This page about tea for gout, page 3 of 3, was last reviewed or updated on 25 August 2015
TIPS FOR GOUTY TEA DRINKERS
Here are six. You’ve probably heard of most before, but not about getting the flavonoids.
(1) Make tea in a pot, or use only tea bags which carry named grades (see below) on the packaging. Pot tea is best.
(2) Use boiling water – it releases more flavonoids.
(3) One study showed that loose tea and tea bag tea reached maximum flavonoid volume after five minutes infusion. And that is the time the experts say you should infuse (steep) tea.
(4) Buy tea which has named grades on the packaging. eg. BOP (Broken orange pekoe) OP,(Orange Pekoe) TGFOP, (Tippy golden flower orange pekoe), FTGFOP, (Finest tippy golden flower orange pekoe), BP (Broken pekoe).
(5) If you drink tea with milk, for a possible negative effect of milk on the tea flavonoids, drink an extra cup. Instead of four a day, drink five.
(6) Tea made from young buds and small leaves is probably the best tea for gout. Young buds are called tippy. The tippy status is shown by the letter T in tea grades such as TGFOP, FTGFOP.
CHOOSING A GRADE OF TEA FOR GOUT
Broken Orange Pekoe (BOP) and Broken Pekoe (BP) were the best performing grades in the study where tea inhibited xanthine oxidase. (1) These grades can be applied across a range of different types such as Darjeeling, Assam, Ceylon. You could have a Darjeeling BOP, Ceylon Orange Pekoe, (OP) Kenya Broken Pekoe etc.
You probably won’t be able to find these grades in your local supermarkets, but they can be found, and online too. For example at Amazon.com and specialist tea sellers who you can find by typing words like “buy broken orange pekoe.” etc. Buy tea which has the grades listed on the packaging.
Here are examples of loose tea BOP and OP – named grades.
Here are examples of tea bag tea BOP and OP - named grades.
INHIBITING XANTHINE OXIDASE (XO) WITH TEA --- IT’S THE QUALITY THAT COUNTS
In an Indonesian study (1) 3 of 15 grades of teas inhibited xanthine oxidase by more than 50% in test tubes.
This means more than half of xanthine oxidase’s (XO) activity during the period when tea was tested. The best inhibition of 61.58% by the Broken orange pekoe grade (BOP) means 61.58% of XO’s activity was inhibited. Second was Broken pekoe, (BP) only about 1% behind. By comparison, the gout drug Allopurinol inhibited XO by 92.76% so you can see BOP and BP did well. Some came close to 50% but other tea grades were poor performers and only inhibited XO by 11-12%.
So in this test tube study, different grades of black tea performed in unalike ways, although they all inhibited XO to some extent. As noted above, whilst some inhibited XO as much as just over 60% and others inhibited it as little as 11-12%. In at least two large population studies (see page 1 of the tea for gout section) black teas did not lower uric acid, but was that because the participants were just not drinking the right sort? Those teas with poor XO inhibition will not lower uric acid.
Specifically in this study the best inhibitor did not have the highest catechin (flavonoids) content and the best had only a small amount of catechins more than the worst inhibitor. And the grade, Broken pekoe, which had the lowest amount of catechins, was second best performer. It ranked only slightly behind Broken Orange Pekoe, by really an insignificant amount.
So more catechin content in tea does not mean more inhibition. The high grades TGFOP, FTGFOP and OP were not tested in this study but since they are also among the highest quality grades it is very likely they would have done well.
DRINKING MILK WITH TEA – IS THERE ANY EFFECT ON
Millions around the world drink tea with milk so this is a huge question. Some studies have concluded that adding milk to tea reduces tea's anti-oxidant power. Perhaps by 25% or more. Others have said it does not.
Milk itself is one of the good drinks for gout. Two of its proteins – casein and lactalbumin - have been found to lower uric acid.
Merely by the act of adding milk, which has less anti-oxidant strength than tea, to tea, you automatically reduce the anti-oxidant strength of the combined blend, but not much. But what about tea plus milk and xanthine oxidase (XO) inhibition and uric acid reduction? XO is the enzyme which converts purines from foods into uric acid. Gout drugs allopurinol and febuxostat work by inhibiting it – and tea has done this too, (in a test tube) but not nearly as much.
It’s not known what effect milk might have if its two proteins were bound to tea’s flavonoids.
If it is true, and you are one of the millions who drink tea with milk, don’t let this put you off. Instead of four cups a day, drink five and you’d generally make up the 25%.This would be even more likely if you drink only those high quality tea grades that have performed best in inhibiting XO or another high quality tea.
TIP Don’t make too much of this. Try to drink an extra cup of well infused loose leaf tea of BOP/OP or other high grades. It isn’t as if tea for gout is your only strategy. Use whole milk, not skimmed/low fat. Focus on drinking the best quality tea and have your milk if you wish.
TEA FOR GOUT SUMMARY
So what is likely to be the truth about drinking tea for gout?
When drinking tea do not imagine this is a standalone gout cure because, despite some positive research, it is highly unlikely tea lowers uric acid enough. Tea might make a small contribution to uric acid reduction as it did in the Mauritian (2) and Thai studies (3) although trialists were not gout sufferers. It does deliver other health benefits because of its flavonoid antioxidants (for example for heart diseases and type 2 diabetes).
Neither could black tea raise uric acid and thus possibly trigger a gout attack. The balance of the scanty evidence points to tea (black and green) lowering uric acid a little, but probably only if you drink the right sort.
Tea drinking during gout attacks has not been studied so we have no idea from science what effect it might have at that time. Tea and gout requires much more scientific research, especially the types, growing conditions and processing of teas that perform best. Research what’s available in your locality and remember, you probably want black tea from young bud, small leaves and named grades.
Note In books, and articles about nutrition, flavonoids may be called polyphenols, phenols, phenolic compounds.
(1) Dadan Rohdiana et al Xanthine Oxidase inhibitory and immunomodulatory activities of fifteen grades of Indonesia orthodox black tea International Journal of Pharmacy and Pharmaceutical Sciences Volume 6, Issue 5, 2014.
(2) Bahorun T et al Black tea reduces uric acid and C-reactive protein levels in humans susceptible to cardiovascular diseases. Toxicology. 2010 Nov 28;278 (1):68-74. doi: 10.1016/j.tox.2009.11.024. Epub 2009 Dec 4.
(3) Kanon Jatuworapruk, MD; Somdet Srichairatanakool, PhD; Sakaewan Ounjaijean, PhD; Nuntana Kasitanon, MD; Suparaporn Wangkaew, MD; Worawit Louthrenoo, MD. Effects of Green Tea Extract on Serum Uric Acid and Urate Clearance in Healthy Individuals Journal of Clinical Rheumatology 2014;20(6):310-313.