Is A Uric Acid Test Included In CBC? — A Guide by CARE

Is a Uric Acid Test Included In a Complete Blood Count Test (CBC)?

The uric acid test is a medical test that checks the amount of uric acid, a metabolic waste product, in your blood or urine. Many ask, “Is uric acid tested in a CBC?” The CBC does not usually show uric acid levels. In conclusion, a complete blood count (CBC) does not typically include a uric acid test. [1]

Uric acid is usually not tested in a CBC or a comprehensive metabolic panel (CMP). Since you have numerous important blood markers and other insightful waste products in your body included in a CBC or metabolic panel, it is hard to test for everything at once.

Therefore, a uric acid test is typically only tested when specifically requested.

What Is The Purpose of a Uric Acid Test?

A uric acid test is an essential tool in diagnosing and managing gout, kidney disease, and kidney stones, which are closely related to the metabolic waste product of uric acid. [1]

But how so? As a natural part of your metabolism, your body breaks down purines, components of your DNA and RNA, which is when uric acid is produced. We call those purines endogenous purines since they are made by your body. [2]

Furthermore, your body produces uric acid from certain foods and drinks that contain purine, such as alcohol, red meat, and organ meats. We refer to those purines as exogenous purines since your body absorbs those purines through the foods you consume. [2]

No matter where the purines come from, the waste product that is produced when purine is broken down, the uric acid, must be eliminated from your body.

Uric acid is eliminated from your body through the kidneys, where it is filtered out of the blood and excreted in urine. This is crucial for maintaining the balance of uric acid levels, preventing the buildup of uric acid crystals that can lead to conditions like gout and kidney stones, by regulating the concentration of this waste product in the bloodstream. [1]

When Should I Do a Uric Acid Test?

If you're dealing with any of the following situations, it might be a good time to consider a uric acid test [1]:

• Joint Pain: If you're experiencing persistent or sudden joint pain, especially in your big toe, that can be pretty distressing. This sudden or specific type of pain might be a sign of gout, a condition related to high levels of uric acid.
• Big Toe Pain or Swelling: Experiencing pain or swelling in your big toe can be incredibly uncomfortable, making it hard to walk or even wear shoes. The big toe pain is a classic symptom of gout. A uric acid test can help confirm if gout is the culprit behind your discomfort.
• Concerns about Kidney Function: Your kidneys are crucial in filtering uric acid out of your blood. If you have concerns about kidney stones or a history of kidney issues in your family, checking your uric acid levels can provide insights into your kidney health.
• Thyroid and Liver Function Concerns: If there are any signs that your thyroid or liver might not function optimally, it's wise to check your uric acid levels. The liver's processing capabilities and the thyroid's hormonal impact can influence uric acid levels, and imbalances here can reflect or contribute to broader health issues.
• Rheumatology Evaluation: If you see a rheumatologist for any ongoing issues with joints or autoimmune conditions, they might suggest a uric acid test. This test can be essential to diagnosing or managing conditions like gout or other forms of arthritis, giving you and your doctor valuable information to guide your treatment plan.

How Is A Uric Acid Test Done?

Your uric acid levels are tested in a laboratory through urine or blood samples. [1]

Blood Serum Test – Serum Urate (SU)

A uric acid blood test measures the concentration of uric acid in your blood serum, providing a snapshot of how much uric acid your body is producing and excreting.

1. Visit Healthcare Professional: Schedule an appointment to discuss your symptoms and your need for a uric acid test.
2. Fasting: Your healthcare provider might advise fasting before a blood test.
3. Blood Draw: A nurse or your physician will disinfect an area on your arm, insert a needle into a vein, and collect a small sample of blood.
4. Lab Analysis: The blood sample is sent to a lab where the uric acid level in your blood serum is measured.
5. Results: Your healthcare provider will review the results with you.

Urine Test

Alternatively, or in addition to the blood test, your doctor might suggest a urine test, also known as urinalysis. This involves collecting your urine produced over 24 hours. This test is a bit more involved, as you'll need to collect urine output in a special container provided by the lab throughout the day and night. This comprehensive collection helps measure how much uric acid is being excreted by your kidneys over a full day.

