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How does alcohol affect gout?

Mina Draskovic, B.Psy., reviewed this content for accuracy on December 8, 2023

According to research, in 2015-2016, 3.9% of American adults were affected by gout. For the millions who suffer from this condition, we answer the question that asks “can alcohol make gout worse?”.

Table of Contents

The causes of gout range from genetic predisposition to diet and obesity, but alcohol consumption definitely doesn’t help with this chronic inflammatory condition. In fact, alcohol may exacerbate inflammation in the body, worsen the symptoms of gout, and trigger even more painful flare-ups.

Are you struggling with alcohol addiction? You can count on our rehab center in Provo, Utah to provide you with everything you need to kick your drinking habit. Our caring and supportive staff can support you through the recovery stages, from alcohol detox to recovery programs and beyond.

My experience at Ardu has been phenomenal. The staff at Ardu is incredible, I have never felt so loved and cared for. They go above and beyond for their clients, they’re truly amazing people and very knowledgeable. You all have made such a huge impact on my life and recovery. I cannot thank you all enough, I would highly recommend Ardu to anyone struggling with addiction or mental health illnesses.

Jenna Perryman


What is gout?

Gout is a common yet very painful type of inflammatory arthritis. It arises when excess uric acid builds up in the bloodstream, causing urate crystals to deposit in the joints and other tissues. Uric acid is a waste product of the natural breakdown of certain compounds. Uric acid turns into crystals that trigger intense inflammation and swelling in the affected area. 

Gout is also called hyperuricemia because of the excess uric acid buildup. Here’s a step-by-step look at how gout develops:

  1. During normal cell processes, purines get metabolized. Purines are chemical compounds that occur naturally in the body and many types of food. They turn into uric acid during cellular processes such as DNA or RNA turnover, tissue repair, cell death, and digestion of purine-rich food.
  2. The levels of uric acid grow, accumulating in the bloodstream and tissues. Your kidneys struggle to efficiently filter out and excrete all of the built-up uric acid.
  3. As a result, excess insoluble uric acid develops into monosodium urate crystals in the spaces between cells, joints, cartilage, and tendons, causing irritation and inflammation.
  4. Your immune system immediately responds against the perceived foreign crystals, unleashing even more inflammatory signals to deal with the threat. Chemicals rush in to destroy and expel the crystals, provoking swelling, heat, skin redness, and pain.

The base of the big toe is the most frequent site of flare-ups that come and go. Gout attacks typically build up over 24 hours, persist for days to weeks if left untreated, and then subside until the next flare-up.

What are the symptoms of gout?

Gout symptoms range in severity and duration. Most of them are centered around intense inflammation, swelling, and pain. Symptoms tend to deteriorate and peak over the span of 8–12 hours after their initial onset.

The hallmark features of an acute gout attack include:

  • Sudden burning pain that typically manifests in the big toe and then travels to the ankles, wrists, or knees.
  • Rapid swelling.
  • Intense sensitivity to touch.
  • Red, inflamed skin stretched taut over the affected joint.
  • Difficulty moving or bearing weight.
  • Nodules under inflamed skin.
  • Chills, fever, and fatigue.
  • Visible accumulation of urate crystals under the skin known as tophi (more common in chronic gout)

While one area generally suffers an isolated attack, some people experience polyarticular flares that afflict multiple joints at once. Gout attacks typically resolve after pain or swelling peaks in a few days, either on their own or through medical treatment.

If uric acid levels are not properly controlled over time, chronic gout can cause significant damage in multiple joints. But what exactly causes the formation of uric acid-creating purines in the first place?

What causes gout?

Many factors can set the stage for the accumulation of uric acid in your body, which is the main precursor to the development of gout. The following factors either increase the production of uric acid or reduce breakdown and elimination.

  1. Some people are genetically predisposed to gout. A family history with instances of gout indicates inherited risk. 
  2. Kidney impairment is a big factor. Chronic kidney disease, aging kidneys, dehydration, and certain medications hamper the kidneys’ ability to filter out waste products such as uric acid.
  3. A diet rich in purines can generate excess uric acid. 
  4. Obesity is often associated with gout. Increased weight and associated health conditions take a toll on the kidneys and affect their ability to eliminate uric acid from the bloodstream.
  5. High blood pressure and metabolic syndrome reduce kidney perfusion, diminish function, and increase the accumulation of uric acid.
  6. Cellular damage from chemotherapy, trauma, surgery, or crash dieting can all accelerate cell turnover and the release of purine compounds needed to generate uric acid.
  7. Regular alcohol consumption strains the kidneys, interfering with the excretion of uric acid. 

