Much of what you wrote is I think correct but…
There are doctors who use colchicine as a diagnosis tool in some cases. It’s much cheaper and easier than arranging an ultrasound and joint fluid test with a skilled hand.
And there also are doctors who discount the results of tests done on blood drawn during an attack.
I wish diagnosis was as simple as a blood test. I have had several tests coming back well under 6 without the benefit of UA reducing drugs. Do you think that means I don’t have gout?
A couple things. I can only speak for my experience, but using Colchicine as a diagnosis tool because it’s much cheaper? I don’t know about that in my experience, and it may be indeed true, but where I’m from, Colchicine is NOT cheap. As a matter of fact, it’s damn expensive. My insurance is billed almost $700 for 90 tablets of 0.6 mgs. I pay a $50 copay, but if I didn’t have insurance, $700 bucks is a steep price to pay for what may, or may not be Gout. I’d rather have more convincing evidence.
For me (again, I only speak from my experience) I had several blood tests, none were taken during an active Gout Flare. Most often, it was taken afterward, then 4 weeks afterward. The highest reading I ever had was 9.6 mg/dL. When I first started Allopurinol, my doctor had me at blood test intervals of 6 weeks for the first 6 months. My Uric Acid is currently at 4.4 mg/dL, but I never take it for granted that I won’t have a Gout Flare, so I’m careful.
With YOUR blood work well below 6 without meds, maybe you’re one of the lucky ones. I hope you are. I could NEVER get my levels below 8 without medication, so I really had no choice. But just because your blood work comes back well below 6, I wouldn’t say you don’t have Gout. You just don’t have symptoms. Keep up whatever you’re doing and be healthy.