Why Does Alcohol Cause Gout
Gout develops from a buildup of a chemical in the bloodstream called uric acid. The body makes uric acid as it breaks down chemicals called purines, which are in foods like seafood and meat. Usually, uric acid is dissolved into the blood and then removed from the body through urine. If there is too much uric acid in the body, it can turn into crystals in your joints and cause a painful gout flare.
Alcohol has been shown to cause gout flare-ups in several ways, including:
- By increasing the amount of uric acid that the body makes
The combination of all three of these factors makes a person more likely to have a gout flare if you drink alcohol. Dehydration, specifically, can cause gout flare-ups because, without enough water in the body, the kidneys cant get rid of the extra uric acid that causes gout. Alcohol only worsens this process. When a person drinks alcohol, it shuts off a chemical in their brain called the antidiuretic hormone, or ADH. Without enough ADH, someone can become extremely dehydrated very quickly because they will urinate a lot in a short time. Dehydration raises a persons chances of having a gout flare.
How Alcohol Affects Gout
Drinking alcohol affects gout risk in two main ways:
Alcohol makes the uric acid be pulled back into the body, with less in the urine. This leads to elevated blood levels of uric acid, says Theodore R. Fields, MD, a rheumatologist at the Hospital for Special Surgery in New York City. When uric acid isnt excreted in urine, it further contributes to the formation of crystals in joints that cause intense pain and inflammation, says Jonathan Greer, MD, a rheumatologist with Arthritis & Rheumatology Associates of Palm Beach, Florida.
An analysis of multiple studies on alcohol consumption and gout which included data on almost 43,000 people found a dose response of gout risk to alcohol consumption. That means that the more alcohol people consumed, the greater the risk of developing gout.
Compared with people who never or rarely consumed alcohol, light drinkers had a 16 percent increased risk of gout, moderate drinkers had a 58 percent increased risk of gout, and heavy drinkers had a 264 percent increased risk of gout.
Red Wine Prevents Disease Progression In Osteoarthritis:
Osteoarthritis is characterized by inflammation and bone loss. Resveratrol treatment has been shown to preserve the structure of articular cartilage and subchondral bone .
It also activates a protein called silent information regulator 2 type 1 which prevents the destruction of cartilage. This further inhibits the progression of the disease in the patient.
What does this mean? The major symptom of an osteoarthritis patient is a loss of bone and cartilage. Resveratrol not only inhibits this process but also prevents further bone deterioration.
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Beer Spirits Increase Gout Risk
But Wine May Be OK, Researcher Says
April 15, 2004 — For centuries, gout has been known as the “disease of kings” because overindulging in rich food and drink is a major cause of the painful joint condition. But it now appears that when it comes to alcohol, the biggest culprit is the beverage long favored by the common man.
In the largest study of its kind, researchers found that as few as two to four beers a week increased the risk of gout by 25%. But men who drank at least two beers a day were more than 200% as likely to develop gout as non-beer drinkers. And the more beer they drank, the more likely they were to suffer an attack of gout.
Liquor drinkers also suffered a gouty fate, though not as severely. As little as one liquor drink a month increased the risk, but the chance of gout jumped 60% with two or more liquor drinks a day.
No increase in risk was seen among wine drinkers.
While there had been some suggestion that beer drinkers may be more at risk than imbibers of alcohol in other forms, lead researcher Hyon K. Choi, MD, of Massachusetts General Hospital, says the strength of the difference was a surprise.
“It certainly suggests that individuals with gout should try to limit or even cut out their beer consumption, whereas wine may be allowed, given other health benefits associated with moderate alcohol consumption,” he says.
Alcohol & Gout Studies
Its long been recognized that alcohol consumption is a high risk factor for gout. And this has been backed up by several studies looking at the effect of alcohol consumption on gout.
One 2004 study, using data from 14,809 participants in the USA, looked at the relationship between alcohol and uric acid.
The study authors concluded that:
These data suggest that the effect of individual alcoholic beverages on serum uric acid levels varies substantially: beer confers a larger increase than liquor, whereas moderate wine drinking does not increase serum uric acid levels.
This study suggests that although drinking beer and spirits is definitely linked to a higher risk of developing gout, moderate wine drinking may not increase the risk.
It should be noted, though, that this study only considered the impact of alcohol on incident gout, i.e., first time gout, not recurrent gout episodes. In other words, on the risk of someone having their first gout attack.
But what about patients who already have gout? How does, for example, moderate amounts of wine affect them?
Well, one recent study looked at just that: the effect of alcohol consumption on recurrent gout. This 2006 study of 197 gout patients concluded that:
And, in terms of the effect of specific alcohol types on gout, they found that:
When the effect of specific alcoholic beverage was assessed separately, the risk of recurrent gout attack increased as the number of drinks of each specific alcoholic beverage increased.
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Red Wine Is A Natural Antimicrobial Agent
The polyphenols in red wine have broad-spectrum activity against bacteria such as Staphylococcus aureus, Clostridium perfringes, Bacillus sp., Klebsiella sp.
