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I Went Keto for 3 Months and Got Gout. Here’s What I Wish I’d Known

A keto-approved plate of scrambled eggs, bacon and veggies on a grey tabletop

My friend walks into a bar – glowing, leaner and the happiest I’ve ever seen her in our 12 year friendship. “Keto,” she says, anticipating the ‘What are you doing?’ question, “I basically eat a lot of Caesar salad – I’ve lost 25 pounds.”

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We’re in our thirties, and every year it feels like there’s another ring around the trunk. While I’ve picked up rec sports like ball hockey and practice yoga semi-regularly, I’ve never been on a diet and haven’t put any actual effort into slimming down. My friend, Janna, and I have always had similar palates: we love bread, pasta, sandwiches, sauce, potatoes and most comfort foods on the regular. “You should do it,” she said, “You can eat so many things — I feel amazing.”

Why I went keto

As an intersectional-feminist who promotes body positivity, I hate how this story starts. It was one long look into my bathroom mirror after a shower when I cried — unhappy with the aged, unfamiliar woman staring back at me. I decided, at that exact moment, that I was going to try keto, as Janna had done.

So, I started the following Monday. I took the weekend to consult with Dr. Google so I could hunt and gather at the grocery store for my new and very first diet.

The ketogenic diet is attractive to people like me (read: who have the palate of a 13-year-old boy in the 90’s with a love for beige food and grease) because you never have to go hungry or calorie count, and you’re allowed to eat bacon, burgers, butter and other foods typically considered unhealthy. It’s a high fat, moderate protein, zero-sugar, low-carb diet. I don’t even like baked goods or sweets.

But I do like bagels, dumplings, corn and other carbs you’re not allowed on keto. Starchy carbs were off the table — so were fruits (including the melon family, mangoes, pineapple, apples etc.) and even a variety of vegetables had to be limited.

What a typical day of eating looked like for me

Like Janna, I ended up eating a lot of Caesar salad with chicken on the regular. Breakfast was all about bacon, eggs (cooked in butter), spinach and avocado. On offer at lunch was usually more leafy greens, roast chicken (sometimes hot, other times cold), cheese and nuts. For snacks, I ate more nuts, more cheese, and sometimes I’d even eat raw spinach out of the bin and call them “keto chips”. Blackberries were a green-lit treat, and very dark chocolate is also OK in moderation. I learned to like cream, and sometimes butter, in my keto coffee.

I also learned to drink so much water, and I peed on a keto strip every morning to make sure I was still in a state of ketosis. Being in the state of dietary ketosis is key to the weight loss benefits of the diet — it means your body is no longer fueled by carbs and is instead running on stored fat (hence the high fat part), producing ketones, so your brain still gets the energy it needs. To enter ketosis, I had to deprive my body of carbs (keeping the serving under 20g per day). The process took about three to five days, which is when I got what’s dubbed the keto flu and lost seven pounds by day six.

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Some challenges I faced while on keto

I made the mistake of going on a road trip to Michigan within my first weeks of keto. Translation: burgers with lettuce, meat sticks, cheese and nuts were pretty much all I consumed that weekend. My mother commented on my appearance: “It’s working. I can see it in your face.” I was thinning out.

They say you stop craving carbs — that never actually happened for me. I didn’t need them, but if I saw my co-worker eating pizza, I knew I’d rather be sinking my teeth into a slice than stabbing at a bowl of cold, raw vegetables.

Keto became a way of life. At post ball hockey drinks, I’d have water and eat a burger in a lettuce bun with celery (no illegal carrots because of the sugar). But I knew this couldn’t go on forever. While editing a story on celebrity diets, I discovered the 80/20 diet and decided to try carb cycling.

What I wish I knew when I got gout

Carb cycling and keto may increase the risk of gout. I wish I’d talked to an actual expert and registered nutritionist before I’d participated in a fad diet to explore the potential risks for myself. For this article, I talked to Julie Mancuso, the weight-loss expert and owner of JM Nutrition.

My friends are doing it, my coworkers are doing it — it works great for them, so it’ll work great for me, is something Mancuso hears all the time from first-time dieters. “Even though we have the same composition, we all have a different makeup, and your friend may not have any pre-dispositions to health issues,” she explains.

It turns out gout runs in my family. I was the first female to get it in my known bloodline — a glass ceiling I really didn’t need to break. But after attempting (and failing) carb cycling, drinking wine and building up too much uric acid, I found myself hopping on one foot with the rich man’s disease. I gave myself gout. It was already in my genes and it was triggered by my diet.

“With keto, you actually get most of the calorie consumption from fat,” says Mancuso. “If someone is predisposed to gallstones and you’re eating an abundance of fat — and [the] body can’t keep up with that — that will cause a problem.” Another thing to note is that spinach is very high in oxalate, the number one cause of kidney stones. So, at least I didn’t get gallstones or kidney stones, right?

Related: A nutritionist reveals 10 best natural foods for glowing skin.

How I would do keto differently

The next time I submit to my insecurities and decide to attempt a drastic diet change, I will consult with a nutritionist or dietitian to help me better my relationship with food.

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According to Mancuso, there are many healthy and sustainable changes people can make to their diet that will help with weight-loss — people don’t need to jump into keto. But many lean towards diets like keto, including Atkins, Paleo and South Beach, because the results are typically fast, and starting something so strict and seemingly effective can be motivating.

“Our culture is like that — when we want something, we want it now,” says Mancuso, who often works with clients and encourages them to start slowly with new diets. She likes to take the time to assess and provide people with a better understanding with how diets and weight-loss actually work.

“What I don’t like about keto is that it’s very restrictive,” explains Mancuso. “The biggest problem is that people have trouble sustaining this diet… what diet restricts broccoli?”

Related: Nutritionist reveals 10 secrets to keeping energy levels up all day long.

What people should keep in mind if going keto

“Keto works for weight-loss” says Mancuso. “What I like is that it steers people away from eating carbs and sugar.”

She would recommend nutritionally balanced keto — which, according to the weight-loss expert, is moderate protein and plenty of vegetables. If the aim is weight-loss, the sugar has to go, and the carbs have to be cut down. As it turns out, there really aren’t any shortcuts or hacks for leading a sustainable, healthy lifestyle.

Feature image courtesy of Getty Images.