Vitamin C for Gout? it is a Good Idea, But There’s a Caution if You Use it as a Gout Treatment
Jun 30
John Mepham asked:
Should you take Vitamin C for gout? The answer is probably yes, but read on for a possibly relevant caution. Gout cures require that uric acid levels be reduced. Vitamins and drugs work in two ways to reduce uric acid levels. One is restricting its supply by inhibiting purine breakdown into uric acid, the other is improving uric acid’s breakdown into the urine. Vitamin C is thought to be a uric acid excretory, not an inhibitor. Improving excretion may be more important than reducing production.
One complicating factor is that elusive fact that most people with hyperuricemia (excess uric acid)do not get gout. Another is that some people with normal uric acid levels do.
A few studies over the past 30 years have concluded that Vitamin C will reduce the uric acid level. They have differed in the amount of Vitamin C given to study participants. A U.S. study of 184 non-smokers, published in 2005, concluded that the amount required to achieve a serum (blood) uric acid level reduction was 500 mg daily. (The Vitamin C was taken as a supplement). This is not a mega dose.
Previously it has been thought that the amount needed was at least 4,000 mg (4 grams) daily. For example, Dr. Robert Atkins in his book ” Vita Nutrient Solutions,” recommended 5,000 -10,000 mg as part of his formula natural remedy for gout.
In the 2005 study by how much did 500 mg of Vitamin C reduce their uric acid level? It found an average, across all participants, reduction of about 10% (0.5 mg/dL). In addition, reductions were larger among participants who had higher levels of uric acid at the start of the study. Participants took the 500 mg daily level for two months. Those who were given a placebo (i.e. not Vitamin C) showed a slight increase in uric acid levels.
0.5 mg/dL is a useful reduction but for most people probably not a natural remedy for gout, although the 0.5 mg/dL figure is an average and some participants did better. But a 0.5mg/dL reduction will not be enough to reduce uric acid below the 6.0 mg/dL level at which the MSU crystals may dissolve. However, when combined with other vitamins for gout, a low purine diet and other natural remedies for gout, it could be.
THE CAUTION
Rapid changes in uric acid levels can trigger a gout attack. This rapid change can be brought about by many factors in addition to possibly mega doses of Vitamin C and by drugs such as probenecid and sulfinpyrazone. People who are susceptible to gout must consider these rapid changes.
Such a rapid change concerned the authors of one study in the 1970’s who had recorded that mega doses of Vitamin C (4,000 mg and 8,000 mg daily) reduced uric acid levels significantly, and by more than in the 2005 study. However, as far as Vitamin C induced changes in uric acid levels is concerned, this triggering has not been reported in any study.
VITAMIN C AS A GOUT PREVENTOR
If 500 mg daily of Vitamin C can reduce uric acid levels, then Vitamin C ought to act as a preventative gout vitamin too. A Taiwan study of males in the late 1990’s examined the weight, diet and lifestyles of gout and non-gout sufferers in Taiwan. It concluded that Vitamin C, folic acid (folate) and fibre were protective against gout.
It also reached the well-known and accepted conclusion that hypertension (high blood pressure) and obesity are risk factors for gout. And one other very different conclusion from the conventional wisdom about purines — purine intake, with the exception of alcohol, was NOT associated with a risk of gout.
However, restricting purines in your diet is not difficult, so it is still worth doing. The conventional wisdom may be correct. Uric acid level tests should tell if a low purine diet works for you.
1,000 MG PLUS DOSES
If you wish to try Vitamin C for gout in doses over 1,000 mg as part of a natural gout remedy discuss it with your doctor or a qualified naturopathic doctor. The 500 mg level is below the British government’s 1,000 mg (1 gram) recommended upper safety level safety limit for Vitamin C. It is half of the maximum amount (1,000 mg) in a Vitamin C tablet sold in the U.S. and many other countries.
If you take Vitamin C for gout as a dietary supplement, remember that it is reckoned to work better in a product that contains added citrus bioflavonoids. In addition, because it is excreted quickly, take it twice daily. To avoid excess acidity (lower pH) also take alkalizing minerals, or another alkalizing agent recommended by your doctor.
