Q: I have had gout for more than 15 years with consistently high uric acid levels. Recently, however, I began taking 2 milligrams of folic acid daily, and I have since had two blood tests showing normal uric acid levels. What is the recent research concerning folic acid and gout?

A: High uric acid levels – due either to excess production of uric acid or to abnormally low excretion of this waste product in the urine – are what cause gout. In recent years there have been a few studies examining the effect of folic acid on uric acid production and excretion. These studies have shown that folic acid has no effect on uric acid levels. It is interesting that in your case folic acid appears to have lowered gout uric acid, but “appears” may be the key word here. Is it possible you have made other changes that might have affected your gout uric acid level, such as switching medications for another health problem? I am glad your uric acid levels have stabilized, for whatever reason. For the moment, I cannot recommend folic acid as a therapy for patients with gout, but it does appear that the issue should be studied further.

Jeffrey N. Katz, MD, MS, Rheumatologist