Gout and low carb

GoutIt’s occasionally claimed that low-carb or keto diets high in meat often cause gout. This does not appear to be true (nor does a low-carb diet have to be high in meat).

However, there may possibly be a temporary increase in risk of gout during the first six weeks on a strict low-carb diet. After this initial time period, a low-carb diet is likely neutral, or even protective, when it comes to gout.

Keep reading to find out what gout is and how to avoid it.

What gout is

Gout is a sudden and painful inflammation of a joint, most often at the base of the big toe (see image). It may also affect other joints, like heels, knees, wrists and finger joints.

The cause of gout is elevated levels of uric acid in the blood, resulting in crystals depositing in the affected joint.

Gout is more common in people who are overweight and have metabolic syndrome, and have thus become more common in recent decades, affecting about 6% of adult men and 2% of women (it’s even more common in older people).1 Historically, it was known as “the disease of kings” or a “rich man’s disease”, but now everyone can afford… sugar.

Meat and gout

Gout has often been blamed on excessive consumption of meat. This is because the uric acid that causes gout is a breakdown product of purines, a building block of protein, that is highly concentrated in meat.

However, avoiding meat seems to have little effect on the risk of gout, and even vegetarians get gout much more often than would be expected if this was the main cause.

Eating more protein (like meat) seems to increase the excretion of uric acid from the kidneys, through the urine, thus not having much of an effect on the blood uric acid levels… or the risk of gout.

Sugar and gout

As there is a very strong connection between gout, obesity, type 2 diabetes and metabolic syndrome, it’s possible that they are all primarily caused by the same thing: sugar and other refined carbohydrates.

In fact, high blood levels of insulin – a consequence of a diet high in refined carbs – has been shown to increase uric acid levels, probably by decreasing the excretion of uric acid by the kidneys.

There is a striking history of gout suddenly becoming common in populations just as sugar consumption started to rise sharply (e.g. in Britain during the eighteenth century, paralleling the birth of the country’s sugar industry).

There’s also experimental proof, showing that consuming fructose (a main component of sugar) sharply increases levels of uric acid in the body.

Alcohol and fructose are metabolized in similar ways in the body, and alcohol increases uric acid levels in the same way as fructose.

Low carb, uric acid and gout

Short term studies show a temporary rise in uric acid during the first few weeks when starting a strict (i.e. keto) low-carb diet. This effect seems to disappear after about six weeks, with uric acid returning to baseline or even lower.

Studies show no significant change in uric acid levels in people doing a low-carb diet over several months or years.2 The exception is one study that actually showed uric acid going down significantly after 6 months on low carb, suggesting it may decrease the risk of gout.3  
After dozens of high-quality studies comparing low-carb diets to other diets, there seems to be none noticing any obvious difference in the risk of gout, although no study has focussed on this specific question in detail.

Doctors regularly treating patients with low-carb diets apparently do not notice an increase in gout episodes even during the first time period. So if there exists an increase in risk during the first few weeks it is likely small or moderate.

Long-term uric acid levels tend to become low on low carb, along with other markers of metabolic syndrome4 and even patients that used to suffer from gout can potentially become gout free. However, it might take months or even years to completely reverse their insulin resistance and achieve normal levels.

 

 

How to avoid gout

Here’s how to avoid gout long term, using only lifestyle modifications:

  1. Minimize intake of sugar.5
  2. Reduce intake of alcohol. Particularly avoid beer and other high-carb alcoholic drinks.6
  3. Lose excess weight and reverse metabolic syndrome. Low carb is a good treatment, as is intermittent fasting.7

As a bonus, these lifestyle modifications have many other positive effects on weight and health. However, if they are not enough, the drug allopurinol is highly effective in preventing gout.8

Given that there may be a temporary rise in uric acid during the first few weeks on a strict low carb diet, people who’ve previously had troublesome gout attacks may want to consider using the drug allopurinol while starting low carb, starting taking the drug at least a week in advance, to minimize any risk of a new gout attack.

 
 

Meat or no meat?

Avoiding meat should not be necessary or effective when it comes to gout prevention.

Furthermore, please note that a low-carb diet is not supposed to be especially high protein or high meat anyway. An effective low-carb diet should be moderate in protein and instead high in natural fat.

A well-formulated low-carb diet (i.e. a low-carb, high-fat diet) likely reduces the risk of gout long term.

Do you have anything to add?

