Easy Beef Stir Fry recipe and photo by Jessi Heggan | Jessi’s Kitchen
By Kelley Herring
If you are among the eight million people in the United States living with gout, you know how painful and debilitating this disease can be.
Gout is the result of the accumulation of urate crystals in different joints throughout the body, most often, the big toe. The symptoms of gout include intense recurring episodes of pain, redness, swelling, and fever. The crystals associated with gout also continuously activate immune cells in the blood and create a cascade of inflammatory effects.
Many of those who suffer from gout experience relief by following a “low-purine diet” consisting of foods that contain low amounts of uric acid. However, new research shows that a unique metabolic diet might be a better way to reverse the symptoms of gout… or, even better, to stop it before it starts.
But first, let’s explore more about…
What Causes Gout?
Gout is a type of inflammatory arthritis. It can cause intense pain and swelling in your joints, with recurrent “flares” that can last for a few days to a few weeks.
Typically, these flares begin in your big toe or a lower limb when high levels of urate build up in your body. The excess urate forms needle-shaped crystals in and around joints, leading to pain and inflammation.
Gout can affect your joints, bursae (cushion-like sacs between bones and other soft tissues), tendon sheaths (membranes that surround tendons), and kidneys (high uric acid levels can lead to stones and kidney damage).
The Stages of Gout
As uric acid levels accumulate, the condition of gout moves through several stages:
- Hyperuricemia: As urate levels increase in the blood, crystals begin to form in your joints. Generally, no symptoms are experienced during this stage.
- Gout flares: An attack of intense pain and swelling in your joints.
- Interval Gout: The time between gout attacks, when symptoms are generally not present.
- Tophi: The late stage of gout, where crystals build up in the skin or other areas of the body. Tophi can permanently damage your joints and internal organs, such as the kidneys.
The good news is that with lifestyle and dietary changes, gout is one of the most controllable forms of arthritis!1
Stopping Gout Before It Starts with the Keto Diet
Researchers have long known that uric acid levels drive a number of pathological conditions – including gout, urinary stones, inflammation, and nephropathy. However, they recently discovered it may not be the uric acid itself that causes the impact, but rather how uric acid affects the immune system.
Research conducted at the Department of Comparative Medicine & Immunobiology at Yale set out to determine if specific ketone bodies (ketones) can inhibit a particular immune complex called the NLRP3 inflammasome.
This compound is already proven to drive flares of gout, so it makes sense that reducing it might help to treat or prevent the condition.
Using an animal model, the researchers found that feeding rats a high-fat, low-carbohydrate ketogenic diet increased β-hydroxybutyrate levels (the ketones they were looking to target). They discovered this protected the rats from joint swelling, tissue damage, and systemic inflammation, normally seen during gout.
Dr. Emily Goldberg states:
“In isolated neutrophils, β-hydroxybutyrate completely blocked NLRP3 inflammasome activation, even when provided at low concentrations that are physiologically achievable through dietary modification”2
Dietary Triggers for Gout
In addition to blocking the action of the inflammasome with a keto diet, there are several foods to watch out for, plus several foods that may help:
- Avoid Alcohol: Drinking alcohol causes your kidneys to work overtime to filter out alcohol (instead of uric acid). This leaves excess uric acid to build up in your body. Beer is especially problematic for gout because it actually contains purines.
- Avoid Sugar: Sugar in any form – and especially foods with high-fructose corn syrup –should be avoided because of their connection to gout.3
- Reduce Purines: Foods high in purines should be reduced. These include anchovies, asparagus, organ meats, legumes, mushrooms, sardines, scallops, herring, and mackerel.
- Stay Hydrated: Drinking water helps to keep uric acid from building up. It also helps to flush this compound out of your body.
- Eat Cherries + Vitamin–C Rich Foods: Certain foods that are high in vitamin C have been shown to lower the level of uric acid in your blood.4
The Keto Diet for Less Pain, Inflammation, and Disease
Changing your fuel source from carbohydrates to fat can profoundly shift your metabolism. It can also reduce inflammation, stave off episodes of gout, and thwart most chronic diseases.
And the nutritional prescription couldn’t be easier…
Enjoy the fat-fueled diet of your ancestors!
Here are a few Ketogenic, Low-Purine Meal ideas to get you started:
- Pastured Eggs with Butter & Avocado
- Grass-Fed Beef & Bell Pepper Stir Fry
- Wild Salmon with Pesto & Cauliflower
- Pastured Pork Chops with Romesco Sauce & Mixed Green Salad
Love comfort foods, but not the carbs? Check out Kelley’s FREE new book – Carb Lover’s Keto – with 100 recipes for all of your favorite comfort foods. From Chicken Parmigiana and Coconut Shrimp to Buffalo Wings and Pizza. Discover how you can indulge – 100% guilt free!
 Emily L. Goldberg, Jennifer L. Asher, Ryan D. Molony, Albert C. Shaw, Caroline J. Zeiss, Chao Wang, Ludmilla A. Morozova-Roche, Raimund I. Herzog, Akiko Iwasaki, Vishwa Deep Dixit. β-Hydroxybutyrate Deactivates Neutrophil NLRP3 Inflammasome to Relieve Gout Flares. Cell Reports, 2017; 18 (9): 2077 DOI: 10.1016/j.celrep.2017.02.004
 Danve A, Sehra ST, Neogi T. Role of diet in hyperuricemia and gout. Best Pract Res Clin Rheumatol. 2021 Dec;35(4):101723. doi: 10.1016/j.berh.2021.101723. Epub 2021 Nov 19. PMID: 34802900; PMCID: PMC8678356.  https://www.kidneyfund.org/living-kidney-disease/health-problems-caused-kidney-disease/gout/diet-gout