Serum urate is one of the most important measurements in gout care, but it is easy to misunderstand. A laboratory reference range is not the same as a treatment target, and a single result does not diagnose gout by itself.
What counts as high?
Laboratory reference ranges vary by sex, method and country. In gout care, 6 mg/dL (about 360 micromol/L) is an important threshold because urate crystals become more likely to persist above that level.
Can uric acid be normal during a gout attack?
Yes. Serum urate can fall during an acute flare, which is one reason a single number cannot diagnose or exclude gout. If the result is below 6 mg/dL while the joint is inflamed and gout is still strongly suspected, NICE recommends repeating the test after the flare has settled; see how gout is diagnosed for the larger clinical picture.
What is the treatment target?
For people receiving urate-lowering therapy, major guidelines generally aim for serum urate below 6 mg/dL. NICE recommends considering a target below 5 mg/dL (300 micromol/L) for people with tophi, chronic gouty arthritis or frequent flares despite being below 6.
Reference range vs. target
A result marked “normal” by the laboratory may still be above the optimal target for someone with established gout. That is why treatment decisions should use the gout target, not just the lab flag.
Units vary by country
The United States commonly reports mg/dL. The UK, Australia, Kenya and many other countries often report micromol/L or mmol/L. Always compare the number with its units.
When should urate be checked?
It may be checked when gout is suspected, after a flare, during dose adjustment of urate-lowering therapy and periodically after the target has been reached. The exact schedule depends on the treatment plan.
This article is educational and is not a substitute for individualized medical advice.
Sources
Related guide
For home monitoring between laboratory tests, see How Can I Check My Uric Acid at Home? Home Tests & Meters.
Evidence checked September 2026.