From the Guidelines
Vitamin C supplementation has been shown to reduce serum urate levels, and thus, may be beneficial in managing gout, as evidenced by a systematic review of 13 trials 1. The relationship between ascorbic acid (Vitamin C) and gout is one of potential benefit, with low-quality evidence suggesting that vitamin C supplementation can lower serum urate levels by −20.8 µmol/L [−0.35 mg/dL] 1.
Key Points to Consider
- The reduction in serum urate levels associated with vitamin C supplementation may help in managing gout, given that urate crystalizes at a level greater than about 416 µmol/L (7 mg/dL) 1.
- While the evidence is not strong, vitamin C may have mild uricosuric effects, helping the body eliminate excess uric acid through urine, and it also has antioxidant properties that can reduce inflammation associated with gout attacks.
- For prevention or management of gout, considering vitamin C supplementation at doses of 500-1,000 mg daily may be beneficial, but it should not replace standard gout medications like allopurinol or febuxostat 1.
- It is crucial to discuss the initiation of vitamin C supplementation with a doctor, especially for individuals who already have gout, as it might potentially trigger flares in some people when first introduced.
Lifestyle Modifications
- In addition to vitamin C supplementation, maintaining a healthy weight, staying hydrated, limiting alcohol consumption, and avoiding high-purine foods such as organ meats, shellfish, and certain alcoholic beverages can help manage gout 1.
- A diet rich in low-fat dairy products, vegetables, and cherries, and low in red meat, shellfish, and yeast-rich foods, may also be beneficial, although evidence on dietary changes specifically for gout management is not conclusive 1.
From the Research
Relationship Between Ascorbic Acid (Vitamin C) and Gout
- The relationship between ascorbic acid (Vitamin C) and gout has been studied in various research papers 2, 3, 4.
- Studies have shown that higher vitamin C intake is associated with lower serum uric acid levels, which can help prevent the development and recurrence of gout 2, 3.
- A prospective study found that men with higher vitamin C intake had a lower risk of gout, with a multivariate relative risk of 0.83 for total vitamin C intake of 500 to 999 mg/d and 0.55 for 1500 mg/d or greater 3.
- Another study found that vitamin C supplementation reduced new gout diagnoses by 12% in middle-aged male physicians, with the greatest effects seen in those with a BMI <25 kg/m2 4.
Mechanism of Action
- The exact mechanism of how vitamin C affects gout is not fully understood, but it is thought to be related to its ability to reduce serum uric acid levels 2.
- Vitamin C may also have anti-inflammatory properties, which could help reduce the symptoms of gout 2.
Clinical Implications
- The studies suggest that vitamin C supplementation may be beneficial in the prevention of gout, particularly in individuals with high serum uric acid levels or a history of gout attacks 3, 4.
- However, more research is needed to determine the optimal dose and duration of vitamin C supplementation for gout prevention and treatment 4.
- Vitamin C supplementation should be considered as part of a comprehensive treatment plan for gout, which includes dietary changes, lifestyle modifications, and medication as needed 2, 5.