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Hi Guys
Just purchased my new UA sure meter and have now tried 5 uric acid test strips.
I have my lancing device set on the highest (5) and only draws a very small droplet of blood.
I have tried to cover the reaction zone but it never seems enough.
The machine counts down and has always given me a reading of “low” which means it's lower than 3mg/dl.
When it was checked a few months ago from the lab it was reading 9.5.
Any advice you can give me .
Thanks in advance.
If you can't get a drop of blood big enough to cover the test strip hole, you will not get an accurate reading. The American Academy of Family Physicians recommends:
If you get blood from your fingertip, try washing your hands in hot water to get the blood flowing. Then dangle your hand below your heart for a minute. Prick your finger quickly and then put your hand back down below your heart. You might also try slowly squeezing the finger from the base to the tip.
Recommendation often include soaking your finger for a few seconds in hot water, and then drying carefully before pricking. Alternatively, swinging your test hand around in a large arc for a few seconds gets more blood into the finger.
Failing that, keep milking the hand to get a big enough drop. NEVER try two applications of blood.
After a while you'll know how big a drop is okay.
I think this discrepancy in the amount of blood delivered is the single cause of erroneous reading.
I think this discrepancy in the amount of blood delivered is the single cause of erroneous reading.
and probably what makes it an expensive but worthless piece of plastic that belongs in a Christmas cracker
However, if like me you've been mug enough to buy one, it is vital to standardize your testing procedure (very difficult with such a tiny sample of blood). I was told by one of my clinical supervisors (MD) that it is important to allow the drop of blood to emerge without squeezing the surrounding flesh, as this will increase the level of interstitial fluid, thereby giving a false reading.
I have had high (8.7) and low-ish (6.0 – 6.7) readings from what I consider to be very similar drops of blood taken at the same time of day (9am fasting) and also tested twice within 5 mins and got 8.5 & 7.9.
which was supposed to be a control test after returning from the hospital to get a proper SUA test.This morning I put the dial on my lancet up from 3 to 4, swung my arm around and still only got a tiny bead out of my thumb. So, rather than waste a test strip, I squeezed from behind the wrist, rather than at the base of the thumb as I have been doing (6.9).
Tomorrow, the lancet will go to the max setting (5)
and I will persevere until the strips run out and then probably file it in the bin.I think a pinned thread on precisely how to use these things would be a good idea.
I'll build a specific advice topic somewhere once I've updated the forum software.
In the meantime, could people post uric acid test meter problems here, and good experiences, and I will summarize them in the new forum.
On the specific issue of blood samples, I would advise people to practice drawing blood before wasting test strips. There are 3 tips above for encouraging blood flow. Vigorous wrist action may also help.
The lancet device has 5 settings. Start on 3, and adjust up if you get an insufficient drop size. I use a different digit for retesting, but I have no scientific reason for this – it seemed logical at the time. It is a while since I've done this, so I cannot be specific, but I did notice that some digits were easier to bleed than others. As blood oozes from the pin-prick, it tends to form a droplet, and you should be able to judge if this is big enough to fill the test area. If not, don't waste a test strip – just draw more blood. You might have to sacrifice a couple of test strips to poor samples in the early days, but a methodical approach will minimize this.
You have to be methodical. You are using a scientific instrument.
Zip2play said: I think this discrepancy in the amount of blood delivered is the single cause of erroneous reading.
That is exactly right. When these machines were tested under lab conditions, blood drawn from the vein compared exactly with tests done by a full size Hitachi lab unit. The capillary blood tests were not quite so accurate, with the results being put down to the problems of sampling capillary blood.
Thanks for the good advice.
I have managed to get a good droplet of blood ( 11.00pm ) for my test strip and managed a reading of 7.5
My lab reading from a month ago was 9.7, so I thought I might be on the right track with my natural remedies to bringing uric acid levels down.
I went out the next evening and eat sensibly no red meat , but had my first drink of alcohol for over a month as I think alcohol is one of my triggers.
( 1 1/2 small glasses red wine) with about 4 glasses of water.
I felt a burning sensation in my big toe in the middle of the night but thankfully it was not a full flare up and I usually get it in my ankle.
I thought I would do a uric acid test that morning about 9.00am and my reading was 9.5
I am not drawing any conclusions just yet as I am still experimenting with my new meter but will keep you posted of any developments.
Once again thanks for all the good advice.
