How to Lower Uric Acid Levels
Lowering uric acid levels is the key to finding relief for gout sufferers –but how does one lower uric acid levels in the body? Read on to find out.
The average person will have low uric acid levels in their blood. The body produces it when breaking down purines, which is a type of chemical compound found in foods and drinks.
When uric acid builds up in the bloodstream, it consists of a condition called hyperuricemia. If you have hyperuricemia, you are at a higher risk to develop gout. This is why doctors advise gout patients to avoid high purine foods.
Aside from eating foods high in purines there are also other possible reasons why uric acid levels can get too high:
- The body produces too much acid (mostly genetic)
- The kidneys can’t properly excrete and flush out uric acid from the bloodstream.
To measure your uric acid levels, you will undergo a blood test. A health professional will take a blood sample from a vein in your arm and measure the amount of uric acid in that sample.
Uric acid can also be measured in urine. This method helps the doctor determine whether your body is producing too much uric acid or your kidneys are not filtering enough of it.
If your uric acid level is over 6.8 mg/dL, you could have hyperuricemia. Your doctor will provide you recommendations based on your symptoms and past health.
Does having hyperuricemia mean you’ll also have gout?
Not likely. Having high uric acid levels doesn’t automatically mean that you have gout. Most people with hyperuricemia do not experience any symptoms. Medical experts have yet to understand why this is.
Even if that person has a painful joint, it doesn’t always translate to gout. To be sure, the fluids from that affected joint need to be tested first.
Asymptomatic hyperuricemia does not require medical treatment but it’s still advised to get checked by a medical professional since the condition could indicate other problems like:
- Kidney stones – Uric acid crystals can accumulate in the kidney, causing kidney stones
- Pseudogout – The symptoms are similar to gout except it’s caused by calcium phosphate crystals, not uric acid crystals
Even if you only suffer from hyperuricemia, it’s still important to be watchful of your lifestyle choices. This is a chance for you to treat your body better so do your best to make healthy decisions that will improve your condition, not worsen it.
A study published in Nephrol suggest that hospitalized patients with high serum uric acid levels have increased risks for acute kidney injury also known as AKI, non-recovery fro AKI and death compared to patients with low levels.
8 Ways To Lower Uric Acid Levels
Whether you suffer from gout, hyperuricemia, or some kidney problems that makes it hard to filter uric acid, these tips will help you to manage your condition better.
1. Maintain a healthy body weight
It’s a known fact that extra body weight is associated with high uric acid levels. Work on maintaining a healthy body weight but don’t go doing crash diets as it might only worsen your symptoms. Instead, work on losing weight gradually to reduce uric acid levels.
2. Avoid high purine foods
Today’s standard diet makes it hard to avoid purines. To avoid uric acid buildup, you need to avoid foods that are high in purines such as seafood, organ meats, processed foods, and beer. In addition, you should also avoid alcohol and saturated fats since these inhibit your body’s ability to metabolize purines properly.
Beer is the worst alcohol to drink for gout because it both contains alcohol and yeast which is high in purines. If you have gout or hyperuricemia, you should completely avoid beer or just drink in moderation, preferably with just organic beer.
3. Avoid sugar too!
Artificial sweeteners are the worst offenders of this. When you drink too much sugar, the body finds it hard to flush out the excess uric acid. Avoid food and drinks that are laced with artificial sugars. This includes all processed sweets, pastries, and sweetened drinks (coke, juice concentrate, etc.).
4. Take high fiber foods and Vitamin C
High fiber foods may help absorb uric acid from the bloodstream, making it easy for the kidneys to filter it. Fruits, vegetables, and whole grains are some of the best sources of fiber.
Vitamin C may also help with uric acid excretion. Try to consume at least 500mg of vitamin C per day, preferably from natural sources like citrus fruits, bell peppers, kale, broccoli, and guavas. Cherry juice (black or tart) is also a great addition to your diet. Though it is low in vitamin C, it has strong anti-inflammatory properties that may help fight uric acid symptoms.
5. Fight inflammation
Since we’re on the topic of anti-inflammatory foods, we might as well mention that fighting inflammation can help fight proteins that’s responsible for inflammation. To reduce uric acid concentration, add anti-inflammatory foods to your diet such as blueberries, cherries, strawberries, bromelain from pineapple and celery.
6. Always drink water
Water dilutes uric acid in the blood and stimulates the kidney to flush out excess uric acid. It’s recommended to drink at least 2 liters of water (8 glasses) every day. I recommend 12 glasses a day! Gout sufferers have to work a little harder. In addition to that, you can also drink other healthy fluids like lemon water, green tea and other herbal teas.
