Citrus for Gout – Natural Lower Uric Acid

Citrus for Gout is my overview of science that shows how citrus fruits can help your gout. Also, I introduce a new list of citrus and other foods that should naturally lower your uric acid. (If you manage your eating habits properly!)

Citrus for Gout Audience

I wrote Citrus for Gout for Gout Foodies who want to eat foods that will help their gout. Also, for Gout Dieters who want to improve specific aspects of their diet to improve uric acid test results. So, if you are not sure which type of gout sufferer you are, start reading Questions for Gout Sufferers now.

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Foods High In Uric Acid And Purines

Foods high in uric acid and purines form the conclusion of the High Purine Foods study, which is described below. This concludes the study: Purine-Rich Foods, Dairy and Protein Intake, and the Risk of Gout in Men.

Your GoutPal Update

I flagged this article for review as part of my project to make this website easier for all gout sufferers. Therefore, I must make it clear that:

  1. This article is aimed at Gout Dieters. Specifically, gout sufferers who are actively monitoring the effects of their diet changes on their uric acid levels. Otherwise, gout sufferers interested in food should start at GoutPal Plan for Gout Foodies.
  2. Gout Dieters should seek high-protein, low-purine foods. But, they must recognize that vegetable purines do not raise uric acid. Because not all foods high in purines can be described as foods high in uric acid.
  3. Individual high protein foods from animals should not be omitted from your diet simply because they are high in purines. Because Gout Dieters must consider total diet and all factors that affect uric acid levels. Especially purine-rich flesh from overweight bodies.

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Losing Weight With Gout Foods To Avoid

During my review and reorganization of the Gout Diet section, I noticed how my old Diet For Gout page was about the benefits of losing weight for gout sufferers. Control of excess calories is important for some gout patients, though probably not as many as is generally believed. There was a lot of useful information on that page, so I reproduce it below.

The latest gout foods to avoid pages, now cover specific aspects of excess calories and gout, including tips for losing weight that do not trigger more acute gout flares.

I will expand the relevant pages in the Gout Diet section to make it clear that a diet for gout must consider different types of foods to avoid (or at least to limit). As excess calories lead directly to extra uric acid from the purines in our own flesh, it pays to consider calorie control. As with all forms of gout treatment and diet changes, your plan must start with gathering information about yourself. This article introduces some tools to help you assess if weight loss needs to be part of your personal gout management plan.

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Gout Foods: Figs and Gout

Figs and gout is the 88th topic in the top gout searches series, described in Gout and You. Figs are a delicious food, often associated with an alkalizing gout diet menu. Before I discuss that, I need to clarify a specific link between figs and gout.

Some time ago, when reviewing how morin is helpful to gout sufferers, I started trying to find the best food sources for morin. I have some useful news about morin, but I cannot find anything meaningful about food sources. Though many gout studies associate morin with figs, those that do reveal sources always refer to extracts from mulberry bark. There are one or two studies into morin extracts from fig leaves, but nothing so far about the fruit. I believe the confusion may arise because mulberry and fig belong to the same plant group. Indeed the wide range of plants in the Moraceae family are often called the fig family or mulberry family. I will stop associating fig fruit with morin unless I find real evidence that it is a useful source. I will report the morin news separately. Meanwhile, back to figs…

Dried figs are often viewed as highly alkalizing. This is one of the dangers of comparing foods based on 100g portion sizes. Nobody eats 100 grams of dried figs. This was one reason why all my recent tables are based on 100 calories servings. It is still not perfect, as many beverages and spices produce outrageously large portion sizes. However, energy based portions are easier to compare than weight based portions.

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How Purines Affect Gout

Purines have been at the center of gout diet management for many years.

But is the purine involvement overstated? Worse still, is it wrong?

We all know that gout is caused by excess uric acid, but where does this uric acid come from? There are two sources – some from the food that we eat (external purines), and some from our own natural cell metabolism (internal purines).

