Fish and Gout

Gout and Fish

Does Fish Belong in a Gout Diet?

You often read on other websites that if you suffer from gout you should avoid eating fish since it is considered high in purines. In this post we will examine this issue and take a closer look and see if fish does belong in a gout diet. First of all fish has been consumed by humans for thousands of years and is we all know it is very healthy for you. Let’s see some of the health benefits that fish provides.

Fish is loaded with nutrients and is considered on the healthiest foods in the world. It is high in protein, vitamin D and is considered the best source for omega-3 fatty acids which is linked to reducing the risk of developing many diseases. Omega-3 fatty acids also helps keep your brain working well reducing the risk of developing dementia or Alzheimer’s. Many studies prove that if you eat fish on a weekly basis, you will experience a slower rate of cognitive decline.

Fish also is good for the heart, in fact it is considered one of the best foods to eat in order to have a healthy heart. Again many studies prove that eating fish regularly is good for the heart in order to avoid a heart attack or stroke. Gout sufferers should take note since we are at a higher risk of developing a heart attack or stroke.

Did you know that fish is also high in vitamin D? A single 4 ounce serving of cooked salmon (which is one my favorites) contains 100% of recommended intake of vitamin D. For more information on important vitamin D is to gout sufferers make sure to read my post titled “Gout and Vitamin D”.

There is also some evidence showing that fish may lower the risk of developing rheumatoid arthritis which is closely related to gout. In addition, fish is very good for your eyes. A study has shown that eating fish just once per week can decrease the risk of developing the disease called macular degeneration by 53%! Fish is also helpful in controlling insulin levels in the body which decreases the risk of developing diabetes.

As you see fish has so many health benefits that I can’t even list them all. So why would you want to avoid such a healthy food cause some idiot told you it’s high in purines and should be avoided? Obviously if you suffer from gout, you know eating too much protein can harm you and fish is high in protein but you still need to eat protein. To enjoy fish all you have to do is make sure that you eat my recommended portion of 4 ounces and you’ll be just fine. If you have fish for lunch don’t be going and eating a steak for supper cause that is too much protein for a gout sufferer to handle.

Choose one day to eat either a nice cut of meat or fish. Don’t be a glutton eating fish at every meal but eat wisely as I have taught you in this website and my ebook. Meaning eat fish in moderation, although it is high in purines, you can’t afford to skip on it since it offers so many other health benefits for you.

NutriGout Dietary Supplement for Gout

 

Now which fish should you eat?

A gout sufferer should avoid seafood, shrimp, lobster and other shellfish which raises uric acid and is simply not healthy for you. See my post on seafood to learn more. What you want to do is eat fish with scales and only eat these types of fish. Nothing else. You can eat salmon, sole, tuna, catfish, red snapper, tilapia, flounder, whitefish, haddock and so many other fish. These fish have anywhere between 50 to 150 milligrams of purines for every 100 grams. Nothing to worry about, believe me!

There are fish that are higher on the purine scale like anchovies, sardines, mackerel and herring, octopus which you should limit since they are over 150 milligrams of purines for every 100 grams. Whatever you do do not eat fish that comes from a can like canned sardines or herring with added oils. Always eat your fish fresh. Do not deep-fry your fish, instead either grill it or simply bake it in the oven. I season my fish with fresh herbs, freshly squeezed lemon juice and some extra virgin olive oil. You don’t need more than that. Try and avoid high sodium seasoning mixes or fish sauces high in sugar.

A few words about fish oil

Purines are found in the meat of the fish but not in distilled fish oil. If you wish to supplement EPA or DHA which are two fatty acids found in fish, then buy only pharmaceutical-grade molecularly distilled fish oil supplements. Some fish oils are also very high in vitamin D, providing you with 200% of the recommended daily intake. Before buying make sure to research what you are getting by checking out the provider’s website, checking reviews online and checking product labels properly. Before purchasing any fish oil make sure to speak to your doctor about it so it doesn’t affect any other medications you may be taking.

Some gout sufferers claim that fish oil can fight gout flares since it is a powerful anti-inflammatory. Regardless, anything that has omega-3 fatty acid is good for gout as explained in other posts on this website as well.

