Gota y Alcohol

Por qué el alcohol provoca tantos ataques de gota

Since most of my gout attacks have always occurred after I’ve had a few drinks in the past day or few days, we will begin our education by me explaining the relationship between gout and alcohol consumption. The bottom line fellow gout sufferer is that drinking more alcohol significantly increases the risk of triggering gout attacks and developing gout in an otherwise normal person. Now I was never an alcoholic but in my early twenties, I liked to go out on the weekend with friends and have a few drinks or even share a bottle of vodka for a friend’s birthday party. It was a very normal thing to do and I was like everybody else at the club, bar or pub, just having a good time with friends but the plain truth is that alcohol consumption increases uric acid levels and people with gout should probably avoid alcohol.

Alcohol enhances purine metabolism to produce more uric acid which can accumulate quickly. In addition, alcohol also stimulates the formation of lactate which reduces the kidneys’ ability to excrete uric acid. Beer is quite high in purines while other forms of alcohol promote purine production in the body which produce more uric acid. There’s no escaping the negative effects of alcohol when you have gout.

Un Estudio realizado en 1984 por la Revista de la Asociación Médica Canadiense, 24 patients with properly diagnosed gout according to the American Rheumatological Association criteria were matched with controls for age, weight and sex, and use of diuretic. Alcohol intake was determined by asking patients how much they drank on each occasion they were seen, over a five-year period. The results came out that patients with gout drank more excessively. Another study completed in 1994 by T.Nishimura et al. (43:745-748):

“Five healthy men who regularly consumed no alcohol, or less than 20 grams occasionally, and five health regular drinkers who consumed more than 60 grams of alcohol a day were given an oral alcohol load of 0.5 grams of ethanol per kg body weight. Blood samples were taken for up to four hours for measurement of xanthine and xanthine metabolites and for uric acid.

Resultados

Antes de consumir alcohol, las concentraciones de ácido úrico y xantinas eran las mismas tanto en los bebedores como en los no bebedores.

Para los abstemios, la ingesta de alcohol no hizo ninguna diferencia en la concentración de ácido úrico y xantinas.

For regular drinkers, ingestion of alcohol resulted in prompt increases in xanthines (by 1.5 µmol/L for hypoxanthine and 5 µmol/L for xanthine) by 60 minutes. Uric acid also rose, by about 40 µmol/L, at 180 minutes.” 1

En otro estudio publicado en 2017 En Investigación y terapia de la artritis Indicó cómo el alcohol altera el riesgo de gota a través del metabolismo de la glucosa y apolipoproteínas. Los investigadores descubrieron que el consumo de alcohol contribuye causalmente a la gota a través de la glucólisis y el metabolismo de apolipoproteínas.

En otro estudio, veamos lo que tienen que decir sobre el consumo de alcohol, en particular de cerveza:

“In a estudio publicado en la revista médica The Lancet En esta primavera, los investigadores siguieron a más de 47,000 profesionales médicos masculinos sin antecedentes de gota durante un máximo de 12 años. Al final del estudio, cerca del 2 por ciento de los hombres habían experimentado ataques de gota. Los hombres que bebían la mayor cantidad de alcohol diariamente tenían el doble de riesgo de desarrollar el trastorno en comparación con aquellos que no bebían. Los bebedores de cerveza aumentaron su riesgo en un 50 por ciento por cada porción diaria, mientras que aquellos que bebían licor aumentaron su riesgo en un 15 por ciento por cada bebida. Los hombres que bebían vino no parecían aumentar su riesgo de gota, aunque pocos hombres tomaban más de dos copas de vino al día, por lo que estos resultados son menos concluyentes.

The researchers believe beer consumption leads to gout because of its high purine content. Through the process of digestion, the purine compound breaks down to form uric acid. Normally, uric acid leaves the body through urine. But if the kidneys are unable to process all of the uric acid, levels in the blood become too high. The uric acid may then form crystal deposits in the joints. These deposits are the cause of gout. Beer was more likely to be associated with gout than spirits, and spirits in turn more than wine.” 2

So beer contains not only alcohol but it also contains purines! PURINES which are found in high protein foods and what your doctor first mentioned to you was the probable cause of your gout. Here’s a helpful article on 7 boissons qui peuvent booster votre risque de gote y particularmente lo que se dice sobre la cerveza:

“Beer contains a large quantity of purines and has a strong association with gout attacks. One study estimated that patients who consumed a 12-ounce serving of beer daily were 1.5 times more likely to have gout compared to those without alcohol consumption,” says Dr. Sloane. Beer is especially bad for you if you tend to get gout symptoms because it is high in alcohol and brewer’s yeast, both of which may trigger gout pain.”

Also check out the other beverages we gout sufferers should try and avoid or at least limit their consumption like soft drinks which I’ll talk about in more detail in a future post:

“One large study found that just one sugar-sweetened drink per day doubled a woman’s risk of developing gout compared with women who had less than one sugar-sweetened drink per month. “Studies show that sugar-sweetened drinks and fruit juices are associated with an increased incidence of gout attacks.”

gota y cerveza

Una cosa que debes tener en cuenta es que la industria del alcohol no está obligada a reportar los ingredientes en las etiquetas y ha hecho lobby durante años para mantenerlo de esta manera, con el fin de proteger sus recetas, pero más importante aún, para ocultar ingredientes que son simplemente perjudiciales para la salud.

