Gout and Atkins. Cautions and criticisms....
are they valid?

Page 3 of 10 about Gout and Atkins.

Referenced studies and study abstracts, the numbers in brackets, are listed on page 10 of the gout and the Atkins diet section

The Gout and the Atkins diet articles are across ten pages. 

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This page about gout and Atkins was last reviewed or updated on 10 April 2015.

SUMMARY of Dr. Atkins’ cautionsmake sure you take you uric acid lowering medications; kidney disease patients – see your doctor because gout patients with severe kidney disease should never do this diet; lose weight slowly to avoid triggering a gout attack.


And now for cautions about gout and Atkins. Don't use the Induction phase unless you are taking gout meds. Over the years in his books Dr.Atkins said a few things about whether people with a history of gout should do his diet.

In his 1977 SuperEnergy diet book (which included his carbohydrate controlled diet) he thought for those with gout, or with a high uric acid level, that the strictest level of his diet, as he called it then - it's now called the Induction phase - i.e. up to 20 carbohydrate grams daily - should NOT be attempted unless the person was on anti gout medication. And the doctor approved of the diet. 

You might think that anyone who has had a gout attack is on medication, but many are not. Some simply don't bother to make follow-up doctors' visits. Others don't wish to take medications, preferring to seek a natural remedies control of gout.

No surprise about the gout part of that, but Dr.Atkins also included those with a high uric acid level. How high is high? He didn't say, but usually above 7.0 mg/dL in men, 5.5 - 6.0 mg/dL in women. The anti gout medication he was probably referring to would be allopurinol or probenecid, (a couple of brand names: Benemid, Benecid; there are more), both in use at that time.

And he thought that those prone to high uric acid, (and I should add, a genetic history of gout) could have a gouty flare up on his diet.

Of course he thought that gout patients, and those who are prone to gout, must get their doctor's approval and remain under regular medical supervision whilst on the diet. That's standard advice.

One reason for this is frequent uric acid blood tests. Another should be the direction of all the insulin resistance and metabolic syndrome markers, discussed on our first page about gout and Atkins. Other points he made about his diet and uric acid are on Page 2 of the gout and Atkins section.

Gout and kidney disease  Many gout sufferers developed it from kidney disease of some type. Dr. Atkins frequently warned that anyone with severe kidney disease should NOT do his diet. If you have any degree of kidney disease, discuss the diet with your doctor first. Don't go on it until you have.


This is my idea, not one explained in Dr.Atkins' books. You could obtain a prescription (RX) from your doctor for advance preventative or pain killer gout medicine (the medical word is prophylaxis) such as low dose colchicine or NSAIDS like indomethacin, ibuprofen or diclofenac sodium. This prescription (RX) is frequently written in conventional pharmaceutical gout treatment when patients are prescribed these to deal with an attack that falling uric acid often, and curiously, causes. Discuss this with your doctor.


Why might a controlled carbohydrate (similar to a ketogenic diet) be a gout attack trigger in someone who has had a gout attack? One reason may be that low carb diets are dehydrating, especially in the first two weeks when some weight lost is water. Dehydration is a known gout trigger. And if falling weight reduces your uric acid that in itself can be a gout trigger. On any diet. The answer of course is:

1. Drink plenty of pure  water - at least the recommended amount of eight glasses daily. Water in other drinks like tea, coffee, and juices and in foods, does not count.

2. Make sure you do the diet correctly. Remember it does mean eating plenty of low carb veggies and fruit. Studies show their fibre (fiber) helps to lower uric acid and LDL cholesterol. They are also required to offset any loss of potassium, which may occur.

Psyllium husks are high fibre (fiber) - about four grams per serving (depends exactly on the brand) - have no net carbs, but do not contain potassium. They also remove hunger pangs.

A second reason is that fast weight loss on any diet can also cause a gout attack. If you avoid the induction phase of 20 carb grams a day, (actually net carbs, (which are the carbs minus the amount of fibre (fiber) number), you should lose weight fast. Two pounds a week is enough.

This can be achieved on the Ongoing Weight Loss phase (OWL) of the diet. Lose five lbs or more a week and if you have high uric acid you could trigger a gout attack especially if you already have had one. So what you have to find out is how many net carb grams a day you can eat in order to lose just two lbs a week. My guess is 35-40 gms a day, but everyone is different and this is one number you will have to discover through self trials and analysis.

What Dr.Atkins said about ketosis and gout - see gout and Atkins page 9

Other Atkins pages  

Go to page 1 of 10 about gout and the Atkins diet, where I explain why it might be good for your gout.

Go to page 2 of 10 What Robert Atkins said about his diet and the uric acid level.

Go to page 4 of 10 where I explain our modifications to the Atkins diet for gout sufferers.

Go to page 5 of 10 The Atkins diet for the insulin resistance cause of gout.

Go to page 6 of 10  My Atkins diet success story

Go to page 7 of 10  Meat and gout on the Atkins diet

Go to page 8 of 10. for free Atkins diet resources

Go to page 9 of 10. What has been said about ketosis and uric acid.

Go to page 10 of 10 which lists the gout studies, study abstracts, other relevant studies and books used as background whilst preparing the pages on the Atkins diet and gout.

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