Beer and arthritis…

As regular readers may know, I have serious and widespread osteo-arthritis – the result of being struck by lightning in 1983, which damaged most of my joints, among much else.

As the condition deteriorates, I’ve noticed that going to the pub means that the following day will be a bad one, both for mobility and pain. I’d assumed that this was caused by to-ing and fro-ing to the Gents’, but it’s a very small pub and I really couldn’t see it being the sole cause, so I started checking out beer and arthritis.

Pretty much immediately I struck gold, with this post**, pointing up the link between the purines (and the decomposition product, uric acid), in beer and the exacerbation of arthritis. Purines are, apparently, so much of a problem that the Japanese are brewing low-purine beers – not much use to me, though. In beers, Guinness has the highest level, lagers the lowest. Cider is very low.

**Not just this post – I verified it by checking quite a few others. Mostly these were websites dealing with gout, medical websites dealing with the problem proving elusive.

Spirits are high in purines, too (though lower than beer), which is why port (which is fortified with brandy), is historically associated with gout (an inflammatory form of arthritis featuring a build-up of uric acid crystals in the joints).

However, beer is by far the worst for purine content, and there are believed to be other factors in beer, besides alcohol, which are the culprits, as this report at BUPA shows. So if, like me, you drink cask beers, abhor lager, and only rarely drink Guinness, and you’re arthritic, you’re pretty much screwed.

Coffee, though, apparently lowers serum levels of uric acid, as does increasing your water intake (within safe and sensible limits, of course).

This website claims that beer is good for arthritis but considering the nature of the site (beer), it can hardly be considered unbiased. Anyway, research that claims benefits for various types of booze is predicated on an extremely small intake, usually one drink a day. Often that’s just not feasible.

I, for example, never drink at home, and have to get a taxi to the pub (£14 round trip) – the effort and the expense, for just one pint, is simply out of the question. (NB: If I have one or two pints, I suffer excruciating heartburn and nausea for hours afterwards; if I have 6 or 8, I’m OK, if a tad blurred round the edges – go figure…)

Not all purines are obtained from beer, of course, as other booze, and foodstuffs, contribute to your overall levels (and food is something I’m currently looking into – see below).

There’s another factor, too. Because of it’s potential for gastric grief, if I’ve been drinking I don’t take my Naproxen when I get home from the pub – it would be foolish (I do, if I remember, take a dose before I go out).

Wine, compared to beer, is quite low in purines, but hard figures are elusive so far.

There is an extensive list of purines in foodstuffs here and another here which also lists some booze, though not wine. Bear in mind that where figures (expressed as mg of uric acid per 100g of foodstuff**), are given for, say, dried beans, the figure for the soaked and cooked version will be lower.

**For beer and the like, it’s mg per litre.

As you can see from this website a low-purine diet, while perfectly  feasible, is staggeringly dull. As with so many things, moderation is better than elimination, unless you actually have gout. As for what I’m going to do, I really don’t know. Going to the pub is my only social activity (the stuff I’d prefer to do, instead, I’m physically prevented from doing – even the pub is a challenge sometimes).

Switching to cider isn’t feasible, because in most pubs there’s nothing worth drinking (Strongbow, or over-priced, over-hyped bottled cider are all that’s usually available**), and anyway, I drink beer because I actually like it, not to get drunk, which is an unwanted side-effect. Spirits are too small, and don’t last long enough, ditto wine – pretty much any alternative to beer is likely to lead to consuming far too much alcohol, which rather defeats the object of it. The only viable solution seems to be to drink less beer. Bugger!

**No such thing as “pear cider”, by the way – the drink you get from fermented pear juice is perry. You get cider only from apples. Putting “pear cider” on the label doesn’t change the fact that you’re drinking perry.