Low Urate levels from Uloric – 8.0 to now 3.0!

[Phillip Ooi]

I had a gout flare up about 2-3 weeks ago.. and then I had been watching my diet and taking ACV, bicarbonate salt, milk, 80mg Uloric (before was taking 40mg on and off) and some tart cherries in pill format. today I got my result of my blood work at Urate level of 3.0. IS THAT POSSIBLE? Then.. my skin on certain parts and legs feel itchy like some neuropathy sort of itch. The doctor said my numbers other than the low uric acid was all fine. A year ago my Urate levels were 8.5 or more. What is going on?

F Uric Acid 3.0 L 3.7-8.6 (mg/dL)
F C-Reactive Protein, Quant 4.1 0.0-4.9 (mg/L)
F Sedimentation Rate-Westergren 2 0-30 (mm/hr)

F WBC 8.0 3.4-10.8 (x10E3/uL) MB
F RBC 4.98 4.14-5.80 (x10E6/uL) MB
F Hemoglobin 13.6 13.0-17.7 (g/dL) MB
F Hematocrit 42.0 37.5-51.0 (%) MB
F MCV 84 79-97 (fL) MB
F MCH 27.3 26.6-33.0 (pg) MB
F MCHC 32.4 31.5-35.7 (g/dL) MB
F RDW 14.0 12.3-15.4 (%) MB
F Platelets 352 150-379 (x10E3/uL) MB
F Neutrophils 66 Not Estab. (%) MB
F Lymphs 20 Not Estab. (%) MB
F Monocytes 8 Not Estab. (%) MB
F Eos 4 Not Estab. (%) MB
F Basos 1 Not Estab. (%) MB
Immature Cells MB
F Neutrophils (Absolute) 5.3 1.4-7.0 (x10E3/uL) MB
F Lymphs (Absolute) 1.6 0.7-3.1 (x10E3/uL) MB
F Monocytes(Absolute) 0.7 0.1-0.9 (x10E3/uL) MB
F Eos (Absolute) 0.3 0.0-0.4 (x10E3/uL) MB
F Baso (Absolute) 0.0 0.0-0.2 (x10E3/uL) MB
F Immature Granulocytes 1 Not Estab. (%) MB
F Immature Grans (Abs) 0.1 0.0-0.1 (x10E3/uL) MB

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Which Uloric brand do you use for low uric acid?

[nobody]

Hi!
What’s most likely going on is that you’ve taking 80mg Uloric which is a very strong dose. On top of that you took other things known to lower uric acid. 80mg Ulric alone is typically slightly less effective (one would expect your uric acid to drop to about 3.4 rather than 3.0 on the basis of that pill alone) but your test result is certainly not surprising since there are differences between individuals which make the drug more or less effective. There are also some random variations in one’s uric acid test results so I would not rush to conclusions based on a single test.
But maybe you could try taking 60mg Uloric instead of 80mg? In the long run, you might do well with a lower dose such as 40mg (or possibly even less). But in the meantime, uric acid testing at 3.0 for a few months is not dangerous as such. The latest guidelines I’ve seen recommend against letting your uric acid remain under 3.0 for an extended period of time so I think it would be prudent for you to avoid taking so much Uloric for years on end. More to the point, there is the matter of the drug’s side effects…

I’m not familiar with all the abbreviations in your blood test result but I am not seeing liver function tests in there. If you are taking a strong Uloric dose, it is vital that your liver function in particular be tested.
It is also very important that you report suspected Uloric side effect such as the itch you are experiencing to a skilled doctor. Drugs can be very dangerous if taken carelessly. So if your itch gets progressively worse, do not allow the problem to fester without an explanation as to what’s causing it! In doubt, you could lower your Uloric dose or replace it with a different drug to see if that helps with your itch. It is not necessary to keep your uric acid lower than 5 or 6 so you should not accept serious side effects. Just be sure to keep monitoring your uric acid if you change your dose or switch to a different drug.

I would also recommend you discontinue bicarbonate for gout in particular unless you know for a fact that it is safe for you to take.
I think you could also do without cherry pills and ACV. Eating actual cherries is of course healthy and there is no particular reason for you to avoid vinegar. I would simply avoid unecessary supplements seeing that the Uloric you’re taking is more than sufficient to control your uric acid.

Finally, gout symptoms aren’t expected to go away immediately after lowering one’s uric acid. The symptoms may instead become progressive milder over the course of several months. In some cases when gout has gone untreated for a long time, years of low uric acid are necessary for the patient to be cured.

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