Does vitamin B12 increase uric acid?

October 13, 2025 •

5 min read

Recent large-scale genetic studies and population-based surveys suggest a complex and often inverse relationship between serum vitamin B12 and urate levels. This evidence challenges the common misconception that vitamin B12 increases uric acid in humans and warrants a closer look at the science.

Quick Summary

The link between vitamin B12 and uric acid levels is not straightforward, with some studies suggesting an inverse association and others finding no significant effect from long-term supplementation.

Key Points

Inverse Relationship: Several large studies, including genetic analyses, suggest that higher serum vitamin B12 levels are associated with lower uric acid, not higher.
Not a Causal Factor: The bulk of human research indicates that vitamin B12 itself does not cause an increase in uric acid levels.
Shared Food Sources: Confusion often arises because foods high in B12, such as red meat and organ meat, are also high in purines, which are the real cause of elevated uric acid.
Deficiency Risk in Gout: Individuals with gout may actually be at a higher risk of B12 deficiency, potentially due to dietary restrictions.
Varying Results: Some conflicting results exist in certain small, specific populations (e.g., elderly Chinese subjects), but the overall consensus in broader research contradicts a causal link.
Focus on Purines: For managing uric acid, the primary focus should be on limiting high-purine foods and staying hydrated, not restricting vitamin B12.

The Complex Relationship Between B12 and Uric Acid

Contrary to some fears, the relationship between vitamin B12 and uric acid is not a simple matter of one increasing the other. Scientific research on this topic presents a complex and sometimes contradictory picture, influenced by factors such as metabolism, diet, and overall health status. The notion that vitamin B12 is a direct causal agent for elevated uric acid is largely unfounded and not supported by the bulk of human studies.

Conflicting Research Findings

Several studies have explored the connection between vitamin B12 intake or serum levels and uric acid concentrations, yielding mixed results depending on the study population and methodology. Understanding these different findings is key to grasping the full picture.

Large Population Surveys: In a large National Health and Nutrition Examination Survey (NHANES) study, researchers found that vitamin B12 levels were inversely related to uric acid levels in men, meaning higher B12 was associated with lower uric acid. No significant association was found in females, highlighting potential gender differences.
Mendelian Randomization: A 2024 Mendelian randomization study, which investigates causal links using genetic data, found robust evidence for a negative causal association between serum vitamin B12 and urate levels. This type of study strengthens the case against a direct increase from B12.
Supplementation Trials: A long-term supplementation trial involving Norwegian patients with coronary artery disease found that adding vitamin B12 (and folic acid) had no significant effect on circulating uric acid concentrations. This suggests that routine supplementation may not impact uric acid levels in all populations.
Specific Populations: An intriguing study in elderly Chinese individuals over 65 years old did find a positive association between plasma vitamin B12 and uric acid levels. This points to the importance of considering specific demographics and health conditions when evaluating the relationship.

How B12 Metabolism Interacts with Uric Acid

Uric acid is the end product of purine metabolism in the body. While vitamin B12 itself does not contain purines, its role in metabolism can be indirectly linked to compounds that interact with the purine pathway. The confusion often arises because many foods rich in vitamin B12, such as organ meats (liver, kidneys) and other red meats, are also high in purines. However, it is the purine content of these foods, not the vitamin B12, that contributes to higher uric acid levels. In animal studies, some early research in young chickens found that B12 tended to increase uric acid, but these findings are not considered applicable to human physiology.

Factors Influencing the B12 and Uric Acid Link

Several factors can influence the complex interplay between vitamin B12 and uric acid, leading to the varied results observed in scientific literature.

Diet and Purine Intake

Diet plays a critical role. An individual consuming a diet high in purine-rich foods—which happen to also be major sources of vitamin B12—is likely to have both higher B12 levels (from food) and higher uric acid. In this case, the food source is the common factor, not the vitamin itself. Dietary management for gout often involves reducing high-purine foods, which can, as a side effect, reduce B12 intake. This is why some studies have found lower B12 levels in people with gout.

