- With Mayo Clinic rheumatologist
April Chang-Miller, M.D.
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April Chang-Miller, M.D.
April Chang-Miller, M.D.
Dr. April Chang-Miller is board certified in internal medicine and rheumatology and is a consultant in the Division of Rheumatology and Internal Medicine at Mayo Clinic in Arizona.
Dr. Chang-Miller's primary field is rheumatology with special interests in inflammatory joint diseases called seronegative spondyloarthropathies such as ankylosing spondylitis and psoriatic arthritis. She also cares for patients with rheumatoid arthritis and polymyalgia rheumatica.
The New York City native is a graduate of the Yale University School of Medicine and had been with Mayo Clinic in Rochester, Minn., between 1991 and 2002 when she relocated to Mayo Clinic, Arizona. She is a fellow in the American College of Rheumatology and has been on the board of directors of the Arthritis Foundation North Central Chapter.
Lifestyle and home remedies (1)
- Gout diet: Reducing purines may improve symptoms
Alternative medicine (1)
- Glucosamine: Can it worsen gout symptoms?
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Question
Gout diet: Reducing purines may improve symptoms
I have gout, and my doctor says I should avoid purines. What foods contain purines?
Answer
from April Chang-Miller, M.D.
Gout is a form of arthritis that's characterized by sudden, severe attacks of pain, redness and tenderness in joints. The cause of gout is a high blood level of uric acid (hyperuricemia), which can accumulate in joints and lead to inflammation. Uric acid is a waste product formed from the breakdown of purines — substances which are found naturally in your body as well as in certain foods.
Treatment of gout used to include severe dietary restrictions. But newer medications to treat gout have reduced the need for such restrictions. Still, some dietary modifications may reduce the severity of gout attacks. They may also be useful for people who have problems with gout medications.
Limit or avoid foods high in purines, such as:
- Organ meats, such as liver, brain, kidney and sweetbreads
- Anchovies
- Herring
- Mackerel
Smaller amounts of purines are found in all meats, fish and poultry. For this reason, limit animal protein in your diet to no more than 5 to 6 ounces of lean meat, poultry or fish a day. Some additional dietary considerations include:
- Avoid alcohol or drink it in moderation. Drinking too much alcohol increases the risk of hyperuricemia because it interferes with the removal of uric acid from the body. If you're having a gout attack, avoid alcohol completely.
- Drink plenty of fluids. Fluids can help remove uric acid from the body. However, limit consumption of sugar-sweetened soft drinks, which have been linked to an increased risk of gout.
- Maintain a healthy weight. Excess weight puts more stress on your joints and increases the risk of hyperuricemia and gout.
- Lose weight if you're overweight. But avoid fasting or rapid-weight-loss diets because they can increase uric acid levels in the blood. Also, avoid low-carbohydrate diets that are high in protein and fat, which can increase hyperuricemia.
