Does Drinking Water Affect Gout?

'A Quick Reader's Question From A Gout Sufferer'

The Short Answer –

Drinking water has long been thought of as essential for the treatment of gout (or ‘gouty arthritis’). But what are the actual facts? Does drinking water affect gout – and if so, how? Can we add anything to water to make it more effective in fighting gout?

Today we look at the case for how drinking water might affect gout, finding it to be essential in the treatment of gout. We also look at a way of making it even more effective and discuss just how much you should be looking to drink…

Image of fresh water pouring into a glass with ice

Could Drinking Water Affect Gout? – The Background

Gout is created when you get a build-up in your levels of uric acid and the acid starts to crystalize in the form of urate crystals. These crystals then attach themselves to your joints and cause inflammation, swelling and potentially the formation of tophi (hard lumps) around your joints.

Uric acid itself is produced by your body as a bi-product of certain foods/ drinks etc that you consume. The uric acid should then be excreted naturally through your urine via your kidneys.

However, sometimes your body produces more uric acid than it can get rid of, either because it is over-producing it or your kidneys are not getting rid of it fast enough.

When this happens, you are said to have ‘hyperuricemia’. This on it’s own does not definitely result in gout though.

For gout to appear, spare uric acid needs to start being converted into urate crystals.

These crystals then attach themselves to your joints causing the pain, inflammation, heat and swelling that is gout.

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So…Does Drinking Water Affect Gout?

As mentioned, gout is determined ultimately by a surplus of uric acid being converted into urate crystals.

One of the ways then to reduce gout is to reduce the concentration of uric acid or make your kidneys work more efficiently.

This is where drinking water comes in. As noted by The American College of Rheumatology 

“In summary, there is a strong association between low water consumption and hyperuricemia. These findings support the physiology of increased uric acid excretion with excess water intake. High water intake may allow for significant benefits to those suffering from gout….”

Remembering that hyperuricemia is just the technical term for a build up of uric acid, this study points to the fact the increased water consumption helps your body to get rid of more uric acid and faster.

The faster your body gets rid of uric acid, the less chance there is of any build up and the less chance there is of them being converted to urate crystals.

In effect, drinking water helps gout by making your kidneys work more efficiently and giving you more urine to physically get rid of the uric acid with.

This is further backed up in The Pharmaceutical Journal which reported findings that 

“When the kidneys are routinely required to produce a low volume, concentrated urine, then total uric acid excretion is likely to be reduced.”

This proved the same theory but from the other side – that if you don’t drink enough water, then the amount of uric acid your body excretes actually goes down.

So drink more water, uric acid excretion increases, drink less water and it decreases.

This makes logical sense, because dehydration is another key trigger for gout attacks.

Making Drinking Water Even More Effective For Helping Gout

So we have fairly safely answered the question ‘does drinking water help gout’, but to add an extra level, is there anything we could to the water to make it even more effective?

I refer to this, because there are plenty of proposed additives or supplements that claim (not necessarily with evidence) to have benefits for preventing gout.

One of these that I do promote slightly more positively is the benefit of adding lemon juice.

A glass of water filled with fresh lemons to be left and then drunk as lemon water

There are several reasons for this – primarily because, at worst, it does no harm and promotes general gut health, but there is also clinical evidence as published in the Annals Of Rheumatology, for it’s use in treating gout. 

In this pilot study, they actually concluded that lemon water added to the diet of gout patients neutralized much of the uric acid (among other acids). Neutralizing some uric acid would mean much less chance of a build up and therefore gout.

More study is potentially needed in to the definitive link between lemon water and gout, but on the basis that fresh lemon juice added to water is also a very refreshing way to enjoy water with no downsides (that I am aware of), if seems very much win-win.

How Much Water Should I Drink?

Whether it is lemon water, spring water or plain water from a tap (if your supply is clean enough to drink), then the recommended quantity is approximately two litres a day.

This breaks down as 8 x 8oz glasses.

If you suffer with gout, you should consider this a minimum, although be careful not to go over 3-4 litres a day, as more people die from over-hydration than dehydration.

Conclusion –

Does drinking water help gout? Yes, in terms of gout prevention, drinking water and remaining fully hydrated is a key determinant of future gout activity.

Furthermore, as suggested above, adding some lemon juice to create ‘lemon water’ can also not only add a refreshing twist to drinking water, but can also help to neutralise some of the uric acid that causes gout.

Either way (and there are plenty of other trials to back this up), drinking water does help gout and should be a significant consideration for monitoring if you suffer with gout.

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References –

1. Patricia Kachur, Chirag Bambhroliya, Hong Liang and Pramil Cheriyath (September 2017). Hydration and Gout: Looking at New Modes of Uric Acid Management. The American College Of Rheumatology.
2. Curwain (Sept 2014). Water Intake Affects Uric Acid Excretion. The Pharmaceutical Journal
3. E.K. Biernatkaluza, N. Schlesinger (2015). Lemon Juice Reduces Serum Uric Acid Level Via Alkalization of Urine in Gouty and Hyperuremic Patients- A Pilot Study. Annals Of The Rheumatic Diseases

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