To demystify gout, we must look at the problem beyond the painful big toe. We have to see through it by understanding the problem from inside out, which is at the cellular level. That’s why I have to explain some basic cellular biology here to help you understand how ionized alkaline water actually works in flushing the unwanted uric acid from your body.

The human body always works to maintain a blood pH of 7.4, which is mildly alkaline. When there are too many acidic chemicals in the blood as a result of an acidic diet or emotional stress, the body triggers a series of homeostatic reactions to raise the blood pH to its optimum level. One mechanism used by the blood is to move the excess acidic compounds, such as uric acid, out of the bloodstream.

Interstitial Fluid

Interstitial fluid (or tissue fluid) is a solution that bathes and surrounds the cells of multicellular animals. It is the main component of the extracellular fluid, which also includes plasma and trans-cellular fluid. The interstitial fluid is found in the interstitial spaces, also known as the tissue spaces.

The direct deposit site of uric acids is the interstitial fluid between the capillaries and cells, as shown in Figure 3.1. Initially, interstitial fluid is just like a temporary storage site for any excess acids until the blood pH is back to normal and can slowly transport those uric acids to the kidneys for removal through urine. But if you continuously eat acidic food (not only high-purine food) and drink acidic drinks (high sugar and carbonated), there is no chance for your body to get rid of those “refugee” acids in the interstitial fluid.

When the acid content of interstitial fluid climbs higher, it forces some acid to seep further and deeper until it reaches the synovial fluid in the joints. Eventually, when the concentration of uric acid in the joint reaches the saturation point, it crystallizes and forms needle-like monosodium urate crystals.

Seed Crystal

A seed crystal is a small piece of crystal material from which a larger crystal of the same material typically can be grown. In a solution, soluble molecules are free to move about in a random flow. This random flow may allow two or more molecular compounds to interact and form the basis for a crystal network. The entrance of a seed crystal into a solution accelerates the crystallization process by eliminating the need for random molecular interaction. With a target crystal to act upon, the molecular interactions occur much more easily than by relying on a random flow. Seeding is therefore said to decrease the amount of time needed for the crystallization process.

Given the right temperature and concentration, a tiny seed crystal of uric acid can form in less than a second and then quickly grow to a needle-like monosodium urate crystal structure in minutes. As soon as our natural immune system detects these solid crystals, it considers them foreign pathogens, and a series of immune defenses triggers in no time. Inflammation, a burning sensation, and extreme pain soon follow. This autoimmune reaction feels exactly the same as being stung by a poisonous bee.

Crystallization happens much more easily at lower temperatures. This explains why the onset of most gout attacks occurs at night, especially during winter. Even while you are sleeping soundly, it can wake you suddenly.

You should now have a clearer picture of how uric acid travels into the joints and forms urate crystals that later trigger a gout attack. Let’s get back to the main question of this chapter …

Why Do Some People Suffer from Gout Attacks Even Though Their Blood Uric Acid Reading Is Low?   

To answer this question, I have come up with the Black Box theory of gout that will help simplify the understanding of the crystallization process (Figure 3.2).

The Gout Black Box Reaction

The journey of uric acids from the blood plasma into the synovial fluid in the joints is not a direct process. The rate at which uric acids become urate crystals in the joints and how fast the immune system kick-starts the inflammation reactions varies from one patient to another. Let’s assume the complicated processes between uric acids in the blood and the onset of a gout attack happens as shown the gout black box reaction.

Some people’s gout black box is very fast and effective in transforming uric acids into urate crystals; these are the gout patients who always have a healthy level of uric acid reading in their blood test reports. Since blood tests can never indicate the existence of urate crystals in the joints, the only way to confirm it is through arthroscopic surgery or synovial fluid analysis.

On the other hand, some patients have a slower gout black box, which is not good at channeling those excess uric acids out of the blood stream to the joint. Those uric acids either stay in the blood or stick in the interstitial fluid and eventually develop into tophi, which pop out from the surface of the skin. These people have constant high blood uric acid readings but seldom or never suffer from gout attacks.

Another group of gout patients consists of those who have high uric acid readings and frequently suffer from gout attacks. Their gout black box is working neither too fast nor too slow. I wouldn’t say it is normal because a normal, healthy person never needs this gout black box at all. In short, there are times that the uric acid level of the blood is low because uric acid is already stored either in the interstitial fluids or in the synovial joints.

The Healing Process

It’s very important to have an idea of what type of gout black box your body is having because it will determine the course of healing reactions you will experience when you start drinking Calkaline water.

If you are in the group of fast gout black box, it means that the alkalinity of Calkaline can reach the joints very fast and “pull” them out from the synovial fluid back into the bloodstream for removal via the kidney. This means you will experience very intense gout attacks or a spike of uric acid in the blood during the first few days or weeks for drinking Calkaline water. Do prepare some painkillers to help you through this process. The duration and the intensity of the healing crisis is depending on how much urate crystals are hidden in the joint.

If you think you are of the fast gout black box type and you worry the healing crisis might affect your daily activities, then you should start the course by drinking Calkaline water of mild alkalinity. Instead of squeezing a droplet of Calkaline powder into 300ml of water which produces alkaline water of pH around 11, you begin the course with concentration ratio of 1 droplet with 600ml instead (pH around 9). That will minimize the intensity of potential healing crisis.

On the other hand, if your body is of slow gout black box type, it will longer time for the Calkaline minerals to reach the areas where uric acid deposited. You might not experience any healing crisis in the beginning, but it also means that it will take longer time for you to experience significant improvement after you begin drinking Calkaline water.

The Gout Black Box theory is a very important paradigm shift toward a true gout cure. Read on to have a better understanding of this notorious disease. By the time you’ve finished reading this book, you should have a very clear understanding of gout, and you will absolutely know what you should do to cure it once and for all.