S. aureus is the leading causWine septic arthritis, and red wine has an anti-microbial action against S. aureus, thus making it an effective natural remedy for septic arthritis.
What does this mean? The polyphenolic compounds in red wine specifically inhibit S.aureus, the major causative agent of septic arthritis. Red wine can be an alternative to antibiotics used to treat the same.
Beer Is High In Purines
People with gout are often told to avoid foods that contain high levels of purines, a substance that breaks down into uric acid. High-purine foods include organ meats such as liver, fatty red meats, and certain types of seafood. Beer contains much higher amounts of purines than other alcoholic beverages, and the researchers suggest that this may explain their findings.
Arthritis expert Roland Moskowitz, MD, says it is probably a good idea for people with gout to cut beer and high-purine foods out of their diets while they are getting the condition under control. But he adds that new treatments that block the formation of uric acid have made diet less of a factor in controlling the disease.
“Gout is now an imminently treatable disease, so maintaining a rigid diet is not as important as it once was,” he tells WebMD. “I wouldn’t want my gout patients to eat a pound of steak every day, but eating a steak once in a while and drinking alcohol in moderation is probably fine.”
SOURCE: Choi, H. The Lancet, April 17, 2004 vol 363: pp 1277-1281. Hyon K. Choi, MD, department of medicine, Massachusetts General Hospital, Harvard Medical School, Boston. Roland Moskowitz, MD, spokesman, American College of Rheumatology professor of medicine, Case Western Reserve University, Cleveland.
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Red Wine Consumption Reduces Cardiovascular Risk
Studies have indicated that patients who have chronic inflammatory arthritis are at a high risk to be affected by cardiovascular events20.
Elderly patients with arthritis have a higher probability of developing atherosclerosis. It has been shown that inflammation plays an important role in the atherosclerotic process.
Rheumatoid arthritis increases cardiovascular disease risk by increasing oxidative stress and dysfunction of the endothelium .
The polyphenolic compounds present in red wine helps in reducing the development of heart diseases in healthy individuals.
Studies have shown that on the consumption of red wine the ratio of good cholesterol: bad cholesterol increased significantly. In patients with type 2, diabetes consumption of 150 ml/day of red wine decreased total cholesterol/High-density lipoprotein ratio.
What does this mean? This suggests that polyphenols of red wine have a significant role in lowering the risk of heart disease in arthritis.
Alcohol And Gout Risk
Although beer may be the worst drink for gout, any alcoholic beverage can trigger gout symptoms in people who are prone to the disease. “Alcohol causes the kidneys to excrete alcohol instead of excreting uric acid. That increases the amount of uric acid in the blood, which could provoke a gout attack in about one or two days,” warns David Freeman, MD, a rheumatologist at the Lahey Clinic in Burlington, Mass.
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If I Am Being Treated For Gout Can I Still Drink Wine
Q: Following a recent trip to “wine camp” and the consumption of a variety of red wines, I experienced an acute gout attack requiring medical treatment. Should wines of all types be avoided if one suffers from gout, even if on medication to treat gout? –Albert, Nashville
A: Gout is an inflammatory form of arthritis caused by excess uric acid in the bloodstream. Most uric acid comes from the breakdown of the body’s own DNA, while some comes from diet. For most people, excess uric acid is simply filtered from the body by the kidney. When the acid remains in the bloodstream, it can crystallize in joints and surrounding tissues, which, over time, build-up and cause the inflammation typical of gout.
According to Herbert S. B. Baraf, MD, a rheumatologist and a clinical professor of medicine at George Washington University, for those worried about developing gout, studies have shown that wine does not increase the risk of gout, although beer can. In a study comparing beer, spirits and wine, he explains, “Using a cut-off point of two drinks a day as “high intake,” beer and, to a lesser extent, the intake of spirits were associated with the subsequent development of new onset gout. Wine did not appear to be a risk factor at this level.”
Have a question about wine and healthy living? .
Wine Versus Other Types Of Alcohol
So, does wine cause gout? In the long run, it might, if you have it in industrial amounts. If you already have gout, it will increase the risk of an attack. An occasional serving every now and then will not make a big difference, but having more than a serving can expose you to a new attack.
Most people are aware of the effects of beer and hard liquors, but wine is not to be overlooked either. Having a couple of glasses of wine one after another will increase the risk of a gout attack by 138%. Simply put, you double up the risk of having a gout attack, which is quite high. To help you get an idea, having two glasses of beer one after another will increase the risk by 75% only still high though.
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Med Study Shows Drinking Worsens Symptoms Of Gout
Imagine your toe or your ankle caught in a vise-like grip thats how many patients describe the excruciating pain of gout, a disease that limits the bodys ability to excrete uric acid. Certain foods, such as red meat, have been known to worsen the condition, but a recent School of Medicine study has linked gout flare-ups to alcohol consumption as well.
