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Natural Remedies for Treating Gout

Written by Institute for Natural Medicine Staff

Medically Reviewed by Sarah Daglis, ND, MS

Published May 16, 2025
Last Updated May 19, 2025

Gout has long been associated with wealth and indulgence. Hippocrates called it “arthritis of the rich,” while during the reign of King Henry VIII, gout was famously known as the “disease of kings.” Today, gout is no longer limited to the elite—it’s the most common form of inflammatory arthritis worldwide, affecting about 10 million U.S. adults.¹

Diet, medications, and environmental toxins are a few known risk factors for gout.² Although greater exposure increases risk, gout is one of the most controllable types of arthritis. Thoughtful dietary and lifestyle changes can reduce flare-ups, ease symptoms, and in some cases, eliminate the disease entirely.³

Purines and gout attacks

Purines are natural substances found in the body and certain foods. When broken down, purines become urate or uric acid. Urate normally dissolves in the blood and is excreted through urine. But build-up and problems eliminating urate can cause it to accumulate in the joints. The result is sharp, needle-like crystals that trigger tenderness, pain, redness, swelling, and reduced mobility.

High-purine foods increase flare risk fivefold.⁴ Organ meat, shellfish, alcohol, and sugary treats and beverages are especially high in purine. Although lowering dietary purines is a central part of gout prevention and symptom control, long-term success also involves reducing inflammation, supporting kidney function, and addressing cardiovascular and metabolic health.

Who’s at risk?

Gout tends to affect more men than women and usually appears in middle age. It is especially problematic during menopause, when estrogen levels drop. Without enough estrogen, the kidneys can’t sufficiently flush out urates, causing uric acid to build up. People with hyperuricemia (high uric acid levels) are three times more likely to experience a gout flare.¹

Family history also plays a significant role. Around 40 to 50 percent of people with gout have a close relative who’s similarly affected.¹ In fact, more than 70 percent of those with a family history of hyperuricemia eventually develop gout.

Co-existing health conditions

Medical professional points to kidney model

Because damaged kidneys can’t eliminate uric acid quickly enough, kidney disease is a major risk factor for gout. Six other conditions may also increase gout risk³^,⁵:

High blood pressure
Metabolic syndrome
Psoriasis
Some cancers
Diabetes
Congestive heart failure

Being overweight or obese significantly increases susceptibility to gout. Research shows that losing weight can lower urate levels, reduce the frequency of flares, and even help prevent the disease.⁵

Some medications may also contribute to gout, including low-dose aspirin, chemotherapy drugs, testosterone replacement therapy, immunosuppressants, and diuretics. Diuretics alone increase the risk of a flare more than threefold.¹^,²^,³

Gout symptoms, stages, and complications

Woman with pain in hand holds up fingers

Gout typically progresses through three stages:

1. Hyperuricemia. Urate levels rise, often without symptoms.¹

2. Gout flares. The second stage begins with symptoms: sudden pain, swelling, redness, and warmth in a joint. Nearly 90 percent of flare-ups affect the legs and feet, with 50 percent starting in the big toe.¹ Symptoms often resolve in one to two weeks. However, 60 percent of people who have gout experience a second flare-up within a year, and 80 percent have a repeat flare within three years.¹^,³

3. Chronic gout. Without treatment, gout can progress. Crystals accumulate and cause damage to joints, soft tissues, and organs. Build-up in the kidneys may lead to kidney stones.³

Most gout complications involve the cardiovascular system, metabolic processes, and kidneys.³ Gout is associated with diabetes, high blood pressure, and excess blood fat. It may contribute to mortality related to infection, digestive disorders, and dementia.¹ Heart attack and stroke risks run higher in the months following a flare.⁶ Gout has also been linked to stomach, liver, lung, and bladder cancer.

When a gout flare strikes, act quickly:

Start treatment within 24 hours of symptom onset.¹
Elevate and rest the affected joint.
Apply ice to reduce swelling and pain.³

Environmental triggers

Several environmental factors have been shown to spark flares:

Lead exposure increases urate levels. People with elevated lead levels have shown a 3.6-fold higher risk of developing gout.²
Climate shifts matter. Gout flares increase with changing temperatures and seasonally. Climate warming may raise the overall burden of gout.
Air pollution also plays a role. A 1 mg/m³ uptick in carbon monoxide raises the rate of gout-related hospitalizations by nearly 4 percent. Ozone and fine particulate matter exposure increases emergency visits by 7 percent and 2 percent, respectively.²

Dietary changes to prevent and relieve gout

Assortment of vegetables, fruits, and foods in the Mediterranean diet

A low-purine diet is the foundation of gout management. Reducing or avoiding certain foods and drinks cuts flare frequency and may also help with weight, blood pressure, and lipid balance⁵^,⁷:

