What Causes Gout Flare-Ups?

Medically Reviewed by Poonam Sachdev on February 08, 2024
4 min read

Once you’ve had one gout flare, you really don’t want another. Gout is a common type of arthritis that's very painful. It often affects the big toe but can also attack the knees, ankles, elbows, and other joints, making them feel tender, warm, and swollen. Your joint might even feel like it's on fire. The spell of pain is called a flare. Flares usually last a week or two, and you don't normally have any symptoms in between flares.

Gout happens when the body makes too much uric acid, which allows uric acid crystals to build up in joints and tissues. The uric acid comes from purines, chemicals found in the body naturally that are also in certain foods and drinks.







To avoid flares, it’s important to figure out the things that set off your symptoms. Here’s a rundown of some common gout triggers and how to handle them.

Some foods and drinks can raise the level of uric acid in your body. If you can limit them, you could head off another flare.

Red meat and seafood. Meat and seafood can be high in purines. When your body breaks them down, your level of uric acid goes up. Meats to be careful of include:

  • Red meats (beef, lamb, pork)
  • Organ meats (liver, tripe, kidney)
  • Game meats (goose, veal, duck)
  • Turkey

Seafoods to avoid include:

  • Anchovies
  • Sardines
  • Mussels 
  • Scallops
  • Tuna 
  • Trout

Instead of meat, get your protein from low-fat dairy products, like skim milk, cheese, and yogurt. You can also eat more beans, soy, and other plant-based forms of protein.

Sweetened drinks. Sodas and juices flavored with fruit sugars, like high-fructose corn syrup, can trigger gout flares.

For a sweet substitute, switch to flavored water or diet soda, which won’t raise your odds of an attack. In general, make sure to drink a lot of fluids. Aim for at least eight glasses a day, with at least half being water.

Alcohol. Liquor and especially beer keeps your kidneys from flushing out uric acid. You don’t have to give up on cocktail hour forever, but your best bet is to limit how much you drink. Your doctor can help you figure out how much is OK.

Certain drugs, health problems, and lifestyle choices can trigger gout, too.

Medications. Aspirin, certain diuretics for high blood pressure (and other conditions), and drugs for people who had organ transplants can trigger gout. After a flare, go over all the medicines you take with your doctor. If needed, they should be able to find another option.

Being overweight. When you work with a doctor to lose weight, you can protect yourself from another flare. 

Fasting or crash diets. If you fast or lose weight too quickly, you could raise your chances of an attack. 

High blood pressure, kidney disease, diabetes, and heart disease. These health conditions make you more likely to have gout, especially if you don’t get treatment. Work with your doctor to keep them under control.

Injuries or surgery. When your body is stressed or sick, you’re more likely to have a flare. Of course, you can’t always avoid this trigger. But if you need to have an operation, make sure your doctor knows you’ve had gout in the past.

Trauma. Sometimes, emotional stress can bring on a gout attack.

Gout triggers differ from person to person. Some people can eat a steak or drink an occasional beer with no problems. Others can’t tolerate a bite or a sip without a flare. So you need to learn what your gout triggers are.

Keep a diary of what you eat for a while. That way, you can go back and see whether you can link flares with specific foods. Then you’ll know what you really need to avoid.

Along with avoiding triggers, here are other things you can do to stay healthy and prevent flares:

  • See your doctor regularly. You may need to adjust your dose of gout medication over time.
  • Always have medicine on hand for flares. The faster you take it, the sooner you can control the symptoms.
  • Eat a heart-healthy diet full of vegetables, fruits, whole grains, low-fat dairy, and plant proteins (like beans and nuts). Cut down on processed foods (like white bread, cakes, and candy).
  • Get regular exercise. Opt for activities that don't put a lot of stress on your joints, like swimming, walking, and biking.

Gout triggers can include red meat, seafood, alcohol, sweet drinks, and certain medications and diseases. Keep a food diary to see what may trigger your gout flares. Have medication for these flares on hand, and eat a heart-healthy diet.

What is the most common trigger for gout?

One study found that the most common gout trigger was alcohol (14% of people in the study reported this), followed by red meat or seafood, dehydration, injury/excess activity, and extremely warm or cold weather. But only 29% of those in the study reported any type of trigger. Most didn't identify anything in particular as triggering their gout.

What is the fastest way to deal with a gout flare?

  1. Take an over-the-counter ibuprofen or naproxen, or an anti-inflammatory medication your doctor may have prescribed, right away. 
  2. Apply an ice pack to the affected joint for 20-30 minutes several times a day.
  3. Drink lots of nonalcoholic fluids. This will flush out uric acid and keep kidney stones at bay. Drink 8-16 cups of fluid, at least half of which should be water.
  4. Avoid alcohol.