GoutPal Interactive

The best lists on the Internet for the pH effect of food start here.

This is acknowledged by the experts on the effects of food and pH. They also have a forum for discussing this kind of thing (including almonds).

The relationship to gout is fairly tenuous, but if it exists, it is simply that by alkalizing the body (IF such a thing is possible) you raise the saturation point of uric acid.

On a list of 10 important things about gout, it probably comes about 15.

And yes, it was misguided of me to devote 27 pages to the subject, but nobody can accuse me of superficiality

Hmm, I’d never before thought of the semantics of syndrome v disease. I’m sure the professors will be delighted to address the role of the gout syndrome and it’s influence on metabolic syndrome, or vice versa.

For many, it is quite clearly a disease, and if doctors want to label under-excretion, or over-production, of uric acid with different labels, then it’s up to them.

To me, it’s gout. If somebody wants to call my version Fat Bastard Syndrome, then that’s fine by me. At least it differentiates between those who have an innate medical problem, and those who have lifestyle issues.

What really matters is that the medical authorities start taking it seriously. I’m amazed how health systems as different as the UK and USA can (mis)manage to cock things up publicly and privately in such spectacular fashion. Perhaps it’s part of the Human Syndrome.

I usually give this acid-base food talk a wide berth because to me it makes absolutely no sense. I KNOW what an acid is and I KNOW what a base is and most foods are completely NEUTRAL like water.

This reminds me most of the Indian chakkra concept or the Yin and Yang stuff…all fine ways for doctors(witch or otherwise)/practitioners/shamans/priests to enrich themselves at the expense of the sick and gullible when actually they had nothing of use. Thus the gurus will ALWAYS claim a treatment cure when there is a disease and no REAL cure. Remember the wonderful movie THE MADNESS OF KING GEORGE. His doctors, the best in the land, insisted he was well because the shape of his stools, examined daily, were picture perfect. (They missed the fact that he was peeing blue!) These same doctors may have drawn up the hoodoo acid-base lists as well…right after an exhausting day of bloodletting.

If there was anything solid behind the methodology and efficacy of acid-base classicfication of foods you wouldn't have trev's list showing black bleans as highly acidic and GP's list as highly alkaline…it CANNOT be both ) and in fact is neither.

Sodium bicarbonate is alkaline because if you put in a piece of red litmus it turns blue. Vinegar is acid becasue blue litmus turns pink. THAT I know.

Gout: syndrome or disease? I think that's mostly symantical but I'll lean towards disease. Syndrome is usually a collection of symptoms POINTING to a disease or an abnormal condition but often without precise cause and rarely a cure. The disease is more pointed.

By this standard gout is more a disease in that it manifests as a crucifyingly painful joint caused by uric acid…not much of “collection of symprtoms” there. Even FLU, which is clearly disease, presents with lung inflammation, fever, headache, malaise, fatigue…which more closely follows the term syndrome.

But again, the terms are so loose that opposing arguments can easily be made.

Post edited 5:50 am – June 14, 2009 by GoutPal

The problem with discussing food and pH is that it means different things to different people. Three sides to this fence!

1. Actual pH of food. This is only really relevant to the canning industry. It forms the basis of several Internet sites for all the wrong reasons. In my early days of gout research, I fell into the trap of repeating this when referred to the data by a site that seemed influential. I try to check sources more now, but remain fallible.
2. pH of the ash. This is measured by burning the food until all water content has been driven off. This seems to be the basis of most Internet sites. It means very little, and is usually at the root of why some lists include food in the wrong category.
3. Affect on urine pH. This is the most useful data from a health point of view. It is the basis for the tables I use (from a PRAL calculation), and it is this data that I am referring to here.

PRAL

Calculation of PRAL and estimation of urinary Net Acid Extraction (NAE): Because the sum of cations excreted in urine equals the sum of anions, urinary NAE (Σcationic TA + NH₄ – anionic HCO₃) is also equal to the difference between the sum of the major urinary nonbicarbonate anions (chloride, phosphate, sulfate, and Organic Acids) minus the sum of the non-TA and non-NH₄ cations (sodium, potassium, magnesium, and calcium). The amounts of these nonbicarbonate anions and mineral cations in urine, except Organic Acids, are primarily influenced by nutritional intake.

