Let me tell you how it all began – my strange interest in something called uric acid, that is.
I awoke in the middle of the night with a dull pain in the back. I got up, thinking maybe I had to pee or maybe it was just one of those weird things that happens and disappears with a little movement. But nothing seemed to relieve the pain. And as the minutes and then hours went by, the pain grew more and more excruciating.
It was unlike anything I had experienced in my life. And let me tell you, I’ve experienced lots of weird and painful shit. But this took the cake – a cake of pain. I couldn’t stand, sit, lie down, or roll over for that matter for more than a few seconds without having to move to another position. I was literally writhing for hours.
I’ll spare you all the drama and cut to the chase. After many failed attempts to relieve the pain with heating pads, water, and herbs, I finally discovered the secret that gave relief: lots of watermelon. Thankfully, it was summer and watermelon was in season. After eating a few of them and peeing like a racehorse, the pain subsided.
Nearly a month later I had a repeat episode. Once again, watermelon saved the day.
Then, a year later, yet another episode. Same as before, only twice as excruciating and twice as long to improve. After the third watermelon I passed a bunch of small, yellow stones that I’m 99.9% sure were uric acid stones. I did not have them tested, but my theory is substantiated by the following: for one, I had purchased some of those pH strips sold for the purposes of testing urine pH, and my urine was testing consistently very acidic, which is the condition in which uric acid stones form (versus oxalic stones, which only form when urine pH is consistently alkaline). For another, over the course of the year I had symptoms of gout – including the classic symptom of pain in the big toe – which is a condition thought to be caused by deposits of uric acid in the joints, and gout and uric acid stones are commonly seen together.
Anyone who has ever experienced kidney stones or gout will know that once having had the experience one is highly motivated not to have a repeat. So understandably, I have been researching the matter for a while now. And what I have found is that much of the common advice is?unhelpful, perhaps even counterproductive, and certainly restrictive. Let me explain.
The common advice available on the internet and from health care providers is as follows: avoid anything and everything that might possibly elevate uric acid levels. Avoid alcohol. Drink a shit load of water.
The first point is the one that I want to focus on: avoid everything that can elevate uric acid levels. This sounds like reasonable advice until one understands what can raise uric acid levels. If we believe the experts then we are to believe that all?meat (including fish and seafood) and especially organ meats raise uric acid levels. But the list doesn’t stop there. Also included are asparagus, cauliflower, most beans and legumes (such as peas), oatmeal, and spinach. And the Mayo Clinic even recommends (apparently still toeing the line that most of us have long since abandoned as bad science) restricting saturated fat because it claims that saturated fat reduces the body’s ability to eliminate uric acid (yet they fail to cite anything to back this claim).
We?re not quite done with that list yet, though. All the sugar haters are practically peeing their pants in delight right now because sugar has just racked up another tally on the evils of sugar tally board. That’s right. Sugar increases uric acid. The worst sugar of all is…wait for it…fructose! Fructose makes up half of sucrose, so cane sugar, beet sugar, and maple syrup (all sucrose) are all guilty. Honey is extremely high in the poison. And then there’s fruit, which is often teeming with the stuff. Sure, some fruits have relatively low amounts of free fructose, but then they often have a lot of sucrose, which, as we have already learned, is fructose hiding behind glucose. So many health advisers actually warn against eating fruit because of the dangers it poses. The worst offenders? Apples and oranges.
So when we put this all together, what we’re left with (if we want to be ultra conservative) is an extremely restricted diet consisting of low fat dairy, grains, and a small handful of vegetables. First of all, yuck. I mean, really. Yuck. And secondly, a substantial reduction in calories is one of the known causes of high levels of uric acid in the blood. So any dietary restrictions that are likely to produce significant caloric decreases will probably increase uric acid. I don’t know about you, but if all I’m allowed to eat is skim milk and rice then I’m probably going to have a caloric deficit, and so I’ll probably have increased uric acid.
Now, I don’t know about you, but it’s starting to look a bit like maybe the body likes uric acid just a little bit. I mean, if just about anything one does seems to create uric acid, then what’s up with that? Stupid evolution must have failed big time, right?
