What types of alcohol are safe for consumption during a gout (gouty arthritis) flare?

From the Guidelines

No type of alcohol is beneficial for gout flare-ups, and all alcoholic beverages should be avoided during a gout attack. According to the 2020 American College of Rheumatology guideline for the management of gout 1, consuming more than 1-2 alcoholic beverage servings in the prior 24 hours was associated with a 40% higher risk of gout flare.

The effects of alcohol on uric acid levels are significant, with a unit of beer raising SU concentrations by 0.16 mg/dl 1. While the impact of diet or individual food items on SU concentration is small, the cumulative effect of regular alcohol consumption can exacerbate gout symptoms.

Key points to consider:

• Alcohol increases uric acid production in the body and decreases uric acid excretion through the kidneys, contributing to higher uric acid levels in the bloodstream
• Beer is particularly problematic due to its high purine content, which breaks down into uric acid
• Wine and spirits, although containing fewer purines than beer, still impair kidney function and dehydrate the body, making them harmful during gout flares
• The best approach for managing gout flares is to focus on drinking plenty of water to help flush uric acid from the system, and considering medications like colchicine, NSAIDs, or corticosteroids for acute treatment, as well as uric acid-lowering medications like allopurinol or febuxostat for long-term management, under the guidance of a healthcare provider 1.

From the Research

Types of Alcohol and Gout Flare

There is no direct evidence in the provided studies to suggest specific types of alcohol that are good for gout flare. However, some studies mention the relationship between alcohol intake and gout:

• Alcohol intake is listed as a risk factor for gout 2
• No specific type of alcohol is recommended for gout flare in the provided studies

Gout Treatment and Management

The provided studies focus on the treatment and management of gout, including:

• Urate-lowering therapy using allopurinol, febuxostat, and other medications 3, 4, 5, 6
• Anti-inflammatory treatment of acute flares using NSAIDs, colchicine, and corticosteroids 3, 4
• Lifestyle modifications as part of gout prevention 4

Urate-Lowering Therapy

The studies compare the effectiveness of different urate-lowering therapies, including:

• Allopurinol and febuxostat as first-line treatments 5, 6
• Febuxostat having worse cardiovascular safety profile 2, 4
• Allopurinol having worse persistence rates than febuxostat 6