You get rid of excess uric acid through two routes: your kidneys flush about two-thirds of it out in urine, and your gut eliminates the remaining third. Lowering your levels means either producing less uric acid in the first place or helping your body excrete it more efficiently. The clinical threshold for “too high” is above 6.8 mg/dL in blood, and the treatment target for people with gout is below 6 mg/dL. Most people can make real progress with dietary changes, better hydration, and a few lifestyle shifts, though some will need medication to reach that target.
Cut the Foods That Raise Uric Acid Most
Uric acid is the end product of breaking down purines, compounds found naturally in your body and in certain foods. The biggest dietary offenders are organ meats (liver, kidney, sweetbreads), which pack some of the highest purine loads of any food. Red meat like beef, lamb, and pork also contributes significantly and should be eaten in smaller portions. Among seafood, anchovies, sardines, shellfish, and cod are the worst culprits.
What catches many people off guard is sugar, specifically fructose. When your liver processes fructose, it burns through energy molecules so rapidly that it generates a cascade of uric acid as a byproduct. Fructose also ramps up your body’s production of brand-new purines, essentially building uric acid from scratch rather than just recycling it from food. This makes sugary drinks, fruit juices, and foods sweetened with high-fructose corn syrup surprisingly powerful uric acid drivers. Cutting back on soda and sweetened beverages can lower your levels even if the rest of your diet stays the same.
Alcohol is the other major trigger. Beer is the worst because it contains purines of its own on top of the effect alcohol has on slowing uric acid excretion through the kidneys. Liquor has a similar, slightly smaller effect. Wine appears less problematic in moderate amounts, but heavy drinking of any type will raise your levels.
Drink Enough Water Every Day
Since your kidneys handle most uric acid removal, giving them plenty of fluid to work with makes a measurable difference. The general recommendation for people with high uric acid is 2 to 3 liters of water per day, spread evenly throughout the day rather than consumed in large amounts at once. Staying consistently hydrated helps your kidneys filter uric acid more efficiently and prevents urine from becoming concentrated enough to form kidney stones, a common complication of hyperuricemia.
Plain water is the best choice. If you find it hard to drink that much, unsweetened herbal tea or water infused with citrus counts toward your total. Avoid replacing water with sugary drinks or fruit juice, which would undermine the effort by adding fructose.
Foods and Drinks That Help
Tart cherry juice is one of the most studied natural options. Research trials have used 30 mL of Montmorency tart cherry concentrate diluted in about 220 mL of water, taken once daily with breakfast. Tart cherries contain compounds that appear to both lower uric acid production and reduce inflammation during flares. You can find the concentrate at most health food stores. Whole tart cherries offer similar benefits if you prefer eating them instead.
Low-fat dairy products, particularly milk and yogurt, are consistently associated with lower uric acid levels. The proteins in dairy seem to help your kidneys excrete uric acid more effectively. Vitamin C from food sources like bell peppers, citrus fruits, and strawberries also has a mild uric acid-lowering effect.
Coffee shows an interesting relationship with uric acid. Research using U.S. national health survey data found that once coffee consumption crosses a certain threshold (roughly equivalent to a cup or two per day), it promotes a decline in uric acid levels. The effect appears to come from compounds in coffee other than caffeine, since decaf shows similar benefits. This doesn’t mean you should start drinking coffee specifically to lower uric acid, but if you already enjoy it, there’s no reason to stop.
Lose Weight Gradually
Carrying excess weight is one of the strongest risk factors for high uric acid. Fat tissue produces more uric acid, and excess weight makes your kidneys less efficient at clearing it. Losing even a moderate amount of weight can bring levels down noticeably. The key word is “gradually.” Crash dieting or fasting can temporarily spike uric acid levels because rapid fat breakdown releases stored purines into your bloodstream. Aim for steady, sustainable weight loss of one to two pounds per week through a combination of dietary changes and regular activity.
Exercise itself helps by improving your body’s metabolic efficiency and insulin sensitivity, both of which influence how your kidneys handle uric acid. Moderate activity like walking, swimming, or cycling is ideal. Intense exercise without adequate hydration can temporarily raise levels, so keep water nearby.
When Lifestyle Changes Aren’t Enough
For many people, especially those who have already experienced gout attacks, diet and lifestyle changes alone won’t bring uric acid below 6 mg/dL. That’s where urate-lowering medication comes in. The most commonly prescribed option works by blocking the enzyme that converts purines into uric acid in the first place. Per American College of Rheumatology guidelines, it’s typically started at a low dose and gradually increased every two to five weeks until blood levels drop below the 6 mg/dL target.
This slow ramp-up matters because dropping uric acid too quickly can actually trigger a gout flare. Your doctor will likely check your levels periodically during the adjustment phase. Once you reach your target, the medication is generally continued long-term, since uric acid levels tend to climb back up if you stop. Think of it less like an antibiotic you finish and more like a blood pressure medication you stay on.
Some people experience gout flares during the first few months of treatment, even as their levels are coming down. This happens because dissolving old uric acid crystal deposits temporarily irritates the joints. Anti-inflammatory medications taken alongside the urate-lowering therapy can prevent or manage these flares during the transition period.
What Raises Uric Acid That You Might Not Expect
Certain medications can raise uric acid as a side effect. Low-dose aspirin, some blood pressure medications (particularly thiazide diuretics), and immunosuppressants can all interfere with your kidneys’ ability to excrete uric acid. If you take any of these and have high levels, it’s worth discussing alternatives with your prescriber.
Dehydration from any cause, whether illness, hot weather, or simply not drinking enough, concentrates uric acid in your blood and reduces kidney clearance. Chronic kidney disease has an even larger impact, since damaged kidneys lose their ability to filter uric acid efficiently. When kidney function declines, the gut picks up some of the slack, but not enough to fully compensate.
Genetics plays a significant role too. About 90% of hyperuricemia cases involve the kidneys not excreting enough uric acid rather than the body producing too much. If high uric acid runs in your family, you may need to be more aggressive with both dietary changes and medication than someone whose levels rose purely from lifestyle factors.