Q: Following a recent trip to "wine camp" and the consumption of a variety of red wines, I experienced an acute gout attack requiring medical treatment. Should wines of all types be avoided if one suffers from gout, even if on medication to treat gout? --Albert, Nashville
A: Gout is an inflammatory form of arthritis caused by excess uric acid in the bloodstream. Most uric acid comes from the breakdown of the body's own DNA, while some comes from diet. For most people, excess uric acid is simply filtered from the body by the kidney. When the acid remains in the bloodstream, it can crystallize in joints and surrounding tissues, which, over time, build-up and cause the inflammation typical of gout.
According to Herbert S. B. Baraf, MD, a rheumatologist and a clinical professor of medicine at George Washington University, for those worried about developing gout, studies have shown that wine does not increase the risk of gout, although beer can. In a study comparing beer, spirits and wine, he explains, "Using a cut-off point of two drinks a day as "high intake," beer and, to a lesser extent, the intake of spirits were associated with the subsequent development of new onset gout. Wine did not appear to be a risk factor at this level."
For those with gout, the matter is a bit trickier. Alcohol, in any form, can trigger attacks of the joint inflammation that characterizes gout. Alcohol may affect the kidney's ability to filter uric acid; this, combined with increased levels of uric acid in the blood, can bring about an attack of gouty arthritis. Baraf asks his patients "to avoid alcohol during the first few months after treatment is initiated to lower uric acid. Once they are on a stable regimen they can resume drinking wine in moderation."
Baraf recommends no more than two glasses of wine a day for gout patients, but only after the gout has been stabilized and recurrences have ceased. "Uric acid lowering treatment is a lifelong matter, much like hypertension and cholesterol treatments," so be sure to consult with your doctor to come up with a plan that is right for you.
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