Well, I’m betting on no. I’m willing to wager that uric acid isn’t the devil it’s been made out to be. So let’s have a looksee. Normally when we hear about uric acid, we hear about how terrible it is. We hear that uric acid is implicated in metabolic syndrome, cardiovascular disease, and even diabetes! Sounds like uric acid really is bad!
But wait just a second. Because, you see, despite the bad rap that uric acid has gotten, it turns out that it is an antioxidant. Yeah. You heard that right. Uric acid is one of the good guys! So what’s going on here? You see, all that has ever been demonstrated in each of these cases is that these conditions happen to be correlated with higher uric acid blood levels. But considering that each of these conditions also correlates with increased oxidative stress, we shouldn’t be surprised to see higher levels of uric acid. Maybe, just maybe, uric acid is helping.
So is there any evidence that uric acid is helpful in any conditions? Uh, yeah, there is. Where to begin? First, there’s the little matter of multiple sclerosis. Turns out that people with MS have low levels of uric acid. [study: http://www.ncbi.nlm.nih.gov/pubmed/11985629] And some people with MS show improvement when uric acid levels increase. [study: http://www.ncbi.nlm.nih.gov/pubmed/17121380] Then there’s the matter of idiopathic (which is the usual sort of) Parkinson’s disease. One study concluded that uric acid may protect against the disease. [study: http://aje.oxfordjournals.org/content/144/5/480] Next, there’s schizophrenia. A study found that uric acid levels are low in cases of schizophrenia. [study: http://www.ncbi.nlm.nih.gov/pubmed/9727961] There’s also a study that shows that uric acid may be helpful in type 1 diabetes and for heavy smokers. [study: http://www.ncbi.nlm.nih.gov/pubmed/17065352] Granted, these studies were all fairly small, and so larger studies would be needed to confirm the outcomes. But thus far, uric acid is looking pretty good, not bad. Which isn’t to say that more uric acid is always better or that uric acid might not be problematic in certain contexts, but it sure seems far from the devil that you’d think it was if you read the recommendations to avoid producing the stuff at all costs.
So in light of this new information, let’s revisit the suggestion to eliminate foods that increase uric acid levels. On the one hand, it may sometimes offer some relief to some people who otherwise have a tendency to deposit uric acid crystals in joints or kidneys. But with the information we’ve just looked at, hopefully this suggestion to reduce uric acid formation in the body starts to look more like a band-aid than a real solution. It may sometimes help, but it certainly isn’t addressing the real problem, because uric acid isn’t likely to be the real problem.
What is the real problem? Well, that’s the million dollar question. And I’m not willing to state that I have all the answers. But with a little digging around I’ve got some good leads and insights that provide much more useful, realistic ideas as to what the problems may be in most cases of gout or uric acid kidney stones.
Both conditions are associated with low pH. In the case of uric acid kidney stones, they can only form when urine pH is consistently acidic. Urine pH has a fairly sizable range that is considered to be normal – from 4.6 to 8. You can test your urine pH using test strips sold in a lot of pharmacies and natural food stores. If your urine is consistently quite acidic (let’s say lower than 6) and you have a history of uric acid kidney stones then probably the very best thing you can do is get your urine pH closer to the 6-7 range. I’d caution against trying to get the pH too alkaline since that would be potentially very unpleasant. When my urine pH was 7.2 I found the experience to be quite unpleasant. So more isn’t always better.
Interestingly, gout also seems to be predicted by low urine pH. So much of what applies to addressing uric acid kidney stones also applies to gout. Namely, if your urine pH is consistently low then raising the pH can probably help.
Now the next million dollar question is: what the hell does one do to raise urine pH? And again, I don’t have all the answers. This is a complicated matter. Perhaps the single most influential regulator of pH in the body is the breath since carbon dioxide is the primary acid found in the body. In the blood carbon dioxide is balanced by bicarbonate, which is alkaline. So when the breath is too rapid or too deep (called hyperventilation) the kidneys will start dumping bicarbonate from the blood into the urine in order to prevent the blood pH from rising too much (blood pH is tightly regulated to stay in the narrow range of 7.35 to 7.45). What this means is that chronic hyperventilation (which is more common than you might think) actually raises urine pH. This is a mixed blessing. On the one hand, it can prevent uric acid kidney stones and gout. But on the other hand, it comes at a cost, which is that hyperventilation has a bunch of unpleasant side effects, including being correlated to a whole bunch of disease states and unpleasant conditions.
