This page about cranberry juice for gout was last reviewed, or updated, on 12 November 2012.
Should you drink cranberry juice? Cranberries are a food many gout sufferers wonder whether they should eat or drink. They are acidic. There is a gout story that more gout attacks often occur in the U.S. after Thanksgiving on account of cranberry sauce eaten with turkeys.
True or not, cranberry sauce is also a popular accompaniment to turkeys in other countries' celebratory and regular meals too, but the story is at present an American one only.
The well known beneficial health effect of cranberry juice is to treat urinary tract infections. This is thought to be because of cranberries' proanthocyanidins (a class of flavonoids), not because of its acidity. But its effect on pH probably makes it unfriendly to gout sufferers.
The theory is that by lowering pH (the body becomes more acidic), less uric acid (UA) is likely to be expelled, and uric acid levels will rise. If you have gout it means the UA level is going in the opposite direction to the one you want. If you have hyperuricemia, but not gout, the rise could be a gout trigger.
A CRANBERRY JUICE AND URIC ACID STUDY
Have cranberries been studied? Cranberry juice, but not the sauce or the berries, has been. In a German study a few years ago 12 healthy males with well functioning kidneys, and without a history of kidney stones, were tested for the effect of cranberry, blackcurrant and plum juices on their pH and urine uric acid levels. The study learnt that their urine pH levels fell and their urine uric acid levels rose. i.e. both went in undesirable directions. There was also no change in the excretion of uric acid by cranberry juice.
They drank 330 ml of these juices (this is about one and a third glasses, or 11 fluid ounces) and the study period was 20 days. Their urine uric acid levels from cranberry juice rose by about a half over the control period level. These males did not have gout or hyperuricemia, nor were they on average over weight. Cranberries and gout has not been studied. Note that we are talking here about the uric acid level of urine, not blood.
Blackcurrant juice increased the pH of urine (a good effect), and it lowered urine UA levels slightly and raised UA excretion by a very small faction, but not by statistically significant amounts. It might have had a more positive effect if more had been drunk. Blackcurrants are not too far above cranberries as an acidic food, but the difference is that blackcurrants are much higher in vitamin C and potassium.
Potassium is alkalizing, (i.e. raises pH) and vitamin C, many studies have learnt, has a positive effect on uric acid excretion. So potassium and vitamin C may have been why blackcurrant juice, at the very least, did not raise uric acid levels when otherwise it might have been expected to do so. Plum juice had no significant effects.
SO IS CRANBERRY JUICE FOR GOUT A GOOD IDEA?
Because of what was learnt in this small study, we think you shouldn't drink cranberry juice for gout, and that cranberries are one of the gout foods to avoid, unless your pH levels are very good. i.e. you have an alkaline body. So when you consider your gout diet restrictions and prepare your gout recipes, it seems that avoiding cranberry juice, sauce, or canned and frozen cranberries, is a good idea. Mixed juices such as apple (alkalizing) and cranberry, and pomegranate and cranberry, are a close call.
Read how healthy young women improved their uric acid excretion (in urine) with more alkaline urine from a more alkaline diet.
You can also alkalize urine (i.e. raise pH) with potassium citrate - potassium is alkalizing, (i.e. raises pH) - read our potassium citrate page
Are cranberries low purine? We have not been able to discover the amount of purines in cranberries but since most fruits, including berries, are low purine, they are probably low purine.
Other acidic fruits Plums, prunes (which are dried plums), gooseberries, probably pomegranates (pH foods tables don't agree about pomegranates) and possibly blueberries (no agreement either). Blueberries are a very good food for gout. The pH of foods can vary with climate, growing conditions and other factors. Note: citrus fruits such as oranges, lemons, grapefruits and limes are alkalizing, not acidic.
GOUT AND KIDNEY STONES
People with gout are at risk of kidney stones developing from uric acid. The key factors to watch are the urine uric acid level, and the pH of urine. One estimate put this risk at 20% among gout sufferers who have acidic urine. The risk can be reduced by drinking at least eight glasses of water daily, which both raises pH (makes uric acid more soluble) and dilutes uric acid. The benefits of raising pH in gout treatment are discussed in more detail in our pH section. Cranberry juice
We recommend regular testing with pH sticks (pH stix) to discover your pH levels and if they are too low, raising them in the various ways discussed in the pH section. The body has various pH levels. For part of the risk of kidney stones developing, it's the pH of urine which is important. And it was the pH of urine which was measured in the study described above.
The pH of urine can be tested with pH strips (stix). One way of raising pH levels is to reduce consumption of acidic foods. You can find links to the pH of foods and beverages in the pH section.
Most kidney stones are made from calcium oxalate, but they may be formed from uric acid, just like the MSU gout crystals in joints and other body areas. Increased fluid intake is also recommended for dealing in part with calcium oxalate stones, but here we have focused on uric acid stones.
PH TEST STRIPS
These pH test strips are especially good at recording the pH of urine accurately. Clicking the advertisement does not commit you - it takes you to the product page at phionbalance.com.
Not expensive. 90 strips per bottle. Practitioner preferred.