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Does Caffeine Trigger Attacks of Gouty Arthritis?

August 17, 2011 by Estella.

The incidence of gouty arthritis doubled in the US between the 1960s and the 1990s, and that trend is continuing. Gout is feared as the most painful type of arthritis. It results from a build up of uric acid in the blood, which ends up deposited around the joint or joints in sharp, needle-like crystals, most often at the base of the big toe.

"Gout is the most common inflammatory arthritis in the US," says Dr. Tuhina Neogi, an associate professor at Boston University School of Medicine, "We have good gout medications that can potentially prevent attacks, yet people do still get attacks, with recurrent attacks being the biggest burden of gout."

While gout is considered a chronic, incurable disease, it can be managed with lifestyle changes and gout medications. Gout flare ups are highly associated with diet, particularly food rich in naturally occurring compounds called purines. Red meat, yeast, certain seafood and alcohol well-known gout triggers.

Researcher Neogi and her team were intrigued by earlier studies that found caffeine intake appeared to lower uric acid levels in the body over time, decreasing the risk of developing gout. But those studies were conducted with non-gout sufferers, and the team wondered about the effect of caffeine on people who already had gout.

Caffeine was of particular interest to the researchers because its chemical structure is very similar to a common uric acid lowering gout medication, allopurinol. While effective over time, allopurinol can trigger a gout attack in patients just starting to take the gout medicine.

This is because, as the uric acid crystals deposited in the joints begin to dissolve, they release uric acid into the blood stream. Neogi and her team wondered if caffeine might have the same short-term effect.

The team studied gout patients who drank caffeine-containing beverages like, coffee, tea, soft drinks and energy drinks. They found that caffeine "binges" did indeed trigger gout flare ups. In fact, gout patients who normally had a low caffeine intake who drank six caffeine containing drinks in a day tripled their risk of experiencing a gout attack within 24 hours.

However, those gout patients that normally drank more than two servings of caffeinated beverages a day had no reaction to increasing their consumption, much as a gout patient taking allopurinol for gout no longer experiences a flare up after the first few doses.

"I would not advise someone with gout to start drinking coffee as a way to lower uric acid levels due to its short-term effects," cautions Neogi. "People with gout who are already habitual caffeine drinkers probably don't need to change their habits, given that long-term caffeine intake can potentially lower uric acid levels. But the person who doesn't drink a lot of caffeine on a regular basis should be aware that drinking more than usual may potentially trigger an attack."

Filed under: Gout Arthritis.

Tags: colchicine, caffeine, gout attack, gouty arthritis, gout medications, gout medication, gout medication allopurinol, gout medicine, allopurinol for gout, lower uric acid, colchicine information, colchi.

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