8

votes

The Connection Between Paleo and Gout

Answered on January 24, 2018
Created February 26, 2010 at 9:13 AM

Could someone please explain to me how the paleo diet can benefit someone who's suffering from gout? I understand that gout is one of the illnesses that fall under syndrome x, and that paleo can eliminate almost all of those illnesses, but how?

Does paleo inhibit or alter the production of uric acid?

Thank you in advance.

Medium avatar

(10601)

on September 25, 2013
at 03:07 PM

@Matt: of course metabolic syndrome is at the bottom of it. This is mainly a result of overeating and being sedentary, not fructose. Dogma about eating red meat and fat is not a helpful course of treatment for gout.

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on September 25, 2013
at 03:07 AM

They get results by reversing metabolic syndrome which is the underlying condition behind gout symptoms.

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on September 25, 2013
at 03:02 AM

Gout is a symptom of an underlying metabolic disorder. Simply avoiding attacks doesn't address the dysfunction.

D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on September 25, 2013
at 02:52 AM

By the way, I agree 100% with your baking soda therapy. It works. I know people who even became gout-free. You can come out of gout 4-5x faster than drinking just plain water. Go to the site icuredmygout.org. What he tells is absolutely true. Because I've seen it work. Sounds too good to be true, I know. And I can't explain it. Chris Kresser pooh-poohed it but he doesn't know that it works in gout sufferers. There is something to this alkaline-acid thing. When your pH is alkaline, it's very hard get gout.

D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on September 25, 2013
at 02:06 AM

The best solution is a high carb Paleo diet. Short-term causes are uric acid volatility from eating purine-rich meats, alcohol, stress, hypothermia, acidity, etc. Your refuge is rice, tubers and dairy; once under attack, that's what you're left with. But the long-term triggers of gout are being weight, excess fructose consumption, and hyperuricemia.

D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on September 25, 2013
at 02:01 AM

Actually the Kitavans suffer from gout disproportionately. If there was a group that is gout-prone, it would be Polynesians. But after being on a Western diet. But this doesn't have to do with high fructose consumption; they're actually high glucose consumers (i.e., sweet potatoes). Yes, they eat fruit. But it's hard to overeat fruits in their natural states, unless you juice it. They're 70%+ carbohounds burning clean glucose (not fructose) from their tubers. So how are they getting excess fructose into their system that sparks gout?

Medium avatar

(10601)

on September 25, 2013
at 01:51 AM

This is an old thread, which exemplifies Atkins paleo-tard thinking at its worst.

Medium avatar

(10601)

on September 25, 2013
at 01:49 AM

This thread is like the "worst of paleo". People eating fatty meat diets with gout might get some minimal benefit from reducing their fructose consumption. But because they need all that red meat and fat to stay in ketosis, they use fructose avoidance as a way to avoid dealing with what would help the most. Stupid self-justification that denies the obvious.

http://www.ncbi.nlm.nih.gov/pubmed/16462528

Medium avatar

(10601)

on September 25, 2013
at 01:40 AM

Thank you for some common sense on this issue. Fructose is offensive to Atkins acolytes who use it as a smokescreen for the best treatment: avoiding fatty red meat.

Medium avatar

(10601)

on September 25, 2013
at 01:37 AM

Total crapola is Taubes trademark. Read his recommendations, do the exact opposite, and watch your heal improve.

Medium avatar

(10601)

on September 25, 2013
at 01:36 AM

This is hocus pocus bro science. Fructose is NOT the cause of gout.

http://www.ncbi.nlm.nih.gov/pubmed/16462528

If you have gout you need to avoid eating all that meat and butter. Paleo is not synonymous with Atkins.

7fc82eebafd44badc73c520f44660150

(3275)

on July 29, 2013
at 03:01 AM

So what protein sources do you eat?

Medium avatar

(39821)

on September 25, 2011
at 08:01 PM

Do you eat anything like nutritional yeast or drink beer? Both of them raise uric acid. Your liver should be able to tolerate fresh fruit, so my guess would be that there is something else in your diet that is raising uric acid and that the fruit is pushing it over the edge. Vitamin C intake increases uric acid excretion, due to their overlapping antioxidant roles, but I'm not sure if that would necessarily help here. In short, the liver is a robust organ that regenerates rapidly when given the chance, so I doubt that you wouldn't be able to return to fruit after a uric acid washout period.

B0fe7b5a9a197cd293978150cbd9055f

(8938)

on September 25, 2011
at 03:59 PM

I had a huge foot when I ate a lot of candy and mostly vegetarian - vegan. If only I would have read this back then, I wouldn't have lost 6 months realizing vegetarianism was destroying me slowly.

