I Proteinmaxxed Too Hard. Here’s What Happened to My Body

During a recent check-up, my doctor reviewed my latest blood tests. As I watched his eyes work their way down the report, I wasn’t stressed. I work out often, play football a couple of times a week, and eat a relatively healthy diet. But then he paused. “You have high uric acid,” he said. “It’s a precursor to gout.”Gout? As in, the Disease of Kings? I didn’t understand. Sure, men are four times more likely to develop gout than women, but as far as I knew, it was usually associated with conditions like obesity, high blood pressure, and diabetes… and most prevalent in men in their sixties. As an active guy in his mid-thirties, with around 15% body fat, I hardly fit the profile.What my doctor said next surprised me even more. “Do you eat a lot of protein?” He explained that consuming too much can increase uric acid levels and potentially lead to gout in otherwise fit and healthy people—such as myself. And with a daily protein intake of around 200 grams, my doctor explained, I was biting off more than my body could chew.Fortunately, I was able to swerve gout, but the condition has grown increasingly common. Based on data from the National Health and Nutrition Examination Survey, 3.9% of adults in the US (9.2 million people), had gout in 2016, and 5.9 million of those cases were men. Experts believe that our recent obsession with proteinmaxxing is partly to blame for this rise, along with an increase in the prevalence of gut issues. “This is a real thing,” says Dr. Spencer Kroll, an internal medicine specialist. “As we’re seeing this explosion of protein availability and encouragement, we're running into some problems.”The gout, the bad, and the uglyGout is a type of arthritis that occurs when a buildup of uric acid causes sodium urate crystals to form in the joints. It’s generally considered to be the most painful form of arthritis. “Classically, it occurs in the toes,” says Dr. Kroll. “But gout can appear anywhere in your body—and the pain can be severe.” Many protein-rich foods, including red meat and some seafood, contain compounds called purines, which are converted to uric acid in the body—hence, the connection between protein and gout.According to dietician Kylie King, gout has long been considered a product of genetics. But that was before protein became a buzzword and people started pushing the boundaries of consumption. “I remember distinctly when protein recommendations started to get really high, about five years ago,” she says. “I was suddenly having a lot of clients come in with these protein recommendations that were given to them by their personal trainers or what they were seeing online.”The trend has only intensified since then, culminating in proteinmaxxing—a well-intentioned but decidedly misguided strategy to maximize protein intake at every possible turn. Dr. Kroll recalls a recent visit from a patient who’d been consuming high amounts of protein in an effort to bulk up. “He came into my office, hobbling, because he couldn't walk. It turned out his uric acid level was extremely high. The fix for him, in addition to giving him some acute medication for the pain, was to reduce the amount of protein—and, specifically, meat—that he was taking in.”Stone-cold side effectsSpeaking of painful conditions you’d probably rather avoid, consuming excessive protein can also put you at risk of developing kidney stones. Just like gout, uric acid stones (one of the more common types of kidney stone) are caused by a buildup of, you guessed it, uric acid. "It's usually going to result from higher protein—especially animal protein—in combination with low hydration,” says King.Piling on the protein could potentially also lead to a second type of kidney stone, says Dr. Kroll. Calcium oxalate stones make up about 80% of all kidney stones. They’re not directly caused by protein, purines, or uric acid, but rather by low levels of calcium.“Sometimes, when someone switches to a predominantly protein-based diet, they may develop a deficiency of calcium as a result,” Dr. Kroll says. “They may be isolating the protein from dairy products, as in the case of whey, which doesn't contain a lot of calcium. So those people are at increased risk for calcium stones.”“That's something that can be really, really painful, but it's not just going to be from protein alone,” says King. If you’re consuming a lot of protein, just make sure you’re not neglecting calcium-rich foods like dairy products and leafy greens. It’s also worth finding out if kidney stones run in your family, King says. “Family history roughly doubles the risk.”Reeking havocUnlike gout or kidney stones, which can be offset to a degree by things like hydration and calcium, bad breath is often an unavoidable by-product of excessive protein consumption. “The issue of bad breath is real,” says King. “People often assume it's a hydration issue, when it's actually metabolic.”In the body, protein is broken down into nitrogen, and then subsequently into ammonia. This happens regardless of how much protein you eat. “It's the normal process of protein metabolism,” says King. “But if you’re consuming protein in excess, you're going to be smelling that ammonia on the breath.”Bad breath, or halitosis, can also result from when high protein intake is paired with an especially low-carb diet. “When high protein is combined with very low carbohydrates, the body also produces acetone as a result of ketosis, which can smell like nail polish remover,” says King. “Depending on whether someone is consuming an excessively high amount of protein or high protein and low carb, you can get two different halitosis outcomes.”In either of these cases, where bad breath originates in the gut, mints and gum are like Band-Aids for a bullet wound.How to make gains without goutmaxxingYou don’t need as much protein as you think. Step one is to be mindful of how much protein you’re actually consuming each day. That way, you can make sure you’re getting enough protein to fuel your goals without letting things get out of hand. “Most people don't need anywhere near the amount of protein they're being sold,” says King. “No more than 40% of your caloric intake should come from protein,” adds Dr. Kroll. “There's really no reason for a person to pack in more than 200 grams of protein per day. It's like taking in too many vitamins. It's just going into the toilet.”Add lowering your risk of gout and kidney stones to the long list of reasons to stay hydrated, too. “Whatever form of protein you choose, increasing your water intake will potentially lead to a reduction and better excretion of uric acid,” says Dr. Kroll. Making sure that you’re drinking enough water each day can also help mitigate the gut health impact of a high-protein diet. “Heavy protein intake without adequate fiber and water disrupts gut function quickly,” says King. “Digestive issues like constipation, bloating, and GI discomfort are among the most common downsides I see.”Remember: not all forms of protein increase uric acid levels. Purines are technically present in just about any protein source, but red meat and seafood are the ones that really move the needle. You don’t have to give these foods up, but occasionally swapping them out for alternative protein sources can make all the difference. “There are some plants and vegetable products that have purines in them, but, interestingly, it seems from the data that their purines don't cause the gout symptoms,” says Dr. Kroll. A high-protein diet also has the tendency to crowd out other nutrients needed to support your goals. Adding more plant-based proteins to your diet will help to ensure you’re getting enough fibre, complex carbs, and calcium. "I would do a mix of animal proteins and plant proteins,” says King.This story originally appeared in British GQ.