Incident report: SIBO, molybdenum, gout, and aspirin

[stag]

An overgrowth of sulfate-reducing bacteria produces a lot of hydrogen sulfide gas. Some of that gas is farted out, but up to 70% is diffused through the tissues. That sulfide must be detoxified through the sulfide -> sulfite -> sulfate pathway.

The jump from sulfite -> sulfate requires the enzyme sulfite oxidase (SUOX). suox requires the trace mineral molybdenum to function. I was taking up to 1mg molybdenum to support suox.

Molybdenum is also a cofactor for xanthine oxidase, the enzyme that facilitates the creation of uric acid, which can precipitate urate crystals and cause gout. I had been megadosing Mo (500-1000mcg for ~1wk, plus lower doses off and on for a month prior) and went for a 5mi walk and accidentally gave myself a gout flare in my feet.

Allopurinol is prescribed for gout, as it is a xanthine oxidase inhibitor, but that only stops the formation of new uric acid. Once the uric acid has been created, it must be excreted via urine.

With no prescriptions immediately available but the pain necessitating a timely response, I attempted to replicate a protocol¹ where aspirin had a biphasic effect on urinary urate excretion, with a big increase at high doses (3g+). My previous highest aspirin dose was 1.5g.

Aspirin will need to be paired with other ancillaries for safety/efficacy. 325:1 is the rule of thumb for aspirin:k2. Glyprin pills use a 2:1 glycine:aspirin ratio so thats a good ballpark. I use perfect brand gelatin which contains 2.6g glycine in one scoop, so a 2.6:1 ratio is simpler for me.

In addition to demonstrating how the uricosuric effect of aspirin starts at 3g, this table also demonstrates a 1:1 ratio of baking soda:aspirin increased urinary urate clearance more than aspirin alone (column E)

With these ratios established, I used an electric kettle to heat filtered water up to 140F and mixed in:
1g aspirin
3mg k2
2.6g glycine via gelatin
1g baking soda
honey to taste

with the intention to do this 5 times, once per hour, until 5g aspirin goal is reached. This is replicating the study, which divided the 5.2g aspirin dose into multiple doses over the course of a day. I also took 500mg B1 once at the beginning.

I had a meal of liver and rice during the dosage period.

The first two doses went well, but after my third dose, I became very fatigued, dizzy, and sensitive to light, with tingling tongue and lips. These symptoms were remedied by eating several tablespoons of honey straight from the jar to taste.

The assumption here is that both liver and aspirin combined to drastically lower my blood sugar past what I had been replenishing it with. Having drastically underestimated the calorie/carb requirements of high dose aspirin, I called off the experiment, ate, and went to bed.

I also experienced tinnitus while falling asleep, which disappeared after ~7hrs of deep restful sleep. I did not experience any bleeding or ulcers.

This reaction makes sense, as at around 3g aspirin becomes a mitochondrial uncoupler that would necessitate higher nutrient requirements.

Despite having to call it off early, I did manage to reach the 3g threshold for improved urate excretion, and my gout symptoms did largely disappear, as well a noticeable improvement in general inflammatory symptoms.

Peat has brought up the idea that gout is actually caused by endotoxin-coated phosphate crystals. Seneff has also proposed the glyphosate plays a role in gout flares.²

These ideas probably have merit, but I think the fact that low-dose aspirin can induce a gout flare³⁴⁵⁶⁷ while a high dose can remedy it implies uric acid plays at least some significant role, given aspirin's dose-dependent effect on urate excretion.

High dose aspirin could work as a remedy for gout flares, but it requires some prep and intention to do right, notably a reliable carb source. It's worth noting that acidic urine will stop uric acid excretion so orange juice is not a good choice for this protocol. The original study is very interesting, and worth the read.

1. STUDY OF THE PARADOXICAL EFFECTS OF SALICYLATE IN LOW, INTERMEDIATE AND HIGH DOSAGE ON THE RENAL MECHANISMS FOR EXCRETION OF URATE IN MAN
2. Can glyphosate’s disruption of the gut microbiome and induction of sulfate deficiency explain the epidemic in gout and associated diseases in the industrialized world?
3. Association Between Low-Dose Aspirin and Uric Acid in the Elderly: An Observational Retrospective Cross-Sectional Study
4. Low-dose aspirin use and recurrent gout attacks
5. The effect of mini-dose aspirin on renal function and uric acid handling in elderly patients
6. The Effect of Low Dose Aspirin on Serum and Urinary Uric Acid Level in Gouty Arthritis Patients
7. Acute attack of gout precipitated by concomitant use of aspirin and diuretic in a rheumatic mitral stenosis patient
8. fwiw low dose aspirin only seems to instigate gout flares in people already predisposed to gout, and one of the studies found no correlation

[TDCRM]

Have you had additional gout flareups since this time, or do you believe you've found a permanent solution for them?

I never suffered gout until I began Peating, but I suspect it's because I didn't consistently incorporate the fiber sources Ray recommends (raw carrots/boiled mushrooms/bamboo shoots) into my diet. This may have left me unable to properly flush endotoxins, and resulted in my gout flare up.

Anyway, I'm in the middle of my second flare up now, and committed to incorporating more fiber in my diet going forward, but I'm still looking for help dealing with the immediate debilitating pain.