A64ed062eb5e2c3407122fcf16c5de6b

(715)

on August 17, 2011
at 07:10 AM

That's also the reasoning put forward in the paper mentioned in http://paleohacks.com/questions/57537/could-this-be-the-simple-explanation-for-a-fructose-leptin-connection

Cff2d3529608e11978967208b0cfaedf

(0)

on October 14, 2010
at 04:12 PM

from http://www.nejm.org/doi/full/10.1056/NEJMoa035700: (which is the first hit on http://scholar.google.com/scholar?hl=en&q=HK+Choi+gout) Conclusions Higher levels of meat and seafood consumption are associated with an increased risk of gout, whereas a higher level of consumption of dairy products is associated with a decreased risk. Moderate intake of purine-rich vegetables or protein is not associated with an increased risk of gout. I thought others reading this might find that study interesting.

6426d61a13689f8f651164b10f121d64

(11478)

on February 27, 2010
at 01:10 AM

Maybe fructose is addictive because our ancestors needed to fatten themselves up in the late summer and fall to prepare for winter, and they did it by consuming seasonal fruit. Nowadays we have the option of dispensing with fruit consumption altogether, or perhaps we should mimic temperate zone paleoman's seasonal consumption pattern, and just skip fruit for 9 months of the year. Maybe it takes 9 months to recover from 3 months of fructose consumption.

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12 Answers

13
E11b5316aba45546e6950f213bf983fa

(350)

on February 26, 2010
at 04:53 PM

I think there are two issues here: what causes gout and what to do once you have it.

It is pretty clear that fructose is the major villain, as Peter at Hyperlipid and Taubes so amply demonstrate. Some extensive research on gout has been done by HK Choi.

However, neither of them speak to the problem of treating gout. Obviously, eliminating fructose is the first step, but elevated uric acid levels have a tendency to stick around even after reducing or eliminating fructose from your diet.

A potential problem with a paleo approach is that, according to Lyle McDonald in his Ketogenic Diet book, ketones compete with uric acid for elimination through the kidneys. So, if one is eating a VLC paleo diet, ketones in the urine could mean less uric acid elimination.

I had my first gout attack in April 2009; my uric acid levels were 7.8 mg/dL. I was eating paleo at the time, and fairly LC (less than 75g/day); I think the attack was triggered by exercise (I had just started some HIIT).

I continued to eat LC, and went VLC (20 g or less per day) for about two months before my test in November 2009. The result: uric acid level of 9.6 mg/dL! To be fair, uric acid levels are supposed to be lower after an attack, but I didn't expect that kind of jump.

One issue that is pertinent here is the acid/alkaline issue. A lot of it is new agey, vegetarianism hokus pokus, but some of it isn't. Uric acid is a weak acid, and more soluble in a alkaline environment, making it easier for elimination.

I read about this study on PubMed, and started taking sodium bicarbonate in water, once in the morning and once at night (1/2 tsp each dose). I also made my own magnesium bicarbonate water (recipe here) to limit sodium intake and increase magnesium. I did this for about a month before my last test.

Results: uric acid levels have come down to 8.2, not quite as low as after my first attack, but definitely headed in the right direction.

Long story short: if you have gout, eat paleo and monitor (and adjust) urine pH.

Dave

Cff2d3529608e11978967208b0cfaedf

(0)

on October 14, 2010
at 04:12 PM

from http://www.nejm.org/doi/full/10.1056/NEJMoa035700: (which is the first hit on http://scholar.google.com/scholar?hl=en&q=HK+Choi+gout) Conclusions Higher levels of meat and seafood consumption are associated with an increased risk of gout, whereas a higher level of consumption of dairy products is associated with a decreased risk. Moderate intake of purine-rich vegetables or protein is not associated with an increased risk of gout. I thought others reading this might find that study interesting.

Medium avatar

(10601)

on September 25, 2013
at 01:36 AM

This is hocus pocus bro science. Fructose is NOT the cause of gout.

http://www.ncbi.nlm.nih.gov/pubmed/16462528

If you have gout you need to avoid eating all that meat and butter. Paleo is not synonymous with Atkins.

10
33974ac55e5240bcc34a067a5644726c

(260)

on February 26, 2010
at 11:55 AM

Maybe you should check Gary Taubes's take on gout. To sum it up in one sentence: gout is caused by sugar.

Medium avatar

(10601)

on September 25, 2013
at 01:37 AM

Total crapola is Taubes trademark. Read his recommendations, do the exact opposite, and watch your heal improve.

8
F0978a2a1c37d2a3d4ec6344c0c4ff82

on February 26, 2010
at 12:06 PM

Petro Dobromylskyj or "Peter from Hyperlipid" as he is generally known has a written a thorough explanation of how fructose drives uric acid production by depriving the body of phosphate needed to make ATP, ultimately leading to gout. A paleo diet limits fructose to sane quantities by eliminating all the High Fructose Corn Syrup (HFCS) and sugar used to sweeten everything in the SAD. I suspect it also makes phosphate more available for the production of ATP through other means (mitochondrial rehabilitation, Vitamin D3 normalization, perhaps) but that is just my speculation.

