Gout

26 remedies

Reference, not prescription. Nothing here is medical advice. Herbs can interact with medicines and be dangerous in pregnancy; tell your doctor or pharmacist about anything you take.

Strong evidence

An approved medicine, or consistent good-quality trials and reviews.

Autumn crocus

Colchicum autumnale

Strong

Colchicine is an approved drug for preventing and treating gout flares. The 2021 Cochrane review found only four trials: low-quality evidence that low-dose colchicine roughly doubled the share of people with at least 50% less pain at 32–36 hours (42% vs 17% on placebo), with benefit similar to NSAIDs; high doses worked no better and caused far more side effects.

Limited evidence

Small or few trials, mixed results, or mainly lab and animal work.

Asian plantain

Plantago asiatica

Limited

Described as widely used in China for gout and high uric acid; an extract lowered serum uric acid and reduced kidney injury in hyperuricaemic mice. No human trials were found.

Bibhitaki

Terminalia bellirica

Limited

In a 24-week Indian double-blind trial in 110 people with high uric acid, an aqueous fruit extract (500 mg twice daily) lowered serum uric acid from 8.1 to 5.8 mg/dL, against 8.5 to 4.3 with febuxostat 40 mg; placebo rose. A second trial in 59 people with chronic kidney disease found 1000 mg twice daily cut uric acid by about 34% (febuxostat 64%) and improved kidney filtration similarly to febuxostat. Both trials were small and by overlapping Indian authors; gout attacks were not measured.

Black poplar

Populus nigra

Limited

Traditional tincture use for gout; bud extracts (100–400 mg/kg) lowered uric acid in mice comparably to allopurinol.

Celery

Apium graveolens

Limited

Water and oil extracts of celery seed lowered serum uric acid and xanthine oxidase in hyperuricaemic mice and reduced ankle swelling and inflammation in rats with urate-crystal arthritis. No human trials were found.

China root

Smilax china

Limited

A traditional Chinese remedy for gout. An ethyl acetate fraction (250 mg/kg) lowered uric acid in hyperuricaemic mice and rats, and its caffeic acid, resveratrol, rutin and oxyresveratrol inhibited xanthine oxidase in vitro.

Chinaroot

Smilax glabra

Limited

Believed in Chinese medicine to help hyperuricaemia and gout, and an ingredient of the Pharmacopoeia gout capsule Tongfengding Jiaonang. Its total flavonoids (mostly astilbin stereoisomers) lowered serum uric acid in hyperuricaemic mice.

Chinese arborvitae

Platycladus orientalis

Limited

Leaf extract and its flavonoids quercetin and rutin lowered serum uric acid in hyperuricaemic mice and inhibited xanthine oxidase in liver tissue.

Common reed

Phragmites australis

Limited

A crude rhizome extract lowered serum uric acid in mice with induced hyperuricaemia, by inhibiting xanthine oxidase and increasing urate excretion. There are no human trials.

Flowering quince

Chaenomeles speciosa

Limited

Fruit extracts inhibited xanthine oxidase in vitro and, in rats and mice with induced high uric acid, lowered serum uric acid and reduced kidney damage. No human data were found.

Karkatashringi

Pistacia integerrima

Limited

Leaf extracts and flavonoids inhibited xanthine oxidase in the lab, and the ethyl-acetate extract lowered uric acid in hyperuricaemic mice, less than allopurinol.

Shiny bush

Peperomia pellucida

Limited

An extract inhibited xanthine oxidase, the enzyme that makes uric acid, in a test-tube assay (IC50 about 43 µg/ml, far weaker than allopurinol at about 1.2 µg/ml). No animal or human studies of uric acid or gout were found.

Sweet cherry

Prunus avium

Limited

In 633 people with gout followed online for a year, eating cherries in the previous two days was linked to a 35% lower risk of a flare (odds ratio 0.65). This was an observational case-crossover study, and the type of cherry was not specified. In 10 healthy women, 280 g of Bing sweet cherries lowered plasma urate about 15% five hours later.

Traditional use

Long recorded use, essentially untested in clinical trials.

Asparagus

Asparagus officinalis

Traditional

Used for gout in ancient Greece and Rome, and for gout in Eastern European and Chinese folk medicine.

Blackcurrant

Ribes nigrum

Traditional

Folk-medicine handbooks cited by EMA describe the leaf as a diuretic 'eliminating uric acid' and list it for gout and rheumatic complaints; no trials.

Caper

Capparis spinosa

Traditional

Folk use for gout across its range (Mediterranean, Himalaya, Middle East).

Chaulmoogra

Hydnocarpus pentandrus

Traditional

Recorded in Ayurveda for gout as well as leprosy, tuberculosis and skin disorders; no clinical studies.

Common peony

Paeonia officinalis

Traditional

Roots, seeds and flowers have been used in Spanish, French, Italian and north-west Balkan folk medicine for gout, credited with anti-inflammatory and pain-relieving effects. No clinical trials were found.

Flame lily

Gloriosa superba

Traditional

In traditional medicine, seed extracts are given for acute gout. The seeds' alkaloid colchicine, purified and in fixed doses, is a US FDA-approved drug for gout flares. The plant itself is not a safe source, because its colchicine content cannot be controlled and the margin between a useful and a lethal dose is narrow.