Alcohol and Gout

January 14, 2007 in Gout Diet

How are Alcohol and Gout Related

Hot on the heels of my reader's message that led to My Gout Diet Plan, came a message about alcohol and gout.

I've been sitting on the fence about this for too long. Time to make a stand for alcohol. Or at least seek better information from people who know better - maybe you!

One of my first pages was about the effects of alcohol. I'm not saying I know everything about gout now, but I knew a lot less then. Not that there is anything wrong with what I said. The main problem for me was including it in my Gout Causes section. At the time, I'd been led to believe that alcohol causes gout. I doubted it then, and I doubt it more now.

I looked at a lot of research, studies and reports about alcohol and gout. I wrote that I would summarize these. But I remained confused. I put things on the back burner until I got this message:

of ALL major types of alcohol which can i consume with the LEAST adverse affects. (i.e. vodka, gin, rum, all whiskeys, wines, beers, liquors, assorted cocktails, shots, etc. etc. etc. can't i have ANYTHING at all? I know high sulfite content is BAD. SOOOO many conflicting answers, studies show beer the worst then liquor then wine..WHAT!!! wine has the HIGHEST sulfite content of ALL three? I'm totally confused here!!!!white wine okay, white wine bad, etc. etc.

Now I haven't had time to look at sulfite and gout - that's for another time. I have had a little think about alcohol. I know how alcohol affects me. I know how alcohol affects my gout. I think it's time for a bit of controversy.

My Alcohol and Gout Theory

Alcohol has very little to do with gout. It's easy to fall into the trap of getting hung up on it. Most doctors tell you alcohol is bad for you, and you end up feeling guilty. Now I'm not advocating alcohol abuse, but I can definitely see from my experience that alcohol has some positive effects.

I find it lifts my mood - important to me when I'm feeling a bit down with the pain of a gout attack.

I find it helps gout attacks to resolve quicker. I drink mainly beer, and I find that after a few pints the swelling goes down and the pain gets less.

Now these are both short term benefits. The downsides of alcohol probably come later, but unless you're drinking excessively, they are beatable.

I do not recommend neat spirit. Spirit with a still mixer is, I think, better than fizzy mixers. Wine and beer should be OK. There's very little more than alcohol and water in most drinks, so it's not worth getting hung up over. In theory, red wine has more health giving trace elements than other drinks, so it should be preferred, but I don't think it's critical.

The first downside is dehydration. There's only one answer to this - drink water. You may have seen my page on water and gout. Keeping hydrated is very important for managing gout. If you get into the water habit, you should never suffer from alcohol-induced dehydration. Make sure you drink water after alcohol, and drink more if you wake through the night.

The second downside is weight gain. You have to manage this over a week, not a night. If you're overweight, aim to balance your diet to loose one or two pounds a week. No more. If you're not overweight, try to maintain a fairly even weight. Managing your weight includes looking at calorie intake, exercise and metabolism. My soon-to-be-launched Gout Diet Plan will cover this in more detail.

There is a risk that alcohol can affect kidney function. Regular water drinking should more than compensate for this. I recommend kidney function tests as a normal part of health checks. Your health care provider should advise the interval.

All in all, I'd say stop reading the studies, and get drinking! Do it sensibly, and if anyone says alcohol causes gout, please ask them for me - How?

Your Thoughts On Alcohol And Gout

I've come to the conclusion that a lot of "scientific evidence" about alcohol and gout is worthless. Alcohol is to be enjoyed as part of a healthy social life, not studied in a lab. I'm much more interested in the practical aspects of living with gout. Deciliters of blood, and micrograms of alcohol, don't interest me.

Please read the Gout And Alcohol guidelines. If you still have questions, please ask in the gout support forum.

Find more (see gouty search hints).


18 responses to Alcohol and Gout

  1. I have suffered from gout since I was 35 (now 45) and I too was very confused about alcohol consumption.

    Just last month I had one of the worst attacks I have had in years. I was almost confined to bed for 7 days. I could barely make it to the bathroom (15ft away) to get rid of the 100,000 gals of water I was drinking with lemon juice and cherries, baking sodas bananas….anything I could possibly find on the internet that would reduce my acid levels.

    After I got to the point where I could walk, but still with a medium level of pain a friend of mine asked me to go out drinking. I reluctantly agreed, but despite my reservations, I had about 5 Johnny Walker scotch’s on the rocks, figuring what the hell life must go on.

    I can tell you the next morning I could have run a marathon!

    About three days passed and I could feel the pain coming back. Went out again, had about three scotches, and low and behold, next morning could have run another marathon.

    I rarely drink, except socially, and I like many sufferers have been told for years that alcohol is BAD BAD BAD for gout sufferers, but I just have never believed it as this was not the first time this alcohol/pain relief has occurred.

