Cod is one of the safest fish choices for people with gout. At roughly 98 milligrams of purines per 100-gram serving, cod falls just under the 100 mg threshold that classifies a food as low-purine. For comparison, anchovies contain 273 mg, sardines hit around 177 mg, and mussels reach 293 mg per the same serving size. If you’ve been avoiding all seafood out of caution, cod is worth putting back on your plate.
Where Cod Ranks Among Seafood
Most fish and shellfish are moderate to high in purines, which is why gout guidelines often flag seafood as a category to limit. But the range is enormous. Anchovies, mussels, shrimp, and sardines all land above 175 mg of purines per 100 grams. Tuna comes in at 157 mg, salmon at 177 mg, and rainbow trout at 180 mg.
Cod sits near the bottom of the scale at 98 mg. Only a handful of other fish fall into the same low-purine range: haddock, perch, pike, and sole. These white, lean fish are consistently recommended as the best seafood options for people managing uric acid levels. Flounder (133 mg), halibut (113 mg), and scallops (105 mg) represent a middle ground, higher than cod but far below the worst offenders.
Omega-3s May Actually Help With Gout
Cod doesn’t just avoid making gout worse. It contains omega-3 fatty acids that may actively reduce flare risk. Omega-3s work as alternate raw materials for the same enzyme pathway that common anti-inflammatory drugs target. When your body processes omega-3s instead of other fats, it produces less inflammatory compounds, essentially functioning as a mild, natural anti-inflammatory.
Lab research has also shown that two specific omega-3s found in fish (EPA and DHA) can block a protein involved in uric acid reabsorption in the kidneys. In theory, this means omega-3s could help your body excrete more uric acid rather than letting it build up. A large internet-based study found that people who ate fish rich in omega-3s had a lower risk of gout flares after adjusting for total purine intake. That’s a meaningful detail: even accounting for the purines in fish, the omega-3s appeared to provide a net benefit.
A case-control study reinforced this, finding that people with higher omega-3 levels in their blood had 38% lower odds of gout attacks compared to those with lower levels, after adjusting for factors like BMI, disease duration, and uric acid levels. A small pilot trial of omega-3 supplementation found that participants who reached a certain omega-3 concentration in their blood experienced zero flares over a 12-week period. Cod is leaner than fatty fish like salmon or mackerel, so it delivers less omega-3 per serving, but it contributes without the purine penalty those fattier fish carry.
How Cooking Affects Purine Levels
If you want to reduce purines even further, how you cook cod matters. Boiling is the most effective method. When fish is boiled, purines dissolve into the cooking water. One study on tilapia found that boiling reduced certain purines by over 46%, the highest reduction of any cooking method tested. Steaming and microwaving also lower purine content, but less dramatically.
The key is discarding the cooking liquid. If you’re making a soup or stew and drinking the broth, you’re consuming the purines that leached out of the fish. Poaching cod in water or broth that you then discard, or simply boiling and draining, gives you the most purine reduction. Frying, by contrast, doesn’t pull purines out the same way since there’s no water-based liquid to absorb them.
Portion Size Still Matters
Even with a low-purine fish like cod, quantity plays a role. A standard serving of fish is around 100 to 115 grams (roughly 3.5 to 4 ounces). At that size, you’re looking at under 100 mg of purines, a manageable amount for most people with gout. Double the portion and you double the purine load, pushing cod into the same territory as moderate-purine fish like halibut or flounder.
Eating cod a few times per week at reasonable portions is a practical approach. You get lean protein, some omega-3 benefit, and minimal purine exposure. Pairing it with low-purine sides like vegetables, rice, or potatoes keeps the overall meal well within safe territory. The pattern to avoid is large portions of high-purine fish (think a big tuna steak or a plate of sardines) eaten frequently, which is a different scenario entirely from a moderate serving of cod.
Fish Eaters and Uric Acid Levels
A cross-sectional analysis of over 10,000 people in a large UK cohort found that people who ate fish but not meat had some of the lowest uric acid concentrations of any dietary group, including meat eaters, vegetarians, and vegans. Among women, fish eaters had the lowest uric acid levels of all four groups. This suggests that the type of fish people choose and the overall dietary pattern around it can offset the purine content of seafood.
The study couldn’t separate out which specific fish people were eating, so it reflects a general fish-eating pattern rather than cod in particular. But it does challenge the blanket advice to avoid all fish with gout. People who build meals around lower-purine options like cod, prepared thoughtfully, can include fish as a regular part of their diet without driving uric acid levels up.