Can I eat fish if uric acid is high?

December 10, 2025 •

4 min read

According to the Mayo Clinic, many types of seafood are excellent sources of healthy omega-3 fatty acids, but some are also high in purines, which can increase uric acid levels. Managing high uric acid, or hyperuricemia, often involves dietary changes, and understanding which fish are safe is a critical part of that process.

Quick Summary

Individuals with high uric acid can eat certain fish in moderation, but should limit or avoid high-purine varieties like anchovies, sardines, and organ meats. Choosing low-to-moderate purine options, controlling serving sizes, and using healthy cooking methods are key strategies for incorporating fish safely into a diet for managing hyperuricemia.

Key Points

High-Purine Fish to Avoid: Limit or completely avoid high-purine seafood like anchovies, sardines, herring, and most shellfish to prevent uric acid spikes.
Low-Purine Fish to Choose: Focus on lower-purine fish options such as flounder, cod, sole, and tilapia, which are generally safe for consumption in moderation.
Practice Serving Size Control: Even for moderate-purine fish like salmon or tuna, limit your intake to a 2–3 ounce serving to minimize purine load.
Use Healthy Cooking Methods: Opt for steaming, poaching, or grilling over frying to reduce overall fat intake, and consider skinning fish as the skin is often higher in purines.
Get Omega-3s from Supplements: To gain the anti-inflammatory benefits of omega-3s without the risk from high-purine fish, consider a purified fish oil supplement after consulting your doctor.
Maintain Overall Low-Purine Diet: Fish consumption should be part of a larger strategy that includes avoiding excessive alcohol, sugary drinks, and high-purine red and organ meats.

Understanding the Connection Between Fish and Uric Acid

High uric acid levels are a medical condition known as hyperuricemia, which can lead to the painful arthritic condition known as gout. Uric acid is formed when the body breaks down chemical compounds called purines. While purines occur naturally in the body, they are also found in many foods, including fish. For individuals managing high uric acid, the amount of purines consumed directly impacts blood uric acid levels. Not all fish contain the same amount of purines, which means some types can be included in a balanced diet while others should be avoided.

High-Purine Fish to Limit or Avoid

Many popular and flavorful fish and seafood varieties are particularly high in purines and can contribute to a spike in uric acid levels, potentially triggering a gout flare-up. These include:

Anchovies and Sardines: Both fresh and canned versions are notoriously high in purines.
Mackerel and Herring: These oily fish contain a significant amount of purines and should be limited.
Tuna: While a moderate purine fish, it can still pose a risk if consumed excessively. Canned tuna is also a concern.
Shellfish: This group, which includes scallops, mussels, shrimp, and lobster, contains high levels of purines.

These fish are best to avoid, especially during a gout flare-up or if you struggle to maintain consistently low uric acid levels.

Moderate-to-Low Purine Fish for Moderation

For those who enjoy seafood, there is good news. Many fish options are safe to eat in moderation as part of a balanced, low-purine diet. A moderate serving is typically 2 to 3 cooked ounces per day. The key is to manage the serving size and frequency. Better choices include:

Flounder
Cod
Catfish
Tilapia
Salmon
Sole

These fish offer the benefits of lean protein and essential nutrients without the high purine load of other seafood. The heart-healthy omega-3 fatty acids found in fish like salmon may also offer anti-inflammatory benefits that are relevant to managing gout.

How to Prepare Fish to Reduce Purine Content

How you cook your fish can also play a role in managing your uric acid levels. Since purines are water-soluble, certain cooking methods can help reduce their concentration in the fish.

Boil, poach, or steam: Cooking fish in water can help draw out some of the purine content. Discard the cooking water afterward.
Grill or roast: These methods are also healthy alternatives to frying, but will not reduce purine content.
Avoid frying: Deep-frying adds unhealthy fats that can worsen inflammation and should be avoided.
Discard the skin: The skin of marine fish tends to have the highest concentration of purines, so skinning your fish before cooking can help.