Do you have anything to add to this guide? Have you experienced any change in gout problems on low carb? Are you aware of further studies regarding gout and low carb?

Feel free to leave a comment below, we’ll read them all.

More about gout

Here’s an entire chapter about gout, from the award-winning science journalist and low-carb expert Gary Taubes:

Tim Ferriss: Gout: The Missing Chapter from Good Calories, Bad Calories

 
 

More low-carb side effects & how to cure them

Common early issues

Less common issues

 

Low-carb myths

 

More

Improve this page

Do you have any suggestion – big or small – to improve this page?
Anything that you’d like added or changed? Any other problems you’d like to see addressed?

Comment below or e-mail me at andreas@dietdoctor.com.

  1. Arthritis & Rheumatology 2011: Prevalence of gout and hyperuricemia in the US general population: The National Health and Nutrition Examination Survey 2007–2008

  2. NEJM 2003: A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity

    Obesity reviews 2012: Systematic review and meta-analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factors

  3. American Collage of Rheumatology 2014: High-Protein Diet (Atkins Diet) and Uric Acid Response

  4. E.g. triglycerides, liver enzymes, blood pressure, glucose, abdominal circumference, and weight.

  5. Sugar is worse than other carbohydrates, even refined carbs, because of the high concentration of uric acid-raising fructose.

  6. Beer not only contains alcohol, but also rapidly digestible carbs, raising insulin and thus lowering excretion of uric acid. Of less importance, beer also contains purines.

    If you want to drink alcohol, ideally choose options low in carbohydrates. This will still raise uric acid levels and the risk of gout, but not by as much:

    1. Low-carb alcohol
    2. Low-carb beer

  7. The American Journal of Medicine: Update on Importance of Diet in Gout

  8. Wikipedia: Allopurinol

57 comments

  1. Derick
    Andreas. Derick here in Denver. Met you in Capetown and Denver. So is there a chance someone who has been on Allopurinol can go off the meds if on LCHF ?
    Reply: #3
  2. Pete
    More people are certainly looking more closely at fructose causing high uric acid. Have a look at this press release from my local university 'Fructose and gout' http://biochem.otago.ac.nz/our-people/academic-teaching-staff/tony-me...
    Reply: #27
  3. Any chance? Sure. Uric acid can eventually end up normal even without it, as all metabolic risk factors often tend to normalize on low carb. But this can take months or years depending on where you start, even if you're successful.
  4. Patrick Kenyon
    I suffered gout in my ankles and knees for a couple of years. So I am very pleased you have written this article.
    I am very keen to reduce my allopurinol dose (500mg a day), I think this high dose makes me thirsty. My blood glucose seems normal.
    Until I gave up sugar and cut out a lot of carbs (most), late last year and joined Diet Doctor, I had no idea that sugar was such a big player in Gout (I blamed my Dad for passing it on! along with the slightly iffy prostate). I tried cutting down Allopurinol, but too much too soon and got a bad knee. Ow!
    I wonder if excess weight is an added cause or a symptom? As I loose weight do extra purines get released into my blood from the fat I am burning and should I get down to my target weight before trying to reduce allopurinol again. I am a couple of Stone over weight. Not sure how to tackle the Gout Monster! HFLC Gouters almost need theit own section lol.
  5. Bodil
    Just saw an interview with Dr. Veech on ketosis. He recommends taking Potassium Citrate when in ketosis, 50 mg once or twice a day. This to prevent formation of both kidney stones and deposits in joints. Now I want to find out if I excrete sufficient in the urine, so should I measure urine as well as blood for uric acid? Our doctor says, blood levels should be enough, but now I have asked also to be measured in a 24 hour urine. What is the optimal glucose level in mmol/L, when in nutritional ketosis? Should it just be lower than the ketone mmol/L reading?
  6. Tim H
    If in real nutritional ketosis, higher levels of uric acid may be expected. This is because ketones and uric acid compete for excretion in the kidneys. The ketones force the retention of uric acid.

    This is all to the good since uric acid provides the most anti-oxidant power in the body, way ahead of vitamin C. Primates have higher levels of uric acid than non-primate mammals, 10X in the case of humans, because primate evolution has lost the enzyme that degraded uric acid. Evolution would not have selected for it if it wasn't good.

