YOUR URIC ACID TEST IS ON US. We cover the lab fee. You only pay a small blood draw fee at your local lab (Usually $9)
High Uric Acid: More Than Just Gout, It Harms Kidneys, Joints, and Heart.
Metabolic Health & Uric Acid Assessment Questionnaire
Purpose: This questionnaire is designed to explore potential signs and symptoms associated with elevated uric acid levels and related metabolic dysfunction. Your answers will help identify patterns that may benefit from further evaluation.
Instructions: Please check [ ] the box for "Yes" or "No" for each question. If a question requires more detail, please use the space provided.
Section 1: The Obvious Suspect – Joint & Pain Symptoms
[ ] Yes [ ] No 1. Have you ever experienced a sudden, severe attack of pain, redness, warmth, and swelling in a joint (e.g., big toe, ankle, knee)?
If yes, please describe the location and frequency:
[ ] Yes [ ] No 2. Did the pain peak within 24 hours and feel like the joint was "on fire" or so sensitive that even a bedsheet was painful?
[ ] Yes [ ] No 3. Do you have any persistent, low-grade achiness or stiffness in your joints, especially in the feet or ankles or Achilles tendon?
If yes, please specify which joints:
[ ] Yes [ ] No 4. Have you noticed any firm, pale lumps under the skin around your joints, on your ears, or elbows? (Possible tophi)
If yes, please describe their location:
Section 2: The Filter System – Kidney & Urinary Health
[ ] Yes [ ] No 5. Have you ever been diagnosed with kidney stones?
If yes, were you told what type?
[ ] Yes [ ] No 6. Do you experience foamy or bubbly urine that doesn't quickly dissipate?
[ ] Yes [ ] No 7. Do you get up to urinate more than twice per night?
[ ] Yes [ ] No 8. Have you ever been told you have high blood pressure?
If yes, are you currently on medication for it?
[ ] Yes [ ] No 9. Do you have a history of frequent urinary tract infections?
[ ] Yes [ ] No 10. Do you notice swelling (edema) in your ankles, feet, or around your eyes?
Section 3: The Metabolic Engine – Blood Sugar, Weight, and Energy
[ ] Yes [ ] No 11. Do you carry excess weight primarily around your abdomen (a "spare tire")?
[ ] Yes [ ] No 12. Do you experience intense cravings for sugary or carbohydrate-rich foods?
[ ] Yes [ ] No 13. Do you feel sleepy, fatigued, or "foggy" after eating a meal?
[ ] Yes [ ] No 14. Have you ever been diagnosed with Prediabetes, Type 2 Diabetes, or Metabolic Syndrome?
[ ] Yes [ ] No 15. Do you have a family history of diabetes or severe obesity?
[ ] Yes [ ] No 16. Have you found it increasingly difficult to lose weight despite effort?
Section 4: The Hormonal Landscape – Testosterone & Thyroid
[ ] Yes [ ] No 17. (For Men): Have you experienced a significant decrease in your sex drive (libido)?
[ ] Yes [ ] No 18. (For Men): Do you struggle with erectile dysfunction or a lack of morning erections?
[ ] Yes [ ] No 19. Do you often feel a lack of motivation, depressed mood, or general fatigue that isn't explained by lack of sleep?
[ ] Yes [ ] No 20. Have you noticed a decrease in muscle mass or strength, or an increase in body fat, even if your weight is stable?
[ ] Yes [ ] No 21. Have you ever had your testosterone or thyroid levels checked?
If yes, were they abnormal?
Section 5: The Biochemical Machinery – Methylation & Detox
[ ] Yes [ ] No 22. Do you react strongly to medications, caffeine, or alcohol (e.g., getting "wired," jittery, or having a severe hangover)?
If yes, please provide an example:
[ ] Yes [ ] No 23. Do you have a history of anxiety, depression, or other mood disorders?
[ ] Yes [ ] No 24. Do you experience "brain fog" or difficulty with concentration and memory?
[ ] Yes [ ] No 25. Have you been diagnosed with conditions like MTHFR gene mutations or Homocystinuria?
[ ] Yes [ ] No 26. Do you have a family history of cardiovascular disease, stroke, or blood clots at a young age?
Section 6: The Bone & Immune Regulator – Vitamin D
[ ] Yes [ ] No 27. Do you have frequent aches and pains in your bones or muscles?
[ ] Yes [ ] No 28. Do you get sick with colds or infections often?
[ ] Yes [ ] No 29. Do you spend very little time in the sun (less than 15-20 minutes per day) without sunscreen?
[ ] Yes [ ] No 30. Have you ever been tested for, or told you have, low Vitamin D levels?
If yes, what was the result?
Section 7: The Lifestyle & Dietary Inputs
[ ] Yes [ ] No 31. How often do you consume red meat, organ meats (liver), or game?
*Please describe frequency (e.g., daily, 3x/week):*
[ ] Yes [ ] No 32. How often do you consume shellfish (shrimp, lobster, scallops) or sardines/anchovies?
Please describe frequency:
[ ] Yes [ ] No 33. What is your typical consumption of sugar-sweetened beverages (soda, sweet tea) or foods high in fructose?
Please describe (e.g., one soda per day):
[ ] Yes [ ] No 34. What is your alcohol consumption, specifically beer or spirits?
*Please describe type and frequency (e.g., 2 beers, 3x/week):*
[ ] Yes [ ] No 35. Do you feel you drink enough water throughout the day?
Please estimate your daily water intake:
[ ] Yes [ ] No 36. How often do you engage in intense, strenuous exercise that leaves you sore?
Please describe the activity and frequency
Test Don't Guess!
The Real Dangers of High Uric Acid
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