Why Alcohol Causes So Many Gout Attacks
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 compared with people without gout, those who do have gout drink more alcohol. 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 has many purines, and when it breaks down in the body, it turns into uric acid which can accummulate quickly. In addition, alcohol also stimulates the metabolism of nucelotides which are additional purines. So not only is alcohol high purine, it also promotes purine production in the body. There’s no escaping the negative effects of alcohol when you have gout.
A 1984 study done by the Canadian Medical Association Journal, 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.
Results
Before taking alcohol, concentrations or uric acid and xanthines were the same in drinkers and non-drinkers.
For abstainers, ingestion of alcohol made no difference to concentration of uric acid and xanthines.
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
In another study published in 2017 in Arthritis Research & Therapy stated how alcohol altered the risk for gout through glucose and apolipoprotein metabolism . The researchers found that alcohol consumption causally contributing to gout via glycolysis and apolipoprotein metabolism.
In another study look what they have to say about alcohol particularly beer consumption:
“In a study published in The Lancet medical journal this spring, researchers followed over 47,000 male medical professionals with no history of gout for up to 12 years. By the end of the study, close to 2 percent of the men had experienced attacks of gout. Men who drank the most alcohol daily had twice the risk of developing the disorder as men who did not drink. Beer drinkers increased their risk by 50% for every daily serving, while those who drank hard liquor increased their risk by 15% for each drink. Men who drank wine did not appear to increase their risk for gout, although few men had more than two glasses of wine daily so these results are less conclusive.
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 Drinks that can increase your Gout risk and particularly what is says bout beer:
“Beer contains a large amount 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.”
Gout and Beer
One thing you should be aware of is that the alcohol industry is not obligated to report ingredients on labels and the industry has lobbied for years to keep it this way in order to protect its recipes but more importantly to hide ingredients that are simply bad for you.
For example, Newcastle beer contains caramel coloring made from ammonia which is categorized as a carcinogen which can cause you cancer! Corona beer from Mexico contains GMO corn syrup which is very similar to high fructose corn syrup and propylene glycol. Michelob Ultra beer is said to contain a genetically modified sweetener also called GMO dextrose. Next up, the king of beers Budweiser has been found to contain generically modified GMO corn and the other popular beer Miller Lite contains GMO corn and corn syrup to sweeten the taste just like Coca-Cola and Pepsi does, so does the beer industry do the same as well as hard liquor companies.
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.
So How Much Alcohol is Too Much?
I would suggest that you completely avoid alcohol but if you can’t, there are certain limits you can follow. One drink is fine once in a while. That one drink alone will already put you at 36% risk for a recurrent gout attack. High alcohol intake means you are drinking 12 or more drinks per week. You don’t want to be too lenient and get too close to this range.
While I don’t recommend you drink beer if you suffer from gout, if you choose to have a drink at a friend’s BBQ party and consider having one and hopefully just one, then consider an organic beer that is brewed locally with organic ingredients. Stay away from American beers since many of them have GMO. Heineken beer would be my first choice or an Amstel Light but please don’t have more than one beer.
If you developed gout at an early age (before 40), you need to be especially careful since alcohol can be a more likely trigger for a gout attack. In one observational study 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.
But what about wine?
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 has 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.
Until there is more data, we should just assume that wine is just as bad as any alcohol and therefore should be strictly limited in consumption.
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 out attacks in the beginning.
Will Quitting Alcohol Remove My Gout?
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 is a genetic disease, not a dietary one. 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.
Finally, I conclude this post with this fact on 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!
106 replies to "Gout and Alcohol"
[…] Note that this was irrespective of other gout risk factors such as diet and alcohol use. […]
Guinness does not contain high fructose corn syrup or fish bladder. It has four ingredients. Malt, barley, hops, yeast. Perhaps you read the ingredients to Guinness BBQ sauce or something.
Great article, exactly what I wanted to find.
We should be aware of the important points in this article about gout and alcohol . This would really mean a lot. Thanks for sharing this one out.
Hi there, 56 years old, have been a heavy (so heavy I’m embarrassed to detail numbers!) beer drinker my adult life. I’m a bit of a red herring though as I eat clean, pump the iron and am not overweight at all. Had a gout attack 3 months ago thought it was sprain so kept drinking, flare 1 six weeks later, flare 2 six weeks after that. Saw doctor, now on the allopurinol. She suggested I cut down to two beer a day and no binging on weekends. My question is non-alcoholic beer; ok? Does the yeast/purine content still make it a bad call? A friend mentioned his brother cuts a light beer with a non-alcoholic beer 50/50 and has worked for him for years.
Yeah non-alcoholic beer is fine, it’s the alcohol mostly that is the gout trigger.
[…] “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.” [6] […]
Thank you for this blog. Whenever my husband drinks beer, his gout is being triggered. According to him, it is painful that he can’t even walk. I’ll advise him to drink red wine instead.
