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> > > > Self-help and daily living for gout

Self-help and daily living for gout

Healthy lifestyle choices

There are a number of changes you can make to your diet and lifestyle to help ease attacks of gout. The most useful things you can do are:

  • losing weight if you’re overweight or obese
  • reducing the foods you eat which are high in purines
  • avoiding excess alcohol, especially beer and spirits
  • avoiding dehydration by drinking plenty of water.

Weight loss

Losing weight sensibly and gradually, if you need to, is the most effective dietary treatment for gout because it can greatly reduce the urate levels in your body. The larger someone’s body is, the more urate is produced.

Weight loss should be gradual and combined with daily exercise. Extreme weight loss or starvation diets increase cell breakdown in your body, which can raise urate levels.

The best way to lose weight is to have a low-fat, balanced and nutritious diet and to exercise regularly, preferably daily.

If you are new to exercise or haven’t exercised for a while, it might be a good idea to talk to your doctor before exercising. A sensible and sustainable approach is to start off an exercise regime with fairly short, but frequent workout sessions, and then to gradually build up the length and intensity of your exercise sessions. Aerobic exercise in which you get out of breath is particularly good for burning calories.

If you regularly burn off more calories than you consume on a daily basis you will lose weight. Determination and motivation are key factors in losing weight.

It helps to find a sport or exercise you enjoy which you will keep doing. Some people find that joining a leisure centre or sports club can help as meeting new people can be fun and motivational.

Lifestyle choices are not the main reason why most people get gout. However, someone who has a healthy lifestyle and also takes prescribed medication will give themselves the best chance of lowering urate levels and this will reduce the likelihood of having attacks of gout.

We don’t recommend Atkins-type weight loss diets for people who are prone to gout. These diets include a lot of meat and are therefore high in animal proteins, which are high in purines and which break down to produce urate.

Read more about exercise and arthritis and about diet and arthritis.

Fluids

Drinking plenty of water may reduce your risk of an attack and of urate forming crystals in joint tissues. If you have kidney stones, you may need as much as  3.5 litres (6 pints) a day. Even if you don’t have kidney stones, you should aim for at least 1 litre (2 pints) of fluid a day.

You can include some other fluids besides water in this total but not beer or other alcoholic drinks.

Sugary fizzy drinks and fruit juices can be high in sugar and fructose content. Keep these to a minimum as fructose sugar is likely to increase the level of urate in your blood. Diet soft drinks don’t appear to increase the risk of gout.

There's some research which suggests that drinking coffee regularly may help by increasing the amount of urate your kidneys get rid of. This doesn’t appear to be due to caffeine but to some other factor that we don’t know about yet.

Drinking a glass of skimmed milk every day may help to prevent attacks of gout.

Alcohol

Drinking too much alcohol, especially beer and spirits, may increase your urate levels and your chances of having a gout attack. A moderate intake of wine doesn't appear to increase the risk.

It's important for many reasons to drink alcohol only in moderation, especially if you have gout. New government guidelines state that men and women shouldn't drink more than 14 units of alcohol a week.

Fourteen units is equivalent to six pints of beer which is 4% alcohol by volume (proof); or six 175 ml glasses of 13% proof wine. The government guidance strongly advises you to make sure you have alcohol free days every week without 'saving units up' to drink in one go.

Your doctor may suggest you drink well below these weekly limits if you have gout.

The charity Drinkaware as well as the NHS Choices website are reliable sources of information on alcohol. Remember that units are calculated from the strength of the drink as well as the quantity.

Other diet tips

Limiting your intake of foods that are particularly high in purines may be helpful, whether or not you need to lose weight.

Foods high in purines include:

  • red meat and offal – for example beef, kidneys, liver, sweetbreads
  • oily fish – for example anchovies, fish roes, herring, mackerel, sardines
  • foods rich in yeast extracts – for example Marmite, Bovril, Vegemite.

Aim to reduce the amount of protein you get from meat. Try replacing one portion of meat or fish a day with other sources of protein, such as beans, eggs, pulses or low-fat dairy products.

Vitamin C encourages the kidneys to get rid of more urate, so a diet rich in vitamin C may be helpful. This is another reason to make sure your diet includes plenty of fruit and vegetables. There’s some evidence that cherries may be particularly beneficial – either the fruit or the juice, fresh or preserved.

Complementary medicine

There’s little evidence for many of the other natural or herbal remedies and supplements available for gout. These include celery seeds, garlic, artichokes and saponins (natural compounds found in peas, beans and some other vegetables).

Generally speaking, complementary and alternative therapies are relatively well tolerated, but you should always discuss their use with your doctor before starting treatment. There are some risks associated with specific therapies.

In many cases the risks associated with complementary and alternative therapies are more to do with the therapist than the therapy. This is why it’s important to go to a legally registered therapist, or one who has a set ethical code and is fully insured.

If you decide to try therapies or supplements you should be critical of what they’re doing for you, and base your decision to continue on whether you notice any improvement.

Read more about complementary therapies and arthritis.

For more information, go to www.arthritisresearchuk.org.
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