Is Milk Lowering Uric Acid a Good Thing or a Bad Thing?

Parkinson’s disease, the second most common neurodegenerative disorder after Alzheimer’s, is characterized by a slowness of movement, rigidity, tremor, and stooping posture, all of which worsen over time. Non-movement symptoms such as cognitive impairment and sleep, smell, and mood disturbances occur as the disease spreads to other areas of the brain. The cause of Parkinson’s is perhaps “one of the important questions posed by the neurobiology [science] of aging.” For example, why is the consumption of dairy products associated with increased risk of Parkinson’s? Perhaps because they contribute to our exposure to pesticides and other neurotoxins like dieldrin, which continues to be found in the autopsied brains of Parkinson’s victims. Even though dieldrin was banned decades ago, it lingers in the environment and we “continue to be exposed to the pesticide through contaminated dairy and meats…”

The cause of Parkinson’s “is unlikely to be due to milk compounds such as calcium, vitamin D, total fat, or total protein as these compounds are not associated with [the disease] when derived from other sources.” However, it could be lactose, the milk sugar, perhaps accounting for the increased associated risk of death and bone fractures, as well as Parkinson’s. Earlier onset of Huntington’s disease has also been identified. There is, however, a third possibility.

As I discuss in my video Parkinson’s Disease and the Uric Acid Sweet Spot, milk lowers uric acid levels, and uric acid may be protective against Huntington’s and also slow the decline caused by Parkinson’s. More importantly, it may lower the risk of getting Parkinson’s in the first place. Why? Perhaps because uric acid is an important antioxidant in the brain, something we’ve known for more than 30 years. We can demonstrate uric acid’s importance directly on human nerve cells in a petri dish. When the pesticide rotenone is added, oxidative stress goes up. Add the pro-oxidant homocysteine, and it goes up even more. But, when uric acid is added, it completely suppresses the oxidative stress caused by the pesticide.

Drinking milk, however, has a uric acid-lowering effect. In the paper making this assertion, a study they cited was “A cute effect of milk on serum urate concentrations,” but that was just a cute typothey meant Acute effect. Indeed, drink cow’s milk, and, within hours, uric acid levels drop 10 percent. Drink soymilk, and, within hours, they go up 10 percent. Now, for gout, a painful arthritic disease caused by too much uric acid, the uric acid-lowering effect of dairy is a good thing—but uric acid is “a double-edged sword.”

If our uric acid levels are too high, we can get gout, but, if they’re too low, it may increase our risk of neurodegenerative diseases, such as Alzheimer’s, Huntington’s, Parkinson’s, and multiple sclerosis.

Incidence rates of gouty arthritis over five years indicate that if our uric acid is over 10.0 mg/dl, we have a 30 percent chance of suffering an attack of gout within the next 5 years. However, at levels under 7.0 mg/dl, our risk is less than 1 percent, so it might make sense to have levels as high as possible without going over 7.0 to protect the brain without risking our joints. But having excessive uric acid in the blood puts more than just our joints in jeopardy. Yes, having levels that are too low may increase our risk of MS, Parkinson’s, Alzheimer’s, and even cancer, but having levels that are too high may increase our risk of gout, kidney disease, and heart disease.

In fact, having a uric acid level over 7.0 mg/dl isn’t only associated with an increased risk of gout, but also an increased risk of dying from all causes. However, having a low uric acid level may also shorten our lifespan by increasing mortality. High uric acid levels are associated with increased risk of death from heart disease, but low uric acid levels are associated with increased risk of fatal stroke. So, keeping uric acid at optimum levels, the sweet spot between 5.0 and 7.0 mg/dl, may protect the brain in more ways than one.

If we measure the uric acid levels in patients with Parkinson’s, they come in around 4.6 mg/dl, which may help explain why dairy consumption may increase risk for Parkinson’s since milk pushes down uric acid levels. Dairy intake may also explain the differences in uric acid levels among meat-eaters, vegetarians, and vegans. In the graph in my video, you can see that vegan men have significantly higher uric acid levels at 5.7 mg/dl than vegetarians, presumably because vegans don’t drink milk, and those who both eat meat and consume milk fall between the vegans and vegetarians.


