Gout is a type of inflammatory arthritis that affects the joints of the body. Symptoms are most common in the feet and toes.
Gout is caused by a condition called hyperuricemia. This occurs when too much uric acid builds up in the body. Uric acid is created when chemical compounds called purines are broken down. When hyperuricemia occurs, uric acid can deposit crystals in the joints, triggering painful swelling and inflammation.
Gout affects roughly 4 percent of adults in the United States. There are many risk factors for gout. Certain conditions, such as blood and metabolism disorders can cause your body to produce too much uric acid. Other diseases, such as kidney and thyroid problems, can impair your body’s ability to eliminate uric acid.
Dietary habits, such as excessive alcohol consumption and eating foods high in purines (red meats and shellfish) or fructose (sugary beverages), can also lead to high uric acid blood levels. However, there’s conflicting information about coffee. Often, coffee drinkers worried about gout are left wondering: Is coffee helpful or harmful?
Let’s take a look at whether coffee raises or lowers your risk of gout, and how it fits into your diet if you already have gout.
Most scientific research studies suggest that coffee can play a role in lowering your risk of gout. Coffee contains a wide variety of beneficial compounds, including minerals, polyphenols, and caffeine. See more about the health benefits of coffee.
Coffee is thought to reduce gout risk by lowering uric acid levels through several mechanisms. Coffee may lower uric acid levels by increasing the rate that your body excretes uric acid. Coffee is also thought to compete with the enzyme that breaks down purines in the body. This can lower the rate at which uric acid is created.
A recent review of the research found that in many cases, drinking coffee was associated with lower levels of uric acid and fewer episodes of hyperuricemia.
In one Japanese study mentioned, researchers found that coffee consumption had an inverse relationship with uric acid levels. Those who drank the most coffee (roughly five cups per day) had the lowest uric acid levels among the study participants. Although both coffee and tea were tested, these results seemed to apply only to coffee.
This evidence implies that compounds in coffee other than caffeine may play a role in lowering uric acid levels.
Another systematic review seems to support this idea. In this 2014 review, the researchers mention two coffee and gout studies from the Third National Health and Nutrition Examination Survey. In one of the studies, both coffee and tea consumption were analyzed next to serum uric acid levels. The researchers found that coffee consumption, but not tea consumption, was associated with lower uric acid levels and hyperuricemia risk.
Why coffee might be beneficial
There are a few reasons why coffee may provide a protective effect against the buildup of uric acid. To understand why, we first need to understand how certain medications for gout work.
There are two types of gout medication that your doctor may prescribe: xanthine oxidase inhibitors and uricosurics.
Xanthine oxidase inhibitors function by inhibiting the activity of xanthine oxidase. Xanthine oxidase is an enzyme that helps the body metabolize purines. Since purines are a source of uric acid, inhibiting this enzyme can help to keep uric acid levels low.
Caffeine is considered to be a methyl xanthine. Therefore, it can also compete with and potentially block the action of xanthine oxidase.
Uricosurics function by helping the kidneys rid the body of uric acid. Although caffeine isn’t necessarily considered a uricosuric, it may function in a similar manner.
Research has suggested that chlorogenic acid, a polyphenol found in coffee, may help to improve insulin sensitivity. One study found that in people with hyperinsulinemia, there was a decline in both sodium and uric acid excretion via the kidneys. When insulin levels decreased, and insulin sensitivity improved, sodium and urate elimination improved as well.
There’s a lack of research that suggests coffee may contribute to raising your risk of gout. However, some researchers believe that there’s insufficient evidence in favor of drinking coffee to reduce gout risk.
In one systematic review, 11 studies were investigated for their results on coffee intake and serum uric acid levels. The researchers found that while there was evidence to suggest coffee intake reduces gout risk, the results were not statistically significant enough to matter.
In addition, one study showed a much different relationship between coffee intake and serum uric acid levels. In that study, researchers discovered that uric acid levels increased during coffee consumption periods and decreased during periods of no coffee intake.
Additional research also suggests it’s genetic variations that play a role in the relationship between coffee consumption and gout risk. In this analysis, certain SNPs (or genetic variations) related to urate metabolism were found to be associated with a higher risk of gout. These same SNPs were also linked to reduced coffee consumption.
This research doesn’t necessarily suggest a negative impact of coffee on gout risk. Rather, it suggests that the relationship between gout and coffee may be influenced by genetics.
Why coffee might be harmful
There’s very little evidence that suggests coffee intake causes gout or increases the risk of a gout flare-up. Although the majority of evidence is in favor of drinking coffee to reduce gout risk, there’s still room to continue to expand the research.
Most of the research points to the fact that drinking coffee can potentially lower your risk of gout. The primary risk factors for gout include:
- being male
- being obese
- a family history of gout
- certain medications
- health conditions, such as hypertension, congestive heart failure, kidney disease, and hyperlipidemia
- significant alcohol consumption
- a diet high in purines (red meat, shellfish, sugary drinks)
If you already have gout, drinking coffee may help to reduce your chance of having a flare-up. This is because coffee may help to lower the uric acid your body creates. It may also improve your body’s excretion of uric acid.
Research also suggests that tea and decaffeinated coffee don’t have the same uric acid-lowering effect that coffee does. Instead, the benefits seem to be the most pronounced with daily, regular coffee intake.
Ultimately, if you’re concerned about your risk of developing gout or triggering a gout attack, reach out to your doctor for more information on how to manage your condition.