Diuretic and Gout
Gout is a condition in which uric acid crystals form in and around the peripheral joints of the body due to elevated levels of monosodium urate in the blood. As such, if you are a sufferer of gout, it is important to take care to avoid foods and medications that can elevate blood uric acid levels. One common class of medication that can trigger hyperuricemia is diuretics. Because of this connection, it is important for everyone who takes diuretics, not just those with, to be aware of the potential side effects. Let's take a look at the connection between diuretic and gout.
Primary gout is the term used to describe cases in which the cause of hyperuricemia in the body is unknown. This is a chronic condition that is typically treated with medication and avoidance of anything in the diet or meds that elevate uric acid concentrations. In secondary gout, the cause of the hyperuricemia is known. It may be due to other disease processes or in some cases due to a side effect of medications such as diuretics. It’s important to know that not everyone with high concentrations of uric acid in the blood develops gout, in fact most do not. (1)
Diuretics are commonly known as water pills because their purpose is to cause the body to excrete more water by causing your kidneys to put more sodium in the urine. The sodium brings water from the blood with it, resulting in more water being excreted from the body. With less fluid flowing through your blood vessels, there is less pressure on the walls of the arteries. This is why diuretics are commonly prescribed for individuals with hypertension (high blood pressure), though they may also be used in patients with heart failure, certain kidney disorders such as kidney stones, osteoporosis, or tissue swelling (edema). (2)
Because your kidneys are responsible for excreting the proper amount of uric acid, and because diuretics directly target kidney function, these medications can hurt blood uric acid levels. For sufferers of gout who already have hyperuricemia, the further elevation of uric acid in the blood that can be caused by diuretics is likely to trigger more acute flare-ups and make treatment of this already chronic condition more difficult. In addition to triggering gout attacks, more blood uric acid also makes a person more susceptible to kidney stones because the uric acid can build up in the kidneys in higher concentrations. (3)
If you already have gout, diuretics should be avoided for the now obvious reasons listed above. The good news is that if you also have high blood pressure, some of the same natural measures that you can take to help with hypertension are also recommended to help patients with gout. These include: eating a healthy diet with an emphasis on vegetables, fruits, and whole grains; drinking little to no alcohol, and maintaining a healthy body weight. This helps you kill two birds with one (non-kidney) stone!