It is not possible to generalize about how high uric acid can lead to gout. Some patients diagnosed with hyperuricemia can have gouty attacks triggered by diet, exercise, and other triggers.
Although elevated blood uric acid is closely related to gout attacks, elevated blood uric acid does not necessarily lead to gout. If you eat a lot of high purine food and drink alcohol, normal people can also have a transient increase in uric acid, but it will not lead to gout.
Hyperuricemia can be diagnosed if the fasting blood uric acid test exceeds 420 μmol/L on two occasions not on the same day. Many patients with hyperuricemia can live their whole life without gout, uric acid nephropathy and other manifestations; a few patients with hyperuricemia, under the triggers of strenuous exercise, high-purine diets, etc., will experience gouty arthritis attacks, and in severe cases, there will be joint deformities, renal function abnormalities and other manifestations.
Patients with high uric acid are advised to consult the rheumatology and immunology department of the hospital to clarify the diagnosis and the need for intervention therapy.