<<...uric acid stones have occasionally been found in epileptic children following the ketogenic diet. This appears to be related to high levels of urinary ketones, low urinary pH and fluid restriction in these patients. It is unknown whether individuals consuming sufficient water on a ketogenic diet have any risk for this complication.>>
Interesting, thanks for that. So there is a risk of a complication from chronically high levels of urinary ketones after all, according to this. I'll ask Lex for his thoughts on this, and if anyone else has heard of it, please chime in.
<<From a practical standpoint, individuals with a genetic predisposition towards gout should either include a minimal amount of carbohydrates (5% of total calories) in their diet or not use a ketogenic diet.>>
I don't have experience with your sort of numbers, symptoms and history, Yuri, but that last quote does sound reasonable. It seems to fall in line with Tyler's experience in which he didn't do well on a strictly ZC diet and had to reintroduce some carbs like berries. If you feel you do better with some fruits or vitamin C in your diet, I wouldn't necessarily argue against it (though I would consider the cautions against fructose from Dr. Harris that I linked to below). I'm actually hoping to add some berries back into my diet at some point and recently I've was able to finish up a little raw honey I had left over in my cupboard without problems other than a little dental film that I took care to brush off. On the other hand, Dr. Harris and others recommend no fruit for gout patients (Harris generally recommends more fat instead--see the blog link below) and I don't know if some fruits would work or not for you. Plus, I'm not a doctor and wouldn't dare prescribe anything for you or anyone else, especially if you think you might have an eating disorder that complicates things further. Did your doctor recommend anything?
From the data it looks like antistreptolysin increased to an excessive level. Assuming that plasma appearance, thymol and B-lipoprotein were OK before (for some reason they're not listed in the earlier results, but presumably were negative), they apparently worsened also. Did your doctor explain any of this? Is he going to do any more tests other than the scan for kidney stones?
If you didn't get enough answers from your doctor, I suppose you could ask Dr. Harris at PaNu your questions, though he can't give you individual medical advice. I think he would be interested, given that he and other like-minded people have fingered fructose as the main causative factor in gout (which you did eat a lot of in the past, apparently). He has explained that while protein doesn't cause gout, it can trigger it once the underlying problems are already there lying beneath the surface, so to speak (see "Reader Comments - 283,"
http://www.paleonu.com/qa-and-testimonials/2009/6/27/questions-and-paleonutrition-testimonials-welcomeclick.html#comment4711781). He suggested in general that people can eat higher proportions of fat (like suet, which is several of us here eat) to avoid consuming excess levels of protein that can trigger gout attacks. Is the meat you're eating all grass-fed?
I also have never heard of a neutral pH of 7 on a ZC diet. Even the critics of ZC agree that it drives the pH down to acidic levels. That is puzzling, though not a lot of people do ZC, so it's hard to know how abnormal this is and it doesn't necessarily indicate a health problem.
It took Lex years to recover from his fasting debacle, so maybe time to heal is also a factor. I don't know for sure about that, but I do know that stressing about things, like possible future kidney stones, isn't going to help and I doubt that there is any perfect exact diet that cures everything. So while I would try something different if it were me (after getting my doctor's advice), given your recent problems on possibly high-protein ZC, I wouldn't agonize over details, seek dietary perfection, or expect miracles. That sort of thinking leads to stress and disappointment, I think. And remember to enjoy life as best you can, whatever comes.
Hope this helps rather than makes things worse--and remember that none of us here are experts so take it all with a grain of salt. This is a dietary forum, not a medical answers forum. So I wouldn't expect the latter here, though sharing experiences can sometimes lead people to investigate things or ask questions that eventually lead to answers. I know an IBS forum (and a doctor's advice) helped lead me to this way of eating that has so far done wonders for me, though it hasn't cured everything 100% and I don't expect it to.
