Gout flare on Paleo AIP?

Answered on April 09, 2013
Created January 31, 2013 at 11:04 PM

Quick history: Longtime gout sufferer, watched Lustig's sugar lecture in 2011 and decided to try and eliminate sugar to eliminate allopurinol and gout. It worked like a charm. Jan 2012 - went for a full 30 day paleo experiment with no issues. Balance of 2012, stayed fully gluten-free (1-2/week of corn tortillas, rice flour pancakes), fully dairy-free, fully legume-free. No issues, in fact, safely reintroduced occasional alcohol after 13 years dry. Now, Jan 2013, I took on paleo AIP in support of my wife's search for nutrition answers to ongoing issues and on day 26 had my first gout flare in 2 years. I've never eaten more clean in my life, so a little frustrated that gout made a comeback.

Macro-intake tracked by myfitnesspal is 53% fat, 25% carbs, 22% protein.

Perhaps I need nightshade vegetables, eggs, and nuts to keep gout at bay?

Thoughts from the community on where to go next with this? Planning to try the baking soda method.

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3 Answers



on April 09, 2013
at 02:16 AM

Unfortunately it's coming from purines in Paleo staples: organ meats, beef and bacon. If you are genetically susceptible to gout, you do have to take it easy on organ meats. Your uric acid level is probably significantly lower than before, as you eliminated fructose (sugar) from your diet. Fructose is the main culprit in increasing your uric acid long-term.

However, gout isn't simply triggered by high uric acid. Only 1 in 10 whose uric acid levels exceed the upper reference range ever suffer gout. Why do you think that's the case? That's because those who get gout have genetic susceptibility: they can't excrete water and uric acid fast enough when body becomes acidic or when purines pile up. 90% of people with high uric acid never get gout because they can excrete normally.

People think it's the high uric acid that causes gout. That's not the case. It's the sudden change in uric acid that sparks gout. If you pig out on bacon and can't excrete purines fast enough, that will be enough. Solution: go easy on purines. Do high carb Paleo. Drink a glass of water with a 1/2 tsp of baking soda before going to sleep. That will make your body alkaline and keep gout at bay when attacks usually happen, at night.


on February 11, 2013
at 07:33 PM

I've learned my attacks can come from one meal or two drinks. Once you eleminate such items from your diet....Your body becomes very sensitive and reactions to bad foods/liquids are almost overnight. Usually you can research your history within a 3-day period of flare up and almost pin-point the cause. I have learned that even too much calcium foods have flared my gout up.



on February 05, 2013
at 08:36 PM

I haven't heard of anyone completely eliminating their gout. I wouldn't think of having an attack as necessarily meaning you were doing anything wrong (although corn and alcohol couldn't help, I do partake on occasion myself).

I think instead you should think of it as you're eating so well you're only going to experience an attack every 2 years instead of every few months and keep chugging along. You can also look into getting medicine specific to an acute attack rather than allopurinol, like a gout specific NSAID. I keep a stash of indocin for this purpose.

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