Uric Acid & Gout
A high uric acid number on a health check is not automatically a disease, and gout, kidney stones and kidney disease are linked more closely than most people realise.
Medically reviewed by the RIIMS medical team · Last updated: June 2026
Go to hospital now
- A hot, swollen joint together with fever, which can mean a joint infection (septic arthritis) rather than gout, until proven otherwise
- Severe joint pain with chills or feeling unwell overall
- Sudden inability to move a joint at all
See a doctor soon (not an emergency)
- A first attack of joint pain and swelling
- Gout attacks becoming more frequent
- A known history of kidney stones with a new high uric acid reading
What does high uric acid actually mean?
Uric acid is a waste product that forms when the body breaks down purines, found in certain foods and made naturally by the body itself. When levels stay high in the blood, a condition called hyperuricaemia, urate crystals can form in joints and cause gout, or settle in the kidneys and contribute to kidney stones and, over time, kidney disease. A high uric acid number on a routine health check, without any joint pain or swelling, is not automatically a disease that needs treating. The American College of Rheumatology's 2020 guideline conditionally recommends against starting urate-lowering medicine for this kind of symptomless high reading, even in people who also have kidney disease, heart disease or kidney stones, because the medicine's downsides can outweigh a benefit that has not been shown for this group. Gout itself is different: once someone has had an actual attack, joint pain with swelling and redness, urate-lowering treatment is usually advised to prevent further attacks and joint damage. One further trap is worth knowing: uric acid levels often fall during an acute gout attack itself, because the inflammation temporarily increases how much is cleared through urine, so a normal reading during a flare does not rule gout out.
Symptoms to watch for
- Sudden, severe pain in a single joint, often the big toe
- Redness, warmth and swelling over the joint
- A high uric acid number found on a routine blood test with no symptoms at all
- Repeated joint attacks over months or years
- A history of kidney stones
- Small firm lumps (tophi) near joints in long-standing gout
When to consult a doctor
A single high uric acid reading with no symptoms usually does not need medicine, though it is worth discussing with a doctor. A joint that is genuinely swollen, red and painful needs prompt evaluation, and if it comes with fever, treat it as an emergency, not ordinary gout.