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Understanding gout

Uric acid, urate, and purines: what’s the difference?

Prepared 2026-10-29 · Read as Markdown

The names can make a straightforward explanation sound like a chemistry exam. Here is the useful distinction: purines are broken down to make uric acid, which is mostly present as urate in the body. Blood-test reports often call the measurement “uric acid.” [S27] [S29]

Body cells and food contribute purines, which lead to blood urate; separate arrows show kidney and other removal routes, with a conditional crystal-formation note.
How purines become urate · illustration

Purines come from your body and your food

Purines are normal parts of cellular molecules, including DNA and RNA. Your body’s own cell turnover contributes to urate production, as does food. A purine count therefore tells you something about a food; it does not explain everything about a person’s blood result. S06 S27

When urate becomes a joint problem

Persistently high urate makes crystal formation more likely. In gout, monosodium urate crystals collect in tissues and can provoke inflammation. Some people have high blood urate without gout, so a result needs to be interpreted alongside symptoms and the rest of the assessment. S06

Your blood result and a food number use different units

Blood results commonly use mg/dL or µmol/L. Food-composition values in this site’s reference use mg per 100 g for foods and mg per 100 mL for beverages. They measure different things. A food value cannot be compared directly with your blood result. S03 S27 S28

Why treatment targets matter

For people receiving urate-lowering treatment for gout, the usual target is below 6 mg/dL, approximately 360 µmol/L in guideline convention. NICE considers a lower target for some people with more severe or persistent disease. Your clinician should explain the target and how progress will be monitored. S02 S03

A lower blood result and the disappearance of existing deposits happen on different timescales. That is one reason follow-up looks at flares and function as well as a number. S02 S03

Sources