QUESTION: This patient is a 30 year old male athlete works out 6 days a week. Presented three months ago after not seeing any healthcare practitioner in more than 8 years. Alongside physical, we ran blood work which came back with an assortment of lows: Low D, Low B12, Low Iron 11 (high Ferritin 188), elevated cholesterol (7.34), high urate (540), low triglycerides 1.25.
He was put on heme iron 30mg (assumed increased lysis from heel strike) , vitamin D (5000 IU), vitamin C (1000mg), Metagenics CorticoB5/B6 (support adrenals), AOR Urate (reduce uric acid), Niacin (cholesterol), Omega 3 (increase triglycerides) and B12 injections (support B12).
I saw the patient regularly over three months, he was regularly taking supplements, felt a lot better. Had reduced gluten and dairy in his life (had occasional pizza), was feeling a lot better. He was coming in for body work specific to athletic injury and pain.
We ran his blood work 3 months later, assuming most of the abnormals would be corrected…and shows correction in Vitamin D, Vitamin B12, improved triglycerides. But Iron is lower (10), Ferritin reduced (88), higher uric acid the previously tested (567) and now high alkaline phosphatase 131 (previous test 113) – but billirubin, ALT, AST, Calcium…all mid normal range.
No Symptoms of Gout, no Symptoms of liver damage, No Candida symptoms, eats very little sugar, few carbs, high meat and veggies diet primarily chicken and beef.
After some discussion, I think he is not digesting well given that his bowels are not grey/black with the iron, and he has no consistency with the niacin flushes. I think he isn’t digesting the iron, so probably with still exercising he is reducing rather than replenishing.
What I am curious about is increased Uric Acid with gluten intolerance? I have two other patients that I have seen this in. I have asked around, no one else has seen this? Also if there are links to Uric Acid and Iron?
ANSWER: This is common if you watch for it in inflammed people. Bottom line is that Uric Acid (like low level AlkPhos / LDH / CRP) is an inflammatory marker above all else. In this case it can be poor digestive absorption as you mention. But mostly it’s general inflammation from something (exercise can do it).
In cases like this I address ReDox first as well as adjusting it to exercise levels (more exercise = more inflammation and ReDox need). After that look for celiac, digestive stuff, chronic infections, toxins etc. I follow the Uric Acid, LDH etc and as they drop then you are getting on top of the inflammation.
