Gout & Alcohol: Does Alcohol Use Affect Gout?

This article will help you understand more about what gout is, the risk factors and causes of this disease, how alcohol use may affect gout, whether quitting drinking can reverse gout, and what your gout treatment options are.

What is Gout?

Gout is a type of inflammatory arthritis that causes extreme pain in affected joints.¹ Symptom flares can begin without warning and linger for days or weeks, and then go into remission, where you are symptom-free for long periods of time, even years.¹ Gout can affect various joints, and typically occurs in one joint at a time. It often impacts the joints in the toes, especially the big toe, but can also occur in the ankle, knee, and other joints.¹ Symptoms include:^1,2

• Pain, usually intense, that begins suddenly and often at night.
• Swelling, stiffness, redness, and warmth in the joint that is affected.

How Does Alcohol Affect Recurrent Attacks of Gout?

Recurrent attacks of gout can be triggered by various factors.² One of the triggers is alcohol intake – especially drinking heavily or regularly.⁷ Drinking any type of alcohol can increase the likelihood of experiencing recurrent flares and episodes of gout, and heavier drinking is associated with a greater risk.^5,8 However, even drinking moderately can dramatically increase the risk of recurrent attacks, especially for men.⁸ Alcohol can also lead to increased levels of uric acid in the body even if you don’t have symptoms, which can cause increased frequency of recurrent attacks and the development of complications.^1,9

Can Quitting Alcohol Reverse Gout?

Gout affects everyone differently, and everyone’s prognosis for gout is different due to a range of individual factors, including overall health, eating habits, weight, and alcohol intake, to name a few. If you’ve been diagnosed with gout, quitting or limiting your alcohol intake, particularly beer and hard liquor, may be a good choice for you, since it has been shown to sometimes bring about flares of gout.^1,8

However, while this can eliminate a major trigger, it may not necessarily reverse gout, but it can reduce the likelihood of recurrent attacks.⁸ Overall, you should discuss your alcohol use and gout diagnosis with your doctor. Remember: a lack of symptoms doesn’t mean that gout has gone away, and damage can still be occurring within your body.⁸

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How Much Can I Drink if I have Gout?

If you’ve been diagnosed with gout, this is an important discussion to have with your physician. They can provide the best guidance for you since they will know the most about your overall health and how severe your gout is. Having more than one drink in the space of a day has been shown to raise the risk of experiencing a flare of gout.⁵  If you’ve been diagnosed with gout, limiting your alcohol intake may help you prevent future gout attacks, especially if alcohol triggered a flare in the past.^7,10

Is Gout Dangerous?

Gout can lead to complications, although the progress and outlook for the condition can vary between individuals depending on a variety of factors. Many of these factors are malleable and can be effectively managed or treated with medication. While gout isn’t directly life-threatening, it can lead to other major issues, including:^1,2,11

• Infections and damage to affected joints, including deformity.
• Formation of kidney stones, chronic kidney disease, or kidney damage.
• Gouty arthritis, a type of progressive arthritis.
• Greater risk of developing heart problems.

Treatment Options for Gout

There are various medications used to treat gout, depending on the severity of your condition and other factors. While gout cannot be cured, medications can be used to:^1,4,7

• Treat flares. If you have a gout attack, nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen or diclofenac, steroids, or a medication called colchicine may be prescribed to help reduce the pain and swelling. In severe cases, corticosteroid injections can be given in the affected joint.
• Lower uric acid levels. If you have many recurrent attacks, your doctor may prescribe medication to reduce your uric acid levels. These medications are taken regularly whether you have symptoms or not, and include allopurinol (Aloprim, Zyloprim), febuxostat (Uloric), and pegloticase (Krystexxa).