Not everyone has the same body type and requirement, so your hydration needs may be different from others. Some factors to consider for determining your hydration requirements include age, gender, height, weight, temperature in your area, and activity levels. You may want to speak with a health professional to get an accurate recommendation.
7. Take apple cider vinegar
Apple cider vinegar is commonly used by gout sufferers and may be able to reduce inflammation and swelling in the joints. Once it turns alkaline in the body, it may help break the uric acid crystals and may help with blood circulation and purification.
8. Follow the 80-10-10 Gout Diet
This is the best diet for gout sufferers that I follow and promote; that is to eat 80% of your daily calories as complex carbohydrates such as fresh vegetables, legumes, some fruit, 100% whole grain breads, pastas, rices and beans for protein. 10% of your daily calories can be lean meats like chicken breast, turkey, red meat and fish. Avoid pork related meats like hot dogs, sausages and cold cuts. The final 10% of your daily calories should be fat as in milk, cheese, eggs, butter, Greek yogurt and so on. Drink only water, herbal teas and coffee. Avoid sugary beverages, processed foods and sugary foods. If you follow this strict diet, you will notice not only that you will feel much better but may also help maintain healthy uric acid levels.
In Conclusion
Lowering your uric acid levels is the best solution to preventing any problems that’s related to gout. Once you already have gout, you’ll do anything just to stop the pain. So do your best to take care of yourself today.
Always monitor your uric acid levels. You want to keep it below 6.0mg/dL. If it’s gets higher than that, consider making immediate changes such as the recommendations we shared above.
What efforts are you currently taking to lower your uric acid levels? Share your thoughts in the comments.
58 replies to "Gout and Uric Acid"
Hi Spiro and to all other gout sufferers.
I am here again to report my uric acid level and new findings.
Here my test result till now:
September 17, 2017 – 7.6
November 06, 2017 – 8.2
November 20, 2017 – 7.5
December 24, 2017 – 6.5
February 01, 2018 – 5.4
March 15, 2018 – 4.1
May 07, 2018 – 4.4
June 24, 2018 – 5.1
August 14, 2018 – 4
October 22,2018 – 4.1
As you can see my UAL is good. I’m still on low purine diet and 300 mg allopurinol.
Actually I dared myself and ate some red meat and drank some Sprite. I didn’t experience an attack and my UAL is good as well. But I seriously do not suggest to anyone to dare themselves even for once. I didn’t encounter an attack but after some thinking I find it so stupid to try something you know that is not good for you in a way or another.
BUT MORE IMPORTANTLY.
This time my GP test something new in my blood.
“bilirubin”
and the result wasn’t up to my expectation. My direct bilirubin was 0.8 and upper limit is 0.4 and my indirect bilirubin was 1.8 and upper limit is 1.1 my total bilirubin was 2.6 and upper level is 1.2. My GP didn’t described why this happening and she didn’t told me if it is a serious condition or not and I won’t access to my doctor for another 2 months.
So I just want to ask what’s the problem? ( I did search a bit in internet and found out that it may mean that my liver is not working properly. I asked another general doctor to look at my test result and he prescribed an ultrasound scan for my liver and gallbladder which it’s result didn’t show any abnormality he said to me, your liver is a bit fatty but not even grade 1 and said to me to just do some daily sports)
and another thing that I must mention.
My ALT elevated from 31 to 42 an my AST is elevated from 19 to 26. So you can clearly see that the damned alcohol work it’s dark magic even after 1 year of total abstinence and I just drank 1.5 bottle of whisky in 2 months. So actually I seriously must consider avoiding alcohol totally for rest of my life and I think all other sufferers may consider it as well.
I wish you all an healthy and long life near your loved ones.
Thanks for your contribution Mamal. Your experiments say a lot. Watch that liver but do consider some milk thistle to cleanse the liver.
I’m 26yrs diagnosed with chronic gout 7 years ago. I’ve always played sports and stayed in great shape. I’m looking for a shoe or insert that would limit how much my big toe bends while walking. Every step is painful, even have to drive with my left foot on occasions because of the resistance from the brake/gas. I try to walk in a way that doesnt bend my toe so I have a constant severe limp. Is there anything out there?
Hi Hayden!
Visit a podiatrist and they can recommend a custom made insole or shoe that can help you with your problem. I know some friends who have done this and it has helped them tremendously.
Hi Spiro,
I have Uric Acid issue on on/off basis. I have been doing exercise & want to increase Muscle size & Protein is essential for that. Since I have Uric acid issue I am avoiding Protein diet, can you please advise what should I take to keep the balance of Uric Acid & still increase body size. Also Shall I do Leg exercise?
Thanks
Ankit
Hi Ankit!
Yes take vegetable protein instead, there are many new protein powders out in the market today based on vegetable protein which won’t affect your kidneys like the other stuff. You can exercise all you want but not when experiencing inflammation. Beans are another great source of vegetable based protein you can try.
