Gout, Kidney stones and fruit in Hawaii: a surprising link

After being gout-free for almost two years, I had a relapse a couple of weeks ago. It came after indulging in pizza and bread dipped in oil at a restaurant in Hawaii.  To keep my gout in check, I rarely eat out and I avoid a whole host of foods that are high in uric acid. In this case, I ingested a lot of canola oil (mixed in a bottle labeled olive oil) followed by a long, hot walk which lodged uric crystals in my toes. While recovering from my gout attack, on a strict white rice and cheese diet, I did more internet research on gout and uncovered some new findings. Gout and incidences of kidney stones are increasing in the US and around the world and though gout and kidney stones are seemingly unrelated, there is a strange relationship between the two.

Gout attacks are brought on by high amounts of uric acid in the blood stream that precipitate out into crystals. The uric crystals lodge in joints and extremities and cause great pain and internal tissue damage. Studies have shown that having a higher acidity level in the body can increase the precipitation of uric crystals. When the body’s temperature increases, like in the summer or after a lot of exercise, sweating causes the body’s acidity to increase. I have noticed a correlation between my gout attacks and heavy Vog (volcanic smog which is highly acidic) days when I do a lot of exercise. Drinking alkaline water has really helped me to neutralize my body’s acidity.

Kidney stones are formed from oxalic acid, which combines chemically with calcium and magnesium in the body to form oxalate, a hard crystal that can build up in the kidneys. Though kidney stones can be formed by other crystals (like uric crystals), 80% of the kidney stone incidences are from oxalate, which can also lodge in other parts of the body and cause pain, like rheumatoid arthritis inflammations.

Surprisingly, kidney stones are also related to heat. Several studies have shown that incidence of kidney stones in the US increases as the average annual temperature increases. In warm Hawaii, studies on older populations showed kidney stone incidence rates approaching 50%.

Oxalic acid is found in high concentrations in plants, which some believe acts as a pesticide. Kidney stones may be a bigger problem in Hawaii because some of the island’s tropical fruits contain oxalic acid and we consume fruit year round. The body also converts vitamin C into oxalic acid, making fruit consumption an even greater source of oxalic acid.

Historically the body dealt with oxalic acid in fruits and vegetables by having good bacteria in the gut that consumed the acid before it could be absorbed into the blood stream. Studies have shown that people with low levels of acid consuming bacteria in their gut are much more likely to have kidney stone attacks than those with higher levels. The prevalence of antibiotics, pesticides, and changes in our diet may have reduced the acid eating bacteria in our bodies allowing more oxalic acid to get into our blood to form oxalate crystals.

Surprisingly, having more uric acid in your system also reduces the body’s ability to remove calcium oxalate crystals from the blood and causes more of them to be created. So gout attacks, signaling high concentrations of uric acid, may lead to kidney stones.

One natural way to increase the good bacteria in the gut to counter the creation of oxalate crystals is by eating acidophilus bacteria. You can get it in yogurt and cheese or take it in pill form. Eating more calcium in the diet also has been shown to aid in ridding the body of oxalic acid, perhaps by making more of it available to bind with the acid. Some studies show that potassium also helps minimize the effects of calcium binding to create stones and magnesium improves the absorption of ingested calcium.

I have changed my diet substantially over the past three years to keep my gout in check, but many of the foods I eat to counter uric acid in my system are high in oxalic acid or vitamin C like cherries, blueberries, almonds, and walnuts. Now I am adding acidophilus rich foods and taking acidophilus capsules to help my body eradicate oxalic acid from the blueberries and cherries I eat, before it can create oxalate crystals.