Note that this is only an estimate, but Remer proved it to be accurate enough for most purposes. A better estimate can be calculated using Net Endogenous Acid Production (NEAP). This is better because it includes all daily intake, but this obviously makes it harder to calculate, and impossible to apply to food choices.

Practical research into the effect of an alkalizing diet on gout seems pretty much nonexistent. It is perfectly right to be skeptical on the outcome.

One benefit that seems to be well accepted is that alkaline urine reduces the risk of uric acid stones forming in the kidneys. For this reason I believe that an alkalizing diet is beneficial, though far from a cure.

Post edited 8:57 am – June 14, 2009 by GoutPal

Do not fall into the trap of thinking in terms of pH just because we refer constantly to uric acid.

This is not about neutralizing uric acid with a base. Nor is it about stimulating uric acid excretion.

The most important aspect of the debate, which I unforgivably omitted from my first response, is that food can have an alkalizing effect on urine. This has a role in reducing the risk for urate kidney stones. It is why gout patients on probenecid (amongst other meds) are advised to alkalize.

My previous post goes just as far as I can go on this. Or as far as I want to. The experts I referred to, phbalance.wikispaces.com, go further for those that need to, and they have a good forum.

The need to alkalize was what got the guy who publishes icuredmygout.org started. He, I think, is responsible for most of the promotion of baking soda for gout.

This is where some of the contention creeps in. Firstly, there is the idea of the “bicarbonate paradox”, which really does not belong in this topic.

Secondly, there is the idea that by increasing pH you increase the solubility of uric acid. Thus, all things being equal, you can reduce the risk of uric acid crystals forming. At the moment, this sits in the folder marked ‘Unproven’.

Others have a different label, but hell – this IS a forum.

Post edited 3:07 pm – June 14, 2009 by zip2play

I went to my large pharmacy to see if there was any commercial litmus tester for urine available. My clerk said NO (but she had the acumen of a cinderblock.)

Have any of you found a cheap dependable urine tester for pH? I'd like to monitor for a while. Preferably something NOT ordered online. I get tired of buying things that cost $1.99 with a $15 shippiing charge added!

Stepping back to the PRAL definition, GP, does it seem top you that urate/uric acid excretion is INCREASED with the administration of a base like sodium bicarbonate (which actually is the source of Na+ ions?) I realize that stones are less likely to form in alkaline urine but does balancing cations and ions actually result in more uricosuria!

For a deep discussion (migraine sufferers should NOT use this link):

http://www.lakesidepress.com/p…..gap.98.htm

zip2play said:

Stepping back to the PRAL definition, GP, does it seem top you that urate/uric acid excretion is INCREASED with the administration of a base like sodium bicarbonate (which actually is the source of Na+ ions?) I realize that stones are less likely to form in alkaline urine but does balancing cations and ions actually result in more uricosuria!

I don’t have an answer for this. I guess the only way to find out would be comparative 24-hour urine analysis with and without sodium bicarbonate. I can’t find anything on this, but I did find a German abstract on PubMed, [Diagnosis and prevention of uric acid stones], which makes the following points:

• The most important risk factor for uric acid crystallization and stone formation is a low urine pH (below 5.5) rather than an increased urinary uric acid excretion.
• Main causes of low urine pH are tubular disorders (including gout), chronic diarrhea or severe dehydration.
• The treatment of uric acid stones consists not only of hydration (urine volume above 2000 ml daily), but mainly of urine alkalinization to pH values between 6.2 and 6.8.
• Urinary alkalization with potassium citrate or sodium bicarbonate is a highly effective treatment, resulting in dissolution of existing stones.
• Potassium citrate is the treatment of choice for the prevention of recurrence of uric acid calculi.
• Allopurinol reduces the frequency of stone formation in hyperuricosuric patients with recurrent uric acid stones and/or gout.