[…] Uric Acid, Hyperuricemia and Gout […]
[…] Gout and Uric Acid — Experiments on Battling Gout – Hi Mama! Good to see your uric acid going down. As for the cholesterol, are you stir frying with the olive oil? if you are avoid it. I always advocate for a diet where you eat your food either baked in the oven, raw or boiled in water. […]
Hi Spiro!
As I promised before I’m going to update my UA status regularly to see how my diet plus medication works.
This is my bloot test result till now:
17 sep 2017 : 7.6
6 nov 2017 : 8.2
20 nov 2017 : 7.5
24 dec 2017 : 6.5
1 feb 2018 : 5.4
18 march 2018 : 4.1
7 may 2018 : 4.4
I’m using 300 mg allopurinol and for past 8 months didn’t drink anything but water and low fat milk. Almost 3.5 litres water daily for about 8 months I didn’t eat any seafood and not even 1 gr of red meat. Nothing fried,nothing and I just used olive oil for cooking and even use that in moderation. I almost didn’t eat anything with sugar. Maybe some dark chocolate. Ate vegetarian pizza now and then. Ate chicken no more than 200 gr per week and not in a single time. The reason I tell you this is that my last result showed that my cholesterol is elevated and now it’s 210. It was 170 like 2 months ago and I didn’t eat any junk food or fried food. So I was wondering what’s happening???? Any thoughts?
Hi Mama!
Good to see your uric acid going down. As for the cholesterol, are you stir frying with the olive oil? if you are avoid it. I always advocate for a diet where you eat your food either baked in the oven, raw or boiled in water. You can add olive oil with both ways but do not fry not even stir fry. Any processed foods? Like pre-cooked.
Hello Spiro,
I thought I had gout for the past 2&1/2 months. My first attack was Jan 14, 2018 with numerous stabbing pain episodes all day long. I went to urgent care in the late afternoon & was given Indocin & after a 3 doses the pain went away. The pain went from the base of my toe radiating to top of my foot.
I found your site, signed up & am reading your book on Kindle. I went on a strict gout diet, did ACV twice a day, lemon juice every other day, alkaline water 1-1&1/2 gallon a day. I continue to have severe attacks off & on these past few months. Sometimes a week goes by & nothing & then I get a few attacks a day. Then it skips a few days then comes back, etc…
My toe & foot never swelled or turned red.
March 29 I had my uric acid test & it is 3.2. All kidney, liver glucose levels are normal. I still got a few attacks after March 29. I am now wondering with a UA level so low, could it really drop to this low in 2 1/2 months?
What do you think about my low level & still having a attacks? Have you heard of this? Is there another diagnosis it could be?
I would greatly appreciate your Highly experienced & intelligent opinion on my situation.
Thank You for doing this Awesome Blog!
Warmly,
Sonia
Hi Sonia!
We usually hear that when somebody starts allopurinol and the process of lowering uric acid begins. This clearing of uric acid may take some time to occur and can be associated with new attacks of gout while the clear out is happening. This can occur for up to 3 months.
Now for you, perhaps all that you are doing as natural remedies can be causing the same effect. I am not sure.
Thank you Spiro for your quick response. I greatly appreciate it.
Yes that could be it. I will continue on my gout diet because it makes me feel so alive & good. Thanks for researching all these topics & sharing with all of us.
My gout attack lasting already 32-33 days. First I took arkokisa 5-6 days (45 ml, 60 ml, 90 ml, 120 ml) it helped me just temporarily. I’m taking 2.5-3 liters water. Don’t eat food triggering gout . Help me what to do
Hi Arman!
You have to go see your doctor and get medication to remove the inflammation and blood test to see how high your uric acid level is at. 33 days is way too long!
Hi Spiro!
I’m a 42 year old male. I take 5mg of Novasc for HBP and a Zantac 300 for acid reflux daily. Also recently diagnosed with moderate sleep apnea.
I’ve battled gout for about 7 years. (Generally between 1-2 gout attacks per year on average.) I usually ate what I wanted except for when I had an attack, would drink tart cherry juice, Motrin for pain and wait it out. Some attacks would be excruciating, always in the feet centered around one of the big toes, but then in other areas in feet as well. Swollen,red, unbearable at times.
In December 17 I had a bad attack following about a month of the Atkins diet that I was on. (Very stupid looking back). Went to doctor and realized it’s time for a lifestyle change.
