An old friend of mine recently experienced his first gout attack in his big toe and reached out to me. In pain and disbelief, he couldn’t understand why, despite not having any beer, seafood, fast food, and red meat for over a month. After explaining that many other factors may contribute to gout, he inspected the food products in his refrigerator. We discovered several processed foods and sauces containing gout-triggering ingredients such as high fructose corn syrup (HFCS), monosodium glutamate (MSG), and anchovy extract.

Since HFCS and MSG have been covered in previous posts, this one will explain why anchovy extract is among the worst and sneakiest gout triggers.

Do anchovies cause gout?

Consuming anchovies can cause gout due to their extremely high purine content. This small-silvery fish is one of the worse, if not, the worse food to eat for people with gout.

Certain types of food contain natural substances known as purines. When they are broken down by the body, uric acid is created. The combination of consuming purine-rich foods like anchovies and having weak kidney function will elevate levels of uric acid in the bloodstream. Excess uric acid can crystallize and deposit in the joints, resulting in severe inflammation and excruciating pain.

Anchovies’ high purine concentration significantly raises your risk of a gout attack, especially when eaten in large amounts and on a regular basis. Gout sufferers should not take the risk as it is not worth the painful consequences.

Products made with anchovies and MSG must be avoided by all gout sufferers. Find out how MSG spikes uric acid: MSG Hidden In Food Causes Sneaky Gout Attacks

Why do anchovies have so much purines?

There are certain reasons why fish, such as anchovies have high purine content.

  • Metabolism: They have a relatively high metabolic rate, meaning their cells are more active and produce more metabolic waste, including purines.
  • Protein content: Anchovies are rich in proteins, which are made from amino acids. Purines are derived from the breakdown of nucleic acids, which are made up of amino acids. Therefore, fish with a higher protein content tend to have higher purine levels.
  • Oily composition: Oily fish have a higher fat content compared to lean fish species. Purines are more soluble in fat than in water, so the oily nature of anchovies may contribute to higher purine concentrations.
  • Purine-rich diet: As smaller fish, they consume various organisms that may contain purines such as plankton, shrimp, and krill. The leads to higher concentrations in their bodies.

Anchovies purine content highest among fish

  • Anchovies: 260mg to well over 400mg – (Very High Risk)
  • Sardines, Mackerel: 100mg to 300mg – (Moderate to High Risk)
  • Herring, Trout, Carp, Whitefish, Bluefish, Salmon, Tuna, Striped Bass: 100mg to 200mg (Moderate Risk)

Note: Purine levels can vary greatly within each fish species depending on factors such as the specific variety, diet, environment and size of the fish. It is one of the reasons why there is not a reliable go-to reference for purine content. Be sure to more about purine concentrations: The Truth About Purine Tables: Helpful But…

What is so special about anchovies?

Anchovies are full of natural umami-producing substances. Umami, characterized by its savory, meaty, or brothy qualities, is one of the five taste sensations that we experiences. It adds depth and richness to foods and is associated with glutamate, an amino acid that enhances the overall flavor experience.

What is the difference between anchovy extract and anchovy paste?

The process of obtaining anchovy extract, also called fish sauce, involves simmering or fermenting anchovies to obtain their flavor and essence. It is a liquid form of concentrated anchovies, often used in sauces, dressings, and numerous packaged foods.

To make anchovy paste, anchovies are ground into a smooth and spreadable form, typically with the addition of salt, oil, and other preservatives. This concentrated paste is also widely used in cooking.

What countries use anchovy-based ingredients?

Anchovy-based ingredients have a long history of culinary use, particularly in Southeast Asia. Here are some countries known to use anchovy paste or extract in their cuisines.

  • Thailand: Thai cuisine often incorporates an umami-rich flavor fish sauce in dishes such as nam prik pla salid (anchovy chili dip) and various Thai curries.
  • Philippines: Known for its extensive use of their fish sauce, known as “patis”. A paste called “bagoong” is also made from fermented shrimp or anchovies. Both are often eaten with fried food.
  • Korea: Broths and sauces are integral to Korean cuisine. Anchovy broth known as “myeolchi yuksu,” is a fundamental component in many soups, stews, and kimchi preparations.
  • Italy: Features anchovies in pasta sauces like puttanesca or in traditional dishes like bagna cauda, where anchovy paste is a key ingredient. Of course, it is a well-known topping on pizza.
  • Japan: They utilize anchovy extract in traditional dashi broth, which forms the foundation for many Japanese soups, sauces, and simmered dishes.
  • Spain: Spanish cuisine incorporates a paste in various preparations, such as the famous tapas dish boquerones en vinagre (marinated anchovies) and anchovy-stuffed olives.
  • Vietnam: Their fish sauce is called nuoc mam. It is a staple condiment that adds the distinct flavor to many Vietnamese recipes.
  • France: Anchovy paste is widely used, particularly in the classic sauce called “sauce anchoïade” and in preparing Niçoise salads.
  • Greece: Greek cuisine incorporates anchovy extract or paste in various dishes, including the popular spread “taramasalata” made with fish roe and anchovy paste.
collage of products with anchovy paste ingredients; fish sauce, omega-3 supplements, salad dressing, anchoy on pizza, Anchovy Extract: Another Sneaky Gout Trigger

What food products sold in the USA contain anchovy extract? 

American cuisines seldom include anchovy extract in traditional recipes. However, it’s crucial for people with gout to realize several popular food products contain it. Various processed foods and condiments frequently incorporate the extract as a flavoring ingredient or as a component in sauces.

