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Gout by Adam Shand

Gout is a form of arthritis caused when the uric acid in your blood crystallises. The needle shaped crystals get stuck in soft tissue where they cause intense pain. A gout flare usually effects a single joint, most often the big toe.

Your doctor will tell you that gout is caused by having too much uric acid (hyperuricemia), which is caused by eating a diet high in purines (eg. red meat). The low carb community will tell you that gout is caused by consuming too much fructose or alcohol. Purines break down into uric acid, and fructose and alcohol make it harder for your kidneys to excrete uric acid. Both of these increase uric acid levels in your blood.

Pete Delannoy clarifies that it's not high uric acid levels that cause gout, but rather sudden changes (either up or down). This is why people who start taking medication to reduce uric acid levels often have gout attacks.  This happened to me when I started taking quercetin. When you start (or stop) medications which affect uric acid levels, it is important to slowly increase/decrease dosages.

Similar to fructose and alcohol, excess ketones also make it harder for your kidneys to excrete uric acid. When you start a ketogenic diet (eg. carnivore) your body is inefficient at producing and consuming ketones. This can result in having more ketones than your body can use. While your kidneys are busy excreting the excess ketones, uric acid is not being excreted and the amount of uric acid in your blood increases.

This is why starting a ketogenic diet (or fasting, which is also ketogenic) can cause gout attacks.

Most carnivores report that their gout goes away and never comes back. Some have a couple flares in the beginning in then it goes away. And a few unfortunate souls (like me) have persistent problems.

Preventing Gout

If carnivore has not magically fixed your gout, there are well studied, reasonably safe pharmaceuticals for lowering uric acid levels (eg. allopurinol). There are also supplements which are effective at reducing uric acid (eg. quercetin). They work by either decreasing the amount of uric acid your body produces or increasing the rate you excrete uric acid.

Treating Gout Attacks

I used to react poorly to most medications and was reluctant to use pharmaceuticals unless absolutely necessary. 

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