Gout

gout
#21

He does 18/6 or better most days. He’s done some 24-fasts, too, and he went a few days hardly eating anything because he was in so much pain, he didn’t want to have to use the toilet. We noticed that when his protein/overall food intake is very low, it actually seems to make his gout worse.

I’ve been speculating that muscle loss might be at fault from breaking down his own bodily protein. It’s a somewhat fine line. He feels better if he doesn’t overeat, but he also seems to feel better if he doesn’t eat too little, either.

(Doug) #22

@Koda Koda, I don’t mean to pry, but I’m wondering about your husband’s dosage of allopurinol. I started with 100 milligrams, once daily. That eliminated my gout attacks, except when I really went crazy, like having 4 to 12 beers and then a massive steak. My doctor looked at my blood tests and increased it to 300 mg once daily, though I didn’t request a change.

Haven’t had any attacks on the higher dosage, and no side effects either. A ketogenic diet does change things, and if the body lessens the excretion of uric acid then gout attacks make sense. Whether it’s after a week, six weeks, or months as in your husband’s case, I feel for him - you said that even opioids didn’t help his pain, so that’s a serious deal.

UrateCrystals

A common shape for urate crystals in the body are spear-shaped things, and you talk about something that can cause pain in a joint!

On a diet ‘higher in carbohydrates,’ I’ve never seen that advocated before. I know that for some people, sugar definitely makes gout attacks worse, and there are often mentions of avoiding refined carbohydrates - sugar, white flour, pasta, etc.

There was a study of people fasting during Ramadan - blood levels of uric acid went up during the fast, but not significantly. https://www.ncbi.nlm.nih.gov/pubmed/25275760

If your husband is doing well now, then good. I was going to say that since it’s been months. might as well go with an increased dose of allopurinol, if the attack was still going on. Yes, might temporarily make an attack worse, but it might make it go away, too, whether immediately or after some very short-term increase.

(jay) #23

Sorry, i wish i knew more, both my Uncle and Cousin had horrible attacks of gout so your husbands plight hit home with me. In both their cases, they were able to midigate attacks by eliminating organ meats, though they are not on and likely never will practice keto. I’m not sure about your hypothesis of muscle breakdown since keto seems to be very conservative of body muscle but unfortunatly I don’t have anything better to offer at this time. I will however keep my radar up and share if I see anything research wise that might be relevant .

#24

He started at 100mg, but he immediately had a gout flare, so his doctor said to stay at that dose until it resolved. When it never did, eventually his doctor said to just discontinue it. Like I said, I think the doctor has no idea what he’s doing. My husband wanted to push through, so he kept taking it. As soon as he was without symptoms for a few days (I think the standard protocol is to wait six weeks before starting allopurinol), I increased him to 150, and then after a week to 200. So far, he hasn’t had a major increase in pain. I’m shooting for 300, then we’ll see what his uric acid level is. I think the maximum dosage is something like 800mg, with 300-600 being typical.

My husband has an appointment in a month (everyone in town is booked!) with a rheumatologist (not the one who advocates more carbs), so hopefully he’ll be able to to provide more guidance, but I’m optimistic now that we’ve gotten on top of this ourselves.

#25

Yes, that was my understanding, too. And Jason Fung says that fasting is muscle sparing, but low-calorie is not. So I wondered if my husband got into trouble by having many days when he didn’t outright fast, but ate very little. Or maybe it’s just the nature of rapid weight loss to elevate uric acid (which many people might not even realize they have, since most people with elevated uric acid DON’T get gout or stones).

Thanks! I’ll bet that there are many people watching these gout threads, and many more will look back on them in the future, so it’s an excellent resource to have as much input as possible.

#26

I have lost about 30 lbs since mid March with another 40 or so to lose, is that rapid enough to trigger gout in someone who has never had it? My foot is feeling better but I have not worn shoes today yet and that seems to start the pain

#27

That’s a great drop (congratulations!), but it’s not too extreme, I don’t think. But I’m not aware of any studies that show that weight loss is a specific trigger, much less what rate could cause a risk. You might want to get your uric acid tested just so you know what it is.

(Doug) #28

That sounds good, Koda. I’m no kind of doctor, but just suffering along with gout attacks…can’t get behind that. There are quite a few possible side effects with Allopurinol, though I never felt any. The way I look at it, get the blood uric acid down low enough where the existing urate crystals will dissolve, ending their brutality within joints. Then at least the patient can breathe, so to speak, and longer-term concerns can be addressed.

(Tracy Ann) #29

TED.earthclinic.com & snake jc guy video “cooling the kidneys” both recommend combinations of ACV & baking soda2x/day. Totally stopped the (pseudo)gout attacks for me.

(Bunny) #30

Does a ketogenic diet increase your risk of gout? - By Dr. Stephen Phinney and the Virta Team

(Eric) #31

I’m not sure if anyone one has mentioned this, but increasing magnesium can help reduce uric acid build up and inflammation.