Hot Drinks and Gout: Which Ones Are Best

mature woman having coffee

Coffee. Tea. Hot chocolate. Mulled wine. When the mercury drops outside, there’s nothing better than coming in from the cold to enjoy a hot drink. And here’s something else to feel good about—certain hot beverages may have benefits for people with gout.1 Read on to learn more about hot drinks and gout: which ones are best.  

Choose your hot drinks carefully

Even though heredity is mostly to blame for gout, it’s still important to be mindful of what you eat—especially if you suffer with gout attacks.2,3 The same is true when it comes to drinks.1 Consider how these hot beverages can affect your risk of gout flares:

Coffee

Research shows that consuming coffee may be associated with a lower risk of gout.1,4 According to an online article published by the Cleveland Clinic, drinking coffee each day may help reduce uric acid levels by slowing the breakdown of purines into uric acid and speeding up the elimination of uric acid from the body.1 But before you make changes to your coffee intake, be sure to check with your doctor.5 People with certain health conditions or who take medications that might be affected by caffeine should limit their coffee intake or avoid it altogether.5

Tea

While research has shown that coffee consumption may be beneficial for people with gout, the same may not be true for tea.6 A 2016 review of the results of nine studies showed there does not appear to be a significant relationship between tea consumption and the risk of gout.6 And a more recent study, conducted in 2021 on 7,644 Chinese men and women, found that tea consumption may actually be associated with a higher risk of gout—particularly in men.7

Warm milk

Though there is little scientific evidence that a cup of warm milk at bedtime can promote a good night’s sleep, low-fat and fat-free dairy products have been proven to lower the uric acid level in the body.8 It is believed that certain proteins in these foods help eliminate uric acid from the bloodstream and thus reduce the risk of gout attacks.8 In addition to helping reduce the amount of uric acid in the body, low-fat and fat-free dairy products contain nutrients that deliver many other health benefits.9

Hot water (with lemon)

According to an online article published by the Cleveland Clinic, people who drink five to eight cups of water each day are less likely to have gout symptoms.1 This is because water is believed to help flush excess uric acid out of the body.1 (If you find plain water to be too bland, consider adding fresh-squeezed lemon for flavor.10)

Coffeehouse treats

As tempting as it may be to ask for a pumpkin spice latte at the coffee shop, think twice before you order. Like sugary foods, sweet beverages are associated with an increased risk of gout flares.1 (They also can be loaded with saturated fat and empty calories.11) Consider skipping the added sugar and try a skim or low-fat latte to reap the benefits of both coffee and low-fat dairy.

Hot toddies

Most people associate drinking beer with a higher risk of gout flares, but it’s not the only alcoholic beverage that can increase your risk of these painful attacks.8 Unfortunately, all alcoholic beverages, including wine, are associated with a higher risk of gout flares.8 If you suffer with gout attacks, it’s best to steer clear of buttered rum, mulled wine and other hot drinks that contain alcohol.8

Stay in touch with your doctor

If you’ve been experiencing gout flares more often than usual, contact your doctor. He or she may want to start you on a urate-lowering therapy (ULT; allopurinol, for example) if you’re not already taking one.12 (If you’ve already been prescribed a ULT, you may need a dose adjustment.12) Your doctor may also recommend a colchicine product such as Mitigare® (Colchicine) 0.6mg Capsules or Generic Colchicine Capsules to help prevent gout flares.13

 

Mitigare® is a registered trademark of Hikma Pharmaceuticals USA Inc.

Colchicine 0.6 mg capsules are contraindicated in patients with renal or hepatic impairment who are currently prescribed drugs that inhibit both P-gp and CYP3A4. Combining these dual inhibitors with colchicine in patients with renal or hepatic impairment has resulted in life-threatening or fatal colchicine toxicity. Patients with both renal and hepatic impairment should not be given Mitigare®.

Fatal overdoses have been reported with colchicine in adults and children. Keep Mitigare® out of the reach of children.

Blood dyscrasias such as myelosuppression, leukopenia, granulocytopenia, thrombocytopenia and aplastic anemia have been reported with colchicine used in therapeutic doses.

Monitor for toxicity and, if present, consider temporary interruption or discontinuation of colchicine.

Drug interaction with dual P-gp and CYP3A4 inhibitors: Co-administration of colchicine with dual P-gp and CYP3A4 inhibitors has resulted in life-threatening interactions and death.

Neuromuscular toxicity and rhabdomyolysis may occur with chronic treatment with colchicine in therapeutic doses, especially in combination with other drugs known to cause this effect. Patients with impaired renal function and elderly patients (including those with normal renal and hepatic function) are at increased risk. Consider temporary interruption or discontinuation of Mitigare®.

The most commonly reported adverse reactions with colchicine are gastrointestinal symptoms, including diarrhea, nausea, vomiting and abdominal pain.

Please see the full Prescribing Information and Medication Guide for Mitigare® for complete product details.