A practical no nonsense website….avoid alcohol.You’ve been warned. Well Done Spiro!
[…] Doran to the formerly drunk Elder Brother (and the likely addict Marwyn). In truth, though, while booze isn’t good for gout, clinically fructose is a greater villain. Thus Doran’s […]
Mass produced commercial beer is what initially triggered my attacks so I avoid those. I have yet to have an attack after drinking a stout. The interesting thing is that my friend can drink mass produced beer but cannot drink micros. Dehydration is also a major contributing factor for me. Diet does not effect me one way or the other (thankfully). Good luck everyone!
Hello, I also have/had a gout attack. Painful, swollen and still having an issue with my knee. Taking Allopurinol for maintenance. Paying attention to my diet closely. I too would enjoy having a glass of red wine on occasions. I usually drink wine from a company that sells paleo healthy wines. Only naturally occurring yeast and sugars. No added sugar, yeast etc. Dry farm wines. Would this be a healthier choice to enjoy in moderation? Europe, in general, does not add sugar to their wines. Thank you
Yes Theresa, dry wines are the ideal choice when suffering from gout, since it has the lowest sugar content. Some extra-dry wines such as an Italian Pinot Grigio and Cabernet Sauvignon are often called “bone-dry.” The sugar content measures less than 1 gram and less than 3 calories in a 5-ounce serving. Again it’s very important to drink moderately when suffering from gout. I personally will enjoy 1-2 glasses of red wine when going to a restaurant for dinner and it’s something that I do not do very often.
Hi Theresa;
Speaking as a sufferer of gout these last 10 years, and with a spouse that keeps me honest with my reality, I will tell you that colchicine with allopurinol is bulletproof. Yet, colchicine is not a drug that can be utilized indefinitely. Once you hit the target reduction level. (Theoretically you stop colchicine and spend the rest of your days adding an allopurinol to your batch of daily vitamins.) That was my hope too; Alas, we are all the same, yet different, so your trigger is yours alone, pay attention, keep good notes. I know I can have about 4oz. of rib-eye whenever I want while I’m on the cocktail of colchicine and allopurinol, but any more purine or if I go off the rails with the red wine then I precipitate an attack which I can’t predict because it builds up how it does and once you cross the line metabolically, the ball starts rolling downhill and your are along for the ride with the consequences, stupid is as stupid does, or like Johnny Cash said: “If you’re dumb you’ve got to be tough.” OK enough Mom-lecture-speak;
Sugar intake is a big factor. Any alcohol is a big factor but beer is the worst. Meat, shellfish, mushrooms, asparagus, even pork are big uric acid contributing factors and triggers. Dry red wine is my least common trigger. Keep notes. Learn.
Chicken is the lowest purine whilst being a satisfying protein on the purine list. Fall in love with chicken all over again. Buy a sous vide circulator, they’re supper cheap now. Get to be a chicken-cooking expert. Go to eBay and get your hands on the Time/Life good cook series from the 70’s just buy the poultry book and get your chicken on.
if stranded on a dessert island with no access to a doctor I can tell you that your reality looks like this, eat all the fin fish you want, avoid every trigger I’ve mentioned and also go dairy free as long as you can stand to. I personally have a thing for low end cheddar and red wine, I’d rather die than give that up so I go in and out of dairy free but it contributes to attacks so don’t count it out as a factor. So for me I know I’m going to eat a lot of cheese and drink a lot of wine on the weekend, I’m hopeless, but you may not be and to each their own.
However, If your were living out in the woods with no doctor and access to any food you wanted; One might eat 4oz. of chicken diced into a green leaf lettuce salad with veggies and apples and Herb Vinaigrette for Dinner. “Light at night” food-wise is good all around. I enjoy the heavier fare in the daytime at lunch. Ground turkey or chicken chili; chicken soup; red bean and tomato vegetable soup; there are many possibilities and those I’ve mentioned are really cheap to mass produce and freeze so you can cook once a week and thaw as you go thru the week, but you must radically alter your diet to reduce purine intake in conjunction with your meds to avoid numerous and yes, endless costly surprise gout attacks.
I’m happily sharing this experience with you because I’m home from work early tonight because I’m suffering from a severe gout attack presently instead of earning at my profession. I can’t presently bear to stand upright any longer even in the boot and after the cortisone shot. I will hobble home and pray for a better tomorrow.
If your lucky or smart, you have people around that love you; I’ll urge you to be patient with your people. They’re trying to help you because they are terrified that you will be diminished in some way that is incomprehensible to them; Fear of loss is a big motivator so now you are now swimming in the deepest of pools, and it’s never going to change, but it can always get worse, sorry I am my mother’s son.
