Gout is a condition that we don’t tend to hear too much about but it is actually the most common cause of inflammatory joint disease in men over 40 years old in the UK. Gout is an arthritic, inflammatory joint, condition that causes swelling and intense pain in one joint in the body, commonly the big toe although it can affect any joint.
Gout affects over five times more men than women. In men, it can occur any time after puberty, whereas in women it is uncommon before the menopause. People who are overweight, have high blood pressure, eat diets rich in protein and drink large quantities of alcohol have an increased risk of developing gout. It is estimated, by the UK Gout Society, that there are around 70,000 sufferers of gout in the UK (1). I would suggest visiting the UK Gout Society website for fantastic information about the condition.
The following information comes from the UK Gout Society(1)
Gout occurs as a result of excess uric acid (urate) in the blood and tissues. After prolonged exposure to uric acid, crystals of urate can form in and around the joints and kidneys. If uric acid crystals enter the joint, they may trigger the development of inflammation. The affected joint becomes red, swollen and extremely painful and tender. Infrequently, stones (calculi) may form in the kidneys. Most patients with gout have high levels of urate in their blood because they do not pass enough in their urine. In most cases this is caused by an inherited peculiarity of the kidneys, which is in other respects harmless. It can also be caused by high levels of uric acid in the diet or by some drugs eg. diuretics. Much less commonly, patients produce too much uric acid in the first place, owing to an inherited metabolic abnormality or disorders associated with greatly increased production of cells in the body (1).
Uric acid is the end product of purine metabolism in the body. The levels normally found in the blood and tissues are derived from both the breakdown of old cells and from the degradation of purine containing foods in normal diets. Foods containing high levels of purines include:
Meat and game – particularly red meat and offal, such as liver and kidney
seafood – especially mussels, herrings, sardines
alcoholic beverages – including beer, lager, port and some red wines
For detailed ways of treating and preventing gout please visit the UK Gout Society where a leaflet “All About Gout” can be downloaded free of charge.
The reason I wanted to write about gout was that a recent study (2) has found that individuals who have a high vitamin C intakes tend to have a significantly reduced risk of suffering from gout and that vitamin C supplements may well be useful in the prevention of this painful inflammatory condition.
The study ran from 1986-2006 and looked at the relationship between vitamin C intake and incidence of gout in almost 47000 men. None of the men had a history of gout at the start of the study. Vitamin C intake was assessed every 4 years through validated questionnaires. 1317 cases of gout were confirmed during the study. Men who consumed the least vitamin C had a significantly higher incidence of gout than those consuming the most.
Men who consumed 500-999mg Vitamin C per day had a 17% lower risk of developing gout than men who consumed less than 205mg per day. Those consuming 1000-1499 mg vitamin C per day had a 34% lower risk of gout than those consuming less than 250mg per day and those with an intake of 1500mg per day or higher had a 45% lower risk of developing gout (2).
Vitamin C seems to be having an effect by reducing the levels of uric acid in the blood thus preventing a build up in joints which may eventually lead to gout. The vitamin C may be affecting the absorption of uric acid by the kidneys and/or by increasing the speed at which the kidneys work to protect against inflammation. Taking a high dose of supplemental vitamin C is quite safe, with most medics agreeing that up to 2,000mg per day is tolerable.
A study last year (3) found that a higher vitamin C intake in men was associated with significantly lower uric acid concentrations in the blood serum. A vitamin C intake of up to 500mg/d was associated with lower uric acid concentrations, further increases in vitamin C was not significantly associated with further lowering of uric acid concentrations. A double-blind placebo controlled study (4) in 184 individuals looked at the affect of taking a 500mg day of vitamin C supplements for 2 months on serum uric acid concentrations in the blood. At the end of the study period, serum uric acid levels were significantly reduced in the vitamin C group but not in the placebo group. The vitamin C seemed to be affecting the way the kidneys worked to reduce uric acid levels.
These studies seem to suggest that vitamin C might be beneficial in the prevention and management of gout and other urate-related diseases. Eating plentiful amounts of fruits and vegetables will help keep vitamin C intakes high. Taking a ‘food state’ vitamin C supplement (these supplements are made from food sources rather than chemicals and are easy for the body to absorb and tolerate) of 500-1000mg per day could be considered if you have previously suffered with gout and want to try and prevent subsequent attacks.
(1) UK Gout Society website
(2)Choi et al. 2009. Vitamin C Intake and the Risk of Gout in Men: A Prospective Study. Archives of Internal Medicine. 169 (5): 502-507
(3) Gao X et al. 2008. Vitamin C intake and serum uric acid concentration in men. Journal of Rheumatology. 35(9):1853-8
(4) Huang HY et al. 2005. The effects of vitamin C supplementation on serum concentrations of uric acid: Results of a randomized controlled trial. Arthritis Rheum. 52(6):1843-1847
Written by Ani Kowal
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