    In the case of calcium oxalate kidney stones, chelation of calcium by proteins expressed in the kidneys of healthy individuals prevents stones despite super-saturation of the urine by both calcium and oxalate. The problem starts when those proteins are not expressed properly or are glycated upon expression. I would imagine there is a similar mechanism operating in the case of gout. I have enjoyed uric acid levels well above reference values for at least 4 years now without the slightest sign of gout. The literature says that centenarians typically have higher than normal uric acid levels.

  7. RICHARD BENSON
    HAVING BEEN OVERWEIGHT FOR MANY YEARS AND THEN DIAGNOSED TYPE2 DIABETIC, I SUFFERED FROM GOUT QUITE SEVERELY, ALTHOUGH NOT USING ALLOPURINOL, BUT RATHER COLCHICINE AS MEDICATION.
    CHANGE TO LOW CARB, HIGH FAT DIET ANDWEIGHT LOSS SAW THE DIABETES OFF, BUT I STILL SUFFERED GOUT, WHICH I THEN IDENTIFIED WITH FRUIT CONSUMPTION. EVEN2 OR 3 STRAWBERRIES WOULD TRIGGER AN OUTBREAK OF GOUT. SINCE THEN I HAVE GIVEN UP ALL FRUIT AND THE GOUT HAS NOW DISAPPEARED. I REGARD THIS AS A VERY DIRECT RELATIONSHIP, WHICH IS UNFORTUNATE, BECAUSE I LOVE FRUIT
  8. dv
    The ONLY time I get gout is when I'm strict low carb high fat. Make no mistake, high fat/high protein diets trigger gout flare ups, not sugar.
  9. Wendy
    Gout is related to Arthritis, I'm hoping a LCHF diet will alleviate my Arthritis, is this possible?
    Reply: #13
  10. Terri F.
    dv, that may be your experience, but many others find relief on LCHF, especially if they cut down on fructose in fruit. I've known a few people that are low carb, yet they eat a lot of fruit and some starches, so perhaps their idea of low carb is much different than mine.
    Reply: #22
  11. Lesley Robertson
    My hubby suffers badly from gout, prior to LCHF diet it was related to white wine and high fat foods , pate, rilettes. He went through a bad spell in week 6-7 of LCHF and we discovered it was cauliflower that was the problem, we had been having a lot of it cooked in various ways. Now even a couple of spoonfuls and he is in extreme pain.
  12. IMB
    Well, dv, unless I am missing something, I'm pretty sure that you're elucidating the old "causation vs. correlation" fallacy here. From what I have read, fat burning, which indeed can be caused by a LCHF diet, can trigger elevated levels of uric acid. These levels could, in turn, cause a gout flare-up. It's the fat-burning that's the culprit in this case, not the diet per se. I'd appreciate if someone more knowledgeable chimed in here, actually. Also, I have read that drinking lemon water can have a good effect on uric acid levels, lowering them.
  13. IMB
    Wendy, when I eliminated sugar from my diet, my arthritis disappeared. I now have joint pain only after I've eaten sugar.
  14. Paula
    I started a keto diet the end of January this year 2017 and was having great success by March 1st I lost close to 40 pounds but then the unthinkable happened! I started have severe pain in my joints of my feet and then in my stomach and then the weight started coming back on.....I was trying to get even stricter with my diet by adding intermittent fasting. But whatever the heck was happening inside my body.....was like an avalanche. The more I tried to press through it the worst the pain got. I then decided to take a break from ketosis for a few days and the pain went away. I was heartbroken because this diet was the first diet in my life to get me such great "initial" success. I guess I have to place this weight problem, and diabetes in the hands of God....who knows more than us all.
    Reply: #18
  15. MerryKate
    I was diagnosed with gout 20 years ago and took allopurinol daily until this year. After reading Gary Taubes' research on the subject, which indicates that gout attacks are triggered by fructose intake, I cut all fructose sources from my diet and went off the allopurinol. 3 months later, no gout attacks. I have always had them when I stopped taking the meds for 3 weeks or more. I've got a bottle of allopurinol handy "just in case" but it's looking like the fructose hypothesis is the right one.

    Paula, I would encourage you to give ketosis another try, this time avoiding any fructose sources (which includes cauliflower and asparagus). If you have a flare up, cherry pills can get you past the problem. Skip ADF if it isn't working for you. Its been known to increase cortisol levels in women which could lead to the other issues.