I have been using SUA Sure Meter for 2 and 1/2 months now. I have got very consistent readings most of the times. I now almost know what the reading is likely to be as my SUA levels seem stable now. For example, I test it just before lunch and all the times, I get the readings in the range of 3.6 to 4.2 with most of the readings 3.8 to 4.1. I have also cross checked the values with lab results. They were all close e.g. home reading of 3.9 while lab of 4.3. Home reading of 3.7 and lab of 3.9 etc.
Once I was getting lot of twinges in the evening. I tested at home and got a value of 4.7( That is the highest value I got at home). I cross checked with lab test just 15 minutes apart and the value was 4.8 at lab. That proved that the meter seems reliable.
I tested it today afternoon again after 10 days. It was 3.8. The value 10 days back was 4.1 and a week before that 3.9. All the values are consistent.
I always wash my hands with soap and hot water. Keep my hand below the heart level, generally rest on my leg for about 10 seconds and then go for the piercing. I know by seeing the size of the drop if it was enough or not. I touch the drop at about 45 – 55 degree to the test slot and it flows and covers the slot fully. I make sure that the test spot is fully covered but remove the finger away as soon as the spot is covered with blood to avoid any overflow. The full drop is not to be transferred if the test spot is covered with lesser blood.
I am on 3rd box of the strips now, which means I have already tested it more than 50 times, and probably have got some better understanding of the droplet size. If for some reasons, the drop looks too small, I do not use it for test and go for another piercing.
I hope, it helps.
Good you're getting such reliable results Utu, practice obviously makes perfect. Have you ever tried re-testing immediately; surely that would be a simple method of checking for accuracy?
For me, it begs the question about how much and how quickly UA levels can fluctuate under a non-medication regime, as I would expect the meds route to provide more stable results. I'm wondering how low it can go on diet restrictions alone (+Chinese meds: acupuncture/herbs)
Today, with the lancet set on max, a hot hand wash & whirling, I still didn't get a suficient drop without some squeezing/fist clenching. Got a reading of 6.2, which “feels” about right: I'm pretty much over my flare up with just a little ankle stiffness in the morning and a bit of tingling if I let my feet get cold. Gradually extending my range of walking and have decided to go ahead with my trip to Marrakech on Friday.
Have a good Crimbo y'all and go easy on the turkey
odo said:
Good you're getting such reliable results Utu, practice obviously makes perfect. Have you ever tried re-testing immediately; surely that would be a simple method of checking for accuracy?
Yes, I re-tested immediately on many occasions. Actually, earlier I used to take 2 readings at the same time, and one day I even did 3 at the same time. Many times, the readings were just the same or almost same, like 4.0 and 4.1. However, there were occasions when the difference was larger more like 3.5 and 4.0.
But these variations are possible. I have 2 medical insurances, one from my employer and one from my wife. So, at any point of time, I generally have at-least one lab test request available to me. Once I had 2 lab requests and took lab test at 2 different labs at almost same time( both of them are top most labs in USA) – within a gap of 15 minutes. The results were 3.9 and 4.3.
So, even the labs can have the variations.
I think, the important thing is that the results are as expected / within the expected range. For me, if the results are in the range of 3.5 to 4.5, I am happy as I expect them to be within that range. Slight variations would always be there. I do get some readings like 3.0 and 4.9 but I ignore them. I have never measured more than 4.9.
Interesting.. and a very thorough road test. So, it seems the UA level test is not really a very exact science regardless of who does it, probably only accurate to within 0.5 and you're still going to get some random results no matter how experienced you are with the kit.
Interesting indeed.
Thank you, Utubelite, for that information. It confirms my thoughts about the variability of tests. Quite right to focus on a 3.5-4.5 range than an absolute number.
Uric acid concentrations vary in the body, as it is constantly being regenerated and disposed of. A spot test is just that, so averages are important. There are hundreds of factors in play, so it is no use looking for specific cause and effect – it just happens. The highest reading is probably most significant, and the reason why I say 6mg/dL is a safe upper limit because it is highly unlikely that natural variations will take the levels over 6.8 where crystals form.
One aspect of “official” testing is the lack of sample control between drawing the blood and testing it. There has to be an element of variety here unless time and temperature are always exactly the same. So even with lab tests, you should look at the average range rather than specific tests.
Just got my lab results over the phone and was told “slightly high at 4.7” by which I assume she meant .47mmol/L (7.9 mg/dL)
Going to have to fess up here and admit that one of the tests (the better drop of blood) I did when I got home was also 7.9.
