Recently, I worked with a couple of clients who were experiencing similar urinary health concerns, including elevated uric acid, kidney stones, and recurring UTIs. Seeing the same issues in more than one person sparked my curiosity and encouraged me to take a deeper look at uric acid and the role it can play in our health.
Uric acid is something we all have in our bodies, but when levels rise, or when conditions in our urine allow it to crystallize, it can contribute to kidney stones and other urinary concerns. I thought this would be an important topic to explore—what uric acid is, why it can become problematic, what symptoms to look for, and how nutrition and lifestyle may help reduce the risk.
Our bodies are constantly giving us information.
Sometimes it shows up as fatigue. Sometimes digestive discomfort. Sometimes it shows up in our bloodwork. And sometimes it appears in a place we may not think much about until something goes wrong—our urine.
Recently, I have seen people dealing with recurring urinary tract infections, kidney stones and blood in their urine. One piece of the puzzle worth investigating in certain individuals is uric acid.
Uric acid is completely normal. We all produce it. Problems can develop, however, when the conditions within the body and urine allow uric acid to crystallize and form stones.
Understanding why this happens gives us another opportunity to become the CEO of our health—asking questions, looking at our labs, and making informed decisions about what we put into our bodies.
What Is Uric Acid?
Uric acid is a waste product created when the body breaks down substances called purines.
Purines occur naturally within our own cells and are also found in foods. Normally, uric acid travels through the bloodstream to the kidneys, where it is filtered and eliminated through the urine.
Having uric acid in your blood or urine is therefore completely normal.
The problem isn't simply having uric acid. Uric acid kidney stones tend to develop when the urine becomes persistently too acidic and concentrated enough for uric acid to crystallize.
This is an important distinction because someone can potentially develop uric acid stones even without dramatically elevated blood uric acid.
How Do Uric Acid Kidney Stones Form?
Think about a glass of water with something dissolved in it. As long as there is enough water and the conditions are right, the substance remains dissolved.
Change those conditions, however, and crystals can begin forming.
Something similar can happen in the urinary tract.
When urine is too acidic, too concentrated, or contains enough uric acid, uric acid becomes less soluble. Tiny crystals can begin forming. Those crystals can eventually join together and develop into kidney stones.
Uric acid stones are associated with several factors, including:
- Persistently acidic urine
- Inadequate hydration or frequent dehydration
- Diets high in certain animal proteins
- High uric acid levels
- Gout
- Insulin resistance, diabetes and metabolic syndrome
- Obesity
- Chronic kidney disease
- Chronic diarrhea or other conditions causing fluid loss
- Certain medications
- Family history
- Previous gastric bypass surgery
This is another reason I believe we need to look beyond a symptom and ask: Why is this happening?
What Do Uric Acid Stones Feel Like?
Kidney stones don't always produce the same symptoms.
Some people experience severe pain, while others may have relatively few symptoms until a stone moves or causes an obstruction.
Symptoms can include:
Blood in the urine. Urine may appear pink, red or brown, or microscopic amounts of blood may only be detected on a urinalysis.
Back or side pain. Kidney stone pain can become intense and may radiate toward the abdomen or groin.
Pain or burning during urination.
Frequent or urgent urination.
Nausea or vomiting.
Cloudy or foul-smelling urine.
A stone moving through the urinary tract can irritate the tissue and cause bleeding. That is one reason kidney stones can produce visible blood in the urine.
However, this is extremely important:
Never assume blood in the urine is simply from a kidney stone or UTI.
Visible or persistent blood in the urine—particularly in an older adult—should be medically evaluated. Kidney stones are one possible cause, but infection, kidney disease, urinary tract abnormalities, and bladder or kidney cancers are among other possibilities.
What About UTIs?
Kidney stones and urinary tract infections can sometimes occur together, but the relationship is complicated.
A stone can interfere with normal urine flow and may make infections more difficult to clear. Conversely, certain bacteria can actually cause a different type of kidney stone called a struvite stone.
Therefore, someone experiencing repeated "UTIs" should ideally have a urine culture rather than assuming every episode is bacterial.
White blood cells, or leukocytes, in the urine indicate inflammation and can occur with infection, but they don't tell us everything on their own.
This is where testing becomes so important.
Know Your Numbers
If someone repeatedly develops kidney stones, UTIs, or blood in the urine, I would encourage them to have a conversation with their healthcare provider about looking beyond the basic urinalysis.
Some important pieces of information can include:
Urinalysis: Look at blood/RBCs, white blood cells, protein, urine pH, specific gravity, nitrites, and other findings.
Urine culture: Determines whether bacteria are actually present and which organism is responsible.
Serum uric acid: Measures the amount of uric acid circulating in the blood.
Kidney function: Creatinine and estimated glomerular filtration rate (eGFR) provide information about kidney filtration.
24-hour urine analysis: For people who repeatedly form stones, this can be incredibly valuable. It can measure urine volume, pH, uric acid, calcium, citrate, oxalate, sodium, and other factors involved in stone formation.
Stone analysis: If you pass a kidney stone, ask whether it can be analyzed. Knowing whether the stone is uric acid, calcium oxalate, struvite or another type dramatically changes the prevention strategy.
Knowledge is power. Don't guess what type of stone you have.
One Number I Would Pay Particular Attention To: Urine pH
Uric acid stones thrive in an acidic environment.
A urine pH below approximately 5.5 strongly favors uric acid crystallization. For people who repeatedly develop uric acid stones, physicians may intentionally raise urinary pH.
