Best and Worst Drinks for Gout: A Complete Guide

What you drink every day has a significant impact on your gout, and not just because of purines. Your beverages affect hydration (which drives kidney excretion), fructose load (which both increases uric acid production and impairs clearance), and metabolic health (which determines how efficiently your body handles uric acid in the first place).

Most gout guides focus exclusively on purines when ranking drinks. That misses the bigger picture. The metabolic effects of your beverages, particularly their fructose content and their impact on hydration, often matter more than trace purine amounts. Here is a comprehensive, research-backed ranking from best to worst.

The Best Drinks for Gout

1. Water: The Foundation

Water is the single most important beverage for gout management, and it works through a straightforward mechanism: adequate hydration supports kidney function and uric acid excretion.

Roughly 70% of uric acid is cleared through the kidneys. When you are dehydrated, uric acid accumulates - urine becomes more concentrated, kidney filtration slows, and uric acid builds up in the blood. A 2009 study published in the American Journal of Epidemiology found that participants who drank more than 8 glasses of water per day had a 48% lower risk of gout flares compared to those who drank one glass or fewer.

Most rheumatologists recommend 2-3 liters (roughly 8-12 glasses) daily for gout patients. The practical indicator is urine color. Pale yellow means you are well hydrated. Dark yellow means you need more water. Simple as that.

Timing also matters. Overnight dehydration is a known contributor to the high rate of nighttime gout flares. Drinking a glass of water before bed and first thing in the morning can help maintain consistent uric acid clearance through the hours when you are not actively drinking.

2. Coffee: A Surprising Ally

Coffee is one of the most well-studied beverages in gout research, and the results are consistently positive. Multiple large prospective studies have found that coffee consumption is associated with lower serum uric acid levels and reduced gout risk.

For a deep dive on coffee’s benefits, see is coffee good or bad for gout. A 2007 study in Arthritis & Rheumatism analyzed data from the Health Professionals Follow-Up Study (over 45,000 men) and found that men who drank 4-5 cups of coffee per day had a 40% lower risk of gout, and those who drank 6 or more cups had a 59% lower risk.

The mechanism appears to involve chlorogenic acid, a compound in coffee that inhibits xanthine oxidase, the same enzyme targeted by the gout medication allopurinol. By slowing this enzyme, coffee reduces the conversion of purines into uric acid.

Importantly, decaf coffee also shows benefits. While the effect is slightly less pronounced than regular coffee, decaf drinkers in the same study still had lower gout risk. This suggests that the beneficial compounds in coffee go beyond caffeine.

One caveat: coffee is a mild diuretic. If you are a heavy coffee drinker, make sure you are also drinking enough water to stay well hydrated. The benefits of coffee are additive to proper hydration, not a replacement for it.

3. Low-Fat Milk and Dairy Drinks

Low-fat milk is one of the few beverages that actively promotes uric acid excretion. The proteins in milk, specifically casein and lactalbumin, have a uricosuric effect, meaning they help the kidneys clear uric acid from the blood.

A study published in the Annals of the Rheumatic Diseases found that dairy protein intake was associated with lower serum uric acid levels and that the effect was linked to improved renal excretion rather than reduced production. This is particularly relevant because roughly 90% of gout patients are classified as “under-excreters,” meaning their kidneys do not clear uric acid efficiently.

The large Framingham Heart Study also found that dairy consumption was inversely associated with serum uric acid levels. People who consumed more dairy tended to have lower uric acid.

Low-fat or skim milk appears to be more beneficial than full-fat dairy, possibly because saturated fat can impair insulin sensitivity, which in turn affects kidney uric acid clearance. Plain yogurt drinks and kefir offer similar benefits with the added bonus of probiotics for gut health, and the gut is responsible for roughly 30% of uric acid excretion.

4. Tea: Modest Benefits

Tea gets a moderate ranking because it provides hydration and contains antioxidants, but it does not appear to have the same active uric acid-lowering properties as coffee.

Green tea contains catechins that have shown some xanthine oxidase inhibition in laboratory studies, but the effect in human studies has been inconsistent and modest. A 2017 meta-analysis found that tea consumption had a weak and non-significant association with gout risk.

The main benefit of tea is that it is a zero-calorie, zero-fructose beverage that contributes to your daily fluid intake. Herbal teas like rooibos and chamomile offer the same hydration benefits without caffeine, making them good options for evening drinking when you want to avoid sleep disruption.

