Does beer cause gout? Yes. Brewer’s yeast produces beer, but unfortunately, uric acid too. The main ingredient to make alcohol is also loaded with purines. If you’re getting frequent gout attacks and popping more pills, then you might want to get hammered less often.
It’s definitely not what any beer connoisseur wants to hear. It sucks, I know. Nothing like a cold ale or lager, especially on the days that deserve one.
According to a Gallup Poll, almost half (46%) of alcohol drinkers in the U.S. prefer beer. The U.S. beer industry sells more than $119.3 billion in beer and malt-based beverages to U.S. consumers each year.
As the number of beer drinkers increase every year, so does the number of gout patients and prescriptions. Is this just a coincidence? Beer may not be the only cause but it is one the most popular and potent gout triggers.
Here’s what we will cover on beer and gouty arthritis:
- Recent clinical studies show beer or any type of alcohol will cause gout
- Brewer’s yeast is the main ingredient that contains most of the purines in beer
- The byproducts from alcohol affect the production and removal of uric acid
- Excessive alcohol drinking can lead to chronic kidney disease and gout
[For the in-depth explanation on how gout develops, check out: What Is Gout? Arthritis, Uric Acid, Purines And Pain!]
Clinical Research Confirms Drinking Alcohol Increases Gout Attacks
In 2004, one of the largest medical studies on gout examined approximately 47,000 men every two years for 12 years. It investigated how their drinking habits may or may not cause gout. The study showed that men who drank beer, even in moderation (one 12 oz per day), had 1.5 times higher risk of a gout flare compared to men who did not drink alcohol.
Researchers also found the participants who drank two or more beers per day increased their risk of gout by a higher factor of 2.5. The risk from drinking hard liquor was less at 1.15. Wine drinkers did not show any significant increase in risk in this study.
There was major caveat to this study. The men’s lifestyles and diets were not considered closely enough. The wine drinkers’ lifestyle typically consisted of a healthier diet and exercise versus beer and liquor drinkers.
Those long-time gout sufferers like me, might recall when this news first came out. Do you remember how many beer-drinkers were trying to switch to wine just to avoid the pain of gout? I still got gout and a hangover.
[For more info on what food to avoid for gout, check out: The Worst Foods To Eat For Gout Sufferers]
A 12-month Boston University study published in 2015, reported on 724 participants that had a history of gout. Researchers found in the prior 24-hours, up to two drinks a day increased gout attacks by 41% for men no matter the alcohol type.
Additionally, gout attacks amongst participants increased proportionally when alcohol consumption increased up to six drinks.
Since then, more studies and reports have shown beer or any alcohol consumption can cause acute gout attacks because the purine-rich yeast increases uric acid production and decreases uric acid excretion. Other major reasons listed were food/diet, dehydration/fasting, and injury/activity.
Purines in Brewer’s Yeast is the Cause of Gout
The main ingredient in beer for fermentation to convert sugar into alcohol is brewer’s yeast. There are several varieties of yeast strains that can add specific aromas and flavors to the beer. In case you were wondering, the hops and malt selection actually influences the taste and color more than yeast.
Although brewer’s yeast does have some nutritional value that can aid digestion and provide energy, it does not outweigh its major drawback to people with gout. It contains a high concentration of purines. As a result, brewer’s yeast is necessary to produce beer, but unfortunately, increase uric acid levels too.
As you may already know, purines are the primary cause that starts the internal chain reaction to a gout attack. Typically, the same foods with proteins contain purines also. When digested and absorbed, they make your body produce uric acid. Excess uric acid will crystalize and build up in your joints, causing the painful symptoms of gout.
Beer generally contains more purines than other alcoholic drinks because it uses more brewer’s yeast. Also, less yeast maybe filtered out depending on the brewery. This supports the findings of the clinical tests mentioned earlier that beer is a higher risk of gout versus wine and liquor.
Beer Compared to Other Gout Triggers
According to a 2009 study, purine content can range from 120 mg to 300 mg per serving (350 ml or 12 oz). This study involved testing Japanese beers.
Surprisingly, there was not a much information available on purine content for American and European beers. (Wouldn’t that be great to know for people with gout? Something I will need to look into further for a future post)
For reference, here are purine content ranges (mg/100g) for other foods: salmon (170-260 mg/100g), lobster (75-120 mg/100g), anchovies (240-411 mg/100g). 100 grams is about 3.5 ounces.
Just from knowing that some Japanese beers can contain over 200 mg of purines and anchovies are one of the worst foods for gout, your taking a big risk not knowing how much purines are in a beer.