A Comparison of High and Low-Purine Fish


Fish Type	Purine Content (per 100g)	Recommendation for High Uric Acid	Key Considerations
Anchovies	Very High (>250mg)	Avoid	Often found canned in oil, also high in sodium.
Sardines	Very High (>250mg)	Avoid	Canned sardines are particularly high in purines.
Mackerel	High (150-250mg)	Limit/Avoid	Also high in omega-3s, but purine content is a risk.
Tuna	Moderate (100-150mg)	Consume in Moderation	Canned light tuna is a better choice than albacore.
Salmon	Moderate (100-150mg)	Consume in Moderation	Contains beneficial omega-3s, which may help with inflammation.
Cod	Low (<100mg)	Generally Safe	A lean, white fish that is a good source of protein.
Flounder	Low (<100mg)	Generally Safe	Another excellent low-purine, white fish option.

The Role of Omega-3s and Uric Acid

While high-purine fish are a concern for those with high uric acid, the omega-3 fatty acids they contain are generally beneficial for health. Omega-3s are known to have anti-inflammatory properties, which can help manage the inflammation associated with gout. However, the risk from high purine intake often outweighs the potential benefits for those with hyperuricemia. For this reason, many healthcare professionals recommend getting omega-3s from purified fish oil supplements instead of high-purine fish. This allows you to gain the anti-inflammatory benefits without the risk of increased uric acid. Always consult your doctor before starting any supplement regimen.

Integrating Fish into a Low-Purine Diet

Successfully incorporating fish into a diet for high uric acid requires a careful approach. Focus on overall dietary patterns rather than just individual foods. This includes maintaining a healthy weight, limiting alcohol (especially beer), and avoiding sugary drinks. The DASH (Dietary Approaches to Stop Hypertension) diet is a plant-based approach that has been shown to effectively lower uric acid levels.

Guidelines for Safe Fish Consumption

Prioritize Low-Purine Fish: Make fish like cod, flounder, and sole your go-to choices.
Practice Moderation: If you choose moderate-purine fish like salmon, limit your intake to a single 2-3 ounce serving, and don't consume it daily.
Use Healthy Cooking Methods: Steaming, poaching, or grilling is preferred over frying.
Hydrate Adequately: Drinking plenty of water helps your kidneys flush out excess uric acid.
Consider Alternatives: If you need more omega-3s, consider low-fat dairy or a high-quality fish oil supplement after consulting a healthcare provider.

Conclusion

It is possible to eat fish with high uric acid, but it requires being selective and practicing moderation. The key is to differentiate between high-purine seafood that should be avoided and low-to-moderate purine options that can be enjoyed in controlled amounts. By choosing the right types of fish, preparing them healthily, and integrating them into a broader low-purine dietary strategy, individuals with hyperuricemia can continue to enjoy the nutritional benefits of seafood while effectively managing their condition. Always consult a healthcare professional or a registered dietitian for personalized advice tailored to your specific needs.

For more detailed nutritional guidelines, consider exploring the resources provided by the Arthritis Foundation, a leading authority on managing inflammatory conditions like gout.

Frequently Asked Questions

The fish and seafood highest in purines include anchovies, sardines, herring, mackerel, trout, and most shellfish like scallops, shrimp, and mussels. These should be limited or avoided if you have high uric acid.

Yes, you can have canned light tuna in moderation. It contains a moderate amount of purines compared to other fish. However, high-purine canned versions like sardines should be avoided.

Salmon can be included in a gout diet in moderation. While it contains moderate levels of purines, it is also a good source of omega-3s. A 2-3 ounce serving is a good guideline.

Steaming, boiling, or poaching fish can help to reduce its purine content because purines are water-soluble. Discard the cooking liquid and consider skinning the fish beforehand, as purines are concentrated in the skin.

No fish can be eaten freely, but low-purine options like cod, flounder, sole, and catfish can be safely included in a regular meal plan when consumed in moderate portions.

Purified fish oil supplements containing omega-3 fatty acids do not typically increase uric acid levels. They are generally considered a safe way to get anti-inflammatory benefits without the high purine content of some fish.

Other foods to limit or avoid include organ meats (liver, kidneys), red meat (beef, lamb), beer and liquor, and sugary drinks or foods containing high-fructose corn syrup.