The key warning with tea is what you add to it. Sweet tea, particularly the bottled varieties common in the southern United States, can contain 20-30 grams of sugar per serving, much of it high-fructose corn syrup. That transforms a neutral-to-positive beverage into a significant gout trigger. If you drink tea, keep it unsweetened or use a non-fructose sweetener.

5. Tart Cherry Juice: Benefits with a Caveat

Tart cherry juice has developed a strong reputation in the gout community, and there is real science behind it. Cherries contain anthocyanins with anti-inflammatory properties, and a 2012 study in Arthritis & Rheumatism found that cherry consumption was associated with a 35% lower risk of gout flares.

However, there is an important caveat that most articles overlook: tart cherry juice contains fructose. A typical 8-ounce serving of tart cherry juice concentrate (diluted) contains roughly 12-18 grams of sugar, a significant portion of which is fructose.

This creates a genuine tension. The anti-inflammatory compounds in cherry juice may help, but the fructose content works against you by increasing uric acid production and impairing excretion. Whether the net effect is positive or negative likely depends on the amount consumed and your individual metabolic profile.

If you want the cherry benefit without the fructose load, consider these alternatives:

• Tart cherry extract capsules deliver the anthocyanins without the sugar
• Whole tart cherries (fresh or frozen) provide fiber that slows fructose absorption
• Small, diluted servings (4 oz diluted with water) minimize fructose while still delivering some anthocyanins

The bottom line is that tart cherry juice is not the uncomplicated positive that many gout guides portray. It has real benefits, but the fructose content means you should be thoughtful about how much and how often you drink it.

The Middle Ground

6. Diet Sodas and Zero-Sugar Drinks

Diet sodas are a complicated topic. On the positive side, they contain zero fructose, which means they avoid the most harmful metabolic pathway for gout. A 2010 study in the BMJ found that diet soft drink consumption was not associated with increased gout risk, unlike their sugar-sweetened counterparts.

On the other hand, diet sodas do not contribute meaningfully to hydration (some evidence suggests artificial sweeteners may have mild diuretic effects), and they do not offer any active uric acid-lowering benefit. Some researchers have also raised concerns about artificial sweeteners’ effects on gut microbiome composition, which could theoretically affect the intestinal pathway of uric acid excretion, though this remains speculative.

The practical takeaway: if you are choosing between a regular soda and a diet soda, the diet version is dramatically better for gout. But if you are choosing between a diet soda and water, coffee, or milk, the latter options are actively helpful rather than merely not harmful.

7. Sparkling Water and Seltzer

Plain sparkling water is functionally equivalent to still water for gout purposes. It hydrates, it contains no fructose, and it supports kidney function. If you prefer carbonation, unflavored sparkling water is an excellent choice.

Flavored sparkling waters are also generally fine, provided they are truly zero-calorie and do not contain added sugars or fruit juice. Read the label carefully. Some “sparkling water” brands are essentially sodas with a different name, containing significant added sugar.

The Worst Drinks for Gout

8. Fruit Juices: The Overlooked Problem

This is where many people are surprised. Fruit juice is widely perceived as healthy, but for gout sufferers, it can be a significant trigger, and the reason is fructose.

Consider the fructose content of common juices:

Juice (8 oz)	Approximate Fructose
Apple juice	15-18g
Orange juice	12-15g
Grape juice	18-22g
Cranberry juice cocktail	15-20g
Pomegranate juice	14-16g

These are comparable to or even higher than many sodas. And because juice is liquid, the fructose hits the liver rapidly, without the fiber that whole fruits provide to slow absorption.

The Health Professionals Follow-Up Study found that men who consumed two or more servings of orange juice per day had a 79% higher risk of gout compared to those who rarely consumed it. This was one of the strongest dietary associations in the entire study.

The vitamin C in orange juice does have a modest uric acid-lowering effect, but the concentrated fructose delivery almost certainly overwhelms this benefit. You are better off eating a whole orange (roughly 6 grams of fructose with fiber) and taking a vitamin C supplement if needed.

9. Regular Sodas and Sugary Drinks

Sugary soft drinks are among the most well-documented gout triggers in the research literature, and fructose is the primary reason.

A 12-ounce can of regular soda sweetened with high-fructose corn syrup contains approximately 22-25 grams of fructose. When consumed as a liquid, this fructose is rapidly absorbed and floods the liver, triggering intense ATP depletion and a sharp spike in uric acid production. Simultaneously, the metabolic byproducts of fructose processing compete with uric acid for kidney excretion, reducing clearance.

