Gout Uric Acid
I’d like to add gout as another area that Dr. Kats can give us advice on. Gout causes problems for a... View more
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Uric Acid, Nitric Oxide, and Potassium
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Uric Acid, Nitric Oxide, and Potassium
Hi Dmitry,
I was recently researching gout and ran across this vid: https://www.youtube.com/watch?v=k9beFmo-bP0 .I’m wondering what you think of this? When he mentioned nitric oxide can inhibit xanthine oxidase, which then creates uric acid, my first thought was L-Glutamine increasing nitric oxide. However, then we have the issue of nicotinic acid increasing uric acid levels. I was trying to look into that and it’s a bit confusing. They seem to think it might be a combo of inhibiting uricase, which helps process uric acid, and reducing excretion via some sort of urate handling.
One of the studies that is referenced in regard to the uricase is this one: https://link.springer.com/article/10.1007/BF02955463 however, I also found that humans do not have uricase due to a gene mutation long ago, so not sure why that would even be applicable here? That still leaves the other theory of niacin reducing excretion. I found this study on that: https://www.sciencedirect.com/science/article/abs/pii/0026049571900266 . Although very small with only 5 participants, they seemed to have a pretty high nicotinic acid dosage of 4.5 g per day, but only for one month. They then found that uric acid clearance decreased by 75%, which seems incredibly high and like that could definitely lead to gout and flare ups. Would you expect the L-glutamine inhibiting effects on xanthine oxidase via nitric oxide increases to be enough to counter the decrease in uric acid clearance? Or perhaps there is something else acting on that decrease in clearance?
In addition, I found the part about potassium to be interesting. I saw in Richard’s thread that he had some success with combating his gout by taking moderately high doses of potassium. I looked back at some blood tests I’ve taken the past couple years and noticed my potassium levels were on the lower end, so perhaps that is related to my gout? Do you see any issue with supplementing a bit of additional potassium once I go back on the protocol?
Thanks,
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4 Replies
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To clarify, I had paused the protocol to try other options to reduce the swelling and especially the pain. Over a few days I experienced a slight reduction in both but I make no claim that potassium was what did it. It could have just as well have been diet (eliminating added sugar and hyperglycemic foods and abstinence from alcohol – which I rarely consume anyway) – or the amount of water I drank or … I tried a lot of things. Eventually I caved, got a prescription for prednisolone and 6 days later was limping enough to walk the dog
The internet is where information goes to die – or at least where it is echoed repeatedly right or wrong. I decided to trust the research that Dr. Kats posted which was more authoritative than anything else I found.
Now up to 14/16.8 per day. Feet are fine. Going for a blood test soon.
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Indeed… and we are seeming to see why gout requires so much niacin + glutamine (as you see at the high dose here) early to really overpower… the lead connection:
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Thanks for clarifying, Richard. I have also changed my diet, most notably, a big reduction in sugar/fructose and simple carbs. I still think the potassium aspect is interesting.
That is interesting, DK. Would you recommend us gout sufferers get a lead levels test?
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I don’t recommend anything… the lead tests may show it in the kidneys; may not … the truthful, objective science would recommend to power it out with sufficient proper flush niacin + equimolar glutamine … messing with the diet is only going to do so much … if and I do think lead is the culprit, given it is such a massive risk factor (and common) per the recently published literature, again – it only beckons for more flush niacin + glutamine to power to clear it… they spend billions hoping people think modifying diet is going to do miracles for gout, just like they do with everything else. Of course, shit diet with fake sugar higher will present aggravation of symptoms, but again, the cause and reversal comes down to the niacin/glutamine supply.
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