  16. Louisa
    Thank you for this very interesting article. Late last year I had a very large kidney stone that blocked off my kidney, it became infected and very swollen. After 3 months of treatment I found out that it was from uric acid, not calcium. I have not been given any advice or reason for it, but have been put on allopurinol. Do you think I will be able to get off the medication eventually, if I stay on LCHF ?
  17. George
    Great article!
    I'm a 67 yo hypertensive, obese male, with a big gut at 178cm & 110kg (5'10~240 lbs). I had a horrible gout episode last year for the first time, which took 6 months to diagnose, which left me almost unable to walk and in chronic pain in my legs and ankles. I was prescribed Colchicine for ten days along with long-term Allopurinol, which seemed to do the trick mostly, although walking was still a bit painful.

    I have been LCHF and below 20g carbs for almost five weeks now and am in ketosis if the urin Ketostix strips are working as advertised. I am now able to walk to the local shops without pain and have even taken to doing the shopping and walk home up a hill with over 10kg of shopping in my backpack without huffing and puffing or pain. Extreme perhaps but I'm trying to strengthen my legs so I can hike again. I've already eliminated one of my Blood pressure meds, Natrilix a diuretic and now plan to suspend the Allopurinol and see if any gout symptoms return.

    I'll repost in a few weeks so please wish me luck...

  18. Ann
    So sorry for you. Kind of puts me off trying this diet.
    Have you had any advise or response regarding this situation from one of the keto experts?
    How are you doing now?
  19. 1 comment removed
  20. Ivory
    Hey, I've been looking for gout articles as I am experiencing gout symptoms in my keto transition. I came across another article after reading this one which I find very interesting! There's lots of technical terms but the gist of the article is fascinating! Here it is... http://www.meandmydiabetes.com/2011/05/30/steve-phinney-and-richard-j...
  21. Andy
    I suffered from occasional gout spells that became more severe over time for over 15 years culminating in a mighty polyarthritis spell which incorporated both feet from the knees downwards, rendering me immobile and I guess I don't have to mention that Inflammations in both feet and both knees with the usual symptoms (pain, inflammation, swelling, bending knees and walking not possible) is no fun.

    I tried to combat it with diclophenac as worked somewhat ok in the past, but not this time.

    So, instead of taking to even stronger drugs I decided to cut them all together and fast.

    Fasting for 5 weeks and going on a low carb diet cured me.

    Before I had been on the usual Western carb-rich diet. I wasn't eating too much meat or drinking alcohol excessively.

    Thanks to the Internet, Gary Taubes had been a revelation, and secretly I have always doubted the traditionally advised carb-rich, low fat, low protein "gout diet".

    Since then I didn't have another spell, and I feel pretty confident that things will stay that way.

    Gout is definitely not a chronic irreversible disease that one simple has to accept.

    However, the traditional carb-rich- low fat- avoid meat- gout diet, will be a life long test of discipline and might get you diabetes anyway. What's more, it at times used to suggest fructose as a replacement for sucrose/saccharose, regardless of whether isolated or not - a sure way to chronic disease.

