Using Cherries to Treat Gout

Treating Gout with Cherry Juice
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Over the last 40 years, the burden of gout, a painful inflammatory arthritis, has risen considerably, now affecting millions of Americans. In fact, gout is now the most common inflammatory arthritis in men and older women.

In my video, Gout Treatment with a Cherry on Top, I profiled new research, suggesting that even as few as a half of a cup of cherries a day may significantly lower the risk of gout attacks. Fresh cherries aren’t always in season, though. There are some alternatives. Frozen cherries appeared second-best and cherry juice concentrate is the runner-up. But does concentrated cherry juice actually help prevent attacks of gout?

The first pilot study was a randomized controlled trial cherry juice concentrate with pomegranate juice concentrate as a control for the prevention of attacks in gout sufferers who were having as many as four attacks a month. The cherry group got a tablespoon of cherry juice concentrate twice a day for four months, and the control group got a tablespoon of pomegranate juice concentrate twice a day for four months.

The number of gout flares in the cherry group dropped from an average of five down to two, better than the pomegranate group, which only dropped from about five to four. And about half of those in the cherry group who were on prescription anti-inflammatory drugs were able to stop their medications within two months after starting the cherry juice, as opposed to none of the patients in the pomegranate group.

The second study, highlighted in my video, Treating Gout with Cherry Juice, was a retrospective investigation over a longer term. Twenty-four gout patients went from having about seven attacks a year, down to two. The researchers concluded that cherry juice concentrate is efficacious for the prevention of gout flares. Large, long-term randomized controlled trials are needed to further evaluate the usefulness of cherries and cherry juice concentrate for gout flare prophylaxis.

So, are cherries now ripe for use as a complementary therapeutic in gout? One commentator “is of the opinion that the current state of evidence remains insufficient to formally recommend cherry fruit or cherry products as complementary therapeutic remedy for gout.” This commentator is also a paid consultant of nine different drug companies, all of which manufacture gout medications. I understand how the pharmaceutical industry can get nervous seeing studies where half of patients were able to stop taking their gout drugs given the billions of dollars at stake, but what’s the downside of eating a half cup of cherries a day, or worst comes to worst a few spoonfuls of cherry juice?

Here are the other videos I’ve done on the power of cherries to control inflammation:

Tart cherries (the kind people make pies out of, not the sweet kind) may also help with sleep (Tart Cherries for Insomnia).

What do you do with frozen cherries? I just eat them straight—suck on them like popsicles, but they’re also an integral part of my Healthy Chocolate Milkshakes.

Another way to help treat gout is to drink lots of water and keep one’s urine alkaline by eating lots of dark green leafy vegetables (see Testing Your Diet with Pee & Purple Cabbage).

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: Benson Kua / Flickr

  • EngineerGA1

    Tart cherries work. They are also bloody expensive! Tart cherry juice that’s real and not from concentrate, when I can find it in Whole Foods or speciality organic stores is $7-8 for 32oz. Whole Foods and Sprouts (and even the speciality organic markets in my area) do not carry tart cherries but rather dark sweet ones.

    Do you know a chain that carries the frozen tart ones? Are the dried ones, assuming they are not sweetened, as effective as frozen ones? The studies that Dr. G has highlighted for reducing muscle soreness emphasized the juice over actual cherries…is there a difference between dark sweet ones and tart ones in gout prevention?

    • David Sprouse MS PA-C NF Mod

      Good morning! Dr. G addresses one of your main questions regarding Sweet Vs Tart Cherries in a blog post from a few months ago; although the emphasis is on anti-inflammatory properties, hopefully that holds true for gout as well.

    • vmh

      I live near Traverse City, Michigan, where (on a good year) they grow most of the cherries produced in the United States. If you google “Michigan tart cherries” you will come up with a bunch of Michigan companies that ship. One of them I just checked only ground-ships frozen tart cherries until March 17. But the concentrate can be shipped anytime.

      • David J

        I buy tart cherry juice and an extract from https://www.traversebayfarms.com/ for gout prevention.
        Seems very high quality although not cheap. If you buy 6 bottles of the concentrate, shipping in the US is free (or was, last time I bought from them).

        • vmh

          Eden’s organic cherry butter isn’t cheap either, but a little goes a long way and it’s great on a baked sweet potato.

          • David J

            Thanks for the input – didn’t even know that existed!

      • EngineerGA1

        Thanks for the heads up. Done.

