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Has taking fish oils caused a gout flare up?

Q) My father has just been diagnosed with gout after a very nasty attack last week where his left toe swelled up. He has just recently started taking omega-3 fish oils for general health benefits but I see from your information booklet that fish oils are high in purines. Do the overall benefits to his health outweigh the increased risk of further attacks of gout or should he stop taking the fish oils altogether? What would you advise?
Wendy, Sheffield (Spring 2007)

A) I think you've misinterpreted the advice in the information booklet on gout – it's oily fish (sardines and mackerel) which are discouraged, not fish oils. Sardines and fish roe are high in protein and this is bad because an end product of protein metabolism is uric acid, the cause of gout. As cod liver oil is almost 100 percent fat it's unlikely to be a problem, providing you take it in moderation. Incidentally, probably the most common cause of a high blood uric acid in elderly people is the use of diuretic (water) tablets, but a moderate alcohol intake should also be considered a risk factor.

This answer was provided by Dr Philip Helliwell for the Spring 2007 edition of our magazine, Arthritis Today, and was correct at the time of publication.

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