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Gout is an inflammatory condition that is caused by the deposit of uric acid crystals in joints (most famously the big toe), as well as other tissues. Typically, attacks of fierce pain, redness, swelling, and heat punctuate pain-free intervals.
Medical treatment consists of anti-inflammatory drugs for acute attacks and of uric acid-lowering drugs for prevention.
Proposed Treatments for Gout
The following herbs and supplements are widely recommended for gout, but as yet they have no reliable scientific support.
In a double-blind, placebo-controlled study of 184 people without gout, use of vitamin C at a daily dose of 500 mg significantly reduced uric acid levels.7 This suggests, but falls far short of proving, that vitamin C might be helpful for preventing or treating gout.
For more information, including dosage and safety issues, see the full Vitamin C article.
Folate has been recommended as a preventive treatment for gout for at least 20 years. Some clinicians report that it can be highly effective. However, what little scientific evidence we have on the method is contradictory.1,2,3 It has been suggested that a contaminant found in folate, pterin-6-aldehyde, may actually be responsible for the positive effects observed by some clinicians.
For more information, including dosage and safety issues, see the full Folate article.
Devil's Claw TOP
The herb devil's claw is sometimes recommended as a pain-relieving treatment for gout based on evidence for its effectiveness in various forms of arthritis.4 However, it has not been tested in gout.
For more information, including dosage and safety issues, see the full Devil's Claw article.
Cherries are also claimed to be helpful for gout, based primarily on a single "scientific" study performed in the 1950s.8 In fact, however, this study was far too poorly designed to prove anything at all, because it did not utilize a placebo group. (For information on why a placebo group is essential, see Why Does This Database Rely on Double-Blind Studies?) A much more recent study did find some evidence that cherry consumption might lower levels of urate in the blood.7 Although high levels of urate are associated with gout, we can not conclude that cherries can directly benefit gout based on this trial. Another larger study did assess direct benefits of cherry on gout when the study assessed the risk of recurrent gout attacks in 633 people using cherries or cherry extract two days prior to a gout attack. Participants taking cherries or cherry extract had 35% lower risk of gout attacks than when they did not use cherries or extract. Further, the addition of cherry consumption with allopurinol treatment reduced the risk of gout attacks by 75% when compared to using only one of either treatment.8. Both trials did have had some design issues that may reduce reliability.
Traditional Chinese Herbal Medicine TOP
Traditional Chinese herbal medicine (TCHM) has a long historical tradition, although it is not quite as ancient as popularly believed. In China today, TCHM is used alongside conventional pharmaceutical treatment. Considerable attempts have been made to subject TCHM to scientific evaluation however, most of the published Chinese studies on the subject fall far short of current scientific standard, making it impossible to determine true benefits. Chinese herbal medicine is also a unique mix of herbs with potency and makeup that can vary greatly between prescriptions.
A review of 17 randomized trials involving TCHM appears to show promise as a treatment for acute gout attacks. In these trials, TCHM was compared to traditional Western medications (colchicine, allopurinol, colchicine plus allopurinol, diclofenac, or meloxicam) in 1,402 people with acute gout symptoms. TCHM had similar improvements in clinical blood markers of gout as traditional medication but TCHM was associated with fewer side effects. However, all trials in this review had several biases, which affect the reliability of the results.9
Other Supplements TOP
On the basis of interesting reasoning but no concrete evidence of effectiveness, fish oil, olive leaf, vitamin E, selenium, bromelain, vitamin A, and aspartic acid have also been recommended for both prevention and treatment of gout.5
Folk Remedies TOP
Celery juice is a traditional folk remedy for gout that is said to be widely used in Australia.
References[ + ]
1. Lewis AS, Murphy L, McCalla C, et al. Inhibition of mammalian xanthine oxidase by folate compounds and amethopterin. J Biol Chem. 1984;259:12-15.
2. Flouvier B, Duvulder B. Folic acid, xanthine oxidase, and uric acid [letter]. Ann Intern Med. 1978;88:269.
3. Boss GR, Ragsdale RA, Zettner A, et al. Failure of folic acid (pteroylglutamic acid) to affect hyperuricemia. J Lab Clin Med. 1980;96:783-789.
4. European Scientific Cooperative on Phytotherapy. Harpagophyti radix. Exeter, UK: ESCOP; 1996-1997:4. Monographs on the Medicinal Uses of Plant Drugs, Fascicule 2.
5. Murray MT, Pizzorno JE. Encyclopedia of Natural Medicine. 2nd ed. Rocklin, Calif: Prima Publishing; 1998:493-494.
7. Huang HY, Appel LJ, Choi MJ, et al. The effects of vitamin C supplementation on serum concentrations of uric acid: results of a randomized controlled trial. Arthritis Rheum. 2005;52(6):1843-1847.
8. Zhang Y, Neogi T, et al. Cherry consumption and decreased risk of recurrent gout attacks. Arthritis Rheum. 2012;64(12):4004-4011.
9. Zhou L, Liu L, et al. Systematic review and meta-analysis of the clinical efficacy and adverse effects of Chinese herbal decoction for the treatment of gout. PLoS One. 2014;9(1):e85008.
Last reviewed December 2015 by EBSCO CAM Review Board
Last Updated: 12/15/2015
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