2
539c9cb1946032ca4cc95e6d26e2c96d

on July 09, 2013
at 08:21 AM

although I dont doubt that fructose and HFCS are bad for you, we dont have HFCS here in England, the cause of gout is usually high purine level from food which causes uric acid levels to rise and create needle like crystals to form in the joints, the best cure for it is to eat about 10 cherries a day or any food with cherry extract in it and drink plenty of water to keep the body flushed out I have had gout for over 20 years and I am a woman which is a mystery to the doctors as to why I have gout lol but also cut all alcohol expecially beer and brewers and bakers yeast as found in marmite/vegemite. Red meat and pork are definitely a no no as well as shell fish and fish, legumes and pulses too. I have stuck to this diet and I very rarely get an attack now. xx

7fc82eebafd44badc73c520f44660150

(3275)

on July 29, 2013
at 03:01 AM

So what protein sources do you eat?

Medium avatar

(10601)

on September 25, 2013
at 01:40 AM

Thank you for some common sense on this issue. Fructose is offensive to Atkins acolytes who use it as a smokescreen for the best treatment: avoiding fatty red meat.

2
58a55f0986b8f49a8bc5666e10492569

on February 27, 2010
at 12:18 AM

Richard J. Johnson MD (chief of nephrology, hypertension, and transplantation at University of FL in Gainesville; former chief of nephrology and director of renal transplantation at Baylor College of Medicine in Houston) has been studying - and proving - the fructose-uric acid connection for much of his more than 25 year career, mostly in the areas of hypertension and kidney disease. I'm now reading his book "The Sugar Fix." He's not Paleo - by a long shot - but amply proves his case against fructose.

Fructose, as we're now learning, is really just incredibly toxic - magnitudes more harmful than starch, which is glucose. High blood pressure, gout, coronary artery disease, obesity, diabetes, metabolic syndrome, fatty liver disease, etc. etc. It even wrecks insulin sensitivity for all other carbs and sugars and shuts down satiety signals to your brain. When you eat fructose, it doesn't satisfy and you uncontrollably want to eat more and more.

Whether the fructose comes from high-fructose corn sryup, fruit, or the small amount of sucrose in the dark chocolate I sometimes enjoy makes little difference. I'm taking a hard look at how much fruit and berries I've been eating, thinking that they were Paleo because they weren't grains or legumes. An apple has almost 16 times as much fructose as a Russet potato, for crying out loud! Even a cup of blueberries has over twelve times as much. Yikes.

6426d61a13689f8f651164b10f121d64

(11478)

on February 27, 2010
at 01:10 AM

Maybe fructose is addictive because our ancestors needed to fatten themselves up in the late summer and fall to prepare for winter, and they did it by consuming seasonal fruit. Nowadays we have the option of dispensing with fruit consumption altogether, or perhaps we should mimic temperate zone paleoman's seasonal consumption pattern, and just skip fruit for 9 months of the year. Maybe it takes 9 months to recover from 3 months of fructose consumption.

A64ed062eb5e2c3407122fcf16c5de6b

(715)

on August 17, 2011
at 07:10 AM

That's also the reasoning put forward in the paper mentioned in http://paleohacks.com/questions/57537/could-this-be-the-simple-explanation-for-a-fructose-leptin-connection

2
52cae90a114ca8f0404948e2b7ccb7ef

(1595)

on February 26, 2010
at 12:24 PM

And protein metabolism increases the excretion of uric acid from the kidneys, while fructose doesn't.

1
84253a62206f981f40bde20dd2f8d27c

(10)

on September 25, 2011
at 03:36 PM

Fascinating thread. Like others I've noticed fuctose in the form of fresh fruit agrivates my symptoms (high bp, joint aches) and I'm wondering if it's because my liver is clogged or damaged from previous years of HFCS consumption. I have to stay under 10 grams to avoid pain. I also have other indications of decreased liver function. I use the chart 1/2 way down on this page: http://articles.mercola.com/sites/articles/archive/2010/07/22/high-fructose-diet-contributes-to-high-blood-pressure.aspx

Maybe fresh fruit/fructose in larger doses would be fine if it not for residual liver damage. If memory serves right the study (Univ of MD?) that did the big study on 2 sets of rats with identical diets and environments -1 on sucrose the 2nd of HFCS only ran for 6 months. And in that 6 months the HFCS rats showed significant liver scarring and damage. What about in humans who've been eating it (unknowingly in many cases) for decades? What kind of livers damage do we have? If I'm not mistaken fructose has to go through the liver to be processed. Maybe the sensitivity we're seeing with fruit fructose is for those whose livers are still healing.