Gout and Vitamin Deficiency

Interestingly, some research suggests that people with gout may be more prone to vitamin B12 deficiency. This could be due to a chronically inflammatory state or specific dietary restrictions imposed to manage gout. In these individuals, treating the underlying vitamin deficiency would be a priority, and it's not expected to exacerbate their uric acid issues. A study of gout patients found a significant prevalence of B12 and Vitamin D deficiency.

Population and Health Status

The differences in research findings, such as the positive correlation in elderly Chinese versus the inverse correlation in NHANES, highlight that the link is not universal. Age, kidney function, and other comorbidities like coronary artery disease can all influence how the body regulates both B12 and uric acid.

Comparing B12 and Uric Acid Research


Study Type	Population	Key Finding	Implication
NHANES (Observational)	US Adults (Males)	Inverse relationship between B12 levels and uric acid	Higher B12 linked to lower uric acid in men.
Mendelian Randomization	European Ancestry	Negative causal association between B12 and urate levels	B12 does not cause higher uric acid.
Supplementation Trial	Norwegian Patients	No effect of long-term B12 supplementation on uric acid	Daily B12 pills do not increase uric acid in this group.
Cross-Sectional	Elderly Chinese	Positive association between plasma B12 and uric acid	Correlation in a specific elderly population; causality not established.
Gout Patient Study	Gout Patients	Higher risk of B12 and Vitamin D deficiencies	Gout and related dietary restrictions may lead to lower B12.

Interpreting the Evidence: Who Should Be Concerned?

Based on the scientific evidence, vitamin B12, particularly in supplement form, is not a significant factor in increasing uric acid for most healthy individuals. The relationship is far more complex and often tied to broader dietary patterns and underlying health conditions. If you have gout or are at risk for hyperuricemia, your focus should remain on managing purine intake, hydration, and other established risk factors. While a B12 deficiency might be present in gout patients, addressing it is generally safe and beneficial. However, it is always wise to consult a healthcare professional before starting any new supplement regimen, especially if you have an existing health condition.

Conclusion

In summary, the best scientific evidence suggests that vitamin B12 does not increase uric acid levels in humans. In fact, some large-scale studies even indicate an inverse relationship, where higher B12 is associated with lower uric acid. The observed link between high B12 and high uric acid in some cases is more likely due to a shared dietary source (e.g., organ meats) rather than a direct effect of the vitamin itself. For individuals with gout, the concern is often not that B12 will raise uric acid, but rather that a gout-management diet may lead to a B12 deficiency. Ultimately, the idea that vitamin B12 is a cause of high uric acid is a myth, and its supplementation for deficiency is generally considered safe for individuals managing gout or hyperuricemia. For more information on vitamin B12, you can refer to the National Institutes of Health Office of Dietary Supplements.

Frequently Asked Questions

Yes, it is generally considered safe to take vitamin B12 supplements if you have gout. Research does not show a causal link between B12 and increased uric acid. In fact, some studies suggest that gout patients may be prone to B12 deficiency, making supplementation potentially beneficial.

This misconception likely stems from the fact that many foods rich in vitamin B12, such as organ meats and certain red meats, are also high in purines. It is the high purine content of these foods, not the vitamin B12, that contributes to higher uric acid levels.

Based on current human research, there is no strong evidence to suggest that B12 injections would cause an increase in uric acid levels. The findings on B12 and uric acid are complex, with some large studies showing an inverse relationship.

To manage uric acid levels, focus on reducing the intake of high-purine foods such as organ meats, red meat, and seafood. Additionally, limiting alcohol (especially beer), sugary drinks, and maintaining proper hydration are key strategies.

A study on patients with coronary artery disease found that long-term supplementation with both vitamin B12 and folic acid had no effect on circulating uric acid levels. This suggests that this combination of supplements does not pose a risk for hyperuricemia.

A low-purine diet, which is often recommended for gout management, involves reducing the consumption of animal products that are also primary sources of vitamin B12. This can increase the risk of developing a B12 deficiency over time.

In some populations, such as one specific study of the elderly in China, a correlation between higher B12 and higher uric acid was observed. However, this is a correlation, not a causation, and likely influenced by other factors like diet and overall health.