Getting rid of gout requires two things: stopping the intense pain of an active flare and then lowering uric acid levels long-term so flares stop coming back. A single strategy won’t do both. The good news is that gout is one of the most treatable forms of arthritis, and most people can reach a point where flares rarely or never happen.
Stopping an Active Flare
When a gout attack hits, the priority is reducing inflammation as fast as possible. Anti-inflammatory medications are the first-line option, and they work best when taken at the earliest sign of a flare, not after pain has fully set in. A large network analysis comparing different categories of these medications found no convincing differences in pain relief between them at two days or at longest follow-up, meaning most common options perform similarly when started early.
Colchicine is another standard treatment specifically for gout flares, but it comes with an important caveat: it can take 24 to 36 hours to produce noticeable relief. Many people make the mistake of taking extra doses during that window because they assume it isn’t working. That leads to side effects, mostly severe nausea and diarrhea, without speeding up recovery.
Corticosteroids, taken orally or injected into the affected joint, are a third option, particularly for people who can’t tolerate other treatments. Regardless of which medication you use, most acute flares resolve within a week or two. Icing the joint and keeping weight off it in the meantime can help manage the discomfort.
Lowering Uric Acid for Good
Flare treatment only puts out the fire. The real goal is lowering the amount of uric acid in your blood below 6 mg/dL, the threshold recommended by the American College of Rheumatology. Below that level, existing uric acid crystals in your joints gradually dissolve, and new ones stop forming. Stay below it consistently, and flares eventually stop.
Urate-lowering therapy is strongly recommended for anyone with visible lumps of uric acid deposits (called tophi), joint damage from gout visible on X-rays, or frequent flares. The preferred first-line medication starts at a low dose and is gradually increased every week or so, guided by blood tests, until your uric acid hits the target. This slow ramp-up matters because dropping uric acid too quickly can paradoxically trigger a flare. The effective range varies widely between people, so the dose is personalized based on regular lab checks rather than set at one fixed amount.
This treat-to-target approach, where your dose is adjusted based on repeated uric acid measurements, produces better outcomes than simply taking a standard dose and hoping for the best. It requires patience, though. It can take several months to find the right dose, and some people experience occasional flares during the adjustment period. Your doctor may prescribe a low-dose anti-inflammatory to take alongside the urate-lowering medication during those first few months to prevent breakthrough flares.
Foods and Drinks That Raise Uric Acid
Diet alone rarely gets uric acid low enough to prevent flares in someone who already has gout, but it makes a meaningful difference alongside medication. The foods that raise uric acid the most are those high in purines, compounds your body breaks down into uric acid. The biggest offenders include organ meats (liver, kidney, sweetbreads), game meats like venison and veal, and certain seafood: herring, scallops, mussels, tuna, trout, and haddock. Red meats like beef, lamb, and pork also contribute.
Sugar is an underappreciated trigger. Table sugar is half fructose, which your body converts directly into uric acid. High fructose corn syrup, found in sodas, packaged snacks, and many processed foods, is an even more concentrated source. Cutting sugary drinks is one of the highest-impact dietary changes you can make.
How Alcohol Affects Gout
All types of alcohol increase the risk of a flare, but the relationship is dose-dependent and varies by type. A study tracking over 700 gout patients found that more than one to two servings of wine in a 24-hour period more than doubled the risk of a flare. Beer showed a clear dose-response pattern: two to four servings raised the risk by 75%, and more than four to six servings raised it by 160%. Liquor followed a similar trend, with more than two to four servings raising risk by 67%.
Alcohol contributes to gout through two mechanisms. Some beverages, especially beer, are high in purines themselves. But all alcohol also impairs your kidneys’ ability to clear uric acid, effectively pulling it back into circulation. This is why even spirits, which are low in purines, still increase flare risk at higher quantities.
Cherries and Tart Cherry Juice
Cherries are the one food with consistent evidence for reducing gout flares. A case-crossover study of 663 gout patients found that cherry intake over two or more days was associated with a 35% lower risk of a gout attack. In a separate study, people with gout who regularly consumed cherry products reported significantly fewer flares than those who didn’t (an average of 1.54 flares versus 1.91). A small randomized trial found that drinking about one cup (240 mL) of tart cherry juice daily reduced uric acid levels by 19.2%.
The benefits likely come from the anti-inflammatory and antioxidant compounds in cherries. While cherries aren’t a substitute for medication in people with established gout, adding them to your diet is a low-risk way to support uric acid management.
Water Intake and Uric Acid
About two-thirds of your body’s uric acid is eliminated through the kidneys, so staying well-hydrated directly supports uric acid clearance. The general recommendation for people with gout or elevated uric acid is 2,000 to 3,000 mL of water per day, roughly 8 to 12 cups. Spreading your intake throughout the day is more effective than drinking large amounts at once. Adequate hydration also helps keep urine at a pH that prevents uric acid from crystallizing in the urinary tract.
Weight Loss and Uric Acid Levels
Carrying extra weight is one of the strongest modifiable risk factors for gout. A large study quantified the relationship: among people with elevated uric acid, every kilogram (about 2.2 pounds) of weight lost correlated with a small but real drop in uric acid. The reductions scaled up with the amount of weight lost. Losing 2 to 11 pounds produced a modest decrease, losing 11 to 22 pounds brought uric acid down by about 0.34 mg/dL, and losing more than 22 pounds reduced it by 0.64 mg/dL.
These numbers might seem small on their own, but when combined with medication and dietary changes, weight loss can be the factor that pushes someone below the 6 mg/dL target and keeps them there. Gradual, sustained weight loss is key. Crash dieting or fasting can temporarily spike uric acid as your body breaks down tissue rapidly, potentially triggering a flare in the short term.
Putting It All Together
Gout management works in layers. Treating acute flares with anti-inflammatory medications or colchicine handles the immediate crisis. Urate-lowering therapy, started at a low dose and titrated up based on blood tests, addresses the root cause by dissolving crystals and preventing new ones from forming. Diet, hydration, weight management, and moderating alcohol reinforce the medication by reducing how much uric acid your body produces and improving how efficiently your kidneys clear it. Most people who stick with a treat-to-target plan eventually reach the point where gout flares become rare, and existing joint deposits slowly shrink and disappear.