Several hundred years ago, gout was attributed solely to overindulging in rich, fatty foods and alcohol, and the consequent obesity. While the implications of rich foods and alcohol for gout sufferers is well-understood, the issue is slightly more complex.

For instance, saturnine gout, an uncommon and secondary type of gout, can result from lead toxicity. Historically, alcoholic beverages were often stored or served in vessels that contained lead. For example, lead crystal and ceramic glazes were used in drinking vessels. Even worse were pewter tankards—pewter is a metal alloy that traditionally contained lead.

When wine and fruit juices, which are quite acidic, are placed in lead-containing vessels, they react with the material and leach lead. Water and beer are less acidic and more neutral, but to a lesser extent also leach lead. It is now believed that long-term, subacute lead poisoning damaged the kidneys of heavy wine drinkers, greatly reducing their ability to excrete uric acid.

Today, lead-free ceramic glazes are used and pewter tankards are less prevalent. However, anyone with gout should still make an effort to remove sources of heavy-metal contamination from their drinking water, food and home environment. Drinking-water filtration systems that remove lead are inexpensive and readily available.

—CLB