Phone hours: 8:30 am - 4:30 pm
For people living with gout, enjoying a glass of beer or wine isn’t always so simple. What starts as a relaxing drink can end with swollen joints, sharp pain, and sleepless nights. Why is alcohol such a potent gout risk? And does every kind of drink carry the same danger?
New Jersey’s top gout specialists break down the science, explore the differences between types of alcohol, and dive into the role of uric acid. If you or someone you love is navigating life with gout, understanding how alcohol plays a part can help you make better choices and avoid those painful flare-ups.
What Is Gout?
Gout is a form of inflammatory arthritis caused by excess buildup of uric acid in the blood. This buildup causes the formation of sharp urate crystals in joints and surrounding tissues — most commonly in the big toe, but other joints can be affected, too.
During a gout attack, the immune system reacts to these crystals as if they’re invaders. This sets off a cascade of painful symptoms: redness, swelling, warmth, and intense pain. While a single flare may last a few days, repeated episodes can lead to long-term joint damage if not treated properly.1
The Role of Uric Acid in Gout Development
Uric acid is a waste product that forms from the breakdown of purines, which are naturally found in the body and in some foods. Normally, uric acid dissolves in the blood and exits through the kidneys into the urine. But when too much is produced or not enough is excreted, it can crystallize and lodge in joints.
Diet plays a huge role in this balance. High-purine foods like red meat, seafood, and, yes, alcohol increase the body’s uric acid load. When that overload becomes chronic, gout can develop or worsen.2
How Alcohol Affects Uric Acid Levels
Alcohol not only raises uric acid levels, but it also makes it harder for the body to eliminate uric acid.
Although different types of alcohol contain different levels of purines, they all stimulate purine breakdown in the liver. When alcohol, particularly beer and spirits, is metabolized, the liver rapidly consumes adenosine triphosphate (ATP) and converts it into adenosine monophosphate (AMP). AMP then breaks down into uric acid, which heightens the risk of gout flares.3
At the same time, alcohol impairs kidney function, reducing the body’s ability to excrete uric acid efficiently. This combination of accelerated production and impaired elimination promotes uric acid buildup and raises the risk of gout flare-ups.3
Beer, Wine, and Spirits: Which Are More Likely to Trigger Gout?
Not all alcohols are created equal when it comes to gout. Multiple studies have investigated how different alcohol types affect gout, and their findings indicate that some beverages pose a much higher risk than others.
Beer
Beer is the worst offender. Not only is it alcoholic, but it also contains high levels of guanosine, one of the purines that break down into uric acid. Studies show that even moderate beer consumption significantly increases the risk of gout attacks while stimulating lactic acid buildup, which traps uric acid in the body.3,4
Spirits (Vodka, Whiskey, Other Liquor)
Liquor falls in the middle. It contains fewer purines than beer, but regular consumption can still impair kidney function and raise blood uric acid levels. Spirits should ideally be avoided or, at the very least, be consumed in moderation if you’re prone to gout.3,4
Wine
Surprisingly, wine is the least likely to trigger gout, but that doesn’t mean it’s entirely safe. Some studies suggest that moderate wine consumption may not raise uric acid levels as much as other alcohols, but heavy consumption still poses a risk.3,4
Gender Differences: Does Alcohol Affect Men and Women Differently?
Gout is more common in men, largely because men naturally have higher uric acid levels. But interestingly enough, studies show that lower testosterone levels are linked to higher uric acid levels.5,6 The reason is that low testosterone might:
- Make the body more insulin resistant, which affects how uric acid is removed5,6
- Affect protein and purine metabolism, potentially increasing uric acid production5,6
- Affect kidney function, which controls how uric acid is flushed out5
On the other hand, women are more likely to develop gout after menopause. Estrogen helps the kidneys flush out uric acid more efficiently. So, when estrogen levels drop after menopause, uric acid builds up, which increases gout risk.7,8
For both sexes, heavy or chronic alcohol consumption is associated with increased uric acid levels and a greater risk of developing gout or experiencing more frequent flares.9
Recognizing the Symptoms of a Gout Flare-Up
Early recognition can help minimize the damage of a gout attack. Symptoms often come on suddenly, especially at night, and may include:
Severe Joint Pain
Most commonly in the big toe, but also in ankles, knees, elbows, wrists, and fingers. The pain is often described as intense and throbbing.
Lingering Discomfort
Even after the sharpest pain fades, you may feel joint discomfort that lasts for days or even weeks.
Inflammation and Redness
The affected joint typically becomes swollen, warm to the touch, and visibly red in color.
Limited Range of Motion
Ongoing inflammation can lead to joint stiffness and reduced flexibility.
The Impact of Alcohol on Gout Medications
For those taking medication to manage gout, alcohol can get in the way — literally. Common gout treatments work by reducing uric acid production or reducing inflammation. But alcohol can diminish their effectiveness or increase side effects.10
For example:
- Allopurinol and febuxostat lower uric acid, but alcohol consumption can offset their progress by causing uric acid spikes.
- Colchicine, often used to reduce inflammation during a flare, may cause gastrointestinal side effects like nausea and diarrhea, effects worsened by alcohol.
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), another common option for flares, can be harsh on the stomach and kidneys. When mixed with alcohol increases, there is a higher risk of internal bleeding.
It’s always wise to speak with a doctor about how medications interact with alcohol. Even moderate drinking might call for adjusting your treatment plan.
Can Infusion Treatments Help with Gout Management?
In some cases, oral medications alone aren’t enough. That’s where infusion therapy comes in as a powerful, targeted treatment option for managing chronic gout.
Infusion treatments for gout involve delivering medication directly into the bloodstream to provide faster relief, especially for those with severe gout, kidney issues, or poor tolerance for pills. At IDYLLIC Infusion Treatment Center, we use KRYSTEXXA to treat chronic gout in patients who have not responded well to other medications. It works by breaking down uric acid into a more easily excreted substance called allantoin.
It’s important to first consult with a primary care provider or rheumatologist. If they agree that infusion therapy could benefit you, the next step is working with a specialized infusion team. We provide expert-guided, personalized care in a calming environment.
Don’t Let Gout Control Your Life — Take the First Step Today
Gout doesn’t have to be a guessing game. Understanding how alcohol impacts your uric acid levels and overall health is a big step in reducing flare-ups and reclaiming control. While skipping that next drink might not be easy, saving your joints from agony? It’s worth it.
Whether you’re newly diagnosed or have been battling gout for years, treatment options are evolving, and help is just around the corner. Talk with your ARBDA doctor today about your symptoms, triggers, and whether advanced therapies like infusion treatment could work for you. Together, you can build a plan that fits your lifestyle and helps you live with less pain, more freedom, and better health.
1https://www.niams.nih.gov/health-topics/gout
2https://pmc.ncbi.nlm.nih.gov/articles/PMC9459802/
3https://pmc.ncbi.nlm.nih.gov/articles/PMC3991555/
4https://pmc.ncbi.nlm.nih.gov/articles/PMC9028689/
5https://pmc.ncbi.nlm.nih.gov/articles/PMC9148059/
6https://pmc.ncbi.nlm.nih.gov/articles/PMC7844527/
7https://pmc.ncbi.nlm.nih.gov/articles/PMC3142742/
8https://pmc.ncbi.nlm.nih.gov/articles/PMC8675498/
9https://pubmed.ncbi.nlm.nih.gov/39196557/
10https://www.mayoclinic.org/diseases-conditions/gout/diagnosis-treatment/drc-20372903
