- With Mayo Clinic internist
Scott C. Litin, M.D.
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Scott C. Litin, M.D.
Scott Litin, M.D.
Editor-in-chief of the third and fourth editions of the "Mayo Clinic Family Health Book," Dr. Scott Litin is a practicing general internist at Mayo Clinic, Rochester, Minn., and a professor at Mayo Clinic College of Medicine.
A distinguished practitioner, lecturer and teacher, Dr. Litin has served in numerous leadership positions at Mayo Clinic and nationally. He's a recipient of many awards, including the prestigious Henry S. Plummer Distinguished Physician Award and the Distinguished Clinician Award from Mayo Clinic. The American College of Physicians has recognized him as a Master of the College.
Dr. Litin has authored numerous medical journal articles and serves in editorial capacities for several Mayo Clinic publications. He is actively involved in continuing education programs for practicing physicians and is frequently an invited speaker at medical gatherings.
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Question
Diuretics and gout: What's the connection?
I've heard that diuretics and gout are somehow linked. When taken for high blood pressure, do diuretics ever cause gout attacks?
Answer
from Scott C. Litin, M.D.
Yes. Taking diuretics may raise uric acid levels in your blood (hyperuricemia). In some people, over time, hyperuricemia leads to gout. For this reason, people with a history of gout are frequently advised to avoid diuretics.
Many medications other than diuretics are available to control blood pressure. With other classes of blood pressure medications, it's usually possible to control high blood pressure without triggering gout or gout flares.
Also, many of the measures you take to reduce blood pressure have the added benefit of lowering uric acid. These measures include:
- Eating a healthy diet, with an emphasis on fruits, vegetables and whole grains, and reduced servings of meat and whole-fat dairy products
- Drinking little to no alcohol
- Losing weight and maintaining a healthy weight based on your body mass index
- Rose BD, et al. Diuretic-induced hyperuricemia and gout. http://www.uptodate.com/home/index.html. Accessed Oct. 25, 2011.
- Singh JA, et al. Risk factors for gout and prevention: A systematic review of the literature. Current Opinion in Rheumatology. 2011;23:192.
- Neogi T. Gout. New England Journal of Medicine. 2011;364:443.
- DeMarco MAM, et al. Diuretic use, increased serum urate and the risk of incident gout in a population-based study of hypertensive adults: The atherosclerosis risk in the communities cohort. Arthritis & Rheumatism. In press. Accessed Oct. 20, 2011.
- Bhole V, et al. Epidemiology of gout in women: Fifty-two-year followup of a prospective cohort. Arthritis & Rheumatism. 2010;62:1069.
- Terkeltaub R. Update on gout: New therapeutic strategies and options. Nature Rheumatology. 2010;6:30.
- AskMayoExpert. When should treatment for hyperuricemia, a risk factor for acute gout, be initiated? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2011.
- AskMayoExpert. What are the initial measures to reduce hyperuricemia in gout? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2011.
- AskMayoExpert. In which conditions should thiazide diuretics be avoided as a first-line treatment? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2011.
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