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Gout and the Kidney-Gut Axis

The UK is considered the gout capital of Europe with one in 40 people affected by the condition, and numbers are rising. Over the last 20 years the prevalence of gout has increased over 60%. It's much more common in men than women and leads to a sudden, out of the blue often painful swelling in the joints of the feet or hands. Attacks of gout last between 3 and 10 days and generally patients are given medication, anti inflammatories and painkillers. This fails to address the underlying issue and contributing factors - kidney depletion, gut health, toxicity and stress and as a result 60% of patients end up having a second attack after being diagnosed.

In this article I explain why kidney and gut health as well as lifestyle factors are so important when it comes to resolving gout. The key point I make is that gout is a symptom of wider imbalance in the body, not a condition. It can only be resolved if the whole body, particularly the kidneys, lifestyle and emotional influences (persistent stress and unconscious fear) are addressed.

Gout presentation in the hands

What exactly is gout?

Gout occurs when there is a swelling usually in the joints, often but not always, accompanied by uric acid build up. It usually affects the metatarsophalangeal joint at the base of the big toe first, but knees, ankles, and joints between smaller bones can also be impacted.

Whilst most research cites uric acid as the culprit, clinicians and scientists are still puzzled because gout occurs even when uric acid levels are normal, suggestive of a wider imbalance when it comes to the excretion of waste proteins. Some research even found uric acid levels were lower in certain gout patients.

What is uric acid?

Uric acid is is a waste product filtered by the body and secreted when we pee.

70% is excreted through the kidney and 30% via the intestine. When our kidneys are no longer performing this function to the degree they need to, when gut health is impaired, uric acid builds up and as temperatures drop when we relax at night and sleep, they forms crystals which accumulate in joints.

Again, we could get overfocused on one waste product but the point here is that toxins that are building up in the body, putting stress on the kidneys and therefore starting to affect the kidney channels and function.

The main issue here is that people go for 'gout treatment' and their kidneys, toxicity and lifestyle, not to mention their past traumas, grief, fears, emotional inner balance are being completely missed out from their picture of health.

What are the risks of gout?

A UK study which looked at 620,000 people's medical histories found that gout more than doubles the risk of kidney failure. Another found patients with gout have a 29% higher risk of developing advanced chronic kidney disorder. The link between gout and cardiovascular disease and type two diabetes is no longer seen as coincidental but is now being researched. Whilst this might sound shocking it's also completely logical.

Gout more than doubles the risk of kidney failure

A recent study conducted in the US found patients with gout had a 1.35-times higher hazard for coronary heart disease mortality.

Why are the kidneys and gut key?

Each day our kidneys filter around 140 litres of blood. They are key to our metabolic function and mental vitality. They work tirelessly around the clock to remove toxins and regulate fluid flow in order to maintain balanced mineral levels for our nervous system. The purity of our blood is key to the vitality of our organs, which in turn affects blood pressure which in turn, affects our entire nervous system.

If our blood has become toxic because of our diet, heavy metals, environment and buried emotions our kidneys are put under excessive pressure to perform. For example, high blood sugar levels means the kidneys have to absorb more urate. High stress can elevate blood pressure leading arteries around the kidneys to weaken or narrow. This impacts vitality of the kidneys which produce hormones that regulate arterial pressure. It's a constant cycle of multiple interacting systems.

Recent research has found gout patients have a significantly altered intestinal microbiota highlighting the importance of the brain-gut–kidney axis

The gut also plays a key role. The liver receives 70% of its blood supply from the intestine. More recent research has found gout patients have a significantly altered intestinal microbiota highlighting the importance of the gut–kidney axis. The precise mechanisms underlying gut microbiome host interactions are elusive at best - it's still a relatively frontier field, however it points to yet again, a need for a full body-lifestyle evaluation and treatment rather than examination of joints. Further consideration of the role of the brain-gut-kidney axis as related to chronic kidney disorders is much needed. Food, antibiotics, and gender are just some of the factors that can throw off the balance between the gut and liver by directly impacting gut microbiota.

Diet, medication, heavy metal toxicity, chronic stress and repeated intake of antibiotics as well as repressed trauma can throw off the balance between the gut and liver by directly impacting gut microbiota.

Brain-Gut-Kidney axis

What about our emotions?

The kidney meridian is the root of life, running and has a pathway to the sole of the foot and heel. You can see this in the image to the left. The reason the joints in the feet are affected is because the feet are usually a lower temperature and uric acid crystallises at lower temperatures.

Beyond physiology our kidneys store our inner potency. This is a very particular and essential essence - related to will power, ability to take action and our confidence to move forward. They also hold unresolved fear. The gut too, as our second brain is vital for the processing of our emotions, particularly anger.