Gout pain sucks in a really bad way. Keep breathing and make good decisions no matter how bad you are feeling. Project and protect your love; In just such the way that you do when you are perfect, don’t let any pain change whom you are. Nobody cares about other folks suffering; we must care about the suffering of others, this is how we create the structure of how we expect to be cared for as we suffer.
Never lie, deal with it! You know what to do. Nothing goes away with time, so better to deal with the feelings now and be done forever . . .The way of the Tao . . .”work is done, then it is forgotten, therefore it lasts forever.”
All you need is love.
Spiro after 4 gout attacks in the past year I have decided to start allopurinol. I just got over my attack yesterday 8/21/19. My question is I have the allopurinol but I read that the allopurinol can bring on an attack, so I decided to wait another week until I’m sure its gone. I also have a prescription for colchicine but after reading about side effects decided to just do the 2 Aleve a day and Tylenol, if pain gets too bad. Anyway, can I start allopurinol without colchicine? Any shot that once I start allopurinol, I won’t get an attack? Starting at 100 mg.
Thanks! Louis
Hi Louis!
Yes you can start taking allopurinol but you may not get an attack. To be safe, take 1 colchicine daily, or ask your doctor if you can split it and have half a portion each day for preventative purposes. Taking Aleve or Tylenol while not feeling any symptoms is not a good idea. You take those once you get a flare up or attack. Try the colchicine and if you feel any side effects, stop it. But taking half and gradually moving towards taking 1 pill a day should do the trick.
Spiro, I have found that legume beans (garbanzo, kidney, pinto, etc.) can all cause gout. I had to give up eating hummus. I no longer eat any meat, chicken, or shellfish. I drink very little alcohol, maybe 3 glasses a week. I don’t drink beer. I’ve had gout for 30 years and was allergic to allopurinol, so my diet avoided most gout attacks for 15 years.
Іt’s hard to find well-informed people in this partіcular subject, һowever, you sound like you know what you’re talking about!
Thаnks
I have two questions, if I’m planning on going out for a few drinks with friends, and I’ve had Apple Cider Vinegar and water before hand, and I drink water while out drinking Vodka while using the washroom often, will that help at all?
Also, I’m curious if any research has been done on drinking alcoholic ciders and gout, if it tends to lean towards more to wine, or beer.
Thanks.
Hi Mike!
None that I have seen. Tread carefully!
Hello Spiro,
I have gout and I’ve been on a very strict diet for over a month and a half. I’ve completely given up alcohol. I was thinking of making myself a risotto this weekend however there is a bit of white wine in it. All of the alcohol is cooked out of it during the cooking process. I only want a small portion to go with some roasted vegetables. What are your thoughts on cooking with a bit of alcohol?
Don’t think it will present a big issue if you throw in a dab in your risotto. It’s not like you are pouring an entire glass in there.
Hi.
I’m a 35 old male and 5 month ago I diagnosed with gout. I was a heavy drinker for last 12 years. Mostly spirits.
Since then didn’t eat even 1 gr of red meat and seafood just some chicken breast like 2 time in week.
I start allopurinol after my second acute gout attack that happened 1 month after first one.
After 5 months of strict diet and daily intake of allopurinol (2*100 mg) my uric acid level is now 5.4.
For past 5 months, I didn’t drink even one sip of alcohol. (actually not even smell it :D)
I have 2 questions that my doctor for some reason unlearned to me does not answered.
First: is gout a condition for life? Or with allopurinol and strict diet it will go in time?
Second: can I get drunk like once in every 30 days?:D I mean I used to drink ¼ of 1 liter 40% vodka every night. Can I cut it down to ¼ liter vodka 1 night in a month and still don’t get that bloody pain in my foot? Or I must forget alcohol like past 5 months totally??
Thank you for your time!
Hi Mamal!
Give up the alcohol! Have a one drink very sparingly. If you want to avoid further aggravating your gout, take my advice. Yes gout is a condition for life for most. With allopurinol and good diet, yes you can control uric acid avoiding any future gout attacks.
Do not get drunk once a month. Have a drink or two once a month is better! If you can avoid alcohol completely, that would be best.
Stay disciplined!
Hi Spiro!
Thank you for your answer.
I’m trying my best. 🙂
BTW I’m a 55 y/o male who is in good physical shape. I have not had another episode since July. My Dr. tested my uric acid three weeks later and is was 5.0. She believes that I went over board with the rich foods and alcohol that particular weekend. That gout flare up was a wake up call for me. I’ve read all of your material, watched your you-tube videos and now watch what I eat and drink more closely. But I do want to have a very strong bourbon stout (8 oz) occasionally. Do you think it is possible?