As it turns out, I got my first kidney stone event after I began practicing reduced breathing exercises to correct chronic hyperventilation. Looking at it now this makes perfect sense. My urine pH probably dropped because I was no longer dumping so much bicarbonate. It could very well be that hyperventilation is often an automatic compensatory measure designed to offset low urine pH. And even though I still think that correcting chronic hyperventilation by way of reduced breathing exercises can be a very good thing, I think it pays to also correct other imbalances.
So far we’ve seen that one possible way to increase urine pH is to hyperventilate. This may work, but it comes at a cost, and I don’t recommend it. Instead, I recommend finding other ways to improve urine pH.
In the medical world, one of the common ways in which uric acid conditions are treated is to prescribe alkalizing mineral supplements. Because of the general fear of sodium and also because potassium supplementation seems to be moderately more effective [study: http://www.nature.com/ki/journal/v30/n3/full/ki1986201a.html], the go-to supplement is potassium citrate. In some cases potassium isn’t tolerated, so then the fallback is either sodium citrate or sodium bicarbonate (baking soda). These supplements often work very well. But they can also have powerful effects that aren’t always pleasant. So they might be a good fallback plan, but they wouldn’t be my first choice on a daily basis. Many people report that half a teaspoon of baking soda in water a few times a day helps tremendously during a kidney stone or gout episode. For my part, though, I think they are powerful enough that I’d much rather find a less heroic means to regulate urine pH if possible and only rely on those supplements as necessary.
To begin with, do foods affect urine pH? Not surprisingly, they do, though generally not as strongly as strong alkalizing supplements. Generally-speaking meats tend to lower urine pH while most fruits and vegetables raise the pH. Fats don’t have much effect that I am aware of. Of course, there is a lot of nonsense out there on the internet with charts describing which foods and beverages are alkalizing and which are acidifying. But by and large, those claims are not backed by any real studies. They seem to be pulled out of thin air. However, there are a handful of studies showing that fruits and vegetables generally have alkalizing effects on urine. [see studies: http://www.jissn.com/content/5/1/20, http://www.ncbi.nlm.nih.gov/pubmed/15569332, and http://www.ncbi.nlm.nih.gov/pubmed/18042305. Note that some of the claims made by these studies are bogus, however. Specifically, the claim that acidic diets are detrimental to bone health are incorrect.] Otherwise, there’s not a lot of good information on the subject, at least not as it applies to humans. There are some studies showing that in non-human animals, grains tend to decrease urine pH. Whether this translates to humans, we don’t know. And the few human studies that use any forms of dairy suggest that most dairy probably has a neutral effect, but some fermented dairy such as yogurt may have a slightly acidifying effect.
I’ve already mentioned this, but it’s worth mentioning again; more is not better – a higher urine pH is not better than a balanced value somewhere in the 6-7 range. I mention this because some people take this alkaline-acid balance thing to the extreme and give up all meat in favor of eating all fruits and vegetables and dairy. That is a mistake because overly alkaline urine creates conditions for oxalate kidney stones and urinary infections. So don’t overdo it.
But on the other hand, it might start to be clear why low carbohydrate/high protein diets can produce uric acid stones and gout more reliably than just about anything else. In fact, though I can’t find the study off hand, I recall that in some populations low carbohydrate diets produce stones 50 times more often than other diets! Low carbohydrate/high protein diets are really the perfect storm for uric acid stones and gout because they tend to decrease urine pH while also increasing uric acid production, leading to what is known as supersaturation, which is the ideal condition in which uric acid crystals can form.
So the idea then is to eat a balanced diet that includes both acid-forming and alkaline-forming foods. Eat meat. Eat dairy. Eat vegetables, including starchy vegetables like potatoes. And eat fruit, lots of fruit. If you tend toward low urine pH then increase the fruit and vegetable to meat ratio.
