Dr Pete, awesome information as always. And so appreciated even if my eyes do glaze over a few times with the chemistry. But I'm an old dog and do want to learn new tricks. You're just about the only person online I know of who I will accept because of your own experience with gout. I'm in my seventies and I can't tell you how many GPs have given faulty advice in the past. Over forty years I've been trying to learn and adjust my habits to tame this beast. I've been carnivore for about 9 months and other than 2 times I have suffered no gout flares. Once, when beginning which was expected, and second when I fell on a broken sidewalk and suffered some trauma to my arm. And boy did that hurt. My history has been that a trauma or stressful event caused way more attacks than diet. I could never really pinpoint any gout food triggers. But in the last couple of years: NO alcohol, No fruit, and No sugar. I do take 300mg of allopurinol but am wary of taking more. This might be associative but my sleep is troubled and vision is a little off, not a lot but a little. Have you noticed any side effects from allopurinol? Many thanks again for this presentation.

Have just watched your video and have found it the most informative on the subject I've seen.as a gout sufferor who has just had a particular bad attack was missing doses of my prescribed allopurinol.after listening to you I will now take my medication religiously.many thanks to bringing these facts to my attention and taking the trouble to do the research.

Amazing and relevant info for that next level of healing. Thank you.

Very good information👌👍

Thank you much needed

Due to my chronic gout (last year monthly) and use of prednisone, my doc is recommending 50mg allopurinol a day. I have driven many of my numbers in the right direction, but UA still 8. My new home meter showing intermittently even higher in 9’s. I have decided after listening to you, Johnson, Perlmutter to do allopurinol as I am a very high risk 70 yr old with heart disease and hi glucose levels ( much lower now). Have put myself on Quercetin, tart cherry and a few others. I have debilitating fibromyalgia so chair exercises and strength training a challenge. But you help encourage me. Thank you. I have been ketogenic for a while.

Thank you for your work Dr Pete, I appreciate the depth of research and level of thought you put into this video. However, the discussion felt incomplete without a head-to-head comparison of the risk of living with asymptomatic uricemia versus the risk of taking allopurinol, which is not a completely safe drug. I am currently analysing these risks myself in order to make an informed decision. The risks associated with allopurinol are well known, and can be mitigated to a degree through genetic testing and very low starting dose, however not removed completely. Would be interested to hear your thoughts on this. Again, thanks.

It would be interesting to see serial cardiac scans on the same patients after treatment. I should note that even with more aggressive Rx (allopurinol, 300mg bid) gout symptoms often take quite a while to lessen (taking as long as 2 years). Of course, allopurinol and febuxostat have no direct on UA deposits. I get the impression that these deposits took a long time to form and, with therapy, dissolve only slowly. This is confirmed in the rare patient with subcutaneous nodules, whose regression under treatment is easy to monitor.

I think the carnivore turned off my endogenous fructose production. Mainly by naturally eating less fat and almost no dairy. Also totally off sweeteners.

What is the right time to use allopurinol

Dr. Pete, I noticed over time, when I had labs in conjunction with a Gout attack or high Uric Acid, the liver enzymes were higher than normal, also higher triglycerides, LDL, low HDL... So I researched a potential association between Gout and NAFLD, and found indeed there is an association. A recent study out of Egypt, performed on lab rats made ill with a high fructose diet(like so many of us) tested a novel treatment approach that seems to make sense. I think you will be interested in the results. "Hyperuricemia is a key player in the pathogenesis of NAFLD. This study investigated the effect of allopurinol (uric acid synthesis inhibitor) in combination with metformin and vitamin E in the prevention of fructose induced-fatty liver in rats." Could Metformin along with Vit E and Allopurinol be a more far-reaching synergistic metabolic solution for some Gout sufferers with hidden NAFLD... short of adding the Keto Diet to allopurinol as you have done? There's much research recently touting Metformin as a possible anti-aging miracle. Certainly, the histopathological improvement to hepatic tissue health, reducing fat deposits and inflammation is remarkable in these rats anyway. Title: Allopurinol potentiates the hepatoprotective effect of metformin and vitamin E in fructose-induced fatty liver in rats Clin Exp Hepatol. 2019 Mar; 5(1): 65-74. Published online 2019 Feb 20. doi: 10.5114/ceh.2019.83159 PMCID: PMC6431087 PMID: 30915409 www.ncbi.nlm.nih.gov/pmc/articles/PMC6431087/#:~:text=Allopurinol%20synergistically%20increases%20the%20protective,acid%20synthesis%20and%20iNOS%20expression.

My UA is at 8.1 I’ve had like 4 flare ups this year. How can I lower my uric acid naturally?? I’m not taking any medication should I be concerned about cardiovascular disease???

Hi Dr Pete great video i have some catching up to do. I think i came across ur videos in the past tho i think ur the reason I’ve bought my UA sure meter. I was quite excited to work with it just received it a week ago. Ive bought it to finetune my UA levels since they’ve started measuring my UA in 2017 when i got diagnosed with T2D it ranged in the 6-7 sometimes 8-ish. Ive put my T2D in remission lost weight Hb1ac is 5.4 no insulin no meds. Only my UA remains high just under 7. My diet has no alcohol no fructose and moderate protein. Im kinda clueless here and unfortunately the measurements with my UA sure are anything inbetween 5 and 7.5 wich makes it useless to tryna finetune. I don’t have gout and don’t have genetic predisposition for gout (dna test). So yh kinda clueless right now

What is the most accurate UA home test kit?

I have Meniere's disease and tried allopurinol but it caused a Meniere's attack the same day, not sure which is worse the nausea or the pain of gout. With keto and supplements my last UA level was 6.8 and I am trying to work mu way down. My foot doctor is concerned for my left big toe and maybe cut it off because of tophi buildup and infection. He want me to see a rheumatologist and IV some drug that knocks UA down fast (krystexxa), what do you think. I'm 69, keto, take querciten, and other supplements to lower UA.

M doctor put me on allopurinol as my uric acid is borderline am on 100mg I have type two diabetes and unstable blood pressure also small vessels disease does borderline uric acid cause CKD

Do you have a plan for going off allopurinol?

Sorry I didn't understand this Statistics. Did you mean to say that 9 million ( if your are rounding should be 8 million correct?) of the US population presents with gout and 43 million of the US population in general are hyperuricemic? If I heard you correctly you said 9 million people presented with gout and within those presenting with gout 43 million are hyperuricemic.