Had my first attack in July of this year. That weekend I had several very rich meals along with several drinks over a 3 day period. Sunday night before I went to bed I had a small slice of carrot cake with a shot of bourbon. The next morning I woke up with a very sore left toe. I’ve changed my diet and lost nearly 15 pounds. I’ve always exercised but ate rich food and drank slightly over moderately on weekends (2 old fashions on Friday and Saturday). I would have an occasional beer/stout (monthly). I would like to try a beer soon (Bourbon stout). Is it safe to have an 8 oz stout?
It’s never safe. That is the honest truth. Tread carefully when drinking alcohol and the key to avoid a gout attack is to drink lots of water before and afterwards since alcohol dehydrates you tremendously.
Hi Spiro,
I just found your site and I like it very much. Congrats!
I just recently came down with ‘gout’ in my hands (only), and being a 68 year old male who is also a strict Whole Foods Plant-based Diet consumer, have concluded that it must be my wine drinking (for more than 40 years) that must be the culprit. So I stopped drinking for 8 days and my hands cleared up.
Anyway, regarding alcohol (and my on-going battle with it), I thought I would enclose a page about ALCOHOL and what it does to the body, from one of my favorite ‘health and fitness’ doctors, Gabe Mirkin MD.
https://www.drmirkin.com
Best regards and keep up the great work,
How long does it take your uric acid levels to drop once you do quit drinking?
Spiro,
Many beers and ales produced in the UK, and other cask beers internationally, use a process after fermentation called fining. It involves taking a product called isinglass and adding it to the beer. Isinglass is dried swim bladder from a fish, usually cod these days, that is, after being dried, primarily collagen. The collagen binds to the yeast that remains in the beer causing it to precipitate out. That is, the remaining yeast, bound to the collagen-rich isinglass, falls to the bottom of the cask (or, in the case of Guinness since the 1950s, the keg). Only minute traces of isinglass remains in the distributed product.
A swin bladder in a fish is like a buoyancy compensator that a SCUBA diver might wear. It fills with air and empties again to allow boney fish to stay at a particular level as they swim. No awful bodily fluids are ever contained in the swim bladder, so it’s not quite as unpleasant as it sounds.
In its dried state, it is almost entirely collagen. I don’t know how purine-rich collagen is. That notwithstanding, the amount of isinglass that is left in beers that are processed with fining is enough to make many vegetarians avoid them, though it seems pretty certain that, since their purpose is to decloud the beer, they must not be leaving much behind.
And it should also be pointed out that a swim bladder certainly would, in its whole form at least, constitute “organ meat” which is no-no for gout sufferers. But it is up for debate if it would still be classified that way by the time it’s isinglass.
I loved this piece. It was very informative and the comments and your replies were inspiring and revealing as well. But you stated in the article that you didn’t know why Guinness would contain fish bladder, and I thought I could explain.
In the end, my information changes nothing, even though I don’t think isinglass materially affects the purine content of Guinness. Avoid all alcohol if you can, especially beer. If you really feel the desire, have as little as you can and never more than you dare! That’s a lesson I’ve taught my daughters as they approach drinking age, even though they don’t have gout, and hopefully never will.
But if they do, I know where to send them for advice! Thanks Spiro for your efforts to make all of our lives better!
Thanks for your enlightening comment Gabe!
Just wondering what triggers where the gout hits. I’ve had it in my elbows, wrists, knees, ankles and of course big toe joints. I’ve begun Allopurinol again (1 daily as prescribed). I hate the pain so bad; I call my doc immediately for a Prednisone power pack, its the only thing that reduces the swelling. I get attacks ever six weeks or so now. I have given up all shellfish, internal organ meats; and Italian cold cured cold cuts of which I’m told are purine heavy. However, I still do enjoy a bit of alcohol drinks a few times weekly but stay away from beer. Please advise?
I know it’s tough to cut alcohol especially if you enjoy it. Try and keep it at a minimum. I’ll have alcohol now only on social occasions, some wine for dinner with friends, a beer or two watching the super bowl, but I never go overboard like I used too and I don’t drink at home when I’m with my family ever now.Before I used to have beer with my meals pretty often. Now never! It was a gradual process and if you start exercising I promise you that exercise will be your new drug and will relax you more than alcohol will ever do. Try it!
Thank you Spiro, I am going to take your advice. Im suffering right now, Ive really haf it with the pain…
Very valid points Spiro! I can totally understand what you’re saying and I agree excercise staves off the need for alcohol.
I love that response. Exercise does AMAZING things physically, mentally, and spiritually!
Cheers to burpees!
…. honestly I move to USA n took to the American beers with a zeal….two days ago I had a gouty attack on my right toe and the pain is like no any other… I have decided to quit altogether… though it will take a strong will..
I am a gout sufferer now as, I live in Cyprus and during past summers with very high temperatures it was so easy to take a beer from the fridge instead of drinking water. My first indication of gout prior to pain was uncomfortable peeing crystals. By then it was too late, the damage was done. My life without big barbeque and copious beers has gone.. Friends, be warned, ease up on beers and meats.
