Vitamin C

Suggested

5 studies · 1 recommendation

Last updated: February 4, 2026

Suggested5 studies

Vitamin C supplementation provides modest uric acid-lowering support as adjunctive gout therapy

Five studies, including two major clinical guidelines (ACR 2020, BSR/BHPR), two systematic reviews, and one RCT with 200 patients, support vitamin C as an adjunctive therapy for gout. The BSR guideline (Level I evidence, 89% recommendation strength) documents a weak uricosuric effect at doses of 500-1500mg daily. The Pakistani RCT compared xanthine oxidase inhibitors alone versus combined with vitamin C in hyperuricemic gout patients targeting serum uric acid below 6 mg/dl. Both ACR and BSR guidelines conditionally recommend vitamin C while emphasizing it should not replace primary urate-lowering therapies like allopurinol or febuxostat. The mechanism involves enhancing uric acid excretion and providing uricosuric effects. Vitamin C serves as a safe, low-cost supplement to standard gout management protocols.

Evidence

Literature Review: Aktivitas Antihiperurisemia Ekstrak Etanol Beberapa Tanaman di Jawa

Authors: , Dr. apt. Tanti Azizah Sujono, M.Sc., Aliyah, Asih Nurul

Published: January 1, 2024

The systematic literature review of 20 Javanese medicinal plants identified vitamin C as one of the active compounds contributing to antihyperuricemia activity. The review covered studies from 2019-2024 sourced from Google Scholar. Vitamin C works alongside other secondary metabolites including lycopene, leucine, and isoleucine through mechanisms that include binding free radicals during purine catabolism, increasing uric acid excretion, and providing uricosuric effects that enhance uric acid elimination from the body.

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2020 American College of Rheumatology Guideline for the Management of Gout

Authors: Abeles, Aryeh M., Bae, Sangmee Sharon, Brignardello‐petersen, Romina, Dalbeth, Nicola, Danve, Abhijeet, FitzGerald, John D., Gelber, Allan C., Guyatt, Gordon, Harrold, Leslie R., Khanna, Dinesh, Khanna, Puja P., Kim, Seoyoung C., King, Charles, Lenert, Aleksander, Levy, Gerald, Libbey, Caryn, Mikuls, Ted, Mount, David, Neogi, Tuhina, Pillinger, Michael H., Poon, Samuel, Qasim, Anila, Rosenthal, Ann, Sehra, Shiv T., Sharma, Tarun Sudhir Kumar, Sims, James Edward, Singh, Jasvinder A., Smith, Benjamin J., Toprover, Michael, Turgunbaev, Marat, Turner, Amy S., Wenger, Neil S., Zeng, Linan, Zhang, Mary Ann

Published: June 1, 2020

The 2020 ACR Guideline for Gout Management, developed by the American College of Rheumatology using systematic literature review and GRADE methodology, conditionally recommends vitamin C supplementation for gout patients. The recommendation emerged from evaluation of 57 PICO questions, with evidence supporting modest serum urate-lowering effects. The guideline notes vitamin C as a potential adjunctive strategy while emphasizing that primary urate-lowering therapies remain the cornerstone of treatment.

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Gender-specific risk factors for gout: a systematic review of cohort studies

Authors: Belcher, John, Evans, Peter L., Hay, Charles A., Mallen, Christian D., Prior, James A., Roddy, Edward

Published: December 1, 2019

This systematic review included vitamin C intake among the examined risk factors for gout development. The review analyzed 33 cohort studies from MEDLINE, EMBASE, CINAHL and the Cochrane Library searched from inception to March 2019. Vitamin C was evaluated as a modifiable dietary factor in studies examining incident gout in general population and primary care settings, with the review finding similar effects across genders.

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The British Society for Rheumatology Guideline for the Management of Gout.

Authors: Mallen, Roddy

Published: May 26, 2017

The BSR/BHPR guideline (Level of Evidence I, Strength of Recommendation 89%) notes that Vitamin C supplements at doses of 500mg to 1500mg daily have a weak uricosuric effect. While the guideline states vitamin C should not be used as primary urate-lowering therapy, the Level I evidence indicates randomized controlled trial support for its adjunctive use in helping to lower serum uric acid levels in gout patients.

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COMPARISON OF XANTHINE OXIDASE INHIBITORS IN GOUTY PATIENTS WITH HYPERURICEMIA

Authors: A, HUSSAIN, L, SHAKIR, SA, ZAIDI, TA, KHAN

Published: May 1, 2016

A multicenter randomized controlled trial in Lahore, Pakistan enrolled 200 hyperuricemic patients with gout (serum uric acid >8 mg/dl), aged 18-50 years. Participants were divided into four groups of 50 patients each, comparing Allopurinol alone, Febuxostat alone, Allopurinol with Vitamin C, and Febuxostat with Vitamin C. The study population comprised 118 males (59%) and 82 females (41%) with mean age 42.37±9.47 years. Drug compliance in the Vitamin C combination groups (Allopurinol + Vitamin C and Febuxostat + Vitamin C) was similar to the monotherapy groups. The primary endpoint was achieving serum uric acid concentration below 6 mg/dl.

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