10 Gout Myths That Are Making Your Flares Worse

Gout has been around for thousands of years, and unfortunately, so have the myths about it. For a research-based foundation, see our complete guide to understanding gout. Many of the most commonly believed “facts” about gout are outdated, oversimplified, or flat-out wrong. Worse, believing them can lead you to focus on the wrong things while the real triggers go unaddressed.

Here are ten myths that might be making your gout management harder than it needs to be.

Myth 1: Gout Is a “Rich Person’s Disease”

This might be the oldest gout myth in the book. Historically, gout was associated with wealthy people who could afford rich foods and alcohol, earning it the nickname “the disease of kings.” In reality, gout affects people across all socioeconomic backgrounds. It is the most common form of inflammatory arthritis, affecting roughly 4% of American adults.

Gout is driven primarily by genetics and metabolic factors, not by how much you spend on groceries. In fact, some of the biggest dietary triggers, like sugary sodas and processed foods with high-fructose corn syrup, are among the cheapest foods available.

Myth 2: Gout Is Only Caused by Eating Too Much Red Meat

While red meat does contain purines that contribute to uric acid production, dietary purines account for only about one-third of the uric acid in your body. The other two-thirds come from your body’s own cellular processes.

More importantly, gout is primarily an excretion problem, not just a production problem. Research shows that dietary purines account for only about 30 percent of total uric acid production. Most people with gout are “under-excreters” whose kidneys do not clear uric acid efficiently. This means you could eliminate red meat entirely and still have high uric acid levels if the underlying excretion issue is not addressed. Factors like insulin resistance, dehydration, and genetics play much larger roles than any single food.

Myth 3: You Should Avoid All Purine-Rich Foods

This myth leads people to unnecessarily restrictive diets that are hard to maintain and often ineffective. Research has shown that vegetable purines, including those in spinach, asparagus, mushrooms, and cauliflower, do not increase gout flare risk. The purines in vegetables appear to be metabolized differently than those in organ meats and certain seafood.

The foods that actually warrant attention are a much shorter list: organ meats (liver, kidney, sweetbreads), certain shellfish (anchovies, sardines, mussels), and foods high in fructose. Trying to avoid all purines leads to an overly restrictive diet without proportional benefit.

Myth 4: Cherry Juice Cures Gout

Cherries do contain anti-inflammatory compounds (anthocyanins) that some research suggests may modestly reduce flare frequency. But “modestly reduce” is very different from “cure.” Gout is a chronic metabolic condition that typically requires medical management.

Here is the irony: many commercial cherry juices contain significant added sugar, and fructose is one of the most potent dietary triggers for uric acid production. Drinking large quantities of sweetened cherry juice to “treat” your gout could actually be making it worse. If you want to try cherries, tart cherry extract in capsule form provides the beneficial compounds without the sugar.

Myth 5: Gout Only Affects the Big Toe

While the big toe (specifically the metatarsophalangeal joint) is the most common site for a first gout attack, gout can affect virtually any joint. Ankles, knees, wrists, fingers, and elbows are all common locations for flares. Some people experience gout in multiple joints simultaneously.

The big toe is a common starting point because it is the coolest joint in the body (farthest from the heart) and uric acid crystals form more readily at lower temperatures. But assuming your ankle or knee pain cannot be gout because it is not in your toe could delay proper diagnosis and treatment.

Myth 6: If You Eat Well, You Do Not Need Medication

This is a dangerous myth that leads some people to refuse or stop medication in favor of dietary management alone. While diet absolutely matters and can help reduce flare frequency, most people with gout cannot achieve target uric acid levels through diet alone.

The American College of Rheumatology recommends urate-lowering therapy for patients with frequent flares, and for good reason. Medication addresses the underlying metabolic issue (under-excretion or overproduction) in ways that diet cannot fully replicate. Diet and medication work together, not as alternatives to each other.

Myth 7: Drinking Lots of Water Will Cure Gout

Hydration is genuinely important for gout management. Adequate water intake helps your kidneys excrete uric acid more efficiently. Dehydration is a well-known flare trigger. But water alone cannot cure gout any more than diet alone can.

Think of hydration as one important piece of a larger puzzle that includes medication (if prescribed), dietary awareness, weight management, and understanding your personal triggers. Drinking water is necessary but not sufficient.

Myth 8: Gout Flares Are Caused by What You Ate Yesterday

The relationship between diet and flares is not as immediate as most people assume. While some triggers like alcohol can provoke a flare relatively quickly, the buildup of uric acid that leads to crystal formation happens over weeks and months, not hours.

A flare is often the culmination of a period of elevated uric acid rather than a direct response to a single meal. This is why tracking your diet and symptoms over time is so much more valuable than trying to blame your last meal. Apps like Urica help you see patterns across weeks and months rather than making snap judgments about individual foods.

Myth 9: Women Do Not Get Gout

Gout is more common in men, but women are far from immune. Before menopause, estrogen helps the kidneys excrete uric acid, which provides some protection. After menopause, that protection decreases significantly, and gout rates in women rise substantially.

Post-menopausal women can develop gout that is every bit as severe as what men experience. The myth that gout is exclusively a “man’s disease” can delay diagnosis in women, whose symptoms may be attributed to other conditions.

Myth 10: Once You Have Gout, Nothing Really Helps

This might be the most harmful myth of all, because it breeds hopelessness and inaction. The truth is that gout is one of the most treatable forms of arthritis. With proper medication, most patients can reduce their uric acid to levels where crystals dissolve and flares stop entirely.

The combination of appropriate medical treatment, informed dietary choices, adequate hydration, and understanding your personal triggers can dramatically improve quality of life. Many people with well-managed gout go years without a single flare.

What Should You Focus on Instead?

Rather than following outdated rules, modern gout management focuses on understanding the metabolic factors that drive your individual condition. This means paying attention to insulin resistance, fructose intake, hydration levels, and kidney function rather than obsessing over a list of “forbidden foods.”

Tracking your diet, hydration, and symptoms over time reveals your personal patterns, which are far more useful than generic advice. Gout is highly individual, and what triggers one person may not affect another at all.

The myths persist because they are simple, and gout is complex. But understanding the reality puts you in a much better position to actually manage the condition effectively.

This article is for informational purposes only and does not constitute medical advice. Always consult your healthcare provider before making changes to your diet or medication regimen.