Diet to prevent gout recurrences

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Gout is a form of arthritis that is due to the abnormal accumulation of monosodium urate (MSU) in joints.

MSU (uric acid)can also deposit in the kidneys, and other tissues. It can cause severe inflammation and pain, most commonly in the big toe, but also in other joints, and it can lead to uric acid kidney stones. If left untreated it may also lead to kidney failure.

Uric acid is the byproduct of purine metabolism and purine content is high in a number of foods, including anchovies, meat, especially organ meats, shellfish, yeast extracts, and some beans.

There are steps that can be taken to prevent gout recurrences.

Reduction of high-purine food intake, as well as cutting back on alcohol can be helpful. Alcohol can reduce uric acid excretion.

Avoiding alcohol, losing weight, stopping drugs that cause elevated blood levels of uric acid, and eating smaller amounts of purine-rich foods all help. Most people who have gout are overweight. As they lose weight, their blood urate levels often return to normal or near normal, and gout attacks are less frequent.

Definitely eat foods low in purines: vegetables, fruits, whole grains, and nuts. Drinking water will help flush uric acid from the body. Some research and clinical experience suggests that eating cherries or drinking the juice can relieve gout.

Vitamin C in high doses (4 to 8 gms per day) can increase uric acid excretion, but it is very important to drink adequate water to prevent the urinary uric acid from crystallizing. Quercetin, a bioflavonoid, inhibits xanthine oxidase, the enzyme that increases purines, in lab tests. The typical daily dose is 800 to 1200 mg.

Curcumin (600 to 900 mg), omega-3 oil (fish oil–3000 to 6000 mg, or flaxseed oil–1 to 3 Tbsp) are anti-inflammatory, as is gamma-linolenic acid (GLA, 240 mg) from evening primrose or borage oils, and they can reduce symptoms of gout.

Purine content of some foods and beverages


Best to avoid:

Liver, kidney, anchovies, sardines, herring, mussels, bacon, codfish, scallops, trout, haddock, veal, venison, turkey, alcoholic beverages


May eat occasionally:

Asparagus, beef, bouillon, chicken, crab, duck, ham, kidney beans, lentils, lima beans, mushrooms, lobster, oysters, pork, shrimp, spinach


No limitation:

Fruits, breads, grains, macaroni, cheese, eggs, milk products, sugar, tomatoes and green vegetables (including lettuce and excluding vegetables listed above)

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