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Gout and Ketosis

author avatar Dr. Eric Berg 08/31/2023

Gout was once known as “the disease of kings." Centuries ago, wealthy people were the only ones who could afford luxury items like sugar, which is now a known risk factor for gout. Fast-forward to today and gout affects about 1-4% of the population. Gout is on the rise, likely because bad dietary habits and a lack of exercise are also on the rise. Because of this, many people try to get healthy by doing keto and getting into ketosis. But, then, some people develop gout or notice ketosis actually worsens gout. So, what are you supposed to do? I'm going to share with you everything you need to know about gout and ketosis, including what may help your situation.

Let's get started.

In this article: -

  1. What is Gout?
  2. Gout and the Keto Diet
  3. Can Ketosis Cause Gout?
  4. Here's What You Can Do
  5. Gout and Ketosis Conclusion

Person on the keto diet with an inflamed big toe due to gout |  Gout and Ketosis


What is Gout?

Gout is associated with the sudden and painful inflammation of a joint. It's a form of arthritis. Typically, gout affects the big toe and the joints in the hands. But, it can affect other joints as well.

Gout is caused by the accumulation of uric acid crystals. Uric acid crystals form as the result of too much uric acid in the blood. A few gout symptoms are redness, pain, and swelling.

To treat gout, doctors will usually prescribe medications or a low-protein diet. The low protein is suggested because some people believe proteins like red meat, fish, and organ meats can cause gout. Some people even believe high-fat diets like the ketogenic diet can cause gout. Can these keto-friendly foods play a part in increasing your risk of gout?


Gout and the Keto Diet

Because gout is caused by a build-up of uric acid, most doctors will advise you to start a low-protein diet. This is because many sources of animal protein are purine-rich. Purines are precursors to uric acid. However, there is little research to support these claims that high-fat diets or even high-protein intake are behind gout.

However, eating high-quality foods like what you would consume on healthy keto, may actually help relieve gout. Of course, low-carb diets, including the ketogenic diet, don't even have to contain high amounts of protein either. The healthy ketogenic diet promotes a moderate amount of protein rather than high-protein.

Instead of high-protein or high-fat, sugar (in particular, fructose) may be the more likely culprit. In fact, a few risk factors for gout are type 2 diabetes and Fat Storing Hormone resistance, which can be caused by high blood sugar

Low-carb diets like the ketogenic diet, and especially the healthy keto diet can help with blood sugar issues as well as other issues that can contribute to high uric acid levels and gout. Overall the healthy ketogenic diet may actually be a beneficial long-term solution for gout. 

Deformed big toe due to gout inflammation  |  Gout and Ketosis 


Can Ketosis Cause Gout?

If the ketogenic diet may be able to help those with gout in the long-run, why do some people have issues with gout after getting into ketosis? When it comes to gout and ketosis, in certain individuals who are predisposed to having high uric acid crystals or even kidney stones, ketosis may aggravate the situation. However, in this situation, gout will usually only last short amount of time. Let me explain.

People typically do a low-carb diet like the ketogenic diet and intermittent fasting to get into ketosis. When you're in ketosis, your body is making ketones. This is a good thing. You want your body to be making ketones. One of the main reasons people choose the low carb keto plan is so they can start making ketones. This, of course, is great for weight loss just getting healthier. However, high levels of ketones can stop your kidneys from properly clearing out uric acid, causing a build-up.

Intermittent fasting can also cause retention of uric acid in certain people. Intermittent fasting doesn't usually lead to gout, but it can increase your uric acid levels.

Here's the thing though, this uric acid build-up that can cause problems with gout, usually only happens for the first few weeks of getting into ketosis. It's not common in those who are fully adapted to ketosis. It's one of the symptoms that can occur when first starting ketosis and becoming keto-adapted. Once you become keto-adapted, your uric acid levels will likely return to normal.

Your body goes through many different shifts and changes during the keto-adaptation phase.  You may also experience things like the keto-flu, a rash, or fatigue. But, all of this goes away once your body gets used to keto, intermittent fasting, and ketosis. This is no reason not to do a low-carb diet like the keto diet as well as intermittent fasting. The low carb healthy ketogenic diet, intermittent fasting, and ketosis are all tools that will help get your body in the healthiest state it's ever been in

Woman on the keto diet drinking lemon water to help with gout |  Gout and Ketosis 


Here's What You Can Do

If you're doing the healthy low carb ketogenic diet and intermittent fasting, you're on the right track to weight loss and improving your overall health. But, if you're getting into ketosis and experiencing gout, although it may be temporary, that's not something you want to have to deal with. Gout can be painful, and you don't want this to stop you from doing the low carb keto diet.

Here are some natural things you can do to help alleviate gout in the meantime. 

Lemon Juice

Lemon juice is a great natural remedy for gout. That's one of the reasons why I recommend consuming a lot of lemon juice while doing the low carb keto diet. Lemon juice can help to counter oxalates and uric acid. It will really help flush things out and normalize your uric acid levels again. Mixing lemon juice in your water is a fantastic and easy way to consume it. 

Electrolyte Powder

Another thing you can do for gout is to take electrolyte powder. My Electrolyte Powder contains 1000 milligrams of potassium citrate. Potassium citrate is really good for gout because it alkalizes the overly acidic state you're in. It helps reduce the symptoms of gout, and potassium citrate also helps neutralize uric acid levels. 


Gout and Ketosis Conclusion

Symptoms of gout can show up from living an unhealthy lifestyle. Weight loss and getting your body in an overall healthier state can really help this condition. However, when some people first get into ketosis by doing the ketogenic diet and intermittent fasting, they experience gout. This may happen because of uric acid build-up.

This isn't an issue for everyone, and it will likely go away once your body adapts to your new healthy lifestyle. Thankfully, in the meantime, there are things you can do. Try consuming more potassium citrate and lemon juice, and see how these natural remedies for gout work for you.

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Disclaimer: Our educational content is not meant or intended for medical advice or treatment.

Editor’s Note: This post has been updated for quality and relevancy.

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