If you buy in to my hypothesis that metabolic syndrome is the real issue driving gout then it becomes pretty straight forward for most people to track progress. There are a million things you could track but at first don’t miss the forest for the trees. These are a short list of things that, if improved, will likely result in improvements to ton of other markers.
Body Composition
The amount of visceral fat you carry around isn’t readily apparent but the presence of it is a telltale indicator of metabolic syndrome. For some people you can get a rough idea by measuring waist to height ratio. Ideally you don’t want the ratio to be over .5 (waist in cm divided by height in cm). BMI is not reliable.
A much better option is DEXA (or DXA) Body Composition Scan. Look for a company setup to use the DEXA to report on body fat, visceral fat, bone density, and lean body mass. Of most interest is the amount of visceral fat. This is the fat that’s highly correlated to many different chronic diseases including heart disease. Each scan should cost $100 to $200.
Get a scan soon to establish a baseline. Then do a follow-up every six months at least. I get them quarterly. When you go for your scan be consistent about time of day and if you have or have not consumed water. We want to know trends and water can be read as lean mass. Don’t over think it but just be consistent for each scan.
Do a Google search for DEXA or DXA. Expect to pay out of pocket. If you are in the Washington DC area I like Composition ID (no relationship to them at all).
The goals for your body composition over time is reduction of visceral fat below 1 lb, but it can and should be lower for optimal health. You should also see stable or increasing bone density, and stable or increasing lean mass.
Blood Markers
Again there are a million things you can track and you could spend a small fortune doing so. I believe for most people that’s a waste. Track a few key items, get those to improve and the others will likely fall into line, or you can make smaller adjustments later. Note that the goal numbers I propose are what I have gathered to be ideal. They are lower/tighter than the normal range provided labs (which skew towards doing lab work for people who are sick, not optimally healthy).
- Uric Acid – Measure of Serum Uric Acid. Goal is at least 5.5 mg/dL, but optimal is 3.4 to 5 mg/dL (Why?)
- HbA1C – A proxy measure for average blood glucose over roughly a 3 month period. Goal is 4 to 5.6 (Why?).
- Triglycerides:HDL-C Ratio – another proxy measurement. The goal for optimal health is less than 1 – divide Trigs by HDL (Why? High TG to HDL-C Predicts Extensive Cardiovascular Disease and Triglycerides, LDL, and HDL on a Ketogetnic Diet).
As with a DEXA scan, expect to pay out of pocket, but these tests are cheap. You can buy from Quest or LabCorp but I love OwnYourLabs.com (again no relationship with them but what Dave Feldman and Siobhan Huggins do is amazing stuff). Plan to test quarterly or how ever often you feel you need to track your progress.
