The AA: EPA test for gout pain relief. Why you use this test to determine your eicosanoids'levels

This page about the AA:EPA test for gout pain relief, was last reviewed or updated on 9 June 2014.

This is an advanced discussion of a test that measures if your body is more likely  to get gout pain relief. It won't mean much if you have not grasped the detail about this natural treatment on these pages which we advise you to read first.

Omega-3 for gout

Omega -6 for gout

Fish oils and GLA dosage

Arachidonic acid and gout One of the central substances in this treatment - it requires lowering  -  is arachidonic acid (AA). The idea is to lower AA by reducing the foods that ultimately produce it. At the same time you raise your level of the Omega -3 fatty acid, EPA, and lower/control insulin.


The AA: EPA ratio is a measure of the amount of arachidonic acid compared with the amount of EPA from omega-3 fish oil, in your blood. By reducing your AA: EPA ratio you can get pain relief for gout and perhaps attack reduction. You want the ratio to be lower, that is less AA, more EPA. 

What the numbers mean is that a ratio of 15 is dreadful, (i.e. far too much AA), above 10 is poor, 1.5 is considered very good. In other words, at 10 and above, you will be producing too many "bad" eicosanoids (actually at these levels they are bad) and in Dr. Sears's theory you are possibly/likely on the road to heart disease to which gout sufferers are prone, and to other health problems too. If your ratio is 1.5 – 3.0, (the best range) you are producing more "good" eicosanoids. 

Eicosanoids themselves cannot be measured by any publicly available test, but the AA: EPA ratio is an excellent indicator of what your body is doing in this respect. If your AA: EPA ratio is below 1.5, the balance has moved too far in favour (favor) of "good" eicosanoids. If so, reduce your intake of fish oils (or high omega -3 fish) and it will rise.

It's very likely your AA:EPA ratio is not good enough. On average the AA:EPA ratio of the typical Western diet is around 11. If you have gout it's probably more.

This is really an inflammation test, and how prone you are to it.


The AA:EPA ratio is revealing, but can you know what yours is? Yes you can. This means: 

1. You get a baseline (starting) reading.

2. Follow the process (essentially high dose high quality pharmaceutical grade fish oils plus gamma linolenic acid - GLA - and insulin reduction).

3. Take a second reading six weeks to two months later. 

If your AA:EPA ratio has fallen, which it almost certainly will, if you follow the ideas outlined on the omega -6 page, you are on the road to a healthier heart, and probably pain relief for gout. You may also relieve gout swelling, get gout flares reduction, and be generally healthier. Moreover the DHA in fish oils has a significant amount of research behind it saying that it combats depression and improves mental ability and mood. Very useful to know if you have to live with gout.

In fact Dr. Sears thinks that about 30 days of following his fish oils, GLA, and the insulin reduction programme (program) is about enough time to begin to see changes. Fish oils and GLA will probably NOT work on their own. You need insulin reduction too.

Gout may be different, harder, because of its intense pain and the unpredictability of when attacks occur. So to be sure you have done this correctly, you probably need to consider two months to try this. The time you require may depend too on the frequency of former gout attacks.

Therefore you need to do the AA: EPA test again after six weeks/two months. To see how well this treatment works you may have to take fish oils at treatment, not maintenance, levels until your next gout attack to see if you have achieved relief for gout pain. Everyone is different and we can't be more specific than this.

The numbers you get from this test will also help you and your doctor decide whether any increase or decrease in your fish oils, or reducing carbohydrate intake further, or at the Zone diet ideal of a DAILY protein: carbohydrate ratio of 0.75 should be undertaken. That means for every three grams of protein you eat, you need to eat four grams of carbohydrate, at every meal. (There is some scope to be flexible about this).

In the Omega RX Zone book, Dr. Sears describes an easy way to judge protein and carbohydrate intake at every meal without counting numbers.

