Medically Reviewed

How Does Alcohol Impact the Risk of Gout?

What is Gout?

Gout is a form of inflammatory arthritis caused by high levels of uric acid in the blood. Uric acid is produced by the body as it breaks down purines, chemical compounds that are found in certain foods such as steak, organ meats and seafood.1 Uric acid build-up in the body leads to the formation of needle-like crystals within joints, resulting in sudden and severe pain, redness, warmth, swelling, and tenderness in these joints.2

The pain associated with gout is most severe within the first 12 hours of onset, and after this initial pain subsides there is often joint discomfort that can last a few days up to a few weeks.2

Does Alcohol Increase the Risk of Gout?

Alcohol is a major source of purines, the chemical compounds that are broken down by the body to produce uric acid. Different types of alcohol vary in the amount of purines they contain, with regular beer having the highest purine content and spirits the lowest.3 Research has shown that drinking alcohol leads to increased uric acid levels in the blood,4 and evidence from several studies have shown that alcohol consumption is a major risk factor for gout.5-6

A study published in The American Journal of Medicine reported that the consumption of beer or spirits can increase one’s risk for gout.7 A 12-year study conducted by Harvard Medical School assessed the potential differences in risk of gout posed by different alcoholic beverages. The researchers found that beer consumption conferred a larger risk than spirits, while wine consumption was not associated with a risk of gout.8

The risk of gout depends on the type of alcohol, the amount of alcohol consumed, and the frequency of consumption. For example, one study determined that the consumption of 2 or more beers per day increases the risk of gout by more than 2.5 times.6

How Does Alcohol Impact Recurrent Attacks of Gout?

Alcohol consumption has been shown to trigger attacks of gout. In a 2-year study conducted in the United Kingdom, 550 participants self-reported the triggers of their most recent gout attacks. The findings from the study showed that alcohol consumption was responsible for about 1 in 7 attacks of recurrent gout.9 This was significantly higher than other self-reported triggers of gout, such as dehydration (5%) and consumption of red-meat or sea-food (6%).

In an even larger study conducted in New Zealand that involved over 2,000 men and women with gout, alcohol was the self-reported trigger of almost half (47.1%) of all gout attacks.10 A study conducted in an outpatient gout clinic in China reported similar findings, with over 60% of the patients that presented with attacks of gout reporting alcohol consumption prior to the attack.11

Treatment Options

There are lifestyle changes that you can make if you are suffering from gout. The Centers for Disease Control and Prevention recommends staying hydrated by drinking plenty of water, maintaining a healthy weight and diet, and limiting the intake of red meat, organ meat, and seafood.12 There are also medications available that can treat acute attacks, prevent future attacks, and reduce the risk of complications from gout. These drugs include xanthine oxidase inhibitors, which block the production of uric acid, and uricosurics, which improve the removal of uric acid from the body.13

Perhaps most importantly, medical professionals strongly recommend cutting back or avoiding alcohol consumption if you have gout. If you or a loved one are struggling with alcohol abuse and find it hard to stop drinking, please know that help is available. An addiction specialist can help you learn more about the different addiction treatment options that can help you lead a healthier and sober life.

Sources

  1. Choi, H.K., Atkinson, K., Karlson, E.W., Willett, W., & Curhan, G. (2004). Purine-rich foods, dairy and protein intake, and the risk of gout in men. New England Journal of Medicine, 350(11), 1093-1103.
  2. Arthritis Foundation. (2019). What is Gout?
  3. Kaneko, K., Yamanobe, T., & Fujimori, S. (2011). Determination of purine contents of alcoholic beverages using high performance liquid chromatography. Biomedical Chromatography, 23(8), 858-864.
  4. Towiwat, P., & Li, Z.G. (2015). The association of vitamin C, alcohol, coffee, tea, milk and yogurt with uric acid and gout. International Journal of Rheumatic Diseases, 18(5), 495-501.
  5. Wang, M., Jiang, X., Wu, W., & Zhang, D. (2013) A meta‐analysis of alcohol consumption and the risk of gout. Clinical Rheumatology, 32(11), 1641–1648.
  6. Roddy, E., & Choi, H.K. (2014). Epidemiology of gout. Rheumatic Disease Clinics, 40(2), 155-175.
  7. Krishnan, E. (2014). Gout in African Americans. The American Journal of Medicine, 127(9), 858-864.
  8. Choi, H.K., Atkinson, K., Karlson, E.W., Willett, W., & Curhan, G. (2013). Alcohol intake and risk of incident gout in men: a prospective study. Lancet, 363(9417), 1277-1281.
  9. Abhishek, A., Valdes, A.M., Jenkins, W., Zhang, W., Doherty, M. (2017). Triggers of acute attacks of gout, does age of gout onset matter? A primary care based cross-sectional study. PLoS One, 12(10), e0186096.
  10. Flynn, T.J., Cadzow, M., Dalbeth, N., Jones, P.B., Stamp, L.K., Hindmarsh, J.H., …& Merriman, T.R. (2015). Positive association of tomato consumption with serum urate: support for tomato consumption as an anecdotal trigger of gout flares. BMC Musculoskeletal Disorders, 16(196), 1-8.
  11. Zhang, B1., Fang, W., Zeng, X., Zhang, Y., Ma, Y., Sheng, F., & Zhang, X. (2015). Clinical characteristics of early- and late-onset gout: A cross-sectional observational study from a Chinese gout clinic. Medicine, 95(47), e5425.
  12. Centers for Disease Control and Prevention. (2019). Gout.
  13. Arthritis Foundation. (2019). Medications for Treating Gout.
Last Updated on October 30, 2019
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