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I am a big coffee drinker – so this is important to me.
On the page – Home remedies for gout choice: Water – it says, “Some drinks contain caffeine or other diuretics. Do not include these as part of your water intake. If you drink lots of tea, coffee, cola or other diuretic drinks, you should increase your water consumption to compensate.”
However, on the page – Gout and Coffee, I read, “One other benefit of coffee for gout is it's water content. Though coffee is mildly diuretic, it still counts towards your daily fluid intake. I cannot overemphasize the importance of hydration.”
So, which is it – should I drink it and count toward total fluid intake? Or should I drink it to obtain the benefits reflected in the study but NOT count it in my total fluid intake? Or – avoid it – and make sure I drink plenty of water?
opa,
You are not alone in your confusion. I have been trying for YEARS to get a resolution of the problem. Here's the gist: the literature says that the source of dietary uric acid (as opposed to natural cell breakdown liberating nucleic acids) is PURINES, primarily xanthine and guanine. These purines in humans have as their natural end point, URIC ACID.
So, what is caffeine? Chemically it is tri-methyl XANTHINE, chemically VERY close to uric acid…or xanthine with three small methyl groups hung on. Now, restrictions on the amount of purines is strict for gout sufferers, on the order of a half gram a day or less.
The AVERAGE amount of uric acid produced in a day is about 700 mg. Since a gram of caffeine seems logically to yield close to a gram of uric acid, caffeine would seem to be a problem especially since an average cup (8 ounces) has about 160 mg. caffeine. I drink about 50 ounces of strong coffee per day…I'm extremely addicted.
But look at the dietician's link that pops up prominantly on a search for gout and caffeine and she says point blank: “CAFFEINE IS NOT A PURINE.” Well, I am a chemist and if the definition of purine is xanthines and guanines, then caffeine, being tri-methyl xanthine, sure as Hell IS a purine. Alass, the web can be the source of some pretty rotten information.
Like I said, I am as confused as you are. If I thought FOR SURE that drinking coffee vastly increased my pool of uric acid, I would stop drinking it. But I don't want to stop for NOTHING…and beside Betty Ford for kicking the addiction is EXPENSIVE.
opa6x57 said:
I am a big coffee drinker – so this is important to me.
On the page – Home remedies for gout choice: Water – it says, “Some drinks contain caffeine or other diuretics. Do not include these as part of your water intake. If you drink lots of tea, coffee, cola or other diuretic drinks, you should increase your water consumption to compensate.”
However, on the page – Gout and Coffee, I read, “One other benefit of coffee for gout is it's water content. Though coffee is mildly diuretic, it still counts towards your daily fluid intake. I cannot overemphasize the importance of hydration.”
So, which is it – should I drink it and count toward total fluid intake? Or should I drink it to obtain the benefits reflected in the study but NOT count it in my total fluid intake? Or – avoid it – and make sure I drink plenty of water?
opa6×57,
Please accept my apologies for the confusion, and my thanks for pointing out this inconsistency.
The first page you mention, Water as a Home Remedy for Gout, is wrong, and I will correct it as soon as I can.
There is sufficient evidence to suggest that coffee is beneficial to gout sufferers.
Not only that, but when I wrote that page, I was misled by information I had seen about the diuretic effects of coffee. It is now clear to me that no amount of coffee will produce negative hydration – i.e. the small diuretic effect of caffeine is more than outweighed by it's water content.
You should follow the advice on the Gout and Coffee page, which is based on more recent research.
Apologies for the confusion – we're all still learning.
The result that seem to say that coffee lowers gout risk is first called a PROSPECTIVE study…to me that means it hasn't been done yet???
Quote:
The June 2007 edition of Arthritis & Rheumatism reports, in Coffee Consumption and Risk of Incident Gout in Men: A Prospective Study
Secondly, what I see is a look back…that is NOT a study. A proper study is a controlled study that looks FORWARD and compares groups to test a hypothesis.
Thirdly, the slim look back results shows that men with gout drank less coffee than men without. If your first diagnosis of gout came with the warning from your doctor to give up, or moderate your coffee wouldn't that “result” be predetermined.
An example might be that people with rheumatoid arthritis are told to stop running. A look back will discolose that those without arthritis tend to run more and therefore falsely indicate that running cures arthritis.
These gout-coffee studies are terrrible and as a result I smell the money influence of the multi-billion dollare coffee industry here.
My best evidence is intuitive: xanthines are purines and purines cause/exacerbate gout. Uric acid is basically a slightly modified xanthine molecule…it is therefore most compelling that caffeine (trimethyl xanthine) theobromine and theophylline (dimethyl xanthiines) break down to uric acid. And the quantities are enormous for heavy coffee drinkers. I get a GRAM of caffeine/xanthine in my coffee
Until someone takes two LARGE blinded groups (or as blinded as one can arrange) dries them out for a couple weeks and feeds one lots of coffee and one lots of SANKA or water, and then measures the average differential in serum uric acid BEFORE and AFTER a suitable amount of time…maybe 14 days…we shall NEVER know for sure.
WHY a simple test like this was not run/published/trumpeted is anyone's guess. But I am reminded of the many decades that no testing, or at least no results of testing released, was done to determine whether or not cigarettes caused cancer and heart disease. Big money talks loudly.
I am CERTAIN that the coffee industry has done definitive studies, as ANY multi-billion dollar industry would…so their NON-publishing speaks volumes.
