Everything you have been told to do works on one end. Getting less uric acid in. Cut the beer, cut the shellfish, lose the weight. If you are on allopurinol, that does the same job from the inside. It tells your body to make less.
Nobody talks about the other end.
Your kidneys pull uric acid out of your blood every day, and it is supposed to leave in your urine. In about 9 out of 10 people with gout, that exit is shut. It gets filtered out and then pulled straight back into the blood instead of leaving.
That is why the diet barely moves your number. And it is why the pill can hold your number in range for years while the flares keep coming.
Anthocyanins, the deep red pigment in tart cherry, are studied on exactly that part of the kidney. Elvar is cold-extracted so they are still there when they reach you.