Gout & Alcohol: Why It Matters
You won’t necessarily have to give up alcoholic beverages if you’re diagnosed with gout. Why does alcohol intake matter at all? Some people who drink a lot of alcohol never get gout. Alcohol can increase levels of uric acid in your body. So it can be a strong cause of hyperuricemia and gout. Alcohol works to raise urate levels by decreasing how much urate your kidneys excrete. Beer has earned a reputation as being especially bad for gout, since it has this effect on your kidneys, but also because beer has its own proteins that are broken down to urate in the body. So drinking beer raises urate in two different ways.
Beer and liquor are especially linked to higher uric acid levels, and wine is linked to this as well. Moderate intake of alcohol is generally defined as two drinks per day for men and one drink per day for women. However, even moderate drinking on a regular basis (which is common for many adults) is associated with a higher risk of recurring gout attacks.
You may be able to drink occasionally and not experience a gout flare, but regular drinking of any type of alcohol (especially beer and liquor, and mixed drinks with sugary sodas or juices) puts you at risk. Also, heavy or even regular moderate drinking adds calories to your daily intake. It can contribute to weight gain in some people (the “beer belly” or “wine gut”).
Also, when making any changes in your diet or alcohol intake related to gout, remember that timing is important. During the first 6 months of taking a urate lowering medication such as allopurinol to lower your urate, you are at especially at risk for gout attacks. This is a great time to be strict with your diet, and to limit your alcohol intake as much as possible. 6 or 12 months down the line as you continue your medication, often your gout attacks are rare or absent, and a lot of the urate has been removed from your joints. At that point, your risk of gout is less and you may well be able to a little less strict with your diet without as much risk of setting off a gout flare.
While only you can decide how much, what or when to drink alcohol, your doctor and nurses can advise you on how to make these changes in a healthy way. Keep these thoughts in mind when you talk about drinking with your healthcare professionals:
Be honest with your doctor and nurses about your regular alcohol intake. Don’t downplay how much or how often you drink. You are not a “bad person” if you drink. Clear information on your alcohol intake can help your healthcare professionals advise you on your risk.
If you’re not sure how much you drink on a regular night out or don’t keep track, write down what you drink in a diary or notepad for a few weeks. Share it with your healthcare professionals.
If you’re not sure how much alcohol is in a normal serving, ask. In general, 12 ounces of beer, four fluid ounces of wine and one ounce (a jigger) of liquor is a serving. Mixers add liquid and, if they contain sugar, calories to a “drink.” A great idea if you are making a drink at home is to use a liquid measuring cup, then pour the proper amount into your glass.
If you would like to cut back on your drinking—either the amount or frequency—but find that it’s hard, ask for help. Talk with your doctor and nurses about ways you can reduce your intake. Ask about resources like counseling that may help you make these changes.
Tips to Cut Back on Alcohol
Order non-alcoholic drinks when you’re out with friends or family. Iced tea, coffee, flavored seltzers or club soda with a lime wedge may be good alternatives to beer or booze.
Set goals. Pick days when you will drink and days when you won’t drink. Keep track of it on your calendar. Set a limit for how much you will drink that night and stick to it. Don’t “save it up” for one night per week and overdo it.
Don’t keep alcoholic beverages in the house. If they’re on hand, it’s easy to reach for them when you want to unwind or if you feel stressed.
Sip, don’t guzzle. Don’t rush through your drinks so they last longer. Sip or “nurse” a drink while you enjoy talking to your friends or watching the game on TV. Don’t let anyone else push you to drink faster or more than you want.
Avoid tempting scenarios. If you typically drink a lot of alcohol in certain settings or during certain activities, such as when you meet your friends to watch sports or after work for happy hour, it’s OK to skip those outings or cut way back on how many you attend.
Are people who encourage you to drink when you’re trying to cut back on or avoid alcohol really your friends? If you decide to quit drinking, drink non-alcoholic beverages instead or simply cut way back on the nights when you drink, your friends and family members should support your decision. They should understand that you’re doing this for your health. If they tease you or try to encourage you to drink “just this one time because it’s a special occasion,” try to stick with your plan not to drink. It’s your body and your life. You don’t need to drink any alcohol to celebrate an occasion or to have fun. While you can’t change your family, you can stop hanging out with friends who don’t support your decision not to drink.
Don’t get discouraged. If you have been a moderate or even heavy drinker for years, it’s not easy to suddenly quit or cut way back. Many men and women socialize or relax with drinking. Many people associate alcohol with celebrating, such as champagne at weddings or New Year’s Eve, or beer when watching football games. You can make changes to how much and how often you drink, and still be a fun person who enjoys life. Don’t give up! You may have setbacks at times. Ask for support if you need it.