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Gout Dugout.Issue #055 uric acid and ketosis | coffee for gout | gout on the up
July 27, 2012

Hello and Welcome to the July 2012 issue of the Gout Dugout newsletter. It's the ten minutes' read that gives you ideas that may help you with your gout. If you have difficulty reading it from the screen, by all means copy and print it.


As you have no doubt realised by subscribing, the Gout Dugout is for those who really want to learn as much as they can about gout and uric acid. Not for those who just spend five minutes on a gout website.

Controlling gout can be simple for some, but very difficult for others. Success may come only after a lot of experimentation which may include more than one diet. You need to know your diets. So what follows here is a finer point about the Atkins diet for gout. Understand this because if you went on this diet..... it might happen to you.

How does uric acid behave in the bodily conditions of a low carb diet that's burning ketones for body and brain fuel? In fact, in the early stage of a low carb diet, uric acid is likely to rise in tandem with the growth of ketones. Why?

Because, it is thought, ketones inhibit the excretion of uric acid, like the inhibition caused by insulin resistance, or an acidic diet, or in those with kidney diseases. That doesn't sound like good news.

But Dr. Stephen Phinney, former Professor of Medicine Emeritus at the University of California at Davis, and a co-author of A New Atkins For A New You is quite certain that uric acid then falls back to the diet start line level, and later, in many, below it. He's said this after over 2,000 patient observations and studies (although participants were not gout patients).

Both Robert Atkins and the Atkins website say that in most people uric acid does not rise (in the long term) on a low carb diet. However, it could be a risk. Rising uric acid might trigger a gout attack of course, but then so can tumbling uric acid. A case for prophylaxis and a good doctor's advice.

If you're interested in the behaviour of uric acid in low carb diet conditions and want to deepen your knowledge and understanding of the substance that's the root cause of gout, read this interview with Dr.Phinney and with Dr. Rick Johnson, author of The Sugar Fix on the website

Or you can listen – 50 minutes. But I think reading would be better.

Rick Johnson is the researcher who is in the vanguard of current research on fructose and gout. The interview is on the website of Take your time, it's fairly advanced material.

The reasons why a low carb diet might be the best for gout patients are explained on the website, and those why it might not be, beginning here.


A few years ago researchers crunched the numbers on the drinking habits of gout patients and discovered a connection between drinking coffee and avoiding gout. The problem was you had to drink a lot of coffee every day, something like six cups to have a chance of a good effect. Although I suppose you might just do it if you consider the water you use in your coffee to be part of the eight glasses a day.

No one seems to know whether you can or can't include water in other drinks and foods. Personally I'd just count pure water. (Please email any opinions on this). And what type of coffee was not much specified. Just coffee, regular not decaffeinated.

Very recently the website journal published an advertisement dated 1652 for a coffee house as they were once called. I think it came from the British Museum's collection. The advert is for London's first coffee house, (it was not Edward Lloyd's – Lloyds Insurance – the more famous one). It was located in the financial district known as "The City." Specifically, in St. Michael's Alley, just off Cornhill. Cornhill is a road which runs from the Royal Exchange and Bank of England, east to Leadenhall Street. In 1652 King Charles 1 had been executed just three years earlier, and Oliver Cromwell ruled.

And surprise, surprise, the ad said, among other benefits such as its stimulating properties and defeating scurvy (very unlikely), that coffee was good for gout. It was the reason people in Turkey at that time "didn’t suffer gout." Of course the hyperbolic copywriter had "been to Turkey" to check that. But coffee's effect on gout must have been something people had noticed by that time. The advert actually said coffee was excellent to prevent and cure gout, but we know better – the best that can be said is that it might help to control it.

Coffee, a new fangled thing in 1652, was very expensive in those days. I just wonder who could afford to drink six cups a day. The gouty bankers of that time?

View this advertisement at journal. And you can read the accompanying modern English translation.

