Uric Acid · low result
Low uric acid: causes and when it matters
Short answer
Low uric acid (hypouricemia) is a level below about 2.0–2.5 mg/dL. It is usually a side effect of treatment or medication — urate-lowering drugs for gout, high-dose aspirin, losartan, fenofibrate, SGLT2 diabetes drugs and estrogens all lower it — or of a very low-purine or vegan diet, low body weight or pregnancy, when it falls normally. Less often it reflects the kidney losing urate (Fanconi syndrome, an inherited renal hypouricemia, Wilson disease), the liver making less (advanced liver disease), or a dilutional state such as SIADH. In most people it is harmless and needs no treatment; the exceptions are the inherited renal form, which carries a risk of acute kidney injury after intense exercise, and a tendency to uric acid kidney stones.
Medically reviewed by Youmna DiStefano, MD · Last reviewed November 2026
When does this result need same-day care?
- Severe low-back or flank pain, nausea, and dark or very little urine within hours of intense exercise — same-day care; this can be acute kidney injury
- Low uric acid together with confusion, severe headache or a seizure — emergency care (a dangerously low sodium is the likely culprit, not the urate)
What is the normal range for Uric Acid?
- Male, age 18+: 3.40 – 7.00 mg/dL
- Female, age 18+: 2.40 – 6.00 mg/dL
Can reflect low purine diet or certain rare metabolic conditions.
Full reference table, citations and testing options: Uric Acid biomarker page.
What are the common causes of low Uric Acid?
- Urate-lowering medication — allopurinol, febuxostat, probenecid; a low level on treatment is intended
- Other medications — high-dose aspirin (over 3 g a day), losartan, fenofibrate, SGLT2 inhibitors (empagliflozin, dapagliflozin), estrogen, and iodinated contrast dye in the days after a scan
- Very low-purine or vegan diets, low body weight and malnutrition
- Pregnancy — uric acid falls by a third in the first and second trimesters and rises again toward term
- SIADH and other dilutional states — the kidney excretes more urate when sodium is low; a low uric acid with a low sodium is a clue to SIADH
- Advanced liver disease — less xanthine oxidase, so less uric acid is produced
- Fanconi syndrome — a proximal kidney tubule disorder that also loses phosphate, glucose and amino acids into the urine; drugs (tenofovir, ifosfamide), myeloma and heavy metals are causes
- Hereditary renal hypouricemia — loss of the URAT1 or GLUT9 urate transporters, more common in people of Japanese and some other East Asian ancestries; levels are often under 1 mg/dL
- Wilson disease (copper deposits injure the tubules) and the very rare hereditary xanthinuria (xanthine oxidase deficiency)
What symptoms go with low Uric Acid?
- None — a low uric acid itself causes no symptoms
- Symptoms belong to the cause: nausea, headache and confusion with a low sodium; bone pain and weakness with Fanconi syndrome
- In hereditary renal hypouricemia: severe loin pain, nausea and dark or scant urine in the hours after intense exercise (exercise-induced acute kidney injury), and uric acid kidney stones
What do clinicians usually check next?
- Review medications first — if the low value is from gout treatment, aspirin, losartan, fenofibrate or an SGLT2 inhibitor, nothing needs doing
- Sodium and serum osmolality when there is nausea, confusion, lung disease, a recent new antidepressant or other reasons to suspect SIADH
- Phosphate, bicarbonate and a urinalysis for glucose and protein when Fanconi syndrome is a possibility (especially on tenofovir or with myeloma)
- A liver panel; and in anyone under 40 with an unexplained low value, ceruloplasmin for Wilson disease
- If persistently under 2 mg/dL without a drug cause: a 24-hour urine uric acid or fractional excretion (over 10% suggests the kidney is leaking urate) and, when high, genetic testing for URAT1/GLUT9 variants
- In confirmed renal hypouricemia: stay well hydrated, avoid short bursts of all-out anaerobic exercise, and check creatinine after any heavy exertion with loin pain
Follow-up tests available at TestWell: Ceruloplasmin Test ($29.99), Glucose Test ($14.99).
For gout treated with urate-lowering therapy, the American College of Rheumatology recommends treating to a serum urate below 6 mg/dL, checking levels every 2–5 weeks while the dose is being adjusted and about every 6 months once stable. Without gout, there's no routine retest interval.
How do you recheck Uric Acid?
Prices are cash-pay; every order adds one $6 lab processing fee. Physician authorization is included; no insurance or referral needed.
| Test or panel | Type | Price | Fasting | Results |
|---|---|---|---|---|
| Gout Panel | Panel · 3 tests | $62.99 | Yes | 2–4 business days |
| Men's Superpowers Panel | Panel · 36 tests | $649.99 | Yes | 7–10 business days (most results in 2–5) |
| Total Body Essentials Panel | Panel · 39 tests | $399.99 | Yes | 3–7 business days |
| Uric Acid Test | Test | $21.99 | No | 1–3 business days |
Common questions
Is low uric acid bad?
Usually not. Most low values are medications or diet and have no consequences. The exceptions are the inherited kidney form, which can cause kidney injury after intense exercise and stones, and a low uric acid that is a clue to another condition such as SIADH or Fanconi syndrome.
What causes low uric acid?
Most often urate-lowering drugs, high-dose aspirin, losartan, fenofibrate or SGLT2 inhibitors; then low-purine or vegan diets, pregnancy and dilution from a low sodium. Kidney tubule disorders, advanced liver disease and inherited transporter defects are the uncommon causes.
Can low uric acid cause kidney problems?
Paradoxically, yes in one situation: in hereditary renal hypouricemia the kidney dumps urate into the urine, which can crystallize and cause stones and, after intense exercise, acute kidney injury. Ordinary low values from medication do not do this.
Which medications lower uric acid?
Allopurinol, febuxostat and probenecid by design; also high-dose aspirin, losartan, fenofibrate, SGLT2 inhibitors (empagliflozin, dapagliflozin, canagliflozin), estrogens and, briefly, iodinated contrast. Low-dose aspirin does the opposite and raises it.
Is low uric acid normal in pregnancy?
Yes. Uric acid falls by about a third in early and mid pregnancy as the kidneys clear more of it, then rises toward term. A rising uric acid late in pregnancy, by contrast, is one of the markers watched for preeclampsia.
Should I eat more purines to raise it?
No. There is no benefit to raising uric acid, and purine-rich foods bring other problems. If the level is low because of a medication or diet and you feel well, leave it alone; if it is unexplained and very low, the workup above looks for a cause.
Educational content, not a diagnosis. Lab results are one input; a clinician interprets them with your history and exam.