This can sometimes involve prescription potassium citrate or another alkalinizing medication. The American Urological Association recommends potassium citrate for uric acid stone formers to raise urinary pH, with a target around 6.0.
I don't recommend self-prescribing this. Potassium citrate isn't appropriate for everyone, particularly people with certain kidney conditions or medications.
But it is certainly worth discussing with a physician once uric acid stones are confirmed.
Food Matters
Food isn't the only reason kidney stones develop, but what we eat can influence uric acid production, urine acidity, hydration, and overall metabolic health.
Foods to Limit
For someone prone to uric acid stones, consider reducing:
Organ meats: Liver, kidney and other organ meats are particularly high in purines.
Red and processed meats: Beef, pork, bacon, sausage and processed meats can contribute considerable purines and dietary acid load.
Certain seafood: Anchovies, sardines, shellfish and some other seafood can contain substantial amounts of purines.
Meat-based gravies and concentrated meat broths: These can contain high levels of purines.
Alcohol—especially beer: Alcohol can contribute to elevated uric acid and dehydration.
Sugar-sweetened beverages: Minimize soda, sweetened drinks, and beverages containing large amounts of high-fructose corn syrup. High fructose intake can contribute to uric acid production.
Highly processed foods: These frequently provide excessive sodium, refined carbohydrates, and added sugars while offering relatively little nutritional value.
What About Cheese?
Cheese isn't particularly high in purines and isn't automatically a cause of uric acid stones.
However, I wouldn't make cheese or other animal foods the foundation of someone's diet when we're trying to improve overall metabolic health and reduce dietary acid load. The National Kidney Foundation actually includes low-fat dairy as an option for people with uric acid stones, so the goal doesn't have to be absolute elimination.
The bigger picture matters more than one individual food.
Foods I Would Emphasize
This is where a predominantly whole-food, plant-forward diet can be extremely beneficial.
Build meals around:
Vegetables: Aim for a wide variety and plenty of color.
Whole fruits: Citrus fruits can be particularly useful because they provide citrate.
Beans, lentils and peas: Although they contain some purines, plant sources such as legumes and soy have not been shown to increase uric acid stone risk in the same way high-purine animal foods do.
Whole grains: Oats, brown rice, quinoa, barley and other minimally processed grains can contribute fiber and nutrients.
Whole soy foods: Tofu, tempeh and edamame can provide plant protein without relying heavily on animal protein.
Nuts and seeds: These can provide plant protein, healthy fats and minerals, although individual recommendations may differ if someone also forms calcium oxalate stones.
Water: Perhaps the simplest and most important intervention of all.
Hydration, Hydration, Hydration
One of the strongest recommendations for preventing kidney stones is also one of the simplest:
Drink water.
When we're chronically dehydrated, urine becomes more concentrated. That creates an environment where substances can crystallize more easily.
For many recurrent stone formers, the goal is enough fluid to produce approximately 2.5 liters of urine every day. That may require roughly 80–100 ounces of fluid daily for many people, although individual requirements vary. I always recommend drinking half your body weight in ounces per day as a measure.
People with heart failure, kidney disease, or other conditions requiring fluid restriction should always follow their healthcare provider's recommendations.
A simple thing to notice throughout the day is urine color. Consistently dark, concentrated urine can remind you that you're probably not drinking enough.
The Metabolic Connection We Shouldn't Ignore
One of the most interesting aspects of uric acid stones is their association with insulin resistance, metabolic syndrome, diabetes, and obesity.
That means I wouldn't look only at uric acid.
I would also want to understand the person's:
- Fasting glucose
- A1C
- Blood pressure
- Triglycerides
- HDL
- Waist circumference and body composition
- Kidney function
- Overall dietary pattern
- Hydration
- Physical activity
Sometimes a kidney stone isn't an isolated problem. It can be another clue telling us to look at metabolic health as a whole.
Prevention Starts With Understanding the Cause
No single "kidney stone diet" works for everyone.
A person with uric acid stones doesn't necessarily need the same nutritional strategy as someone with calcium oxalate stones. Someone with infection-related struvite stones has another issue to address.
This is why testing matters.
If you repeatedly develop stones, don't simply accept that you're a person who "gets kidney stones."
Ask:
What kind of stone am I producing?
What is my urine pH?
Am I drinking enough water?
What does my 24-hour urine analysis show?
Is my uric acid elevated?
Could insulin resistance or another metabolic condition be contributing?
Are my UTIs actually being confirmed with cultures?
Then use that information to create a plan.
Food as Medicine—But Information First
I will always believe in the tremendous influence nutrition and lifestyle can have on our health. But Food as Medicine doesn't mean assuming that food is the cause—or the cure—for every condition.
It means understanding our biology, gathering information, and then using nutrition as one of the tools available to support the body.
Drink more water. Eat more plants. Reduce highly processed foods and added sugars. Don't make animal protein the centerpiece of every meal. Move your body. Understand your bloodwork. Understand your urine results.
And most importantly, pay attention when your body tells you something isn't right.
Blood in your urine, recurrent UTIs, and repeated kidney stones aren't symptoms to ignore.
Your body is giving you information.
Listen to it.
To Health & Longevity, 🌿
Innovative Wellness
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References:
- National Kidney Foundation. Uric Acid Kidney Stones: Symptoms, Treatment & Prevention. Updated February 27, 2026.
- National Kidney Foundation. Kidney Stones: Diet and Prevention. Updated July 27, 2026.
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Eating, Diet & Nutrition for Kidney Stones.
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Symptoms & Causes of Kidney Stones.
- American Urological Association. Medical Management of Kidney Stones: AUA Guideline.