Last Updated on April 12, 2024 by Fasting Planet
If you have gout, then your day-to-day life is probably quite painful. Besides the current, doctor-prescribed treatment you’re on, you’d also like to try holistic measures for lessening your symptoms. One such treatment that has interested you lately is fasting. Can fasting help with gout? If so, how?
Fasting allows you to lose weight and avoid purines from food, making gout attacks less likely. That said, slow and steady wins this race, as dropping too much weight at once can worsen gout symptoms as your body prioritizes expelling ketones instead of uric acid.
In this article, we’ll further explore the link between fasting and gout, how it can help, and which types of fasts are best. If you’re eager to try something new for your gout pain, then you’re not going to want to miss this article.
Understanding Gout
Whether it’s you who has gout or a loved one, this overview will give you lots of useful information on the condition, including triggers you may not have been aware of!
Description
Gout is a type of arthritis that causes joint tenderness, redness, swelling, and pain. Most of this pain is centralized around your feet, specifically the big toe at the base, but pain can occur elsewhere for some people.
When you feel an onset of pain, this is known as a gout attack. Triggers (which we’ll talk more about shortly) can cause a gout attack, but sometimes it seemingly comes on out of nowhere. You could be at work, asleep, exercising, or in the middle of grocery shopping and have a gout attack.
During a gout attack, you can feel a fiery, burning sensation, especially in the feet. Besides that, the affected joint may actually be warm to the touch. Tenderness of the joint may increase, as can swelling.
Symptoms
Gout symptoms, when they manifest, tend to do so at night more than during the day. That said, you can have a gout attack anytime, as we said, and often with very little warning. Even if you’re not experiencing a gout attack, pain and discomfort can persist in the form of these symptoms:
- Decreased motion, which tends to happen in patients with more advanced cases of gout
- Post-gout attack pain, which may persist for hours but can also stick around for weeks at a time
- Very painful joints, such as the fingers, wrists, elbows, knees, and ankles
- Pain that gets worse over time, especially four to 12 hours later
Causes
What causes gout in the first place? This arthritic condition becomes painful when your joints develop too many urate crystals. The crystals are comprised of uric acid. If you’re not familiar, uric acid is a type of heterocyclic compound or chemical with hydrogen, oxygen, nitrogen, and carbon.
Uric acid comes from purines, a chemical compound in many of the beverages and foods you eat every day. The foods that are highest in purines are:
- Thymus gland, kidney, liver, and other organ meat, sometimes referred to as sweetbreads
- Haddock, trout, scallops, codfish, mussels, herring, anchovies, sardines, and tuna
- Red meat
- Duck, venison, veal, and other wild game
- Beer
- Dried beans
Your body also makes purines, even outside of the food you eat. The purines then get broken down to make uric acid. The acid doesn’t stay in your system forever, as uric acid will dissolve if it reaches the bloodstream. Otherwise, you dispel uric acid each time you urinate.
Someone with gout may have an excess of uric acid. For other patients, their kidneys don’t release enough uric acid, retaining the levels within the body. As uric acid accumulates, it makes urate crystals. These are thin with razor-sharp edges.
When a urate crystal meets the joint, you feel it, and it’s awful.
Triggers
What triggers can make gout worse? Here are some to beware:
- Wearing too-tight shoes: Even if you don’t necessarily increase your body’s uric acid levels with your footwear choices, you can certainly inflame already irritated joints, making your feet very achy by the end of the day.
- Sustaining an injury: What we consider small injuries are major ones for those with gout. For example, if you stub your toe, the pain that radiates through your joints could be something you feel for hours to come. It’s also believed that uric acid could build up at the site of the injury, increasing your risk of a weeks-long gout attack.
- Having menopause: Older women entering menopause may find that, besides the cramps and hot flashes, they develop gout when they didn’t have it before. Those who already have gout and are going through menopause may experience worsening symptoms. This happens because the estrogen that allows the kidneys to release uric acid drops off in menopause.
- Losing weight too quickly: We’ll talk about this more in the next section, but crash dieting and other quick weight loss methods can lead to gout pain. As ketones increase in your system from dieting, your body will prioritize excreting the ketones instead of uric acid.