I’ve been overweight for many years gradually adding about 5 lbs a year for the last 20! (Mostly through eating out and too much.) In December 2017, I weighed 273 lbs and since then I’ve lost 45 lbs breaking into the 220’s. My eating habits include mostly organic foods, daily juicing, almost no meats except for chicken which I’ve recently heard also has a high purine count. Stopped drinking coffee, no fructose or sugars outside of fruit etc.. My daily caloric intake has dropped substantially and the only thing I drink other than fresh juicing, is a lot of water.
I have had what feels like mild gout in my toe or side of foot after walking sometimes, (if I were to count since January I’d say 3-4 times this happened, it is very discouraging as with the weight loss, I’m trying to exercise more and when gout attacks happen it’s not possible to hobble to the bathroom let alone walk a mile or 2!)
About 2 weeks ago I developed a bad attack starting in side of left big toe, foot swelled, red lump, excruciating pain etc..it’s coming out of it now I believe, (I’m walking with mild pain) but during this attack it’s affected the big toe in both feet!
With right now my attacks being more often, my diet is way better, I’m still losing weight etc.. but more frequent attacks? (My Uric acid level last checked in Feb 18 was 7.2, in December it was 8.) I saw a rheumatologist at Mayo, they said I needed to decide on starting allopurinol but once I started I can’t ever stop it.
Still weighing the decision but close to biting the bullet and just doing it even though I’m trying to avoid going on meds. With these changes, losing 45 lbs, eating better, shouldn’t this be helping my gout but it seems to be worsening it? Thanks and a great forum btw!
(Any experienced attacks similar to my situation your advice is also welcomed)
Hi Johnny!
It takes over a year for uric acid to leave your body. Also it could be that as you lose weight and uric acid crystals melt away, it triggers attacks. Especially if you are losing weight rapidly, this is considered a popular gout trigger. Your uric acid is too high! Remember dieting will take a longer time to see results compared to medication. At the end it’s your personal decision but get another opinion from a qualified rheumatologist and way your options. Maybe take more frequent blood tests to see how your diet is impacting your uric acid levels.
Good luck!
Hi Spiro!
I never stir fry anything but I do use olive oil for frying sometimes like when I make a dish of mash potatoes and chicken Breast ( frying chicken with a bit of olive oil not much). Going to try and limit that as well to see what’s going to happen.
And I have another question is soy bean safe for gout sufferers? Lately I’m starting to think about making some of my usual food ( before gout I mean) with soy ( replacing meat with soy ) but I notice soy have almost 2.5 time more protein that meat. So is it safe? ( thinking of a damn big hamburger is killing me! So I thought maybe cook a soy hamburger. Not sure about the taste as I never ate soy before 😀 )
As I almost read all of your posts, I did notice in this post (https://goutandyou.com/purines/) you mentioned tofu and some talk about soy in this post (https://goutandyou.com/gout-and-beans/) but I wasnted to ask is it safe in greater amount or not.
Thank you!
People in Asia eat tons of soy and these populations have significantly lower rates of obesity, heart disease, and breast cancer compared to people in the U.S.It’s plant based protein so it’s much different than animal based protein, the way your body breaks it down. It is always better to eat plant based protein.
Hi Spiro,
I just came across your website. All of your recommended self treatments have to do with what we eat, or don’t eat. That misses the biggest factor — sleep apnea. Sleep apnea is the frequent cessation of breathing during sleep for many seconds at a time. It is often accompanied by snoring before an abrupt breathing stoppage. The result of sleep apnea is the reduction of oxygen in the blood, which then causes the cells to produce excess uric acid, reduces the solubility of uric acid in the blood, and gradually reduces kidney function. Sleep apnea is known to have a number of life-threatening consequences if left untreated for a long time. But gout is an early warning of it, allowing for diagnosis and treatment before the really serious consequences develop. Treatments that focus only on relieving the gout are just treating the symptom of the underlying disease.
BTW, your picture shows a large neck circumference. If your collar size is larger than 17″, that’s one of the tell-tale signs of sleep apnea.
I’m facing trouble with weight, and I’m trying to gain muscle, on general diet I was asked to keep protein intake of about 160 gms everyday, but due to having high uric acid, how much should I limit my protein intake? That would be safe.
To 10% of your daily calories, so if you consume 2000 calories, then 200 calories can be protein as in lean chicken breast, turkey, lean beef, fish. That comes out to about 4 to 6 ounces of meat a day.
Is it limited to meat?? Meaning can I consume protein through non meat sources, like kidney beans, chick peas, cottage cheese etc?
Yes that is the preferred way of eating protein as outlined in my book and on this website. Instead of meat choose beans for protein which your body and kidneys digest way easier than meat.
Thanks Spiro, and may say that you provide such a wide information on gout , nobody does, very little knowledge about the condition, thanks for this site I learned a lot!
