Does Monosodium Glutamate (MSG) cause gout?

MSG Salt and Gout: No Direct Causal Relationship

There is no evidence that monosodium glutamate (MSG) causes gout or triggers gout attacks. While gout is caused by the deposition of monosodium urate crystals in joints and tissues, this is unrelated to dietary MSG consumption.

Understanding Gout and Its Causes

Gout is the most common form of inflammatory arthritis, characterized by:

• Deposition of monosodium urate crystals in joints and tissues due to chronic hyperuricemia 1
• Acute attacks presenting as self-limited episodes of synovitis, often called "gout flares" 1
• Significant impact on quality of life and work productivity 1

Primary Risk Factors for Gout:

• Hyperuricemia (elevated serum uric acid levels) 1
• Genetic factors, particularly polymorphisms of renal transporters of urate 1
• Dietary factors including:
  • Purine-rich foods (especially organ meats and shellfish) 2, 3
  • Alcohol consumption, particularly beer 2, 4
  • High-fructose corn syrup 2, 4
• Medical conditions and medications:
  • Obesity and metabolic syndrome 1, 5
  • Hypertension 1
  • Diuretic use 1, 4
  • Chronic kidney disease 1

MSG vs. Monosodium Urate: Important Distinction

Despite the similar name, it's important to understand:

• Monosodium glutamate (MSG) is a food additive and flavor enhancer composed of sodium and glutamic acid 5
• Monosodium urate is formed from uric acid (a breakdown product of purines) and is the crystal that causes gout 1
• These are completely different chemical compounds with different metabolic pathways 5

Evidence-Based Dietary Recommendations for Gout

Current guidelines for gout management focus on specific dietary modifications:

• Limit consumption of purine-rich foods, especially those of animal origin 2, 3
• Avoid or reduce alcohol intake, particularly beer 1, 2
• Avoid beverages sweetened with high-fructose corn syrup 2, 4
• Encourage consumption of vegetables and low-fat dairy products 2, 5
• Consider weight loss for overweight/obese patients 1

None of the major guidelines or research studies on gout mention MSG as a risk factor or trigger for gout attacks 1.

Low-Purine Diet for Gout Management

Research supports that a low-purine diet can be effective in reducing gout attacks:

• A case-crossover study found that higher purine intake increases the risk of recurrent gout attacks by almost fivefold 3
• A retrospective study showed that patients following a low-purine diet after sleeve gastrectomy had fewer gouty attacks compared to those on a normal-purine diet 6

Common Pitfalls in Gout Management

When counseling patients about gout, be aware of these common misconceptions:

• Focusing only on serum uric acid levels without addressing dietary and lifestyle factors 1
• Discontinuing urate-lowering therapy during acute attacks, which can worsen and prolong the attack 7
• Failing to provide prophylaxis when initiating urate-lowering therapy 7
• Overlooking the importance of treating comorbidities that contribute to hyperuricemia 1

Conclusion

While dietary factors play an important role in gout management, there is no evidence in current guidelines or research that MSG consumption causes gout or triggers gout attacks. Patients with gout should focus on limiting purine-rich foods, alcohol, and high-fructose corn syrup while maintaining a healthy weight.