Vitamin C and Gout


Vitamin C has been in the news lately as a natural means of managing gout.  It has been known for a long time that vitamin C intake helps the kidneys eliminate uric acid from the body and I wrote about it in my book, but this new study focused on seeing if this actually translated into a reduction in the frequency of gout attacks.  The results are pretty compelling.

This study, which followed 46,994 men over the course of twenty years showed that taking over 1500mg of vitamin C per day resulted in a 45% reduction in the risk of gout attacks.  Of course, taking this much vitamin C per day can be problematic for a couple of reasons:

  1. Vitamin C is a natural uricosuric which means that it helps the kidneys eliminate uric acid.  The increase in uric acid in your kidneys and urine can increase your risk of kidney stones – both kidney stones made from uric acid crystals but also from the more common calcium stones.
  2. Vitamin C’s technical name is ascorbic acid.  Because vitamin C is an acid and uric acid is an acid, taking large amounts of vitamin C cause your urine to become more acidic which can significantly increase your risk of kidney stones.  This is because uric acid is more likely to form crystals in an acidic solution.

You can lower your risk of kidney stones, even if you are taking a high dose of vitamin C by making sure that your urine does not become too acidic.  This can be done by measuring your urine’s pH with pH test strips available online or at your local drug store.  If your urine is below 6, then it is too acidic.

Probably the best way of raising this number is to drink a teaspoon of baking soda mixed in a glass of water.  Be careful though.  Baking soda contains a lot of sodium, so if you have high blood pressure you may want to talk to your doctor first.

What I have found that works best for me is to measure my urine pH in the morning.  Urine is most acidic in the morning when you first wake up then again just before I go to bed.  I then drink a glass of baking soda and water just before going to sleep.  I adjust the amount of baking soda based on the pH reading that morning to make sure that my urine pH is always about 6.  Eventually, once you get the hang of it, you won’t need to measure your urine pH in the evening because you morning number will give you all the information you need to adjust your baking soda dose.

Of course, you might find a method that works better for you but whatever you do, talk to your doctor first to make sure this is a good idea based on your medical history.

Regardless, I recommend sticking to between 500-1000mg vitamin C per day to keep the risks manageable and you still end up with a 17-35% reduction on the risk of an attack.

I often get asked about alternative medicine treatments for gout and vitamin C is a good one but like all treatments, even “natural” treatments, there are always risks.  It is important to understand them and take steps to prevent them.

This chart shows the risk of gout based on vitamin C intake.

This chart shows the risk of gout based on vitamin C intake.



If you liked this post, you will love the book, Beating Gout: A Sufferer’s Guide to Living Pain Free. Get the whole story in one easy-to-understand book, get your copy of Beating Gout: A Sufferer’s Guide to Living Pain Free now. Over 500 research articles and texts where studied and dozens of world class experts on gout were interviews for this book yet it is written for the non-expert. No other book on gout is more up-to-date, comprehensive or easy-to-understand – guaranteed!

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  1. #1 by John on March 30, 2009 - 8:08 pm

    Hi Victor – Interesting blog, an angle I hadn’t quite considered. I see discussion of hyperuricemia, however, would the same discussion and remedies apply to hypouricemia? My diagnosis points to the hypo type of gout, which I believe is the body not excreting the uric acid quick enough to keep up with its production.
    Thanks – John

  2. #2 by Burton Abrams on March 31, 2009 - 1:51 pm

    Hi Victor – There is another reason why vitamin C is helpful in reducing the frequency of gout flares. According to Dr. Richard Johnson, Chief of Nephrology at the University of Florida in Gainesville, Vitamin C mitigates the excess production of uric acid by the liver that is stimulated by ingesting fructose. Fructose is a type of sugar that is a component of every natural sweetener. Because our diets contain so many natural sweeteners (cane sugar, high fructose corn syrup, honey, molasses, etc.), the impact of vitamin C is significant.

  3. #3 by Victor Konshin on March 31, 2009 - 3:44 pm

    John, hypouricemia means having too little uric acid in your body. If you are hypouricemic, then it is not possible for you to get gout since gout is caused by high levels of uric acid. You mentioned in this post that your body does not excrete uric acid quickly enough – this is the leading cause of hyperuricemia and where vitamin C can help. Incidentally, you are considered hypouricemic if your blood uric acid level is 2.16mg/dL or lower. At this level you are at risk for neurological problems (among others). Gout attacks are possible only when your uric acid level is above 6.8mg/dL.

  4. #4 by John on March 31, 2009 - 10:10 pm

    Victor Konshin :
    John, hypouricemia means having too little uric acid in your body. If you are hypouricemic, then it is not possible for you to get gout since gout is caused by high levels of uric acid. You mentioned in this post that your body does not excrete uric acid quickly enough – this is the leading cause of hyperuricemia and where vitamin C can help. Incidentally, you are considered hypouricemic if your blood uric acid level is 2.16mg/dL or lower. At this level you are at risk for neurological problems (among others). Gout attacks are possible only when your uric acid level is above 6.8mg/dL.

    Thanks for the reply. Then it is hyperuricemia. I’ll check with the dr, might have been a misunderstanding. My uric acid levels, even with meds, is regularly around 8.5. My last attack a couple weeks ago, the level was 12. Thanks again, that answered my question concerning whether the remedies posed in your book are applicable. – John

  5. #5 by johnstevens on June 22, 2009 - 11:29 am

    п»ї
    Interesting stuff.

  6. #6 by pjones on August 13, 2010 - 1:50 pm

    Hi
    Is there any concern with taking .6mg of Colchicine twice a day and taking 500mg of vitamin c each day?

    Thanks-PAT

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