    There is so much conflicting information, I too agree that everyone must experiment for themselves and see what works or doesn’t work. I won’t strat drinking every time I have an attack, but I can tell you that if it gets unbearable again, I am breaking out the scotch! And if it works again, I will surely re-post.

    BTW, Beer does seem to trigger attacks for me. I believe it is from the hops and barley and yeast which are very high in purines. Or at least that is what I read. it seems logical that fermented spirits would be higher in purines than distilled ones, but, I am not a scientist.

    Hope this helps at least one person, and thanks for the continuing info I often refer too.

  2. I often feel that we are looking for scapegoats for our gout pain, and alcohol is constantly flagged as a massive gout problem by the medical profession. Personally, I get gout if I drink, and I get gout on those very rare occasions when I don’t drink.

    I think you know my conclusion

  3. Sorry to beat the “iron drum” again. Alcohol is one of the best foods you can eat to get the maximum amount of iron out of your food in as short amount of time as possible. Iron that normally wouldn’t be absorbed across the intestinal lining will when alcohol is present. The enzyme responsible for converting purines into uric acid is xanthine oxidase (XO). XO is able to work better and faster when iron is available in the proteins that the body uses to store iron (free iron is toxic to cells). If you eat a meal with 1000 purines in it, it may all get turned to uric acid but the longer it takes, the better. With a good amount of alcohol, it will take considerable less time. The result is your uric acid level spikes which makes the crystal formation more likely. However, if you do decide to drink, the smart move might be to drink on an empty stomach.

  4. Scratch the last bit about drinking on an empty stomach. Bad idea.

  5. I used to binge drink and binge eat. I recently had what I thought was my first real gout attack. I did the whole purine free thing, the meds and the gout seemed to be going away. I had 2 pints and the next day I was back to square one, meds and all. A week later I could not bear the pain anymore so I caved in and had 2 fingers of scotch before dinner followed by 2 pints of water and had my first painfree night in a week. I do not know why but beer seems more of a trigger for me and if a few shots of the hard stuff when wanted help why not. Life goes on. Remember to hydrate.

  6. i myself,i got watch dark/heavy beers,dark rum.had some brewers yeast that i took & got a attack on my rt.knee.coors,bud lite,etc.seems to be ok

  7. I have recently got what is suspected as gout. I have had my second attack. first attack i dismissed as some infection. Now being told to give up beer and most of the food i have eaten all my life. while i appreciate my heavy drinking and at times bad diet i think a more realistic target would be better. i.e cutting back on alcohol, eating less red meat and curriesand taking more fruit and vegetables. i do not eat a lot of fish but think i should as part as a more healthy diet but am told this is bad for me also. i would like some help as to a general weekly diet that i should follow. but please remember i never got to the stage i am at now with living as a saint. as much as i want to try to cut back a totally strict diet will probably make me stick my head in the sand. i have to have some social life and in glasgow that means a few pints now and again and a curry.

  8. I’m with you on all of that Peter.

    Gently, gently with gout is the best way.

    People who give a long list of food and drink to avoid don’t really understand the typical gout sufferer. Food is rarely bad for us, though the way we consume it often is.

    The spices in curries are good for gout. Adding vegetables to curries, in my opinion, improves them taste-wise – it definitely improves them from the gout diet point of view. Keema and peas and lamb saag are excellent combinations. Onion bahjis or vegetable samosas make excellent starters.

    In my experience, alcohol helps my gout. Last week I was actually dancing at a Christmas party, and I wouldn’t have done that without a few pints. Next day my feet felt fine – a good (not too strenuous) workout for gouty joints is an excellent way to improve mobility.

    It is important to keep hydrated so make sure your night out ends with a pint of water, and take more through the night or when you wake.

    Please note that this is only my personal opinion, and your doctor might advise otherwise.

    Finally, if anyone gives you a list of diet restrictions for gout, without explaining the need to monitor and control uric acid levels, treat them to a “Glasgow kiss” *. They truly are not worth listening to.

    * From kiss (AKA Glesga Kiss):

    Glaswegien slang for ‘Headbutt’

  9. I am in the middle of my first gout attack. my doc told me not to stop drinking red wine completely but moderate it to a couple of glasses with meals.I have read all sorts of alarmist info on the net and I am frankly confused. Can I drink moderately during a crisis or do I have to wait till it’s passed?

  10. There is some evidence to suggest that alcohol makes gout worse. However, none of the studies that I have seen take into account other fluids.

    In my experience, as long as you avoid dehydration, then alcohol is OK. Of course, prolonged excess alcohol is likely to cause other health problems.

