Gout is an inflammatory arthritis characterized by sudden, intense episodes of joint pain. Tart cherry juice has emerged as a popular, traditional dietary remedy for managing this painful condition. This article investigates the biological mechanisms behind tart cherry juice and reviews the current research to determine its place in a modern gout management plan.
What Gout Is and Why It Hurts
Gout is a metabolic disorder resulting in hyperuricemia, an excessive concentration of uric acid in the bloodstream. Uric acid is a natural waste product formed when the body breaks down purines, compounds found in many foods and produced by the body itself. Normally, the kidneys filter this acid, but when production is too high or excretion is too low, the acid level rises.
When uric acid reaches a high enough saturation point, it forms sharp, needle-like monosodium urate crystals. These crystals deposit in the joints and surrounding soft tissues, triggering a severe immune system response. The resulting inflammation manifests as a gout attack, causing the affected joint to become red, swollen, and intensely painful. The pain usually peaks rapidly within the first 12 hours of onset.
How Tart Cherries Affect Uric Acid Levels
The potential benefits of tart cherry juice are attributed to its rich concentration of bioactive compounds, particularly anthocyanins and other polyphenols. Anthocyanins are the pigments that give cherries their deep red color and possess potent antioxidant and anti-inflammatory properties. These compounds are believed to play a dual role in managing the underlying causes and symptoms of gout.
One proposed mechanism involves the inhibition of xanthine oxidase, an enzyme responsible for converting purines into uric acid. By slowing down this enzyme, tart cherry compounds may help reduce the overall production of uric acid in the body. Furthermore, some evidence suggests that tart cherry consumption may increase the kidney’s ability to excrete uric acid through the urine.
The anti-inflammatory action of the anthocyanins helps manage the inflammatory cascade that causes the severe pain of a gout attack. These compounds are thought to reduce the levels of inflammatory markers in the blood, mitigating joint swelling and tenderness. This dual action provides a scientific basis for the traditional use of tart cherries for gout management.
Reviewing the Research and Recommended Consumption
Clinical research supports incorporating tart cherry products into a long-term strategy for gout management, particularly for prevention. One observational study found that consuming cherries over a two-day period was associated with a 35% lower risk of experiencing a gout attack compared to periods of no consumption. This protective effect was observed with both whole cherries and cherry extract.
The evidence suggests the benefit is dose-dependent, stabilizing after consuming the equivalent of approximately three servings over two days. Research also found that combining cherry consumption with the prescription medication allopurinol reduced the risk of gout attacks by 75%. This indicates that tart cherry products may serve as a useful complement to traditional pharmacological treatment rather than a replacement.
Tart cherry concentrate is a common form of consumption due to its potency for individuals considering a consistent regimen. A typical daily recommendation is to consume around 30 milliliters of Montmorency tart cherry concentrate, often diluted with water. This serving size is roughly equivalent to eating 90 to 100 fresh tart cherries. Alternatively, drinking 8 ounces of 100% tart cherry juice daily can also help reduce serum uric acid levels over a period of weeks.
Who Should Exercise Caution
While generally considered safe, certain individuals should discuss the addition of tart cherry juice with a healthcare professional. Because it is a concentrated fruit product, large doses can sometimes lead to gastrointestinal discomfort, including mild diarrhea or stomach upset, due to the natural sugar and sorbitol content. Starting with a smaller serving and gradually increasing the intake can help the digestive system adjust.
Patients taking prescription medications for gout, such as allopurinol or febuxostat, should consult their physician before relying on tart cherry juice. Cherry products should not be used as a substitute for physician-prescribed uric acid-lowering therapy, though they may complement these treatments. Tart cherry compounds may also affect liver enzymes, which is relevant for people taking blood thinners or other medications metabolized by the liver. A medical consultation ensures the dietary change will not interfere with existing drug protocols or mask the need for more intensive treatment.