Gout, Sauna & Sweating

If you have gout, a sauna might seem the ideal way to relax.

Yes, it keeps your gouty joints nice and warm, but what about side effects?

You need to take care in the sauna, as excess sweating can soon cause high uric acid levels.

Generally speaking, warmth is good for gout sufferers. But what happens when you get too hot and start to sweat?

There are some gout research studies in this area that have helped me get a better understanding of gout and sweating.

Uric Aid & Sweat

In, Excretion of nitrogen compounds in sweat during a sauna, D Czarnowski and J Górski determined that:

No uric acid was detected in sweat.

However, this was contradicted by a later study from C T Huang et al in Uric acid and urea in human sweat. They did measure small amounts of uric acid, equivalent to 6.3% of that found in the blood, though they note:

The results indicate that sweat uric acid concentration is quite minimal, and the estimated total uric acid excretion per day in normal physiological range is insignificant.

More importantly, they make the point that heavy sweating reduces urinary excretion of uric acid. These results are from experiments in which sweating was induced by vigorous exercise. Strenuous exercise raises uric acid levels, so I conclude that the extra uric acid from this exercise is the likeliest reason why uric acid in sweat was measurable in this study.

In 2004, T Yamamoto et al reported on Effect of sauna bathing and beer ingestion on plasma concentrations of purine bases. This study did not measure uric acid in sweat, but they do confirm that

sauna bathing […] decreased the urinary excretion of uric acid.

So does this get us any nearer understanding if sweating causes gout?

It seems clear to me that what causes gout here is dehydration rather than any direct effect of heat. If you want to avoid gout attacks when using the sauna, make sure you drink plenty of water.

Gout and Heat

This is a personal account of a gout sufferer who was struggling to lower uric acid despite allopurinol, as he was an under-excreter. Your circumstances may be different, but his story confirms the value of drinking plenty of water when using heat for gout.

Mick was suffering from what he describes as chronic inflammation rather than an acute gout flare. He ranks the inflammation level as 30%. He came up with the idea of turning the heating up in his home, and drinking 5 liters of water per day. After one and a half days, his inflammation was virtually gone, being 5%.

Gout Sauna: Next Steps

You have learned that sauna bathing, due to sweating can cause high uric acid. If you take part in any activity that leads to sweating, take care to replace lost fluids as soon as possible.

If you have further questions, or want to share your experiences of gout and sauna, please use the Gout Forum.

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