In conclusion, you often hear health experts or dieticians say “you should only eat fish no more than two times a week”. Why? Fish is the healthiest meat, healthier than beef, lamb and chicken. If you like fish, you can eat it every day but make sure it is the only meat you eat that day since gout sufferers should not eat more than 4 ounces of meat in any given day to avoid higher uric acid levels in the bloodstream.

As for mercury in the fish, it depends in which part of the world you are located in. I recommend you buy organic fish and make sure it is always labeled as “wild caught” instead of “farmed”. Like fishing? Here in North America we have plenty of clean lakes where you can fish from and enjoy some good quality fish. I’m kinda getting hungry and think I might just go and prepare myself some Pacific salmon that I bought the other day. To your health!

Posted by Spiro Koulouris

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38 Comments

  • Faiz

    Reply Reply November 15, 2016

    The Indian Gooseberry which is called ‘Nelli Fruit’ in Sri Lanka and India is an ideal fruit for the controlling of uric acid. The juice of this miracle fruit relieves gout pain in a very surprising manner. Take a nelli fruit chop it into small pieces and leave in a 250 ml container filled with warm water during the night. The next morning drink the juice in an empty stomach. By the mercy of the almighty creator you will get relief. Continue this daily if you are a chronic gout patient. Avoid Canned fish, Dried Fish totally. Better avoid fish. Avoid dark green leafy salads except lettuce. Avoid having sweets in early morning in empty stomach. Avoid dairy foods. For me even yogurt turns hurts. Avoid eating beets and beans for dinner.

  • Cynthia

    Reply Reply November 14, 2016

    What if you take blood pressure medication? What type causes gout flares? My doctor doesn’t seem to believe me when I tell him some of the medication I’m taking is causing flare ups.

    • Spiro Koulouris

      Reply Reply November 14, 2016

      Hi Cynthia!

      Point him to my article here about Gout and Diuretics but don’t expect him to be too happy. But as always I back what I say with scientific studies that he has access to as well. It is very common for patients taking blood pressure medication to be at an increased risk of getting flare-ups.

  • Glenn

    Reply Reply October 30, 2016

    Hi Spiro,

    Thank you for all the work you do regarding gout, your book is great!
    What’s your verdict on Salmon oil?
    Salmon contains the highest levels of Omega 3 with no artificial additives or preservatives.
    It contains the powerful antioxidant called astaxanthin, which has anti-inflammatory properties.
    Wild caught salmon have higher levels of Omega 3 and Vitamin D than their farm raised counterparts.
    Alaskan Sockeye Salmon live in the northernmost region of Alaska, far away from the pollutants of man-kind.
    The supplements have been tested free of hazardous levels of heavy metals by an independent agency or by using industry-specific standards.
    Pure Sockeye salmon oil hasn’t been molecularly distilled as this can damaged the oil. Do you think unrefined Salmon oil is better than refined fish oil?

    • Spiro Koulouris

      Reply Reply October 31, 2016

      Hi Glenn!

      I would go with unrefined Salmon oil because it is cold-pressed, which means the oils are mechanically extracted by a machine which applies pressure and not heat. This leaves the high flavour and nutrient content in the oil, making it a healthier choice.

      • Glenn

        Reply Reply November 6, 2016

        Hi Spiro,

        Thank you for your advice, I will give Salmon oil a try.

  • Don

    Reply Reply September 25, 2016

    I bought and ate some Monk fish few days agof even before checking the purine levels. I was pleasantly surprised that it was the lowest o of any of the fish in this particular list….far lower! Poor mans lobster is what it is also called.

    I’ve read where chocolate with a high cocoa content of at least 35% helps with gout. I’ve had about 3oz every day with good results. Lot of good reviews. Sugar free chocolate that is.

  • Chad

    Reply Reply September 4, 2016

    Everything I’ve read so far about gout says tomatoes are one of the best fruits to eat when you have gout.Just for the record catfish is not a scale fish.

  • Riky

    Reply Reply August 16, 2016

    Hi Spiro, thank you about your very interesting post. I need official purine/uric acid fishes list, because I can’t find it (if you have it about all kind of foods will be great): can you help me please? Thank you very much again.

  • Abdul

    Reply Reply July 31, 2016

    Hi. Suffered from gout for a year . Obesity , and general over consumption of offal, fish like herring and sugar . Since going pesco vegetarian I’ve not had an attack. I don’t know if you are aware between the link of haem iron build up over years of eating red meat and gout ? Donating blood may change everything

    • Spiro Koulouris

      Reply Reply July 31, 2016

      Hi Abdul!

