Gout — characterised by excruciatingly painful joint inflammation from uric acid crystal deposition — affects approximately 1 in 40 UK adults, predominantly men over 40. The relationship between keto and gout is nuanced.
During ketogenic adaptation (first 2–4 weeks), uric acid levels temporarily rise as the kidneys reduce uric acid excretion while increasing ketone excretion. This transitional period may trigger a gout flare in susceptible individuals.
Fructose — abundant in sugar and high-fructose corn syrup — is the main dietary driver of uric acid production. Keto eliminates fructose entirely. Long-term keto practitioners who have passed the adaptation phase often see uric acid levels normalise.
Obesity is strongly associated with gout. Keto’s significant weight reduction effect reduces the serum uric acid load from adipose tissue turnover over time.
Stay very well hydrated during adaptation. Cherry extract and vitamin C are both shown to reduce uric acid levels. Discuss with your GP if you are at high gout risk.
Choose lower-purine proteins (eggs, chicken) during the adaptation phase. Our keto breakfast ideas and keto main dishes offer varied protein options.