Uric Acid


GOUT is associated with raised uric acid (or urate) levels. Although some people have a genetic susceptibility to gout, foods make a major difference as they can increase or decrease uric acid levels. Supplements can also make a difference. Uric acid levels have doubled in the last twenty years.

Diseases Associated with Raised Uric Acid


            Unfortunately raised uric acid does not just cause gout but can predispose to hypertension, diabetes (quarter of the risk of diabetes is from uric acid) , fatty liver and memory decline (for a detailed account of this see the book Drop Acid by Dr David Perlmutter).

Why Uric Acid Increases


            The most important source of uric acid is fructose (sugar is half fructose and half sucrose). High fructose corn syrup (HFCS) is normally 55% fructose and 45% glucose but in soft drinks like colas in can be up to 90% fructose. HFCS has gone up 1000% in the USA in two decades. (Another source of fructose is fruit but whole fruit also contains fibre so fructose is absorbed much more slowly and rarely causes problems. With fruit juices it is a different story and you can and will  get a “fructose hit”. You will not be surprised to know that soft drinks and fruit juices are strongly associated with gout.

The other main sources of uric acid are purines (predominately from meat, poultry and fish) and alcohol.

Which food caused the biggest increase in risk of gout? In a 2018 study the biggest increase was with alcohol, particularly beer (158% increase in risk), then fructose 114%. Seafood increased the risk 31% and meat 29%. Vegetables, dairy products and coffee reduced the risk. Half a cup of cherries reduced the risk by 35%. 

Treating Gout


            In recurrent gout it is common to use drugs like allopurinol to control uric acid levels. It does this by blocking the enzyme xanthine oxidase which produces uric acid. Guidelines in the UK suggest lowering the uric acid level to 300 µmol/l. However a number of natural substances block xanthine oxidase including quercetin (500mg daily) and luteolin (100mg daily).

Dr Blau published research in the 1950s showing that cherry juice can relieve attacks of gout. He found that taking 12 cherries daily or the equivalent in juice brought uric acid levels down to normal.  Try taking cherries or drinking cherry juice at the first sign of an attack can help (cherries or cheery extracts are preferable to juice as there is less sugar in them).

Other Foods that may Help


            Cider vinegar may help. Try a tablespoonful daily.

            Large quantities of water (at least 2 litres a day) can relieve attacks of gout.

            Coriander – 20 sprigs of coriander daily reduced uric acid levels by half in two months in one study. 

            Vitamin C is known to increase uric acid secretion (it works in a similar way to the drug probenecid). However large doses are needed, Start with one grams twice daily, gradually increasing to 3 grams daily then reducing to 2 grams after improvement. Four grams of Vitamin C daily has been shown to reduce uric acid levels threefold. (This dose can sometimes cause loose stools and bloating).