Gout, also called metabolic arthritis, occurs when an excess of uric acid forms needle-like crystals in the cartilage of a joint and in the surrounding tissues. Alcohol consumption has long been suspected to trigger gout attacks, but the hypothesis had not formally been tested until Yuqing Zhang, a MED professor of medicine and epidemiology, and his colleagues studied 279 patients who had episodes of gout within the previous year. The study was published in the September issue of the American Journal of Medicine.
Contrary to assumptions in the medical community, Zhang found that it doesnt take heavy drinking to set off a gout attack. Even a light-to-moderate amount of alcohol can cause inflammation of tissues usually in the big toe within 24 hours of imbibing. Those who drank five to six alcoholic beverages during a 48-hour period were twice as likely to have a recurrent attack than individuals who did not drink, says Zhang. Patients who drank seven or more drinks over a two-day period were two and a half times more likely to experience a gout flare-up than those who abstained.
Brian Fitzgerald can be reached at .
Red Wine Benefits In Gout
Resveratrol has been found to be effective against gouty arthritis which is caused by monosodium urate crystal deposition thereby resulting in an increased amount of uric acid in the patient.
It inhibits articular inflammation and downregulates serum uric acid. It can prove beneficial in the management of gouty arthritis as it can prevent recurrent acute attacks of gouty arthritis.
What does this mean? Resveratrol, a potent antioxidant can prevent attacks of chronic gouty arthritis by reducing the level of uric acid in patients serum. This is a preventive measure for managing gouty arthritis.
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Is A Little Alcohol Ever Safe If You Have Gout Find Out What Science And Experts Have To Say
According to oft-stated health advice, one drink of alcohol a day is generally safe for women daily and two drinks a day is generally safe for men. But if youve been diagnosed for gout or are at risk for developing gout, you may need to cut back on drinking alcohol.
Gout is a type of arthritis where high blood levels of uric acid, a metabolism byproduct, start to crystallize in the joints, causing pain and swelling that is often sudden and severe. Gout typically develops in stages in the first stage, uric acid levels are rising but not causing symptoms in the second stage, a person has started to experience painful gout attacks, called flares. As gout progresses, it becomes chronic, affecting more joints, with time between flares shortening.
Uric acid crystals can also form in the kidneys and cause kidney stones and can build up in various places in the body, such as below the skin and cause bumps called tophi. People with gout are also at risk for serious comorbidities, including heart disease and diabetes.
If youre at risk for gout or have been diagnosed with gout, your doctor may advise you to cut back on certain foods that can contribute to gout symptoms, such as those high in purines, which break down into uric acid during digestion. On that list is also alcoholic beverages, including wine, beer, and spirits.
Here, learn more the connection between drinking alcohol and gout, and considerations to keep in mind for optimal health.
Does Alcohol Cause Gout And Can You Drink With Gout
Anyone who has had the misfortune to suffer from a gout attack will tell you how excruciatingly painful it is, and it can be very difficult to treat. However, it is avoidable with a monitored diet. One question which comes up time and time again with regard to this is does alcohol cause gout?
To truly understand if alcohol causes gout, lets look at the condition itself.
Gout is a form or arthritis, tiny crystals form around the joints, in the hands and feet in particular. Swelling occurs, as does a great deal of discomfort.
A gout attack can come on suddenly, often overnight. The crystals are a by-product of uric acid, which is a chemical produced by the body to break down purines.
Foods such as offal, oily fish, seafood, game, yeast extract , as well as beer, stout and port, are all very high in purines, so if any of these are your tipple of choice, then the answer to does alcohol cause gout, is that it is probably a major factor.
There is some good news for beer drinkers though. Gout is becoming more and more common, and some people have labelled purines as the new gluten. So purine free, or low purine beers are starting to hit the market. It is also important to add, that if you enjoy beer, being susceptible to gout doesnt mean that you have to abstain completely. I must add that I say this from a personal view, not a medical one.
Ive spoken to many other gout victims in the past, and there is very much two camps of different opinion.
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Wine And Plasma Antioxidant Capacity
Early studies by St Leger et al and Renaud et al demonstrated an inverse relation between incidence of coronary heart disease and wine consumption in different developed countries, which prompted the efforts to discover the mechanisms underlying the observed effects. Soon, it was recognized that polyphenolic compounds highly contained in wine, especially in red wine, were responsible for various biological effects, including potent antioxidative activity.
Antioxidative activity of polyphenols is based on two mechanisms: chelation of free metal atoms such as iron and copper, which prevents biochemical reactions generating reactive oxygen species and scavenging of free radicals as effective hydrogen donors . Indeed, Frankel et al showed in 1993 that red wine phenolics inhibited oxidation of human low-density lipoprotein in vitro .
An increase in serum antioxidant activity following ingestion of red wine was first described in 1994 by Maxwell et al . In a similar study, Whitehead et al showed that serum antioxidant capacity one hour after ingestion of 300 mL of red wine increased by 18%, which was comparable with 22% increase in serum antioxidant capacity after ingestion of 1 g of vitamin C.