My last two Uric acid tests showed 8.6 in 2016 then 9.2 back in June. I have had a handful of attacks, but in my ankles, never my toes, yet my Dr suggested it could be arthritis/gout due to the UA levels. 99% of the time I feel fine, but last night was the worst attack ever - writhing in pain, unable to sleep, Ibuprofen did nothing at all. Finally I found a 5 year old bottle of Naproxen and it took the edge off.

I'm 41, and in good shape. I eat moderately heathy but not perfect. I exercise several times a week, usually drink tons of water, however, I have a stressful job, borderline low T (400ish), erection quality loss, and just started low dose Cialis which has worked wonders for the erections. My triglycerides and HDL/LDL ratios are usually a bit elevated due to genes. I also brew and drink craft beer a few times a week, which I don't want to give up.

Anyway, back in June the Dr said to get on a special diet, but it basically takes away all meat, most carbs, beans, all beverages, and sweeteners.

Clearly I need to get my UA levels down, but I won't become a vegan or a complete teetotaler. But I could modify the diet if there is a reasonable and proven list of what would give me the most bang for my buck.

Also, are meds a good option? Does allopurinol really cause significant ED issues or is that just a coincidence of fat old men who also have gout? What about OTC supplements - how much can they lower UA? Cherry juice?

Also, how responsive are UA levels to diet? Is it a day by day/hour by hour thing like blood sugars are for a diabetic, or more of a long term habit effect like A1C levels?