Eating enough is important. Some of the literature about gout and uric acid stones suggest that obesity is a risk factor. That may be, but I suspect that in this case obesity is actually a stand in for low metabolic rate. So remaining in a state of semi-starvation and maintaining a sluggish metabolic rate is a bad idea. Instead, eat enough of everything in order to get your metabolic rate up. It can take some time, but based on a bunch of studies starting with the Minnesota Starvation Experiment it has been demonstrated over and over again that once the metabolic rate increases with consistent, adequate caloric and nutrient intake, the weight set point will lower and the body composition will naturally and effortlessly shift toward less fat and more lean mass. In other words, eating more may, in the long run, lead to less obesity. And therefore, it is at least plausible that eating more (as in enough) will lower risk of uric acid crystallization.
Hypothyroidism correlates very strongly with gout and uric acid kidney stones. And hypothyroidism can be worsened or produced by restrictive eating. So again, eating enough is likely essential for improving the condition.
What about beverages? To begin with, as Matt Stone has repeatedly pointed out, the advice to drink so much water that you start to pee clear is bad advice. That just means that you’re diluting your fluids and creating electrolyte imbalances. But on the other hand, particularly for those who have a history of kidney stones or gout, overly-concentrated urine is also a problem. So be sure to drink fluids when thirsty. Don’t make the mistake of avoiding fluids entirely in an attempt to increase metabolic rate (as I see some people doing). Drinking enough fluids so that urine doesn’t become saturated is important, and including adequate dietary salt can help to protect against electrolyte imbalance.
What fluids? Well, fruit juice is good. Orange juice may be a double win because not only does it provide overall alkalizing effects, it also provides citrate, which as we’ll see in a moment, is beneficial. Cherry juice is particularly good as well – though perhaps expensive. But cherries and cherry juice have been shown in numerous studies (here’s just one: http://www.ncbi.nlm.nih.gov/pubmed/12771324) to help with gout and uric acid kidney stones.
Despite the fact that many acid-alkaline diet proponents claim otherwise, coffee does not seem to affect urine pH. [study: http://www.sciencedirect.com/science/article/pii/0306460380900131] In fact, numerous studies demonstrate that coffee (though not the caffeine) consumption is inversely correlated to serum uric acid levels (though it is important to note that serum uric acid levels are not always a good predictor of problems related to uric acid crystalization). More importantly, coffee consumption is inversely correlated to gout. Personally, I am not a coffee drinker. I just don’t care for it. But if you like coffee then it’s probably just fine and maybe even protective against gout and uric acid kidney stones.
Alcohol is strongly positively correlated with gout. The evidence is that it would be best to avoid it for anyone who has a tendency to form uric acid crystal deposits.
What about soda? I’d strongly recommend skipping it. I’m sorry to jump on the anti-soda bandwagon, but it doesn’t look good when it comes to matters of uric acid complications. Not all sodas are equal in this regard, of course. So let me specify. In particular, I suggest avoiding any soda containing phosphoric acid because it will significantly decrease urine pH. And although the jury is still out on high fructose corn syrup, there is some evidence that the free (unbound) fructose content in corn syrup acts differently than either bound fructose (in sucrose, for example) or fructose occurring naturally in fruit. For anyone with a history of uric acid crystallization, I’d avoid it.
Some water is probably okay, but most water isn’t very mineralized, and as a result over consumption of water leads to electrolyte imbalances. So don’t drink a bunch of highly filtered water. Or, if you do, at least add some minerals to it. There are some notable historical accounts exist of the use of natural mineral water in treatment of kidney stones and gout. For example, the Italian mineral water, Fiuggi, has long been used to treat these conditions, and Michelangelo is said to have been cured of kidney stones from the water. As it turns out, the efficacy of mineral water – specifically Fiuggi water, has been tested and shown to be a valuable aid in improving urinary markers. But before you buy a bunch of expensive Italian mineral water, you might consider merely increasing fruit intake and possibly ensuring adequate salt intake with your water and possibly some of the supplements suggested next.
