Gout History

Before I started my Keto journey, I already had a history of gout. My first attack was in October 2016 – what started out as a discomfort on the joint in my right toe turned out to be a living nightmare that does not have any ending. Well, it disappears for a while, and then attacks again when I get off track with lowering my uric acid through food, or through my maintenance medicine. Everyone tells me I’m too young to be having gout, and maybe that’s true – but considering the amount of alcohol (beer) I used to drink as well as my love for meat and internal organs (liver, pig brain, intestines), gout is almost inevitable.

Gout Attack #2

Enter Keto – I’ve cut down carbs and sugar to bare minimum and perhaps increased my intake of fat through fatty and fried meat. It’s bad for my uric acid. The second time I had an attack was on the first week of August 2018, almost two years after the first, and on the 6th month of my Keto diet. This was around the time I started intermittent fasting, and even OMAD (one meal a day) on some days. I knew I wasn’t drinking enough water, which I believed caused the trigger. My body was super dehydrated to the point that my lips were cracking and bleeding while I was sleeping (imagine waking up to blood stains on your pillow LOL). I knew I had to drink water, but I got lazy bringing a bottle around.

While in pain, I tried to research what could have caused this attack and I learned that 1) uric acid can get elevated during fasting and 2) when you already have a history of gout, that can be easily triggered. That was just fasting – when you combine that with Keto – the risk could have significantly increased. At this point, I was already used to fasting, so I felt bad having to stop. I started eating normally – bulletproof coffee for breakfast, some meat and veggies for lunch and dinner.

Gout Attack #3

I was already recovering for a month or so, until two-three weeks ago when I went home to Cebu when I started drinking a lot of alcohol again. Not only did that mess up my ketosis for sure, but it probably increased my uric acid to risky levels again. I was also not taking my daily medication at this time because I left in Manila and when I got back, I just totally forgot about it.

Last Friday (the day of the Sam Smith concert), I only ate one meal (lunch), and got the rest of my energy from 4 big servings of coffee. As you know, coffee dehydrates you – I was trying to hold my pee during the concert as well because I wouldn’t want to miss a minute of Sam’s performance. When I got home, I forgot about dinner, went to sleep – and then woke up last Saturday with a tingle in my toe. Sunday, it got worst, despite taking medicines and drinking water. And then Monday, I had the worst attack ever, probably worst than my first one – which I already rated a 12/10 in terms of pain level.

I had to skip work – there was no way I could even wear socks on this swollen foot. I tried to pass time watching shows on Netflix but I couldn’t even distract myself from the pain. Cooling the swollen area works so I stayed at the bathroom letting cold water run on it for a while until the pain disappeared. Since I was drinking a lot of water to flush out the uric acid, I was also peeing a lot. It hurt to get up and walk all the way to the bathroom. So, the bathroom was my sanctuary for the day. When I was about to sleep, I also used a cold water bottle so soothe my foot whenever it started throbbing.

Gout vs. Keto

I am struggling to find the right balance between my diet and avoiding gout. Can one really do both Keto when one has a history of gout? I believe it’s still possible – but there’s a need to be extra careful with the food I eat, avoiding alcohol as much as possible, and really getting myself hydrated. I need to minimize my intake of high-purine food such as meats and internal organs (bye igado for now), and increase my vegetables. There are also some home remedies that you can take to lower down uric acid such as drinking lemon water (which is keto-friendly) and apple cider vinegar daily. These are things I can do – I just have to overcome the laziness. I should also be disciplined in terms of taking my medicine daily.

It’s just a little disappointing getting this attack now, just when I’ve started running again. I cannot put a lot of pressure on my foot even after the pain goes a way, at least for a while, to help it recover.

Worth it?

Yes. Sure, it would be a lot easier without the gout – but when I look back at old photos of myself, even with all of this pain, I will say that it’s worth it. Again, I just need to find that balance – it’s not one or the other. Ultimately, I want to be healthy and gout-free and I really believe I can achieve that with Keto!