[…] The Correlation Between Alcohol Consumption and Gout … – Learn how alcohol consumption increases uric acid levels and people with gout should probably avoid alcohol. Many studies prove this fact and researchers warn of the … […]
Thanks for blog site info, suffered since 24 and now 55.Attacks getting more frequent and time to knock alcohol on head, unless there’s a one without purines, I see today some beers are advertised as gluten free so maybe one day they may be purine free. Heard rumor Japanese Saki brewed from rice, I think, was ok.
Fresh orange juice with bits in it strikes me within hours.
Taken in comments from others.
Cheers,
Johnnie.
Hi John!
Yes beer is high in purines but alcohol is no good for any gout sufferer. Best that you try and avoid it, if not limit it to a couple beers a week max. Gluten free beers are lower in purines but it’s mostly the alcohol that affects uric acid levels.
Hi Spiro,
Good information. What about red wine and gout medication? I am taking febuxostat (80mg) daily, but sometimes drink a glass or two of red wine only (no beer/hard liquor). Are there any red flags? My doctor did not mention any restrictions
Hi Partha!
If you drink an occasional glass or 2 of red wine, this is not something to worry about. From what I know there shouldn’t be any complications but always follow your doctor’s orders since they know your full health profile best.
Hi
Can I drink Brandy or Whiskey or Gin/Vodka?
Or is there something that I can drink with alcohol that’s not trigger the gout attack?
But not the wine, champagne or more expensive drink because I can’t afford it hehe
Can you help me? I’m too alcoholic that’s my big problem 🙁
Hi Zee!
If you put your mind to it, you can quit drinking. Believe me. Like everything in life, it is hard. But once you change your mindset, you can move mountains.
Hi Spiro, great article. As others have mentioned, the conflicting information on the internet is maddening. My question is this… Is there anything that I can take before having alcohol that will help me avoid a gout flare up? Medication, food, etc.. Thanks!
I ask because I am in the alcohol industry, I work for a brewery! Its hard to think I can never have a few drinks with my colleagues without getting gout again.
Hi Alfred!
Drink plenty of water before drinking alcohol, this way it’ll flush out of your system much quicker and remember alcohol dehydrates you so the water will help balance this out since many gout attacks can be caused by dehydration. Also take some apple cider vinegar beforehand, it will help you digest the alcohol and break it down more efficiently.
HI,
ONE OF MY FRIENDS IS SUFFERING FROM GOUT LAST COUPLE OF MONTHS. NOW HIS URIC ACID LEVEL IS 7.5. IS IT OK TO HAVE A SMALL PORTION OF VODKA ON WEEKENDS??? WE HEARD SOMETHING THAT VODKA AND WHISKY SHALL NOT AFFECT THE GOUT SERIOUSLY….. IS THIS TRUE????
I only have gout flare ups every 2 to 3 yeas and I love champagne and drink a bottle a day! I also take a diuretic called triamterene for my hypertension which I’m told by many different doctors has a size effect that causes gout attacks. I also take allopurinol daily and have read that the body can handle up to 2 allopurinol a day but I take 1.5. I eat whatever I please but am a healthy eater in general. I’ve learned to stay away from hard liquor though because that usually seems to be my trigger. Sometimes I feel like gout reminds me (like a God thing) that I need to reel it in! I love my champagne though and so far, for years, it’s the only alcohol that I can drink!
I just want to address john Smith? Real name? Who’s got all of life’s answers for Carla. First off if an adult male (her bf), wants to have a few drinks on Friday /sat, he’s not a raging alcoholic. Intervention really? Trump comments, really? Obviously alcohol is addictive and easily abused. But to not be able to enjoy a few beers after busting your ass all day is a bad thing than sign me up I’m on his team. If he doesn’t take care of himself and takes it out on her, (the pain) and doesn’t have proper meds to help attack that’s on him. I’ve had horrible attacks that brought me to emergency room. Indomethacin being one, always have the stuff that will save you or your in trouble pain wise.Life goes on, maybe not if you take allopurinol for a few years and it kills your liver which it will do. We all know the does and don’ts in life, however hard they are, especially addiction, no one has all the answers, no one, we’re all grown ass men, thanks for the advice.
Is it possible to have normal Uric acid levels and still have gout? I’m in the restaurant business and find it hard not to enjoy a wine with a meal cocktails and liquor things I’ve enjoyed and studied my whole career
Hi Mark!
Yes it can and alcohol is probably the cause.
