Drinking Behaviour In Patients With Acute Gout
CR Sharpe. A case-control study of alcohol consumption and drinking behaviour in patients with acute gout. Canadian Medical Association Journal 1984 131: 563-567.
In this study, 24 patients with properly diagnosed gout according to the American Rheumatological Association criteria were matched with controls for age, weight and sex, and use of diuretic. Alcohol intake was determined by asking patients how much they drank on each occasion they were seen, over a five year period. When a range of intakes was given, the mean was taken.
Alcohol intake was calculated in grams, with one drink equalling 13.6 grams of ethanol. One drink was 340 mL Canadian beer, 43 mL of Canadian spirit, 142 mL wine or 85 mL of sherry, port or vermouth. Drinking behaviour was classified according to:
- Class 1 – abstention
- Class 2 – moderate drinking without loss of control
- Class 3 – occasional heavy drinking
- Class 4 – problem drinking, exceeding cultural limits, causing concern to family
- Class 5 – alcoholism – repeated excessive drinking that interferes with health, relationships or work
Excessive alcohol intake was set at 60 grams a day for men and 20 grams a day for women. There were 22 men and two women.
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.
Can I Drink Non
Q) I’m a 61-year-old man with gout and have been told that I shouldn’t drink alcohol as it may exacerbate my symptoms and worsen my attacks. Does this include low or non-alcoholic beers?
James, Andover – 2007
A) Drinking alcohol can make gout worse and alcohol can work against the effect of drugs used to treat gout. The more alcohol, the more this is true. However, there are a few rays of hope. Firstly, not everyone who drinks gets gout, and people can get gout who’ve never touched a drop. The latter group is more common in my experience. Two common conditions where gout occurs are older women taking water tablets and people with a strong family history of gout. Another fact worth knowing is that some forms of alcohol are worse for gout than others. Beer is particularly bad and wine is better. So low alcohol drinks are denitely better than high alcohol drinks, but beer isn’t the best way to take your tipple.
This answer was provided by Dr Philip Helliwell in 2007, and was correct at the time of publication.
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The Relationship Between Alcohol & Gout
Gout is a type of arthritis. Gout does not flare up and cause pain all the time but will occur only occasionally, and months or years can pass between attacks. It usually affects one joint at a time, most often the big toe. A gout attack can happen quickly, and its incredibly painful for most people.
The pain of gout leads most people to want to avoid gout in any possible way. One of the best ways to prevent gout starts with diet, especially monitoring alcohol use. Drinking alcohol can cause gout flare-ups.
When To See A Doctor
If you develop symptoms that look like arthritis, a visit to the doctor is the best way to get a clear diagnosis. Your doctor will run several tests to either rule out or arrive at a diagnosis of gout. These include X-rays, which rule out other health issues an ultrasound can view areas where uric acid is building up, and/or a joint fluid test, conducted by removing fluid with a needle from an inflamed joint. The collected fluid is studied with a microscope to see if crystals are present/visible. A blood test allows the doctor to check your uric acid level. Remember, even if your uric acid level is high, that doesnt necessarily mean that you have gout.
See your doctor if you dont know what is causing your joint pain. They will be able to diagnose gout or any other illnesses, such as a joint infection, which may have symptoms common to gout. A gout flare may cause a mild fever. If you have a high fever with chills, you may not be experiencing a flare and you should go to the hospital right away. Infections are serious and should be treated immediately.
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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.
Can Changing Your Drinking Habits Prevent Gout
When you have gout, its important to keep your uric acid levels as low as possible to avoid a flare-up. Because alcohol increases uric acid levels, many doctors will recommend drinking only in moderation or cutting back significantly.
If you enjoy alcohol, making simple changes to your drinking habits may help avoid future flare-ups. Even if you dont have gout, avoiding heavy drinking may even help prevent a first-time gout experience.
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Gout Not The Wine Drinker’s Curse
I have a sore hand. Gout. Which makes writing painful, but not impossible.
And, because I can still hold a glass thank God, allows me still to enjoy the odd wine.
But doesn’t wine, red in particular, cause gout, the so-called “disease of kings” suffered by Leonardo da Vinci, Charles Darwin, Isaac Newton, the musical genius Beethhoven, and the gluttonous King Henry VIII?
Also suffered these days by one in 40 Britons, a rise of 64 per cent in 15 years, and, even more disturbingly, by more elderly New Zealanders than any other people in the world.
First, what is gout?
It is a painful arthritic condition that results when too much uric acid builds up in the body. The uric acid forms crystals, which settle in the joints, usually of the big toe, instep, heel, ankle, knees, wrists, fingers, and elbows.
The uric acid works to break up natural substances called purines, which are usually present in the tissue of the body as well as most foods. When the kidneys don’t effectively process the acid or too many purines are consumed the uric acid begins to build up, leading to – ouch, gout.
Gout can also be caused by obesity, which could include having high blood pressure or diabetes, having close relatives with gout or having long-term kidney problems.
What about alcohol?
In one of the largest studies of its kind a group of leading American researchers has for 12 years charted the effect of alcohol consumption on gout among 47,000 people.
What Alcohol Is Best To Drink With Gout: What You Should Know
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Can Eliminating Alcohol Reverse Gout
In a word, no. Eliminating or cutting back on alcohol alone likely wont lower uric acid levels enough to effectively treat gout. For many people with gout, the target uric acid level is less than 6 mg/dL. If a person with high levels of uric acid goes on a diet, loses weight, eliminates high-purine foods like shellfish and stops drinking beer, they can lower their uric acid from, say, 10 to 9, but usually not much lower. Dietary improvements are still not enough the patient has to be on uric acid-lowering medication at this level, says Dr. Fields.
