Synopsis

Source of validity: Traditional
Rating (out of 5): 2

Alkaline substances (often referred to as "alkaline therapy" or "alkaline water") have a traditional basis for use in gout management, primarily rooted in the historical understanding of uric acid solubility. Gout is caused by the deposition of monosodium urate crystals in joints, which occurs when uric acid levels in the blood are elevated. Historically, it was believed that making the body or urine more alkaline could help dissolve uric acid crystals and facilitate their excretion, as uric acid is more soluble at higher (alkaline) pH levels. This led to the recommendation of alkaline mineral waters, alkaline diets, or even alkaline salts (such as potassium citrate) as adjuncts in gout management.

However, modern scientific evidence supporting the efficacy of unspecified "alkaline" supplements or generalized alkaline diets in treating or preventing gout is limited and inconsistent. Clinical guidelines focus on medications that lower uric acid production or enhance its excretion. While urine alkalinization with specific agents may be used in rare cases (e.g., for uric acid kidney stones), broad recommendation of "alkaline" substances for gout is not supported by strong clinical trials. Thus, the use of alkaline substances for gout is primarily rooted in traditional practice, with a modest historical rationale but low-quality supporting evidence.

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