Also, the large beer corporations are required to pasteurize and filter the yeast from their products. Since filtration is optional for microbreweries and imports, their beers will most likely contain more yeast. If you are not drinking from tap, check the bottom of the bottles for any yeast residue. This indicates their brew is probably unfiltered and got a whole lot of brewer’s yeast to set your gout off.
Major Japanese beer companies like Asahi, Sapporo, Kirin and Suntory produce low-purine products. I have not had a chance to try any. Most reviews and forums rated them from average to poor tasting.
Since no one really knows how much purines are in most beers, this is like playing roulette hoping for a low number. However, I know plenty of people with chronic gout that can drink 2-4 beers a week and not have any flare ups. However, they do take 300 mg of allopurinol daily and maintain on a low purine diet just to satisfy their beer craving.
Guanine: The Fastest Purine
Guanine is one of several types of purines found in brewer’s yeast. What makes it stand out from the rest is that it is absorbed into your blood and system the fastest. This means your body converts guanine to uric acid immediately, where other purines will go through a much longer process to metabolize.
The faster uric acid is created in the body means less time for the kidneys to flush it out. This creates the condition of hyperuricemia, which can lead to gout if the removal of uric acid cannot keep up to its production.
Alcohol’s Harmful Byproducts
The fact is drinking beer in excess changes your body chemistry which disrupts optimal functions of your five vital organs; brain, liver, heart, kidneys and lungs. The disruption of liver and kidney functions can worsen the condition of hyperuricemia and gout.
The liver breaks down alcohol into many byproducts, where lactate, phosphate and acetaldehyde have shown to play major roles regarding the progression of gout development. Lactate and phosphate slows down the kidneys from filtering out toxins and other waste products like uric acid. This leads to joint inflammation and other gout symptoms.
Acetaldehyde is also found in food, cigarette smoke and polluted air. The presence of acetaldehyde does contribute to short term hangover symptoms like an immense headache and extreme fatigue.
Continual and long term exposure to acetaldehyde can lead to an imbalance in anti-oxidants. Just like other toxins, it can deplete or negate antioxidants in your body which weakens your immune system.
It is important for acetaldehyde to be flushed from your body. It can build up and remain in your system to cause serious long-term health risks like liver disease, bone disease, kidney disorders and cancer.
A natural diuretic, acetaldehyde will make you lose more water than you can retain. This is the reason why you get dehydrated from beer or alcohol. Dehydration is another reason why the kidneys will have a difficult time removing uric acid from your body.
Chronic Kidney Disease (CKD) and Gout are Directly Related
The National Institute on Alcohol Abuse and Alcoholism (NIAAA), considers heavy drinking as more than 14 drinks/week for men and more than seven drinks/week for women. Over time, heavy drinking can damage the kidneys and double the risk for chronic kidney disease (CKD).
Poor kidney functions results to more waste products like uric acid will remain in your system. Smokers who are heavy drinkers have about five times the chance of developing CKD than people who don’t smoke or drink alcohol to excess.
There is a bidirectional relationship between CKD and gout. Patients with CKD are at increased risk for gout, and those with gout are at increased risk of CKD.The National Kidney Foundation – www.kidney.org
- More comprehensive studies in recent years have indicated that alcohol consumption of any type can increase the risk of gout attacks
- Brewer’s yeast is the main ingredient to make alcohol but also the source of purines that increase uric acid
- Purine content in most beers are unknown and needs to investigated further to help gout sufferers
- The byproducts from beer stunts the kidneys from filtering out uric acid
- Acetaldehyde is the toxin from alcohol that contributes to dehydration, hangovers and long-term health issues like liver and kidney disorders
- Gout and chronic kidney disease (CKD) are directly linked
So drinking beer will make your body create more uric acid and interfere with your kidneys on removing it. This is a double edged sword for anyone fighting gout. Nevertheless, I know plenty of people that are still willing to take their chances and the consequences.
Abstaining from beer and alcohol is no easy lifestyle change, especially if it has always been your drink of choice. I’m not here to tell anyone to stop drinking beer.
I still love beer and the buzz. I just choose not to get obliterated like I used to! No hangover, no gout. That’s what helping me, and maybe you too, in the quest to become GOUTPROOF.
- All alcohol, even wine, raises risk of gout flare-ups: study – Reuters Health 2014
- Umami: The Taste That Drives Purine Intake – The Journal of Rheumatology 2013
- Biochemical Characterization of Kluyveromyces lactis Adenine Deaminase and Guanine Deaminase and Their Potential Application in Lowering Purine Content in Beer – PubMEd 2018
- Total Purine and Purine Base Content of Common Foodstuffs – The Pharmaceutical Society of Japan 2014
- Alcohol intake and risk of incident gout in men: a prospective study – PubMed 2004