According to a survey compiled by the National Institute on Alcohol Abuse and Alcoholism, 132.9 million Americans age 18 and older drank at least one alcoholic drink in the past month. Furthermore, 60.4 million adults reported binge drinking (four to five drinks in one sitting).1) and 16.3 million adults reported heavy drinking (four to five drinks on any given day).2) in the last month.3
These figures are concerning, as alcohol consumption is strongly associated with an increased risk of gout. According to Mount Sinai Health System, approximately 8.3 million people in the United States have gout.4 This number is expected to grow further as risk factors such as alcohol consumption remain unchanged. But how much does alcohol contribute to the development of gout?
Research links alcohol consumption to an increased risk of gout.
In a study published in JAMA Network Open,5 British researchers have found that alcohol is a risk factor for gout. From there, they wanted to measure how much drinking could increase the risk of gout.
The researchers selected men and women aged 37 to 73 from the UK Biobank, which contains 502,411 participants. From this database, they excluded participants who had poor health, had a history of gout (as well as those taking gout medication), and reduced alcohol consumption due to ongoing pain. After exclusions, they were validated against a final test population of 401,128 participants.6
Then they created two categories – men (179,828) and women (221,300). All participants were asked to categorize their status with these three choices—never, previously, or currently drinking. They were asked to describe the types of alcoholic beverages they currently drink (such as beer or wine) and their average weekly consumption.7
After the analysis, the researchers found that there were 5,278 cases of gout after follow-up – 4,096 in men and 1,182 in women. The researchers added that among men, current drinkers were 69% more likely to develop gout compared to non-drinkers. Interestingly, this association was not found among women.8,9
While the study doesn’t go into the mechanisms of how alcohol triggers gout, it does theorize that type of drink may affect gout risk rather than biological differences between men and women.
“In this prospective cohort study, after careful consideration of confounding and reverse factors, consumption of multiple specific alcoholic beverages was associated with a higher risk of gout in both sexes.
Sex-specific differences in the association of total alcohol consumption with incident gout may be due to the types of alcohol consumed rather than biological differences between men and women.
How drinking alcohol causes gout
Purines are naturally occurring substances in your body that are used to build DNA and RNA. Research shows that two-thirds of the purines circulating in your body are endogenous, with the rest coming from external sources such as food and alcohol. Once purines are metabolized, the end product is uric acid, which is lost in the urine.10
Uric acid itself is not bad – in fact, it plays a protective role in your health. A study stated that uric acid “contributes to approximately 60% of plasma antioxidant activity and maintains the stability of blood pressure and antioxidant stress”.11
Normal blood uric acid levels hover between 2.5 and 7.0 mg/dL for men and between 1.5 and 6.00 mg/dL for women.12 However, it becomes a problem when your body produces more uric acid than it can get rid of, causing gout to form crystals from the blood plasma and deposit in the joints and soft tissues.13 And again, one of the biggest contributors is alcohol consumption.
Going back to the JAMA Network Open study, there are two ways that alcohol consumption affects the production of uric acid that leads to gout – the frequency of drinking and the type of alcohol consumed. According to JAMA Network Open study researchers:14
“Among current drinkers… heavy alcohol consumption was associated with a higher risk of gout among men and a slightly higher risk among women. Regardless of gender, heavy consumption of certain alcoholic beverages, particularly beer or cider, was associated with an increased risk of gout…
Among current drinkers, men who drank five or more times a week had approximately twice the risk of developing gout compared to those who drank less than once a week. Among female drinkers, a positive association between drinking frequency and risk of gout was found after adjustment for BMI (body mass index), especially after additional information for confounding factors…”
As you can see, beer consumption has been cited as a major contributor to increased uric acid levels, and this finding has been echoed in other studies. Review in 202115 The molecularly imprinted beer showed higher serum acid levels than whiskey and shochu (a traditional Japanese strong drink) within just one hour of drinking.
Exercise is a healthy way to control uric acid levels
The best way to prevent alcohol from harming your health is to not drink in the first place. But if you’ve been drinking for a while and want to better control your uric acid levels and prevent gout, I recommend exercise, as it has many systemic benefits.
According to a study16 Published in the Indonesian Journal of Global Health Research, overweight people generally have higher uric acid levels compared to the normal reference range. This is because visceral fat and adipose tissue produce uric acid as a byproduct.
Research on the contrary17 It has been shown that once you start exercising regularly, low or moderate levels of physical activity can start to produce anti-inflammatory effects that reduce the inflammatory response caused by uric acid crystals.