Most people are not aware or willing to look at their emotional lives in relation to their physical health - that includes people who are well versed in the interactions between the mind and the body. It is challenging, confronting and personal territory. However the truth is, as long as emotions and life experiences are left buried, unconscious fear patterns remain held in the nervous system. With the kidneys, a sense of being controlled, trapped, unable to move, not knowing how to progress forward, creates a stagnation and a depletion. Kidneys are associated with water, flow, movement and energy, emotions, thoughts and behaviours need to flow through to avoid freezing.

When a person has become so stressed, unconsciously, they meet life's emotional challenges with a freeze response which essentially puts the breaks on action - if action means danger then the only way to stay safe is to stop. In fact research shows people suffering with gout experience more depression (suppression of emotion).

Kidneys are associated with water, flow, movement and they need to be 'open' as filters rather than blocked. If they are holding unprocessed fear, patterns of tension and charge remain held in the nervous system.

5 ways craniosacral therapy can resolve gout

Craniosacral work can address the physical factors - organ vitality, spinal integrity, nervous system charge and fluid flow and drainage, but importantly, can address the underlying holding or fear that might be unconscious to the person at the time. As therapists we need to also explain this to our clients who might expect us to be working on their joints. Yes this work can be incorporated, but the whole body and all the organs must be addressed first.

The main aspects of working with gout are laid out below.

1/ Attend to the thoracolumbar spine alignment and mobility

Our kidneys receive most of their sympathetic innervation from T10-L1 and parasympathetic from the vagus nerve. Structural misalignment because of injury, impaired posture or held tension can affect the nerves that innervate the kidneys. This can also have a knock on effect on the legs which might feel stiff and held contributing to that internal sense of not knowing how to move forward. Working with the spine is a good place to. start.

2/ Free the kidneys and gut

The kidneys move inside the body, internally rotating and shifting up slightly. If movement is impaired because fascia around the kidneys has become tight or matted for example, or because of compression in the lower thoracic or because of inflammation, the free movement of the kidneys will be affected. Craniosacral work can use gentle touch to renew fascial integrity and create more space. This has an effect not just on a tissue level but can also improve lymphatic drainage from the kidneys. The same goes for the gut, feeling for tightness and knots in the gut, and the general sense of what is being held onto here can really help.

3/ Reduce blood pressure

The vagus nerve (cranial nerve X) offers parasympathetic innervation to the kidneys and when stimulated it can trigger the release of proinflammatory molecules which can aid the healing process. Studies have shown that as vagal tone improves, blood pressure drops leading to a feeling of calm and rest. Work can also be done to release tension in the solar plexus and in the intermesenteric plexus (the nerve plexus on the abdominal aorta). All of this work will facilitate a rest and digest state where blood pressure and fluid pressure in the body can start to normalise.

4/ Detoxify the body

If the blood is toxic the kidneys will have to work harder. The lymphatic system plays a key role in regulating salts, metabolising fats and draining toxins from the body. The kidneys have specific lymphatic vessels that drain into lymph nodes above the stomach. Working gently to reactivate these important nodes can improve the drainage of lymph from the kidneys which reduces toxicity.

5/ Support release of fear

Craniosacral work can help a person to become aware of a freeze response in their body and to slowly acknowledge what it relates to. Continuing to work with a focus on somatic release can help the nervous system to recalibrate to integrate a new way of being that is more restful and conducive of flow. This can offer new insight and renewed ability to move forward in life. Often working with the kidneys will release multiple tidal waves of energy up towards the heart. The kidneys almost saying here, take this back, it's yours to feel. It's really important that the kidneys are clear, they are the open gates for everything we don't need to flow through us.

What can you do for yourself?

To resolve gout you need to start paying attention to your whole nervous system and your lifestyle. To reiterate, gout is a symptom, not a condition. As long as we keep focusing on feet and joints we are barking up the wrong tree. We are looking at symptoms instead of the cause, at localisation rather than the whole body and the whole person.

Here are some tips:

Reduce excessive stress in your life - this is key - rest, meditate, learn to be still

Remove toxic foods, thoughts and people from your day - this requires ongoing awareness

Clear your gut!

Minimise your use of painkillers

Drink water, lots of it, as priority.

Limit intake of meat dairy and protein.

Cut excessive salt and processed food

Exercise - circulation is key to your detoxification

Get some craniosacral therapy (obviously)

Lymphatic drainage massage

Try introducing more:



Celery Juice

Apple cider vinegar, lemon juice, and turmeric

Ginger tea

Dark leafy green

Dark berries


Activated Charcoal (if you're not taking any other meds or supplements)


If you have gout symptoms or you're worried about a loved one, and you'd like to book a session please contact me




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