how the keto diet benefits gout patients

For millions of Americans, the symptoms of gout are a painful daily struggle. The rheumatic disease affects over 8 million people in the US alone, around 4% of the total population. Rates of the disease are soaring worldwide, with the UK and Australia affected by similar statistics. Caused by abnormal uric acid production, gout either causes rapid drops and fluctuations, or it produces excessive amounts, causing uric acid crystals to build up within the body and trigger immune cells. As a result, sufferers experience pain, inflammation, and fever. Discover more about this disease and what your diet can do to improve it, whether you're at risk or have already been diagnosed.

What Is Gout, and Who Does It Affect?

Gout is a form of arthritis. Along with daily pain, inflammation, and fever, patients also suffer from visible swelling and redness. While it can occur nearly anywhere in the body, the big toe is the most common area affected, followed by the heel, ankle, and knee. These distressing symptoms make walking difficult, with pain reaching agonizing levels that require immediate medical care. Gout is primarily caused by dietary factors, so anyone is at risk. The primary factors are obesity, diabetes, and an unhealthy diet. Sugar, caffeine, and alcohol also affect uric acid levels, so if they're consumed regularly, dieters face an increased risk. If you're already suffering from the disease, it's easy to see how improving your diet can also improve symptoms. Thankfully for gout sufferers, diet can make a world of difference.

How Does a Ketogenic Diet Reduce Gout Symptoms?

A study conducted at the laboratory of Vishwa Deep Dixit, a professor of comparative medicine and immunobiology at Yale School of Medicine, strongly suggests that a ketogenic diet has a strong effect on reducing gout symptoms, making everyday life easier for current patients, while reducing the chance of development for those at risk. Since a keto diet should keep your body in a steady state of ketosis, your body should be burning ketones for energy regularly, even while sleeping. Dixit's study suggests that one of those primary ketones, beta-hydroxybutyrate (BHB), is the ketone body that affects gout, and by burning ketones for energy, it has potential for dieters wanting to reduce gout symptoms.

How Does a Ketogenic Diet Increase BHB Levels?

The Dixit study used detailed testing amongst both rats and humans to discover exactly how a ketogenic diet increases BHB levels, successfully relieving the painful symptoms of gout. Here's a rundown of how the study was conducted, and how the final results will surprise and relieve gout sufferers.

How Gout Flare-Ups Are Caused

First, it's important to understand how gout flare-ups work. While they're caused by crystallized uric acid, the disease is more complicated than that. Painful flare-ups are triggered by an inflammasome called NLRP3 and neutrophils, the body's most prevalent white blood cell. Together, the combination of NLRP3 and neutrophils activate a pro-inflammatory cytokine known as 1B. This cytokine is what causes painful flare-ups, swelling, and redness to the surface, along with fever and the destruction of joints over time.


Prior to the study, the rats were kept in clean, pathogen-free conditions and fed a strong ketogenic diet a week before testing began. Then, rats were injected in the knees with a trace amount of monosodium urate, just 1.25 mg. For the rodent participants, this was enough to cause gout symptoms similar to those found in humans. After injection, researchers measured the rats' knee thickness and performed pathology tests of both their ligaments and menisci. They measured BHB levels both before and after testing, carefully documenting the numbers.


Human participants also maintained a healthy ketogenic diet a week before testing. These participants were diverse in age, gender, and lifestyle habits, but all of them were healthy and steroid-free, and most were between the ages of 18 and 45. Older adults aged 65 and over also participated, so that the condition's symptoms could be monitored across all age levels. Peripheral blood was collected, statistical analyses were conducted, and all experiments were completed at least twice on every human participant involved.

The Results

The researchers discovered similar results amongst both rodent and human participants—news that sparks excellent results for gout sufferers considering a ketogenic diet. The diet raised BHB levels. In turn, that inhibited NLRP3. Since this inflammasome was the leading cause behind the painful symptoms of gout, its inhibition relieved those symptoms.

Testing also blocked other causes of gout flare-ups, including the IL-1B pro-inflammatory cytokine that fueled pain. The diet blocked this cytokine in rodents and humans alike, regardless of age. This meant that no matter what age a patient was experiencing gout, turning to a ketogenic diet could alleviate symptoms. For those at risk, this is also excellent news.

Since a ketogenic diet directly backs the body's scientific components that result in flare-ups, switching up dietary habits could prevent the disease from occurring all together. According to study co-author Emily Goldberg, BHB production was boosted, and, as an anti-inflammatory molecule, BHB alone could serve as treatment for gout, and that boosting its production was entirely possible through dietary changes alone. If you're suffering from gout, the low-carb lifestyle might be the right choice for you, with results helping patients of all ages achieve welcome relief. The ketogenic diet now has even more health benefits!

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