The substance citrate, which is a derivative of citric acid, found in (not surprisingly) citrus fruits among other foods, has positive effects in regard to improving renal (kidney) health. The best documented of these benefits is that it protects against calcium stones that can occur when pH of urine is alkaline. But there is also some evidence that citrate may help dissolve uric acid crystals. One possible source of citrate is from supplements such as potassium citrate or sodium citrate. But another source is (again, not surprisingly) citrus fruits. Orange juice is the most palatable of citrus fruit juices, and it contains some citrate, but lemon juice is the most concentrated source. In fact, one study showed that lemon juice worked nearly as well as potassium citrate supplementation for increasing urine citrate levels. [study: http://www.ncbi.nlm.nih.gov/pubmed/18946667]
Magnesium may also be involved in uric acid disorders, though I cannot find any human studies on the matter. Anecdotally, magnesium supplementation sometimes helps. And epsom salt (magnesium sulfate) baths have long been known to be helpful for gout. Also, gout is generally accompanied by high blood pressure. Magnesium can normalize high blood pressure, which may reduce the likelihood of uric acid crystallization. And finally, at least one study showed that of various supplements tested, magnesium potassium citrate proved the most effective in reducing urinary risk factors for stone formers. [study: http://www.ncbi.nlm.nih.gov/pubmed/15117041] So although magnesium supplementation isn’t as well studied as other possible ways to improve uric acid disorders, it shows some promise. Magnesium citrate is commonly available, relatively inexpensive, and less likely to cause unwanted side effects when compared to magnesium potassium citrate. Plus, potassium is pretty easy to get from foods when eating fruits and vegetables, but magnesium is a little trickier. Just don’t overdo the magnesium supplementation. It can have unpleasantly explosive results, if you know what I mean.
In summary, for those who have a history of uric acid stones or gout, I’m suggesting that the standard recommendations to restrict or eliminate large categories of foods, including meats (including fish and seafood), sugar, and fruit are misguided. Uric acid is not inherently bad. In fact, uric acid seems to have lots of really positive effects in the body. The problem arises when uric acid crystallizes and deposits in the joints or in the kidneys. And these problems seem to be averted or corrected by eating enough, correcting hypothyroidism, including enough fluids (without diluting bodily fluids and causing electrolyte imbalances), and increasing urine pH to the 6-7 range. The last point can generally be achieved by including adequate fruits and vegetables (including starchy vegetables) in the diet. Don’t forget to salt food to taste. Supplementing with cherries, citrus, and possibly magnesium citrate may be helpful. And in extreme or acute cases, supplementing with potassium citrate, sodium citrate, or sodium bicarbonate (baking soda) can be very helpful. However, if using these latter supplements, please use caution as they are very strong alkalizers, and they can easily lead to overly alkaline conditions that are just as undesirable as gout or kidney stones.
Oh, and just for the record, there isn’t any evidence that most people will benefit from any of this stuff. This probably only applies to people who have a history of gout or uric acid kidney stones. So if that’s not you then don’t stock up on cherry juice and pH strips. It probably won’t improve your life much. Though, admittedly, peeing on a strip of paper and having it turn colors (other than yellow) is strangely fun. But not that fun. Still, this information may come in?handy one day after you or someone you know makes the bad decision of trying a low carb diet or moves to the kidney belt.
Well, that’s all for now. Until next time, pee safely.
Joey Lott investigates and unmasks all forms of suffering. If you like what you’ve read here, then you can read more of his free content at his website, or you can check out his books.
Aloha Joey, really great article. You may be interested in researching Buteyko Breath technique out of Russia created by Konstantin Buteyko, MD in 1960’s that restores arterial CO2 levels back to normal. Carbon dioxide has impact on Uric acid levels according to Dr Buteyko so as CO2 level increases it causes a corresponding decrease in Uric acid, along with reducing blood pressure and releasing more oxygen into the body. Check out normalbreathing.com for lots of info. This method deals alot with reducing acidity in diet. High acidic diets reduce CO2 (increasing Uric / Lactic acids) which then utilizes Respiratory Alkolosis (exhaling co2) to reduce acidity / PH levels. I utilized Buteyko to eliminate severe Asthma symptoms ten years ago and this method now has 9 clinical trials confirming 95% reduction in symptoms in 8 – 12 weeks as an adjunct treatment. Hope this is helpful.
Joey’s done plenty of research on that and is even coming out with a book on that topic later this month called “Breathe.”
Greg,
Than you for your comment. As Matt said, I am familiar with Buteyko. I am also familiar with normalbreathing.com, which is a mostly good, but perhaps zealous resource.
