Gout is ultimately a liver and kidney issue. The kidneys have been irritated to a point of dysfunction by urinating out an irritant (most common is unregulated carbohydrates/sugars that act like sandpaper on the kidneys). This means a low carb diet is part of the fix (not zero carb, but lowered carbs). However, the liver can no longer effectively handle protein which is why eating protein causes the gout to worsen and why most MDs advise lowering protein intake (but they miss the carb part). If you need to lower protein AND carbs, only fat is left. I'm not huge fan of the true "keto" diet (low carb, low protein, high fat - exact ratios adjusted per patient) as a one-size-fits-all for everyone, but for gout patients it's the best strategy while treating the liver and kidneys holistically (plant medicines, clinical nutrition, etc.).

For the fun of it, I copied my comment into AI without changing it (here is the link): it says I'm wrong while highlighting the involvement of the liver and kidneys, lol. I think the AI summary actually confirms what I'm say while saying it's in disagreement. Whatever, I've been treating this patient category with diet and herbs for over 20 years with solid outcomes. Ideally, find a doctor you like and follow their lead. Good luck!

https://grok.com/share/bGVnYWN5LWNvcHk_a7da15d0-c4aa-4ce8-993d-f6609fff6344