A colleague recently sent me an e-mail asking, "Is it true cherries are good for gout?"
It was a question I hadn't heard before. I was ready to dismiss it as yet another medical myth. But, I figured I'd look into it first. Sometimes, what seems like folklore, rumor or myth, turns out to be an effective remedy.
Gout occurs when uric acid, a normal byproduct of the body's metabolism, forms crystals in a joint. This causes intense inflammation. Pain can be so severe that it hurts to have a sheet placed over the affected joint. The first toe, foot and ankle are common places for gout. But just about any joint can be involved. Similar crystals can form in the kidney causing painful kidney stones.
Gout is a common condition. It affects up to 3 million people in the United States. While it's more common among older adults, it tends to affect postmenopausal women and men at any age. Risk factors include kidney disease, diuretic use (water pills) and obesity.
The joint inflammation caused by gout usually lasts a few days. Then, for rather mysterious reasons, it quiets down on its own. However, a number of medications, including non-steroidal anti-inflammatory drugs (NSAIDs) — ibuprofen or naproxen — and corticosteroids, can dramatically speed recovery. After many years of living with the disease, attacks may last longer and be more difficult to treat. Fortunately, we have other medicines (especially allopurinol) that can lower uric acid and effectively prevent attacks of gout.
One thing was clear as I researched cherries and gout: Many patients swear by the fruit. As I asked around, it became clear that my colleague's patient was not the only one. But is that enough to say they work?
Anecdotes and untested information passed down through families, friends or health-care providers are generally not enough to convince skeptical doctors. After all, we live in an era of "evidence-based medicine." So, you might wonder, what's the evidence that cherries are useful for gout?
Actually, there are at least two studies suggesting that cherries could be helpful for gout:
Studies to date offer several enticing explanations for why eating cherries might be useful for people with gout:
The studies above suggest that cherries may potentially help to prevent or treat gout. However, it's hard to know whether this approach will work because we lack high-quality studies designed to measure their ability to treat or prevent the condition. It's one thing to document changes in uric acid or markers of inflammation after eating cherries, or to ask gout sufferers to keep food diaries to link attacks to their diets. But it's quite another to show conclusively that cherries improve gout. And it's even more difficult to show they prevent it.
Still, we need the right types of studies to know whether cherry consumption can help gout. But don't hold your breath. Large, expensive clinical studies are usually sponsored by drug companies or the government — neither is likely to fund a study proving the benefits of cherries for gout.
Even if cherries are helpful for gout, it's not clear whether eating them would matter much.
If attacks are rare and readily controlled with non-steroidal anti-inflammatory drugs (as is true for many people with gout), it's unlikely that eating more cherries would provide much additional benefit.
It's unlikely that cherries would take the place of drugs that are used now to treat gout.
Then there are the "risks" of cherries to consider:
Eating cherries to prevent gout is probably harmless. And it could complement more traditional therapies. Given the evidence today, I'm not ready to call the cherry remedy for gout a myth. But I'd also say there's too little evidence to recommend them.
Robert H. Shmerling, M.D. is associate physician at Beth Israel Deaconess Medical Center and associate professor at Harvard Medical School. He has been a practicing rheumatologist for over 20 years at Beth Israel Deaconess Medical Center. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program.