I have seen a handful of abstracts for human studies with small numbers of participants that do conclude that Buteyko is safe and can be effective in reducing asthma symptoms and improving quality of life. It would be nice to see more studies regarding the other effects and potential of the method. Many Buteyko advocates make some pretty strong claims that aren’t yet backed by any good human studies. Based on my own experience and my understanding of the effects of reduced breathing exercises, I do believe that there are many potential benefits, but I also think there are some cautions that should accompany any discussion of reduced breathing exercises, particular those that involve breath holds as advocated by many Buteyko instructors. More research into the matter will probably reveal what those cautions should be.
I’m all for n=1 experimentation. But since my own experiences with n=1 experimentation have sometimes had extreme effects, I now greatly value prudent, safe experimentation with as much good information as possible.
It sounds to me like Joey is saying that the Buteyko method creates more uric acid stones by lowering the urine ph. I get them too and my two dilemmas are: drink more fluids even though the temps are in the mid 97 range and do the bag breathing or not? I like how I feel when I am warm and bag breathing is super calming but I don’t want the uric acid stones or joint pain either
Oh and another interesting bit about kidney stones is that whether passing them is actually a good sign. I found that the more I diluted my urine the worse the pain got. Then I said “ok I’ll just eat cheese for the next few hours”, I got warm and passed the stone easily in a couple of hours. Maybe raising your metabolic rate actually helps you get rid of them and that’s a positive thing. K2 is supposed to help also.
From further reading (mostly from the Ray Peat community) it appears that co2 would indeed help dissolve uric acid stones and help push them out NOT help create them. Baking soda, carbonated water, bag breathing and increased carbohydrates in the diet all increase co2. Co2 warms you up by increasing circulation.
Rose,
Unfortunately, there just doesn’t seem to be a lot of research into these matters, so we have to rely on what research has been done, anecdotal reports, and personal experimentation coupled with a basic understanding of physiology. Granted, when it comes to physiology, things are complex, and sometimes the effects are a bit paradoxical or counter-intuitive.
To be clear, I am not saying that reduced breathing causes uric acid stone formation. What I am saying is that reduced breathing does increase the CO2 concentration of the blood, and since blood pH is very tightly controlled to stay within the 7.35 to 7.45 range the increased CO2 in the blood means that bicarbonate concentrations also have to increase. Normally, during hyperventilation, bicarbonate is excreted into the urine through the kidneys (the kidneys filter the blood). So logically, reduced breathing -> increased blood CO2 -> decreased bicarbonate excretion via the kidneys -> lowered urine pH.
In this context I am not sure that it is relevant whether CO2 dissolved uric acid stones (though I’m not sure by what mechanism it would do that, to be honest) because CO2 isn’t going into the urine. The kidneys are regulating bicarbonate levels in the blood and urine. So the mechanism by which breathing can change urine pH is indirect. It is not through directly changing CO2 in the urine since that is not what is happening.
As I indicated in the post, metabolic rate definitely plays a role. A normalization of metabolic rate generally improves just about everything, and it is reasonable to think that normalizing metabolic rate will reduce stone formation.
Also, please note that there are different types of kidney stones. The most common are calcium oxalate stones, which form when urine pH is consistently alkaline. In that context, reduced breathing exercises should help dissolve stones (over time) and decrease the likelihood of them forming because the reduction of bicarbonate in the urine will decrease the pH. So it is important to understand that the types of stones will respond differently. Uric acid stones will require increasing urine pH while oxalate stones will require decreasing urine pH.
Diluting urine generally seems like very bad advise in my opinion, despite the fact that nearly every professional healthcare recommendation I come across suggests that one should. As I write in the post, diluting urine generally means creating electrolyte imbalances, which is not a good thing. Of course, as I suggest in the post, it is possible to have the opposite problem and have overly concentrated urine. In that case, if urine pH is low and too concentrated you have supersaturation conditions which is what leads to uric acid stones. So it is generally best to drink when thirsty and drink enough to quench thirst.
K2 and D can reportedly help, particularly with oxalate stones since K2 and D deficiencies can lead to calcium being everywhere except in the bones and teeth where it should be. So if you have calcium oxalate stones then K2 and D may be helpful. I have also read that some uric acid stone formers are deficient in D, but I haven’t come across enough good information on that to warrant having included it in the post. I don’t think it’s a primary driver of uric acid crystallization.