Should you take Vitamin C for gout? The answer is probably yes, but read on for a possibly relevant caution. Gout cures require that uric acid levels be reduced. Vitamins and drugs work in two ways to reduce uric acid levels. One is restricting its supply by inhibiting purine breakdown into uric acid, the other is improving uric acid’s breakdown into the urine. Vitamin C is thought to be a uric acid excretory, not an inhibitor. Improving excretion may be more important than reducing production.
One complicating factor is that elusive fact that most people with hyperuricemia (excess uric acid)do not get gout. Another is that some people with normal uric acid levels do.
A few studies over the past 30 years have concluded that Vitamin C will reduce the uric acid level. They have differed in the amount of Vitamin C given to study participants. A U.S. study of 184 non-smokers, published in 2005, concluded that the amount required to achieve a serum (blood) uric acid level reduction was 500 mg daily. (The Vitamin C was taken as a supplement). This is not a mega dose.
Previously it has been thought that the amount needed was at least 4,000 mg (4 grams) daily. For example, Dr. Robert Atkins in his book ” Vita Nutrient Solutions,” recommended 5,000 -10,000 mg as part of his formula natural remedy for gout.
In the 2005 study by how much did 500 mg of Vitamin C reduce their uric acid level? It found an average, across all participants, reduction of about 10% (0.5 mg/dL). In addition, reductions were larger among participants who had higher levels of uric acid at the start of the study. Participants took the 500 mg daily level for two months. Those who were given a placebo (i.e. not Vitamin C) showed a slight increase in uric acid levels.
0.5 mg/dL is a useful reduction but for most people probably not a natural remedy for gout, although the 0.5 mg/dL figure is an average and some participants did better. But a 0.5mg/dL reduction will not be enough to reduce uric acid below the 6.0 mg/dL level at which the MSU crystals may dissolve. However, when combined with other vitamins for gout, a low purine diet and other natural remedies for gout, it could be.
THE CAUTION
Rapid changes in uric acid levels can trigger a gout attack. This rapid change can be brought about by many factors in addition to possibly mega doses of Vitamin C and by drugs such as probenecid and sulfinpyrazone. People who are susceptible to gout must consider these rapid changes.
Such a rapid change concerned the authors of one study in the 1970’s who had recorded that mega doses of Vitamin C (4,000 mg and 8,000 mg daily) reduced uric acid levels significantly, and by more than in the 2005 study. However, as far as Vitamin C induced changes in uric acid levels is concerned, this triggering has not been reported in any study.
VITAMIN C AS A GOUT PREVENTOR
If 500 mg daily of Vitamin C can reduce uric acid levels, then Vitamin C ought to act as a preventative gout vitamin too. A Taiwan study of males in the late 1990’s examined the weight, diet and lifestyles of gout and non-gout sufferers in Taiwan. It concluded that Vitamin C, folic acid (folate) and fibre were protective against gout.
It also reached the well-known and accepted conclusion that hypertension (high blood pressure) and obesity are risk factors for gout. And one other very different conclusion from the conventional wisdom about purines — purine intake, with the exception of alcohol, was NOT associated with a risk of gout.
However, restricting purines in your diet is not difficult, so it is still worth doing. The conventional wisdom may be correct. Uric acid level tests should tell if a low purine diet works for you.
1,000 MG PLUS DOSES
If you wish to try Vitamin C for gout in doses over 1,000 mg as part of a natural gout remedy discuss it with your doctor or a qualified naturopathic doctor. The 500 mg level is below the British government’s 1,000 mg (1 gram) recommended upper safety level safety limit for Vitamin C. It is half of the maximum amount (1,000 mg) in a Vitamin C tablet sold in the U.S. and many other countries.
If you take Vitamin C for gout as a dietary supplement, remember that it is reckoned to work better in a product that contains added citrus bioflavonoids. In addition, because it is excreted quickly, take it twice daily. To avoid excess acidity (lower pH) also take alkalizing minerals, or another alkalizing agent recommended by your doctor.