Oh dear, in terms of the accuracy of the meter, I can see a relatively large portion of lo-purine humble pie heading in my direction
( but only as long as the sampling procedure is accurate).I'm getting a full monty blood count done tomorrow, mainly to check renal & hepatic profiles (although I stopped taking it 5 yrs ago, I was on mesalazine for about 8yrs, which is cautioned for renal toxicity and serious hepatic impairment, so possibly a factor in my developing gout). It won't hurt to know cholestorol as well, and maybe I'll get another UA thrown in.
Finally, could I have a clarification of these units? It's all very well seeing them written down but I'm a bit unsure of how to say them. Is it:
mg/dL = milligrams per deci-litre
mmol/L = millimol per litre
µmol/L = mewmol per litre (I know this is right because it's on the UA Levels page – but would be handy to have them all there for us non scientific types
)µmol/L = mewmol per litre
That would properly be pronounced MICR0 MOLE per liter (and is 1/1000 the concentration of a MILLIMOLE (mmol) per liter
odo said:
Just got my lab results over the phone and was told “slightly high at 4.7″ by which I assume she meant .47mmol/L (7.9 mg/dL)
Going to have to fess up here and admit that one of the tests (the better drop of blood) I did when I got home was also 7.9.
Oh dear, in terms of the accuracy of the meter, I can see a relatively large portion of lo-purine humble pie heading in my direction
( but only as long as the sampling procedure is accurate).
From the Morris Dictionary of Word and Phrase Origins:
“humble pie. Here we have a play upon words which dates back to the time of William the Conqueror. First, the pie referred to in 'eating humble pie' was really umble pie, made from the umbles – heart, liver and gizzard – of a deer. It was made to be eaten by servants and huntsmen, while the lord of the manor and his guests dined on venison. Thus a person who had to eat umble pie was in a position of inferiority — one who had to humble himself before his betters. The pun resulting from umble and humble is even more precise when you recall that in several British dialects – notably Cockney – the h in humble would be silent. Actually, the two words come from quite different roots, humble from the Latin 'humilis'(low or slight), and 'umbie' from the Latin 'lumulus' (loin).”
Not much chance of lo-purine then, with heart liver and gizzard!
You are right – the home uric acid test is absolutely down to accurate sampling procedure, which does take some practice.
'Umbly Yours
GoutPal
Just wanted the followers of this thread to know that the UASUre is now availble for purchase directly from the USA from a new website. also on eBay
I have just got a UASure meter after trying to manage gout attacks unsuccessfully over 10 years.
For me the instructions allow some variability. I can get a drop of blood which covers the area of the chamber but doesn’t give a miniscus over the top of the chamber – currently i get a reading of around 11mg/dl.
if i fill the chamber completely (with a miniscus of blood over the entire area of the chamber I get a reading of about 8.5 mg/dl.
so there is a lot of variability, i have organised a test at my docs so i can do a control check with my meter and a lab test to see which way i should do it – any recommendations would be welcomed.
also i am recovering from a bad attack in my ankle and wrist – could that make the reading as high as 8.5 or above? with there being my normal level of UA in the blood plus the UA dissolving from the joints.
Thanks very much
Graham
So what’s the recommendation for Uric acid test meter. Which one should I buy, the EasyTouch Meter or the UASure meter?
Thanks,
GirishHi @girish-kumar welcome to the gout forum. As this is your first response here, this question about a uric acid test meter was delayed for moderation. Your future messages should get posted immediately.
I have only used the UASure meter, and I found it to be accurate. I have not used the EasyTouch meter, but I have no reason to believe that it is not as useful. If I were planning on buying a meter today, I would look at availability and price of the test strips. Strips cannot be re-used, so you need to be certain you have access to however many you need.
Whichever meter you choose, you need to be prepared for a period of getting used to it. This means establishing a fixed routine for testing that you always follow.
I know this is not a clear recommendation, but I do not really think the brand matters that much. I know several visitors here have bought the EasyTouch brand, so I’d be very interested to see their comments.
I live in New York City and bought my UAsure from Arctic Medical in England. It arrived a couple of days ago but I used it this morning for the first time.
I have a lot of experience testing my blood because I am a diabetic, so I measure blood glucose numerous times each day.
I cannot get a large drop of blood without squeezing the finger. I tried for more than half an hour before giving up. My fingers are all quite sore right now.
My reading was 4.8 mg/dl, today December 2. I suspect that that is way lower than my actual value.
I started allopurinol 300 mg on November 17. On November 28 my SUA lab test value was 6.4.
I took my last allopurinol November 30. I stopped taking it because I could not tolerate the gut discomfort it caused.