Alcohol is a significant trigger for gout flare-ups. Luckily, booze is an adjustable lifestyle factor. Ditch drinking so your health can recover, and put those flare-ups behind you for good.

If you’re struggling to remain sober, our alcohol addiction treatment center can offer the help, support, and knowledge you need to take care of your body.

How does alcohol affect gout?

Alcohol consumption can increase the risk of incident gout and exacerbate its symptoms. The culprit is ethanol, the main constituent of alcohol. It carries potent inflammatory and dehydrating properties that negatively impact a wide range of bodily systems and contribute to the development of gout. 

Heavy drinking may not only increase the risk of gout flare, but also directly trigger recurrent flare-ups. Let’s deep dive into the harmful effects of alcohol on gout.

Ethanol is high in purines

Some alcoholic drinks are high in purines. The Arthritis Foundation claims that all types of alcoholic beverages are high in purines. 

Episodic alcohol intake triggers gout attacks, regardless of type of alcohol. Thus, individuals with established gout and pre-existing risk factors should limit all types of alcohol intake to prevent gout episodes. (Nieradko-Iwanicka)

Beer tops the list with far higher purine content than other beverages, but there are others that you should avoid if you’re prone to gout attacks. 

  1. Beer, especially darker varieties such as stouts and porters. They contain high amounts of purines called guanosine that get converted to uric acid.
  2. Gin made from juniper berries and rye mash is rich in purine supplies.
  3. Rum is produced from molasses and sugarcane byproducts. As a result, they provide a considerable level of purine content.
  4. Whiskey distilled from rye, barley, or wheat contains moderate purine levels.
  5. Fortified wines such as sherry, port, and Madeira are made from grains and grapes. They have higher purine amounts.
  6. Grappa, an Italian pomace brandy, contains purines from grape pressings. 

Medical News Today reports that alcohol is not only rich in purines but also prevents uric acid from leaving the body. 

Alcohol impairs kidney function

Your kidneys play a vital role in filtering the blood of excess uric acid. Heavy drinking strains the kidneys and interferes with the filtering process, leading to uric acid buildup. 

  1. The kidneys in heavy drinkers work harder to filter out harmful alcoholic byproducts, affecting their ability to regulate fluid and electrolytes in the body. You can thank alcohol’s dehydrating effects for that.
  2. Alcohol also disrupts important hormones that affect kidney function.
  3. Alcohol impairs liver function, leading to a wide range of alcoholic liver diseases. A liver that’s not working properly adds to the kidneys’ overload. 

Similar to alcohol, illicit drugs such as cocaine, amphetamines, and opioid abuse can also trigger or exacerbate gout. The general reason for this is the fact that alcohol and drugs ruin your kidneys, which indirectly increases uric acid production.

Read more about what drug addiction does to your kidneys.

Alcohol metabolism increases uric acid production

The complex process of alcohol metabolism releases harmful byproducts that increase levels of uric acid. Together, they boost inflammation, prolong gout flare-ups, and decrease the kidneys’ efficiency in filtering the blood.

  • As the body breaks down ethanol, lactic acid is generated. Lactic acid is an acidic waste product that builds up in your muscles during intense exercise, causing fatigue, soreness, and cramping. Research suggests that higher levels of lactic acid in the blood impair the kidneys’ ability to reabsorb uric acid from filtrate. The uric acid is accumulated and crystalized, leading to painful gout.
  • Acetaldehyde is the most toxic alcoholic byproduct. It contributes to the production of urate, a form of uric acid. Newcombe suggests that “the primary cause for the occurrence of hyperuricemia in this setting is an increased generation of NADH as a result of the oxidation of ethanol to acetaldehyde.”
  • Alcohol metabolism triggers ketone production. Ketones are organic compounds produced when the liver breaks down fats for energy. Newcombe explains that ketoacids affect the tubular transport of uric acid and that this impairs uric acid excretion.

Drinking accelerates cell turnover and purine generation

Regular exposure to alcohol increases and accelerates cell death. As cells expand, replicate, and die off at higher rates, they release intracellular components such as nucleic DNA or RNA. These compounds contain purine bases, the core building blocks for the synthesis of uric acid.

One study found that ethanol and acetate increase purine nucleotide degradation by enhancing the turnover of the adenine nucleotide pool. 

Extra cell generation and destruction when alcohol is present makes your metabolic pathways struggle to convert the sudden influx of purines into uric acid. The result is increased inflammation and build-up of uric acid crystals that cause joint pain. 

