DROP ACID By David Perlmutter, MD
Don’t let the title of this book fool you—it is not about the 1960s LSD counterculture or the latest fascination with micro-dosing psychedelics! In this book, Dr. Perlmutter (author of Grain Brain 2013) focuses on uric acid and its potential negative impact on numerous aspects of health. When I mention uric acid, most people familiar with this chemical generally associate it with gout and/or kidney stones. Uric acid is a waste product found in the blood stream; it is produced when the body breaks down purines.
The book is divided into two sections; in the first section Dr. Perlmutter makes his case for why elevated uric acid is a driving force for many other health conditions besides gout, including obesity, insulin resistance/metabolic syndrome, diabetes, liver disease, high blood pressure, heart disease, stroke, cancer, neurological disorders, dementia, migraine, psoriasis, kidney disease, hypothyroidism, and depression. He strongly recommends that all adults have their uric acid levels checked annually, even if they do not suffer from gout pain; his optimal target range is less than 5.5 mg/dL. Apparently, there are home uric acid kits that you can order if you choose to check your uric acids more frequently. The good news for those of us who live locally is that you can get your uric acid level tested at Sanford Direct Access for $10! I did learn that uric acid levels are typically highest in the early morning, so it is best to have this lab work drawn both fasting and as early as possible.
Most of us who have some awareness about uric acid know that meat, seafood, and alcohol can cause elevated uric acid levels in susceptible individuals. The author points out in the introduction and follows up with an entire chapter on how and why fructose (the processed version, not the whole fruit version) is the primary culprit for elevated uric acid levels. I was thrilled to have this nutrition level reinforced because it was not taught in medical school, I only learned of this connection during my residency and most people are still not aware of this glaring oversight.
If you are not really into science and a lot of medical mumbo-jumbo (although I did read the chapter on uric acid and cognitive decline aloud to 2 lay people on a drive to Bemidji a few weeks ago and they understood the content), either skip or skim part I and jump into part 2 which contains the real meat and potatoes on what to do if you are afflicted with high uric acid levels.
The highlights of part 2 include six acid-lowering supplements (quercetin, luteolin, DHA (fish oil), vitamin C, chlorella, probiotics), the benefits of continuous glucose monitoring (he recommends a company called Levels which I have not investigated yet), routine lab tests (glucose, insulin, A1C, C-reactive protein, uric acid), the benefits of fasting, and the LUV dietary protocol on what to eat and what to avoid along with a meal plan and recipes. He also provides valuable counsel on sleep, movement, nature, and meal timing.
The take home message is get your uric acid levels checked and if they are about 5.5 mg/dL do something about it proactively to prevent the countless diseases associated with elevated levels.
*A special shoutout to Master Nick Bretz for loaning me this book for review.
Rachel Oppitz, ND
