Can I Reverse Gout?

A doctor talks triggers for painful gout attacks, and ways to prevent them

Adam Rosenbluth, M.D.,

AARP

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Published May 11, 2026

An illustration on a blue background shows an older man sitting in a chair with his foot raised, looking concerned as a doctor kneels before him and points toward his swollen big toe.

James Yates

How can I reduce painful gout attacks?

Gout has a way of announcing itself: suddenly, intensely, and often at the most inconvenient moment. Patients describe going to bed feeling fine and waking up with a red, hot, swollen and exquisitely tender joint. Most often it’s their big toe, and just touching the bedsheets can be agony.

At its core, gout is a form of inflammatory arthritis caused by a buildup of uric acid in the bloodstream. Over time, that uric acid forms needlelike crystals that deposit in joints. When your immune system reacts to those crystals, you get a flare, which will trigger pain, swelling, heat and redness that can be severe enough to limit walking or even standing.

Some people are more prone to gout than others. Genetics play a role; many patients have a family history of it. Age matters, too. Men tend to develop gout earlier, while women’s risk rises after menopause, when estrogen, which helps to clear uric acid, declines.

The question you’re asking — how to reduce attacks — is exactly the right one, because gout isn’t just about managing pain in the moment. Repeated flares can damage joints permanently. Preventing them is the goal.

If you’ve had gout, your doctor should measure your uric acid. While “normal” levels vary, for people with gout we generally aim for keeping their uric acid levels below 6mg/dL. Research continues to support a “treat-to-target” approach. A 2022 review in the journal Nature Reviews Rheumatology confirmed that maintaining uric acid below this threshold significantly reduces flares.

Uric acid is measured as a concentration in your blood. When you’re dehydrated, whether from travel, illness or even a busy day, you effectively concentrate those crystals. That’s why gout attacks often follow dehydration. Drinking water consistently all day is one of the simplest yet most effective preventative strategies.

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Diet plays a powerful role, but it’s about patterns, not perfection. Certain foods are rich in purines, natural chemical compounds found in our body’s tissues. Our body breaks down purines into uric acid, so you want to avoid foods that are high in this chemical.

The biggest culprits are organ meats like liver, kidney and sweetbreads, red meats like beef and lamb, shellfish and some fish (such as anchovies, sardines and mackerel), alcohol (particularly beer) and sugary drinks. You don’t necessarily have to eliminate these entirely, but reducing them can make a meaningful difference.

What should you eat instead? Think in terms of an anti-inflammatory pattern that includes fruits, vegetables, whole grains, nuts and lean proteins. A few years ago I read an analysis of studies that found some evidence that dietary patterns similar to the DASH or Mediterranean diets were associated with lower uric levels. Weight also matters, as excess weight can increase the production of uric acid while also stressing your joints. These food plans could help you drop pounds.

You may have heard about cherry juice and coffee as home remedies. There is some evidence behind these natural treatments. A few studies found that tart cherry juice was associated with modest reductions in uric acid. Coffee has also been linked to lower uric acid levels in observational studies. Both drinks can be helpful additions, but they’re no substitute for a comprehensive plan.

More from Dr. Adam

If you’re having more than two gout attacks a year, it’s time to have a conversation with your doctor about medication. Drugs such as allopurinol reduce the production of uric acid in the body and may prevent future flares. More importantly, they can protect your joints from long-term damage.

One final point. Gout isn’t random. People often describe themselves as “lucky” when they go a year without a flare, but the condition is driven by identifiable factors: hydration, diet, weight and uric acid levels. When you manage those consistently, you shift the odds in your favor.

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