This DNA-level damage makes avoiding alcohol imperative for people with gout. You’d be surprised at what kind of damaging effects booze has on DNA.

Alcohol leads to weight gain and obesity

Too much booze has the potential to pack on extra pounds—and that’s a serious double whammy when it comes to gout.

Alcohol metabolism overwhelms the liver. Instead of burning calories and getting rid of excess fat, your body is stuck breaking down alcohol. That’s how you gain substantial weight over time. Research shows that obesity impairs kidney function and blood flow. Throw alcohol into the mix, and your kidneys become too overwhelmed to filter out that gout-provoking uric acid. 

Not to mention how all that excess weight places further strain on your already irritated joints,  intensifying the agony of gout attacks. A 2020 study found that “each 5 kg/m2 BMI increment was associated with a 55% elevated risk of gout.” 

Given alcohol’s extensive impacts on joint irritation, it might be a good idea to rethink drinking altogether. If you’re struggling with excessive alcohol consumption, don’t hesitate to seek professional help. Ardu is here for you every step of the way.

What are the symptoms of alcohol-related gout?

The symptoms of gout flares triggered by alcohol are typically no different than attacks caused by other factors. Occasional drinkers and long-term alcoholics experience intense pain, swelling, redness, inflammation, and tenderness in their big toes, ankles, knees, or wrists.

However, there are a few important differences:

  • The onset of alcohol-related gout attacks may be more acute since alcohol has a rapid impact that spikes uric acid levels much quicker.
  • Excessive alcohol intake can also make attacks more severe and prolonged.
  • After drinking, you’re more likely to experience flare-ups in multiple joints simultaneously.
  • The risk of gout attacks in the same joints is much higher when heavy alcohol consumption is involved. 
  • People battling chronic alcoholism may never experience symptom-free periods between painful flares.

Are you drinking too much? Your body can show physical symptoms of alcohol addiction that may not have anything to do with gout.

Does alcoholism make gout worse?

For people caught in the destructive cycle of addiction, alcoholism without question makes gout worse over time. Unlike an occasional drink here and there, alcoholism repeatedly spikes blood alcohol levels, placing a constant burden on your liver and kidneys. (You need those to work properly if you want to avoid recurrent gout attacks.)

Occasional drinking can impair the function of your organs, but imagine what chronic heavy drinking does to your body. The organs of heavy drinkers and alcoholics have a crippled ability to regulate fluids, produce energy, clear toxins, and perform other important duties that keep gout-inciting uric acid in check. 

Remember how alcohol accelerates cell turnover and purine release, which boosts the production of uric acid? In alcoholics, cells replicate and die off at accelerated rates. Purine-rich nucleic cellular debris floods the system, causing a spike in uric acid and those painful urate crystals that affect your joints. 

That’s why alcoholics experience far more frequent and severe gout attacks.

While an occasional drink may not be a huge problem, if you want the best odds of overcoming gout, it would be wise to abstain from alcohol altogether. In the long run, alcohol is bad for your brain, liver, kidneys, heart, immune system, skin… The list is endless. The decision to end alcohol dependency isn’t an easy one, but it truly is life-changing.

Contact the experts at Ardu Recovery Center and take your first steps toward a new life. 

Can I drink alcohol during a gout attack?

It’s generally a bad idea to drink any alcohol during an acute gout attack. An occasional drink may not always trigger gout for some people, but excessive alcohol concentrations in the blood during an active flare can be too risky. 

Here’s why:

  • Certain alcoholic beverages contain high levels of purine. 
  • All types of alcohol impair kidney function and hinder the excretion of uric acid from the blood.
  • Alcohol’s diuretic effects cause fluid loss and dehydration, which prevent your body from flushing out crystals.
  • Alcohol triggers widespread inflammation and suppresses your immune system, hindering your body’s ability to resolve acute gout flares.

It’s best to stay away from drinking until gout symptoms fully resolve and uric acid levels stabilize. Even better—stay away from alcohol for good and never worry about its damaging effects on your body again. Some alcohol damage is reversible, but your best bet is to quit drinking while you’re ahead.

Will gout go away if I stop drinking?

When you eliminate alcohol, you may be able to resolve gout attacks and potentially achieve long-term remission. Remember how alcohol triggers inflammatory processes on top of gout-induced? Once you take ethanol out of the picture, the amount of irritation and the accumulation of uric acid should be reduced.

