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Keto and Gout: What You Need to Know to Keep Your Joints Happy

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Maintaining good joint health is essential for leading a pain-free and active lifestyle. Gout, a form of arthritis, can significantly impact joint health and cause discomfort. If you're following a ketogenic diet or considering it, it's important to understand the potential implications for gout and how to navigate this dietary approach without compromising your joint health.

This article discusses the relationship between the ketogenic diet and gout, providing valuable insights to keep your joints happy.

What is Gout?

Gout is a type of arthritis that is caused by a buildup of uric acid in the blood. Uric acid is a waste product that is normally excreted from the body through the kidneys.

However, in people with gout, the body produces too much uric acid, or the kidneys are unable to excrete it properly. This leads to the formation of urate crystals in the joints, which can cause inflammation, swelling, and pain.

Arthritis and Joint Supplements

If you live with Arthritis or joint pain, make sure you read our expert reviews and recommendations of the best supplements for joint pain. Supplements can improve joint health and reduce the symptoms and pain from Arthritis.

What is the Keto Diet?

The keto diet is a high-fat, low-carbohydrate diet that is designed to put the body into a state of ketosis. Ketosis occurs when the body is deprived of carbohydrates, and begins to burn fat for energy instead. This process produces ketones, which can be used as fuel by the body and brain.

How Could Keto Affect Gout?

On the surface, the keto diet seems like a good option for those with gout. After all, the diet is low in carbohydrates, which are known to increase uric acid levels in the blood. However, some potential concerns should be considered.

High Fat Intake

One of the main concerns with the keto diet is its high fat content. While fat is an important nutrient, too much of it can lead to weight gain, which is a risk factor for gout. In addition, some types of fat, such as saturated fat, have been linked to an increased risk of gout flares.

Increased Uric Acid Production

Another concern is that the keto diet could increase uric acid production in some people. This is because the body produces uric acid when it breaks down purines, which are found in high amounts in certain types of meat and seafood. While the keto diet is low in carbohydrates, it is often high in protein, which can lead to an increased intake of purines.


Finally, the keto diet can be dehydrating, which can increase the concentration of uric acid in the blood and potentially trigger gout flares. This is because the body excretes uric acid through the urine, and when there is less water in the body, the urine becomes more concentrated.

Can the Keto Diet Trigger Gout Attacks?

While the keto diet has been shown to have several health benefits, it can also be high in purines, which can increase uric acid levels in the body and trigger gout attacks. Foods high in purines include red meat, organ meats (such as liver and kidney), shellfish, sardines, anchovies, and some vegetables, such as asparagus and mushrooms.

However, not all low-carbohydrate diets are equally likely to trigger gout attacks. Some studies have suggested that a low-carbohydrate diet that is also low in purines may effectively reduce gout symptoms and prevent attacks. A low-carbohydrate diet that is high in plant-based foods, such as fruits, vegetables, legumes, and whole grains, may be particularly beneficial, as these foods are low in purines and rich in anti-inflammatory compounds that can help reduce joint pain and swelling.

Tips for Managing Gout Symptoms on the Keto Diet

If you have gout and are considering the keto diet, it's important to talk to your doctor or a registered dietitian to develop a personalized plan that takes your individual needs and health status into account. However, there are some general tips that may help manage gout symptoms while following a keto diet:

1. Choose low-purine foods

As mentioned earlier, foods that are low in purines can help lower uric acid levels and reduce gout symptoms. Some examples of low-purine foods include:

  • Fruits, such as berries, cherries, and apples
  • Vegetables, such as leafy greens, broccoli, and cauliflower
  • Low-fat dairy products, such as milk, yogurt, and cheese

2. Limit high-purine foods

While following a keto diet, limiting your intake of high-purine foods is important to help prevent gout attacks. Some examples of high-purine foods to avoid or limit include:

  • Red meat, such as beef, pork, and lamb
  • Organ meats, such as liver and kidneys
  • Seafood, such as anchovies, sardines, and mussels
  • Beer and other alcoholic beverages

3. Keep an Eye on Your Protein Intake

Protein is an essential nutrient for maintaining muscle mass and overall health. However, consuming too much protein can increase uric acid levels, which can aggravate gout symptoms.

On the keto diet, consuming high amounts of protein is common to make up for the lack of carbohydrates. But if you have gout, it's crucial to monitor your protein intake and not go overboard.

Consult with your doctor or a registered dietitian to determine how much protein is appropriate for you, taking into account your individual health history and any medication you're taking. They may recommend lean protein sources such as chicken, fish, or plant-based protein like tofu and legumes.

4. Stay Hydrated

Staying hydrated is critical for preventing gout attacks. Adequate hydration helps to flush excess uric acid out of the body and reduce the risk of urate crystal formation. Drinking enough water can also help you feel fuller and reduce your overall calorie intake.

On the keto diet, it's especially important to drink plenty of fluids since the diet tends to have a diuretic effect, meaning it can cause increased urine output. Aim to drink at least 8-10 cups of water per day, and more if you're physically active or live in a hot climate.

5. Incorporate Low-Purine Foods

Purines are naturally occurring compounds found in many foods, including meat, fish, and poultry. When purines are broken down in the body, they create uric acid. Therefore, it's important to limit your intake of high-purine foods if you have gout.

On the keto diet, it's easy to consume a lot of high-purine foods like red meat and organ meats. However, there are still plenty of low-purine options to choose from, including vegetables like broccoli, cauliflower, and mushrooms, as well as nuts and seeds. Try to incorporate more of these foods into your meals to help keep uric acid levels in check.

6. Consider Supplementation

Certain supplements may help to reduce gout symptoms and prevent flare-ups. For example, research has shown that vitamin C supplementation may lower uric acid levels in the blood. Omega-3 fatty acids, found in fish oil supplements, may also have anti-inflammatory effects that can benefit people with gout.

However, it's essential to talk to your doctor before taking any new supplements, as they may interact with other medications or have unwanted side effects.

7. Keep Your Keto Diet Balanced

Finally, it's crucial to maintain a balanced and varied keto diet to ensure you're getting all the nutrients your body needs. Focus on incorporating plenty of non-starchy vegetables, healthy fats like olive oil and avocado, and various protein sources. Avoid relying too heavily on processed or packaged foods, which can be high in sodium and other additives that may trigger gout attacks.


Maintaining joint health while following a ketogenic diet requires careful consideration and a personalized approach. While the ketogenic diet may have potential benefits, it is crucial to be mindful of its impact on gout, a condition influenced by uric acid levels.

By adopting moderation, staying hydrated, incorporating anti-inflammatory foods, monitoring uric acid levels, and seeking guidance from healthcare professionals, individuals with gout can navigate the ketogenic diet while keeping their joints happy. Everyone's body is unique, so it's essential to listen to your body's responses and make adjustments accordingly.

Aaron Bernstein, MD, MPH

Aaron Bernstein is the Interim Director of The Center for Climate, Health, and the Global Environment, a pediatrician at Boston Children’s Hospital, and an Assistant Professor of Pediatrics.

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