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The Gout Dugout.Issue #033. A little known cause of gout theory; the trialed diet for gouty folk.
September 04, 2010

A warm welcome to the September 2010 issue of the Gout Dugout newsletter. The ten minutes' read that I hope gives you a couple, or more, useful gout ideas.


We all know that most gout is caused by too much uric acid in the blood, and the most common reasons, I would say, are kidney disease, over eating or drinking high purine foods and beverages (not medium or low purine, unless you discover one that triggers your gout). And insulin resistance and, the metabolic syndrome or just three conditions of it:

High blood pressure
Hyperinsulinemia, (excess insulin and insulin resistance)
Hyperlipidemia (too many triglycerides and cholesterol in the blood)
High total cholesterol
High LDL cholesterol
High blood sugar (hyperglycemia)
A poor HDL/LDL cholesterol ratio. (Too little HDL, and simply put too much LDL - it's actually the VLDL particles that are dangerous)

In addition there are over ten other less numerous causes of gout.

Another cause? But I wonder how many readers have heard of this suggested cause, or more likely, part cause? I first read of it about 10 years ago in Dr.Atkins' Vita-Nutrient Solution. A couple of weeks ago I was browsing around a doctor's website to see what she had written about how she dealt with gout, and I came across this theory again.

It is known that uric acid is an antioxidant - you know, the stuff that quells the free radicals that damage our cells through oxidation and ages us faster. "Free radicals" is a dreadfully poor term because it makes people think of politics, not medicine or health, but we are stuck with it.

And another effect of uric acid in excess is that there is accumulating modern evidence that it not only causes gout, but also heart disease, high blood pressure and kidney disease as well as gout being a result of these maladies. Whether this is done by uric acid directly is not yet agreed. But instead of ignoring it, as medical researchers did for so many years - it was said it was just there and harmless if it didn't crystallise (crystallize) - it is now a, if not hot, at least warm, topic for non-gout reasons.

It's often true that the more things change, the more they stay the same. Much of what's being said now about uric acid causing other maladies, apart from gout, was said by Dr.Garrod, the first person to learn that excess uric acid in the blood was usually the cause of gout, over 150 years ago.

"Many of the more powerful predisposing causes of gout tend to produce other diseases, but when these latter occur they are not necessarily of a gouty character; such causes for example, will not infrequently lead to cardiac diseases."

And in 1892 Dr.Alexander Haig wrote Uric Acid as a Factor in the Causation of Disease . He managed to write about 700 pages. The book sold so well though so many editions that the publishers were still having copies printed in 1908 and it had grown to over 900 pages. He, like Garrod, believed the more alkaline the blood, the more soluble uric acid becomes. Today it's said that Haig thought too many diseases were caused by uric acid, but at least one of his that has stayed the course is high blood pressure.

I've only mentioned a little here about a big subject, just to encourage you in your battle with uric acid.

Back to the antioxidant theory But all that is uric acid as a "bad boy." So what about the uric acid as the "good boy" antioxidant? There is much more uric acid in the blood than vitamin C, and vitamin E. And more than carotenoids, as they put it, (also antioxidants)in the study I have referenced below. Beta-carotene is probably the one measured in this study.(1) Unless, I guess, someone took mega doses of Vit C or has very low serum uric acid. And serum (blood) uric acid has been shown to be more or less as powerful an antioxidant as vitamin C.(1)

What's supposed to happen? The idea is that the uric acid level rises because the body requires more antioxidants, since it's not getting enough from food and vitamins, and it is producing too many free radicals. I don't think this has been proved and I am sure that it cannot be the only cause of gout across large populations.

After all, during gout attacks uric acid falls, when you might expect it to rise according to this theory, because more free radicals are created during gout flare ups. But it doesn't rise during this period. Maybe it is the sole cause of gout in a few individual cases. However, there are a couple of lessons from this theory, true or not, worth noting.