My boyfriend has severely increased his uric acid levels, yet refuses to stop drinking alcohol every Friday & Saturday night, plus a few times weekly. Gout attacks affect his knees, ankles – even his elbows! He’s aware that it’s a major gout trigger, and is in so much pain during the attacks that he even drinks for pain control. I’m just absolutely at a loss for how to try & help him. He’s got Allopurinol and Colchicine, and somehow thinks that taking these drugs will still banish his gout, even if he keeps pouring alcohol and soda into his body. I’ve explained the science behind why alcohol and sugar should be avoided…and encouraged him to do his own research, because he doesn’t seem to believe me. It’s gotten to the point where he can not walk long distances, and can’t even get a job because of the toll gout has taken on his joints. Anybody out there have tips for reasoning with someone who has gout, to stop drinking alcohol? The past few years have been beyond frustrating trying to deal with all this!
Hi Carla!
Sounds like he’s fighting his addiction, he’ll need professional help to make him stop drinking but that’s if he acknowledges he needs the help in the first place, I would recommend a friends and family intervention, get him to understand his problem and that it can lead to further deterioration of his health both physically and mentally.
Hi Carla,
I agree with what Spiro Koulouris said, but I might even suggest that you take it a step further.
Threaten to leave him if he doesn’t shape up (shape up, or I’ll ship out)…. Explain to him that you do not want to hang around and watch him slowly kill himself, and that you are not going to assist him financially to what basically amounts to a slow motion suicide.
He obviously has an addiction to both alcohol and sugar, both of which can even be life threatening if not addressed. Sometimes a shock to the system (like a slap in the face) is what is needed for some people to finally address their problems.
I think it is a kind of psychological stubbornness to resist change. To the point of cognitive dissonance in so much as to even ignore irrefutable facts when presented to them (which also explains Donald Trump).
I call it the “spoiled brat effect”. It is usually found in people who have never had an authority figure (usually a parent) force them to do something they did not want to do (like changing/stopping a certain behavior), even though it was for their own dammed good. You don’t realize it at the time, but many years later you think to yourself “Oh! That’s why my dad whooped my ass. I was being a disrespectful, irresponsible, lazy shit”.
The premise is that the total lack of corporal punishment (or any consequences for bad behavior) at a young age (when you DO NOT understand even simple abstract concepts) encourages the “I can do WTF ever I want to do” attitude later on in life. I know many won’t agree with me, but I’ve been around long enough to have seen the cause and effects of it first hand over many years. But I digress….
Most people can’t wrap their brains around what seems to be even simple (once you’re familiar with & understand them) “abstract” concepts. If you do A &/or B, then C, D, & E happens, leading to F. It’s not unlike playing chess, in that you have to see upwards of five moves ahead to be successful. But in this case, “F” is an early grave. I find that most people younger than me (51yo), and even some people around my age, have this problem (see previous reasoning above).
Getting back to my original advice… If you simplify the abstraction a bit by saying, “if you don’t stop doing A & B (consuming alcohol & sugar), then I’m gonna do C (leave you)”, then maybe he’ll finally get it. Oh, and just like with a child, if you threaten to do something, you must be prepared to actually follow through with it, or the threat of “punishment” will be empty from then on…
There is no other way to say it. Your boyfriend is an alcoholic.
About proteins…you recommend not eating too much protein, but are you referring to animal proteins only ? I ask because there are many studies that animal proteins are bad for us, causing many diseases, but plant proteins are considered very healthy.
Hi Jim!
Yes plant proteins are metabolized way differently than animal protein (meats) so if you can skip the meat and eat more plant proteins, you’re on the right track but again all your body needs is about 10% protein from your daily calories.
I’m not sure where to leave this comment, so I’m trying here. I’ve found one very notable trigger for me – taking any type of B Vitamin supplement! My latest flare came after taking a sustained release B-12 tab recommended for my glaucoma. Bingo! Instant super flare 2 days later. I always suspected the B connection, and it’s now verified. I believe high purine foods are also high in B content, so it makes sense.
Thank you so much for mentioning this! I’m a new gout sufferer, and I have been taking a B Vitamin supplement. I don’t know that I ever would have made that connection. Thank you!
Hi Spiro
I walk a lot for the exercise and being a former karate guy , I have been suplementing that with kicking , using trees , telephone poles benches and the like as targets , After 5 or so months of this I notice pain on the balls of my feet as well as on the tops . i am 69 and had noticed slight pain in my big toes prior to this . Do you think this is more a case of stress fracture , or maybe an aggravation of the gout by the contact or a combination of both . Im taking a break from that routine to see how it heals .
Hi Dave!
I wouldn’t be able to tell you, please visit your doctor. If you have a history of gout, then maybe.
i cook my chicken on a pan, no oil added, is this ok or not.
is ok to eat chicken every night, i eat meat once a day at tea around 5 – 6 ounces
Hi Andrew!
As long as you don’t eat any other meat or protein in the same day, you can eat 5 ounces of chicken, and heating it in a pan with no oil seems like it’s baked, so yes that is fine, as long as it’s not fried.