Medium avatar

(39821)

on September 25, 2011
at 08:01 PM

Do you eat anything like nutritional yeast or drink beer? Both of them raise uric acid. Your liver should be able to tolerate fresh fruit, so my guess would be that there is something else in your diet that is raising uric acid and that the fruit is pushing it over the edge. Vitamin C intake increases uric acid excretion, due to their overlapping antioxidant roles, but I'm not sure if that would necessarily help here. In short, the liver is a robust organ that regenerates rapidly when given the chance, so I doubt that you wouldn't be able to return to fruit after a uric acid washout period.

0
571ba7d50ff5c43166eb5b7827db1a2a

on January 24, 2018
at 06:04 PM

Have you considered using a uric acid meter to keep track of how diet changes can affect the uric acid level in your blood?

0
7fc82eebafd44badc73c520f44660150

on May 23, 2017
at 07:08 PM

Thanks for posting the link to:  https://sites.google.com/site/icuredmygout/  

 

It was most informative.  I'm going to try the baking soda mentioned.

 

-Mike

 

0
D0d278f2488738505ac90fe867836703

on September 26, 2013
at 04:30 PM

I have been a gout sufferer for the past 10 years. 6 weeks ago I started the Paleo diet, and have had amazing results. Here is my blog post on the matter:

http://www.paleogaga.com/paleo-diet-and-riddance-of-joint-inflamation-gout/

0
56c28e3654d4dd8a8abdb2c1f525202e

(1822)

on September 25, 2013
at 01:29 AM

Some of the statements here about fructose are amazing. Surely the Hadza or the inhabitants of Kitava, who eat fruits in great amounts, all suffer from gout. The longest living people in the world, the Okinawans, likewise eat fruits in great amounts. I myself eat six apples a day, plus some other fruits every day, six months a year and watermelon and other fruits the rest of the year. My father in law eats about six apples a day and is very active at 80. Yes, my pressure is quite low. Perhaps all of you meant "refined sugars" ?

Medium avatar

(10601)

on September 25, 2013
at 01:49 AM

This thread is like the "worst of paleo". People eating fatty meat diets with gout might get some minimal benefit from reducing their fructose consumption. But because they need all that red meat and fat to stay in ketosis, they use fructose avoidance as a way to avoid dealing with what would help the most. Stupid self-justification that denies the obvious.

http://www.ncbi.nlm.nih.gov/pubmed/16462528

D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on September 25, 2013
at 02:01 AM

Actually the Kitavans suffer from gout disproportionately. If there was a group that is gout-prone, it would be Polynesians. But after being on a Western diet. But this doesn't have to do with high fructose consumption; they're actually high glucose consumers (i.e., sweet potatoes). Yes, they eat fruit. But it's hard to overeat fruits in their natural states, unless you juice it. They're 70%+ carbohounds burning clean glucose (not fructose) from their tubers. So how are they getting excess fructose into their system that sparks gout?

0
E9c62817e065a50b4054d8db62ff7900

on September 24, 2013
at 09:03 PM

All you need to do to beat gout is in here: http://goutandyou.com/ Make sure to eat 80% carbs (frutis, vegetables and grains) 10% protein in lean meats and scale fish and 10% fat in dairy products, why? Because carbs burn clean and don't need that much work from the kidneys to break it down, so less uric acid is produced. Obviously, eating cherries, taking vitamin C, turmeric, alfalfa, drinking coffee and green tea are very popular ways in beating gout. Also make sure to limit alcohol and sugar especially HFCS (high fructose corn syrup), furthermore adding baking soda and apple cider vinegar in a glass of water is a very popular home remedy in relieving the gout sufferer of a gout attack and/or to lower uric acid levels in their body.

Medium avatar

(10601)

on September 25, 2013
at 01:51 AM

This is an old thread, which exemplifies Atkins paleo-tard thinking at its worst.

D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on September 25, 2013
at 02:52 AM

By the way, I agree 100% with your baking soda therapy. It works. I know people who even became gout-free. You can come out of gout 4-5x faster than drinking just plain water. Go to the site icuredmygout.org. What he tells is absolutely true. Because I've seen it work. Sounds too good to be true, I know. And I can't explain it. Chris Kresser pooh-poohed it but he doesn't know that it works in gout sufferers. There is something to this alkaline-acid thing. When your pH is alkaline, it's very hard get gout.

D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on September 25, 2013
at 02:06 AM

The best solution is a high carb Paleo diet. Short-term causes are uric acid volatility from eating purine-rich meats, alcohol, stress, hypothermia, acidity, etc. Your refuge is rice, tubers and dairy; once under attack, that's what you're left with. But the long-term triggers of gout are being weight, excess fructose consumption, and hyperuricemia.

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