  22. dv
    Cherries are very high in fructose (more than bananas) and virtually every gout sufferer knows that eating cherries alleviates gout. I'm still doubting this fructose = gout concept.
    Reply: #41
  23. Lcc
    I doubt everything in this article. I am a recent gout sufferer and I got it from doing intermittent fasting for 7 months, with a high protein low carbs diet. That protocol was effective to get in better shape because I lost 13 pounds and I was training 5/6 days a week but BUT now I have gout. I am depressed.. can't move much and worried that all the weight that I lost, may come back soon with all this carbohydrate and fruit eating...
    Reply: #35
  24. Deb
    I have never had gout until four weeks into the LCHF way of eating. I am now on week 11 and am still suffering from gout. When I limit meat it eases up somewhat. I don't eat as much cauliflower as well. I am extremely disappointed!
  25. Jon
    Interesting article - gout is a strange mistress, whenever I get a flair up coming I drink 3-4 pints of real ale, the next day the symptoms of gout have subsided - this goes against all advice given but I can assure you its absolutely true. I went vegetarian and gave up drinking when first diagnosed, now on 100mg allopurinol and did use colchicine for flair ups, but since discovering real ale works the colchicine hasn't been used in 4 years. This senario does make losing weight almost impossible - any advice would be gratefully received.
  26. Leonie Roberts
    I suffer from osteoarthritis and have very sore knees. I have been on the ketone diet for 3 weeks. I don't think their is any correlation as my knee pain started increasing awhile ago and this is one of the basic reasons I started on this journey in the hope that the pain
    would decrease with weight loss.
    Unfortunately only about 500g weight loss and still very sore knees. Any suggestion on what else I can be doi g to loose the pain.
  27. Nancy
    Your link is not to the article on fructose and gout. It is to a staff page. Can you send me the link to the article?
  28. Joy Martin
    Daughter losing weight and her sugar levels have dropped considerably since going HFLC! It's wonderful. I'm thin, healthy - no diabetes, weight problems - but after being HFLC for about two months I'm finding my joints are sore and gout in big toe! I am eating more meat than previously - but not excess. Will keep an eye on things for next couple of months but hope it settles down.
  29. Lorraine
    I have never had joint pain of any kind. Started the HFLC diet in August. I do eat lots of meat because it is hard to take other foods to work. Two weeks ago I started to have knee pain. For the life of me I could not figure out why as my activities had not changed. Googled it and found this site. Confused and would like to see science on the issue. Will it pass, is it bad for me, should I stop HFLC diet etc. If the diet is so good for us, why would it do this?
  30. John Suarez
    I lost 40 lbs on Ketogenic diet and felt great. I definitely had a bout of gout. I felt like I broke my pinky toe which was an unusual location for it. After being misdiagnosed and being fitted for walking boot, orthopedic tech told doc to give me 6 pills for gout. 3 days later pain was gone. I now take potassium citrate ordered from amazon twice a day and haven't had a flare up since. Good luck and much success
  31. Patrick Carroll
    I had started on the keto diet. Was successful and losing lots of weight. But had developed gout. I felt that if gout is created buy uric acid, that I should get my body more alkaline. So I've been drinking baking soda to get my pH in my body up on alkaline side. This has been working great for myself, no signs of gout. This may not be for everyone but for some it may be the greatest thing,
  32. Kevin O'Keefe
    A more natural remedy or prevention (as opposed to taking prescription allopurinol) for gout is tart cherry. Since you probably don't want the sugar in tart cherries or in tart cherry juice, you would probably want to use tart cherry suplements, which are available in most health food stores. Web MD says no known side effects, but they don't have enough info about pregnant and breast feeding women.
    https://www.webmd.com/vitamins-supplements/ingredientmono-771-sour%20...
    Reply: #42
  33. Karen Clemente
    The article is interesting, but I am not sure it fits my experience. In the last few years, I have been eating lots of fresh vegetables, but staying away from red meat( except for an occasional hamburger or sausage, maybe once a month). I also only used half and half in my coffee. It was only when I started eating red meat 3 times a day and consuming lots of heavy cream, that I suddenly got gout. I know the article says a low-carb diet rids your body of uric acid, but when I was on Adkins, I never got gout. I also never ate the amount of red meat or cream like I did with Keto, but I lost 26 pounds. (My metabolism plateaued for 2 years, by the way, with Adkins). I'm 54 and have "enviable" blood sugar levels( according to my doctor), but I am 40 pounds overweight and have moderate osteoarthritis in my knees. I should add that I have never been more than an occasional consumer of alcohol, I rarely eat honey or agave and I am vigilant about not eating foods with high fructose corn syrup. When I eat fruit, it's strawberries, blueberries, banana, oranges, and lemons. I'd be interested in hearing about anyone else's experiences as they go forward. I'll stick w Keto, but modified to leave red meat and cream by the wayside.
