I'm not worried. I'm looking for knowledge. I read some of the things on the link you provided. Although he says it's clear what to do, it's still very obvious to me that we don't know how to treat or prevent gout or high uric acid in the blood, without the use of drugs. Consequently, the "solutions" to treat gout and high uric acid aren't solutions at all, they are merely suggestions just in case to cover all the bases.

For example, he says to avoid starving or fasting or high protein diets. If starving and fasting triggered gout, it would show up in the poor population before it would show up in the rich population. As it happens, gout used to be called a disease of the rich. In other words, only the rich could do the things that triggered gout. So, no starving or fasting. But certainly lots of alcohol and sugar, both of these things were expensive and only the rich could afford to consume enough of it to cause gout.

A high protein diet (whatever that means) doesn't cause gout. But maybe it can cause high uric acid. However, even on that website he acknowledges that high uric acid in the blood is misleading. We're back to square one.

There seems to be this persistent belief that high uric acid in the blood has anything to do with gout. Just like there is this persistent belief that cholesterol in the blood has anything to do with atherosclerosis. In other words, we blame uric acid only because we found it at the scene of the crime, not because we understand how it got there. We still don't understand how it got there, and that's what I want to find out.

Anyway, in this age of anti-oxidants, and uric acid is a very potent anti-oxidant, isn't it preferable to have more anti-oxidants than less? I mean, why would we use that as a selling point for everything else then?

He mentions something about blood PH and baking soda. I believe that baking soda could do something about gout, but I don't believe it has the capacity to change blood PH. This is because blood PH is one of the, if not the, most tightly controlled parameter of the blood. Any change either way will cause a cascade of changes, none of which are good for the rest of the body. In other words, if baking soda works, it's not because it changes blood PH.

I experience gout attacks on occasion and when I feel an an attack coming on I start taking Colchicine until the symptoms subside. I have some idea of how Colchicine works, but I am not knowledgeable enough to try to explain it.

This site, http://arthritis.about.com/od/colch..._medication.htm seems to offer a more technical view on how the drug works. The report has some useful information in it.

I have been on daily doses of Alopurinol or Probenicid and I no longer take either. Both drugs were prescribed because of high uric acid count in my blood and because of occasional attacks.

Martin, now you've got me curious. I thought I remembered Cordain wrote about gout and here it is:

http://www.thepaleodiet.com/newslet...PDN_Vol2No4.pdf

He says most people with high uric acid levels are "underexcretors" - the kidney can't get rid of uric acid as fast as the person makes it. Also, insulin suppresses the kidney's ability to excrete uric acid.

He doesn't say what triggers the formation of crystals. Could it be a concentration trigger? When you get the blood super-saturated? Remembering making sugar crystals in a super saturated sugar solution.

Putting those together with your eating "a boatload of meat" - I don't know how much or how often you eat, but perhaps your meal amounts and timing are making an insulin rise such that your kidneys can't excrete uric acid as fast as it's forming.

I wonder if your uric acid numbers would go down if you switched to more fat and fewer boatloads of protein. Or had smaller meals with more time in between for insulin to go down.

Well, I don't know. I don't eat that much protein. I mean, muscle meat is about 80% water and only 20% protein. I do eat a lot of fat. Interestingly, I tested high uric acid in a period when I was trying 20/4 intermittent fasting. So even if insulin had an effect on uric acid level, in my case it didn't do much to reduce it.

I read a bit more about uric acid level in the blood. Some things will make it go down. These things aren't good in themselves. For example, surgical anesthetics. Whatever that does might have a purpose fur surgery, but it doesn't serve anything outside the operating room. I mean, I wouldn't want to be senseless just so that my uric acid level is lower. The point I'm trying o make here is that I don't believe that high uric acid is bad at all. In fact, I believe that uric acid, since it is a normal substance that is produced for a purpose, just like cholesterol, must be essential for proper function whatever those functions are. So, I'm not worried about high uric acid. I just want to know what causes this uric acid to accumulate and crystallize in the joint fluid.