If the AA:EPA ratio has not improved. it could mean you have been taking too much GLA. In that case, only use the Eico Rx product or the Omega Rx product plus oats (oatmeal/porridge oats), since oats contain only a small amount of GLA.


United States  Go to

Other countries Enter AA: EPA ratio (or test) into an internet search box and the name of your country. You can use the search box at the bottom of this page. 

You may find it difficult to get the AA: EPA ratio test done in your country. If so use the TG: HDL test, explained below, as a guide to your current and future eicosanoid balance and insulin levels.

By explaining this test, we are not talking here about a herb or other substance that may or may not have delivered gout pain relief 200 years ago without any modern scientific evidence. We ARE talking about an American researched and studied process that in many other countries is still unknown or hardly known and it's still cutting edge.


TG:HDL test  First, you need to know your baseline (starting) ratio of triglycerides (blood fats) to HDL cholesterol. (TG:HDL). If this blood test doesn't show it, ask your doctor to divide the TG figure by the HDL figure. Or do that yourself.

You aim for a low number for triglycerides and high number for HDL "good" cholesterol. If this ratio is under 2.0, that's good. If it's above 3.0 it isn't. This ratio is considered by many the leading indicator of heart disease, more meaningful than simple LDL or HDL cholesterol readings.

Why is it a proxy for the AA:EPA test ? If you have a high number you probably have too many "bad" eicosanoids and a high insulin level. Whilst the AA: EPA test, and the insulin test, will tell you this, this test also shows whether markers of heart disease are improving. Full details are in the Omega RX Zone book.

After six weeks/two months of the Zone diet, or carbohydrate restriction plus fish oils and GLA, you can expect it to fall considerably.

So if you live in a country where it's difficult, or expensive, to get the AA:EPA test, and the insulin test done, use this TG:HDL test result ratio to judge your insulin level. As stated above the number should be below 2.0. A poor TG:HDL result probably means elevated insulin and a poor eicosanoid balance which is bad for inflammation.

Insulin levels test  You also need a baseline (starting) fasting insulin blood test. Remember, later on you need to know that your insulin level is controlled or falling – and hopefully it will – because improving eicosanoid balance also requires a lowered insulin level. The numbers that are good, poor and bad for this test are ones your doctor will know, or you can find them in the Omega Rx Zone book.

Overweight gout sufferers are very likely to have an insulin level that is too high. Elevated insulin may also mean you have insulin resistance, which is a cause of gout because studies have found that excess insulin inhibits uric acid excretion.

The baseline (starting) tests are VITAL because without their results subsequent tests will not tell you whether progress is being made.

Are the tests, plus the AA: EPA test, going to take up a lot of your time and possibly/probably expense?

There is no point in evading the truth. They are. As an encouragement, here is our page that links to testimonials for this treatment, which is  fully explained in the OmegaRX Zone.

What is the reason for producing more "good" than "bad" eicosanoids? 

You should immediately know the answer. If you don't you probably haven't grasped this yet. You need to study this process more from the omega -3 and omega -6 pages.

However, as a refresher, "good" eicosanoids are the ones that have an anti pain, anti inflammation action. "Bad" eicosanoids are pro-pain and inflammation. This is why you can get gout pain relief from this method.

Related pages

Click here to read successful testimonials in achieving gout pain relief with this method.

How much fish oil do you need to take daily for a pain relief for gout dosage ? Read this page

Click here to read about the quality of Eico Rx and Omega Rx. They test every batch.

To help you understand this relief from gout treatment visit this page which shows our dietary diagram for relief from gout pain

                                            CAUTION !

You will need to work with a doctor who is familiar with these ideas. Do NOT attempt to do-it-yourself. For just four reasons, you may have a medical condition which precludes the use of high dose fish oil. For example, it may thin the blood too much and it may cause a rise in blood glucose levels. It may be contraindicated with a medicine you are already taking. And cheap fish oils may have too many impurities at the levels Dr.Sears talks about.

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