Alcohol and Gout: Which Drinks Are Safest, and How Much Is Too Much
Beer, wine, champagne, liquor: which raises uric acid the most, how many drinks it takes to raise your flare risk, and how to get through the holidays without a flare.
Alcohol and Gout: Which Drinks Are Safest, and How Much Is Too Much
The short answer: beer is the drink most strongly linked to gout, liquor a little less, and wine the least. But once you already have gout, every type of alcohol raises your risk of a flare within 24 hours, wine and champagne included, and the risk climbs with each drink. No amount is guaranteed safe. If you do drink over the holidays: a glass or two of wine or champagne rather than several beers, a glass of water between drinks, and never on an empty stomach.
Why alcohol raises uric acid, even without purines
Gout is caused by too much uric acid in the blood, which eventually forms crystals in the joints. Most people think of the purines in food, but alcohol mostly works in other ways:
- It makes your body produce more uric acid. Breaking down alcohol takes a lot of energy in the liver, and that process generates uric acid.
- It slows how your kidneys clear it. Alcohol is broken down into lactic acid, which competes with uric acid in the kidneys, so less uric acid leaves in your urine.
- It dehydrates you. Less water means more concentrated uric acid, which crystallizes more easily.
Beer has a fourth problem: it also brings purines of its own, from the malt and yeast. That is why it comes out worst.
Beer, wine, champagne, liquor: how they compare
| Drink | Purines (mg per 100 ml) | Purines per drink | Link with gout |
|---|---|---|---|
| Lager beer (12 oz) | 11.8 | ≈ 42 mg | Strongest |
| Hard cider (12 oz) | 7.4 | ≈ 26 mg | Alcohol plus sugars |
| Whiskey, vodka, rum (1.5 oz) | 5 to 5.5 | ≈ 2 mg | Moderate |
| Red or white wine (5 oz) | 4.9 to 5.6 | ≈ 8 mg | Weakest, but real |
| Champagne (5 oz flute) | 5 | ≈ 7 mg | Same as wine |
Purine figures: Gout-Cha! food database. Notice that purines alone don't explain the ranking: a shot of whiskey has fewer purines than a glass of wine, yet liquor is more strongly linked to gout. It's the alcohol itself that matters.
What the research shows
The landmark study followed more than 47,000 men for 12 years. Each daily beer raised the risk of developing gout by about 49%, each daily shot of liquor by about 15%, while moderate wine drinking was not linked to any extra risk (Choi et al., The Lancet, 2004).
But that study looked at who develops gout. In people who already have it, a later study of 724 patients looked at what they drank in the 24 hours before a flare. Flare risk was 1.36 times higher after one to two drinks, and 1.51 times higher after two to four drinks, whatever the type of alcohol, wine included. The more people drank, the higher the risk (Neogi et al., American Journal of Medicine, 2014).
The takeaway: the beer, liquor, wine ranking applies to your risk of getting gout. Once you have it, every drink counts, whatever it is. That is why the American College of Rheumatology recommends limiting alcohol for everyone with gout (ACR guideline, 2020).
How much? The amount of alcohol matters more than the ABV
What raises uric acid is how much pure alcohol you take in, not the percentage on the label. In the US, one standard drink contains about 14 g of pure alcohol, and each of these counts as one:
- 12 oz of beer at 5%;
- 5 oz of wine or champagne at 12%;
- 1.5 oz of liquor at 40%.
With gout, there is no proven safe threshold: flare risk already rises after one to two drinks. If you are going through a period of repeated flares, the safest choice is not to drink at all, and to talk it over with your doctor.
Getting through the holidays: 7 habits
- A glass of water between every drink, and at least 2 liters (about 8 cups) of water over the day.
- Never on an empty stomach: drink with the meal, not while waiting for it.
- Pick your drink: a glass of champagne or wine rather than several beers.
- Watch sweet cocktails: soda and fruit juice add fructose, which also raises uric acid.
- Think in days, not meals: Thanksgiving, Christmas and New Year's Eve add up. Keep alcohol-free days in between.
- Never stop your uric acid medication over the holidays: it's a common trigger for flares.
- No alcohol during a flare, or in the days that follow.
Non-alcoholic beer can help, but it still contains purines: our article on non-alcoholic beer and gout explains why. For the meal itself, see our guide to Christmas dinner with gout. And if a flare starts during the night, here is how to react.
Find out what triggers your own flares
Everyone reacts differently: some people tolerate a glass of wine, others flare after two beers. In the Gout-Cha! app, you log your meals and your drinks like any other food, along with your flares. You can then see what you ate and drank in the days before, which helps you spot your own triggers and discuss them with your doctor.
Frequently asked questions
What is the best alcohol to drink with gout?
Wine, including champagne, is the least linked to gout, while beer is the most. But in people who already have gout, every type of alcohol raises the risk of a flare within 24 hours. The "best" alcohol is still the one you drink in small amounts.
Is champagne bad for gout?
Champagne contains very few purines, about 5 mg per 100 ml, but it is alcohol, and alcohol raises uric acid on its own. One or two glasses with food, alternated with water, is a reasonable compromise for a holiday meal.
How many drinks can you have with gout?
There is no risk-free amount. Flare risk already rises after one to two drinks in 24 hours, and more beyond that. During a period of flares, the safest choice is not to drink. Talk to your doctor, especially if you take medication.
Is non-alcoholic beer a good alternative?
It is better than regular beer, since it has almost no alcohol, but it still contains purines from the malt, so it is not something to drink without limit.
Can you drink alcohol while taking allopurinol?
Alcohol keeps raising uric acid, which works against your treatment and can reduce its effect. Never change your treatment on your own: ask your doctor what is reasonable for you. This article is not a substitute for medical advice.
