This page about gout and vitamin C was last reviewed or updated on 5 May 2015
Vitamin C for gout? Yes it's a good connection, if not 100% reliable. It is that Vitamin C is reckoned in many studies to lower uric acid levels somewhat, but don't expect the kind of reduction you get from medications.
Recall that vitamins and drugs work in two ways to reduce uric acid levels. One is restricting its supply by inhibiting purine breakdown into uric acid, the other is improving uric acid’s excretion in the urine. Vitamin C is thought to be a uric acid excretor, not an inhibitor. Improving excretion may reduce your uric acid more than reducing production. That is often the case with drugs medications.
GOUT AND VITAMIN C STUDIES
The connection between gout and Vitamin C has been the subject of a number of studies over the past 30 years. They have concluded that Vitamin C will reduce the uric acid level, but have differed in the amount of Vitamin C given to study participants. A U.S. study of 184 non smokers, published in 2005 looked at gout and Vitamin C. It concluded that the amount of Vitamin C required to achieve a serum (blood) uric acid level reduction was only 500 mg daily.
The Vitamin C was taken as a supplement. 500 mg daily is not a mega dose. Previously it has been thought that the amount needed was at least 4,000 mg (4 grams) daily. Dr Robert Atkins,(the Atkins diet), in another of his books, "Dr.Atkins' Vita Nutrient Solution," recommended 5,000 -10,000 mg (5 - 120 grams) as part of his formula for a natural remedy for gout.
In the 2005 study, how much did 500 mg of Vitamin C reduce participants' uric acid level? It found an average, across all, reduction of about 10% (0.5 mg/dL). And reductions were larger among participants who had higher levels of uric acid at the start of the study. Participants took the 500 mg daily amount for two months. Those who were given a placebo (i.e. a dummy) showed a slight increase in uric acid levels. Vitamin E was also given to participants but had no effect on uric acid levels.
0.5 mg/dL is a useful reduction but for most people probably not a natural remedy for gout, although the 0.5 mg/dL figure is an average and some participants did better. But a 0.5mg/dL reduction will not be enough for most to reduce uric acid below the 6.0 mg/dL level at which the MSU gout crystals may dissolve. However, when combined with other vitamins for gout, a low purine diet and the other natural remedies for gout described elsewhere on this website, it could be a very useful reinforcement.
A small caution
Rapid changes in uric acid levels can trigger a gout attack. This rapid change can be brought about by many factors in addition to mega doses of Vitamin C, including by drug medications that lower uric acid. (It's why doctors prescribe prophylatic medicines such as Colchicine or NSAIDS, along with uric acid lowering medicines). People who are susceptible to gout must consider these rapid changes.
Such a rapid change concerned the authors of one study in the 1970’s who also examined the link between gout and Vitamin C. They recorded that mega doses of Vitamin C (4,000 mg and 8,000 mg daily) reduced uric acid levels significantly, and by more than in the 2005 study. i.e. the same conclusion as Dr. Robert Atkins. However, as far as Vitamin C induced rapid changes in uric acid levels is concerned, this kind of change has not been reported in any study.
Vitamin C for preventing gout
If 500 mg daily of Vitamin C can reduce uric acid levels, then Vitamin C ought to act as a preventative gout vitamin too. A Taiwan study of males in the late 1990’s examined the weight, diet and lifestyles of gout and non-gout patients in Taiwan. It concluded that Vitamin C, and folic acid (folate) were protective against gout. Folic acid is the dietary supplement form; folate is the food form. It also found fibre (fiber) is protective against gout. And it reached the well known and accepted conclusions that hypertension (high blood pressure) and obesity are risk factors for gout.
1,000 mg plus doses
If you wish to try Vitamin C for gout in doses over 1,000 mg as part of a natural gout remedy discuss it with your doctor, or a qualified naturopathic doctor. The 500 mg level is below the British government’s 1,000 mg (1 gram) daily recommended upper safety level safety limit for Vitamin C. It’s half of the maximum amount (1,000 mg) in a Vitamin C tablet sold in the U.S. and many other countries.
To avoid excess acidity (lower pH) also take alkalizing minerals, or another alkalizing agent recommended by your doctor. Drink plenty of water and check your urine pH regularly. Acidic urine can lead to kidney stones
Or take an Ester-C version of Vitamin C, because this is non-acidic.
Use Vitamin C products that have added flavonoids, because flavonoids improve its absorption, as do time release versions. One flavonoid added to better Vitamin C products is rutin. A 2009 study found that rutin itself lowered blood uric acid levels in rats with elevated blood uric acid. The other flavonoid that did this in this study was quercetin.
These preparations cost a bit more, but it's a bit more money well spent.
However don't expect 100% reliability from Vitamin C..... A New Zealand study, published in mid 2013 in the journal Arthritis & Rheumatism, found that Vitamin C at a dose of 500 mg daily for 8 weeks, scarcely lowered uric acid.
But this has also sometimes happened in earlier studies about Vitamin C and uric acid. A meta-analysis (a study of studies) of 13 Vitamin C and uric acid studies between 1990 and 2009 found that it fell in 9, rose in 4, and there was no change in 1. When Vitamin C was the only substance taken (9 of 13 studies), the uric acid fall was a useful – 0.54 mg/dL.
Dr.Atkins in his Vita Nutrient Solution book said 8 grams of Vitamin C was needed to lower uric acid.
This meta-analysis was an important analysis of what Vitamin C can do, so I’ve written a page about it. The only caveat is that the studies were not in gout patients. And there have been other Vitamin C studies at higher doses which lowered uric acid by more, or did not lower it, but were not included in the 13 of the meta-analysis. Some patients in these studies were gout patients.
If you want to read the 2005 study click here to download it. It's called: "The Effects of Vitamin C Supplementation on Serum Concentrations of Uric Acid". The study is provided free by Wiley InterScience. When the page arrives click on the Full Text: HTML or PDF (64k) links above the study title. If you want the PDF version you need Adobe Reader.
VITAMIN C FROM FOODS AND BEVERAGES
Try to eat more foods with high amounts of Vitamin C.
Our link which enables you to download the free National Nutrient database is on this page. Use this link to download the database itself or download a list of foods high in Vitamin C sorted by highest amount first downwards.
Scarcely known high Vitamin C foods
Of course you know some foods high in Vitamin C such as oranges and other citrus fruit.
But here's some not very well known foods which are very high in Vitamin C - Acerola cherry (aka the Barbados cherry); Indian gooseberry (from which Amla powder is made); Kakadu plum; various types of pepper. Horseradish is surprisingly high in Vitamin C, which is why it was a remedy for scurvy in past centuries.
OUR VITAMIN C TESTIMONIALS PAGE
Can you report success, or not, with Vitamin C for gout treatment? Read what our visitors say and tell our visitors what your experience has been if you can. Visit our Gout and Vitamin C testimonials page
TEST YOUR VITAMIN C LEVEL
Want to test your Vitamin C level, and then re-test it later to see if it has improved?
If you live in the continental United States or Anchorage, Alaska you can test it with Life Extension.org.
Click on the banner below. On the page that arrives click on nutrient testing.(Right panel). The vitamin C test is on the second page, currently number 19.
You can also have your uric acid level tested as part of the Chemistry and Complete Blood Count (CBC) Blood Test at Life Extension.com. Results of the other tests included in this package will be very useful to know.
The Lipid profile tests for example, are used at the beginning of any diet which attempts to lower uric acid, especially if insulin resistance is considered the cause of high uric acid. Read our sections on the Zone diet and the Atkins diet.