This page about folic acid for gout was last reviewed, or updated, on 3 May 2010.
The benefits of folic acid for gout are not clear in medical academic studies, where the highly technical studies are inconclusive. One study, for example, in the 1980's was emphatic that folic acid (Vitamin B9) and a couple of its derivatives, does inhibit xanthine oxidase, the enzyme required to convert purines into uric acid. And it found it was done considerably more strongly than by allopurinol, and quickly. But it wasn't a human study.
Another study was conducted among only 10 gout sufferers. It used high levels of folic acid - 1 mg per 1 kilo of body weight, so someone weighing say 165 lbs (75 kilos) would have received 75 mg of folic acid. This amount of folic acid was taken every day for a month but it found no effect on their uric acid level.
But there is a realm of thought out there that says that if you take enough of it, folic acid can prevent recurring gout attacks, and even end a current one.
If you look at your multi-vitamin container you' ll find that we don't require much folic acid – only 200 mcg to 500 mcg are in a daily multi. Or up to 800 mcg for standalone folic acid. That's micrograms - and one million make up just one gram or 1,000 make up one milligram (mg). Many people first hear of folic acid when women become pregnant and it's prescribed to prevent birth defects, notably spina bifida. We need it to help in producing new red blood cells.
But the amount recommended as a vitamin for gout is considerably more. Between 10 mg and 40 mg is the usually quoted amount. You won't be able to buy this amount in any dietary supplement so you would need a physician's folic acid prescription (RX). In any case self administering large amounts of folic acid for gout should never be done.
Large amounts probably won't cause side effects but they can cause problems such as masking the symptoms of pernicious anaemia (anemia) and masking symptoms of a Vitamin B12 shortage. A lack of vitamin B12, and your body won't produce enough red blood cells.
So you certainly need to work with a doctor who has experience of using folic acid for gout. S/he will probably want to prescribe it with all the other B vitamins since B vitamins work better in tandem, although whether this is true in inhibiting xanthine oxidase is not known.
FOLIC ACID FROM YOUR DIET
There are two terms used to describe folic acid, whose chemical name is pteroylglutamic acid. Folate is the form found in foods and juices such as orange, lemon and lime; folic acid is the form in dietary supplements. In many countries folic acid is added to popularly eaten basic foods such as flour, (and products made from it), cereals, rice and bread to ensure we get enough. That's why, if you download this list of foods containing folate, beginning with the highest, you'll find the folic acid fortified foods both at the top of the list and featuring prominently on it. The list is courtesy of the USDA National Nutrient database.ug on the list's header is the same as mcg, a microgram.
As with vitamin supplements, it's not possible to eat your way up to 10 mg - 40 mg daily. Neither is it likely that the folate in such gout positive foods as cherries, strawberries and other berries, and celery will make any contribution to their gout fighting ability, because the amount of folate in them is simply too small.
FOLIC ACID FOR GOUT TESTIMONIALS
One gout sufferer found that just 2 mg of folic acid a day did the trick. This is completely at odds with the conventional wisdom. He had suffered from gout for 15 years but after taking this amount of folic acid for an unspecified period, and without describing any dietary techniques used, (if there were any), learnt from a couple of blood tests that his uric acid level had normalised.
Another gout sufferer told his (unsolicited) folic acid story to this website. In his case, 30 mg of folic acid, taken with a natural anti-inflammatory product, which he preferred to an NSAID medication, ended his gout attack in two days, with a 90% reduction in gout pain in that period.
FOLIC ACID FOR GOUT SUPPORTERS
Two eminent natural remedy doctors have endorsed folic acid for gout. The late Dr.Robert Atkins (the Atkins diet) included folic acid as part of his gout vitamins remedy formula, which is described in his book Dr.Atkins' Vita Nutrient Solution. Almost certainly he had studied the studies. The amount of folic acid he recommended was high. It wasn't the only gout vitamin in his gout formula. We can imagine he used this formula for his gout sufferers, but its effectiveness is not publicly known.
Another is Dr.Joseph Pizzorno ND of Bastyr University in Seattle, and co-author with Michael Murray ND of natural remedy books such as the Textbook of Natural Medicine (a 2-volume set) and the Encyclopedia of Natural Medicine. He sees folic acid as a way to prevent future gout attacks once you've had one, in conjunction with dietary changes.
FOLATE IS PROTECTIVE AGAINST GOUT
A few years ago in Taiwan a study (1) examined the diet and lifestyles of 92 gout male sufferers in Taipei, its capital, compared with 92 males there who didn't have gout. The risk of gout in the Taiwan population over 45 years old is high. Their intake of 493 Chinese food items over the previous year was analysed and a 24 hour what-have-you-eaten-and what-did-you-drink questionnaire was also answered.
Around 30 vitamins, minerals, other food nutrients and levels of protein, fats, carbohydrates, and purines, in all the foods and drinks consumed were analysed.
This study found an interesting link between gout and folate. In this study the researchers concluded that folate (the food form of folic acid) was one of the top three nutrients that are protective against gout. The others were fibre (fiber) in foods and Vitamin C. Other studies have learnt of the value of fibre (fiber) in food and Vitamin C in anti gout diets.
How much folate to eat a day? And you didn't have to eat that much folate daily. The odds of not getting gout were lowest if the folate you ate was more than 134.35 ug (aka mcg, or micrograms) or more than 62.48 ug (mcg) on the other food data collection method, mentioned above. Remember this was folate in foods, not folic acid in dietary supplements. Use the foods highest on folate list, mentioned above, to see how easy this is. So easy in fact that maybe this is one reason why so few people with high uric acid actually have a gout attack!
It's likely to be better that you choose foods where folic acid has not been added. e.g. not the folate in cereals or enriched wheat flour or enriched white rice (and foods made from them) because natural folate probably has an edge. The best are the fruits and vegetables high in folate. But make sure you also consider the purines in the ones you plan to eat and other dietary factors relevant to your diet e.g. their carbohydrate content.
Other findings If you know a lot about gout, some of its other findings will surprise you, as they did the researchers. However there are much larger human population (epidemiological) studies of gout. There were no women in the study.
As well as the surprising findings, many of the conventional ideas about avoiding and dealing with gout were confirmed. The risk of gout is much higher with alcohol consumption, hereditary factors, being overweight and hypertension. And of course, to avoid gout, and help deal with it, eat your fruit and veggies, especially those high in fibre (fiber), folate and vitamin C.
This study can be downloaded free courtesy of the American Journal of Clinical Nutrition. Put the name of the study below into an Internet search box.
(1) Li-Ching Lyu, Chi-Yin Hsu, Ching-Ying Yeh, Meei-Shyuan Lee, Su-Hua Huang, and Ching-Lan Chen A case-control study of the association of diet and obesity with gout in Taiwan. Am J Clin Nutr 2003;78:690–701.
Folic acid for gout is a topic chronically crying out for some more studies among a large number of gout sufferers. In the meantime, if you have any experience of using folic acid for gout you would like to pass on, please use the www.best-gout-remedies.com contact form
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