3

votes

Gout and fructose

Answered on August 19, 2014
Created January 07, 2011 at 2:34 PM

First the good news: After a bit of clever chess, (by enlisting my nagging but loveable mom) I got my 63 year old dad and the myriad of problems he's carrying in his 350lb+ frame to go paleo in the new year.

Now the bad news: The males in my family, including myself, are predisposed to gout. He's been strict paleo for about four days and yesterday he ate 2 oranges and woke up this morning with a flare-up. I'm of the belief after reading Taubes, Peter from Hyperlipid, and past paleohacks discussions on this that the fructose caused it because, I had a flare-up a month or so ago after devouring nine oranges in a 3 hour period(i know, seems very stupid in retrospect) trying to ward off a cold. It was my first flare-up after having been paleo for 9 months and consuming all of the things that the traditional gout treatment orthodoxy said i shouldn't- beef, shellfish, organ meat, etc. Anyways, I'm pretty sure that much fructose in that concentration is what led to the flareup.

Now back to my dad. I was pretty surprised that two oranges called a flare up but i have some theories as to why and i wanted to see what you guys thought. I'm thinking that being i have them (i've been trying to help about 15 people who decided to take the paleo plunge this year) on a somewhat low carbish paleo plan that will probably push them all into ketosis for faster weight loss, since almost everyone i'm helping has significant weight to lose. I've told them to eat fruit if feeling symptoms from "low carb flu". I believe that the liver while dealing with this transition during ketosis is having problem regulating the uric acid so any fructose that comes in during this period has a greater chance of going into the bloodstream as uric acid and therefore causing gout. What do you guys think? Also, if this is the case, do you think that once the body is keto-adapted, those of us who are genetically more acidic are able to handle fructose in moderation- from fruit and veggies of course?

On a personal note, over the last several months, I've gotten invaluable information from this site that has helped me tweak aspects of my diet when I've been stumped(like when i couldn't figure out the fact that i was eating a half pound of almonds a day was the reason i had stalled out in late summer:)). Hopefully, in the near future as more people stumble in here without a lot of knowledge you can be of the same help to them as they try to unlearn the years of what their doctors and nutritionists have taught them. Happy New Year.

Update: 10+ months later, my dad's lost 100lbs and, other than a slight flare-up early on, has not had any gout issues.

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on July 10, 2012
at 03:01 AM

Aparrently ketosis reduces the elimination of uric acid. High purine foods like meat and particularly fish increase the input (although usually on its own that has little influence), and fructose and alcohol produce a reaction where the body calls for more of it. If I had gout, i would stay out of ketosis doing paleo, and keep my fructose low, and alcohol non-existant.

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on July 10, 2012
at 02:56 AM

Aparrently ketosis reduces the elimination of uric acid. High purine foods like meat and particularly fish increase the input, and fructose and alcohol produce a reaction where the body calls for more of it. If I had gout, i would stay out of ketosis doing paleo, and keep my fructose low, and alcohol non-existant, possibly also watch my fish intake and drink lots of water.

Cf4576cbcc44fc7f2294135609bce9e5

(3125)

on December 29, 2011
at 05:12 AM

i have gout issues also. Does the baking soda change your body chemistry? i thought humans buffered the serum with albumin, and by blowing off carbonic acid into the air as co2. i dont mean to be a wise ass. I will try this because NSAID block healing and repair mechanisms. im glad i read this. thank you.

66e6b190e62fb3bcf42d4c60801c7bf6

(12407)

on January 07, 2011
at 04:31 PM

thanks for that... his stuff is pretty much along the lines of what i've experienced with gout.

66e6b190e62fb3bcf42d4c60801c7bf6

(12407)

on January 07, 2011
at 03:55 PM

thanks! it was the name of my now defunct band. you know why it's harder for you to convert them over to paleo? it's because you lost most of your weight on your former plan. i literally lost fat right in front of their eyes with half the physical output i was doing before. people literally kept asking what new workout i was doing. in past weight loss experiences it was always i was losing weight, this time it's all about how healthy and lean i look rather than just looking smaller. i like that aspect more because i like my shoulders and would like to keep them, thank you very much :)

7e746be2f0e550a8cd7df881322ae705

(18701)

on January 07, 2011
at 03:46 PM

That is excellent luckybastard (as an aside, love your username)! I did well converting more people to my high protein/high fiber way of eating before this. I don't think I explain Paleo very well yet. So much of it goes against conventional wisdom, I've been having a hard time with the WHY it works part.

