If you’re woken in the middle of the night by sharp, excruciating pain in your big toe, you may be having a gout attack. Gout is a common form of arthritis that causes sudden, severe pain, redness, swelling, warmth, and tenderness in the joints—often starting in the big toes but also affecting other joints, such as the ankles, knees, and fingers. It’s typically treated with anti-inflammatory medications for acute flares followed by a medication called allopurinol for lowering the uric acid
The gout occurs when excessive uric acid accumulates in the body. Uric acid is a byproduct of purine, a natural compound used to produce DNA and RNA. When we consume purine-rich foods, like red meat, organ meats, fish and shellfish, and certain beans and legumes, the body breaks them down into uric acid, some of which is excreted in the urine. Some people retain more than usual amounts of uric acid in the body, and this condition is called hyperuricemia. Sometimes the excess uric acid is deposited in joints and under the skin (called tophi). At times, the uric acid deposited in the joints initiates an acute inflammatory response resulting in a gout flare. Risk factors that can contribute to hyperuricemia include a purine-rich diet, obesity, insulin resistance, medications, alcohol consumption, and genetic factors. Risk factors for gout flare include dehydration, physical stress like surgery, excessive alcohol consumption, or intake of purine-rich meals.
If you’ve been diagnosed with gout, you probably know that modifying your diet and beverages can help with reducing uric acid levels and gout flares. One common question among coffee drinkers is whether drinking java is safe. The answer is a resounding yes—individuals with gout can enjoy coffee, and it may even offer some health benefits!
Can I drink coffee if I have gout?
“Coffee has no known adverse effects on gout and is even deemed protective in some cases,” says Michael Chichak, MD, instructor with Northeast Ohio Medical University. In fact, moderate coffee consumption—especially caffeinated coffee—may actually lower the risk of developing gout and help manage existing symptoms.
“Studies have demonstrated that drinking coffee is associated with a reduced risk for gout,” says Jesus Lizarzaburu, MD, a board-certified family medicine provider at Tidewater Physicians Multispecialty Group in Yorktown, Virginia. He says there is a positive correlation between coffee intake and reduced levels of uric acid. For example, a study published in Clinical Rheumatology found that coffee intake significantly decreased the risk of gout by lowering levels of urate (the salt form of uric acid) and urea (a waste product that, when elevated, can signify impaired kidney function).
According to one cohort study investigating the link between coffee consumption and the incidence of gout in women, higher coffee consumption reduced serum uric acid levels significantly; the risk of gout was 22% lower with an intake of one to three cups of coffee per day, and 57% lower among those who drank four or more cups daily. Interestingly, a systematic review found that women need to drink more servings (4-6 cups/day) than men to lower serum uric acid than men (1-3 cups/day).
Is coffee good for gout?
Dr. Lizarzaburu says that drinking coffee is beneficial for gout, but you should discuss the safety of caffeine consumption with your healthcare provider. In addition to reducing the formation of uric acid, caffeine may enhance the urinary excretion of uric acid by inhibiting urate transporters in the kidneys, which then leads to lower uric acid levels in the blood. Dr. Chichak adds that coffee is rich in antioxidants that protect against oxidative stress, which triggers the inflammation behind gout flare-ups.
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Which coffee is best for high uric acid?
Although research shows that caffeinated coffee is best for reducing uric acid, decaffeinated coffee also has benefits, although to a lesser degree. One reason that coffee with caffeine is so beneficial is the presence of cholinergic acid (CGA). CGA is a polyphenol, or plant compound, with antioxidant properties found naturally in coffee beans. The decaffeination process decreases the CGA content in coffee but doesn’t remove the compound entirely.
Dr. Lizarzaburu explains that the CGA in coffee helps eliminate uric acid in the body mainly by blocking xanthine oxidase (XO), an enzyme that produces uric acid. When CGA inhibits this enzyme, less uric acid is made, which helps lower the amount in the blood. Plus, CGA has anti-inflammatory benefits that can help reduce swelling and stress in the joints, which are often linked to high uric acid levels and conditions like gout. Tea consumption has also been shown to help in this regard.
In addition to chlorogenic acid, coffee is rich in other antioxidants and polyphenols known to combat inflammation and support overall health. These compounds may help mitigate the risk of gout flare-ups, making coffee a favorable addition to your diet.
What is the best thing to drink if you have gout?
While coffee is an excellent beverage for individuals with gout, Dr. Lizarzaburu says water is the best choice. That’s because staying well-hydrated assists the kidneys in flushing out excess uric acid, which can help prevent the formation of crystals in the joints.
Low-fat milk and yogurt are also good options. The proteins in these products can help reduce uric acid levels, decreasing the frequency of gout attacks.
When it comes to gout flares, certain beverages can make matters worse. For example, alcohol, particularly beer, contains high levels of purines, which the body breaks down into uric acid.
Additionally, sugary drinks, such as sodas and certain fruit juices, can contribute to an increased risk of gout and should be consumed cautiously. High fructose corn syrup, commonly found in many processed foods and beverages, has also been linked to increased uric acid production.
The bottom line
Coffee is more likely to be helpful than harmful for individuals managing gout. Studies indicate that caffeinated coffee is particularly effective in lowering uric acid levels and reducing the frequency of gout attacks. If you’re a coffee lover, incorporating this beverage into your daily routine may provide a protective effect against gout. Just remember to stay hydrated, limit purine-rich foods, avoid alcohol and high-fructose drinks, and check with your healthcare provider about the safety of caffeine intake.
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