Alcohol: Beer, which contains more than 10 times the purines of whiskey or wine, raises urate levels significantly. Wine is a lesser offender. All alcohol increases gout risk, with more than two drinks per day upping the ante by 36 percent. Having more than four drinks per day raises the risk by 51 percent.²
Sugars: High-fructose corn syrup (HFCS) is especially risky. Consuming two or more servings per day of HFCS increases gout risk by 62 percent,² with urate levels rising just two hours after ingestion.⁵
Meat, fish, and seafood: Organ meat, veal, lamb, chicken with skin, and canned, dried, or oily fish (sardines, anchovies, herring, mackerel) have a high purine content.²^,³ However, salmon and tuna, which contain heart-healthy omega–3s, may help reduce flares. Eating two servings of omega–3–rich fish lowered flare risk by 26 percent.⁵ Cod, haddock, perch, and sole also contain less purine.²

The DASH diet, rich in fruits, vegetables, whole grains, healthy fats, and lean proteins (but low in red meat, sugar, and saturated fat), is known for reducing blood pressure and urate levels and may lessen gout risk by 32 percent.⁵ Similar to DASH but allowing moderate wine intake, the Mediterranean diet supports heart, metabolic, and kidney health.

Gout-friendly foods

Vegetables: Even vegetables high in purines, like asparagus, mushrooms, and spinach, don’t increase gout risk. In fact, vegetarians have the lowest rates of gout.²
Fruit: Natural fruit sugars are safe. Small studies show cherries and tart cherry supplements may reduce flare risk by curbing inflammation and supporting kidney health.⁵^,⁷^,⁸
Dairy: One or more servings of dairy (even milk powder) can lower urate levels and reduce flare frequency.⁵
Water: Drinking more than eight glasses of water a day can cut flare risk in half.²
Coffee: Coffee (regular or decaf) lowers gout risk significantly, while tea does not. Drinking one to three cups daily reduces susceptibility by 22 percent; more than four cups cuts risk by 57 percent.⁵

Herbs, supplements, and acupuncture

Several natural therapies show promise for gout:

Vitamin D supplements may help lower urate levels, which tend to be high in people with vitamin D deficiency.²
Taking 500 mg of vitamin C per day may lower urate and reduce gout risk, especially in women.¹^,²
Probiotics may help restore balance and reduce inflammation in people with gout, who tend to have fewer gut microbes and less microbial diversity.
One study shoed that 2 g of fish oil (omega–3) daily can may decrease uric acid within a month and reduce flare frequency.⁵
Research suggests traditional Chinese medicine taken internally and used topically may lower urate, pain, and inflammation. Combined herbal and acupuncture (particularly electroacupuncture) therapies may outperform conventional treatments for some individuals.⁹^,¹⁰^,¹¹

Footnotes

1
Fenando A, Rednam M, Gujarathi R, Widrich J. Gout. In: StatPearls. StatPearls Publishing; 2025. Accessed April 8, 2025. http://www.ncbi.nlm.nih.gov/books/NBK546606
2
Helget LN, Mikuls TR. Environmental triggers of hyperuricemia and gout. Rheum Dis Clin North Am. 2022;48(4):891-906. https://pmc.ncbi.nlm.nih.gov/articles/PMC10351897
3
Gout. National Institute of Arthritis and Musculoskeletal and Skin Diseases. April 12, 2017. Accessed April 8, 2025. https://www.niams.nih.gov/health-topics/gout
4
Zhang Y, Chen C, Choi H, Chaisson C, Hunter D, Niu J, Neogi T. Purine-rich foods intake and recurrent gout attacks. Ann Rheum Dis. 2012 Sep;71(9):1448-53. https://doi.org/10.1136/annrheumdis-2011-201215
5
Danve A, Sehra ST, Neogi T. Role of diet in hyperuricemia and gout. Best Pract Res Clin Rheumatol. 2021;35(4):101723. https://pmc.ncbi.nlm.nih.gov/articles/PMC8678356
6
Cipolletta E, Tata LJ, Nakafero G, Avery AJ, Mamas MA, Abhishek A. Association between gout flare and subsequent cardiovascular events among patients with gout. JAMA. 2022 Aug 2;328(5):440-450. https://doi.org/10.1001/jama.2022.11390
7
Chen Z, Xue X, Ma L, et al. Effect of low-purine diet on the serum uric acid of gout patients in different clinical subtypes: a prospective cohort study. Eur J Med Res. 2024;29(1):449. https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-024-02012-1
8
Wang C, Sun W, Dalbeth N, et al. Efficacy and safety of tart cherry supplementary citrate mixture on gout patients: a prospective, randomized, controlled study. Arthritis Res Ther. 2023 Sep 7;25(1):164. https://doi.org/10.1186/s13075-023-03152-1
9
Choi SH, Song HS, Hwang J. Herbal medicine for external use in acute gouty arthritis: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore). 2023;102(37):e34936. https://pmc.ncbi.nlm.nih.gov/articles/PMC10508450
10
Liang H, Wu Y, Zhang W, et al. Efficacy and safety of acupuncture combined with herbal medicine in treating gouty arthritis: meta-analysis of randomized controlled trials. Evid Based Complement Alternat Med. 2021 Dec 30;2021:8161731. https://doi.org/10.1155/2021/8161731
11
Ni Z, Xiao Q, Xia Z, Kuang K, Yin B, Peng D. Electroacupuncture for acute gouty arthritis: a systematic review and meta-analysis of randomized controlled trials. Front Immunol. 2024 Jan 4;14:1295154. https://doi.org/10.3389/fimmu.2023.1295154

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