The only thing I found to lower uric acid naturally is baking soda. I had gout real bad in 1992 and couldn’t tolerate the medications and came across an article in a book called “Dr’s medical book of home remedies” I looked up gout and it said if you can’t tolerate the Gout medications baking soda is a good substitute.
I had my doctor test me and I was at 11.0 and after one month taking it 3 times a day my uric acid went down to 7.5 and after 4 months it was 6.4 and after all the gout was out of me it is now at 5.4 and I never had another gout flare up after the first year and I been taking it since 1992. I tried all the other things cherries, diet change ETC. and nothing did any good for me. I do have to stay away from high purine foods as when I eat fish once a week it rises my uric acid from 5.4 to 6.4 for a few days then it drops back down.
So if you can keep it under 7.2 it won’t crystalize PLUS Cocoa powder will dissolve the gout out of your joints the Government did a test on this and it works. It also lowers your Chrolestrol and Trigriclites I take 1 tbsp of that per day and lowerd my chrolesterol Medication from 40MG to 20 MG as when I started the Cocoa powder it caused my Cholestrol to drop to 60 and my triglicerites droped to 85 they were at 150 and 178 and I was taking 40 MG of simvastatin to lower them now I take 20MG and they are in normal range now.
Hi Spiro,
You are running a great website and many people are benefiting from it.
Recent tests revealed that my uric acid level is 7.5. Please advice what diet I may follow keeping in mind that my weight is 140 kg. (6’3″ height)
Hi Saad!
Diet is the same for all gout sufferers as outlined here on my website as well as my book.
If your required daily calories are 2000 a day or 2500 a day let’s say then eat 80% of your daily calories as complex carbs like fresh vegetables, legumes, beans, 100% whole grain breads, 100% whole gain pastas and rice.
10% of your daily calories can be protein as in lean meats like chicken breast, turkey, beef and fish.
Lastly, 10% of your daily calories can be fat as in eggs, milk, cheese, butter and yogurt.
Good luck!
Hi again spiro!
I write this comment because I’m so confused. More I search, I get more questions instead of answers.
I found out that gout is result of kidney dysfunction or weakening ability of kidney for filtering body’s waste. Correct me if I’m wrong.
The confusing part for me is this :” as gout patient isn’t it logical that my kidney tests ( certain+urea and BUN and GFR ) show some irregularity ?
My last test result was like this :
Urea 22.2 (range 15-45) BUN 10 (range 7-20.6) Creatinine 0.76 (range 0.6 – 1.5) . my GFR is 119 ( I used this site :https://www.davita.com/gfr-calculator/)
As you can see there isn’t anything out of range here and my liver tests are the same as well (ast 19 ( range 0-38) alt 32 ( range up to 41).
and my uric acid was 5.4.
My doctor only was interested about my UA level.
Is it common for all test results to be in range despite of gout?
or is it possible that gout sufferer normal range different from healthy adult!?
I’m so confused. Recently I start to think that my high level of uric acid and acute gout attack after that was a result of drinking too much alcohol that result in increasing uric acid levels for years and not gout. Is this a possibility or just make fun of myself?:D ( my doctor clearly said to me that I have gout.)
This can occur because of diet, genetic predisposition, or underexcretion of urate, the salts of uric acid. Underexcretion of uric acid by the kidney is the primary cause of hyperuricemia in about 90% of cases, while overproduction is the cause in less than 10%.
Furthermore, gout is partly genetic, contributing to about 60% of variability in uric acid level. The SLC2A9, SLC22A12, and ABCG2 genes have been found to be commonly associated with gout and variations in them can approximately double the risk. Loss-of-function mutations in SLC2A9 and SLC22A12 cause hereditary hyperuricemia by reducing urate absorption and unopposed urate secretion.
So this can potentially be your issue.
Hi again Spiro!
As I promised I’m going to update my uric acid level regularly so maybe someone find it he helpful. ( again my English is sooo bad i’m sorry :D).
I didn’t buy your book but the diet that my doctor gave me is really similar to your general guidelines so I thought it’s important to share my status to others, so they can see if it works or not.
For past 6 months I didn’t drink anything except water ( almost 3 liters a day) + tea and coffee.
I didn’t eat any red meat or sea food. The only meat I ate was chicken ( Brest and not fried ).
So basically no meat (other than chicken) no alcohol no sugar ( in any form). My diet is pasta+rice whole grain bread vegetable ( actually I ate too much tomatoes and mushrooms) Legumes ( almost too much every day). 1 apple everyday. Low fat milk and yogurt.
I was on allopurinol 100 mg for 1 month then 200 mg 1 month and 300 mg for two months now.
