the urine for kidney stone formation. The urine test is used most often to monitor patients already diagnosed with kidney stones, but it can also be used to detect disorders that affect the body's production of uric acid and to help measure the level of kidney functioning.

 
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Abnormal results

The critical value for the blood test is a level of uric acid higher than 12 milligrams per deciliter (about 3.4 ounces).

What kind of cause can trigger arthritis? While genes appear to be a contributing factor to arthritis, there are other causes. Researchers believe that environmental agents -- a virus, or even stress, can trigger the disease in people who are genetically predisposed to it.

Secondly, although tart cherries have been studied for years, no real effort was ever really made to promote the health benefits of the tart cherry. However, the cherry growers are really getting the word out about cherries to the world.

How many Amercians suffer from chronic symptoms of arthritis? 40 million! Are there several forms of arthritis? Yes, there are more than one hundred forms of arthritis and the causes of many are unclear. The two most common forms of arthritis are osteoarthritis (commonly referred to as simply arthritis) and rheumatoid arthritis. Gout is a less common form of the disease.

Key Terms

Fanconi's syndrome
A rare disorder caused by vitamin D deficiency or exposure to heavy metals.
Gout
A metabolic disorder characterized by sudden recurring attacks of arthritis caused by deposits of crystals that build up in the joints due to abnormally high uric acid blood levels. In gout, uric acid may be overproduced, underexcreted, or both.
Hyperuricemia
Excessively high levels of uric acid in the blood, often producing gout.
Purine
A white crystalline substance that is one of the building blocks of DNA. Uric acid is produced when purine is broken down in the body.
Uric acid
A compound resulting from the body's breakdown of purine. It is normally present in human urine only in small amounts.
Uricosuria
Increased levels of uric acid in the urine.
Wilson's disease
A rare hereditary disease marked by the buildup of copper in the liver and brain, causing loss of kidney function.

Further Reading

For Your Information

    Books

  • Laboratory Test Handbook, edited by David S. Jacobs. Cleveland, OH: Lexi-Comp Inc., 1996.
  • Mosby's Diagnostic and Laboratory Test Reference, edited by Kathleen Deska Pagana and Timothy James Pagana. St. Louis: Mosby-Year Book, Inc., 1998.
  • Springhouse Corporation. Handbook of Diagnostic Tests, edited by Matthew Cahill. Springhouse, PA: Springhouse Corporation, 1995.

Bio



Uric acid is a waste product that results from the breakdown of purine, a nucleic acid. (Nucleic acids are the building blocks of DNA.) Uric acid is made in the liver and excreted by the kidneys. If the liver produces too much uric acid or the kidneys excrete too little, the patient will have too much uric acid in the blood. This condition is called hyperuricemia. Supersaturated uric acid in the urine (uricosuria) can crystallize to form kidney stones that may block the tubes that lead from the kidneys to the bladder (the ureters).

For people with gout, NSAIDs, Corticosteroids, Allopurinol and Probenecid are effective drugs. Be sure to see your doctor if you have been suffering with any symptom of chronic pain.

Decreased excretion of uric acid is seen in chronic kidney disease, low thyroid, toxemia of pregnancy, and alcoholism. Patients with gout excrete less than half the uric acid in their blood as other persons. Only 10-15% of the total cases of hyperuricemia, however, are caused by gout.

Preparation

The uric acid test requires either a blood or urine sample. For the blood sample, the patient should be fasting (nothing to eat or drink) for at least eight hours before the test. The urine test for uric acid requires a 24-hour urine collection. The urine test does not require the patient to fast or cut down on fluids. Some laboratories encourage patients to drink plenty of fluids during the collection period.

In fact, just a few years ago the FDA threatened over two dozen cherries companies for sharing information on the research conducted by the USDA how cherries help fight gout and joint pain. So much for freedom of speech in America. This is something similar to what happened to the cranberry sellers several years ago. They were also threatened. But look at it today, research shows that cranberries can fight urinary tract infections. Thanks for the freedom of speech in America.

Certain foods that are high in purine may increase the patient's levels of uric acid. These include kidneys, liver, sweetbreads, sardines, anchovies, and meat extracts.

What exactly is arthritis? The term arthritis literally means joint inflammation, but it also is used to refer to more than 100 rheumatic diseases. These diseases can cause pain, stiffness, and swelling in joints and may also affect other parts of the body. Some common types of arthritis are osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, gout, juvenile rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis.

In addition to fighting joint pain, research also shows tart cherry juice helps to soothe sore muscles due to physical exercise. According to a study published in the British Journal of Medicine in June 2006, found that a drink made with tart cherry juice proved effective in reducing exercise-caused muscle pain and exercise-induced strength loss. The study was conducted on college athletes and the results basically found that the tart cherry drink helped to reduce pain and strength loss when compared to the placebo.

In reality, there are no easy cause-and-effect connections, but contributing factors include: age, weight, anatomy, infection of the joint and trauma. Lastly, some believe that joint replacement surgery (arthroplasty) should be avoided for as long as possible. Yet the surgery has helped millions of Americans and is seen as a viable option when exercise, physical therapy and medication fail.

Cherries are a natural and high source of Melatonin. This helps to regulate circadian rhythms and maintain nightly sleep patterns. Also, cherries have been shown to have naturally occurring anthocyanins. Although, anthocyanins are present in also any number of colored fruit, the unique make-up of the compounds found in the tart cherry helps to fight joint pain. So in other words, the compounds in the tart cherry are natural COX-1 and COX-2 inhibitors.

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