I haven't posted on here for a long time but as a 4/4 I have regularly checked in since finding out my status in 2017. I'm posting today because over the past few weeks something is really concerning me and I'm wondering if others had any thoughts on it or the same worried as me.
About a month ago I listened to Dhru Purohit's podcast with Dr Perlmutter which was on APOE 4/4 Facebook page https://www.youtube.com/watch?v=ImfCoaqr_SE
and then read his blog on the topic of uric acid which he addresses in the interview https://www.drperlmutter.com/uric-acid- ... -diseases/
(I hope these links work - been a while since I posted and may be doing it wrong!).
I follow Dr Bredesen's protocol - 16 hour daily fast, no dairy, sugar, fruit (apart from few berries every day and odd organic apple when they're in season), grains, alcohol and I also cut out most lectin rich vegetables. I eat some grass fed meat now and again and lots of salmon and a couple of cans of tinned fish (mackerel and sardine) a week. My diet is low carb and high fat as many of us on this site. My ketone levels are routinely somewhere between 2 and 4 and my fasting glucose usually between 75-85. I struggle with my weight, as many of us do and try to keep it around 47-48kg (I'm 168 cm), however at mo it's dropped off a bit at 46kg.
I assumed my uric acid levels would be low and looked back over blood test results I've had over past 5 years, last one September 2020 - all around 2. something so no worries. However, the podcast had made a strong impression on me and following Dr Perlmutter's advice I bought a home testing uric acid kit - pin prick blood one like glucose and ketones. That was about 10 days ago and I have been shocked and worried by the results I've had - lowest was 7.8mg/dL and Dr Perlmutter's recommendation is that it should be under 5.5! I've tried different times of day and have higher reading than that but no lower. I left it for a week, drank diluted Apple Cider Vinegar everyday, cut out the mackerel and sardines and ate more eggs and tried again - still 7.something. Investigating today I found this about hyperuricemia: https://en.wikipedia.org/wiki/Hyperuricemia
Here is says "A ketogenic diet impairs the ability of the kidney to excrete uric acid, due to competition for transport between uric acid and ketones." and "Starvation causes the body to metabolize its own (purine-rich) tissues for energy. Thus, like a high purine diet, starvation increases the amount of purine converted to uric acid. A very low calorie diet lacking in carbohydrates can induce extreme hyperuricemia; including some carbohydrate (and reducing the protein) reduces the level of hyperuricemia. Starvation also impairs the ability of the kidney to excrete uric acid, due to competition for transport between uric acid and ketones"
I'm worried. I have no symptoms of gout and all my other markers are good. Should I be eating more carbs? Is it my home test kit that's inaccurate (I have paid for a full blood test next week so we'll see...)? Should we 4/4s really be as concerned about this as Dr Perlmutter suggests? Can I ever eat mackerel again?
If anyone has any thoughts on this I'd be really interested.
Thank you so much everyone.