Hello all,
Doug (a newbie to the site) here. I have beeen fighting a flare up for the last two weeks, pain has moved all around in my right foot and ankle and is FINALLY subsiding…

I visited the doctor last Tuesday and he was ready to put me on an Rx treatment. I told him about what I had been reading up online (mostly from GoutPal) and wanted to try some dietary changes first – much to my suprise,he agreed!

As the site suggests, a gout diet is as much about balance as what we eat. I also see alot of talk about pH balance. I have been drinking distilled water for 30+ years. After reading about the balance of foods and pH, I decided to check the pH of the distilled water and found it to be 6.4! What is the chance of all of the acidic foods + beer, topped off with acidic water are increasing my attacks?

If so, does anyone have any knowledge of how to best turn water alkaline? There is a ton of information on this on the web but it is very contradictory.

Thanks for the help, great site!


  • Hi Doug and welcome,

    The first consideration has to be your uric acid level. The cornerstone of a good plan for managing gout has to start with your current uric acid level, and a target for the next few months.

    With your target set, you can plan a strategy based on either diet, drugs, or a combination. Much depends on your starting point. Some people, myself included, have plenty of scope to lower uric acid through improved diet. Others might have great difficulty overcoming hereditary barriers that block all attempts at reducing uric acid through lifestyle choices.

    Whatever your situation, you have to monitor uric acid and adjust your diet accordingly. Gout attacks are not useful indicators of progress, as you can get gout flares from old uric acid crystals dissolving almost as easily as you can from new crystals forming.

    As you say, “balance” is important for a good gout diet, though it is not always clear what a good balance is. I’m currently restarting my own gout diet plan, and I will expand more on this over the next few weeks.

    pH balance is much misunderstood in it’s own right, and is often made even more confused when discussed in the context of gout. The primary reason for considering the pH aspect of diet is that alkaline urine is much less likely to form kidney stones. This is important for anyone with high uric acid, and also for gout patients taking allopurinol.

    An alkalizing diet is absolutely nothing to do with the pH of food and drink that goes in the mouth. Many foods are acidic when tested, but have an alkalizing effect on urine. The pH of food items, including water, is totally irrelevant. What matters is the protein and mineral content. I have prepared food tables that show estimates of the alkalizing / acidifying effect of foods from the USDA database, using the PRAL calculation. This calculation is accurate for most foodstuffs, and is best supported in practice by pH testing of urine.

    Balance, or variety, is crucial to avoid nutritional shortages. One must never seek all alkalizing foods, but balance acid producing with alkaline producing such that the total is alkaline producing. In simple terms, take your portion of protein (meat, fish etc) and balance it with two to three times as much veg and fruit.

    Usually, one would ignore water in this context as it has no contribution to the PRAL calculation. If you are struggling to achieve alkaline urine with a balanced diet, you could add lemon juice or baking soda to water. Switching to a cheap mineral water might also work, depending on its mineral content, but avoid expensive alkalizing waters that claim miracles – they are simply a waste of money.

  • dlbarnha

    I have stopped drinking the distilled water (0 minerals) and switched to filtered tap water. I have also been using your PRAL info to try and balance out the protiens.

    I also saw a comparison for pruines in beer that showed home brew to be about 80% lower than commercial brews. I’ve been drinking 2 waters per beer and no more than 1-2 brews a day… I have also increased water intake to 80-100 oz./day…

    I have a physical scheduled for mid Feburary and plan on asking for a uric acid level with the lab work.

    BTW – I have been doing the Master Cleanser fast twice a year for the last 5-6 years. It is a 10 day fast w/ a special lemonade (10 oz. water, fresh lemon juice, maple syrup & cayane pepper) only taken for 10 or more days. Would you think this helps gout or aggrevates it?

    Thanks fro the reply!

    • Good to hear you are getting a uric acid test, Doug. This is vital for managing gout. Regular monitoring is the only way to tell if your diet is improving your gout or not.

      Also good to hear you are using the PRAL tables. I’m actually working on some new ones that give values by calorie intake, or typical serving.

      Fasting raises uric acid levels during the first few days. In people with normal uric acid, it returns to normal after 4 or 5 days, but I have seen no data for gouties. Fasting or bingeing is never good for gout – much better to spread the food and drink intake as much as possible. Breakfast – snack – lunch – snack – dinner is good. See more about diet for gout.

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