  34. Roy Walker
    dv Low carb diet is not a high protein diet, 15% protein, it is a high fat diet, dietary fat is benign in so far as uric acid production is concerned. If you do a low carb woe properly, it is low carb 4 to 10% carbs, 15-20% protein and the rest is Fat. But most people are afraid of fat especially saturated fat, science has proved time and again, dietary fat does not kill, But processed carbs excess sugar surely does. The poison is in the dose. Vegetable oils (not olive or avocardo) are a big culprit as well because of the high amount of omega 6 in them, this causes inflamation, a close relationship with omega 3 which is anti inflammatory needs to be sought.
  35. Roy Walker
    A proper low carb diet is NOT a HIGH PROTEIN DIET, if you are a body builder, take no more than 1 gram of protein for every lb of LEAN BODY MASS, not the butterball weight. No more than 5% of green vegetable carbs, absolutely no grains, or potatoes, rice sweet potato, the main ingredient is FAT. Do not be afraid of FAT, Starches and sugar are your enemy, FAT is your friend. Salt is your friend take plenty of salt, if you have no energy have a bouillon cube, you need sodium, green vegetables and avocado will top up your magnesium, don't be afraid to supplement. And keep up your Potassium levels, take omega 3 oil.
  36. Yossi
    I would strongly recommend NOT taking Montmorency cherry juice. I tried it and it did nothing to alleviate my gout. However overnight my weight shot up by 3lbs and my morning blood sugar by 4 points. I really should have known, bearing in mind the quantity of sugar in it, but the pain was so intense that I thought I'd try it. I'm now going to fast for 48 hours and take Ibuprofen.
  37. Brianna
    I had no history of gout. All my mineral levels are normal. Within the second month of keto, experienced serious gout attack. Could not walk, considerable pain and swelling in joint of great toe, etc. Had on going and extreme leg muscle cramps. Was assured "it will pass" and this went on for 2 mths. Finally, went to urgent care when pain was so severe and ibuprofen just wasnt doing it for me anymore; unfortunately was given quite a dose of prednisone. Swelling came down, of course, but felt heavily medicated... stopped that in two days.
    As I gave up sugar well in advance of keto diet, eliminated all starches and grains; ate according to keto diet- calculating my protein levels and stuck to less than 30 g carbs -- I do not feel a fructose/gout connection in my case. I am totally disappointed in this journey into keto. After all this, I only lost 4 lbs. My doctor wanted me off the diet; the urgent care doctor said get out of ketosis. As I can't pinpoint what the direct cause was, I have to assume that it's the overall elements of the diet itself. I managed the constipation, I got to the point of regular intermittent fasting, enjoyed not being hungry every three hours but now feel that losing 4 lbs. had a very high price. I can't recommend keto to anyone and I did have a number of people that were following me and I raved about keto, long term health benefits, etc. Now, I just don't know what to say. There are less extreme ways to lose weight and stay healthy.. my dr. recommends balance in diet, not extremes... imagine that as an option.
  38. Nan
    GOUT ! I'm in week 4 of my cold turkey transition to low carb. I'm a T1D and had a kidney transplant in 2007, and I've had a lot of complications on my 50 year journey with diabetes. I've had a BIG outbreak of gout and the transplant team put me on 80 mg of Uloric. But after 3 weeks on this drug, I'm still experiencing gout. It interferes with my ability to walk and exercise. I'm hopeful this will pass, but I'm wondering if LCHF is sustainable with stage III CKD and a transplant. I'm hopeful others with CKD and/or a transplant can share their experience? I converted to LCHF after 11 years of eating Vegan, but found I couldnt easily do low carb on a vegan diet. It was a big step for me and I really don't want to go back to a vegan diet. Thanks all.
  39. Linda Wright
    All my family on my mother's side including my brother have gout and take medication. I had been made aware water intake is an important factor. For some number of years I've ensured I drank at least 1 1/2 liters per day. I had gouty twinges when I first started keto June 2017, upped my water intake and haven't had any problems since. Now 9 months into keto have shed 32 kilos, absolutely no gouty signs at all.
  40. David
    I can only tell you my experience. I have had gout for over 40 years, gradually getting more frequent with time. I eventually ended up on a daily tablet of Allopurinol, which does the job 100%.

