It might be gout if your big toe feels like it’s broken and just the thought of a sheet touching it makes you break out into a cold sweat. The gout toe pain can be extreme and excruciating.

Researchers have suspected for many years that gout, a form of inflammatory arthritis, was linked to the consumption of alcohol. However, the theory was never proved until the first large epidemiological study was conducted to determine whether alcohol could be linked to gout.

Results of the research on gout and alcohol was conducted by a team at Massachusetts General Hospital, and published recently in The Lancet. They found alcohol consumption does trigger an increased production of uric acid, the cause of gout. Gout affects the joints of both men and women leaving them with painful and swollen joints.

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The association between alcohol consumption and gout was suspected for hundreds of years and incidence of gout has risen for the past several decades due possibly to changes in diet such as people consuming more red meat, becoming more sedentary and drinking beer.

The study on how alcohol increases gout risk involved 47,000 men. They concluded men who over-indulge in some forms alcohol --particularly beer -- are at heightened risk for gout.

Scientists say alcohol may affect both uric acid removal and production. They have found when alcohol is converted to lactic acid; it reduces the amount of uric acid that is removed from the body through the kidneys. The lactic acid, in a sense, competes with the uric acid for removal from the kidneys.

Researchers studying the link between alcohol and gout followed the men over the course of 12 years. They found increased levels of alcohol in the body increases production of uric acid.

The findings on alcohol and gout risk were shocking: 730 of the 47,000 men developed gout. Men who drank 50 grams or two or more alcohol servings (in the form of beers) per day were 2.5 times more likely to develop gout than those who did not drink. When alcohol was consumed in the form of two shots of spirits per day, the risk of gout increased by 1.6 times compared with no spirit intake.

Indeed, if you are going to consume alcohol, researchers suggest some forms of alcohol are less risky when it comes to gout than others.  Beer consumption as the choice of alcohol showed the strongest association with the risk of gout. Meanwhile, subjects who drank spirits as their alcohol had a weaker association or risk. Moderate wine consumption was not associated with increased grout risk.

During the study of the link between gout and alcohol, researchers used standard portions to measure alcohol consumption: 1 Shot (44ml) of spirits - containing 14.0g of ethanol (alcohol); 12oz (355ml) bottle or can of beer - containing 12.8g of ethanol (alcohol) and 4 oz (118ml) glass of wine - containing 11.0g of ethanol (alcohol).
 

Their findings indicated the risk of gout was significantly raised with alcohol intake as low as 10.0-14.9g per day. Comparing the subjects to people who abstain from alcohol, researchers found alcohol consumption can raise the risk of gout: 10-15g per day increased risk by 30 percent; 15-30g per day increased risk by 50 percent; 30-50g per day increased risk by 100 percent and more than 50g per day increased risk by 150 percent.

Researchers continue to debate the meaning of the study on alcohol and gout. Some argue there might be a non-alcoholic ingredient in beer that contributes to the increase risk of gout. They note the fact that beer is the only alcoholic drink to contain purines, chemicals that play a key role in gout.

While researchers point to the role of purines, many physicians point out that the evidence is not conclusive with regard to purines playing a role in gout. In fact, in one study of Taiwanese vegetarians who ate a diet that is high in purines, the subjects showed a reduced risk of developing gout toe issues.

Some experts suspect the reason beer drinkers have a higher risk than other people who consume alcohol has more to do with lifestyle factors. For example, a person who drinks beer might be at increased risk for gout simply because he is coach potato who opts for a sedentary lifestyle. People who drink wine as their alcohol of choice might be more health-conscious overall, choosing to drink their alcohol with fruits, vegetables and lean vegetable proteins as opposed to a beer drinker who has a high-fat hot dog and fries.

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