Beer contains some purines and sugar which are known to elevate uric acid. But is there enough in beer to trigger gout attacks? The key is in the ingredients and brewing process.
Beer and Gout
For us gout sufferers, when considering whether a certain food or drink is safe, the first thing to consider is its purine and sugar content, and beer is no exception.
Naturally occurring purines, in your body’s cells and in the food and drinks you consume, metabolize into uric acid which is dissolved in the blood and circulates around the body.
But when excess uric acid is being produced, or not enough is being excreted (via urine), blood uric acid can increase to such an extent that monosodium urate crystals form in your joints and surrounding tissue, causing a gout attack or flare-up.
Too much sugar consumption can also elevate your blood uric acid levels and trigger a gout attack in the same way.
Let’s now take a look at how beer is made:
How Beer is Made
According to this Wikipedia article about beer…
“Beer is one of the oldest and most widely consumed in the world, and the third most popular drink overall after and tea. Beer is brewed from cereal grains—most commonly from malted barley, though wheat, maize (corn), and rice are also used. During the brewing process, fermentation of the starch sugars in the wort produces ethanol and carbonation in the resulting beer. Most modern beer is brewed with hops, which add bitterness and other flavours and act as a natural preservative and stabilizing agent. Other flavouring agents such as gruit, herbs, or fruits may be included or used instead of hops. In commercial brewing, the natural carbonation effect is often removed during processing and replaced with forced carbonation.”
Our first clue is ‘cereal grains’ because it’s known that grains contain varying amounts of purines. And the second is ‘starch sugars.’ We’re interested in sugar too, right?
So now please take a few minutes to watch this excellent video, to help us understand the key process elements that may cause beer to trigger gout, if at all:
So, the first thing we need to look for is beer’s purine content:
Purines in Beer
We see that brewer’s yeast is a fundamental ingredient in beer.
Unfortunately for gout sufferers, brewer’s yeast is considered a high-purine food, i.e. greater than 200 mg uric acid per 3.5 oz (100 g) serving. And beer gets most of its purine content from brewer’s yeast.
So beer is rich in purines.
Sugar in Beer
You cannot make beer without sugar! Not table sugar, but the sugars contained in those grains (e.g. barley) in the form of carbohydrates that the yeast helps to forment into alcohol and carbon dioxide (CO2).
But doesn’t all that sugar get turned into alcohol? No, ‘fraid not! Even after the whole process is finished the beer you’ll buy or be served will still have some residual sugar in it. And this amount will vary by beer type, brewing process, and manufacturer, etc.
So Does Drinking Beer Cause Gout?
With beer there’s a double whammy of purines and sugar so, on the face of it, there has to be a heightened risk of gout flare-ups.
And the science backs this up:
If you already have gout, you are highly likely to trigger gout attacks through drinking too much beer (and indeed all types of alcohol) according to a 2014 study by Tuhina Neogi, et al., that looked into the effect of different alcoholic drinks on patients with an existing gout condition:
“Episodic alcohol consumption, regardless of type of alcoholic beverage, was associated with an increased risk of recurrent gout attacks, including potentially with moderate amounts. Persons with gout should limit alcohol intake of all types to reduce the risk of recurrent gout attacks.”
And it doesn’t stop there…
Other studies have shown that not only does alcohol increase uric acid, it also makes it more difficult for the body to excrete excess uric acid.
Furthermore, alcohol causes dehydration, and it’s known that urate crystals can form more readily in a dehydrated body.
These three effects — increased uric acid, decreased excretion, and dehydration — compound to heighten the risk of recurrent gout attacks even further.
To sum up, if you do have gout it’s best to completely avoid beer and other alcoholic drinks.
At the very least, you ought to severely limit your intake. Although I would still say to avoid beer altogether.