    I lost about 60lbs last year on LCHF and I saw Dr Westman in a video on Diet Dr questioning whether Allopurinol was really necessary for those who had reversed their diabetes and had reached a sensible weight.

    I was flushed with success and wanted to ditch even more of the mound of tablets that had built up over the years. So, goodbye, Allopurinol. Three months later I started to get gouty painful and swolen thumb joints. When the pain became too bad to tolerate in the hope that this was just temporary, I reached for the Allopurinol and within a couple of weeks I returned to stability. I remain stable.

    Different folks....

  41. Lee
    Cherries NEVER alleviated my gout, not one whit. Nor the gout of anyone I know.
  42. Lee
    Cherries, tart or black or otherwise, as juice, in pills, or just eating cherries, does NOT NOT NOT work to alleviate gout. At all. Neither I nor anyone I know with gout have ever had good results with cherries in any form.
  43. Michael
    Hi,

    I had gout as I was overweight (166 kg @ 1,86m). Since I lost over 70 kg with keto I could drop medication an never had problems with gout. So keto can heal gout! And I definitly eat more meat then before....

  44. Theresa
    My husband had attacks of gout multiple times and was in extreme pain and swelling and red. I have been involved in health and fitness for over half my life. So I researched quite a few programs.They all seemed to contradict the other and none of it helped! He began losing weight because he was afraid to eat anything! We are firm believers in Jesus Christ and so I began to pray for a solution. I stumbled on to low carb,no sugar or processed foods, and then 1 juice of a freshly sqeezed lemon daily did the trick!!
    I found out that the lemon is alkaline upon digesting. So therefore it will neutralize the uric acid. It worked!! It has been over 1 year and all is well!
    Thank you Jesus!!
  45. Theresa
    Oh yeah, the lemon was mixed with luke warm water in a coffee cup. You can do half lemon in a coffee cup with luke warm water a.m. and the other half p.m
  46. Anna
    For more info in agreement with this site but in more detail, see Craysor.com
    It really explains a lot regarding eating low carb, sugar causing gout and eating meat and about purines. It is very informative.
  47. Anna
    By the way.........thanks for recipes! A huge help! :)
  48. Tracy
    Since I started the Keto diet and 3 weeks in, I have developed gout in my right foot. I’ve never had it before, I thought I broke my foot. It’s very painful and the pain stays even with no weight on it. I am not sure if I should tough it out and it will eventually go away? I am upset because I finally find a diet that works and this happens. ☹️Suggestions please.
  49. Marilynn
    Hello, Wow, what a commentary on gout and/or the LCHF way of eating! I will add my bit. I had my first gout flare about five years ago. It was brought on by a wine indulgence event. The classic picture and description as on google. Pain? OH yes!. I am over weight, prediabettic, all of the "pres" of metabolic syndrone. In the past, I have had high uric acid readings. This was in the days when uric acid was measured routinely with blood tests. Nothing was ever said to me about this, and as a result, i'm stumbling through life, fat and dumb concerning gout. I left the ER room with prescriptions for colchicine and allopurinal. It worked. I did a lot of research and studying and started using an herbal treatment. That seemed to work for a couple years and I finally stopped using it. My daughter was successfully following the "keto" diet. I decided to try it. In the meantime I moved changed doctors and so on. During the visit with new doctor I mentioned I had had a gout flare in the past, so she ordered a uric acid test. It was high 9.2 but I was fine, no symptoms. So I started taking allopurinol, On the 30th day of my allopurinol trial and the second week of keto. I had a full blown flare. This was a weekend of course, which I spent with my foot up, iced, drinking cherry juice and eating celery. By Monday the pain and swelling had abated. The next week I cut back on the cherry juice because of the sugar. Well, not a good idea, it came back with a vengence. I end up in Urgent Care, give up allopurinal, take colchecine and take a course of prednisone. I am not in pain, but it has raised havoc with my Keto attempts. I have lost some weight and will not give up, and i'm back on herbal care for gout. (all my other lab results were down}
  50. Balaji
    Hi All,

    Noticed my uric acid levels go high and caused swelling and pain of right hand ring finger and pain in all other fingers. I was on and off Keto diet for prior 5 months ( mostly on Keto than not) which means i am not taking any sugars but still my Uric acid went high.

    So what i want to say is that Sugars/Fructose were NOT the cause for Uric acid level increase in my case but perhaps lot of cheese/fats might be, since that is what i have been taking for past 5 months !.

    Thanks
    Balaji

  51. Lacosta Hodges
    My husband has gout flare ups when he cheats. He has been lchf for 3 years. This year at the beach he had some refined sugar when we went out which triggered a gout flare up. I think it is his body's reaction to the spike in sugar. This just validates our commitment to the lchf lifestyle. If your body reacts that strongly to sugar when you are not used to it then its poison!
  52. Barbara
    I just cheated for several days while on vacation, came home, got back into ketosis and ended up with gout within a week. Never had it before. Terribly painful. Hobbled, couldn’t bear weight on my swollen red foot. I had been fat adapted for a long time previously and this certainly showed me how insulin resistant I truly am. I was uncomfortable taking the prescribed anti inflammatory and drank ACV and lemon juice instead, along w a pain med. Lesson learned. Hope I never experience this awful affliction again. My heart goes out to those who do.
  53. Arlene
    A few weeks I went much lower carb. I also increased my exercise levels considerably, and along with the heat (summer in Ontario, Canada can sometimes be brutal) ended up in ER with tachycardia.