Finally my UA level is this :
17 sep 2017 : 7.6
6 nov 2017 : 8.2
20 nov 2017 : 7.5
24 dec 2017 : 6.5
1 feb 2018 : 5.4
18 march 2018 : 4.1
I had 1 acute attack between 17sep and 6nov 2017. And another attack ( so week it was painful but didn’t stop me from walking) betwwen 6nov and 20nov 2017. After that i didn’t encounter any attack.
I wish you and all other readers the best 🙂
That’s great Mamal!
You’re on the right track! Keep it up! Discipline is key in a gout diet.
In research and trial-and-error over the last couple of weeks after my first series of gout flares, I have discovered that it is not just purines and sugar that I need to be concerned about. I was doing several things prior to my first gout flare that were leading me to my first gout flare:
1.) I was eating way too much sugar.
2.) I was taking the wrong supplementation (creatine).
3.) I was ingesting way too much iron.
All of these have the effect of promoting a state of acidosis in the body. As my diet was already relatively low or at worst moderate in purine intake, I quickly realized that purines were not really my problem. Over the last two weeks, I discovered a correlation between eating processed cereal HEAVILY fortified with iron (Cheerios) and the onset of my gout flares (about 8 to 16 hours later). Unless you are definitely iron deficient, in addition to avoiding high purine foods during a gout flare, you should also avoid foods with high iron content. Most moderate and high purine content foods also contain a significant amount of iron. But not all high iron content foods contain lots of purines. By the time men reach 45 to 50 years of age, they have more often than not built up significant reserves of iron in their bodies and thus do not need to ingest as much iron. To keep ingesting iron at the same level that you did in your teens and 20s will more often then not tend to push you toward a state of acidosis in your body. One of the many bad potential consequences of this is gout. Women are at least protected from this until menopause. After menopause, women also need to be careful about the amount of iron intake.
To summarize, if you are a gout sufferer, also stay away from high iron content foods (except for those who have been diagnosed with an iron deficiency).
As an additional comment, I do not mean that you should avoid all iron. Just avoid the foods that give 50+% of your daily iron needs in one serving. Spread it out among foods that contain 10% or less or your daily iron needs per serving. That way, you are much less likely to intake to much iron.
Urine pH is also important. This following study shows that uric acid excretion from the kidneys is strongly dependent on urine pH:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3406944/
Adjusting the urine pH from 5 to 7 appears to increase uric acid excretion by the kidneys by at least a factor of four. This can make all of the difference in the world in reducing and controlling blood serum uric acid levels. The best way to do this is to include sufficient potassium in the diet. As long as purine intake is not at high levels, this should help minimize and perhaps even prevent future flares. From the supplement side, potassium citrate and potassium bicarbonate also do a good job at increasing urine pH. Potassium citrate (99 mg capsule) should be taken 5 minutes before eating a meal. Potassium bicarbonate (I personally use oral tri-salts) should be taken 1.5 hours after a meal so as to not interfere with digestion. I have been trying this approach over the past few days and have increased my urine pH from 5 up to over 7. It seems to be working, but the true test will be this upcoming week when I visit my doctor once more and get another blood test and also an urine test.
Charles Weber posted this link on the website four years ago:
https://www.webmedcentral.com/article_view/4217
I think the key to why this works is the effect of potassium salts (except chloride) on urine pH.
One additional thing. Do not overdo it. Keeping the urine pH above 7 for extended periods of time make you more susceptible to urinary tract infections. It is best to maintain it at 7 or just slightly under.
I just got my test results back. Uric acid levels have dropped from 8.7 to 5.7, and my urine pH tested at 7. The creatinine levels have dropped significantly indicating that my kidneys are now functioning more effectively (previously slightly high, now in the middle of the normal range). My pre-hypertension and fast heart rates are now gone (typical numbers now are 110/70 and in the middle 60s beats/minute range – used to be 135/90 and around 90 beats/minute). And this is without even having started my new exercise regiment yet. For me, the key was to significantly increase potassium intake (~4000 mg/day) and decrease sodium intake (<2000 mg/day) along with drinking 100 oz of water every day. When I start my exercise regiment, I will probably have to increase both my potassium and sodium intake by several hundred mg each to keep my electrolytes in balance. My gout appears to have been a warning about a lack of essential minerals in my diet (especially potassium but also calcium and magnesium) and too much sodium and sugar.
I am 67 years old and a life-long exerciser who loved beer and sweet red wine. I had gout for eight years. It got progressively worse and more frequent. After I got it in my ankles and I had to crawl to the bathroom and use crutches to get around I decided to take drastic action that ultimately cured me of gout. I took no medications other than over-the-counter pain killers.
I quit drinking alcohol in any form, adopted a lacto-ovo vegetarian diet and used stevia as a sugar substitute, renouncing use of honey or any other form of sugar. I also drank a cup of water with 1/2 teaspoon of baking soda every night before I went to bed. I kept this up for one year. At the end of that year I began eating fish, meat and fowl of any and all kinds, along with quantities of raw fruit and vegetables and whole grains.