For more on Parkinson’s see:

Uric acid as an antioxidant? I’ve touched on that before in Miocene Meteorites and Uric Acid.

If uric acid levels are too high consider cutting down on Flesh and Fructose and eating cherries. (See Gout Treatment with a Cherry on Top and Treating Gout with Cherry Juice for more information.) Also, check out Preventing Gout Attacks with Diet.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

The Benefits of Sesame Seeds for Knee Osteoarthritis

Doctors have been injecting arthritis patients with gold since the 1920s. In fact, “[g]old-based medicines have been in use for thousands of years…and remarkably…are still in clinical use as DMARDs,” or disease-modifying anti-rheumatic drugs, meaning they can slow the progression of rheumatoid arthritis. Unfortunately, such drugs can be toxic and even fatal, causing conditions such as gold lung, a gold-induced lung disease. “Although its use can be limited by the incidence of serious toxicity,” injectable gold has been shown to be beneficial to patients with rheumatoid arthritis. But maybe, as some researchers have suspected, some of that benefit comes from the sesame oil that’s injected, which is used as the liquid carrier for the gold.

As I discuss in my video Sesame Seeds for Knee Osteoarthritis, sesame seeds contain anti-inflammatory compounds with names such as sesamin and sesamol, which researchers suggest “may serve as a potential treatment for various inflammatory diseases.” Those observations, however, came from in vitro (test tube) studies. First, we have to see if sesame seeds have an anti-inflammatory effect in people, not just in cells in a petri dish, but there haven’t been any studies on the effects of sesame seeds on inflammatory markers in people with arthritis, for example…until now.

The abstract states: “Considering the high prevalence of osteoarthritis (OA) and since until now there had not been any human studies to evaluate the effect of sesame in OA patients, this study was designed to assess the effect of administration of sesame on inflammation…” Indeed, researchers found a significant drop in inflammatory markers, but what effect did sesame seeds have on the patients’ actual disease?

Fifty patients with osteoarthritis of the knee were split into two groups. Both received standard treatment, but the sesame group also received about a quarter cup of sesame seeds a day for two months. Before they started, the patients described their pain as about nine out of ten, where zero is no pain and ten is the maximum tolerable pain. After two months, the control group felt a little better and reported their pain was down to seven, but the sesame group dropped down to three and a half, significantly lower than the control group. The researchers concluded that sesame appeared to have a “positive effect…improving clinical signs and symptoms in patients with knee OA…”

The main problem with the study, though, is that the control group hadn’t been given a placebo. It’s hard to come up with a fake sesame seed, but without a placebo, researchers basically compared doing nothing to doing something, and any time you have patients do something, you can’t discount the placebo effect. That said, what are the downsides? That’s the nice thing about using food as medicine—only good side effects. Though the results are mixed, there have been studies using placebo controls that found that adding sesame seeds to our diet may improve our cholesterol and antioxidant status, and the amount of sesamin found in as little as about one tablespoon of sesame seeds can modestly lower blood pressure a few points within a month, enough, perhaps, to lower fatal stroke and heart attack risk by about 5 percent, potentially saving thousands of lives.


What other dietary interventions can help with arthritis? Check out:

If the placebo effect is really that powerful, should doctors prescribe them? They already do! Check out The Lie That Heals: Should Doctors Give Placebos? for more on this.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

The Best Diet for Rheumatoid Arthritis

Rheumatoid arthritis is a chronic systemic autoimmune disease affecting millions. It is characterized by persistent pain, stiffness, and progressive joint destruction leading to crippling deformities, particularly in the hands and feet. What can we do to prevent and treat it?

In my video Why Do Plant-Based Diets Help Rheumatoid Arthritis?, I show a famous 13-month randomized controlled trial of plant-based diets for rheumatoid arthritis where patients were put on a vegan diet for three and a half months and then switched to an egg-free lactovegetarian diet for the remainder of the study. Compared to the control group (who didn’t change their diet at all), the plant-based group experienced significant improvements starting within weeks. Their morning stiffness improved within the first month, cutting the number of hours they suffered from joint stiffness in half. Their pain level dropped from 5 out of 10 down to less than 3 out of 10. Disability levels dropped, and subjects reported feeling better; they had greater grip strength, fewer tender joints, less tenderness per joint, and less swelling. They also had a drop in inflammatory markers in their blood, such as sedimentation rate, C-reactive protein, and white blood cell count. As a bonus, they lost about 13 pounds and kept most of that weight off throughout the year.

