Klyan Klinisch Nutricioloog

GOUT: More Than a Painful Joint

Most people associate gout with sudden, severe pain in the big toe. However, gout is not simply a problem of one painful joint.

Gout is an inflammatory arthritis caused by the deposition of monosodium urate crystals in and around the joints. Persistent hyperuricaemia an elevated level of uric acid in the blood is the main risk factor for crystal formation. However, not everyone with elevated uric acid develops gout.

Gout most commonly affects:

• the big toe
• the ankle
• the knee
• the wrist
• the fingers

The most important clinical question is not only:
“How high is the uric acid?”It is also:
“Why is it elevated?”

Possible contributing factors include:
• reduced uric acid excretion by the kidneys
• impaired kidney function
• insulin resistance and metabolic syndrome
• excess body weight
• high intake of fructose-sweetened drinks
• alcohol consumption, particularly beer and spirits
• dehydration
• rapid weight loss or prolonged fasting
• genetic predisposition
• certain medications

Insulin resistance deserves particular attention. Higher insulin levels may reduce the kidneys’ ability to excrete uric acid efficiently. Elevated uric acid can therefore be part of a wider metabolic picture involving abdominal obesity, fatty liver, elevated blood pressure and impaired glucose regulation.

In my clinical approach, I also consider digestive function.

Current evidence does not show that low stomach acid directly causes hyperuricaemia or gout. However, reduced gastric acidity may contribute indirectly to a broader metabolic imbalance through impaired digestion, altered nutrient absorption and changes in the gut microbiome.

This is a biologically plausible clinical pathway, but it should not be presented as an established direct cause.

A comprehensive assessment may include:

• serum uric acid
• creatinine and eGFR
• urine analysis and urinary albumin
• fasting glucose and insulin
• HbA1c
• lipid profile
• blood pressure
• liver enzymes
• medication review
• alcohol, fructose, hydration and overall dietary pattern

Nutrition and lifestyle can support treatment, but recurrent attacks, visible tophi, kidney stones, severe joint inflammation or persistently high uric acid require medical assessment.

Prescribed medication should never be stopped or changed without consultation with the treating physician.
An elevated uric acid level is not simply a number. It is a metabolic signal that deserves context.

Treat the patient , not only the laboratory result.

Have you ever had your uric acid level checked and was the underlying cause investigated?

Karinè Klyan
Clinical Nutritionist
Klyan Klinisch Nutricioloog

❤️
What a beautiful gesture from a grateful client.

These flowers mean so much to me. They are not just flowers, but a sign of trust, appreciation and a beautiful journey we walked together.

Two months ago, my client started her trajectory with migraine, acne and a body that clearly needed balance and support. Step by step, with careful guidance, nutrition, lifestyle support and — when needed — supplements, together with good cooperation with medical specialists, we worked on restoring balance from within.

Today, after two months, we see such beautiful results:
less migraine, 7 kg weight loss, improved liver balance and clear skin.

Moments like this touch my heart and remind me why I do this work with so much love.

From complaint to strength, with nutrition that nourishes, heals and connects.

Karinè Klyan
Klyan Klinisch Nutricioloog

Cholesterol

Menopause is not a lack of willpower. It is a lack of serious healthcare.

We understand it. Truly.
“Exercise more.”
“Relax more often.”
“Just have more sex.”

But let’s be honest.

As long as women’s health, menopause, and hormonal transitions continue to be structurally underestimated in medicine, many women will keep struggling with symptoms they did not cause yet are forced to carry.

Women who were once energetic.
Sharp.
Emotionally balanced.
Sexually connected.
Fully themselves.

And then menopause arrives.
With loss of libido, sleep, muscle mass, bone density, mental clarity, and emotional resilience.
Not because women are “not trying hard enough,” but because their biology changes — while care lags behind.

At Klyan Clinical Nutritionist & Sexologist, we therefore look beyond superficial advice.
We work with nutrition and when necessary targeted supplementation, tailored to support:

• hormonal balance
• brain function and mood
• energy and stress regulation
• metabolism and insulin sensitivity
• sexual health and intimacy

Not from shame.
Not from blame.
But from understanding, biology, and evidence.

Because women do not need quick fixes.
They deserve knowledge, guidance, and respect for their bodies.

From complaint to strength, with nutrition that nourishes, heals, and connects.