My year-long diet and alcohol abstinence and use of baking soda seems to have allowed the crystals in my joints to dissolve and rendered me gout free. I have had no attacks in two years. I have no doubts that in my case it was the beer, sweet red wine and honey that brought on the gout and that meat-eating had nothing to do with it.
Thanks Andrew
Your approach worked probably because you readjusted your body chemistry through your diet. Deficiency in magnesium, calcium, and especially potassium can be a significant contributor to gout. The key is to maintain a balanced diet that keeps your urine pH around 7. About adding foods back into your diet, balance them between acid forming and alkaline forming foods within the body. Everything in moderation.
Diet is indeed primary, in my opinion Your comment, Mark, about Magnesium, Calcium and Potassium is meaningful, however it was not a problem with me because I have taken high-quality vitamin and mineral supplements for many years, to include well prior to the onset of gout in my sixtieth year of life. What works for some may not work for others, but for me it was the beer, sweet wine and honey that I consumed copiously that brought on the gout, also that I drank very little water which I drink in quantity now and have for the two years I have been gout free. I eat seafood, red meat, pork and fowl as much as I want and suffer no consequences. I have no faith in the PH theory. Recent studies demonstrate sucrose, sugar of all kinds to be the enemy and that I believe. My recent medical checkup showed all signs to be excellent. I will continue what I am doing.
The body typically has a hard time absorbing the type of mineral salts in most supplements. They may not have been doing you much good. From the description of your previous diet, it seems to have been high in both simple carbs (sugar and alcohol), animal protein, and salt and low in complex carbs and water intake (and probably low in potassium). The combination of these would tend to build uric acid levels in the body over time due to inefficient kidney function. Just like you, I went on a mostly complex carb and dairy diet (also eggs). To ensure good mineral absorption, I was mixing two tablespoons of freshly squeezed lemon juice with a 1/4 teaspoon of baking soda and a 1/4 teaspoon of tri-salts in 8 ounces of water and drinking that in the morning and evening. The chemical reaction creates citrate salts of potassium, calcium, magnesium, and sodium which are easily absorbed by the body. Replacing some sodium chloride (salt) with sodium citrate for sodium intake helps to maintain better pH balance for kidney function. Now that my test results for kidney and liver function are normal, I have started adding some meat and natural source sugars (that also contain potassium) back into my diet without any ill effects.
Very helpful advice. Thanks a lot !
Will definitely try to adhere to it !!
Hi Spiro
First of all, thank you for your website, which I have found more illuminating on the subject of gout than any other resource.
Testament to this is that I have purchased your Ultimate Gout book and tart cherry extract supplements.
I had a first gout attack in April of last year, and had two more gout attacks in the next of six months.
My condition was initially misdiagnosed because I had not been overweight, exercised regularly and had followed an almost entirely plant-based, wholegrain, low-oil diet for more than 5 years. I never ate meat but occasionally ate fish including shell fish, but not in great quantities and I consumed no sugary drinks and consumed very little sugar. There was no known suggestion of gout in my own medical history or that of my family. A couple of weeks, before my first attack my uric acid was measured at 5.5 and a couple of weeks after it, my uric acid levels was 5.9. I have no reason to think that my uric acid level had been higher than this previously.
I did drink dry white wine on a daily basis, but this was the case when my levels were measured at below 6. I was also consuming a typical amount of fish and shellfish when these levels were produced.
Testing fluid from my toe joint eventually confirmed that gout was the problem, and at that time my uric acid level was 7.4. This is the only time a professional lab measured my serum uric acid level above 6.
I presently take 100mg Alopurinol daily, together with 6mg colchicine. I no longer drink alcohol, have returned to an entirely plant-based diet. avoid stress, continue to exercise, drink no-fat milk daily, and as well as tart cherry, I supplement with devil’s claw; celery seed, and terminalia bellerica.
Despite all this labwork measures my my serum uric acid level to hover around 5.6.
I also self-test my serum uric acid on a daily basis, using a UASure meter, and while I don’t find the results to be very accurate, they sometimes seem helpful in indicating momentary spikes in my levels. When this happens, I test several times, to verify that the result is not a testing error. Even when the spike in levels tests consistently, I can never think of a particular reason why my levels should have spiked but suppose this may have been happening for many years previously without me knowing, but I would have thought that any urate crystals that formed during occasional spikes would dissolve during the much longer subsequent lulls.
Do you think it is possible for someone to develop gout from sporadic increases above normal range in their uric acid levels, if the levels return to within range less than a day later?