What does diet have to do with joint disease?

Rheumatoid arthritis is an autoimmune disease, in which our own body attacks the lining of our joints. There’s also a different autoimmune disease called rheumatic fever, in which our body attacks our heart. Why would it do that? It appears to be a matter of friendly fire.

Rheumatic fever is caused by strep throat, which is itself caused by a bacterium that has a protein that looks an awful lot like a protein in our heart. When our immune system attacks the strep bacteria, it also attacks our heart valves, triggering an autoimmune attack by “molecular mimicry.” The protein on the strep bacteria is mimicking a protein in our heart; so, our body gets confused and attacks both. That’s why it’s critical to treat strep throat early to prevent our heart from getting caught in the crossfire.

Researchers figured that rheumatoid arthritis might be triggered by an infection as well. A clue to where to start looking was the fact that women seem to get it three times more frequently than men. What type of infection do women get more than men? Urinary tract infections (UTIs). So, researchers started testing the urine of rheumatoid arthritis sufferers and, lo and behold, found a bacterium called Proteus mirabilis. Not enough to cause symptoms of a UTI, but enough to trigger an immune response. And indeed, there’s a molecule in the bacterium that looks an awful lot like one of the molecules in our joints.

The theory is that anti-Proteus antibodies against the bacterial molecule may inadvertently damage our own joint tissues, leading eventually to joint destruction. Therefore, interventions to remove this bacterium from the bodies of patients, with consequent reduction of antibodies against the organism, should lead to a decrease in inflammation.

As we saw in my video Avoiding Chicken to Avoid Bladder Infections, urinary tract infections originate from the fecal flora. The bacteria crawl up from the rectum into the bladder. How might we change the bugs in our colons? By changing our diet.

Some of the first studies published more than 20 years ago to fundamentally shift people’s gut flora were done using raw vegan diets, figuring that’s about as fundamental a shift from the standard Western diet as possible. Indeed, within days researchers could significantly change subjects’ gut flora. When researchers put rheumatoid arthritis sufferers on that kind of diet, they experienced relief, and the greatest improvements were linked to greatest changes in gut flora. The diet was considered so intolerable, though, that half the patients couldn’t take it and dropped out, perhaps because they were trying to feed people things like “buckwheat-beetroot cutlets” buttered with a spread made out of almonds and fermented cucumber juice.

Thankfully, regular vegetarian and vegan diets work too, changing the intestinal flora and improving rheumatoid arthritis. However, we didn’t specifically have confirmation that plant-based diets brought down anti-Proteus antibodies until 2014. Subjects that responded to the plant-based diet showed a significant drop in anti-Proteus mirabilis antibodies compared to the control group. Maybe it just dropped immune responses across the board? No, antibody levels against other bugs remained the same; so, the assumption is that the plant-based diet reduced urinary or gut levels of the bacteria.

A shift from an omnivorous to a vegetarian diet has a profound influence on the composition of urine as well. For example, those eating plant-based had higher levels of lignans in their urine. Up until now, it was thought that they only protected people from getting cancer, but we now know lignans can also have antimicrobial properties. Perhaps, they help clear Proteus mirabilis from the system. Either way, these data suggest a new type of therapy for the management of rheumatoid arthritis: anti-Proteus measures including plant-based diets.


I have to admit I had never even heard of Proteus mirabilis. That’s why I love doing work—I learn as much as you do!

I explored another unconventional theory as to why plant-based diets are so successful in treating inflammatory arthritis in Potassium and Autoimmune Disease.

There’s another foodborne bacteria implicated in human disease, the EXPEC in chicken leading to urinary tract infections—another game-changer: Avoiding Chicken To Avoid Bladder Infections.

I have a bunch of videos on gut flora—the microbiome. They include: 

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank / Flickr. This image has been modified.