It is a myth that gout is a dietary disease, and that watching your diet will be enough to manage gout.
Gout is a genetic disease and extremely few people can make enough of a change in their blood uric acid level with diet to control their gout, says Dr. Fields. That said, its still important for people to limit those foods and beverages mentioned as part of their treatment, especially in the first six months after they start uric acid-lowering therapy when the patient is vulnerable to flares since these foods and drinks can make gout worse. Watching your diet, especially early in treatment, can make a difference, says Dr. Fields.
Risks Of Gout Flareups When Having Wine
While everyone is aware of the effects of beer and hard liquors on gout, most people are unaware of the fact that wine can also become a significant trigger. In other words, there is a connection between rose, white or red wine and gout. Thinking that you can dilute the wine by mixing it with something else will not necessarily help. Just because it is not that strong, it does not mean that it will not affect you it is a matter of quantity, after all.
According to recent studies, it depends on how severe your gout is. For example, if you experience intense flareups on a regular basis, a single glass of wine can knock you down and bring a new flareup. On the other hand, if you barely have a few episodes a year and your diet keeps it under control, a glass will not necessarily ruin you. Of course, in an ideal case, you should simply avoid it altogether to reduce the risks to minimum.
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Other Ways To Avoid Gout Flares
In addition to avoiding alcohol, there are some other steps you can take to lower your risk of gout flares.
Purines are commonly found in everyday foods. But just like alcohol, some foods have more purine than others. Foods high in purines include:
- Certain fish, like sardines, trout, cod, and haddock
- Shellfish, like mussels, scallops, shrimp, oysters, crab, and lobster
- All meats, but liver, bacon, veal, venison, and turkey all have particularly high purine levels.
There are other things you can do to decrease your risk of gout flares:
- Fructose is a type of sugar that can also lead to gout flares. High-fructose corn syrup is in a lot of different foods that we eat every day. Check the ingredient lists on your food for high-fructose corn syrup.
- Hydrochlorothiazide, a blood pressure medication, can lead to gout flare-ups. If youre taking it, talk with your provider to see if there is a better option to treat your blood pressure.
- Obesity can also cause gout, so weight loss can help.
Soft Drinks And Gout Risk
Several studies have found an increased gout risk from sugar-sweetened drinks. This link has been found in both men and women. One large study found that just one sugar-sweetened drink per day doubled a woman’s risk of developing gout compared with women who had less than one sugar-sweetened drink per month. “Studies show that sugar-sweetened drinks and fruit juices are associated with an increased incidence of gout attacks. Interestingly, these studies show that diet soda intake is not related to increased frequency of gout attacks,” says Sloane.
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What Kinds Of Alcohol Cause Gout
Studies have shown that all kinds of alcohol cause gout flares. Doctors used to think that beer and liquor were more likely than wine to cause gout flare-ups, but recent research shows that all alcohol forms can cause gout.
Also, the amount of alcohol doesnt matter gout can flare up even if a person is not drinking heavily or often. Medical professionals usually tell people to avoid all alcohol if they have gout.
White Wine For Gout: Is It A Fact Or A Bluff
We always see wine at various gatherings and events. It is undoubtable that wine is one of the most common beverages in the whole wide world. Furthermore, this particular drink haws a long-long history. Its history has religious and royal involvement. A history of men betraying their own wives employing the mental effect of alcohol as their excuse. Moreover, some also say that wine and gout as their own history.
Gout, as we know is a notorious disease that may cause a lingering pain and a very discomforting feeling. This disease doesnt choose who to attack. If you experience this, then you might probably be one of the unlucky ones. In this article, you will get to understand the connection between wine and gout, specifically the white wine. Can it be beneficial for the condition? Lets see.
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Caffeine And Gout Risk
Studies show that caffeine may protect you from gout because caffeine is similar in chemical structure to a common gout medication. But other research shows that increasing your caffeine intake can actually trigger gout pain â in fact, one study found that suddenly doubling your caffeine intake could increase the risk of gout symptoms by up to 80 percent. So if you are a coffee or tea drinker, caffeine could be helping protect you â just remember that a sudden binge could bring on a gout attack.
Wine Implicated In Gout Flares
Beer and hard liquor have long been known to increase the risk of gout, the most common form of inflammatory arthritis, but according to a 2014 study in The American Journal of Medicine, wine also can contribute to recurrent gout attacks.
Gout occurs when excess uric acid builds up around joints often in the big toe, but also in the feet, ankles, knees, wrists and elbows leading to episodes of intense pain, redness and swelling. It affects more than 8 million adults in the United States, and the numbers are rising sharply, due mainly to obesity and other lifestyle factors.
In the 2014 study, 724 gout patients completed questionnaires every few months as well as after gout attacks about their diet, medications, exercise and number of alcoholic drinks consumed. The researchers compared what a participant consumed on an average day to what that participant had consumed in the 24 hours before a gout attack. Researchers looked at the overall effect of alcohol on gout attacks as well as the individual effects of wine, beer and liquor, while taking diet and other factors into account.
Results showed that a single serving of wine, beer or liquor in a 24-hour period didnt significantly increase the chance of repeat gout attacks. But consuming more than one to two drinks a day did by 36%. With two to four drinks, the risk rose 50%, and it continued to rise with the amount of alcohol consumed.
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What Alcohol Is Best To Drink With Gout
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