- Your diet: As we touched on above, the foods you eat and the beverages you drink add more purines to your body. When you combine these with the purines your body already makes, you’re more likely to end up with excruciating urate crystals.
- Obesity: Gaining weight, whether through purine-heavy foods or not, is not recommended for those without gout. If you become overweight or obese, it’s believed the body stops uric acid from exiting while simultaneously increasing how much uric acid your body produces.
- Being dehydrated: You should aim to drink eight glasses of water, eight ounces each serving, every single day. If you don’t and you become dehydrated, your blood uric acid concentration goes up, which could cause a gout attack.
- Using diuretics: If you have high blood pressure and your doctor prescribed diuretics, you’ll want to talk to them about taking a different medication. Diuretics can prevent the kidneys from breaking down uric acid, so it builds up. This results in gout pain for you.
- Taking aspirin: Another medication that boosts uric acid is over-the-counter aspirin. One or two tablets shouldn’t hurt, but popping three, four, or more does put you at a higher risk of urate crystal formation.
Besides those triggers, the following risk factors also come into play regarding who gets gout and who doesn’t:
- Your gender, with men having gout more frequently than women, probably because women have estrogen to move uric acid from the body. Menopausal women are at almost as much risk for gout as men.
- Your age, as most men tend to get gout from 30 to 50 years old. For women, it’s during or after menopause.
- Your family history, as gout will run in families.
- Having other medical conditions, especially kidney or heart disease, metabolic syndrome, diabetes, and high blood pressure.
Treatments
You can treat your gout in several ways. It’s believed that consuming cherries, coffee, and foods and beverages rife with vitamin C may be able to reduce your uric acid levels, thus keeping gout pain at bay.
Your doctor may prescribe you medications that can prevent or lessen the production of uric acid or those that promote the body to dispel uric acid. The former class of drugs, xanthine oxidase inhibitors, are Uloric (febuxostat), and Zyloprim, Lopurin, Aloprim (allopurinol). The medications that help your body excrete uric acid are known as uricosurics, such as Zurampic (lesinurad) and Probalan (probenecid).
NSAIDs, corticosteroids (frequently injected), and colchicine medications like Mitigare and Colcrys can lessen the pain of a gout attack as well.
How Does Fasting Help with Gout?
If you’re thinking of fasting for gout, you may be able to reduce the symptoms of this arthritic condition in two ways.
Fewer Purines in the Body
As you remember, purines are chemical compounds that the body uses to make uric acid. You can’t necessarily stop your body from making purines, but you can help the purines you put into your system through your food and beverage choices.
For many types of fasts, you forego food for a period, often a day or two. If you consume beverages, water is the primary drink, with green tea and black coffee other low-calorie choices. Coffee especially is a great beverage if you have gout.
Why is that? Coffee can disrupt the enzyme that’s responsible for purine breakdown, slowing the speed of uric acid creation. The caffeinated beverage may also be able to push uric acid out of the body faster.
In 2017, the American Journal of Lifestyle Medicine published data about coffee’s effects on patients with gout. The study wraps up by mentioning that coffee drinkers tend to have less risk of hyperuricemia, which increases blood uric acid past a healthy degree. Those who drank coffee also decreased their concentration of uric acid.
Not only does fasting prohibit further purine production in the body then, but sipping black coffee may be able to lower your concentrations of uric acid as well. You could feel far less gout pain on a fast.
Healthier Weight
One of the biggest risk factors of gout is being overweight or obese. Fasting can control your weight in several ways. For one, you consume fewer calories than your body burns, which results in weight loss.
The other is through fat burning. You see, when you eat and drink, you’re not just adding purines to your body, but glucose as well. Glucose is a form of energy that comes from our diets, primarily foods heavy in carbohydrates. When glycogenesis occurs, your liver converts glucose to glycogen, a usable form of energy.
You burn glycogen throughout the day to fuel your daily activities, but you usually replenish it when you sit down to eat.
In a fasted state, you want to burn through that glycogen until there’s nothing left. It’s only then that your body can switch to burning fat, which propels weight loss. It can take upwards of 12 to 14 hours for fat burning to start during a fast, but it may be longer for first-time fasters.
What’s the Best Type of Fast for Gout?