The first is that if you keep your body "topped up" with antioxidants, there will be no need for the uric acid level to slowly inch up. You have to do this anyway on a good gout diet. In fact it might even fall, with more consumed antioxidants. And the fact that eating plenty of antioxidants is good for you has been shown in many studies. And where do you find them naturally?

In fruit, vegetables and spices of course, although the amounts in spices, whilst high, are in reality low because we don't put so many on our food. Perhaps garlic and ginger are exceptions. The ORAC score shows the foods highest in antioxidants. It measures how many different foods have. The higher the number the better.

You can download, free, this latest version from the U.S. Dept. of Agriculture - Oxygen Radical Absorbance Capacity (ORAC) of Selected Foods, Release 2 (2010).

A pdf file. It's somewhat larger than the previous 2007 version. You might find your favourite (favorite) fruit is high ORAC. You can see all the scores if you download the file.

The second lesson is that we're always talking about lowering the uric acid level, (UA) but what if UA gets too low and doesn't act well as an antioxidant? Say below 2.0 mg/dL. So again you need to eat lots of fruit and veg, and among the fruits berries have good ORAC scores; the highest berries are chokeberries, elderberries and black raspberries. So do pears, plums and pomegranates. Among the veg - artichokes and red cabbage. Some nuts score very well. Our berries pages begin here.

If you do read the berries pages I recommend you pay particular attention to elderberries. No one eats them much and few people know much about them, but they are made into a very healthy high antioxidant drink, and I think elderberry juice is one of the biggest secrets in natural gout remedies. If anybody reading this has success with elderberry juice, please let me know.

Plus there are the antioxidant vitamins like C, E, and Selenium. If you lower your uric acid level, as you must with gout, ensure you get plenty of other antioxidants which means fruit, veg, spices and dietary supplements. Why not just snack on fruit and nothing else?

Alternative Health Research/Flamasil™


If you live in the U.S look at this vitamin C product from Solgar at still has excellent deals. You buy Ester C because it's a non acidic form of Vitamin C (ascorbic acid). Gouty bodies need to be alkaline, and because acidic urine encourages kidney stones, with which about 20% of gout sufferers end up.

If you don't live in the U.S. want to find out if Solgar products can be bought in your country? Visit and click on the Worldwide tab on the home page. They can be purchased in 47 countries, but this website is not an e.commerce site.

For the kind of Vitamin C you need, on the home page select Products, enter Vitamin C in the search box, and then click on the Ester-C® Plus 1000 mg Vitamin C Tablets (Ester-C® Ascorbate Complex) link which will show it to you.

Click on the link below to buy this Solgar Ester C product at The buy button doesn't commit you, it takes you to the product's page. And whilst you are on the www. site, go to the home page to look at some serious discounts. MotherNature currently have 20% off Solgar products.

Vitamin C is not only an antioxidant. For gout sufferers it has been shown in many studies to increase the excretion of uric acid. And eating and swallowing plenty of it lowers the risk of getting gout.

Solgar Ester-C Plus Vitamin C - 1000 mg- 60 tab

Solgar Ester-C Plus Vitamin C - 1000 mg- 60 tab

Highly absorbable, non-acidic Vitamin C/Bioflavonoid Complex.


Every year or so, at the risk of boring regular readers, I write a piece about this diet because there are new subscribers who haven't read about it on the website, and because even some regular readers might decide to try it if they read about it again. So please bear with me (or skip this section) if you've read this before. The details about the diet for gout sufferers can be found on this page.

You can also download the study itself from this page free. It doesn't cut purines, or alcohol, although the gouty participants didn't drink much alcohol. They did not cut out "red" meat and were encouraged to eat fish four times a week. In this case purines weren't the was something else.

In this trial, the 13 gout sufferers had insulin resistance and many metabolic syndrome markers. It was by using dietary measures alone that uric acid levels and gout attacks fell. In some cases gout attacks had ceased one year later. Absolutely no medicines were used. You might say "just what the doctor didn't order." (But please always consult a doctor before you do this diet).

