Gout Flares with good UA levels?

Hi Everyone,

I had a flare up this past weekend and was sure it couldn't be gout since I take allo, properly hydrate, eat a gout friendly diet and have had UA under 5 for the past 8 months. I've been on Allo for about 10 years and still have struggled to stay below 6. Attacks have been extremely rare, but this is my second attack this year, both while my UA was low.

For context, I underwent an MRI on my hip and had to flex my toes for the entire scan. By the time I got off the machine, I was in immense pain in my big toe joint (where I usually get attacks).

Colchicine helped the symptoms resolve quickly (another indicator that it was a flare up), but I'm at a loss. I was under the impression that controlled UA would eliminate attacks. I was wondering whether my creatine supplement (5 mg/day) was causing this, but I believe that would be reflected in elevated UA.

Anyone else experience random attacks like this? Any advice?

Thanks,

W