The Nurses’ Health Study, following over 78,000 women for 22 years, found that women who consumed one or more sugary sodas per day had a 74% higher risk of developing gout. Those who consumed two or more daily had a 2.4-fold increased risk. These associations were independent of purine intake.

This is worth emphasizing: the association between sugary drinks and gout was stronger than the association between many high-purine foods and gout. For many people, eliminating sugary sodas may do more for their gout than eliminating shellfish.

Energy drinks, sweetened iced teas, lemonade, and other sugar-sweetened beverages carry the same risk. Any drink sweetened with HFCS or large amounts of sugar delivers a concentrated fructose hit that is bad news for uric acid.

10. Beer: The Double Hit

Beer is consistently identified as the most problematic alcoholic beverage for gout, and it earns that distinction through two separate mechanisms.

First, beer contains significant purines, primarily from the yeast and malt used in brewing. A standard beer contains roughly 10-15mg of purines per 12-ounce serving, which is modest per serving but adds up quickly over several drinks.

Second, and more importantly, alcohol impairs kidney excretion of uric acid. Ethanol metabolism produces lactic acid, which competes with uric acid for excretion through the kidneys. This means that alcohol does not just add purines; it also prevents your body from clearing the uric acid it already has.

Beer combines both mechanisms: it adds purines AND impairs their clearance. A 2004 study in The Lancet found that beer consumption had the strongest association with gout flares among all alcoholic beverages. Two or more beers per day was associated with a 2.5-fold increase in gout risk.

11. Wine: Moderate Concerns

Wine contains minimal purines and has shown a weaker association with gout risk than beer. The same Lancet study found that moderate wine consumption (one to two glasses per day) was not significantly associated with increased gout risk, though heavier consumption was.

Wine still contains alcohol, which impairs uric acid excretion through the lactic acid mechanism described above. The key word is moderation. A glass of wine with dinner is likely fine for most gout sufferers. Several glasses is not.

Red wine also contains resveratrol and other polyphenols with anti-inflammatory properties, which may partially offset the negative effects of the alcohol. But these compounds are not present in sufficient quantities to make wine a net positive for gout.

12. Spirits: The Excretion Problem

Hard liquor (vodka, whiskey, rum, gin) contains no purines, which gives it an advantage over beer. However, spirits still impair kidney excretion of uric acid through the same alcohol-lactic acid pathway.

The research on spirits and gout is somewhat mixed. The Lancet study found that spirits were associated with increased gout risk, but the association was weaker than for beer. The practical concern with spirits is that they are often consumed with sugary mixers (tonic water, cola, juice, simple syrup) that add a significant fructose load on top of the alcohol’s excretion-impairing effect.

If you choose to drink spirits, the gout-friendliest approach is with water, soda water, or a zero-sugar mixer. A vodka soda is dramatically better for gout than a rum and Coke or a margarita made with sweetened mix.

Practical Beverage Strategy

Rather than memorizing a rigid list, here is a practical framework for daily beverage choices:

Build your foundation on:

• Water throughout the day (aim for 2-3 liters)
• Coffee (if you enjoy it, 2-4 cups daily)
• Low-fat milk or dairy drinks

Enjoy in moderation:

• Unsweetened tea
• Sparkling water
• Small amounts of tart cherry juice (diluted)
• An occasional glass of wine

Minimize or eliminate:

• Regular sodas and sugary drinks
• Fruit juices (eat whole fruit instead)
• Beer (or limit to rare occasions)
• Cocktails with sugary mixers

Track your personal response: Everyone’s triggers are different. Some people tolerate moderate wine perfectly well; others find it triggers flares. Some people notice that coffee helps; others feel it disrupts their sleep in ways that increase flare risk. The most valuable thing you can do is track what you drink alongside your symptoms over time and identify your personal patterns.

The Fructose Takeaway

If there is one theme running through this guide, it is this: fructose matters more than most people realize. Many beverages that seem healthy (fruit juice, sweetened tart cherry juice, smoothies with added honey) deliver concentrated fructose loads that can spike uric acid levels within hours.

The single most impactful beverage change for many gout sufferers is not giving up beer or avoiding a specific type of tea. It is eliminating or drastically reducing sugar-sweetened drinks and fruit juices. That one change removes a significant source of fructose, the only dietary component that both increases uric acid production AND impairs excretion simultaneously.

Combined with consistent water intake to support kidney clearance, this simple shift in drinking habits can meaningfully improve uric acid management for a large number of people. For more on how diet affects gout, see our gout and food guide.

This article is for informational purposes only and is not medical advice. Consult your rheumatologist or healthcare provider about your specific dietary needs.