VANCOUVER, Canada—Gout risk is lower in men with high levels of vitamin C intake and drops by nearly half in those who take 1500 mg/day or more of vitamin C supplements, according to Hyon K. Choi, MD, and colleagues.¹

In a large, prospective, 20-year follow-up study reported in Archives of Internal Medicine, the researchers show that:

• gout relative risk (RR) was nearly 20% lower in men with total vitamin C intake of 500-999 mg/day, compared to men consuming less than 250 mg/day of vitamin C
• gout risk was 37% lower in men ingesting 1500 mg/day or more total vitamin C
• adding vitamin C supplements cut gout risk by 34% for 1000-1499 mg/day doses and 45% for doses over 1500 mg/day, compared to men who did not take extra vitamin C.

“Vitamin C intake levels among men have a strong influence in the risk of gout,” Dr. Choi told MSKreport.com. The researchers found that each 500-mg increase in total daily vitamin C intake reduced the RR to 0.83.

“Higher vitamin C intake is independently associated with a lower risk of gout. Supplemental vitamin C intake may be beneficial in the prevention of gout,” Dr. Choi concluded. Dr. Choi is in the Division of Rheumatology and the Arthritis Research Centre of Canada at Vancouver, General Hospital, University of British Columbia, Vancouver, Canada.

The researchers prospectively examined the relationship between vitamin C and risk of incident gout in nearly 50,000 men participating in the Health Professionals Follow-up Study. Duration of follow-up was 20 years, during which time diet was assessed at baseline and again every 4 years, and gout and other heath issues were assessed every 2 years.

H. Ralph Schumacher, MD, who headed the recent pivotal study of febuxostat, told MSKreport.com that this study adds an important piece of information about gout etiology to factors such as milk and fructose identified in prior work by Dr. Choi and others. Dr. Schumacher is Professor of Medicine in the Rheumatology Division at the University of Pennsylvania School of Medicine, in Philadelphia.

Translating research into practice: no routine vitamin C for gout prevention

Drs. Choi and Schumacher agree that it would be premature for men in general to start downing 500 mg/day of vitamin C in the hope of preventing gout.

“Perhaps for those at a high risk of developing gout and also those with existing gout 500 mg daily would be reasonable,” Dr. Choi said.

Dr. Schumacher thinks that vitamin C supplements will deserve a second look if further research shows that in addition to lowering uric acid levels, vitamin C can reduce the cardiovascular risk associated with hyperuricemia.

A final unanswered question is whether patients with treatment-resistant gout might benefit from adding vitamin C to gout drug treatment regimens,” Dr. Schumacher said.

Reference

1. Choi HK, Gao XG, Curhan G. Vitamin C intake and the risk of gout in men: A prospective study. Arch Intern Med 2009;169:502-507.