Hi Spiro, your website and comments are amazing. I cannot express how frusterating it is to find recipes and beverages (we really do enjoy social drinking) that won’t trigger it. My husband was just diagnosed with mild gout. He’s young… 29 yrs old. We eat rich foods. Yes I know we are in for an overhaul but we really prefer to live off the land if we can, and as pioneers if you will. I find its really a double edged sword. Eat meat from the store, get cancer. Eat Venison or game meat you’ve hunted, increase the chances of a gout attack. Its borderline depressing! Can you recommend any tasty recipes for rich food lovers that don’t involve eggplant?? Also, if we were to partake in any festivities this holiday season, what truly is lowest?? I read the same thing… red wine is bad, then white wine vice versa. 🙁 Have you sworn off bacon? That’s another thing that is depressing lol. Thanks again!
Hi Danielle!
I’ll have bacon like once or twice a year, just to remind myself of the taste 🙂 but I know it’s very unhealthy in a gout diet, as for recipes, my cookbook has 101 recipes that can get you started. Have your meat during the holidays but don’t eat a big serving, basically don’t be a glutton, stuffing your mouth with all kinds of cold cuts as appetizers or meat balls then have turkey or roast beef, if you know what I mean. Have a nice salad int he beginning, then have your meat and potatoes, then after an hour or so, have a small piece of your favourite dessert and call it a day. A glass of red wine is fine during the holidays but again don’t go drinking many glasses cause that’s what will get you into trouble possibly triggering a gout flare.
Had gout since 23. Tried all kinds of dietary regimen. The following more or less summarizes my (unmedicated) experience:
23-25–No real diet control until 25, and had major gout attacks (pain between 7-9 on 10 pt scale) every 4 months, lasting up to 5 weeks as the pain drops off, with minor attacks (up to a 5 in pain) in between;
25-27–Dietary controls in place, and have stopped (almost) all red meat, sodas, and yeast intake, except on special occasion. Frequency of attacks remains about the same, but pain levels are slightly lower across the board;
27-28–Full dietary control, including (un)sweet tea and fish now. Have switched to coffee on recommendation since late 28th year. Minor attacks have largely stopped, only triggering from dehydration and over-indulgence of lower quality white/dark meat, with major attacks now only going up to about a 7 at worst and lasting less than 3 weeks after a few months of being on coffee.
28-29– Roughly the same. Water intake maintained at around 1 gallon a day, coffee between 2-4 cups, potassium intake raised to match water intake, and only rarely experimenting with “health food” products (Jenny-O doesn’t use high enough quality meat to not trigger gout, for the record). Major attacks continue, but pain is still limited and attack length has dropped off to 2 weeks.
29-Present–Diet still going strong, with no dark meat at all, and tightening control on portions and food quality entirely. I have developed a profound fondness for herbs and spices as a result of having a very restricted list of foods I can eat. No attacks for past year.
It’s worth noting that the switch FROM tea TO coffee produced almost immediately notable drop-offs in pain and frequency of attacks, with no other changes, so I imagine that the defensive qualities of caffeine and coffee are likely entirely related to the coffee as the carrier, which is why there are mixed results (since sodas and tea are… problematic).
Thanks for walking us through your diet for the past decade there Chris!
Hi all,
Great article Spiro.
I have found paleo to be the best first for gout with a little diary, I’ve experimented with everything for the last 15 years.
Cheap white wine and lite beers have been worse, and dark ales. Guinness has never caused me problems although now I know it has fish bladder in it I might leave it!
Many thanks all
And good luck over the festive period….stay strong 🙂
Andrew
For me the main culprit is wheat and sugare
I am so blessed to have come across your website! I just recently found out that I may have Gout (it’s not 100% just yet). I just wanted to let you know how nice it is to have such a thorough website to help in the understanding of this disease.
One question I am having a struggle finding an answer to is Tequila. I know that beer is horrible and alcohol in general isn’t good for gout, but I am an avid Tequila drinker (nothing in excess, just sipping on it on the weekends and after hard days), and no one says anything specifically about that booze of choice. I wonder since it is unique in its own (being that its made from agave) if it’s a better choice. Just wondering if you have any input on the matter.
Hahaha I wish! I could still be drinking JD but are you taking allopurinol daily? Cause if you are, you can sip here and there but if not, watch out! The only alcohol that has shown less risk of triggering gout flares is red wine. But I understand you have to live a little.
I’m not getting on any medications until I know for sure what I have. They just told me on Friday it might be gout…. They found crystals in the fluid in my knee, but for the last year my Uric acid levels have been fine.
I’ve gotten my blood drawn 4 times every few months cause they didn’t know what I had.. Since the inflammation is in my knee, I was mis-diagnosed with a meniscus tear.
But in general I eat really well and I am not over weight, so the only thing that saddens me to to not have my occasional tequila.