Here’s what happens to chronic gout episodes when you stop drinking:

  • Your kidneys will be able to focus on their normal metabolic processes and properly filter uric acid from the bloodstream.
  • No alcoholic drinks—less dietary purine intake.
  • Cell turnover rate will reduce, leading to less purines for uric acid production.
  • Overall serum uric acid levels will return to normal.
  • Your painful gout attacks may reduce in intensity and recurrence. Once booze is out of the picture, you may experience long-term gout remission.
  • Alcohol was most likely reducing the efficacy of gout medication and other treatments. With no impediment to their effectiveness, you may experience longer-lasting improvement.

It’s always a good idea for your overall health to cut alcohol out of your life. Your kidneys, liver, heart, pancreas, and other vital organs will thank you.

Why do I get gout when I stop drinking?

We now know how alcohol increases the levels of uric acid in the blood, and how this leads to gout. But for some people, when they stop drinking, their bodies may undergo several changes that could potentially trigger a gout attack.

There are a few reasons why halting alcohol intake can trigger painful flares.

  1. Long-term alcohol abuse changes kidney transporters that regulate uric acid. When you suddenly quit, these pathways alter again, causing unstable uric acid levels.
  2. When drinking stops, the kidneys start retaining more fluid which can temporarily increase uric acid concentration and crystallization.
  3. Liver function improves when alcohol is removed. Your recovering liver can now break down tissues and repair the damage, paving the way for the release of more purines.
  4. When you stop drinking, your body undergoes alcohol withdrawal, which can cause many different physiological changes. Trevisian, et. al. suggest that some of them may potentially trigger a gout attack.
  5. Many people start losing weight rapidly once they say goodbye to booze. This sudden weight loss can cause a temporary increase in uric acid levels, potentially triggering gout.

Don’t let this dishearten you: the best thing you can do for your health is to quit alcohol. In the short term, quitting may trigger a gout attack. Look at the bigger picture—the absence of ethanol may help reduce the frequency and severity of gout attacks and lead to an overall improvement in health. If you experience gout attacks after you stop drinking, consult with a healthcare professional and learn how to manage your symptoms safely and prevent future flare-ups.

Ardu can help you detox safely from alcohol and set the stage for long-term gout remission and a return to health.

Ardu Recovery Center

Anyone struggling with alcohol abuse or alcoholism is welcome to take part in our addiction treatment program. Our recovery center is for people seeking help to overcome alcohol addiction and restore their physical and mental health. Our dedicated team of professionals is here to guide and support you in the addiction treatment process, laying the foundation for long-term sobriety and relapse prevention.

At our rehab center in Provo, Utah, our team specializes in helping those with dual diagnoses: addiction and concurrent health issues. We provide:

To enroll in an Ardu alcohol rehab program, contact us online or via phone (801-810-1234). We will do our best to find a recovery path that works for you during the detox process and beyond. For more information, read our admissions process page.

Getting proper treatment empowers you to manage alcoholism while implementing lifestyle changes to improve health. With compassion and expertise, we can help you achieve lasting sobriety and wellness. 

Alcohol and gout FAQ

Does alcohol limit gout?

According to epidemiologic studies and meta-analyses, alcohol does not limit or decrease gout risk. A 2014 study showed that alcohol intake can exacerbate gout by increasing urate production. 

Episodic alcohol consumption, regardless of type of alcoholic beverage, was associated with an increased risk of recurrent gout attacks, including potentially with moderate amounts. Persons with gout should limit alcohol intake of all types to reduce the risk of recurrent gout attacks.

This positive correlation was strongest with beer intake, followed by liquor consumption. Subjects in the study drinking four or more daily alcoholic beverage equivalents had a risk of gout that was twofold those who abstained during the preceding 24-hour period. 

Is whiskey good for uric acid?

Whiskey is not beneficial for uric acid levels or gout risk. As a type of liquor, whiskey has consistently been linked to increased serum urate production and blood levels. Neogi et al. found that subjects consuming liquor had a 1.6-fold increased risk of developing incident gout compared to wine drinkers or non-drinkers in age-adjusted models. This suggests that whiskey can also contribute to acute arthritis flare-ups in those with established gout due to spikes in urate levels. 

Moderation seems to be key if those with gout want to consume whiskey. 2 standardized drink servings daily appear safe for men, and 1 serving daily for women, without causing increased arthritis attacks. According to a Clin Rheumatol analysis, staying away from alcohol altogether seems to be the best solution for gout (and other health issues).

Is red wine OK for gout?

Some analyses have found that consuming moderate quantities of red wine does not increase gout risk or urate levels. A large prospective study following over 47,000 men for 12 years had subjects report their average alcoholic beverage intake over the preceding year. They found no association between moderate red wine intake, classified as 2 or fewer 4 oz glasses daily, and risk of incident gout diagnosis. 

