Aspirin and gout: Discover why aspirin should never be taken for a gout attack. But what if you have to take daily aspirin for a medical condition? What then?
Aspirin and Gout
When we are in pain most of us tend to use over-the-counter medicines, aspirin being one of the most popular.
It’s sold as ‘Aspirin’ but also under brand names such as Anacin, Acuprin, Bufferin, Ecotrin, Genprin, Minitabs, Zorprin, and more.
It comes under the class of drugs called ‘nonsteroidal anti-inflammatory drugs’ (NSAIDs) and as such would seem a perfect, relatively low cost, solution for a gout attack.
However, aspirin has certain characteristics that makes it unsuitable for treating the inflammation and pain of a gout attack.
Gout is a very painful form of arthritis caused by high levels of uric acid in the blood forming microscopic crystals in the joints. Uric acid itself is produced when chemical compounds in our bodies, called ‘purines,’ breakdown during metabolization. Purines also exist in food which, when ingested, adds to the totality of uric acid being produced.
Normally, our kidneys process and excrete excess uric acid in urine. However, if more uric acid is produced than the kidneys can handle, or the kidneys don’t work to their full potential or are impeded from doing so, then insufficient uric acid is excreted, leaving high uric acid levels in the blood.
Low Dose Aspirin
It’s known that aspirin in low doses — the doses you’re allowed to buy over-the-counter — can increase uric acid levels by reducing the ability of the kidneys to process and excrete uric acid. So to take aspirin at the onset of, or during, a gout attack would only make matters worse and not to be recommended. There are other NSAIDs which can tackle the inflammation and pain without raising your uric acid levels.
But, there are many people who have to take low-dose aspirin on a daily basis for medical reasons: low-dose aspirin (75 mg – 325 mg per day according to the Mayo Clinic) is increasingly being used by doctors as a ‘platelet aggregation inhibitor’ to help reduce clotting and the risk of heart disease and stroke.
So, those on a medicinal low-dose aspirin, and who also have gout, are at a higher risk of having recurring attacks. This was confirmed in a study, published in February 2014 in PubMed.gov,which looked at the link between the cardioprotective use of low-dose aspirin and the risk of recurrent gout attacks among gout patients. The study followed 724 gout patients over a period of 1 year.
It gathered data on gout attacks during that period: date of onset, daily aspirin use / dosage, symptoms, any risk factors, and medications being taken. It particularly looked at the data during the 2-day period prior to gout attacks and over 2-day control periods.
The study authors concluded that…
“…the use of low-dose aspirin on two consecutive days is associated with an increased risk of recurrent gout attacks. Recommended serum urate monitoring with concomitant use and dose adjustment of a urate-lowering therapy among patients with gout may be especially important to help avoid the risk of gout attacks associated with low-dose aspirin.”
So, if you take low doses of aspirin for a health condition, and you also have a gout condition, you must not stop taking your daily aspirin. Instead, talk to your doctor about taking a uric acid-lowering medicine, such as allopurinol, as well as aspirin. Your doctor will advise you on the best one for your particular case.
However, there are natural ways to reduce and maintain your uric acid at healthy levels: things like avoiding high purine foods, eating lots of fruit and vegetables, avoiding sugar, reducing alcohol intake and getting down to a healthy weight. More and more people prefer to go the natural route since drugs for reducing uric acid usually have to be taken for life.
High Dose Aspirin and Gout
As you saw above, low-dose aspirin can increase uric acid in the blood by reducing the ability of the kidneys to process and excrete uric acid. On the other hand, high-dose aspirin (>325 mg) has been found to lower blood uric acid by impeding the normal reabsorption of uric acid by the kidneys.
So, could taking high-dose aspirin during a gout attack be beneficial, not only in terms of reducing inflammation & pain, but also in lowering uric acid? Unfortunately, no. Sudden changes in blood uric acid levels, either up or down, can actually trigger a gout attack or make an existing one even worse. So taking high doses of aspirin at the onset of, or during, an attack could actually exacerbate it. This is why doctors generally recommend other NSAIDs such as ibuprofen and naproxen.
In conclusion, if you suffer from gout, but don’t have to take daily aspirin for other health conditions, you should not use aspirin to reduce the inflammation and pain of a gout attack. Use other NSAIDs instead. Alternatively, there are many natural remedies that have proven to be effective in reducing inflammation and pain.
But if you have to take daily aspirin for another health condition, keep taking it and control your uric acid levels by either taking long term uric acid-lowering medicine prescribed by your doctor, or using natural remedies, as mentioned earlier. If you are considering the natural route you must speak to your doctor first to make sure that nothing you do or take will interfere with the effectiveness of the aspirin; this is extremely important.