Remind yourself about coffee for gout at this page on


Another reminder that if any reader wants the spreadsheet I prepared to do the calculations for calories, carbs and fructose in the foods used for the first alkaline diet that improved uric acid excretion, (one of the last two month's stories), just email me at There’s no charge.


I am appealing for photos. Do you have any photos of your gout? Any part of the body - elbows, arms, hands, ankles, feet, wrists, fingers, toes and big toes, knees, ears, wherever. I know many like to keep their gout confidential so if you don't wish to be identified, don't send me faces – not likely anyway since gout of the ear isn't common. Or, on request, I could always crop out, or blur them.

Please email me at

Click on the Flamasil ad to go to the Flamasil website

Alternative Health Research/Flamasil™

The UASure is a DIY home uric acid test kit. It measures the level of uric acid in the blood. Click on the link below to visit a company who can ship it world-wide, including the United States and Canada, from Britain.


In the past couple of months - Britain's Daily Mail newspaper has reported that Britain's gout population has got younger; in America, a Pittsburg doctor said he noticed his gout patients were younger than they had been; and recent figures from the other side of the globe, in Taiwan, showed that the age of gout sufferers has fallen. Over half there are now under 40 – and it has even been found in teenagers.

Number crunching of the latest U.S. NHANES survey showed uric acid levels were above normal in 43.3 MILLION U.S. adults. Yes, you read that right – 43.3 million. I wonder how many of them know they are at risk of gout? At least over 8 million do since that's now the estimated number of U.S. gout sufferers.

And Time magazine put gout onto a newsfeed last month – why gout is "making a come back" in the US, according to health experts. Actually this "comeback" has been going on for donkeys years.

Hip New Disease says the Time headline. More like a disease of the hip. I've seen nothing to suggest gout is fashionable, quite the opposite. You know, all those awful stories about men who announce they have gout and get a giggle as a response.

There's an old maxim that when news magazines put a trend (eg. stockmarket prices), or announce another trend, on their cover, then the trend is over and it is time to sell or discontinue.

If that's the case, now that Time has published this story, maybe the growth of gout sufferers is over too. But according to my next paragraph it still behaves, in one way, just as it always has……

Some more recent number crunching published in Arthritis Care & Research has reminded us of another old truth. Researchers at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland, analysed (analyzed) some fairly old (20 years) and some new numbers (5 to 2 years ago) from the National Health and Nutrition Examination Surveys (NHANES) in 1988 to 1994 and 2007 to 2010. And they found the prevalence of gout was greater in those who were overweight. And the more overweight, the more likely.

But then you knew that anyway.

Furthermore for those with gout 74% had hypertension; 71% had chronic kidney disease; 53% were obese; 26% had diabetes; 24% had kidney stones. I could go on. No chicken livers for me tonight and I' d better take the dog for a walk. How long before "low uric acid" becomes a slogan on supermarket shelves and replaces that "low fat" tag?

If you are not a subscriber to the Gout Dugout, this free monthly gout newsletter, you can sign up at this page - click on the link below.

Go to the home page by clicking on the link below.

Tip Use the website's search box, located towards the bottom of the Home Page, to find site references to any word you enter into it. It is a good way to find out where and what the site has to say about any gout topic. There are currently nearly 200 pages, including the back issues of this newsletter. It works. Use it!


I had planned for the latest (second) alkaline diet study to be in this issue but I am still working on it. It is worth waiting for – maybe the best gout diet study for 12 years, and a possible route map to getting more uric acid out of the body. So it's held over till next month.

Thanks for reading, and all the best of health.

John Mepham BA.(Econ).

799, Infantry Street,
Palar, Armor Vllage,
Makati City 1201,

P.S. You may distribute this newsletter freely and free-of-charge, providing any links in it remain unchanged and it remains intact. Partial copying is not allowed.

NB. The contents of this newsletter contain medical information, not medical advice. Please always discuss gout remedies with a doctor, or other health care professional, before implementing any treatment.

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