These effects of alcohol intake point to the potential for non-alcoholic components in wine to offset uric acid excretion. Specifically, polyphenols found predominantly in wine demonstrate uricosuric effects in rat studies. Additional research is still needed to confirm if similar beneficial effects translate to humans with gout. Until then, rheumatoid arthritis guidelines caution restricting even moderate red wine intake during acute gouty arthritis flares to help control joint inflammation. 

How do you detox from gout?

An effective gout detox plan involves a multi-pronged approach to lower serum urate levels. Lifestyle changes play a key role, such as:

  • Staying well hydrated with non-alcoholic fluids to promote daily uric acid excretion
  • Abstaining from alcohol intake
  • Eliminating high dietary purine sources such as shellfish and red meat
  • Encouraging activity and exercise for optimal physical activity
  • Losing excess body weight for those overweight

Dietary adjustments also aid in urate reduction. These include increased intake of plant fiber sources, tart cherry products, skim milk dairy, certain supplements like vitamin C with uricosuric properties, and limiting sugar-sweetened beverages associated with higher gout incidence. 

It’s important to seek input from a rheumatologist or dietician that will include personalizing and monitoring medical therapy while incorporating these detoxifying lifestyle approaches to effectively manage gout and control symptomatic flares.

Is vodka OK for uric acid? 

There is limited research analyzing vodka’s effects on gout risk and urate levels specifically. Several epidemiologic studies have consistently linked liquor intake, regardless of type, with increased gout risk and serum urate levels. Even if vodka itself does not contain purines, data suggests it likely induces similar increases in uric acid production and reduces excretion comparable to other liquors through its alcohol content and dehydrating effects. 

For those with high baseline urate levels or pre-existing gout, maintenance of hyperuricemia could worsen disease progression and provoke painful arthritis flares. Moderation seems to be the key if you can’t help yourself drinking vodka. Limit your intake to one or fewer standardized drink servings per day, or avoid it altogether during acute gout attacks. 

Does beer increase uric acid? 

Several large epidemiologic studies have demonstrated clear positive correlations between beer intake and hyperuricemia as well as the development of primary gout. Of all alcoholic beverage types analyzed, beer consumption shared the strongest association with elevated uric acid measures and gout risk—even when adjusting for total alcohol intake. This effect is attributed to the high brewer’s yeast and grain content of most beers introducing purines that generate uric acid production. 

A cross-sectional analysis found that men consuming over 2 beers daily had an odds ratio of 3.07 for hyperuricemia and 1.77 for gout incidence relative to those drinking none. This suggests that even moderate daily beer intake promotes chronically higher urate levels. Those with asymptomatic hyperuricemia and particularly patients with tophaceous gout are better off avoiding regular beer and ale intake.

Does wine cause gout?

There is no clear evidence that low to moderate wine consumption can cause the onset or worsening of hyperuricemia or gout in studies conducted thus far. Most analyses have observed a non-linear relationship: heavy and excessive wine intake shows positive associations with recurring gout attacks and can provoke arthritis flares. Modest consumption within limits (1 glass for women, 1-2 glasses for men) has not demonstrated clear links to directly causing primary gout or persistently raising uric acid. 

Overall there is consensus among experts that patients with gout can safely consume limited wine servings per day and restrict intake during acute attacks. Those with recurrent arthritis flares may need to abstain due to indirect triggers.

Can I drink if I have high blood pressure and gout?

For people with co-occurring hypertension and gout, alcohol intake poses added risks. Alcohol may contribute to the development of hypertension—heavy consumption promotes spikes in systolic blood pressure as well as diastolic blood pressure, worsens hypertension control, and increases the likelihood of developing medication-resistant high blood pressure. 

Alcohol-induced hypertension can further compound inflammation and pain in those with inflammatory arthritis. Recent epidemiologic data highlights gout as a potential risk factor for myocardial infarction, stroke, and premature cardiovascular death irrespective of traditional risk factors like hypertension. 

A 2006 study found that “hyperuricemia and gouty arthritis are independent risk factors for acute myocardial infarction (MI), even when accounting for renal function, diuretic use, metabolic syndrome, and other established risk factors.”


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Further reading

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How do I know I have alcohol poisoning?

Is drinking bad for my teeth?

Is alcoholism a genetic disease?

How to overcome your alcohol addiction in 6 steps

What is a high-functioning alcoholic?

How can booze lead to cardiovascular disease?

How many drinks per day is too much?

How can I help someone I love with their alcohol addiction?