66e6b190e62fb3bcf42d4c60801c7bf6

(12407)

on January 07, 2011
at 03:33 PM

i have him following that whole30 plan about 95% of the way. i am letting him drink coffee with heavy whipping cream and eat pastured butter because being in a fixed income, it's easier for him to get good fat intakes that way. i agree with the fact that insulin sensitivity may indeed be the culprit. and now that i believe he's started going into ketosis, i can wean him off fruit for awhile to let the insulin sensitivity issues to clear up. it took me about 3-4 months, however, he has more weight to lose than i did...

66e6b190e62fb3bcf42d4c60801c7bf6

(12407)

on January 07, 2011
at 03:30 PM

@sherpamelissa i actually converted my whole family, 3 coworkers and a few friends of friends. everyone who told me how i looked better than ever, i just told them what i was doing and told them i'd help them do the same whenever they were ready.

66e6b190e62fb3bcf42d4c60801c7bf6

(12407)

on January 07, 2011
at 03:29 PM

i have been battling bouts of gout for about ten years. i eat liver once or twice a week and have recently eaten cow heart. organ meats and shellfish- the two with the highest purine content- don't affect my gout. however, the one time i had fructose in high concentration, it did. so, by way of my own experience, i'm pretty sold on the fructose causes gout theory.

F53a74de3f8df19a114c5ac702af2b12

(826)

on January 07, 2011
at 02:54 PM

Im interested in this too. My mom has Gout and wont eat any organ meats, although we all know its good for her. Her diet is really problematic

7e746be2f0e550a8cd7df881322ae705

(18701)

on January 07, 2011
at 02:53 PM

Congrats on converting your dad! That is awesome.

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8 Answers

3
96bf58d8c6bd492dc5b8ae46203fe247

(37227)

on November 07, 2011
at 05:30 PM

Update: 10+ months later, my dad's lost 100lbs and, other than a slight flare-up early on, has not had any gout issues.

Yaaay! What a great thing to read. Thanks for letting us know.

3
674576ff6bff66c5c7d2e6f07886ec0b

on November 07, 2011
at 05:12 PM

Here is my story. It was the middle of the night. I opened my eyes and was awakened by earth shattering pain. My big toe was throbbing. In fact it felt like a towering inferno.
I turned on the light and was startled to see that my great toe was 3 times its normal size. It was bright red and red hot, just like a firecracker and the pain was the most severe that I've ever experienced by far.The suffering that I had to endure was almost unbelievable. That was over ten years ago. At the beginning I was having attacks every 6 months. Then gradually I was getting them every 3 months, then every month and eventually every week. It started at my big toe and then it was moving sometimes in my knees,and generally all around my joints, in my feet.And the pain was agonising. I have tried all the cures you can imagine.I tried ACV, lemons, drinking a lot of water, but to no avail.I tried water fasting, juice fasting,baking soda, again without success. I almost gave up meat, limiting it to only once a week ,gave up alcohol completely,again no success. I was living on vegetables, lots and lots of fresh fruit, milk ,cheese beans and so on .My eating habits could not be healthier ,or so I thought.But my gout was worsening. Then I decided to increase the amount of fruit I was consuming, thinking that if some fruit is healthy, more fruit will be more healthy.Some days I was eating fruit only ,others over 10 portions a day. And alas my gout instead of improving it became chronic ,it was there all the time. I was desperate I did not know what to do. And then one day accidentally I read an article about fructose,which is contained in fruit in large quantities.It said that it increases uric acid, in a matter of minutes. Fructose is also present in table sugar, and in HFCS, which is used in soft drinks. I put two and two together and realised what I was doing wrong. I stopped eating fruit and all other sugars, for a period of 3 weeks,and by magic I saw a dramatic improvement.Pain was gone, swelling was gone, I was fine. I re introduced fruit again in my diet but reducing them to 1 or 2 a day, and my gout completely disappeared. I do eat more meat now, and occasionally have an alcoholic drink, and thank God everything seems to be fine. Fructose was my enemy.

2
Da9d20766ee0c96026244fd4afc26695

(90)

on January 08, 2011
at 03:54 AM

I did some research a while back on gout. I combined info from Cordain and Taubes plus some other sources.

The main contributors to flare ups are fructose and alcohol, and dehydration seems to play a role.

