this post was submitted on 15 May 2025
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A bit of my past, back in about 2003 - before I had eliminated sugar from my diet - I went to an all day event, got dehydrated and had a gout attack.

I mistook it for a foot injury from jumping down some stairs

But it happened again and nothing I had done could be blamed, so I ended up on allopurinol

Time passed, allopurinol worked. Then about COVID lockdown time I fell off keto and went back to eating junk, then in December 2022, just before Christmas I read The Fat Of The Land and went carnivore, calling it zero carb

So everything I read said there's no gout without sugar, so I stopped using allopurinol

Then in April this year I got foot pain. Not quite the classic big toe ball of the foot swelling but the next three toes' joint

So I blamed gout despite having no sugar for years

I got prescribed an anti inflammatory and it quickly cleared the problem

Then it happened again and I noticed the pattern, it was particular shoes. I cut my toe nails shorter and now those shoes don't compress my toes and cause toe pain

So I'm pretty sure again that gout needs sugar

Reversal being:

  • I thought I had an injury but it was a gout attack when I ate junk
  • I thought I had a gout attack but it was an injury while I was eating just meat
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[–] [email protected] 2 points 1 week ago (1 children)

Interesting journey. Did you find blood uric acid levels related to the frequency of gout attacks?

Since going zero carb did your uric acid levels go down, or is it still high?

The second shoe pain incident, was it a gout flare caused by compression? I.e. did it still hurt when you were barefoot?

[–] [email protected] 2 points 1 week ago (1 children)

0.45mmol/L, compared to 0.36mmol/L while on allopurinol

Reference range is 0.20 to 0.42, I don't have the numbers from when I was having attacks.

The recent pain was because my toenails were long enough that they were pressed hard against the toe of my shoe (my right foot has about half a centimetre free space ahead of it with close trimmed nails). It wasn't gout at all.

[–] [email protected] 2 points 1 week ago (1 children)

When you had your gout attacks it was only in the toe?

Thanks for sharing! its fascinating

[–] [email protected] 2 points 1 week ago

Only on the big toe joint, which is pretty typical