Gout and keto
There’s loads more to it than simply blaming red meat or whatever is this weeks uric acid demon food. Some people with high uric acid never experience gout, whilst others with low levels get it often – and vice versa, it’s all about CLEARANCE and avoiding the feedback loop. Simply put – swapping out pig for fish won’t fix the clearance issue, it may reduce the build-up ever so slightly, but I seriously doubt it.
Short version for ketards is ketones compete with uric acid for flushing, so that period where you are just acclimatising is when it’s most likely. Once you are using your ketones effectively the uric clearance thing isn’t an issue.
The worst thing someone susceptible to gout can do is go back and forth from carby to keto and never fully adapt – this is gout limbo, and I’m guessing a good way to develop kidney stones in the long term.
As it stands I consider it a catalyst feature – as in whatever susceptibility I have toward joint issues lays dormant until something ELSE happens. One catalyst that semi-correlates is food, each of the last few times I’ve experienced pain it’s been within a day or two of Thai food – but a confounder is that each time I also drank a bunch of beer too. Another is 12+ hours on a chair when I’m in research and writing mode that promotes poor circulation, so probably inducing some kind of mild thrombosis which is enough to start a cascade of events that end up in inflammation of a joint/nerve. And each time seems to be within days where I’ve experienced a twisting/whatever of an ankle/knee too for some reason.
It’s a reflective problem which gets itself into a feedback loop. I’ve researched far and beyond the whole “it’s cos you eat red meat and wine brah” thing from years ago, it’s nothing to do with that. What happens is the uric acid is ALWAYS cycling in and out, but ONE thing can tip the delicate balance – for instance hypoxia induced possibly by sleep apnea, or an acute inability of the kidneys to be able to flush out uric acid and other antioxidants effectively (even for a few minutes).
So then in a suddenly acidic environment these urea effectively deposit on gelatinous stuff (in joints) and form crystals (think of liquid sugar crystallising into glassy structures, much the same), this calls forth white blood cells to attack and fix, the crystals basically pop the cells which releases their amino acids (proteins), this calls more white blood cells and inflammation begins, the area becomes more acidic from the proteins etc which then goes back to allowing more urea to deposit and crystallise – cycle begins again, repeat until joints are ridiculously filled with broken-glass-like crystals and inflammation.
Now, is that caused by the day-to-day eating of red meat and wine and shrimp etc? Nope. It’s the catalyst – SOMETHING that causes a very short moment where the stars align and a feedback loop of inflammation is formed. What can be done about it? Drugs and therapy to lower serum levels of whatever is to blame is useless EXCEPT when an attack begins, problem is you never know when an attack begins, you only know when it’s already in full swing.
Sorry, it’s a really complex issue and you can’t extract one element out as a singular cause.
There are a ton more resources here:
– http://highsteaks.com/forum/health-nutrition-and-science/uric-acid-gout-and-kidney-stones-111.0.html
TL;DR – it could be the transient keto-adaptation, but it’s highly unlikely to be caused by the specific foods directly
Link: http://www.reddit.com/r/keto/comments/2ao8h1/keto_gout_and_pescatarian_keto/cix4fnr