I think the diet worked because it improved insulin resistance and some MetS markers and so more uric acid was excreted. In other words because they had insulin resistance and some markers of the metabolic syndrome, these gout sufferers were under-excretors, not over-producers.

90%? We are told that 90% of gout sufferers are under-excretors but that sounds like too high a percentage to me, when we know that over producing uric acid from foods and beverages is significant and widespread, and sometimes over producing may be from cell turnover.

To find out if you are an under-excretor your doctor or rheumatologist has to do a few 24 hour urine uric acid tests. This tells him/her how much uric acid you remove in 24 hours and from his or her experience he/she should know whether you under excrete - kidney malfunctioning would be an obvious cause and so too would insulin resistance.

The diet for gout sufferers used in this study was the Zone diet which is well known in the U.S. and quite well known in some other countries eg. the other English speaking ones and Italy. You might get better results than the study if you take the necessary amounts of pharmaceutical grade fish oil plus small extra touches like sesame seed oil.

There are in all 11 pages about the Zone diet for gout on in addition to the page about the diet for gout patients study. It takes a lot of learning but research has shown that people who understand why they do what they have to do in medicine, get better results. The pages start here. Make sure you read all the linked pages. And you need to read the Omega RX Zone by Barry Sears.

If only it was always as easy as the next story......


Browsing around gouty stuff on the internet last month I came across a delightful remedy for gout. We all know about cherries for gout. A fellow said that whenever he felt a gout attack coming on he went to his refridgerator (refrigerator) and got out some cherry pie. It usually did the trick and staved off the attack. I swear this is what he said. It has to be the best gout remedy of all time, along with strawberries and cream. The only problem is that if you're on a carbohydrate restricted diet a piece of cherry pie is going to cost a lot of net carbs.

In case new readers, who are new to gout, think I'm exaggerating, I should say there are reasons why cherries, strawberries, and cream are excellent for gout, and you can read them on the cherries, and the strawberries, and the milk and gout pages You may have often read that tart (sour) cherries are the only ones to eat for gout but this could be marketing hype. What is actually true is that sweet cherries are too. Why? Because at least one of the cherries studies demonstrated that lowering uric acid was done by sweet Bing cherries, not the tart (sour) ones.

Cherry pie manufacturers often tart (sour) cherries for the pies, sweetened up of course, so in this case these worked too.


There are now a number of pages about how gout attacks affect different parts of the body . For example, want to read about elbow gout, or big toe gout and gout in other spots? The index page for these pages is here. Because of the big interest in baking soda for gout (bicarbonate of soda), there's now an additional page with tips and cautions about using it. You can read it here


Many diets are capable of getting the uric acid level down. Another is an alkaline (pH) diet. If you want a free pH food chart with 45 alkalizing recipes, click on this link to and when the home page arrives, the download link for the chart is on the right. You can then print out the food chart, so that you can take it with you when you go shopping for food. pHionbalance products


The U.S. FDA said they would decide whether to approve Krystexxa,(pegloticase) in September. Whatever they decide, you'll be able to read about it in next month's issue. Krytexxa is a very significant gout treatment because it can reduce uric acid very quickly and by a significant amount. Down to 3.0 mg/dL and lower in some cases. (They'll need their antioxidants).If it's approved, it will only be for gout sufferers for whom all else fails for one reason or another, and some medical conditions will prohibit its use. In the long history of gout, this decision is a significant event.

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

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Thanks for reading, and all the best of health.

John Mepham BA.(Econ).

799,Infantry Street,
Armor Village,
Makati City 1201,

(1) Uric acid provides an antioxidant defense in humans against oxidant-and radical-caused aging and cancer: A hypothesis. Bruce N.Ames, Richard Cathcart, Elizabeth Schwiers and Paul Hochstein. Proceedings of the National Academy of Sciences USA Vol. 78, No. 11, pp. 6858-6862, November 1981.

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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