Gout and Alcohol- Why They Don’t Go Together

Gout and Alcohol: Why They Don’t Go Together

Gout is a type of arthritis or joint inflammation. It happens when high amounts of uric acid (more than 6 mg/dl) crystallize around the joints. Symptoms include swelling, tenderness, redness, and pain around the joints, especially on the big toe.

A diet rich in meat, seafood, and alcohol (specifically beer) can trigger this condition. As such, experts recommended that alcohol intake be minimized (if not eliminated) in people at risk of gout.

How Gout Occurs -

How Gout Occurs

Gouty arthritis takes place when uric acid (urate) crystals accumulate around the joint. This leads to the following symptoms:

  • Joint pain that commonly affects the wrists, elbows, knees, and fingers
  • Tender, swollen, warm, and reddened joints
  • Limited range of motion for affected joints
  • Discomfort that lasts for several days/weeks, even when the pain has subsided

This happens when purines – substances found in meat, seafood, alcohol, and high-sugar beverages – are transformed into uric acid. While they are normally passed through the urine, the body may not be able to excrete high amounts of such. This leads to a uric acid build-up in the joints, which leads to the symptoms stated above.

Risk Factors

The following factors place certain individuals at a higher risk of developing gout:

  • Consumption of red meat, seafood, sweetened beverages, and alcoholic drinks (especially beer)
  • Excess weight or obesity, as the kidneys have a harder time excreting uric acid
  • Gender and age factors. Males typically develop gout from 30 to 50 years old. Females, on the other hand, are more likely to have attacks after menopause.
  • Chronic conditions such as high blood pressure, heart problems, kidney disease, diabetes, or metabolic syndrome
  • Family history of gout
  • Use of aspirin, thiazide diuretics (for hypertension), or anti-rejection drugs (for organ transplants)
  • Recent trauma or surgery

Complications of Gout

Gout, if left untreated or unmanaged, can lead to the following complications:

Recurrent gout

This refers to gout attacks that occur sporadically throughout the years.

Advanced gout

Gout, if left untreated, can lead to the formation of tophi (nodules) under the skin. Although they are not painful, they can become swollen and tender during gouty attacks.  These nodules are usually found on the fingers, hands, elbows, back of the ankles, and feet.

Kidney stones

Since uric acid is primarily excreted through the urine, some particles may end up accumulating in the kidney. These then lead to urate crystal kidney stones.

The Gout and Alcohol Connection

In the early days, researchers believed that most alcoholic beverages – with the exception of wine – can trigger gout attacks. The study by Neogi et al., however, has shown that frequent alcohol intake, regardless of type, can trigger gouty episodes.

The researchers surveyed 724 participants. They were then followed-up in the course of one year. Results showed that those who drank 1-2 servings were 1.36 times more likely to develop gout within 24 hours. The risks are markedly higher in people who consumed 2-4 beverages, as they were 1.5 times more likely to suffer gout attacks.

As to why this occurs, ethanol may be to blame. This alcohol ingredient can increase uric acid production, as it can delay its excretion as well. These mechanisms ultimately result in gout episodes.

As has been mentioned, all types of alcohol can precipitate gout. Beer, however, can hasten the accumulation of uric acid crystals. More than ethanol, beer contains guanosine, a type of purine.

While alcohol is known to increase gout risk alone, additional consumption of high-purine foods or diuretics (water pills) can further worsen the situation. The risk is somehow lowered if anti-gout medications such as Colchicine and Allopurinol are taken.

Despite the availability of the aforementioned meds, the authors recommend limiting the intake of all types of alcohol to prevent gout re-occurrence.

What You Can Do

Avoid or Reduce Alcohol Intake

Because alcohol obviously triggers gout attacks, doctors recommend limiting (if not avoiding) intake. After all, alcoholic beer can increase uric acid levels by as much as 6.6%. Non-alcoholic liquor, on the other hand, can still raise uric acid levels by 4.4%.

Reducing alcohol intake is particularly important for men, as they are at a higher risk of developing gout. Even if you haven’t experienced gout for quite some time, it is important to minimize alcohol consumption to prevent the attacks for good.

Say No to High-Purine Foods

You should avoid consuming high-purine foods. These should be avoided, if not eaten in small quantities:

  • Beef, pork, lamb, venison, bison, specifically the liver and kidney parts
  • Sardines, anchovies, tuna, and shellfish
  • Asparagus and spinach
  • Candies, sweetened cereals, or bakery goods
  • Caffeinated coffee

Eat these Foods Instead

Although some foods need to be avoided, some may help lower uric acid levels in the body. According to the Mayo Clinic and the Arthritis Foundation, these are the foods that may help prevent gout attacks:

  • Leafy and starchy greens
  • Lentils, peas, beans, and tofu
  • Low-fat dairy products, such as yogurt, milk, or cheese
  • Cherries or cherry juice
  • Vitamin C (500 mg per day)

Drink Lots of Water

Hydration is key, as this can help remove the uric acid crystals in the body. According to the Arthritis Foundation, drinking at least 8 glasses of water is advisable. But in the event of a gout flare, you might need to take as much as 16 glasses of water per day.

Take Gout Medications

In high-risk populations, certain medications may be prescribed. Allopurinol and Febuxostat can help decrease uric acid production. Lesinurad and Probenecid, on the other hand, can aid the kidneys in faster uric acid excretion. Pegloticase, also known as Krystexxa, may be used to help break down uric acid.

As for the symptoms, Colchicine and steroids can reduce joint inflammation. Pain relievers such as Indomethacin, naproxen, and ibuprofen may be taken for severe discomfort.

Wrapping Up

Gouty arthritis occurs when uric acid crystals accumulate around the joints. It makes joints painful, swollen, tender and reddened. Range of motion is affected as well. Alcohol is a known trigger for gout flare-ups. Not only is it high in purines, but it can also delay its excretion. With that being said, alcohol intake should be limited or avoided, especially in men and other high-risk populations.

Latest posts by Raychel Ria Agramon, BSN, RN, MPM (see all)

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