Protein - the best way to limit it to moderate limit

(Pascal Menezes) #1

Hey, I am new here but not new to Ketogenic Lifestyle. I started my journey in July 2016 and so far I lost 14 Kgs (I am into metric) from 82 Kg to 70 Kg in the first 9 months and then plateaued but gradually I am now at 68 Kg. I was pre-diabetic but my blood sugar is now very much in the normal range.

I was on Lipitor and stopped taking it when I started LCHF but I continue to take Allopurinol for gout. I have not had an attack of Gout for the past 12 years but that changed in the last two weeks and I got a severe attach and I am wondering why.

I watched a video by Meagan Ramos at Ketofest 2017 - The IDM Protocol - and learnt that people on Ketogenic diet have complained of gout flare-ups. I already know that gout is caused by purines in protein that produces uric acid which crystallizes and gets into your joint causing the pain. Meagan recommends Black Cherry but that has 15% carbs.

So now I am thinking that the attack of Gout was caused by all meat that I was eating, the bacon and pork belly and am wondering whether there is a better way to limit my meat intake, and thereby my protein intake, without having to measure every time I eat.

Thanks
Pascal

(VLC.MD) #2

What are your macros ?

(Pascal Menezes) #3

I don’t measure anymore but I believe by experience I follow the 80, 15, 5 formula.

Thanks

Pascal

(Ernest) #4

You might need to track your protein for a week. Collect Some data and take it from there.
Without knowing how much you’re actually taking, it would be hard to adjust/ help.

#5

About 2 months ago I had an attack of something that may or may not have been gout. At first I thought it was my new sandals. I have never been diagnosed with gout but kidney stones run in my family (uric acid) I am not certain it was gout and there is research that claims there is a link between carbs and gout not meat read the unplublished chapter of Gary Taubes book. There is something about people getting flare ups when they are new to LC, I forget why exactly but you say you have been doing this for a year.

What helped was taking tart cherry pills, celery pills and some other stuff I found online in pill form so no worries about carbs but I was trying to avoid going to a conventional doctor. Based on advice I got here I stopped eating anything with Fructose, which was berries. What finally did the trick was drinking apple cider vinegar diluted in some water a couple of times a day. I was already starting to feel better but this made me feel better the next day

#6

I looked at what else I took, it was grape seed extract and Querticin. I would try the ACV first, that really seem to help

(Pascal Menezes) #7

Thanks Ernest. I am on Keto for the past 15 months and I have been consistent with what I have been eating so I don’t understand why I did not get the attack before this time.

(Mark) #8

Yes, you’ll need to track your Protein for sure… Most adult males require 50 grams/day
or less. Dr. Ron Rosedale recommends .75 grams protein per KG LBM per day for most folks. :slight_smile:

#9

Have you been monitoring your uric acid? I think anyone who has ever had gout or uric acid kidney stones should have their level tested before beginning to low-carb, and then periodically, every few weeks at first, then maybe every couple of months, to see how they respond. I think getting the uric acid level under control BEFORE starting keto is extremely important in such individuals because it’s much easier to prevent gout or stones than to cure them once they begin.

It is my understanding that ketones compete with uric acid for excretion. I personally think that the gout flares that some people experience when low-carbing have little, if anything, to do with meat consumption; it’s the ketones. My husband had a horrendous gout flare a couple of months into keto, and it was very difficult to get on top of (prednisone was the key to stabilizing him long enough to increase his allopurinol dose). For a while during this, he was in such excruciating pain that he became bedridden and hardly ate at all. Not eating definitely made the gout dramatically worse.

Even now, seven months into keto, his uric acid level is still too high. His gout flare resolved a couple months ago, but we’ve just upped his allopurinol again, and even if he doesn’t have another flare, we’ll keep raising his dosage until his uric acid is below 6.

It’s possible that he might be able to back off the allopurinol someday, but I’m not counting on it.

My uric acid level is also too high, but I get stones instead of gout. And I don’t eat a lot of meat. I try to keep my protein low (40-50 grams), and hardly any of that is from red meat. So I feel confident that protein/meat is not the problem for us.

(Pascal Menezes) #10

I do ACV once in the morning. You think I should do it 2 or 3 times a day?

(Pascal Menezes) #11

I have been taking Allopurinol for several years now. In the past 12 years this is the first flare up and more than 15 months after I started with Low Carb.

It is interesting to know that Ketones compete with Uric Acid - never knew that before. I will research more but in the mean time if you can send me some links that I can follow. Also interesting is that Gout has nothing to do with protein/meat and all the time I am wondering if the flare up was because of consuming meats, eggs and cheese all quite rich in protein.

A member of the forum Saphire thinks Apple Cider Vinegar helped his/her reduce the pain.

Thanks

#12

We’ll, I wouldn’t go so far as to say that there is NO correlation, but there is a growing awareness and very slow and begrudging shift in the medical community away from saying that dietary purines are the primary cause of elevated uric acid.

I’m sorry, I read so much in trying to address my husband’s gout that I have no idea where I read these things, but it was in more than one place.

#13

I rarely take ACV. When I used it for what may have been gout I think I was doing it two three times a day. Since then I haven’t used it even once. Make sure it does not upset your stomach or aggravate gerd

(VLC.MD) #14

Try 300mg daily vs 200mg ?

Did you stop the allopurinol when you got the attack ?

Have some emergency colchicine 0.6mg tabs on hand in case !

(Pascal Menezes) #15

I have been taking 100 mg all along, for the last 12 years, and during the recent attack. For the past 3 days I don’t have any pain and so I am not limping anymore. Is colchicine 0.6 mg for quick relief?

You know, I was hoping to reverse Gout with Ketogenic lifestyle and stop having to take Allopurinol. But that may not happen.

(Doug) #16

Hi Pascal. I’ve had gout for 17 years. There does not always seem be identifiable cause-and-effect for me, i.e. “I don’t know why I’m having a gout attack…” (Or not having one.)

I started with 100mg Allopurinol once a day, and that worked well, took care of most of the pain. My doctor said my uric acid was still high, so he increased the dose to 300mg. That works very well for me, almost never any pain, and no side effects. I don’t take it when fasting, and I don’t always take it anyway - just forget to. There are times when I take it that it seems like an attack may be coming on, but usually does not get very bad. There are times when I don’t take it and no problems.

I have not had any problems with a keto diet. For me, it’s avoiding large amounts of alcohol while eating the foods that contain purines that is the key. There may be doubt about what extent purines are the cause of gout attacks, but a lot of booze and a huge steak is the most frequent time when I can feel a big toe start to hurt in the next couple days.

(Pascal Menezes) #17

Hey Doug,
As I said, I did not get an attack for more than 12 years now. So the recent attach was not expected as I did not do any thing extraordinary. My Alcohol consumption is only during weekends and only in moderation, at home, never at bars. So before I got this attack it was business as usual and therefore "I don’t know why I got the gout attack…”

(Doug) #18

Pork is fairly high in purines, Pascal, if one is concerned about them. Perhaps try less pork and something else - dairy products, eggs, poultry, tuna and salmon?

(Pascal Menezes) #19

There goes my bacon! ha ha ha! Thanks Doug.

(VLC.MD) #20

I’d take 300mg of allopurinol before I’d quit bacon. YMMV.