    I take a 12.5mg thiazide diuretic for high blood pressure and this I believe was a factor as well in that I become quite dehydrated.

    Blood work indicated low potassium (3.2), low magnesium (.73mmol) and high uric acid (401 umol.)

    I had blood work done again to follow up on those results last week, and all this has resolved. My uric acid is down to 224 umol, and my potassium is normal at 4.5.

    For anyone taking diuretic medication for high blood pressure please be aware that there is a chance that this will additionally increase uric acid levels initially when significantly lowering carbohydrate intake and going into ketosis.

    In my case I am happy to report it was transitory and has resolved spontaneously.

  54. Linda
    About 3 years ago, I was on no particular diet, I had an episode of gout in my left big toe. When it didn't go away in a couple of weeks, my doctor gave me a prednisone shot. That did nothing. Then she prescribed allopurinol -- OMG - suddenly the gout became so much worse and spread to other joints including my left foot and ankle. I was unable to walk even to the bathroom and hubby had to push me in a wheelchair! I started researching and found that allopurinol should NOT be started during a gout outbreak. I called my pharmacist and he confirmed this was correct and to stop taking it immediately and call my doctor. She was very unconcerned! I hung up and determined to switch doctors right then and there. Further researching, I found an over-the-counter remedy on Amazon with a 90-day money back guarantee. I ordered it with 2-day shipping and started taking it. Literally in 3 days, my gout was so much better and in 6 days it was gone. I don't know if this will help anyone else, but the product is Urcinol. I'm just an ordinary customers (very satisfied customer) and have nothing to gain from putting this information out there. I would just be so happy if this helped others the way it has helped me. I recently had a blood test that showed my gout level was up a bit. I came home and checked the pills in my monthly pill case and found that I had inadvertently left it out when I filled it 2 weeks ago. I am convinced that it works for me and I hope it will help some of you. No one wants to deal with gout! I am on Week 2 of low carb and already down 5 lbs. and feeling so much more energetic and clear headed. Good luck everyone on your journey.
  55. JOHN
    normal keto does not brother my gout only after 3 continuous days of fasting brings it on. i just wonder if uric acid is stored in the fat cells that are getting burned? can not be in the food that i am eating because on a fast you do not eat anything. so where is the uric acid coming from? has to be in the fat cells. just my option, meat does not brother me, i ever eat liver a lot and it never hurts me, only fasting does
  56. Cyrus
    Interesting thread. I reduced my gout 90% when I fixed my gut health issues. There seems to be a relationship between gut bacteria and gout. Google "gut bacteria gout" to see the studies. Obviously, changing your diet and the foods you eat (protein, carbs, fat, fructose, etc.) will alter everyone's microbe different.

    My own healing moment came when I started taking GOS (Galactomune) which is a prebiotic that promotes the growth of bifidobacterium and lactobacillus. I believe GOS is technically a carb, but you don't have to take very much of it, or for very long. Food for thought for anyone struggling with this.

  57. Pekka Huttunen
    I have been on low carb diet now for five years. My gout episodes are basically non-existent. My arthritis doctor kept on telling me to avoid meat and fatty foods. I decided with advise from another doctor to do the opposite and also cut gluten off my diet. This decision basically saved my life!
  58. Brian
    I expect that liver function plays a predominant role in gout flare ups and often falls under the influence of various harsh inputs such as heavy carb loads, spikes in fructose, ketones etc. A livers function to cleanse out toxins, unic acids and ketones will be reduced if swamped by high carbs, fructose spikes, alchohol binges or large amounts of purines being converted.

    Non alchohol fatty liver disease diagnosis is a growing trend and likely a cause for my gout flare ups and triggered by generally flooding of it by rapid absorption spikes in fructose (including diet pop sweeteners that also wreak havoc), general over consumption of carbs and occasional binges of sweets or high purine meats.

    Don’t recommend anyone seek a single silver bullet solution to gout, such as tart cherries, but rather pursue the overall health of your liver to be the source of your blood level readings which are ultimately excreted by kidneys.

    The anti-inflammatory long term approach with herbs & meds as needed to boost should be paramount as well as avoiding of spike events to the liver.

    Staying well hydrated helps the body cleanse out toxins, uric acid crystals and ketones vs allowing them to settle in joints and causing inflammation.

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