      • First_Blush21

        I get mine from Traverse Bay Farms. I’ve been doing the Tart Cherry concentrate for about a year and a half.
        I (truthfully) almost died from an adverse reaction to Uloric. (2.5 months, as sick as a ‘dog’, from it. My chronic gout has (knock on wood) been cured. Just by the tart cherry juice. “From blossom to bottle” it has saved my life, beyond a shadow of a doubt.

        TBF are nearly 100% Organic. Just a few acres left …. ‘almost there’. Other brands may be less
        costly.. BECAUSE some of them claim to sell “Organic” , but it is shipped from China, and other countries where the standard for “organic’ is not as strict as in the USA. (I had gout, one bout after another for over a year, with only a week in-between, and then WHAM. It’s been over 1.5 years, of ZERO gout. I truly thank God for being well again. It’s no fun to nearly lose 2 years of your LIFE in that kind of pain!

        PS: My PCP scoffs at CHERRY JUICE, but I am living proof, it is a reliable, and SAFE fix.

    • Karl Young

      Hi EngineerGA1, I don’t know where you’re located but in the SF bay area where I am the Costco chain has pretty good prices on frozen tart cherries (can’t remember the exact price offhand but remember it comparing favorably with places like Whole Paycheck when I checked).

      Re. dried tart cherries, I gave up even investigating that avenue as I’ve never been able to find an unsweetened version. If anyone else knows of the existence of such it would be nice to know about.

    • Rebecca Cody

      If we didn’t have insurance that pays for most drug costs, the cost of cherry juice would probably be much less than the cost of drugs, and that’s not even looking at the havoc many drugs create in our bodies, just the financial costs.

      • First_Blush21

        You are correct. I nearly died two years ago from a reaction to Uloric. Never again!
        The Tart Cherry Juice (I get it from Traverse Bay Farms) has literally saved my life~!

        • Rebecca Cody

          Drugs are so often terribly toxic to many. We’re all guinea pigs when taking them, especially newer ones. After they kill enough people they finally pull them from the market. What a system!

    • Psych MD

      According to this video dried are not as effective as fresh or frozen:
      http://nutritionfacts.org/video/anti-inflammatory-life-is-a-bowl-of-cherries/

    • SeedyCharacter

      I buy huge bags of organic tart cherries at Costco (in Santa Cruz, CA). I don’t recall the price exactly, but it’s not bad. Costco also has big bags of organic blackberries, strawberries, etc. in the freezer section. I like a tablespoon or so of the juice concentrate in the water I take to bed with me every evening. I read for a while and sip on the dilute juice. Not sure if it helps me sleep better, but it’s tasty and healthy. (The bottle, though pricey, lasts me for quite a while since I use so little per glass)

    • Linda

      There are a few cherry orchards in Michigan that grow tart/sour cherries. The one I buy from — quart of concentrate contains 2000 cherries — is great. We get it by the case. They are called Shoreline Fruit.

  • ostrich

    I bought dried tart Montmorency cherries at Costco. They do have added sugar and oil used in processing although nutrition facts say 0 grams of fat. They also have frozen tart cherries but I didn’t look at the label. Next time I go I will check the frozen ones.

  • Frozen cherries only take about 30 minutes to thaw. I eat them all the time, just put them in a container, take it to work, and by the time I’m there they are ready to eat. Same with blueberries. Blackberries take a little longer to thaw, and, Strawberries take the longest, depending on the size, as long as 2-3 hours.

    I usually cut up some bananas in there, too. Makes a filling meal.

    As for tart cherries, I love them but they are hard to find in the US. So, I only get to eat them from time to time. In Europe I found them everywhere many years ago when I stayed there for a few months on an exchange program way back in 1998. That’s actually when I first discovered them, but never could find them on a regular basis here in the US.

    • Try http://www.keimling.de and lock for “Sauerkirschen”… I’m pretty sure they send a parcel to you, if you order enough ;-)
      They have raw food quality – sensationally test, I promise it.

  • Mark Bailey

    I used to suffer from gout and have managed to get my uric acid serum levels down with Allopurinol and keep them down through diet. When one consumes cherries, what is the mechanism for reducing the gout attacks? Are serum levels reduced thereby dissolving the acid crystals like what occurs with Allopurinl or are the crystals being bound up with protein, rather like what happens with colchicine?

