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I am a big coffee drinker – so this is important to me.
On the page – Home remedies for gout choice: Water – it says, “Some drinks contain caffeine or other diuretics. Do not include these as part of your water intake. If you drink lots of tea, coffee, cola or other diuretic drinks, you should increase your water consumption to compensate.”
However, on the page – Gout and Coffee, I read, “One other benefit of coffee for gout is it's water content. Though coffee is mildly diuretic, it still counts towards your daily fluid intake. I cannot overemphasize the importance of hydration.”
So, which is it – should I drink it and count toward total fluid intake? Or should I drink it to obtain the benefits reflected in the study but NOT count it in my total fluid intake? Or – avoid it – and make sure I drink plenty of water?
1:04 pm February 10, 2009
zip2play
Tophi Terror
posts 938
2
opa,
You are not alone in your confusion. I have been trying for YEARS to get a resolution of the problem. Here's the gist: the literature says that the source of dietary uric acid (as opposed to natural cell breakdown liberating nucleic acids) is PURINES, primarily xanthine and guanine. These purines in humans have as their natural end point, URIC ACID.
So, what is caffeine? Chemically it is tri-methyl XANTHINE, chemically VERY close to uric acid…or xanthine with three small methyl groups hung on. Now, restrictions on the amount of purines is strict for gout sufferers, on the order of a half gram a day or less.
The AVERAGE amount of uric acid produced in a day is about 700 mg. Since a gram of caffeine seems logically to yield close to a gram of uric acid, caffeine would seem to be a problem especially since an average cup (8 ounces) has about 160 mg. caffeine. I drink about 50 ounces of strong coffee per day…I'm extremely addicted.
But look at the dietician's link that pops up prominantly on a search for gout and caffeine and she says point blank: “CAFFEINE IS NOT A PURINE.” Well, I am a chemist and if the definition of purine is xanthines and guanines, then caffeine, being tri-methyl xanthine, sure as Hell IS a purine. Alass, the web can be the source of some pretty rotten information.
Like I said, I am as confused as you are. If I thought FOR SURE that drinking coffee vastly increased my pool of uric acid, I would stop drinking it. But I don't want to stop for NOTHING…and beside Betty Ford for kicking the addiction is EXPENSIVE.
I am a big coffee drinker – so this is important to me.
On the page – Home remedies for gout choice: Water – it says, “Some drinks contain caffeine or other diuretics. Do not include these as part of your water intake. If you drink lots of tea, coffee, cola or other diuretic drinks, you should increase your water consumption to compensate.”
However, on the page – Gout and Coffee, I read, “One other benefit of coffee for gout is it's water content. Though coffee is mildly diuretic, it still counts towards your daily fluid intake. I cannot overemphasize the importance of hydration.”
So, which is it – should I drink it and count toward total fluid intake? Or should I drink it to obtain the benefits reflected in the study but NOT count it in my total fluid intake? Or – avoid it – and make sure I drink plenty of water?
opa6×57,
Please accept my apologies for the confusion, and my thanks for pointing out this inconsistency.
There is sufficient evidence to suggest that coffee is beneficial to gout sufferers.
Not only that, but when I wrote that page, I was misled by information I had seen about the diuretic effects of coffee. It is now clear to me that no amount of coffee will produce negative hydration – i.e. the small diuretic effect of caffeine is more than outweighed by it's water content.
You should follow the advice on the Gout and Coffee page, which is based on more recent research.
Apologies for the confusion – we're all still learning.
Unless replying to specific points in this topic, please start a new topic. See new topic link above, or gout forum guidelines. Current gout status in my profile.
You have prompted me to review all my pages related to coffee, and I now believe I've avoided some gout and coffee confusion.
Hopefully… (scuttles off to double check, hoping for more help to spot any inconsistencies)
Unless replying to specific points in this topic, please start a new topic. See new topic link above, or gout forum guidelines. Current gout status in my profile.
2:53 pm February 11, 2009
zip2play
Tophi Terror
posts 938
6
The result that seem to say that coffee lowers gout risk is first called a PROSPECTIVE study…to me that means it hasn't been done yet???
Quote:
The June 2007 edition of Arthritis & Rheumatism reports, in Coffee Consumption and Risk of Incident Gout in Men: A Prospective Study
Secondly, what I see is a look back…that is NOT a study. A proper study is a controlled study that looks FORWARD and compares groups to test a hypothesis.
Thirdly, the slim look back results shows that men with gout drank less coffee than men without. If your first diagnosis of gout came with the warning from your doctor to give up, or moderate your coffee wouldn't that “result” be predetermined.
An example might be that people with rheumatoid arthritis are told to stop running. A look back will discolose that those without arthritis tend to run more and therefore falsely indicate that running cures arthritis.
These gout-coffee studies are terrrible and as a result I smell the money influence of the multi-billion dollare coffee industry here.
My best evidence is intuitive: xanthines are purines and purines cause/exacerbate gout. Uric acid is basically a slightly modified xanthine molecule…it is therefore most compelling that caffeine (trimethyl xanthine) theobromine and theophylline (dimethyl xanthiines) break down to uric acid. And the quantities are enormous for heavy coffee drinkers. I get a GRAM of caffeine/xanthine in my coffee
Until someone takes two LARGE blinded groups (or as blinded as one can arrange) dries them out for a couple weeks and feeds one lots of coffee and one lots of SANKA or water, and then measures the average differential in serum uric acid BEFORE and AFTER a suitable amount of time…maybe 14 days…we shall NEVER know for sure.
WHY a simple test like this was not run/published/trumpeted is anyone's guess. But I am reminded of the many decades that no testing, or at least no results of testing released, was done to determine whether or not cigarettes caused cancer and heart disease. Big money talks loudly.
I am CERTAIN that the coffee industry has done definitive studies, as ANY multi-billion dollar industry would…so their NON-publishing speaks volumes.
As for the diuretic effect of coffee, for myself I have PROVEN that it is nonexistant, one of those old saws that is repeated ad-infinitum with zero facts to back it up. If I driink lots of coffee on an empty stomach, as I do for 3 hours every morning, I am considerable HEAVIER than when I started, not lighter. The same goes for BEER (although other spirits and wine are very dehydrating.)
Prospective study: A study in which the subjects are identified and then followed forward in time.
These are quite cheap to do, because they just use data (in this case from over 45,000 men). They identified subjects who did not have gout, then profiled them after 12 years. Statistically coffee drinkers developed less gout.
The data has been used for a range of other analysis – and each time it produces a separate report, presumably bringing reward to the authors.
Significantly, it was this data that led to the suggestion that vegetable purines do not contribute to raised uric acid – but again, I am unaware of any reliable blinded study that properly analyses different sources of purines on uric acid.
Quite simply, there is nobody on the planet going to finance this type of study.
So we just have to struggle on – with or without coffee cup in hand.
Unless replying to specific points in this topic, please start a new topic. See new topic link above, or gout forum guidelines. Current gout status in my profile.
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