Although I would prefer not to, I have no significant reservations about taking gout medication for the rest of my life, even though I am unsure as to any benefits this offers me, given that my baseline levels (and possibly spikes in those levels) seem unaffected by the medication and my modified lifestyle (no fish, sugar or alcohol; fat-free milk; supplements).
Can you suggest any subjects I could research that might help me find a reason why I developed gout, and why my levels do seems to spike occasionally for no obvious reason? I feel that knowing this might help me minimize the frequency and intensity of future attacks.
Thanks if you are are able to respond, and sorry for bothering you if you are not!
Best,
Angus
Hi Angus!
Thank you for your comment!
If you are eating well and uric acid does rise, it’s probably a kidney related issue, maybe go seek the advice of a nephrologist who can test your kidney health. I for example was born with some thalassemia, a blood disorder connected to the kidneys, so it seems my gout came about at a young age due to this health related disorder. Anything I do diet-wise can still affect me if I don’t take my allopurinol.
You can read more about it here–>https://goutandyou.com/gout-and-thalassemia/
Good luck!
Have gout in left hand. Will fasting but drinking lots of water help rid of it quicker!?
Drinking lots of water will help but I am not a fan of fasting, eat but eat wisely. Eat mostly complex carbs as in fresh vegetables, legumes, 100% whole grain breads, pastas, rices, beans and some fruit. Avoid meat, any food or beverage with sugar, alcohol, processed foods.
Good luck!
Hi,
I started to do the following to handle gout and uric acid levels.
a) 2 teaspoons of apple cider vinegar with honey every day. This helped to lower the uric acid level to 7.2 with very less medication.
b) ginger juice once a week. This helped to reduce the pain in my leg due to sprains (developed through jogging)
I am concerned when I read suggestions similar to the article. Some of the content is DEAD WRONG!
Gout pain for me is life threatening and ties me up in bed for weeks at a time-wishing the frig I was dead.
Whole grain foods contain gluten (most of them do). Even if you don’t have an apparent allergy to gluten, it still produces leaky gut when it is consumed. Leaky gut means that very small undigested food particles leak through the gut and end up in the blood and various fluids in the body. The reaction of the body is to attack the invaders with extreme prejudice as well as invoking a fight or flight brain reaction which puts the body in an offensive mode. While in this mode, the body doesn’t heal normally because of the heightened body wide alarm.
Gluten is the enemy-don’t specify ‘whole grains’ without noting that gluten containing whole grains are to be avoided at all costs.
I have just learned that I have gout (I’m 63 years old). I just started a 10 day regiment with gout meds from my doctor. I seem to be finding a lot of conflicting info on the internet though. Here are some examples:
(1) some sites say no to asparagus, others say it’s good for gout.
(2) I’ve seen in a lot of places that tart cherry juice is good for gout, others say fruit juice is loaded with sugar, & should be avoided.
(3) I’ve seen that tuna & salmon are bad, but another site recommends fish oil?
I really want to control this thing, but it’s hard to sort out what to do or not do. Can you help?
Regards,
John Russell
Hi John!
I know it can get confusing but the biggest study done on this subject is very clear and it’s the diet I propose.
80% of your daily calories should be complex carbohydrates as in fresh vegetables, legumes, 100% whole grain breads, pastas and rice. Throw out all the white stuff. Beans instead of meat for protein is ideal. Some fruit is fine too but not too much, 1-2 portions max.
10% of your daily calories should be fat as in low fat milk, cheeses, yogurt, eggs, butter, nuts etc…
10% of your daily calories should be lean meat like chicken breast, turkey and lean beef from time to time and/or fish. That’s about 4 to 6 ounces a day.
Drink only water, herbal teas and coffee.
Avoid all processed foods, alcohol and sugary beverages.
Asparagus is fine, yes it’s a complex carb that is a bit higher in purines but won’t result in a direct gout attack ever cause your body metabolizes a vegetable differently compared to meat or sugar.
Cherry juice is loaded with sugar so best to consume a tart cherry extract for best results!
Tuna and salmon you can eat 4 to 6 ounces occasionally.
Hope this action helps you get on the right track concerning your gout diet.
Good luck!
I was told to avoid carrots for uric acid, why is that?
You can eat carrots. They don’t affect uric acid.
Very good information, very simple, not far off what my doctor gave me
You mention artificial sugars or sweeteners in soft drinks as being a problem….what is the situation with sweeteners 950 & 951?
Avoid all artificial sweeteners like aspartame and stevia, they are bad for your overall health and your gout by increasing your risk of metabolic syndrome which directly affects your gout. See this study–> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3772345/
Thanks for your information. I am now drinking lots of water and am taking Organic Apple Cider Vinegar with Raw Honey and feel this is doing me good. Thanks once again, much appreciated.