Can Aspirin Treat Gout?
“Do not use aspirin with gout” has been the cry for decades.
Scientists have said low dose aspirin can help heart disease and stroke, but not treat gout because it raises uric acid.
Many believed that high dosage aspirin could help reduce pain and swelling in gout, but low dosage made it worse. A new study has shown that low dosage aspirin has no effect on uric acid levels, so it should be OK to treat gout. Low-Dose Aspirin Use and Serum Urate Levels: A Population Based Propensity Analysis studied nearly 2000 subjects. It concludes that “Low-dose aspirin use was not associated with increase of serum urate levels”
2008 Update
I’ve changed the link for this report to my recent review. It appears that the jury is still well and truly out on the subject of low-dosage aspirin and uric acid.
If you take low dose aspirin, and you have gout, or if you are at risk of gout, please see a doctor as soon as you can to discuss your best options.
Do you take aspirin, or have you been told to avoid aspirin because of gout? Please share your views and experiences in the GoutPal Forum.
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I have heart disease and gout and have taken 2 full-sized (325mg.) aspirin per day. I am beginning to realize that I should either take much MORE or much less. There is no way I can risk a heart attack with none.
Here’s some ancient data on the subject that I find VERY informative:
You can clearly see that the tipping point between urate RETENSION and EXCRETION lies somewhere between 2 and 3 grams per day (between 6 and 9 aspirin.) This study doesn’t directly address the use of the miniscule dosage of 75 or 150 mg./day but it points in the direction that less aspirin is MORE troublesome for uric acid control.
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Here’s the result of a 2004 study of elderly patients put on low dose aspirin therapy:
Quote:
There were 83 patients in the active treatment group and 40 in the control group. The average age was 81 years (range, 56 to 98). After two weeks of low-dose aspirin therapy (100 mg./day), 72 percent of the patients had decreased urinary excretion of creatinine, and 45 percent had decreased uric acid excretion. In addition, mean creatinine levels and uric acid clearances decreased, while serum BUN, creatinine, and uric acid levels increased significantly. When these patients were compared with the group of patients who did not receive aspirin therapy, a significant deterioration in all levels was noted. At the end of the three-week follow-up period, 48 percent of patients who had received low-dose aspirin therapy had a persisted decline in creatinine clearance from baseline. This decline also was significant when this group was compared with the control group.
The authors conclude that short-term, low-dose aspirin therapy may have a significant adverse effect on renal function in elderly patients. They note that this negative effect persisted for at least three weeks after aspirin therapy was discontinued.
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Seems to me, that whilst the studies do point to a positive benefit from high dose aspirin, the definition of high will vary from person to person.
Therefore individual dosing is reliant on careful monitoring of kidney function and uric acid excretion (as well as blood uric acid measurement) by a sympathetic and capable doctor.
The search for the Gouty Grail?
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I have tried the high dose aspirin treatiment. It isn’t easy.
I took 3-4 grams a day for 10 days (10-12 aspirin per day.) It isn’t easy because tinnitus is loud and there’s always a slight stomach discomfort for me…others may find a HUGE stomach discomfort.
I don’t think this could be a regular remiment for me.
But a cute coincidence (maybe) is that the day after I stopped the aspirin, my knee pain of almost 2 months duration abated significantly. But I don’t make too much of the probably anecdotal connection. But then who knows!
I have just read that the half life of low dose aspirin is a few hours but that HIGH does aspirin has a half life measured in WEEKS. Again, interesting but nothing to draw conclusions from. The MAJOR excetory product of aspirin is…get ready for this: SalicURIC acid. THAT speaks volumes to me.
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I had a gout attack some 6 years ago and have only just recieved my next painfull episode ,the only thing i can say is that my doctor recently asked me to start taking a one a day Asprin and now the Gout has come back .. ??
over to you guys
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i have gout my uric acid level is 9 for reducing this i take medicine alluronil & colichene and also take asprin 75 mg please advice me asprin is beneficial for me or not
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Well Sanjay, from the previous on here- it looks like the standard situation.
Low dose aspirin in not helpful for gout -but then gout is not heart attack ,is it?
You don’t say how much AlloP you take- this would affect comment on here- as it needs to be adjusted to your personal situation and what results are gained from this, in blood tests for SUA.
I’m sure you’ll get good advice here ,from Goutpal and Zip,in particular, but you need to explain a bit more about your dosages and the length of time you’ve been using it.
If it’s early days in your treatment ,and you get away without an attack by the time you get down to a < 6Mg/dL SUA level, a reasonable result- if you've managed to stay with the aspirin usage without any attack at all ,but this is not guaranteed in any event!
Like a lot of these treatment regimes- it's a case of try it gently, and see the result!
Unfortunately ,with gout,we don't know what's going on too well under the surface!
[Until it's a bit too late!]
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The reults for aspirin as a treatment for gout have got me jumping around from a variety of different resources with no conclusive answers. The one commonn factor that seems the same for all is that a high doseage of aspirin for gout stops reabsorption of uric acid by the kidneys allowing the body to dispose of it via urine. I don’t think there has been a study done long enough to give accurate results for the possible side affects if any.
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Yes, the studies are too limited, but it is unlikely to be a topic that attracts much research interest. One thing that appears to come out of the research into treating gout with aspirin is the likelihood that different people have different dosage reactions where aspirin changes from increasing uric acid to lowering it.
This being the case, dosage can be increased in line with uric acid level testing to find the right amount, though the risks of high dose aspirin may well outweigh the benefits when compared to probenecid or allopurinol.
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The risks of high dose aspirin leading to bleeding in the stomach is too high to consider safe use for Gout -without in-patient monitoring and invasive sampling IMO. [Ignoring other known side effects]
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