Sincerely,
Joey
sorry dudes, passing a stone still pales in comparison with birthing a baby through the old v jj sorry for your lots.
xo
deb the hag
Hello Joey, I’ve just been enjoying your books, thanks to Matt for the recommendation. You mentioned the Frolov device in one of them and I bought one, in order to revisit Buteyko without having to do the reduced volume breathing exercises.
In the 90s I accompanied my then teenage asthmatic daughter to a Buteyko workshop in England, and was so impressed with the results that I went on to do the teacher training.
The discussion on uric acid and urine pH is v interesting.
My understanding of the physiology of HV is that the initial effect of ensuing low carbonic acid is alkalosis, which triggers the dumping of bicarbonate in order to maintain blood pH.
However, if the HV becomes chronic there is a secondary effect. The body’s bicarb reserve becomes depleted and under-oxygenated cells switch to anaerobic respiration, which produces lactic acid, and acidosis then ensues.
Correcting the HV should therefore result in a more alkaline system.
Not sure how this relates to your kidney stone and reduced volume breathing. I know that the Russian doctors who have researched HV and Buteyko quite extensively have a theory about how different levels of HV and recovery from it may trigger certain reactions and disease states. For example, an enfeebled acidic system may actually inhibit the proliferation of certain pathogens which become activated by increased oxygenation.
Frances,
Great comment. Obviously, my speculation about the effects of normalizing breath on urine pH is, well, speculative at this point. There hasn’t been a great deal of human research into this matter that I know of – at least not in English. It is known that lactic acid may buffer a CO2 deficiency in the blood in the short term as in during exercise. But it in the long term, I’m not sure that is true. Generally, the evidence is that during chronic hyperventilation the kidneys compensate by regulating bicarbonate levels in blood and urine.
But the Russians may have a different perspective.
Thanks again for your comments.
Sincerely,
Joey
When my uric acid levels rose over 7, I was concerned. At the time I saw the rise, I was on a HFLC diet. After about 4 months of Peating, my UA dropped to 3.6.
I asked Ray about the UA numbers and he said UA was a good thing as it acted as an antioxidant.
I’m still more comfortable having the numbers lower.
Mercola always said that fructose made UA higher, but I barely ate fruit on a low carb diet and had that high number. Once I added in fruits, it came down. Strange.
I think there is some decent evidence that metabolic acidosis is detrimental to health.
http://www.ncbi.nlm.nih.gov/pubmed/11416968
http://www.ncbi.nlm.nih.gov/pubmed/21352078
http://www.ncbi.nlm.nih.gov/pubmed/8995736
Something that went unmentioned concerning the metabolic acidosis that can precipitate some problems (including literally precipitating uric acid crystals) is how some cases of acidosis, including lactic acidosis, is often best NOT treated with alkaline agents (like citrates or bicarbonates), since this can actually result in further tissue hypoxia.
The Bohr effect is that oxygen transfer from blood to tissues increases with high CO2 (such as high dissolved bicarbonate in blood) and/or with low pH (high acidity). If someone has raynaud’s or some other type of tissue hypoxia with increased lactic acid, supplementing bicarb makes this worse, for unknown reasons. Instead, at least in critical care patients, it is best treated by correcting the root cause of the lactic acidosis.
http://www.ncbi.nlm.nih.gov/pubmed/11251027
Offhand, two potential causes of chronic lactic acidosis that should be fixed prior to alkaline supplements would be thiamin deficiency and potentially some SIBO issues. Even hypothyroidism generally could cause acidosis (via several mechanisms: inhibiting kidney acid excretion, promoting bacterial overgrowth via bad digestion, and poor lactate to pyruvate conversion resulting in lactic acidosis).
http://ccforum.com/content/15/6/457
For those with a high anion gap ([Na] – ([CO2] + [Cl]) > 14 to 16) on their blood tests and/or simply low CO2 measures (<26), it might be worthy to supplement thaimin to see if you can speed along lactate to pyruvate and lower the acid load on the kidneys and thereby spare both phosphate and bicarb.