1. Urine Collection Container: You'll receive a special container for urine collection from your healthcare provider or lab.
2. 24-Hour Collection: Collect all urine produced in 24 hours in the provided container. This includes the first urine of the morning on the day after you start the collection.
3. Storage: Keep the container refrigerated or in a cool place during those 24 hours.
4. Return the Sample: After 24 hours, return the collected urine to the lab or healthcare facility.
5. Lab Analysis: The lab measures the total amount of uric acid excreted in your urine.
6. Results: Discuss the findings with your healthcare professional to understand what they mean.

What Do Your Uric Acid Test Results Mean?

Before we dive into the implications of high and low uric acid levels, let us take a quick look at normal ranges for uric acid in your blood and urine.

Normal Ranges for Uric Acid Levels

• Blood Test: The normal range for uric acid (serum urate) in the blood is typically 2.5 to 7 milligrams per deciliter (mg/dL) for men and 1.5 to 6.0 mg/dL for women. [3] However, these values can vary slightly depending on the laboratory.

• Urine Test: The normal range for a 24-hour urine collection is generally considered 250 to 750 milligrams per 24 hours (1.48 to 4.43 mmol/24 hours). [4] Again, exact ranges can vary by lab.

What Do High Levels of Uric Acid Mean?

• Excessive Consumption of Certain Foods & Alcohol: Alcohol consumption, especially beer and spirits, can increase uric acid levels in the body by accelerating purine breakdown and impairing the kidneys' ability to excrete uric acid, leading to its buildup and potentially causing gout-like symptoms. Certain foods high in purines, such as red meat, organ meats, and certain types of seafood, can also elevate uric acid levels, contributing to the formation of urate crystals in the joints, resulting in inflammation and pain.

• Hyperuricemia: This term refers to having high uric acid levels in the blood. It can be an indication of several medical conditions. If your results show too much uric acid, your body may be producing too much uric acid or not excreting enough of it. [1]

• Diagnose Gout: High uric acid levels in the blood can lead to the formation and build-up of uric acid crystals in the joints, causing gout, a type of inflammatory arthritis. This condition is characterized by sudden, severe attacks of pain, swelling, redness, and tenderness in the joints, often in the big toe. [1]

• Kidney Stones and CKD: Uric acid kidney stones are a painful condition that can block the urinary tract and lead to infections or more serious kidney problems. Chronic high levels of uric acid can also cause direct damage to the kidneys, potentially leading to CKD, which is characterized by a gradual loss of kidney function over time. [1]

• Abnormalities: Sometimes, high uric acid levels might indicate abnormalities in how your body processes waste products, possibly due to genetic factors, diet, or other health issues. [1]

• Obesity: Obesity is linked to high uric acid levels. [1]

• Cardiovascular Implications: Continuously high uric acid levels can negatively impact heart health by inducing inflammation and affecting the function of endothelial cells, which are crucial for the health of your cardiovascular system. This can also influence the behavior of red blood cells, such as hematocrit and platelets, potentially leading to increased blood viscosity and contributing to the risk of cardiovascular diseases, including hypertension, stroke, heart attacks, and heart disease. [5]

What Do Low Levels of Uric Acid Mean?

Low uric acid levels in the blood are less common than high levels and are often considered less concerning, but they can still indicate certain health conditions or factors related to your diet. [1]

Here's what your low uric acid levels could mean:

• Dietary Factors: A diet low in purines found in foods like red meat and seafood can lead to lower uric acid levels. While generally healthier, an extremely low-purine diet might result in uric acid levels that are lower than usual.

• Excessive Excretion of Uric Acid: If your body is excreting too much uric acid through your urine, it could lead to lower levels in your blood. This might be due to certain medications, such as uricosuric drugs used to treat gout, which increase the excretion of uric acid. [1]

• Fanconi Syndrome: This rare kidney disorder affects the kidney's ability to process certain substances, leading to increased excretion of uric acid in the urine and, consequently, lower levels in the blood. [1]

• Excessive Alcohol Consumption: Although alcohol can increase uric acid production, certain types of alcohol, especially those that lead to a condition called alcoholic ketoacidosis, can paradoxically lower blood uric acid levels due to the way they affect uric acid metabolism and excretion. [1]

Are There Any Risks to a Uric Acid Test?

There are no risk factors for a uric acid test when done via a urine sample.

If your uric acid blood test is done by a healthcare provider, there are common risk factors associated with drawing blood, like pain, bruising, infection, and/or hematoma at the injection site. Still, drawing blood is a routine medical practice, and the risks are minor when a professional draws a blood sample.