Knowing all this, we’re not ignoring that medical experts have called fasting a risk factor for triggering gout attacks. That’s because your body begins producing more ketones, which are liver chemicals that form when your body lacks enough insulin to convert glucose into usable energy.
The more ketones in your system, the more these get excreted over uric acid. This can cause a uric acid buildup that can contribute to gout pain or lead to a gout attack.
Would we say to never fast for gout? Not necessarily. First, we’d recommend you schedule an appointment with your doctor and ask if they think you should go on a fast.
If they give you the green light, then we’d suggest an intermittent fast over a longer-term one when fasting for gout. The longer your fast, the better the chances you’ll build up ketones, which you don’t necessarily want if you have gout.
It takes 12 to 14 hours to enter partial ketosis for some people, but it can be upwards of 10 days before you reach full ketosis according to LIFE Apps.
We’d suggest you start with a shorter intermittent fast then, such as a 12:12 fast, where you spend 12 hours fasting and then another 12 eating a gout diet. During this time, you will enter ketosis, but since it’s only partial ketosis, it might not irritate your gout symptoms.
If that turns out to be the case, then you might increase the length of your fast to something like a 16:8 fast, where you spend eight hours eating and then 16 fasting. The 5:2 diet is another good one, as it allows you to eat normally for five days a week. The other two days, you restrict your calories to no more than 500 to 600 a day, which is about 25 percent of your daily recommended intake.
You might even be able to successfully do an alternate-day fast, where you spend one 24-hour period fasting and then the next 24 hours eating as you usually do.
Of course, if at any time you have a gout attack that you sense was related to the fast, or if you feel worsening symptoms, you should stop fasting and call your doctor right away. It’s also very important that you maintain your hydration when in a fasted state, as dehydration is a trigger for a gout attack.
Should Fasting Be Your Only Gout Treatment?
Fasting may be part of a successful treatment for some gout patients, but we would never say it should be your only treatment. As we’ve discussed throughout this article, fasting for some gout patients can cause more pain than it’s necessarily worth. For others, they may be able to do an intermittent fast in short bursts, but not a longer fast.
No matter which camp you fall into, you must do more to treat your gout pain than fast. If your doctor has given you medication, make sure you take it diligently.
Modifying your diet is another big thing you can do to lessen your gout pain. This will keep your weight down and limit how much uric acid your body produces.
We already talked about some foods to avoid, but you also want to skip the yeast supplements, brewer’s yeast, and nutritional yeast. Sugary drinks such as soda and fruit juices are also no-nos, as are cookies, cakes, white bread, and other sources of refined carbs.
Begin incorporating these foods into your diet instead:
- Flax, olive, coconut, canola, and other plant-based oils
- Spices and herbs
- Green tea
- Black coffee
- Eggs
- Low-fat dairy, which a classic study from the American Journal of Clinical Nutrition found can help those with gout
- Barley, brown rice, oats, and other sources of whole grains
- Seeds and nuts
- Vegetables, including dark leafy veggies, eggplants, mushrooms, peas, and potatoes
- Fruits, especially cherries
These foods all contain 100 milligrams of purines or fewer for every 100 grams or 3.5 ounces you consume.
For breakfast, you might whip up something like a bowl of unsweetened, whole-grain cereal with some strawberries and low-fat or skim milk. You can drink water or coffee with your meal.
For lunch, you can try a mixed green salad with plenty of nuts and veggies. Olive oil-based dressing or balsamic vinegar are two dressing choices. A glass of water or low-fat milk makes this a balanced lunch.
If you want a more substantial lunch, try roasting chicken breasts, putting them on a whole-grain roll, and adding a dollop of mustard.
For dinner, you can make a roasted salmon or poultry if you didn’t have it for lunch. You may also enjoy up to a cup of whole-grain pasta, mixing it with lemon pepper and olive oil. For dessert, snack on a cup of melon or a single low-fat yogurt.
Conclusion
Gout is an incurable arthritic condition caused by the buildup of urate crystals in the joints, which causes immense pain. While gout typically affects the feet, other joints can become painful as well.
Fasting may help with gout in that it can cause you to lose weight and reduce the consumption of foods that boost your uric acid levels. That said, too many ketones in your system can prevent the body from expelling uric acid, so make sure you enter only partial ketosis on your fast, not full ketosis. Good luck!