I would also add that I think purposefully slowing down breathing will of course increase CO2, and bicarb with it, but it will disproportionally increase H+ in the blood and drop pH. Now this may make people feel warmer or better due to the Bohr effect mentioned above (lower pH and higher CO2 leads to increased oxygenation of tissue), however, this will strain the secondary buffers of the body like phosphate and glutamine/glycine and likely lead to increase hydroxylation of 25(OH)D to 1,25(OH)D which could cause issues regarding calcification long-term. Thus, I would not recommend the breathing exercises for those with acidosis, which are likely the ones who would 'feel' a benefit from doing them.
For those in the community pumping themselves with sugar, and/or for those with notable acidosis or 'anxiety' issues, I think modest thiamin supplementation (10-15 mg daily) is warranted.
I’d say there’s more than decent evidence that metabolic acidosis is detrimental to health. Many of the known causes are nutrient deficiencies, starvation, or intoxication from drugs or chemicals. So it’s definitely not something one should strive for if the goal is to feel good.
Obviously, if metabolic acidosis is the driver for hyperventilation then correcting the imbalances is important since hyperventilation is a compensatory factor in those cases. But in those cases, unless one does extreme practices involving breath holds (which I personally think are potentially dangerous), then most likely the changes in breathing will be fairly minor until the underlying imbalances are corrected.
Thank you for your comments.
Anion gap is the term the medical fraudsters use to try to hide the fact that PH matters. Yes there is an anion gap between acid and base.
Allways love your way of thinking. Because I am the same HAHA. Not easy, since everybody seems one is an idiot not believing right on in what, by repetition, has been decided to be the truth.
Say whatever, and I will turn it over and over to find if it holds. There are always so many + and – to theories, that one should be stupid just believing “cause everybody know it’s thrue, we have allways heard!”. :D Keep up your work!
Oh, haha, now I see, it is not Matt who wrote this. A guest writer. Ok. There are more of us, GREAT :)
I am so tired of all those “truths” out there, which one can’t argue without getting the “are you stupid” or like me: got kicked out of GAPS FB group since I told about the Heinzh Body hemolytic anemia I got from all the onion and garlic Dr N says to eat. Or when I wanted to discuss the death of one who got potassium dificiency from all enemas (and probably all the fluid, drinking litres of stock every day). I am glad I made it and did not die.
Great to heal the gut, but not if dying is the cost, or not living, or “kill wrong bacteria, but do never start feeding the new good ones, keep starving the gut flora by not eating starch at all and get yourself oversensitive to starch also – collect food sensitivites”.
Hey Joey,
Neat article right there. I particularly like the way watermelon literally saved you. You know very well that watermelon is packed with fluids (better than water) which helps dilute uric acid and makes it easier for the kidneys to excrete it through urine. I particularly mentioned that in my website (LowPurineDiets.com) along with some tools and materials.
Hi there,
Great article, with references too !!
A Question:
I tried to cut down on beer by drinking carbonated (fizzy) water instead.
I think it was then I started to get gout.
I didn’t correlate it.
We are always told to drink plenty of water !
Years later, I thought about the CO2, and cut out the fizzy water… I haven’t had gout since.
Do you reckon there’s a correlation here ?
Cheers !
Excellent info. Very very helpful. I am diabetic but used to suffer from uric acid crystallization attacks often. Not gout nor kidney stones but misery all over the body. Nothing seems to work not even Prednisone because of my restrictive diabetic diet, I can’t rely too much on fruits. I believe you’ve covered just about everything in your write up but if you think of anything else please let me know because I no longer have attacks but in constant daily pain. Thank you in advance
Its not rocket science, blood ph is just a red herring, inttacellular fluid and extracellular vary much more. Anyways Its well established that urinary PH can drastically affect drug excretion..by factors of 14x. Uric acid intake doesnt matter, a fact proven by the Indian practice of shivambu. Urinary PH is the million dollar answer to gout. Poof 4 percent of the population cured. Incidently you actively release bone mineral in response to acid produced by exercise.
Diet will likely only affect urinary PH about .5 PH whereas what you drink easily moves it 2 PH in under an hour. Just test your urine after an hour of exercise and test it a while after bicarb in water. Orange juice will raise urinary PH too(can find a study on this) Chronic hyperventilation likely means your lungs are trying to make up for your lack of urinary excretion of acid.