Maybe you’re wondering why you only do low- and moderate-intensity exercises? This is because intense exercise causes lactic acid to build up in your body. When this happens, your body stores more uric acid, which is what you want to lower in the first place.18
In the year A study published in 2021 found that improving uric acid levels “may help reduce the risk of chronic diseases such as high blood pressure, obesity, diabetes and insulin resistance.”19
I’m a fan of moderate-intensity exercise. And my interview with cardiologist Dr. James O’Keefe He talks about the logic in detail. From the research, he says that with moderate intensity, your body has a dose-dependent reduction in mortality, diabetes, depression, high blood pressure, osteoporosis and sarcopenia.
What’s more, O’Keefe found that people who did high-intensity exercise for a long period of time did not experience any additional benefits. I encourage you to read my article about the studies for more information. I’ll also provide examples of moderate-intensity exercises you can do there.
Oxalates cause an inflammatory reaction similar to gout
For years, I struggled with a mysterious rash, and believed that detoxing by sweating in an infrared sauna three times a week would do the trick. Despite my best efforts, the problem persists. Eventually, I learned that I had a condition called oxalate dermatitis, caused by the oxalates embedded in my skin.
Oxalates are natural compounds found in many foods such as leafy greens and seeds. They are also called dicarboxylic acids because they are made of two carbon dioxide molecules. The problem with oxalates is that they can lose protons under certain conditions, leaving them with a negative charge that binds to positively charged ions such as calcium.
When oxalates interact with calcium, oxalate crystals are formed, which are insoluble and often accumulate in the kidneys. In my case, my kidney function is impaired, so they are lodged in my skin.
So, how do oxalate crystals relate to gout? They work in the same way as uric acid crystals. As mentioned earlier, when your body produces uric acid faster than it can remove it from your body, uric acid crystals begin to build up in your joints, causing gout.
During my search for a solution to my oxalate issue, I discovered that citrates are an effective tool. Citrates made from calcium, potassium or magnesium bind to oxalates in your skin. Since the process of oxalate accumulation is similar to that of uric acid in gout, I suspect that applying citrate to the joints will provide similar relief of gout symptoms.
Interestingly, previous studies suggest a relationship between uric acid levels and the formation of oxalates. Calcium oxalate kidney stones are more likely to form when you urinate more uric acid because the calcium salts remove mucopolysaccharides, a sugar molecule that inhibits stone formation.20
Therefore, a two-pronged approach is ideal in order to protect your health – reduce your alcohol intake and reduce your uric acid levels while simultaneously reducing your oxalate load. A more logical starting point is to avoid oxalate-rich foods:
- Spinach – It usually has 600 to 800 milligrams of oxalates per 100 grams
- almonds – It contains 122 mg per 100 grams. I recommend avoiding nuts in general. Linoleic acidA toxin that destroys your mitochondrial health
- Peanut Butter – It usually reaches 140 mg per 100 grams
- sweet potato – They contain 30 mg per 100 grams
- fig – Contains 40 mg per 100 grams
Other strategies to help lower uric acid levels
Exercise isn’t the only strategy available to lower your uric acid levels into a healthy range. Here are some other tips I encourage you to try:
• Avoid processed sugar – A study published in Frontiers in Nutrition found that fructose consumption stimulates pathways that produce uric acid from amino acid precursors.21 While the exact process has not been identified, some observations have been made. Obstetrician and gynecologist Dr. Liji Thomas explains:22
After ingestion, fructose is taken up by the liver and converted to fructose-1-phosphate, which causes a decrease in ATP.
This can lead to uric acid synthesis. Increased fructose levels and decreased ATP levels may result in increased purine nucleotide production and increased uric acid as a side effect.
Another possibility is that decreased insulin sensitivity may reduce uric acid excretion due to fructose-induced fat storage.
To protect your health, avoid all kinds of highly processed foods and drinks that contain refined sugar, especially high-fructose corn syrup. In addition to stimulating uric acid production, refined sugar can harm your health in other ways.
Examples include the production of endotoxin in your gut, which destroys mitochondrial function, tooth decay, and heart disease. For more information on the dangers of fructose, read my article “Does eating refined carbohydrates make you less attractive?“
• Consider taking quercetin: Various medications are taken by people with gout to reduce uric acid levels and pain. However, these drugs often have side effects and contraindications, which make gout management more difficult. It is a study done in 2022.23 It has been suggested that quercetin’s antioxidant, anti-inflammatory and anti-hyperuricemia effects may provide a drug-free way to relieve gout.
According to the data collected by the researchers, quercetin helps to reduce the production of uric acid “by inhibiting the related enzymes and by regulating the renal urate transporters, increasing uric excretion.” Moreover, quercetin inhibits the activity of adenosine, which is key to purine metabolism in aortic endothelial cells.
Another way to help reduce quercetin production is by slowing the metabolism of fructose, which as I mentioned earlier is another way your body produces uric acid.24
Quercetin is found in many foods, including green leafy vegetables, broccoli, apples, onions, green tea, red wine, and berries. Quercetin is also available as a supplement. Zinc is an ionophore, so taking it with zinc will have synergistic benefits for your immune function.25