    • David J

      from the article by Zhang et al.
      http://www.ncbi.nlm.nih.gov/pubmed/23023818

      “These findings led investigators to speculate that cherries may exert their urate-lowering effect through increasing the glomerular filtration rate or reducing tubular reabsorption. In an animal study, intake of tart cherry juice significantly decreased the levels of serum uric acid in rats with hyperuricemia by inhibiting the hepatic activity of xanthine oxidase and xanthine dehydrogenase, suggesting that cherries may possess the capacity of lowering uric acid production (6). Cherries and cherry extract contain high levels of anthocyanins (7-9) that possess anti-inflammatory properties either through inhibiting cyclooxygenase activity (8, 10-12) or via scavenging of nitric oxide radicals (23). Thus, cherries may also have anti-inflammatory properties against the series of inflammatory responses triggered by monosodium urate crystals. Although cherries contain vitamin C, the amount they include (~ 80mg in 6 servings of cherries) (5) would likely be too low to have an impact on the risk of gout, as the relevant vitamin C doses associated with lower serum uric acid levels and gout risk have been approximately 500mg/daily or higher (24-26).”

  • Walt

    I used to have gout, but since I have been eating plants it has vanished. Losing weight and not eating meat is also a factor. When I had gout I weighed about 50 lbs more than I do now & I ate a lot of beef, chicken, ham, bacon, eggs, fish, etc.

    • Karl Young

      That’s certainly a great strategy but unfortunately doesn’t seem to, alone, be enough for some. E.g. I’ve been WFPB for about 10 years now but had a couple of gout attacks (for the first time) last year. I have been eating more tart cherries (mostly frozen) and so far so good since the last attack, about 7 months ago.

      • David J

        My experience is similar although I’ve only been a WFPB vegan for about 2 years (various forms of vegetarian for decades before that), but have had 2 attacks since quitting fish, dairy (lowers uric acid levels) and coffee. I’ve gone back to decafe coffee as it can lower UA levels, added tart cherry concentrate or extract, as well as upped my vitamin C as that also can have a significant effect on UA levels. On the other hand, my UA levels have never been measured to be higher than high normal (6.4-6.8), and sometimes as low as the target for medication (5-6 ng/dL). I am hoping that if I can keep my UA level below 6, I’ll not suffer another attack. Good luck to you!

        • guest

          Karl & David: I remember reading somewhere that sugars (table sugar, HFCS, etc.) can raise the blood uric-acid level.

          • Karl Young

            Thanks guest and David – sugar is something that may be an issue for me ; I’m not a heavy consumer but can’t resist the occasional piece of vegan chocolate cake. But the correlation of gout with uric acid levels seems a little complicated. Testing during my attacks last year “only” yielded high normal (as I recall something like 6.5).

            And good luck to you too David – gout isn’t something I’d particularly enjoy again !

          • NFmoderatorStephanie

            Hi Kari, congrats on being WFPB for such a long time! Refined sugar contributes to creating an acidic environment in the body which also sets the stage for gout attacks.

            You are correct, the correlation between gout attacks and uric acid levels can be confusing. Gout occurs when excessive blood uric acid crystals traveling in the blood stream get “stuck” around joints. The buildup of uric acid crystals around a joint create the characteristic red, hot, & painful joint. However, if you were to have your uric acid levels checked during a gout attack they MAY not be elevated. The reason is because the excess uric acid is concentrated around the painful joint and the remainder of the blood may still test normal. Does that make sense?

          • Karl Young

            Thanks Stephanie, that does make sense (and is probably even true ! :-)). But it is a little confusing re. why the uric acid levels are tested given that they don’t sound like a particularly good marker re. predicting severity or frequency of attacks. I guess, since I had none of the classic dietary predictors (re. being vegan and a non drinker), my doc just wanted to make sure that the levels weren’t anomalously high re. thinking about drugs…

          • NFmoderatorStephanie

            You are correct Kari, testing uric acid levels during a gout attack is not always an accurate way of diagnosing gout. Gout can usually be diagnosed clinically (a warm, swollen, red, joint), but sometimes a uric acid level is checked in attempt to verify gout versus another condition that may present similarly (for example, cellulitis – a skin infection).

          • David J

            The gold standard diagnosis is by joint aspiration. It can also be confused with pseudo-gout. Doctors who rely on UA tests and conclude one does not have gout (as 2 of mine have) when the results are normal or high normal, simply do not know what they are talking about. They use the test because it is easy and cheap, IMHO.

