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Can Drinking Beer Trigger a Gout Attack?

By Edited Nov 6, 2016 1 0

Drinking Beer

A lot of avid beer drinkers I know today are suffering from gouty arthritis. At first, I thought it was probably due to the foods they regularly consume while enjoying a few bottles of this alcoholic beverage. However, upon doing some digging, I found out that there is actually a correlation between gout and beer. So, how does beer trigger gout? You will know more as you read further. 

A Brief Description of Gout

Gout is a type of arthritis that is medically characterized by joint stiffness, swelling and pain. It is normally observed in one's big toe, but it can also manifest in other joints of your body. For individuals who are also suffering from osteoarthritis, they typically experience gout attacks in the joints of their fingers.

There are certain features that make this medical condition unique from its counterparts. One in particular is the abrupt occurrence of symptoms which completely ends after a certain period of time. Another distinct characteristic is the formation of a large crystal made of uric acid known as tophi. With these unique features, there is one common question almost everyone wants to know.  So, how does a person develop gouty arthritis?

Diagram of gout in big toe

In one of my previous articles entitled Arthritis as a Degenerative Disease: Important Facts to Remember, I've mentioned that gouty arthritis occurs when someone has accumulated high amounts of uric acid in their system. But, what causes uric acid build-up?

Several factors may cause this abnormality. It can be due to insufficient intake of vitamin C. Some medical conditions and medications such as diuretics can also influence a rise in uric acid levels in your body. But, the most common factor that leads to gout is the food and beverages you consume. To name a few; purine rich foods, high-fructose drinks and alcoholic beverages are some of the most common culprits that can increase your chance of experiencing this specific type of arthritis.

So, can beer drinking trigger a gout attack? If yes, what is the relationship between gout and alcohol consumption? 

Getting to Know a Beer's Contents

Before we go to the core topic of this article, let me first give you a brief introduction about the most common contents of this type of alcoholic drink. Although there are several kinds of beers sold all over the world, all beers have a lot of things in common.

Having the same brewing process is just one of the commonality in all beer products. Aside from that, they also have the same basic ingredients. Each ingredient plays a vital role in creating a complex yet distinct flavor that some of you may or may not favor. But, which of these ingredients can substantially explain the connection between gout and beer? 

Beer bottle

1. Malt or Grains 

Beer brewing is a very long process that involves chemical conversion. One in particular is converting sugar into alcohol.

Basically, among the four main ingredients of beer, malt like barley or unmalted grain like rye is the constituent responsible for the beer's sugar content. Hence, malt is a valuable component of this beverage. Without it, this beverage will not give you an extraordinary flavor and the sedating or relaxing effects of a typical alcoholic drink brings. 

2. Hops

We all know that beer is prominent for its bittersweet zest. But, what exactly is the reason for this distinct flavor? Hops is actually the bitter constituent of this beverage. It then balances the sweetness that the malt provides, bringing forth a bitter yet sweet effect on your taste buds.  

3. Yeast 

Of course, this beverage is incomplete without its alcohol content, albeit it only ranges from 3% to 4% per volume and a little higher for pale lagers.

A Glass of Beer
As I've mentioned above, converting one chemical to another is imperative to make this type of alcoholic beverage. To make this happen, yeast is typically added to the group. Basically, this ingredient activates the so-called fermentation process. During this process, sugar is chemically converted into carbon dioxide and ethyl alcohol. Thus, yeast is responsible for both the carbonation and alcohol content of this product.

4. Water  

Last, but not the least is water. After all, this is a beverage. So, water is imperative to complete the formula. To be exact, this product has about 88 to 97% water depending on its type or brand.  

Keep in mind that these four are the fundamental ingredients of beer. Most manufacturers and home brewers will add other components to produce a flavor that will make their product top-notch, favorable and marketable compared to their counterparts. 

Gout and Beer: How Beer Triggers a Gout Attack?

Going back to the main topic of this article, which is the relationship between gout and beer. So, can beer trigger a gout attack? The simple answer to this question is yes. But, to make this topic more fascinating, let me further discuss how this all time favorite drink is evidently considered as a predisposing cause of gouty arthritis especially if consumed excessively.

A pint of beer

It is known that this specific type of fermented product can increase the production of uric acid and decrease your body's ability to excrete the same compound. How so?  

