Lemon for gout: with water, garlic, tea

Urate-lowering therapy (ULT): allopurinol, febuxostat, probenecid, or pegloticase, is the key to successful long-term treatment of gout. The American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) guidelines for the treatment of gout support the use of diet along with pharmacologic interventions [ 1 ], [ 2 ]. Thus, optimal treatment of gout may require a combination of pharmacologic interventions, dietary modification, and possibly the use of nutritional supplements. [ 3 ]

Gout is the most common type of chronic inflammatory arthritis in adults, a disease that is accompanied by a disorder of purine metabolism. [ 4 ] In this case, there is an excess of uric acid, which cannot be completely filtered by the kidneys and its salts are deposited in the joints.

There are many gaps in treatment and knowledge in the field of gout management. Key treatment gaps include low cure rates with ULT and low adherence to ULT medications [ 5 ], as well as lack of control and achievement of serum urate target of <6 mg/dL, an important therapeutic goal. A recent internet-based gout survey found that 50% of gout patients reported using dietary supplements or natural remedies, most commonly cherry extract or juice, but also vitamins, celery seed, turmeric, lemon juice, etc. [ 6 ].

In the treatment of gout, one of the most important aspects is diet. Dietary changes recommended for the treatment of gout include increasing the intake of low-fat dairy products and vitamin C, and reducing the intake of total protein, alcohol, and high-fructose beverages [ 7 ], [ 8 ].

Can you eat lemon if you have gout?

The diet for gout is vegetarian in nature with some peculiarities. [ 9 ] To reduce the amount of purines in food, protein and fats are limited. During remission, lean meat and fish can be eaten up to three times a week, and during an exacerbation of gout, they are excluded from the diet. Also, you cannot eat smoked foods, canned goods, salted pickled vegetables, offal, legumes. These products are rich in purine bases, which cause great harm to joints during gout. [ 10 ], [ 11 ] It is forbidden to drink alcohol. [ 12 ] The cooking process is of great importance. Meat and fish in limited quantities during remission are allowed only in boiled form. At the same time, you cannot drink meat and fish broths, since purines remain there after cooking. You need to reduce your salt intake. [ 13 ], [ 14 ]

The foods that should be eaten with gout are rye bread and cereals, potato and vegetable soups, milk, sour cream, cottage cheese. Vegetables and fruits should be eaten in large quantities. It is recommended to drink a lot of liquid. Preference is given to weak tea with lemon, fruit drinks, rosehip decoction.

Plant-based foods should be the preferred source of protein for gout patients, [ 15 ] given that plant-based foods (especially nuts and legumes) are excellent sources of protein, fiber, vitamins, and minerals, and studies have shown that they are beneficial against the risk of weight gain, [ 16 ] coronary heart disease, [ 17 ], [ 18 ] sudden cardiac death, [ 19 ] and type 2 diabetes. [ 20 ]

Very often now you can find in the recommendations of patients with gout such a folk treatment as the well-known lemon.

Several studies have highlighted lemon as an important health-promoting fruit rich in phenolic compounds as well as vitamins, minerals, dietary fiber, essential oils, and carotenoids. [ 21 ] Lemon juice may be an alternative in the treatment of urolithiasis in patients with hypocitraturia. [ 22 ] Lemon juice is rich in ericositrin and hesperidin. Animal studies have shown that ericositrin and hesperidin have antioxidant properties and can reduce oxidative stress. [ 23 ] Flavonoids, coumarins, and essential oil from citrus fruits exhibit anti-inflammatory effects that can be used as supplements to protect against or reduce chronic inflammatory diseases. [ 24 ] Citrus fruits with high content of secondary metabolites including flavonoids, limonoids and coumarins reduce the risk of cancer including gastric cancer, breast cancer, lung carcinogenesis, colon carcinogenesis, hepatocarcinogenesis and blood malignancies etc. [ 25 ], [ 26 ]

Then the question arose whether it is possible to eat lemon with gout, because it is an acid in its pure form, and uric acid, on the contrary, is neutralized by alkalis. After studying this issue, several explanations for the use of lemon for gout appeared. One of them is that citric acid lowers the pH, which prevents the deposition of uric acid. [ 27 ], [ 28 ], [ 29 ] Also, lemon juice affects the liver by improving the outflow of bile, and this, as is known, reduces the overall level of purines.

Therefore, the answer to the question “can you eat lemon if you have gout” is yes.

Benefits or harm of lemon for gout

Gout is a disease that requires a certain mandatory diet. And any errors can become a provoking factor for the exacerbation of the disease. Therefore, you should carefully monitor your diet.

Today, the benefits and harms of lemon for gout are widely discussed. Citric acid is harmful to people with gastrointestinal diseases - gastritis, peptic ulcer, acute pancreatitis - and lemons are contraindicated, as it increases the acidity of the stomach. The question arises, what benefits can lemon have for gout. Much is said about this, but the main fact confirming the benefits of lemon for gout is the neutralizing effect of lemon juice on uric acid. Lemon also contains a huge amount of vitamins, bioflavonoids, pectin substances and fiber, which promotes normal digestion and the elimination of toxins in gout. Potassium, which is contained in lemon, improves kidney function and removes uric acid salts. Therefore, we can confirm the unequivocal benefits of lemon for gout.

Citrus flavonoids (hesperidin, naringin, neohesperidin, and nobiletin) significantly inhibited amylase-catalyzed starch degradation. In addition, naringin and neohesperidin mainly inhibited amylose digestion, whereas hesperidin and nobiletin inhibited the degradation of both amylose and amylopectin. These results indicated that citrus flavonoids play an important role in preventing the progression of hyperglycemia, partly by binding to starch, increasing hepatic glycolysis and glycogen concentration, and decreasing hepatic gluconeogenesis.[ 30 ] Hesperidin, naringin, and nobiletin also exhibited antidiabetic activity, partly by decreasing hepatic gluconeogenesis or improving insulin sensitivity.[ 31 ]

Naringenin and hesperetin may exert their antiatherogenic effects in part by activating peroxisome proliferator-activated receptor and increasing adiponectin expression in adipocytes.[ 32 ]

It has been proven that the use of garlic and lemon juice leads to an improvement in the level of lipids, fibrinogen and blood pressure in patients with hyperlipidemia. [ 33 ] There is a recipe according to which you need to take lemon juice from one lemon in its pure form, one or two teaspoons twice a day. According to another recipe, you need to add one grated clove of garlic to lemon juice and take it in the morning and evening. You need to choose which recipe is optimal for yourself.

Lemon for gout is one of the remedies with a well-founded mechanism of action. Alkaline derivatives that are formed in the process of citric acid breakdown neutralize uric acid. Lemon also has an eliminative property in relation not only to uric acid salts, but also to other toxins.

Therefore, even if lemon treatment does not seem like a good method to you, just eat it and it will improve your condition.

[ 34 ], [ 35 ], [ 36 ], [ 37 ]