Normal Uric Acid Confusion

When is uric acid safe? Confusion comes from the normal uric acid range. Because it’s normal for some people to have gout. See if you are safely below 6 mg/dL.

Uric Acid and Temperature

Commenting on Uric Acid Level Ranges, Darth Vader writes:

You say that the safe uric acid level is 5.0 mg/dL and that over 7.0 is dangerous. You don’t provide a source.

However, my clinic says that the normal range is 3.5-7.2 (I’m at 6.4). Is this a controversial issue?

So my immediate reply is “Yes! Normal uric acid is controversial.” In fact, it’s the reason I started this campaign to stop using the term altogether. Because “normal” is a statistic with no medical value. Worse still, it leads to misdiagnosis and inadequate uric acid treatment.

But what can you do when your professional health advisors are confused by normal uric acid?

Safe Uric Acid Levels

First, let me address the issue of my source for safe uric acid. But be aware that your doctor needs to assess the safe target in conjunction with your lifestyle and medical history. So there might be good reasons why your doctor sets a target below 5 mg/dL. Similarly, there might be medical factors that mean your doctor has to settle for a higher target of 6 mg/dL.

However, the target of 5 mg/dL comes from various national rheumatologists organizations. Which are well summarized by Ruoff and Edwards[1].

Is 5 Always Safe?

Before I move on to dealing with professionals who are confused by normal uric acid, I need you to consider if 5 is low enough for you. Medically, your doctor must review your history. Especially looking at other health problems you might have. Beyond that, you also need to explain your lifestyle if you are often exposed to prolonged periods of cold. Or if you have poor circulation. Because uric acid crystallization is affected by temperature as well as concentration.

Loeb shows us the dramatic effect temperature has on safe uric acid levels[2]. So if you work at sea, in a refrigeration plant, or other cold conditions, you must tell your doctor about this so that your personal uric acid target can be set to a safe limit.

Avoiding Normal Uric Acid

So you can see that normal uric acid ranges are meaningless for gout management. But what do you do when your doctor, clinic, or other health professional says you’re OK because your uric acid is “normal” or “within range”?

Well, what you cannot do is accept it. Because gout is a serious progressive illness. Where uric acid crystals spread to all joints causing physical damage. Then more crystals can spread to all your organs except the brain. Where the resulting damage can be unsightly, debilitating, and occasionally fatal.

With some doctors, you can try to explain that “normal” is an average that often includes potential gout sufferers. In my experience, one doctor listened to what I said, but two did not. Fortunately, I attended a group practice where I eventually found a doctor who had seen and understood the professional rheumatology guidelines.

Also, at my current practice, all the doctors I have seen so far have some knowledge of professional gout guidelines. So things seem to be improving slowly. But if you can’t find a doctor who accepts the professional guidelines, my best advice is to ask for a referral to a rheumatologist.

If you need personal help dealing with normal uric acid confusion, you can ask in the gout forum. Or use the feedback form below.

 


Normal Uric Acid Confusion References

  1. Ruoff, Gary, and N. Lawrence Edwards. “Overview of serum uric acid treatment targets in gout: why less than 6 mg/dL?.” Postgraduate medicine 128, no. 7 (2016): 706-715.
  2. Loeb, John N. “The influence of temperature on the solubility of monosodium urate.” Arthritis & Rheumatism: Official Journal of the American College of Rheumatology 15, no. 2 (1972): 189-192.

Author: Keith Taylor

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