As for the diuretic effect of coffee, for myself I have PROVEN that it is nonexistant, one of those old saws that is repeated ad-infinitum with zero facts to back it up. If I driink lots of coffee on an empty stomach, as I do for 3 hours every morning, I am considerable HEAVIER than when I started, not lighter. The same goes for BEER (although other spirits and wine are very dehydrating.)
From medterms.com:
Definition of Prospective study
Prospective study: A study in which the subjects are identified and then followed forward in time.
These are quite cheap to do, because they just use data (in this case from over 45,000 men). They identified subjects who did not have gout, then profiled them after 12 years. Statistically coffee drinkers developed less gout.
The data has been used for a range of other analysis – and each time it produces a separate report, presumably bringing reward to the authors.
Significantly, it was this data that led to the suggestion that vegetable purines do not contribute to raised uric acid – but again, I am unaware of any reliable blinded study that properly analyses different sources of purines on uric acid.
Quite simply, there is nobody on the planet going to finance this type of study.
So we just have to struggle on – with or without coffee cup in hand.
My first attack was 1 year ago and since then have been on a bit of a rollercoaster. I began with Allopurinol 2months ago and after some initial flare ups things have settled down. The cheat sheet from the pharmacy said avoid coffee so I have cut it out entirely. Now that I have “stabilized” I am anxious to get back to my coffee habit. I asked the pharmacist and he reiterated that the coffee inhibits the efficacy of the medication. On this site I see that coffee may even be beneficial.
Any opinions on whether coffee interferes with Allopurinol?
Thanks
q
I'm a seasonal coffee drinker. I have a friend back in the US who runs a coffee roasting business and I get some great stuff from him. In the warmer months, I drink diet soda, now mostly Pepsi Max (no sugar, no calories, but around 200mg caffeine per liter). I know I shouldn't, I know it's probably not great for me, but I'm addicted to the stuff. I should note, that I drink a minimum of 4.5 liters of water a day and usually more.
About a month ago, I decided to try to kick the pepsi max habit. I stopped entirely and just drank water for a week. I had my worst gout attack in five months two days after I gave up the pepsi! Coincidence? Probably. But, it was the only thing at that moment that I had changed in my dietary ways and lifestyle. Once I was over that attack, I had another bad attack, still while remaining off of the pepsi.
About two weeks ago, I started back up on the pepsi max. No bad attacks since, just the normal middling attacks that plague me while my body cleanses itself of old deposits (I'm on 600mg/day of Allo – six months now).
I don't think the Pepsi is hurting me (except for the chemicals on my internal organs, perhaps!). I can't correlate any effects from drinking the Pepsi and my gout, though.
Just got my latest test results back today:
UA 4.9 (yay!)
Liver and Kidney functions good
Blood Pressure continuing to lower
Everything else checked out fine too
qas said:
My first attack was 1 year ago and since then have been on a bit of a rollercoaster. I began with Allopurinol 2months ago and after some initial flare ups things have settled down. The cheat sheet from the pharmacy said avoid coffee so I have cut it out entirely. Now that I have “stabilized” I am anxious to get back to my coffee habit. I asked the pharmacist and he reiterated that the coffee inhibits the efficacy of the medication. On this site I see that coffee may even be beneficial.
Any opinions on whether coffee interferes with Allopurinol?
Thanks
q
The cheatsheet I got pharmacy does not talk about Coffee…it does talk about alcohol….My doctor did not say to avoid coffee. In fact, as I was feeling lethargic when I started Allopurinol, I used to take more coffee to wean off the drowsiness and lethargy caused by Allopurinol. I did not feel or notice any negative effects though my coffee is generally my favourite drink – Starbucks Double Shot Tall Non Fat Latte….twice a day..that is 4 shots a day…
NateA said:
I'm a seasonal coffee drinker. I have a friend back in the US who runs a coffee roasting business and I get some great stuff from him. In the warmer months, I drink diet soda, now mostly Pepsi Max (no sugar, no calories, but around 200mg caffeine per liter). I know I shouldn't, I know it's probably not great for me, but I'm addicted to the stuff. I should note, that I drink a minimum of 4.5 liters of water a day and usually more.
About a month ago, I decided to try to kick the pepsi max habit. I stopped entirely and just drank water for a week. I had my worst gout attack in five months two days after I gave up the pepsi! Coincidence? Probably. But, it was the only thing at that moment that I had changed in my dietary ways and lifestyle. Once I was over that attack, I had another bad attack, still while remaining off of the pepsi.
About two weeks ago, I started back up on the pepsi max. No bad attacks since, just the normal middling attacks that plague me while my body cleanses itself of old deposits (I'm on 600mg/day of Allo – six months now).
I don't think the Pepsi is hurting me (except for the chemicals on my internal organs, perhaps!). I can't correlate any effects from drinking the Pepsi and my gout, though.
Just got my latest test results back today:
UA 4.9 (yay!)
Liver and Kidney functions good
Blood Pressure continuing to lower
Everything else checked out fine too
Stopping drinking Diet Pepsi gave you a gout attack? Dude you are in denial heaven
I drink 2 large cups of coffee every AM to help prevent migraines (caffeine helps prevent vasodilation and cranial blood vessel spasms) and I use Stevia sweetner in the coffee. The rest of the day, I drink 1 gallon of water or lemonade with tart cherry juice. I am on my 1st week of Allopurinol (100mg a day). This past weekend was rough as my toes hurt quite a bit. I'm 6'1″ and 180lbs, so I'm not overweight.
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