Fighting Gout With Skim Milk and Water

New Studies Suggest Water and Skim Milk Can Help Treat Attacks of Gout

By Charlene Laino
WebMD Health News

Reviewed By Louise Chang, MD

Oct. 19, 2009 (Philadelphia) -- There's a new reason to drink plenty of water and skim milk: Both may help to prevent painful gout attacks, new studies show.

"With gout, we spend a lot of time telling patients what they can't do -- to avoid beer and red meat, for example," says University of Auckland rheumatologist Nicola Dalbeth, MD, who headed the milk study.

"It's useful to have something we can tell them they can do" to help control their disease, she tells WebMD.

The studies were presented at the annual meeting of the American College of Rheumatology.

Gout, a type of arthritis that occurs most frequently in overweight, middle-aged men, is caused by the buildup of uric acid and needle-like crystals in the joints.

While there is certainly a genetic link to the disease, there is no question that lifestyle is a key contributing factor.

One recently identified trigger for the painful attacks is dehydration. So researchers set out to determine if drinking water could be an antidote.

Using ads on Google, the researchers recruited 535 people who said they had a gout attack within the past year. Participants' medical records were used to confirm the diagnosis.

Within two days of an attack, participants logged onto a special web site and answered questions about what they ate and drank in the 24 hours preceding the attack. Then, they were asked to log in another time, when they were gout-free, and answer the same questions.

Reducing Risk of Gout's Return

Results showed the more water they drank, the lower their risk of recurrent gout attacks. "For example, having five to eight glasses of water in the past 24 hours was associated with a 40% lower risk of having a gout attack, compared with drinking none or one glass of water in the past day," says Tuhina Neogi, MD, PhD, assistant professor of medicine at Boston University School of Medicine.

Neogi stresses that people with gout shouldn't substitute water for other treatments their doctors prescribe.

"But this suggests that dehydration may indeed be an important trigger for gout attacks, and that drinking water may be a simple intervention to help reduce the risk of recurrent attacks," she tells WebMD.

Previous studies have shown that people who drink a lot of milk have a lower risk of developing gout, Dalbeth says.

So she and colleagues decided to study the effects of skim milk on blood uric acid concentrations, which, when elevated, raise the risk of gout.

The researchers collected blood and urine samples from 16 volunteers immediately before they drank soy or skim milk and then hourly over a three-hour period.

Results showed that after they drank soy milk, levels of uric acid rose 10% over a three-hour period. Drinking skim milk led to a 10% drop in uric acid levels. In comparison, Zyloprim, a standard medication used to treat gout, results in a 20% to 30% drop in uric acid, Dalbeth tells WebMD.

She credits a substance in skim milk called orotic acid that promotes uric acid removal by the kidneys.

The researchers are now studying the longer-term effects of milk in people with gout.

Elaine Husni, MD, a rheumatologist at the Cleveland Clinic, says it's too early to make recommendations based on either study. "But water and milk are such common staples and they're something people can control."

SOURCES: American College of Rheumatology Annual Meeting, Philadelphia, Oct. 17-21, 2009.

Nicola Dalbeth, MD, University of Auckland, New Zealand.

Tuhina Neogi, MD, PhD, assistant professor of medicine, Boston University School of Medicine.

Elaine Husni, MD, Cleveland Clinic.

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