Por ejemplo, la cerveza Newcastle contiene colorante de caramelo hecho a partir de amoníaco, el cual está categorizado como un carcinógeno que puede causar cáncer. La cerveza Corona de México contiene... [Please provide the information you would like to know about Corona beer. Jarabe de maíz transgénico que es muy similar al jarabe de maíz con alto contenido de fructosa Y el propilenglicol. Se dice que la cerveza Michelob Ultra contiene un edulcorante modificado genéticamente también conocido como dextrosa GMO. En cuanto a la cerveza Budweiser, conocida como el rey de las cervezas, se ha encontrado que contiene maíz modificado genéticamente (GMO). Por otro lado, la popular cerveza Miller Lite contiene maíz GMO y jarabe de maíz para endulzar su sabor, al igual que lo hacen Coca-Cola y Pepsi, por lo que la industria cervecera hace lo mismo, al igual que las compañías de licores fuertes.

So you can understand why alcohol nowadays may be responsible for so many gout attacks around the world. Guinness beer which was one of my favorite beers due to its’ creamy smoothness, contains high fructose corn syrup but also fish bladder! Why did they do that? Beats me! I remember saying to myself after a few gout attacks, “I’ll only stick to Coors light beer from now on since it’s low on calories, has a light taste and doesn’t bloat you as much”, …well I sadly discovered later on that it too contains GMO corn syrup.

Entonces, ¿cuánto alcohol es demasiado?

Te sugeriría que evites por completo el alcohol, pero si no puedes, hay ciertos límites que puedes seguir. Una bebida está bien de vez en cuando. Esa sola bebida ya te pondrá en un 36% de riesgo de sufrir un ataque recurrente de gota. Un consumo elevado de alcohol significa que estás tomando 12 o más bebidas por semana. No quieres ser demasiado tolerante y acercarte demasiado a este rango.

Aunque no recomiendo que bebas cerveza si sufres de gota, si decides tomar una bebida en una fiesta de barbacoa con amigos y consideras tomar una, y espero que solo una, considera una cerveza orgánica que se elabore localmente con ingredientes orgánicos. Mantente alejado de las cervezas estadounidenses, ya que muchas de ellas contienen organismos genéticamente modificados (OGM). Mi primera elección sería una cerveza Heineken o una Amstel Light, pero por favor no tomes más de una cerveza.

Si desarrollaste gota a una edad temprana (antes de los 40), debes tener especial cuidado, ya que el alcohol puede ser un desencadenante más probable de un ataque de gota. En un estudio observacional estudio which followed 700 people, they found that those who developed gout before 40 were more likely to experience a gout attack triggered by alcohol compared to those who had gout after 40. This is probably because younger patients are more likely to drink beer than any other type of alcohol. 

Pero ¿y el vino?

Wine seems to be the lesser evil compared to all alcohols but that doesn’t mean you should go on a wine drinking spree. Wine is alcohol and it can still increase your risk although there have been some conflicting opinions on this. Some don’t seem to have a problem while others still experience a gout attack after having a couple but there is a consensus that all alcohols including wine must be avoided during a gout attack because they can worsen the flare.

Hasta que haya más datos, debemos asumir que el vino es tan perjudicial como cualquier otra bebida alcohólica y, por lo tanto, debe ser estrictamente limitado en su consumo.

If you just started taking gout medication, you need to be especially careful with your alcohol intake within the first six months since certain medications make you more vulnerable to gout attacks in the beginning.

¿Dejar el alcohol eliminará mi gota?

It won’t, unfortunately. Eliminating it from your lifestyle is going to reduce your risk for gout attacks because you’ll need to do other things as well such as eat a healthy diet and stay active. In addition, you also need to be taking uric acid lowering medication. This is because gout has a strong genetic component, but it is also strongly influenced by lifestyle factors like diet, alcohol intake, body weight, kidney function and compliance of medication. This means that no matter how religiously you avoid alcohol, you’re still at risk for symptoms if you don’t control your uric acid.

Finalmente, concluyo este post con este dato sobre el alcohol:

“Alcohol does all kinds of things in the body, and we’re not fully aware of all its effects,” says James C. Garbutt, MD, professor of psychiatry at the University of North Carolina at Chapel Hill School of Medicine and a researcher at the university’s Bowles Center for Alcohol Studies. “It’s a pretty complicated little molecule.” 3

Yes, it is and I am a witness to it, yes you may get gout attacks triggered from purines or something else but I tend to get my attacks either the night of, after having a few drinks or having had a few drinks a couple of days before. It always gets me even after the last time several months ago in which I stopped my Allopurinol completely for about 3 months thinking I probably had this thing beat; whereby I had a couple of beers on a Saturday, then a beer with my meal at my mom’s place on Sunday and finally had another glass of wine with my supper on Tuesday. Then Wednesday night the gout attack followed on my right toe and was back at my local clinic getting a prescription for Colchicine.

Of course, alcohol shouldn’t be the only one thing you monitor. Though it’s on top of the list of things to watch out for, you should also avoid high purine foods, avoid getting dehydrated, and control your weight. A combination of all these things will help reduce your risk for experiencing a gout attack. 

So, watch your alcohol intake dear gout sufferer! Tread carefully!

AVISO LEGAL

This article is for educational purposes only and should not replace medical advice. Patients should consult their physician for individual management.