Gout and low carb
, medical review by Dr. Michael Tamber, MD
Evidence based
After dozens of high-quality studies comparing low-carb diets to other diets, there seem to be none noticing any obvious difference in the risk of gout, although no study has specifically focused on this question.
Doctors regularly treating patients with low-carb diets do not notice a sharp increase in gout episodes, even during the initial time period.
How to avoid gout
Here’s how to avoid gout long term, using only lifestyle modifications:
- Minimize intake of sugar.
- Reduce intake of alcohol. Particularly avoid beer and other high-carb alcoholic drinks.
- Lose excess weight and reverse metabolic syndrome. Low carb is a good treatment, as is intermittent fasting.
- Avoid dehydration.
As a bonus, these lifestyle modifications have many other positive effects on weight and health.
Given that there may be a temporary rise in uric acid during the first few weeks on a strict low carb diet, some recommend that people who’ve previously had troublesome gout attacks may want to consider using the drug allopurinol while starting low carb.
However, rheumatologist Dr. Edward Skol from Scripps Clinic warns against temporary use of allopurinol for this purpose; it is known to initially increase the risk of an acute attack when started (and when stopped) without the use of additional anti-gout medication. This is supported by the American College of Rheumatology official guidelines, which strongly recommend only starting allopurinol in conjunction with a medication like colchicine or ibuprofen to decrease this initial risk.
In Dr. Skol’s practice, if medication is desired to prevent gout attacks at the start of a low-carb diet, he most commonly uses just colchicine or ibuprofen without allopurinol. He also summarizes, “The best advice is probably just avoiding dehydration when starting a ketogenic diet.”
Meat or no meat?
Avoiding meat should not be necessary when it comes to gout prevention, especially when otherwise following a low-carb diet.
Furthermore, please note that a low-carb diet does not have to be especially high in meat anyway. Multiple other foods exist to achieve your protein needs.
A well-formulated low-carb diet that reduced sugars and refined carbohydrates could potentially reduce the risk of gout long term.
More low-carb side effects & how to cure them
Common early issues
Less common issues
Low-carb myths
More
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