Clinical nutritionist Veneka Jain recently highlighted five signs that may be indicative of high uric acid levels: joint pain, swelling, difficulty losing belly fat, fatigue and frequent urination. She described uric acid as a form of “trash” produced by the body and explained that elevated levels can lead to the formation of crystals that accumulate in the joints.

But not every symptom on this list signals high uric acid. So, what does elevated uric acid actually do to the body, and which symptoms should you watch for? Dr Ruby Taparia, Consultant Rheumatologist, KIMS Hospital, Thane, explains.

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What exactly is uric acid?

“Uric acid is better described as a normal waste product of purine metabolism, rather than ‘trash’,” says Dr Taparia. Most uric acid is removed by the kidneys through urine, while a smaller amount leaves the body through the gut.

Uric acid levels can rise when the body produces too much, the kidneys do not remove enough, or both. “Genetics, kidney function, obesity, dehydration, alcohol intake and diets high in purine-rich foods can contribute,” she says.

High intake of fructose and sugary drinks can also raise uric acid levels. At the same time, Dr Taparia points out that foods such as eggs, dairy and plant proteins including dal do not need to be automatically eliminated from the diet.

Does high uric acid always cause symptoms?

“The important point is that high uric acid itself often causes no symptoms. It becomes clinically significant when urate crystals deposit in tissues,” explains Dr Taparia.

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These crystals can trigger an inflammatory response, resulting in gout attacks. Some symptoms can provide clues, but they cannot confirm that a person’s uric acid is high.

1. Sudden, severe joint pain

One of the characteristic symptoms of gout is sudden and intense pain in a joint, commonly affecting the big toe. “Pain that starts abruptly, often at night and can be extremely intense,” says Dr Taparia, is one of the clues to look out for. The pain may be severe enough to make even light contact with the affected area uncomfortable.

2. A swollen, red and warm joint

When urate crystals trigger inflammation, the affected joint can become visibly swollen, red and warm. “Affected joints may develop swelling, redness and warmth,” says Dr Taparia.

However, a swollen joint does not automatically mean that uric acid is responsible. Several other conditions can produce similar symptoms.

3. Repeated attacks

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If episodes of severe joint pain and swelling keep returning, particularly in the same joint, gout becomes another possibility to consider. “Recurrent attacks involving the same or other joints, particularly the ankles or knees,” can be a clue, Dr Taparia says.

A person should not, however, rely on symptoms alone to diagnose gout or high uric acid.

4. Tophi or firm deposits under the skin

With prolonged, uncontrolled gout, urate crystals can accumulate and form tophi — firm lumps or deposits around joints, the ears or beneath the skin.

“These are firm deposits of urate that can develop around joints, ears or under the skin after prolonged uncontrolled gout,” says Dr Taparia. Their presence can indicate longstanding crystal deposition and warrants medical assessment.

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5. A painful big toe — but not every big-toe problem is gout

A suddenly painful and swollen big toe is often associated with gout and can indeed be an important clue. But Dr Taparia cautions against treating this symptom as proof of high uric acid. “These signs are not proof of high uric acid on their own. A blood test and clinical assessment are needed,” she says.

What about belly fat, fatigue and frequent urination?

High uric acid is associated with metabolic conditions such as insulin resistance, obesity, high triglycerides and fatty liver, says Dr Taparia. But that does not mean uric acid itself is necessarily the direct cause of difficulty losing belly fat.

Similarly, joint inflammation can make someone feel unwell or fatigued, but tiredness is not a specific sign of high uric acid.

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Frequent urination, particularly at night, also has many possible causes and should not automatically be attributed to elevated uric acid, he adds.

What can you do to prevent high uric acid?

Lifestyle measures can help reduce the risk of elevated uric acid and gout attacks. “For prevention, focus on healthy weight, good hydration, regular physical activity and a balanced diet,” recommends Dr Taparia.

She advises limiting beer and spirits, sugary drinks, excessive sweets, and frequent large portions of red or organ meat and certain seafood.

Importantly, people do not need to eliminate every food containing purines. “There is no need to completely stop dal, vegetables or other nutritious foods solely because they contain purines,” she says.

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