What should uric acid levels be maintained below for gout patients? (Typically <360 μmol/L; <300 μmol/L for patients with tophi or frequent flare-ups)

Hello, regarding gout and uric acid control, I'd like to share some insights.

You can imagine our blood as a glass of water, and uric acid as salt. If there's too much salt, it won't dissolve in the water and will crystallize and precipitate. These crystals are the "urate crystals" that cause our joint pain. Therefore, the key to controlling gout is to prevent too much "salt" in the "water" of our blood.

So, how low should it be to be considered safe?

For most patients: Doctors usually require us to keep our blood uric acid levels below 360 μmol/L. By lowering it to this level, the uric acid in the blood reaches a relatively "safe" concentration, making it less likely for new crystals to form. This significantly reduces the risk of gout attacks.
For special cases: If your gout attacks are particularly frequent (e.g., several times a year), or if you have already developed tophi (those hard lumps on your joints), it indicates that you have too much uric acid "stored" in your body. In such cases, the target needs to be stricter, requiring blood uric acid to be lowered to below 300 μmol/L. This is not only to prevent new formations but also to gradually "dissolve" existing crystals, causing the tophi to shrink or even disappear.

In summary:

Standard target: < 360 μmol/L
Strict target: < 300 μmol/L (for patients with frequent attacks or existing tophi)

Consistently keeping uric acid below the target level is the only way to truly and effectively control gout.