Coffee Consumption and Uric Acid Levels
Frequent coffee drinking does not increase uric acid levels; in fact, it significantly lowers serum uric acid and reduces the risk of hyperuricemia and gout. 1, 2
Evidence from Guidelines and Research
The relationship between coffee and uric acid is well-established through multiple high-quality studies:
Coffee Lowers Serum Uric Acid
Men require 1-3 cups daily to achieve significant uric acid reduction, while women need 4-6 cups daily for the same effect, demonstrating important gender differences in dosing. 2
In a nationally representative US sample of 14,758 adults, consuming 4-5 cups of coffee daily lowered serum uric acid by 0.26 mg/dL, while ≥6 cups daily reduced it by 0.43 mg/dL compared to non-drinkers (P < 0.001). 1
The multivariate odds ratio for hyperuricemia in individuals drinking ≥6 cups daily was 0.57 (95% CI 0.35-0.94), representing a 43% risk reduction. 1
The Mechanism is Not Caffeine-Related
Decaffeinated coffee also shows an inverse association with serum uric acid levels (P = 0.035), indicating the protective effect comes from non-caffeine components of coffee. 1
Tea consumption and total caffeine intake from all beverages show no association with serum uric acid levels (P = 0.15), confirming that caffeine itself is not the active agent. 1
This finding is reinforced by guideline evidence showing that coffee, tea, beer, and wine reduce stone formation risk, but the mechanisms differ by beverage type. 3
Gout Risk Reduction
Coffee intake of ≥1 cup daily is significantly associated with reduced gout risk, with a negative dose-response relationship for both genders—more coffee equals lower risk. 2
This protective effect is consistent across multiple populations, including Japanese men where those consuming ≥5 cups daily had serum uric acid levels 4 mg/L lower than those drinking <1 cup daily (P < 0.0001). 4
Important Caveats and Context
Conflicting Evidence Exists
One 2020 Korean study found no significant relationship between coffee consumption and serum uric acid levels in 3,005 participants. 5 However, this single study is outweighed by multiple larger, higher-quality investigations showing consistent inverse associations. 1, 6, 2, 4
Contrast with Fructose
While coffee lowers uric acid, fructose consumption increases it through rapid ATP depletion during metabolism, leading to adenosine monophosphate conversion to uric acid. 3 This mechanism explains why sugar-sweetened beverages (especially those with high-fructose corn syrup) should be avoided, while coffee should be encouraged. 3
Clinical Application
Coffee drinking appears protective and can be recommended as part of lifestyle modifications for patients with hyperuricemia or gout, alongside weight loss, limiting alcohol (especially beer and spirits), and avoiding sugar-sweetened drinks. 3
The European League Against Rheumatism guidelines support encouraging low-fat dairy products and regular exercise, and coffee fits within this framework of beneficial dietary modifications. 3
Coffee consumption up to 2 cups daily decreases alcoholic cirrhosis risk by nearly half (relative risk 0.62), demonstrating broader hepatoprotective effects beyond uric acid reduction. 3