Gout responds to a combination of medication, dietary changes, and lifestyle adjustments. During a flare, anti-inflammatory drugs bring the fastest relief. Between flares, the goal shifts to keeping uric acid levels below 6 mg/dL, the threshold where crystals stop forming and existing deposits gradually dissolve. Most people need both medication and lifestyle changes to hit that target consistently.
Managing an Active Flare
When a gout attack strikes, the priority is reducing inflammation as quickly as possible. Anti-inflammatory medications are the first-line option and work best when taken within the first 24 hours of symptoms. Colchicine, a medication specifically used for gout, is another common choice your doctor may prescribe for flares. Corticosteroids are typically reserved for people who can’t tolerate the other options or who have kidney problems.
Icing the joint for 15 to 20 minutes and elevating it can help alongside medication. Most flares resolve within a week or two with treatment, though untreated attacks can linger for weeks.
Uric Acid-Lowering Medication
If you get more than one or two flares a year, or if you have visible deposits of uric acid crystite (called tophi), you’ll likely be started on a daily medication to lower your uric acid. The most commonly prescribed option starts at a low dose of 100 mg or less per day, then gets increased every two to five weeks until your uric acid drops below the 6 mg/dL target. Some people need much higher doses to reach that number.
The target matters. People whose uric acid stays below 6 mg/dL have about a 10% chance of experiencing flares, while nearly two-thirds of those with levels above 9 mg/dL continue to suffer attacks. Reaching and staying below target is the single most effective thing you can do for long-term gout control. It takes time, though. Expect several months of dose adjustments, and don’t be surprised if you get a flare during the early weeks of treatment. That’s a common and temporary side effect as crystals start dissolving.
Foods That Help and Foods to Limit
Diet alone rarely controls gout, but it makes a real difference at the margins. The foods highest in purines, the compounds your body converts to uric acid, include organ meats like liver, certain seafood (anchovies, sardines, herring, mussels, scallops), and bacon. These are worth limiting or avoiding entirely.
Moderate-purine foods like beef, chicken, pork, shrimp, crab, and lobster don’t need to be eliminated, but keeping portions reasonable helps. Low-purine proteins like eggs, low-fat dairy, and most plant-based proteins are the safest everyday choices. Dairy in particular appears to have a protective effect against gout.
Sugary drinks and foods high in fructose also raise uric acid. Cutting back on sodas and fruit juices sweetened with high-fructose corn syrup is one of the simpler dietary changes with a meaningful payoff.
Alcohol and Gout
All types of alcohol increase the risk of gout flares. A study of gout patients found that wine, beer, and liquor were each independently associated with a higher risk of recurrent attacks, even at moderate amounts. Beer has long been considered the worst offender because it contains purines on top of the alcohol itself, but the research makes clear that no alcoholic beverage gets a free pass. If you’re trying to reduce flares, cutting back across the board is more effective than simply switching from beer to wine.
Hydration
About two-thirds of the uric acid your body produces is filtered out through the kidneys, so staying well-hydrated helps your body clear it more efficiently. Aiming for 2 to 3 liters of water per day (roughly 8 to 12 cups) is a common recommendation for people with gout. Spacing your water intake throughout the day is more effective than drinking large amounts at once. Keeping urine dilute also reduces the risk of uric acid kidney stones, which gout patients are more prone to.
Cherries and Vitamin C
Tart cherries are the most studied natural remedy for gout, and the evidence is genuinely encouraging. A study of 633 gout patients found that cherry consumption was associated with a 35% reduction in the risk of gout flares. Both fresh cherries and tart cherry juice concentrate appear to work, likely through a combination of anti-inflammatory compounds and a modest uric-acid-lowering effect. Two to three servings per day during a flare, or a daily serving for prevention, is a common approach.
Vitamin C supplementation at 500 mg per day has been shown to lower uric acid in people with elevated levels but without established gout, reducing it by about 0.78 mg/dL over two months in one trial. However, the same study found no significant benefit in people who already had gout. Vitamin C may be more useful as a preventive measure for people with borderline-high uric acid than as a treatment once gout is established.
Weight Loss: Helpful but Not a Cure
Carrying extra weight raises uric acid levels, and losing weight does bring them down, but the relationship isn’t as straightforward as many people hope. Research analyzing the connection found that for men, every 1% drop in BMI translates to roughly a 0.35% drop in uric acid. That means a man with a uric acid level of 8 mg/dL would need a dramatic amount of weight loss to reach the 6 mg/dL target through weight loss alone.
That doesn’t mean weight loss isn’t worth pursuing. Even modest reductions in weight improve insulin sensitivity and lower inflammation, both of which benefit gout indirectly. The practical takeaway is that gradual, sustainable weight loss helps but almost always needs to be paired with medication to bring uric acid into a safe range. Crash diets and fasting can actually trigger flares by temporarily spiking uric acid, so slow and steady is the safer approach.
Putting It All Together
The most effective gout management combines daily uric-acid-lowering medication with a handful of consistent lifestyle habits: staying hydrated, limiting high-purine foods and alcohol, maintaining a healthy weight, and possibly adding tart cherries to your diet. None of these strategies works as well in isolation as they do together. The 6 mg/dL uric acid target is the number to track. Once you’re consistently below it, flares become far less frequent, and existing crystal deposits slowly shrink over months to years.