If you struggle to stop drinking, behavioral therapy for alcohol use disorder (AUD) or medications to help you reduce your alcohol intake can be an important part of treatment in managing gout as well. Behavioral therapies typically focus on changing patterns of thought that influence behavior, allowing you to learn healthy coping skills and recognize the stressors and other triggers that lead to drinking. They also improve your ability to communicate with others, enhance problem-solving skills, allow you to learn how to incorporate healthy activities to replace drinking, and improve motivation towards staying sober.¹³ Some of the most commonly used behavioral therapies used to treat alcohol abuse and AUD include cognitive-behavioral therapy (CBT), contingency management, motivational interviewing, community reinforcement approach (CRA), motivational enhancement therapy (MET), 12-step facilitation therapy, and family behavior therapy.¹³

Coping & Prevention Tips

Lifestyle changes can help you cope with gout and may help to prevent attacks. When you have a flare, it can be helpful to rest the affected joint, keep it elevated, and use ice on it for short periods of time.³ Staying hydrated can also help the flare pass. Managing gout involves taking steps to avoid future flares, and can include many different things, including:^1,3

• Maintaining a healthy weight. If you are overweight, losing weight can lower the risk of future flares and reduce pressure on the joints.
• Dietary changes. Staying away from foods high in purines, such as red meat, organ meat, and seafood can help you avoid triggers. Eat plenty of fruits, vegetables, and whole grains. Also, try to avoid eating a lot of fatty or sweet foods. Incorporating more low-fat dairy into your diet can help to lower the number of flares you get.
• Talk to your doctor about the medications you take. Since some medications can trigger attacks, your doctor may want you to stop them. If you are prescribed medications to lower uric acid levels, it is important to take them as prescribed even if you don’t have symptoms.
• Stay away from soda and limit your alcohol intake, particularly beer and hard liquor, which are known triggers for gout attacks. Make sure to drink sufficient water to stay hydrated.
• Moderate levels of low-impact exercise, such as walking, swimming, or riding a bicycle, can help to protect your joints and maintain a healthy weight.
• Avoid cigarettes. If you smoke, quitting is a good idea.
• Get enough vitamins. Speak to your doctor about taking vitamin C supplements.

Gout Statistics

Important gout statistics include:^3,5,11

• Gout is the most commonly occurring type of inflammatory arthritis affecting adults.
• More than 8 million adults in America have gout, although nearly 3 times as many men have it as women.
• Currently, 6.1 million men and 2.2 million women are diagnosed with gout, equivalent to 3.9% of adults in America.
• Almost 70% of people experience at least one recurrent attack yearly.
• In men, consuming 2 drinks can increase the risk of a recurrent gout flare by 41%.

Sources

1. Centers for Disease Control and Prevention. (2020, July 27). Gout
2. National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2020, February). Gout.
3. Choi, H.K., Atkinson, K., Karlson, E.W., Gillet, W., & Curhan, G. (2004). Purine-rich foods, dairy and protein intake, and the risk of gout in men. The New England journal of medicine, 350(11), 1093-1103.
4. Stiburková, B., Pavliková, M., Sokolová, J., & Kožich, V. (2014). Metabolic syndrome, alcohol consumption and genetic factors are associated with serum uric acid concentration. PLOS One, 9(5).
5. Neogi, T., Chen, T., Niu, J., Chaisson, C., Hunter, D.J., & Zhang, Y. (2014). Alcohol quantity and type on risk of recurrent gout attacks: An internet-based case-crossover study. The American journal of medicine, 127(4), 311-318.
6. Snaith, M. (2004). Gout and alcohol. Rheumatology, 43(10), 1208-1209.
7. Nieradko-Iwanicka, B. (2021). The role of alcohol consumption in pathogenesis of gout. Critical reviews in food science and nutrition, 1-9.
8. Kakutani-Hatayama, M., Kadıya, M., Okazaki, H., Kurajoh, M., Shoji, T., Koyama, H. … & Yamamoto, T. (2015). Nonpharmacological management of gout and hyperuricemia: Hints for better lifestyle. American journal of lifestyle medicine, 11(4), 321-329.
9. Abhishek, A., Valdes, A.M., Jenkins, W., Zhang, W., & Doherty, M. (2017). Triggers of acute attacks of gout, does age of onset matter? A primary care based cross-sectional study. PLOS ONE, 12(10).
10. National Kidney Foundation. (2021). Quick facts: Gout and chronic kidney disease.
11. National Institute on Drug Abuse. (2018, January). Principles of drug addiction treatment: A research-based guide (3rd edition).