          • First_Blush21

            My PCP is a very NICE person. But knew ZERO about gout. Frankly, I had to CRAWL through tons of information on the web to get any information that was trustworthy ,, even blogs, and SEARCH, SEARCH, SEARCH. Finally I contacted a HOLISTIC Doc that my son in PA told me about … and began with “G-OUT”, a capsule of pure tart cherry powder. Then, I quickly switched to the Tart Cherry Juice, and am SOLD on it, because .. it has stopped my gout. Pain had been hitting at least ’13’ , felt like my foot was EXPLODING from the inside out. 2 years of ONGOING, horrible suffering… and then along came CHERRIES! :)

          • David J

            I’m glad to hear tart cherry juice is working for you.

            Are you saying the juice works better than the powder? I recently switched from tart cherry concentrate to an extract, but am not sure that is a good move.

          • David J

            >>>, my doc just wanted to make sure that the levels weren’t anomalously high re. thinking about drugs…

            This seems likely (despite my negative comments below about ‘cheap and easy’) since it is pointless to prescribe medication if the UA level is normal. Also UA is a primary anti-oxidant (people with high levels tend not to get various neurological diseases) and lowering it too much could be unwise (from what I’ve read, there is apparently a U-shaped curve). But to prevent gout, one should have measured levels no higher than 6.0 ng/dL with 5.0 – 5.5 ng/dL even better, but normal lab levels go up to 7 or even 8 (depends on the lab). [Note that normal levels are different for men and women; women typically have lower levels.]. Upshot: one should really have their levels checked every so often or do it themselves (although most meters are not very accurate).

          • David J

            Right. Fructose is the problem sugar as it can raise UA levels, but then sucrose is fructose + glucose, so it contributes to any issue in UA metabolism. However, studies are not consistent, as was pointed out to me in another thread on this topic (it’s a complicated topic). Nevertheless I do restrict my fructose intake as some specialists, e.g. Dr. RIchard Johnson, U of Col, recommends. Thanks for the response.

  • Guest2

    I’ve had gout for several years. I’ve tried cherries and tart cherries, but they didn’t seem to help much and were expensive, inconvenient, and had digestive repercussions. However, when I take celery seed extract capsules, I have no problem whatever with gout. When I forget to take them for a period of time, a mild twinge reminds me to take them, and the symptoms quickly go away. Celery seed extract is inexpensive, convenient, and has no side effects. In a pinch, celery is also said to work, but you have to eat about 8 stalks a day, so I stick with the capsules.

    • Guest2

      I’m sorry, there was an error in what I wrote above. There can be some side effects with celery seed extract. It is diuretic and anti-inflammatory, and it can also lower blood pressure, thin the blood, reduce arthritis pain,
      and interact with thyroid medications. You can find quite a few articles about it online. This one has links to research: http://doctormurray.com/celery-and-celery-seed-extract-are-powerful-proven-healers/.

      • David J

        Thanks for the pointer. This is very interesting. I am wondering though how much it would lower my blood pressure since it is already low normal.
        How much do you take? What has been your experience?

      • First_Blush21

        Thanks for the celery tip. I have high BP, and am allergic to most BP drugs. I’m definitely gong to try this.
        “If God don’t make it .. Don’t eat it.” :) Cheers!

  • Hello Dr. Greger, why not dried cherries use as a second-best? Here in Germany I have a supplier who is able to sell dried fruits without any additions like sugar or sulfur and they has been dried by temperatures under 40 °C. So they have raw food quality.;-)
    I’m pretty sure you have the same quality in America…

    • NFmoderatorStephanie

      Hi Steffen. I have been searching for an answer to your question. Usually whole fruit is preferable to dried fruit since the lack of water in dried fruit makes them less filling and therefore more calorie-dense. However, if you’re able to find dried cherries without sugar or preservatives, I don’t see why it wouldn’t be OK, as long as your diet has plenty of other sources of fresh fruits and vegetables. Here’s one of Dr. Greger’s articles where he touts the benefits of dried fruits.

      • Dear Stephanie, thank you for your reply. My thought was more a idea then a issue… ;-) You are right to mention that dried fruits have more calories but, according to the science not empty calories and I have no calory phobia because I’m a vegan :-)))
        Here in Germany I get dried fruits as raw quality food, meaning it was dried by temperatures under 40° C, so the most of vitamins are not destroid and often I put them into filtrated water for a while before eating or add them to my smoothie…
        I have a please – can you check the link again please, it doesn’t function and I’m very eager to read them. Thank you so much.

