Vitamin C supplementation: High doses of vitamin C can increase uric acid excretion, leading to low serum uric acid levels. This is a common and benign cause of low uric acid.

Renal failure: Decreased uric acid reabsorption in the kidneys can result in low serum uric acid levels. This is a relatively common cause, especially in patients with chronic kidney disease.
Hepatic dysfunction: The liver plays a role in uric acid production, and liver disease can lead to decreased uric acid production and low serum levels.
Dietary factors: A diet low in purines (e.g., vegetarian or vegan diet) can result in low uric acid levels.
Medications: Certain medications, such as fenofibrate, losartan, and probenecid, can increase uric acid excretion and lead to low serum levels.

Wilson's disease: A rare genetic disorder that leads to copper accumulation in the body, which can cause low uric acid levels due to increased uric acid excretion. Missing this diagnosis can lead to severe liver and neurological damage.
Hemolytic anemia: Certain types of hemolytic anemia, such as paroxysmal nocturnal hemoglobinuria, can lead to low uric acid levels due to increased uric acid excretion. Failing to diagnose and treat hemolytic anemia can be life-threatening.

Xanthinuria: A rare genetic disorder that affects xanthine metabolism, leading to low uric acid levels and increased xanthine levels.
Uric acid metabolism disorders: Rare genetic disorders, such as hypouricemia due to uric acid transporter defects, can lead to low uric acid levels.
Fanconi syndrome: A rare disorder characterized by impaired renal reabsorption of various substances, including uric acid, leading to low serum uric acid levels.