Purine-Free Beer: Does It Really Exist?
Can gout sufferers drink beer safely? We examine whether purine-free beer truly exists and what it means for uric acid levels and gout management.
Purine-free beer does not really exist: beer is brewed with yeast, and the purines it contains (compounds the body breaks down into uric acid) come largely from that fermentation. Some products, mainly on the Japanese market, are sold as reduced-purine or purine-free beer-style drinks, but even then the alcohol remains, and alcohol itself raises uric acid.
For people with gout (a chronic condition in which urate crystals deposit in the joints), beer is a particular concern. In a large prospective study of men published in The Lancet (Choi et al., Lancet 2004), each additional daily 12-oz serving of beer was associated with a 1.49 times higher risk of developing gout, a stronger association than for spirits (1.15 per daily drink), while wine was not associated with gout. Knowing what is actually in your glass is therefore a real health question.
What is the purine content of regular beer?
In the Gout-Cha! food database, lager contains 11.8 mg of purines per 100 g, brown beer 12.4 mg and IPA 11.9 mg. For beer, 100 g is roughly 100 ml, so a 330 ml bottle provides about 39 to 41 mg of purines. That is far less than a serving of meat or fish, but beer also brings alcohol, which acts on uric acid on its own.
Alcohol increases the body's own production of uric acid: in a study of six patients with gout given a very high dose of alcohol (1.8 g per kg of body weight per day) for eight days (Faller and Fox, NEJM 1982), serum urate rose from 8.4 to 10.1 mg/dl, through increased urate production. The lactate produced when alcohol is metabolized has also been proposed to reduce uric acid excretion by the kidneys, although in this study urate clearance actually increased. This combination of purines and alcohol helps explain why beer is considered particularly problematic.
The specific purines found in beer
The purines in beer come mainly from the yeast used for fermentation. Brewer's yeast itself is one of the richest foods in purines in our database (442.3 mg per 100 g), which is why unfiltered beers, which retain more yeast, are sometimes suspected of containing more. We do not have measured data to confirm this.
Does non-alcoholic beer contain fewer purines?
Non-alcoholic beer is still brewed with yeast and therefore still contains purines. Its content varies by product and manufacturing process, and it is not yet in our food database, so we do not give a figure. Removing the alcohol removes one of the two mechanisms that raise uric acid, but not the purines from fermentation.
Does alcohol protect against the purines in beer?
No, alcohol is not protective: it raises uric acid on its own. The idea that removing the alcohol automatically makes a beer harmless for people with gout is a misconception, just as is the idea that a low-purine alcoholic drink is safe. Alcohol and purines each contribute to raising uricemia (blood uric acid concentration).
Do truly low-purine beers exist?
Products marketed as reduced-purine or purine-free beer-style drinks exist, mainly in Japan, where brewers use specific processes to lower purine content. We have not been able to verify their content independently, and they are rarely found in Western stores.
Even a beer with very few purines would still contain alcohol if it is not alcohol-free. And so-called "light" or "low-carb" beers are not low-purine beers: these labels refer only to carbohydrate or calorie content.
The large prospective study cited above (Choi et al., Lancet 2004) found that the risk of gout varied with the type of drink: beer had the strongest association, spirits a weaker one, and moderate wine drinking was not associated with gout in these men. The authors did not separate the role of purines from that of alcohol.
Comparative table of purine content in different beers
The following table shows the values in our food database for beers and a few other alcoholic drinks, useful for people following a low-purine diet.
| Drink | Purines (mg/100 g) | Typical serving |
|---|---|---|
| Lager | 11.8 | 330 ml: about 39 mg |
| Brown beer | 12.4 | 330 ml: about 41 mg |
| IPA | 11.9 | 330 ml: about 39 mg |
| Dry cider | 7.4 | 330 ml: about 24 mg |
| Red wine | 4.9 | 150 ml glass: about 7 mg |
| Whisky | 5.5 | 40 ml: about 2 mg |
| Non-alcoholic, light or reduced-purine beers | not in our database | no figure |
Values from the Gout-Cha! food database (per 100 g; for drinks, 100 g is roughly 100 ml). A low purine content does not make a drink safe: wine and spirits still contain alcohol.
