Tart cherry juice (TCJ) has gained considerable attention as a potential natural remedy for managing gout, a common and painful form of inflammatory arthritis. Many people experiencing gout flares look for dietary ways to reduce their symptoms, and the bright red juice presents a popular option. This article explores the scientific validity of using tart cherry juice for gout management by examining its biological mechanisms and the evidence provided by scientific research.
Understanding Gout
Gout is a condition characterized by sudden, severe attacks of pain, swelling, and redness in a joint, most often the big toe. The underlying cause is hyperuricemia, which means there are excessive levels of uric acid in the blood. Uric acid is a waste product formed when the body breaks down purines, compounds found naturally in the body and in many foods.
When the concentration of uric acid is too high, it fails to dissolve completely and begins to form sharp, needle-like monosodium urate crystals. These crystals then deposit in the joints and surrounding tissues, triggering an intense inflammatory response that causes the characteristic severe pain of a gout flare. Management focuses on lowering uric acid levels and controlling the resulting inflammation.
How Tart Cherry Juice Targets Uric Acid
Tart cherry juice is thought to exert its influence on gout through its high concentration of bioactive compounds, particularly a group of antioxidants called anthocyanins. These compounds are responsible for the cherry’s deep red color and possess significant anti-inflammatory properties. The anthocyanins may help reduce the severe pain and swelling that accompany an acute gout attack by dampening the body’s inflammatory pathways, similar to the action of some non-steroidal anti-inflammatory drugs (NSAIDs).
TCJ is also theorized to affect the production and excretion of uric acid. Some research suggests that compounds in tart cherries can help inhibit the enzyme xanthine oxidase, which converts purines into uric acid. By inhibiting this enzyme, TCJ potentially reduces the total amount of uric acid produced, a mechanism similar to the prescription medication allopurinol. Furthermore, cherry consumption has been shown to temporarily increase the excretion of uric acid through urine, which helps lower the concentration in the bloodstream.
What Clinical Studies Show
Clinical and epidemiological studies have provided mixed but generally promising evidence regarding the effect of tart cherry consumption on gout outcomes. A large observational case-crossover study found that consuming cherries over a two-day period was associated with a 35% lower risk of recurrent gout attacks. The risk reduction was even greater—up to 75%—when cherry intake was combined with the urate-lowering drug allopurinol.
Some smaller intervention studies have demonstrated that tart cherry juice consumption can lead to a measurable reduction in serum uric acid levels, often within a few hours of consumption. Other studies suggest that the benefit of cherry concentrate on reducing gout flares may be mediated more by its anti-inflammatory actions rather than a sustained reduction in serum urate levels. One study noted that concentrate consumption reduced the incidence of flares regardless of changes in uric acid levels, pointing to a strong anti-inflammatory effect. However, some trials have not found a significant effect on serum urate levels or flare frequency in people with established gout.
Dosage and Forms of Consumption
Tart cherry products are available in several forms, including pure juice, juice concentrate, and capsules or extracts. The concentrate and extracts typically contain higher, more potent levels of the beneficial anthocyanins and polyphenols than the diluted juice.
While there is no universally standardized dosage, some studies have used a measure equivalent to 8 ounces of 100% tart cherry juice daily for four weeks. A commonly suggested dose for the concentrate is 1 to 2 tablespoons (about 15 to 30 milliliters) mixed into water one or two times per day. This dose of concentrate is roughly equivalent to eating 45 to 60 whole tart cherries. Consistency is necessary for potential long-term preventative effects, rather than just taking the product during an acute flare.
Considerations and Side Effects
While tart cherry juice is generally well-tolerated, there are several practical considerations, especially for individuals managing chronic health conditions. A primary concern with commercially available juices is their sugar content, which can be high due to added sweeteners. This high sugar load is a concern for people with diabetes or those working to manage their weight, as high-fructose beverages are themselves a risk factor for gout.
Digestive side effects, such as mild diarrhea or upset stomach, are the most commonly reported issues, particularly when consuming larger doses of the juice or concentrate. People with kidney issues should exercise caution, as tart cherry juice can be high in potassium. This may pose a risk for those whose kidneys are unable to filter out excess minerals. It is important to consult a healthcare provider before incorporating tart cherry products into a gout management plan, as it should not be used as a substitute for prescribed urate-lowering medications.