Alcohol and Gout: Effects, Quantity, and Alternatives

Drinking alcohol can trigger flares of gout. As little as one alcoholic beverage in a 24-hour period can cause a gout flare, and the risk increases the more drinks you have daily.

Gout (also called gouty arthritis) is caused by hyperuricemia, a condition marked by an excess amount of uric acid in the blood. Alcohol can increase uric acid levels in the body, resulting in gout flares.

Gout symptoms include sudden and severe joint pain (especially in the fingers and toes), swelling, stiffness, and a mild fever. Both the type of alcohol consumed as well as the amount of alcohol consumed play a role in the severity and likelihood of a gout flare.

This article will discuss the effects of consuming alcohol on individuals who experience gout, including how much alcohol and the types of alcohol that impact gout the most. This article will also detail alcohol alternatives, gout medications, and more.

Flare-Ups, Alcohol, and Gout

Gout is marked by periods of remission (no symptoms) and times of flare-ups, when symptoms worsen. Alcohol can trigger flare-ups for several reasons.

Effects

Gout is caused by an excess amount of uric acid in the body. Uric acid is a waste product produced by the body, carried in the bloodstream, and eliminated in the urine.

While most uric acid is produced by the body naturally, some foods and drinks have substances called purines that can be converted into uric acid and therefore raise uric acid levels.

Alcohol can raise uric acid levels for a number of reasons, including:

• Alcoholic beverages contain purines (which are especially high in beer).
• Alcohol increases the breakdown of nucleotides, another source of purines that can be converted into additional uric acid.
• Alcohol affects the rate of uric acid excretion, which can also raise uric acid levels.

This excess amount of uric acid can lead to the development of crystals that end up lodging in the joints, usually the big toe. This is what triggers what is known as a gout flare.

Quantity

The amount of alcohol consumed matters. Research has shown that high alcohol consumption is an independent risk factor for developing gout.

Once a person has gout, any amount of alcohol increases the risk of a flare. Dietary recommendations for people with gout include not drinking alcohol at least three days per week.

A 2014 study found that participants who had gout and consumed one to two alcoholic beverages in 24 hours increased their risk of having a gout flare by 1.36 times compared to those who consumed no alcohol within a 24-hour period.

In that same study, participants who consumed two to four alcoholic beverages in 24 hours increased the risk of having a gout flare by 1.51 times compared to their zero-alcohol counterparts.

Types of Alcohol

The type of alcohol consumed matters. Studies have found that while beer, liquor, and wine can all impact gout to varying degrees, beer comes with the highest risk of triggering a gout flare.

Can You Drink Alcohol With Gout?

Yes, you can drink alcohol with gout, although limited quantities are recommended. Every person will experience gout differently, which means paying attention to your particular triggers is vital to managing your condition.

Allopurinol and Alcohol

Allopurinol is a type of gout medication that reduces the production of uric acid in the body. It is sold under the brand names Zyloprim and Lopurin in the United States. Allopurinol is prescribed to prevent gout attacks. There are no restrictions on taking it while drinking alcohol. However, it can cause drowsiness.

Other Gout Medications

Other gout medications used to prevent a flare include:

• Uloric (febuxostat)
• Probalan (probenecid)

Gout medications used during a flare include:

• Colcrys (colchicine)
• Oral steroids or intra-articular (into the joint) steroid injections

Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and inflammation during a gout attack. However, you should not consume large amounts of alcohol while taking any NSAID. These include:

• Advil or Motrin (ibuprofen)
• Aleve or Naprosyn (naproxen)
  
• Indocin (indomethacin)
  
• Clinoril (sulindac)
• Voltaren (diclofenac)
  

Alcohol Alternatives

Because there is a social component to alcohol, you may be interested in finding alcohol alternatives when socializing. Some such options include nonalcoholic seltzers and mocktails (also called zero-proof beverages).

But when selecting alternative beverages, opt for those not sweetened with sugar, fructose, or high-fructose corn syrup, as these can raise uric acid levels.

You never need an excuse for enjoying an alternative to alcohol. It is an individual choice and should be respected.

Summary

Alcohol can raise the risk of developing gout and the risk of having a gout flare for a person with gout. The risk of triggering a flare increases with each drink. Because of this, reducing or eliminating alcohol is recommended for those with gout.

Gout is an incredibly painful form of arthritis. While there is no cure for gout, managing the condition can help improve your quality of life. One way to manage gout is by understanding and avoiding the triggers that can lead to flare-ups in you. Talk to a healthcare provider if you are concerned about gout.