Coffee Gout

Does Coffee Help or Hurt Gout?

Nearly two-thirds of Americans start their day with a cup or more of coffee. Besides its wake-up java jolt effect, coffee could be good for your health. Studies have linked regular coffee consumption with a lower risk for heart disease, some types of cancer, and type 2 diabetes, among other conditions.

Could your morning cup of Joe also help prevent bouts of painful gout? While some evidence suggests this popular beverage might help you avoid joint pain, the caffeine it contains might actually lead to more flare-ups if you already have gout.

Coffee and Gout Prevention

A 2007 study investigated the potential link between coffee intake and gout risk among nearly 46,000 men. The authors found that men who drank four to five cups of coffee a day had a 40 percent lower relative risk of gout compared to men who weren’t coffee drinkers. Decaf coffee also modestly lowered gout risk, but tea didn’t have any effect, suggesting that something other than caffeine is responsible for the effect on gout.

“There is a theory that a component of coffee, chlorogenic acid, an antioxidant, may actually be the reason that coffee is associated with a lower incidence of gout,” explains Elinor Mody, MD, director of the Women’s Orthopedic and Joint Disease Program at Brigham and Women’s Hospital in Boston.

Chlorogenic acid and other antioxidants help reduce blood levels of the hormone, insulin. Levels of insulin and uric acid (the chemical that triggers gout) are closely related. When insulin levels are low, uric acid tends to be lower, too. To illustrate the connection, another 2007 study by the same authors found that people who drank several cups of coffee a day had lower uric acid levels.

Caffeine and Gout Risk

While coffee might be helpful for preventing gout in people who don’t already have the disease, the caffeine it contains could spell trouble for people who already live with gout—particularly if they’re not consistent coffee drinkers. In a 2010 study, people who suddenly increased their intake of caffeinated beverages like tea and coffee were more likely to have gout attacks.

The reason? Caffeine is similar in structure to allopurinol, a drug used to treat gout, explains Tuhina Neogi, MD, associate professor of medicine and epidemiology at the Boston University School of Medicine and lead author of the study. “When people first start taking allopurinol, they have an increased risk of gout attacks as the uric acid is mobilized from body tissues. Over time, taking allopurinol consistently decreases the uric acid sufficiently such that attacks no longer occur.” That’s why people in Neogi’s study who drank caffeinated beverages from time to time had an increased of gout attacks, while those who drank these beverages consistently did not.

However, she said because her study didn’t differentiate sweetened from unsweetened caffeinated drinks, it wasn’t clear how much of the gout risk was due to sugar or high-fructose corn syrup (which can both increase blood uric acid levels) in the beverages.

The Coffee/Caffeine Conundrum

Neogi doesn’t recommend changing your coffee habits solely to lower your odds of getting gout. Instead, use more reliable preventive methods like watching your weight and limiting or avoiding foods known to trigger the disease, including meat, shellfish, and beer.

If you do drink coffee, try not to add sugar and high-fat dairy creams. And avoid unhealthy sources of caffeine. “I strongly advise patients to avoid drinking sodas or other drinks with high-fructose corn syrup added, not only for gout, but for numerous health issues,” Neogi says.

For those who already live with gout, good treatments are available to relieve joint pain and prevent future attacks. “I recommend that anyone with gout talk to their rheumatologist,” Mody advises.

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