See http://www.emotionsforengineers.com/2009/09/causes-of-gout.html

Cheers, Tony

1
6342fa5ab7f62e313a279992baacbe4d

(10)

on July 10, 2012
at 01:53 AM

I had chronic gout, to the point of needing daily medication. I was listening to Michael Savage one night, and he mentioned that eliminating almost all sugar and dairy can help most people with gout. Four months later, I've lost 34 pounds and have not had gout since about 2 weeks after starting the dairy free and sugar (+fructose free) diet. I've never felt better and many of my other joint issues are gone. I used to get gout in my big toe, knees, foot and elbows. Not any longer! On top of that, I have not had to take daily anti-flare NSAIDS and/or any other medication. My blood pressure is much better too. I've always exercised a lot, and that did not change with the change in diet and lifestyle. Good Luck to you!

1
3c6b4eed18dc57f746755b698426e7c8

on November 08, 2011
at 04:47 AM

Fructose plus acid-base balance. Gout preceded my fatty liver, and fatty liver preceded T2 diabetes. I don't know any gout sufferer that was not a heavy soda junkie.

To cure gout, it helps to lay off fructose. But the other half of the equation is the acid-base balance, which is the real trigger. You can have elevated uric acid levels but won't suffer from gout if there is no trigger. Conduct an experiment: as soon as gout starts, drink a glass of water mixed with a tablespoon of baking soda. Take one glass every half hour.

I used to take Naproxen when gout flared but ever since I started this baking soda therapy (howicuredmygout.org), I haven't needed NSAID. In fact, I haven't had one in the last 9 months, which is rare since gout used to visit me every 2 months, like clockwork, even after I lost 60 lbs. and reached 22 BMI.

Cf4576cbcc44fc7f2294135609bce9e5

(3125)

on December 29, 2011
at 05:12 AM

i have gout issues also. Does the baking soda change your body chemistry? i thought humans buffered the serum with albumin, and by blowing off carbonic acid into the air as co2. i dont mean to be a wise ass. I will try this because NSAID block healing and repair mechanisms. im glad i read this. thank you.

1
461281c9092d3cb306b46831064e2fc4

on January 07, 2011
at 03:39 PM

Check into the work by Richard Johnson, MD, on the link between fructose consumption, uric acid, gout, and insulin resistance. He also has a book called Sugar Fix that is frustrating in many ways, but illuminating in regards to fructose.

http://www.google.com/search?q=johnson+gout+fructose+uric+acid

66e6b190e62fb3bcf42d4c60801c7bf6

(12407)

on January 07, 2011
at 04:31 PM

thanks for that... his stuff is pretty much along the lines of what i've experienced with gout.

1
00fe9c58f7020500007bd5f9638747fa

on January 07, 2011
at 03:17 PM

So you're right about the fructose being more problematic than other sugars because of fructose's requirement to be filtered by the liver, but fructose itself isn't the root cause so much as general hyper-insulinism.

Your father probably had a flare up after two oranges simply because he is still incredibly insulin resistant at this point. To this end cutting out all sugars, starches, and dairy should help immensely and as insulin sensitivity is restored the ability to handle fructose should increase dramatically.

I think the way to get people spun up - especially those who are specifically looking to lose weight is to hit the whole 30. Here's a link:

http://whole9life.com/2010/10/whole-30-v3/

If you want to read more on gout, grab Professor Cordain's newsletter on it here:

http://www.thepaleodiet.com/newsletter/back_issues.shtml

66e6b190e62fb3bcf42d4c60801c7bf6

(12407)

on January 07, 2011
at 03:33 PM

i have him following that whole30 plan about 95% of the way. i am letting him drink coffee with heavy whipping cream and eat pastured butter because being in a fixed income, it's easier for him to get good fat intakes that way. i agree with the fact that insulin sensitivity may indeed be the culprit. and now that i believe he's started going into ketosis, i can wean him off fruit for awhile to let the insulin sensitivity issues to clear up. it took me about 3-4 months, however, he has more weight to lose than i did...

0
149af6e19a06675614dfbb6838a7d7c0

on January 08, 2011
at 04:44 AM

Good detective work on your part. Gout is a result of excess fructose. For me...thats any. JAMA. 2010 Nov 24;304(20):2270-8. Epub 2010 Nov 10. http://articles.mercola.com/sites/articles/archive/2010/11/25/new-proof-that-fruit-juice-and-soda-increase-risk-of-gout.aspx

As far as the low carb flu, when you start lowering the carbs your insulin drops. As inslin drops, you release water. Insulin retains water and that is why blood pressure drops with lowering insulin. As you flush out water, you flush out magnesium and potassium. You must supplement with 600mgs of ELEMENTAL mag and potassium each/day. This will get you thru the flu. Fruit is for fruit flys.

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