Ok you’re not a confirmed gout sufferer,so you have a better chance at reversing gout now that’s it’s early. If you do get a definite confirmation then I would suggest you stop alcohol for a while, eat very well, drink only water to rid your body of any uric acid crystals cause the truth is its one of the biggest triggers of a gout attack.
I agree with switching from red wine/beer/spirits to white wine or lager which have less purines in and taking care to avoid dehydration e.g. sweating a lot at the gym and then have a beer.
You are a genius Spiro, Your knowledge on gout and how it affects the human body is is very important and very informative. I’m a 41yr old female and have been dealing with this madness of gout for the past 11yrs, It was passed on to me from my mom… out of 9 children I was the lucky recipient. Just reading your blog for 10min has given me more insight on what to and what not to eat or drink than some of the information given to me from my own PCP.The prescriptions alone has some of the craziest side effects….extremely dry skin or excema now with that being said!!”one disease supposedly being treated” now turns into 2….Anyway very good information. Thank you and keep on getting the word out. I will help you here in Indiana.I will let all my gout suffering Americans in the dirty south that Spiro sent me.
Happy to hear Veronica!
Everyone note that purine content for non-alcoholic beer is very very low and almost 50% lower than pilsners and lagers. Look this up on a Purine Chart. Go to the Beer listings. I have been drinking non-alcoholic beer and no gout attacks. I also take tart cherry tablets from GNC. My giut attacks have subsided to zero.
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had not had an attack for 2+ years, while I shifted my alcohol consumption over to whiskeys/scotch. two nights ago I met an old friend and shared 5 beers. the next day whammo. am limping around and taking NSAIDs for my forgetfulness. a grim reminder of what not to do
So, is it a good substitute to drink whiskey and skotch instead of beer? Say an old fashioned drink?
Hahaha! Not really! If you got gout, say goodbye to alcohol, it’ll only worsen your condition if you drink alcohol often as in more than 2-3 times a week. For example, I’ll have a beer or glass of wine on special occasions with company once every 4 to 6 weeks. But that is my choice. If you take your allopurinol, sure you can drink more but down the road, what happens with your health is what you need t watch out for.
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Thanks Spiro! That makes sense and that does help. Appreciate and here’s to good health!
Hi Spiro,
I realize that beer is terrible for gout sufferers but I’ve just noticed that on many purine charts, beer is listed a very low along with most vegetables. Are you able to advise on why beer is listed this way? Or are these charts inaccurate? Thanks so much!
Hi Gerald!
Thank you for your questions. Remember with beer it’s not only about the purines and yes they are not amongst the highest but mix that with alcohol and you have yourself a double-whammy dangerous food/beverage that can wreak havoc with your uric acid levels and trigger a gout attack. Tread carefully if you want to drink beer, try and cap it at 2 beers only on occasion and drink plenty of water before and after to avoid a gout flare.
I bought your book on what I can eat. This has been a total lifestyle change for me. I too liked Jack and coke ;).
Are there any wines that are less harmful than others? Thank you Suzy
Suzy I will drink a glass of wine here and there on a special occasion or during a holiday meal with friends and family. I strongly recommend that you choose red wine only and avoid the white. Plus, choose wines that are low in sugar, lots of wines are being offered in the marketplace so choose wisely and choose wines that are low in sugar. Obviously, best is to avoid any type of alcohol but we are human and we do like just a taste here and there in moderation of course. For those who just can’t resist a zero tolerance policy on alcohol, that would be my choice.
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can gout patitent drink non alcohol beer???.also alcohol beer ones in week. Can eat chicken 3 times in a week??/
Hi Anit!
Yes non-alcoholic beer is better than beer with alcohol of course, so if you just want to enjoy a non-alcoholic beer once in a while, then go ahead but the purine levels are still high due to beer’s ingredients. I cut my beer intake tremendously and now will only drink one if I’m socializing and at a dinner in the summertime when it’s hot. It got me into too much trouble in the past, so I cut it! As for chicken, as long as you don’t fry it, eat either boiled or baked in the oven, ya you can eat it 3 times a week but make sure your portions are small like 4 ounces, a gout sufferer should limit protein intake to 10% a day. More than that will increase uric acid levels.
Are you sure about the red wine? Almost everywhere else I read that red wine should be avoided and white wine should be chosen instead…
Also, I noticed that several purine-charts make completely different statements about purine-levels in beer. E.g.:
http://www.goutpal.com/gout-diet/purine-rich-foods/
vs
http://www.acumedico.com/purine.htm
This drives me mad..
Hi Erik!
Here’a Harvard University study–> http://www.health.harvard.edu/family_health_guide/alcohol-increases-the-risk-of-gout
But at the end of the day best to avoid alcohol altogether since suffering from gout, it seriously increases uric acid but if you want to enjoy a glass of red wine from time to time, then go ahead, from all the different alcohols, it is considered the best for you health wise.
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