If it was possible to crystallize uric acid by saturating the blood, then I believe it would require a whole lot more than just 7mg/dl. I mean, think about it, even honey which is mostly sugar has a hard time crystallizing, yet it does if it's allowed to sit for a very long time. The blood doesn't sit for any length of time. However, the joint fluid might be sitting there for along time and if it contained a lot of uric acid, then it just might crystallize. Remember, it doesn't crystallize in the blood, it crystallizes in the joint fluid. And as I've learned by reading more on the subject, it's not uric acid that crystallizes, but a compound monosodium urate (MSU) that crystallizes.

Here are a few more ideas to play with. Aside from gout, high uric levels are also linked to risk factors for dementia, high blood pressure, atherosclerosis, type 2 diabetes, kidney stones and metabolic syndrome.

It’s also known that adults with uric-acid levels at the high end of the normal range have the lowest scores on tests of mental processing speed, verbal memory and working memory.

Do as you wish, but if it were myself, I’d try to lower my levels to the medically recognized normal range.

Good luck.

Bo

These are all symptoms of carbohydrate poisoning. I don't eat carbs anymore. My BP is quite normal, even lower than what's expected of a 41 yo male. 100/70. I'm not crazy. I'm pretty sure I have atherosclerosis from my previous diet of ~37 years or so, but I'm also pretty sure that it won't be a problem anymore. I don't have diabetes or kidney stones or metabolic syndrome. I've been getting smarter and smarter since I cut our carbs from my diet and began eating only meat.

In other words, whatever is considered normal for others who eat carbs might not apply to me.

FWIW, I was falsely diagnosed with Gout last year despite the fact my uric acid levels were normal. This diagnosis was crap, the real culprit was Hemochromatosis. Please see this post.

http://forum.lowcarber.org/showthread.php?t=409358

That's very interesting! Sounds like a House, MD episode.

Just an update.

The uric acid measured in the blood was 513 μmol/L. The reference values are 202 - 417 μmol/L for this lab. Interestingly, my blood glucose was measured at 3.5 mmol/L (63mg/dl) in the same test. Reference values are 3.6 - 6.1 mmol/L (65 - 110 mg/dl) for that lab. I don't have a result for insulin though. They didn't test that apparently. Remember I said I tested during a period of IF? Well, that would explain the blood glucose level.

There's also ketones in my urine. Which should be normal considering my diet of uber high fat. Bilirubin found in the urine as well. I don't know what that last means but I don't much care either. Anyway, both those results are considered abnormal.

Aside from the four values above, everything else measured, and there are quite a few more things in the list, is within normal reference values for that lab. They say that the level of uric acid measured is "clinically significant". It's important to note that I got tested again a couple days later to check uric acid and it was measured at 499 μmol/L. In my opinion, it would be clinically significant if that lab value was supported by other diagnostic parameters such as pain in the joints or inflammation or anything else that is typically associated with gout. I have none of these things. Only high uric acid in the blood.

In this age of treating lab values with drugs on a massive scale in the guise of preventative medicine, I doubt that my skepticism is going to be contagious.

What is your inflammation? This should be measured as either Westergren sedimentation rate or C-Reactive Protein? Also, did you ever test positive on any Antinuclear Antibodies Direct (ANA)?

You're basically on a ketogenic low-carb diet, resulting in ketones in urine. I would ignore anything doctors say about that, since most are not familiar with ketosis. Aside from stinking up your house with the rancid urine smell, there is no harm. What is IF?

I don't have numbers for either CRP or ANA. At least the list of abbreviations doesn't contain those. Anyway, as I understand it, CRP doesn't just rise on its own, there must be a cause. A disease, poisoning, something. I don't eat carbs, I don't feel sick, I don't do anything that would cause CRP to rise. If it was measured, I'm pretty sure it would be pretty low by now.

Is there anything else that would also rise with CRP? Even then, everything else on the list is within normal reference values for that lab.

IF is short for intermittent fasting.

Something I just came across. Apparently, vitamin C will lower uric acid plasma concentration somewhat. Here's the info:

http://www.ncbi.nlm.nih.gov/pubmed/18464304
http://www.ncbi.nlm.nih.gov/pubmed/15934094