      Here is a good study on the subject of haem iron–> http://www.ncbi.nlm.nih.gov/pubmed/6623242 and remember eating meat as 10% of your daily calories will provide you with more then enough haem iron for your nutrition, or even if you prefer to eat meat once a week. Yes being pesco vegetarian eating a plant based diet and some fish, is a good recommended diet for gout. Thanks for your comment.

    • zahoor ahmad sheikh

      Reply Reply October 20, 2016

      Kindly advise me about the diet as I have 10.5 uric acid ,my face and feet are slightly swollen but no pain.
      Pl.advise me also which medicine I take .thanks

      • Spiro Koulouris

        Reply Reply October 20, 2016

        Hi Zahoor!

        I am not a doctor so I do not give drug advice but go see your doctor and he will probalby prescribe you colchicine for the pain and inflammation and/or allopurinol for long term care of keeping uric acid levels normal.

  • Claude

    Reply Reply July 21, 2016

    Hi Spiro,
    I saw that you were having bad flare ups from what you thought was alcohol and tomatoes. The alcohol would probably cause them but the tomatoes would absolutely not have caused the flare ups as they are almost 90% water and are extremely low in purines.

  • Raymond

    Reply Reply July 15, 2016

    What about striped bass?

  • Peter jones

    Reply Reply July 2, 2016

    I am also unsure what is the best fish to have and are glucosamine tablets no good as they have shellfish etc in them

    • Spiro Koulouris

      Reply Reply July 2, 2016

      Hi Peter!

      Avoid all seafood, shrimp etc… and stick to fish with scales like salmon, trout, cod, etc…and if you want to take glucosamine, look for other ingredients other than shellfish.

  • Peter jones

    Reply Reply July 2, 2016

    What a great load of info I have gout at the moment and trying to find what is triggering it would being run down and just getting over a week of bronchitis cause this I am drinking plenty of water and want to find a balance to keep it under control

  • Vijay Dsilva

    Reply Reply April 18, 2016

    Hi Spiro,

    I have had high Uric acid since about 2 years which I’ve neglected.
    In last 2 years I have consumed lots of alcohol and neglected my health gaining lots of weight.
    Last week I got my punishment, I suffered a Gout attack on my Toe. Unbearable pain and no sleep.
    Now I want to control my diet and decided to stop the alcohol. I like fish a lot, and generally fry it with minimum oil. Can you please advise what you mean by scaled fish, are ALL scaled fish non dangerous ?

    • Spiro Koulouris

      Reply Reply April 18, 2016

      Hi Vijay!

      Fish with scales are fish like salmon, snappers, trout, sole, mackerel, bass, halibut and by definition ” any of various mostly cold-blooded aquatic vertebrates usually having scales and breathing through gills;” so do not eat seafood like lobster, octopus, shrimps etc… since those fish don’t have scales and fins. These are the healthy fish to eat, seafood fish are basically the cockroaches of the ocean, they eat all the garbage of the ocean and are the bottom feeders so if you want to avoid disease, best to avoid them completely in your gout diet. That’s why they raise uric acid levels. They’re not good for you. Simple as that.

  • John Heropoulos

    Reply Reply March 20, 2016

    Dear Spiros:
    I take Fish oil 4 tablets 1000mg each every day. I have ferocious attacks that I am dealing with. The ingredients say they include: anchovy, mackerel and sardine. Do you think this contributes to my gout attacks?

    Similarly, I take glucosamine chondroitin for my knees. These tablets contain shrimp, crab and crayfish.

    What is your thinking on this?
    Thank you very much for your excellent work!
    Your fellow Greek!
    John

    • Spiro Koulouris

      Reply Reply March 21, 2016

      Hi John!

      As for the Glucosamine Chondroitin, I know you can find a vegetarian formula and skip the shrimp, crab and crayfish. So chech that out. As for the Fish Oil causing gout attacks, I doubt it causes your attacks. Best thing to do, is write a diary of everything you eat and drink every day and then you’ll notice a common trigger for your gout attacks. For me it has been mostly alcohol, tomatoes. I remember one summer I was eating nothing but greek salads cause tomoatoes taste best in August, and that got me into trouble. But my worst attacks were always related to alcohol. That’s just me! You may have another food or beverage that triggers the attack. Study it!