Here are examples of well-known products and brands that have anchovies as an ingredient.

Worcestershire sauce: This sauce is a popular condiment that typically includes anchovies as one of its key ingredients. It adds a distinct umami flavor. Furthermore, some sauces combines high fructose corn syrup (HFCS), which makes this sauce a very dangerous gout trigger! Brands with anchovies: Lea & Perrins, French’s, Heinz)

Salad dressing: Many brands incorporate anchovy extract to recreate the traditional ranch, blue cheese or Caesar salad taste. Again, HFCS may also be in these dressings. Salad dressing brands made with anchovies: Cardini’s, Newman’s Own, Ken’s Steak, Wish-Bone.

Fish sauce: Essentially what anchovy extract is. A sauce made by fermenting fish, often anchovies, in salt. May be made with MSG, which makes it very dangerous gout trigger! Colatura di Alici is an Italian fish sauce with a lighter ‘fishy’ taste than an Asian-style brands. Popular fish sauce brands: Datu Puti, Rufina, Red Boat, Thai Kitchen, Gustiamo’s.

Seafood sauces & spreads: Many spreads, pâtés, and cocktail sauces, include an anchovy extract for added flavor. Note, many cocktail sauces will contain Worcestershire sauce. Brands of seafood sauces containing anchovies: Roland, Zona, Crosse & Blackwell, Barnsider

Frozen Foods/Dinners: Gout sufferers may be aware to avoid anchovy toppings on pizza, but it’s important to keep an eye out for sneaky sources within packaged frozen foods. These seemingly harmless meals can contain enormous amounts of anchovy extract, which can spell trouble for our gout-prone bodies. Plus, frozen pizzas and ready-to-eat meals often contain other gout-triggering ingredients.

Note: Anchovies contain Inosine monophosphate (IMP) and guanosine monophosphate (GMP). These two substances provide umami flavor enhancing capabilities. What do you think they work best with? Monosodium Glutamate (MSG)! IMP and GMP significantly enhances the umami flavor of MSG, but amplifies uric acid production.”

Do you want to know easy and tasty gout friendly recipes? Check this out: Five Simple Recipes For Gout-Friendly Meals

What are gout-friendly alternatives to anchovy extract or fish sauce?

Decent alternative condiments to anchovy or fish sauce taste are tamari sauce, coconut aminos, miso paste, soy sauce and spicy dry-powder seasonings. Make sure to choose soy sauce with no MSG.

Does omega-3 fish oil supplements affect gout?

Omega-3 supplements often utilize high-purine fish such as anchovies, sardines, and mackerel due to their higher concentrations of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). The two key omega-3 fatty acids provide health benefits for: heart health, brain function, inflammation/joint health and mental health.

Strangely enough, there is no research suggesting that omega-3 supplements derived from fish can provoke gout symptoms. The only research to be found was a small 24-week study study in 2022 indicated omega-3 fish oil had little effect on uric acid levels of 40 gout patients.

Algae alternative to anchovy Omega-3 supplements

Algae and seaweed are key sources of omega-3 for vegetarians and vegans. They are among the few plants that contain both DHA and EPA found in fish. This is great for gout sufferers in need of omega-3 supplementation because algae is low in purines.

Popular brands that source algae for their omega-3 supplements: Nordic Naturals Algae Omega, Source Naturals Vegan Omega-3s, Deva Vegan Omega-3 DHA, Ovega-3 Vegetarian/Vegan Omega-3, Testa Omega-3 Algae Oil, Opti3 Omega-3 EPA & DHA.

Final Thoughts

While scientific data does not prove it, it does not mean it cannot happen. I’ve felt gouty each time I tried different omega-3 supplements years ago. However, it was when I was not so health conscious.

Recently, I was gifted a bunch of vitamin supplements, which included a bottle of omega-3 softgels (2100mg). I decided to try it, since it was made from Alaska Pollock (considered low in purines). After a week of taking it every day, I woke up with that oh-so familiar slight pinch of gout in my right knee. Yup. Although it wasn’t derived from anchovy extract, I’m sure this omega-3 supplement was responsible for my gout symptoms.

Omega-3 supplements with Anchovy extract triggers gout, goutproof blog, fish sauce, Anchovy Extract: Another Sneaky Gout Trigger

In my opinion, omega-3 supplements might accelerate the activity of certain liver enzymes. Fatty acids may stimulate the breakdown of more purines than normal, leading to an increased production of uric acid. Secondly, because supplements are not reviewed by the FDA, the distillation and purification processes for this product may be of low quality. This means that lots of toxic ingredients (sh!t), including other fish purines, can remain in the product.

Anchovies typically top the list for foods with the highest purine content. The high purine concentration in anchovies can be compared to that of a shot of high-proof liquor. While the alcohol content in liquor is accurately measured, the exact amount of anchovies and purines used in food and food products remain uncertain. This makes eating anchovy products extremely high risk for gout sufferers. Despite numerous redundant and generic precautions from certain medical sources to avoid this high-purine fish, not enough emphasis is placed on the numerous food items that contain anchovies.

Take my friend’s unexpected gout flare as a valuable lesson that gout food sources extend beyond the popular culprits of beer, red meat, and shellfish. If consumed frequently, your uric acid levels can steadily creep up due to sauces, dressings and processed foods loaded with anchovy ingredients.

Anchovy extract, or fish sauce, can cause gout by increasing uric acid levels like MSG and HFCS. Once you get into the habit of checking ingredient lists for sneaky gout triggers, you’ll find yourself becoming GOUTPROOF!

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