    I have found that taking a drink or three helps me cope with gout attacks, as long as I drink plenty of water afterwards.

  11. I’m a habitual beer drinker – I love the stuff. I find it makes my joints better. Bells, Johnny’s, all good. I drank 24 ciders over a week-end (very, very hot)and had a chronic gout attack. I told my doctor about it and he said it had nothing to do with it. He gave me no other information because until now I realised he had no other information to give. You have a very informative website. I believe it’s every man to his own and there’s a lot of enlightenment taking place here. BTW in South Africa we have Citrus-Soda which really works very well for controlling uric acid levels but alas I only take it when I sense an attack coming. Wondering if I should use it as mix for my Johnny’s? But no, truth be said all of the comments are fair – I don’t think my gout is any worse because of beer drinking, but not out in the sun because of the dehydration.

  12. Cheers Ian, I’ll drink to that!

  13. I am 38 and have suffered with gout for more than 12 years. I am in the middle of my 1st ever double-joint attack, yes… both knees. This has knocked me on my back, and made me take a good hard look at what I’m eating and drinking. This attack was almost certainly brought on by cider. Ian, for your doctor to dismiss cider like that just shows that he/she has no appreciation of what’s going on in your body. I’m not saying that cider will be a problem for everyone, but you will know if it is for you (it certainly is for me). I’m an amateur home brewer, and have a shed full of beer and cider that I’m going to give away to my friends. I’m going to cut my consumption back, and go to scotch and dry.

  14. I am 22 and been diagnosed with gout for 2 years now. My first attack was last year around right after new years. i stubbed my toe and thougth i broked it but after all xrays my toe wasnt broken it was gout. i was depressed over the doctor telling me not to eat and drink alcohol anymore. my gout lasted for a month. my uric acid was 10.5 and i had to be on allopurinol but i stopped after a month. since then i just drank beer like about 3 to 6 days a month because i love drinking. i drink a lot of coronas and heinkens and i didnt get a gout attack for a year unitl right now at dis moment i am recovering from my second gotu attack. i was wondering y it didn’t happen earlier it took about a little more than a year til another attck happended. I am not overweight i am 5’6” and about 135lbs and now the doctor asked me agen if i was still drinking and i sed yes. the doc told me to stop and she gave me more allopurinol. I was like no way not agen but dis time she sed if i dont want kidney stones i gotta take it. now i was wondering if i could take allopurinol and still drink beer?

  15. My two-pints worth… had my first gout attack as a skinny 19-year old girl – and almost 20 years later, still suffering (ouch!). The most obvious point is that I don’t/didn’t fit the stereotyped profile of gout-sufferer (weight, sex, age, vegetarian) – and the only thing I can contribute to this discussion is that lager is a potential problem: having been gout free for more than a year (until three days ago) I THINK I can attribute this latest attack to being smug and drinking a few bottles of lager three times in one week. Red wine is fine. Cider not so much. But MOST IMPORTANT: LITRES OF WATER, day in, day out. The recent lager-drinking coincided with forgetting to drink water for a few days, so who knows? (By the way, drink alcohol almost daily, but loadsa water also.)

  16. Sigh, The effects of alcohol are EXTREMELY HARMFUL the the body, the “positive effects” of alchohol are Weak, do not last long, and the negatives including YES gout! brain damage, obesity (alcohol is extremely fattening) Impaired reasoning and on top of this, alcohol is quite expensive. Furthermore the positive effects of alcohol are short lasting and bring on a hangover afterwards. Also Gout is also caused by lack of variety in diet, the history of gout points to nobles as having the most gout for a few reasons, 1 alchohol 2 lead in wine to sweeten it (not smart) 3 It was Etremely looked down upon to eat vegtables before say the 18th century, and so the lack of nutrients very severly caused gout in people, and even now people suffer from eating too much meat, and not enough else. the very idea that not eating meat causes gout is rediculous. all alcohol and meat abstaining people i’ve met recieve (if at all) gout much later than others. i’m sorry goutpal but please keep opinions of gout to yourself, for your researching apparently not been very up to date, as many studies have indeed confirmed up to a 250% risk of gout in people that consume 50g of alcohol or more, a 160% risk for 10g or more, and wine has little or no effect on gout.

  17. And there is about one ounce of alcohol in a beer which is about 24 grams of alcohol in a beer so 2+ beers a day is harmful to you gout-wise, and goutpal ever hear of henry VIII? his horrible gout?he is a pristine example, he had horrible gout because of a diet high in red meat, and lots of alcoholic beverages. his ulcers from gout caused him the smell because the ulcers could not heal. goutpal your research goes against conventional wisdom. take it from somone who is a medical researcher and son of a doctor.