What alternatives to beer are recommended for people with gout?
Water, herbal teas and coffee (in moderation) are the simplest alternatives for people with gout. Wine is not a free pass: see below.
- Still or sparkling water remains the reference drink: drinking around 1.5 to 2 liters a day, unless your doctor advises otherwise, supports the renal excretion of uric acid.
- Coffee is associated with a lower risk of gout: a meta-analysis of 11 observational studies (Zhang et al., BMJ Open 2016) found this association, while noting that the evidence remains limited. Our article on coffee and gout details these studies.
- Wine was not associated with developing gout in the Lancet study of men, but in people who already have gout, wine, beer and spirits were each associated with a higher risk of an attack within the following 24 hours (Neogi et al., Am J Med 2014). If you have gout, all types of alcohol are worth limiting.
- Fruit juices and fructose-rich fruits were associated with a higher risk of gout in a large study of men (Choi and Curhan, BMJ 2008): keep juices occasional.
Any dietary change related to gout should be discussed with your doctor, as part of overall management that combines treatment when indicated and dietary adjustments. To adapt your diet during a flare, see our guide on diet during a gout attack.
What do official medical guidelines say about beer and gout?
The 2020 American College of Rheumatology guideline states that limiting alcohol intake is conditionally recommended for people with gout. It does not make a specific recommendation on non-alcoholic beer. The same guideline names allopurinol as the preferred first-line urate-lowering therapy.
Gout is a chronic disease (Dalbeth et al., Lancet 2021): long-term urate-lowering therapy, such as allopurinol, dissolves urate crystals and ultimately prevents flares and tophi. Lifestyle and dietary measures, including cutting back on alcohol and purine-rich foods, complement this treatment when it is needed; they do not replace it.
To understand the long-term risks of poorly controlled gout, see our article on gout attack symptoms, causes and treatments.
Frequently Asked Questions
Is non-alcoholic beer safe for people with gout?
It is not purine-free: it is brewed with yeast and contains purines, in amounts that vary by product. It does, however, avoid the effect of alcohol. Data specific to gout are limited, so if you drink it, keep it occasional and discuss it with your doctor, especially if your attacks are frequent.
Can you find purine-free beer?
Products marketed as reduced-purine or purine-free beer-style drinks exist, mainly in Japan, but they are rare in Western stores and we have not been able to verify their content. "Light" or "low-calorie" beers refer to calories or carbohydrates, not purines. And an alcoholic drink with few purines still raises uric acid through its alcohol.
How many beers can you consume per week with gout?
There is no established safe threshold. In people with gout (Neogi et al., Am J Med 2014), the risk of an attack rose with the amount of alcohol drunk over the previous 24 hours: it was 1.36 times higher for more than 1 to 2 drinks and 1.51 times higher for more than 2 to 4 drinks, compared with no alcohol. Discuss your own limit with your doctor based on your uric acid level, treatment and frequency of attacks.
Does craft beer contain more purines than industrial beer?
Not according to our database: IPA (11.9 mg per 100 g) and lager (11.8 mg) are almost identical, and brown beer is barely higher (12.4 mg). Unfiltered or bottle-conditioned beers retain more yeast and may contain a little more, but we do not have measured data for them.
What drinks can you have instead of beer at social occasions?
Sparkling water with lemon, unsweetened iced tea or herbal tea, or coffee are good options. Diet soft drinks were not associated with gout in a large study of men (Choi and Curhan, BMJ 2008), unlike sugar-sweetened ones. Wine is not a risk-free alternative for people with gout, since any type of alcohol has been associated with attacks.