There are actually several explanations on how beer triggers a gout attack. First, is due to alcohol metabolism. Since beer still has minimal alcohol content, metabolizing this specific component will inevitably form a certain compound that is medically observed to affect or elevate your uric acid levels. This specific compound I'm referring is adenosine monophosphate (AMP), which is chemically produced by breaking down adenosine triphosphate (ATP). Afterwards, AMP is again broken down into purine intermediates such adenosine and uric acid.

Another viable explanation is that alcohol consumption indirectly activates ketoacidosis and lactate production. Both these processes will increase your uric acid levels by increasing urate re-absorption and by interfering with your normal urate excretion.

Aside from these two consequences, constant consumption of alcohol-containing drinks can also hinder the conversion of allopurinol's prodrug namely oxypurinol. As you know, allopurinol is a medication prescribed to regulate or lower high uric acid levels in your system. If it is incompletely metabolized, its effects will not take place, making the drug useless. Hence, combining gout and alcohol consumption is not recommended especially if you're taking medications.

beer mug

The last explanation for the negative relationship between gout and beer concerns one of the basic ingredients typically used to create this beverage. To be specific, yeast, especially brewer's yeast is one of the few products considered to have high amounts of purines. According to several nutrition-related articles, brewer's yeast is under the “high purine containing food” category wherein a hundred grams of yeast may contain approximately a hundred to a thousand milligrams of the said compound. How is this related to uric acid?

Keep in mind that purines when broken down will form uric acid. Although yeast is typically sifted during the brewing process, experiments and assays revealed that the purine content of this alcoholic beverage is still detectable. Thus, if you are suffering from gouty arthritis, this product should only be consumed occasionally or as much as possible avoided. Remember, once alcohol is completely metabolized by your body, your risk of experiencing a gout attack is amplified due to the other bodily process mentioned above. 

Beer VS Spirits and Wine: Which Alcoholic Beverage has a Higher Risk of Causing Gout?

Now that we know that gout and beer is not a perfect match, you might be thinking, what about the other types of alcoholic beverages?

A glass of red wine

As I've mentioned above, gout and alcohol consumption is a big no-no. Hence; spirits such as brandy, vodka and whiskey can also trigger gouty arthritis. However, compared to beer, spirits possess a lesser threat. To be precise, it was statistically noted that spirit drinkers have a 1.6% risk of experiencing gout while avid beer drinkers have  a 2 ½% chance.

According to several health advocates, fermented liquors are the most dominant predisposing cause of gouty arthritis.

Surprisingly, the relationship between wine and gout is not as awful its counterparts. The primary reason for this is still unknown. However, there are speculations that it is probably due to the antioxidants present in this drink. It can also be due to the healthy lifestyle or health consciousness practiced by most wine drinkers. Nonetheless, wine products are slightly preferred since they have a lesser risk of causing gout compared to other kinds of alcoholic beverage. But, of course, since it still contains alcohol, the chances of experiencing gout are still within the vicinity. For that reason, it is best to regulate your consumption of any type of wine to an utmost of two glasses per day or less if possible

Recommendations

How Beer Triggers a Gout Attack

Individuals suffering from gout should apply or practice a long list of precautionary measures to avoid experiencing this specific type of arthritis.

Monitoring your consumption of food and drinks is on top of the list. As you know, there are various purine rich foods sold in today's market. One must be wary of these products. This article entitled Foods to Avoid when Dealing with Arthritis may shed some insights about food products that may set off arthritis.

As for alcoholic beverages, avoiding or reducing your intake of these products is highly recommended. But, of course, this is easier said than done. So, while you're undergoing the transition process of totally eliminating alcoholic beverages in your day-to-day routine, you can opt for low purine beers like malt beer. Dr. Mitsuhiro Osame actually wrote a book entitled Treating Gout while Still Drinking Beer to share his experiences and experiments on how he managed to overcome gout while still enjoying beer. One of his noted recommendations is "to find a level of alcohol suitable for your body, then you can drink at your own pace." 

If you're suffering from chronic gout; it is best to evaluate your current lifestyle, which includes your diet, alcohol consumption or other factors that may trigger this medical condition. From there, it is highly recommended that you opt for the healthier choices. This is the best option you can take to reduce or cease the occurrence of gouty arthritis. 

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