As a podiatrist and foot surgeon, I am often asked, “What can I do to help prevent gout pain in the future; are there foods I should avoid or a vitamin I should take?”
I have posted on the belief by some scientists that the advised daily intake of vitamin C be increased to 200 mg and the potential importance of vitamin C and the overall anti-oxidant benefit as it relates to pre-diabetes metabolic syndrome.
In addition to its possible role in diabetes and prediabetes, vitamin C has also been a source of interest to me as it relates to uric acid levels and the onset of painful gout arthritis in the foot, as well as the possible role of uric acid in the development of cardiovascular disease that causes decreased blood flow to the foot and leg.
The increased blood levels of uric acid that causes gout are suspected risk factors for cardiovascular disease (CVD), but researchers are not sure if it causes CVD or is an effect of something else that is causing the CVD. In other words, the same thing that is causing CVD may be causing uric acid levels to rise, triggering a gout attack.
We really do not have a good handle on uric acid, and its role in our bodies. It seems as though uric acid is a “two-faced” compound. Studies on animals suggest that uric acid can increase inflammation in the blood leading to damaged circulation, but on the other hand, uric acid also apparently has potentially positive role in our body as a strong antioxidant.
Vitamin C Uric Acid Association
A recent meta-analysis from Johns Hopkins University School of Medicine looked at the relationship of vitamin C and levels of serum uric acid. They reviewed 13 clinical trials with a total of 556 people taking a vitamin C supplement with a median dose of 500 mg/day.
They found a significant reduction in the level of uric acid in the blood of 0.35 mg/dL. The acceptable range of uric acid in the blood is around 3-8 mg/dL with problems starting as the level rises above 6.5 mg/dL as this is the level at which the acid starts to come out of the blood and into the joints and surrounding tissues.
This lead the researchers to conclude that, “based on their review, vitamin C supplementation significantly lowered uric acid, and that future trials are needed to learn more about whether taking a vitamin C supplement can reduce elevated uric acid or prevent gout.”
Another study done over 20 years looked at 46,994 men with no history of gout at the start, and looked at the vitamin C intake in those men that developed gout. They found that the risk of gout was reduced in men taking more than 250 mg/day of vitamin C. They concluded that, “Higher vitamin C intake is independently associated with a lower risk of gout. Supplemental vitamin C intake may be beneficial in the prevention of gout.”
The carbohydrate limited “ancestral” prediabetes and type 2 diabetes diet plan that this site generally advocates requires the limitation of fructose sugar containing fruits that can be a source of vitamin C, but don’t worry because, as smart Nutrientology readers know, this diet contains many vegetables that are a high source of vitamin C. Some examples are: peppers (highest), broccoli, brussel sprouts, cabbage, and cauliflower.
While future studies are needed, at this time I believe the literature supports taking a daily vitamin C supplement on the order of 250-500 mg/day for those with a history of an elevated uric acid level or some other known problem with metabolism causing an “oxidative pressure” such as diabetes or prediabetes metabolic syndrome.