Joint and pain boost: Gout treatment could be enhanced by alkaline water: RCT

By Audrey Yow

- Last updated on GMT

Alkaline water has been shown to be effective in treating gouty arthritis symptoms in a randomised controlled trial. © Getty Images
Alkaline water has been shown to be effective in treating gouty arthritis symptoms in a randomised controlled trial. © Getty Images

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Alkaline water has been shown to be effective in treating gouty arthritis symptoms in randomised controlled trial (RCT)

Researchers in China found that alkaline water reduced symptoms of chronic gouty arthritis suffers in an RCT.

“Alkaline water, particularly at high concentrations, effectively alleviated pain, reduced joint swelling, enhanced daily activities, and improved joint motion in chronic gouty arthritis treatment,” wrote the researchers in Medicine​.

“It significantly reduced key inflammatory markers (C-reactive protein, interleukin-1β, tumor necrosis factor-α) and serum uric acid levels, suggesting its potential as a valuable adjunct in gout management.”

Currently, the treatment of chronic gouty arthritis focuses primarily on lowering uric acid levels and managing acute attacks. Traditional medications like allopurinol and benzbromarone are effective in controlling uric acid levels but may cause side effects such as gastrointestinal reactions and liver or kidney damage with long-term use. Hence, exploring safer, less adverse supplementary treatments has become a research focus in recent years.

Alkaline water, a non-pharmacological supplementary treatment, has gained attention for its potential to regulate body fluid pH, possibly aiding in improving urid acid solubility and excretion, which helps to lower blood uric acid levels. Alkaline water may also alleviate inflammation and pain caused by gout, improving quality of life.

Therefore, researchers wanted to explore the efficacy and safety of combining alkaline water with conventional Western medication to treat chronic gouty arthritis in an RCT.

For this one-year trial, researchers recruited 400 patients with chronic arthritis. They were between 18 to 70 years old and received treatment at the Gout Department of Guangdong Provincial Hydropower Hospital from September 2021 to September 2023.

The participants were randomly allocated to either the control group or the experimental group.

Those in the control group adhered to a low-purine diet and consumed 2000 mL water daily to facilitate uric acid excretion. During acute phases, affected joints were moderately rested, and strenuous exercise or exposure to cold environments were avoided. As medication, they took a 40-gram dose of febuxostat (brand name: Uloric, produced by Jiangsu Wanbang Biochemical Pharmaceutical Group Co., Ltd.). The medication was taken once daily to lower hyperuricemia (high uric acid in the blood).

Those in the experimental group were divided into three groups. They all had the same medical treatment as those in the control group, but they adhered to a normal diet. They also took varying concentrations of 2,000 mL alkaline water per day: one group took a low pH concentration of 8.0–8.2, the second group took a medium concentration of 8.3–8.5, and the last group took a high concentration of 8.8–9.

At the end of the trial, participants were assessed for pain, degree of improvement in joint swelling, and quality of life. They were also assessed via their biochemical markers (serum uric acid, creatinine, urea nitrogen), which indicated the impact of treatment on uric acid metabolism. Their inflammatory markers C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin-1β (IL-1β), and tumour necrosis factor-α (TNF-α) were also measured.

The researchers found that those who took a high concentration of alkaline water had significantly reduced pain, and they had the greatest improvement in joint swelling reduction.

All participants who took the alkaline water could also move their joints more freely, engaging in daily activities previously hindered by pain and stiffness. Both their biochemical and inflammatory markers also saw a notable decrease.

“In this study, we particularly focused on key indicators such as CRP, ESR, IL-1β, and TNF-α to assess the impact of alkaline water on the inflammatory response in patients with gouty arthritis. The results showed significant improvements in these inflammatory markers among patients consuming alkaline water compared to the control group, especially in levels of CRP and IL-1β. This finding supports the hypothesis that alkaline water alleviates the inflammatory response in gouty arthritis,”​ concluded the researchers.

However, they said it is critical to use the appropriate concentration of alkaline water. This research examined varying concentrations and found that all levels, particularly the high concentration, were effective. But the safety and side effects of this treatment warrant attention.

“While no significant safety concerns were observed in this study, further long-term clinical research is necessary to assess the long-term safety and tolerance of alkaline water. Moreover, when used in combination with conventional Western medication, careful monitoring of drug interactions and adverse reactions is crucial to ensure treatment safety,”​ said the researchers.

Source: Medicine

DOI: https://doi.org/10.1097/MD.0000000000037589​  

“Assessment of the efficacy of alkaline water in conjunction with conventional medication for the treatment of chronic gouty arthritis: A randomized controlled study”

Authors: Wu, Yong; Pang, Shuwen MD et al​.

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