Since I stopped the allopurinol, I expected, if anything, my SUA to be higher than 6.4. Instead it was lower (4.8).
Maybe 4.8 is an accurate reading or maybe I need to find a way to get blood without squeezing my finger.
For completely other reasons, I just purchased a (very expensive) Genteel Lancing Instrument. It is supposed to provide painless lancing. It has not yet arrived. But I am not sure if it would be compatible with UAsure because I believe it does use a vacuum to draw blood. It seems to me that a vacuum would have similar drawbacks to squeezing the finger.
Moises, I’m sorry that you are struggling to get a proper blood droplet.
There are many considerations here, but I can only write from my own experiences and common sense.
Firstly, as this is a medical matter, you ought to consult your doctor. I have no idea if the inability to draw a droplet of blood from the finger has any medical significance.
Years ago, when I had a meter, I was frustrated initially at my lack of consistency. I adopted various rituals to try to remove any variables, and for a time I focused carefully on the lancet settings. By experimenting with different settings, I eventually found the setting that enabled me to perform the test. Note that I do not consider the droplet size to be large – just sufficient to cover the designated area on the strip. If it is too large, it can also affect results, as can an insufficient sample.
I do not have personal experience of diabetic testing, though I have known people who have had to test daily. From what I saw, the tests were quite different. However, I must stress that I have very little expertise here. I do know that if I ever had a question about my meter, the support staff at Arctic Medical always gave prompt and professional service. They may well have advice about blood testing.
Also, if you consult your doctor, or practice nurse, they might be able to advise on better techniques or different sample sites.
My main concern however is “I took my last allopurinol November 30. I stopped taking it because I could not tolerate the gut discomfort it caused.”
With allopurinol, the correct starting dose for allopurinol is 100mg. If it causes discomfort, there are several options. You can take it at different times of day. Before, during, and after meals. You can take it with other meds that reduce gut discomfort. In many cases, this is not a physical reaction, but an anxiety related condition based on starting a new treatment. It is important to take this seriously, but not so seriously that you become more anxious. Starting any new drug can cause initial side effects that pass after a few days. You need to work with your doctor to find ways round your allopurinol intolerance.
If you really cannot tolerate allopurinol, then it is vital to discuss alternatives with your doctor. Wait a week or two to ensure no allopurinol remains in your system. Then arrange a 24-hour urine test to assess your uric acid excretion rate. If this is low, your doctor should prescribe uricosuric drugs to encourage excretion. If not, then consider Uloric.
Please remember that, every day your uric acid is high, the resulting crystals are destroying your joints. This happens whether or not you experience flares. Uric acid control is vital, and your doctor has a duty of care to help you control uric acid safely to 5mg/dL or below.
Home test units are fine for people who want more data to help them manage gout. However, they are not a valid substitute for professional medical care. At the very least, you need the additional blood tests I described in my 8 rules for allopurinol dosing: https://gout-pal.com/gout-pal-forum/please-help-my-gout/gout-advice-please/#post-18611
I hope you can sort out your problems with the uric acid test kit, but I’m even more concerned that you find an acceptable way to control your uric acid.
Keith,
I appreciate your thoughtful post. I tested my UA today, at the same time as yesterday, and it was 6.9 mg/dl, versus yesterday’s 4.8. I am aware that my MD should have started me on 100 mg allopurinol not 300 mg.
I bought the meter because I am committed to getting my UA below 5 mg/dl. It just might take a while before I figure out the meter and my body.
Thanks for this site and all the work you do for us.
Moises
“I am committed to getting my UA below 5 mg/dl” – that is music to my ears, Moises. If there is anything I can do to help you achieve your uric acid commitment, please let me know.
as to the easy touch meter, I have one, overall in the mornings I have found consistent results of 5.1 to 5.6, tried it at various times of the day and usually it is consistent there were two times it seemed very variable, tonight was one I checked the index finger and suddenly it was up to 7.2 before dinner but after a snack of almonds, since that seemed off I checked it on the next finger,6.3,then thenext 6.8, then 10 minutes later 6.2. The only other change today was I felt a mild flair up that I assumed was coming on due to lowering UA levels, so I tried some colchicine and acetaminophen. That is the only change I have, been managing the gout with diet(primarily vegetarian),herbs, green tea, and acupuncture. it seemed to be successfully, but tonight has me thrown off. I have purchased a new meter and will check it against lab tests this week.
While researching I did find one study that said generally home meters overestimated UA levels in comparison to lab tests leading to over use of meds, so that is what I am hoping is going on
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