References

  1. Gout Low Purine Diet. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/treatments/22548-gout-low-purne-diet. Accessed August 11, 2022.
  2. Higashino T, Takada T, Nakaoka H, et al. Multiple common and rare variants of ABCG2 cause gout. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5706492/pdf/rmdopen-2017-000464.pdf RMD Open. 2017;3:e000464.
  3. Chen C-J, Tseng C-C et al. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5816657/pdf/41598_2018_Article_21425.pdf. Nature/Scientific Reports. 2018;8:3137.
  4. Shirai Y, Nakayama A, Kawamura Y, et al. Coffee Consumption Reduces Gout Risk Independently of Serum Uric Acid Levels: Mendelian Randomization Analyses Across Ancestry Populations. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9190218/pdf/ACR2-4-534.pdf ACR Open Rheumatol. 2022;4(6):534-539.
  5. Caffeine. Medline Plus website. Available at: https://medlineplus.gov/caffeine.html Accessed August 11, 2022.
  6. Zhang Y, Cui Y, Li X-a, et al. Is tea consumption associated with the serum uric acid level, hyperuricemia or the risk of gout? A systematic review and meta-analysis. Available at: https://bmcmusculoskeletdisord.biomedcentral.com/track/pdf/10.1186/s12891-017-1456-x.pdf BMC Musculoskeletal Disorders. 2017;18(95).
  7. Li R, Zeng L, Wu C, et al. Tea Consumption is Associated with an Increased Risk of Hyperuricemia in an Occupational Population in Guangdong, China. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8922363/pdf/ijgm-15-2747.pdf Int J Gen Med. 2022;15:2747-2757.
  8. Kakutani-Hatayama M, Kadoya M, Yamomoto T. Nonpharmacological Management of Gout and Hyperuricemia: Hints for Better Lifestyle. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6125106 Am J Lifestyle Med. 2017;11(4):321-329.
  9. Dairy. USDA MyPlate/US Department of Agriculture. Available at: https://www.myplate.gov/eat-healthy/dairy Accessed August 22, 2022.
  10. Wang H, Cheng L, Lin D, Ma Z, Deng X. Lemon fruits lower the blood uric acid levels in humans and mice. Available at: https://www.sciencedirect.com/science/article/abs/pii/S0304423817301851 Sci Hortic. 2017;220:4-10.
  11. The Unhealthiest Coffee Drinks in America. Eat This, Not That! Available at: https://www.eatthis.com/8-worst-coffee-drinks-in-america. Accessed August 22, 2022.
  12. FitzGerald JD, Dalbeth N. 2020 American College of Rheumatology Guideline for the Management of Gout. Available at: https://onlinelibrary.wiley.com/doi/10.1002/acr.24180 Arthritis Care Res. 2020;72(6):744-760.
  13. Mitigare® (Colchicine) 0.6mg Capsules [prescribing information available at: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=cb5f9d85-6b81-49f8-bcd6-17b7bfbc10f2]. Columbus, OH: West-Ward Columbus, Inc.; 2019.s, OH: West-Ward Columbus, Inc.; 2019.

Important Safety Information for Mitigare® (colchicine) 0.6 mg capsules

  • Colchicine 0.6 mg capsules are contraindicated in patients with renal or hepatic impairment who are currently prescribed drugs that inhibit both P-gp and CYP3A4. Combining these dual inhibitors with colchicine in patients with renal or hepatic impairment has resulted in life-threatening or fatal colchicine toxicity. Patients with both renal and hepatic impairment should not be given Mitigare®.
  • Fatal overdoses have been reported with colchicine in adults and children. Keep Mitigare® out of the reach of children.
  • Blood dyscrasias such as myelosuppression, leukopenia, granulocytopenia, thrombocytopenia, and aplastic anemia have been reported with colchicine used in therapeutic doses.
  • Monitor for toxicity and if present consider temporary interruption or discontinuation of colchicine.
  • Drug interaction with dual P-gp and CYP3A4 inhibitors: Co-administration of colchicine with dual P-gp and CYP3A4 inhibitors has resulted in life-threatening interactions and death.
  • Neuromuscular toxicity and rhabdomyolysis may occur with chronic treatment with colchicine in therapeutic doses, especially in combination with other drugs known to cause this effect. Patients with impaired renal function and elderly patients (including those with normal renal and hepatic function) are at increased risk. Consider temporary interruption or discontinuation of Mitigare®.
  • The most commonly reported adverse reactions with colchicine are gastrointestinal symptoms, including diarrhea, nausea, vomiting, and abdominal pain.

Indication

Mitigare® is indicated for prophylaxis of gout flares in adults. The safety and effectiveness of Mitigare for acute treatment of gout flares during prophylaxis has not been studied.

Mitigare® is not an analgesic medication and should not be used to treat pain from other causes.

For Full Prescribing Information please CLICK HERE and for Medication Guide CLICK HERE.

You are encouraged to report negative side effects of prescription drugs to the FDA.

Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Manufactured by: West-Ward Columbus Inc., Columbus, OH 43228

Important Safety Information for Mitigare® (colchicine) 0.6 mg capsules

  • Colchicine 0.6 mg capsules are contraindicated in patients with renal or hepatic impairment who are currently prescribed drugs that inhibit both P-gp and CYP3A4.