        • NFmoderatorStephanie

          I hope it works this time. http://nutritionfacts.org/topics/dried-fruit/. They way you described your dried fruits seems healthy to me. Keep up the good work on your excellent diet! I love to hear from people who are so health-conscious. :-)

  • Matthew Smith

    Modern medicine uses large compounds, like gold injections, for arthritis. Perhaps Boron or Niacin, smaller compounds, are the right answer. Maybe even carrots, rich in Beryllium would be effective in my opinion.

  • Mark Butler

    I remember back in the late 1960’s my father had gout and our family doctor told him to eat cherries, preferably black cherries. The only ones he could get at that time were canned. He was cured in no time.

  • Susie

    I can’t tolerate tart cherries as they play havoc with my reflux. Is there any chance of doing an article on LPR and/or GERF, please? I am suffering at the moment.

  • Susan M. Risk

    Hi I searched my own herb website to see if I could add to the quality of this type of care. Although Autum Crocus is not great for self-care, some use can be made of Physalis alkegenge (Chinese Lantern) for the treatment of gout. It actually works for other types of foot pain, and from very fine quantities. Elder, Oatstraw (Avena sativa) and CInquefoil are all easy to grow or to harvest from wild spaces.

    A Page of Properties about the Autumn Crocus (Cochicum autumnale)

    In 1763 this was confirmed by Storck. A native of Europe, Autumn Crocus has been used traditionally, since then, until modern times for the treatment of gout.

    http://www.northdaysimage.ca/colchicum.html

    Autumn Crocus: Text – Only Page

    This page offers interest links to works about the Autumn Crocus, which offers a medicine for gout, called colchicine.

    http://www.northdaysimage.ca/autumncrocustxt.html

    Oatstraw (Avena sativa) Properties Page

    Good for rheumatic problems, lumbago, paralysis, liver ailments and gout, kidney , and gravel problems. Bath herb (Oatstraw or Oatmeal) to soften skin and to …

    http://www.northdaysimage.ca/oatstraw.html

    Chinese Lantern (Physalis alkegenge) Properties page

    Physalis is a name from the Greek for bladder (phusa). Warning! Somnifera leaves have been found with Egyptian Mummies! For Gout, take eight berries at the …

    http://www.northdaysimage.ca/chineselantern.html

    Elder (Sambucus nigra) Properties Page

    Berries were used by gerard, 16th c. for ‘dropsie, sweelings,’ tumours and gout, and the green berries for piles. When dried, black or brown flowers are rejected: …

    http://www.northdaysimage.ca/elder.html

    Soapwort

    Acne, As a shampoo, Boils, Constipation, Dandruff, Gout, Intestinal problems, Jaundice, Rheumatism, Skin problems, including psoriasis (scaly, raised skin …

    http://www.northdaysimage.ca/saponariatxt.html

    Cinquefoil Potentilla anserina Properties

    external astringent for: skin problems,jaundice, malaria, cystitis,palsy, shingles, itch, sciatica, gout,rheumatism, arthritis, quinsey, epilepsy,toothache, bleeding …

    http://www.northdaysimage.ca/c_potentillatxt.html

    Medicinal Fruits Text-Only Page

    Its high vitamin C content helps lower the risk of arthritis and gout. It is also essential for a healthy immune system and resistance to infection particularly colds …

    http://www.northdaysimage.ca/medicinal_fruitstxt.html

    Cinquefoil: Text-Only Page

    A tisane used externally is also useful as an astringent for skin problems, jaundice, malaria, cystitis, palsy, shingles, itch, sciatica, gout, rheumatism, arthritis, …

    http://www.northdaysimage.ca/cinquefoiltxt.html

    Why Dad Refused to do the Dishes

    It is particularly useful in cases of arthritic joint inflammation and when the uric acid level in the urine is high, as in cases of gout. Green straw tea will release …

    http://www.northdaysimage.ca/zostertxt.html

  • Nirmala

    Nice piece of information. Happy to see this great advantage of Cherry. Thanks for sharing.

    http://www.nutritioncentrechennai.com/tnagar/herbalife-in-chennai.html

  • First_Blush21

    Thank you for this GREAT web site! Will return often! And, will share with many others. Best website I’ve EVER seen for Holistic health!