      • Saby Pinto

        Reply Reply June 14, 2016

        Hi Spiro,
        I beg to differ on this. John is right. I too have been suffering from frequent gout attacks. I avoid all that causes gout flares. I would emphasise that any tablet that contains fish oils (esp.Omega-3 fatty acids) does flare up your gout attack. I had taken just 1 tablet; had an attack just the next day. Although, there are some fish which do not cause any increase in uric acid levels. But I would also like to agree when you say, that we have to keep a tab on what food causes the attack. The best thing is to walk for 30-40 minutess or do exercises or aerobics which causes you to perspire and lose weight; drink lots of water at regular intervals. Thx..Rgds…Saby

  • Jeremy

    Reply Reply March 17, 2016

    Hi,

    You say “Whatever you do do not eat fish that comes from a can like canned sardines or herring with added oils. Always eat your fish fresh.”

    What’s the reasoning behind this? Just simple ‘fresh is better’ mentality? Or something else. Because as I understand it, of the two fish I eat, salmon is lower than tuna in purines. But fresh salmon is only available in season, and farmed salmon is absolutely horrible for you. So canned is my only option for most of the months of the year. I’m curious as to why this is bad.

    • Spiro Koulouris

      Reply Reply March 17, 2016

      Hi Jeremy!

      yes that’s fine. With everything, fresh is a always better than anything that is canned, as in canned fruit, canned vegetables, canned fish etc…

      Enjoy!

  • Dan

    Reply Reply January 23, 2016

    Spiro,
    I wanted to confirm if there was anything to worry about if the fish oil source is from sardines, anchovies and mackerel. I believe the product I use a fish oil supplement that uses a distilled process as stated on the label and confirmed by a phone call I made to the company. Does that process eliminate the purines from these fish?

    • Spiro Koulouris

      Reply Reply January 25, 2016

      Yeah, there’s no purines involved in a supplement, you’re consuming just the fish oil.

  • Patrick

    Reply Reply August 23, 2015

    Hi Spiro,
    The article says never eat fish that do not have scales, however, catfish are included in the list of fish acceptable to eat.
    Thanks

    • Spiro Koulouris

      Reply Reply August 23, 2015

      Yes Patrick, catfish is debatable and I don’t eat it but they have very thin scales outside of North America but here in North America, they don’t! Personally I never ate catfish and don’t plan to, I like my favourites and just stick to those, mostly salmon, red snapper, haddock and some tuna.

  • Ricardo Morimoto

    Reply Reply August 17, 2015

    Dear Spiro,
    greetings from Brazil ! Since I found out your blog few months ago, I have been reading everything and have to say that you are great ! I have been suffering gout since 90ties and until some years ago had attack about 4 times per year, even taking allopurinol every day. Now I’d like to ask your opinion about Black Vinegar in pills. About 3 years ago my father read in a japanese magazine about it and since then I have been taking 1 pill per day and I do not remember my last attack, I believe it happened 2 years ago. Ah, about 3 months ago, I added 1 pill of ACV in daily basis. FYI, I drink a daily Vodka with lemon juice & sparkling water to relax and meat & fish are part of my regular diet however I never eat shrimps, lobster, oysters and crabs. Please let me know Master Jedi of Gout control. Thanks !

    • Spiro Koulouris

      Reply Reply August 17, 2015

      Hi Ricardo!

      Only take Apple Cider Vinegar supplements, I used to have heartburn every day and since I consume ACV every single day, I haven’t experience and heartburn since. It also helps with digestion and with gout. A gout cure? Not for me but should be part of your daily diet for sure! As for the vodka, I’d stay away from it my friend, it’ll only cause problems but if you enjoy so much try and keep it a minimum.

    • phyllis

      Reply Reply September 17, 2015

      I really enjoy reading your information on gout which I do have. bad to say I also have 3 stage Kidney Disease which create another problem for my health. All your info is helpful for gout but what about ckd. Can you give any help for me in dealing with my health

      • Spiro Koulouris

        Reply Reply September 19, 2015

        CKD? what do you mean Phyllis?

        • chris

          Reply Reply May 7, 2016

          I’d imagine CKD probably stands for Chronic Kidney Disease.

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