As this is the Gout Diet Section, I should focus on purines from food (and drink), but I believe it is important that you understand how our own purines affect gout before we consider the additional purines from meals and snacks.

Internal Purines, Uric Acid, And Gout

Very briefly:

  1. When cells die in our bodies, complex chemical reactions breakdown the cell contents, forming purines and other substances.
  2. Our bodies produce a substance called Xanthine Oxidase (XO), that turns purines into uric acid
  3. Our kidneys extract uric acid from blood, then return most of it, excreting any surplus. Several factors will influence what our kidneys consider to be a surplus, and that process can be changed by genetics, the amount of protein in our diet, other substances such as alcohol and some medicines.
  4. Where uric acid becomes too concentrated in our blood, it will pass into joints and other tissues, where it may form the crystals that cause gout.

It is important to realize from this that, irrespective of diet, our bodies produce their own uric acid supply. Complex processes work on the raw materials (purines), and may create the excess uric acid that can cause gout.

External Purines

External purines from our diet simply increase the raw materials available for uric acid production. If our bodies have problems in parts of the internal purine processing described above, then external purines might make the problem worse, but they do not cause gout directly.

Think of traffic at a busy intersection. When all is OK, the traffic flows, but if there is an accident, extra traffic adds to delays – it does not (usually) cause more accidents. Traffic is internally generated as an essential part of city life, and it can be increased by external traffic from visitors. When traffic problems occur, we do not ban visitors, though we might advise alternate routes.

When uric acid processing problems lead to gout, do not ban all your favorite foods. Life will become miserable, and you might achieve nothing. Yes, reducing external purines has a good chance of reducing uric acid. But it is a slight reduction, which is rarely sufficient to bring uric acid in the blood down to safe levels.

If your uric acid levels are up to about 8 mg/dL ( 0.5 mmol/L), then you might consider purine control as a gout management option, though be sure to understand that all purines are not the same. For any levels above that, purine control is, at best, a component in a comprehensive gout management plan, or, at worst, a complete waste of time and effort.

Types Of Purine

If you do decide to control purines to reduce your uric acid level, you must be very careful. As I explain in my other purine articles, there are many different types of purines, yet almost all published information quotes total purine content. The 4 main types of purine are Xanthine, Hypoxanthine, Guanine, and Adenine.

Of the 4 main types of purine, only two have been shown to increase uric acid levels. Not all purines are equal, so be careful when you look for foods high in purines. The purine rich foods chart is a better resource for purines that are most likely to affect gout.

Gout research tells us that we only need to consider purine food from animal sources. Vegetable purines do not increase uric acid. Vegetable purines means food from plant sources. Therefore you can ignore the purine content of legumes, fruit, nuts, seeds, and all other food from plant sources. There is another group – mushrooms and other fungi, such as yeast. These are rarely consumed in high enough volumes to cause uric acid problems. However, you always need to take a personal view, and get regular uric acid tests from your doctor.

Purines: Next Steps

You now know that purines, the source of uric acid, may come from gout diet, but mainly come from our own bodies as part of natural cell turnover.

Of the purines in food, only two out of the main four purines are likely to effect gout. Read the purine rich foods chart for details of the individual purines in certain foods. That is the only way to see foods high in purines that affect gout.

To be certain that your dietary changes are improving your uric acid level, you must carefully monitor uric acid in your blood.

Leave this Purines page to browse the Gout Diet Section.

This How Purines Affect Gout page was first published May 22, 2011
It was reviewed and updated on Nov 20, 2012
Latest review and amendment: May 29, 2016

Another Low Purine Foods List

Here’s another low purines food list. It complements yesterday’s list in Is Very Low Purine Gout Diet Possible?

Just like the very low purine foods list, these foods are from recent Japanese gout research. Therefore, some foods might be unfamiliar. But, that’s just a chance to try something new. You can share some new low purine recipes in the gout forum, if you find something really tasty that’s also gout-friendly.

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