Gout is a painful form of arthritis linked to uric acid buildup and dietary purines. While many people are told to avoid seafood entirely, research shows that not all fish and shellfish are high in purines. This article breaks down which wild-caught seafood options are lower in purines, how purine content really works, and how people with gout can make informed, evidence based food choices without unnecessarily restricting nutrient dense foods. This article is intended to clarify common misconceptions about gout and seafood and help readers make informed, evidence based choices, not to replace medical advice.
What Causes Gout and Why Purines Matter
Millions of people around the world have gout, a type of arthritis. Gout attacks can happen when crystals of uric acid build up in the joints, which causes severe pain, swelling, and inflammation.
Uric acid is made when purines, which are found in many foods, are broken down by our body. Uric acid usually dissolves in the bloodstream and leaves our body through urine. But if the body makes too much uric acid or the kidneys can't get rid of it quickly enough, it can build up in the body and turn into crystals that settle in the joints and begin to wreak havoc!
Attacks of gout can come on quickly and without warning, and they often happen in the middle of the night. The joint that hurts gets hot, red, and swollen, and the pain can be unbearable. Oftentimes it will happen in the big toe joint, known as the podagra. Attacks of gout can last for days or weeks and can be very painful, and a huge inconvenience to everyday activities.
Medication can of course help with gout symptoms, and speaking with your doctor about medication options is very important to tackle gout! From the prevention side, a low-purine diet is also a great way to stop attacks.
How Much Purine Intake Is Recommended for Gout
The purine limit per day for someone trying to avoid gout flare-ups can vary depending on several factors, including age, sex, weight, and medical history. The American College of Rheumatology recommends that people with gout limit their daily purine intake to no more than 400 to 500 milligrams per day; even lower may be better! A 2012 study published in the New England Journal of Medicine found that men who consumed the lowest amount of purines (less than 100 mg per day) had a significantly lower risk of gout attacks than men who consumed higher amounts of purines.
Not All Seafood Is High in Purines
Some foods are high in purines, which can make you more likely to get gout. Red meat, organ meats, some seafood, and alcoholic drinks, especially beer, are all things high in purines, and important to limit or avoid completely. Not all seafood and fish have high purine levels!!
Low Purine Seafood Options That Can Fit a Gout Diet
Here are some wild caught seafood and wild fish options that are safe to eat on a gout diet because they are low in purines:
1) Salmon: Salmon has a lot of omega-3 fatty acids and not many purines. It is an excellent choice for people with gout who want to eat more fish. Both wild Alaskan king salmon and wild Alaskan sockeye salmon are considered to be low in purines and can be safely consumed by people struggling with gout as part of a balanced diet.
Wild Alaskan King Salmon: 67 mg purines per 3.5 oz
Wild Alaskan Sockeye Salmon: 63 mg purines per 3.5 oz
These values are relatively low compared to other high-purine foods like red meat and organ meats, which can contain several hundred milligrams of purines per 3.5 oz.
2) Canned Tuna: Some kinds of tuna are high in purines, but skipjack and albacore tuna are considered low to moderate in purines and safe for people with gout to eat. Tuna is also a good way to get omega-3 fatty acids and protein. The purine content of canned albacore tuna can vary depending on the specific product and brand. Generally speaking, canned albacore tuna is considered to be a moderate-purine food, similar to fresh albacore tuna.
Canned Albacore Tuna: 84 mg purines per 3.5 oz
This is slightly lower than the purine content of fresh albacore tuna, which is approximately 90 mg purines per 3.5 oz. Some canned tuna products may contain added ingredients, such as oils or flavorings, that could increase the purine content.
Additionally, some types of canned tuna, such as those labeled as "light" tuna, may contain different species of tuna that could have varying purine contents.
3) Shrimp: While most shellfish are high in purines, shrimp has a low amount of purines, so people with gout can eat it in moderation. Shrimp is also a good source of protein and other essential nutrients. Wild Alaskan shrimp, including spot prawns, are generally considered to be low in purines and can be safely consumed as part of a gout-friendly diet.
Wild Alaskan Spot Prawns (cooked): 93 mg purines per 3.5 oz
While this is slightly higher than some other types of seafood like salmon, it is still considered to be a relatively low-purine food compared to red meat, organ meats, and some types of seafood like anchovies and sardines. By staying away from high-purine foods and eating more low-purine foods like salmon, tuna, and shrimp, you can help reduce the number and severity of gout attacks.
2024 Update: What the Research Really Says About Shrimp and Purines
This update addresses common concerns raised in the comments and reflects current research as of 2024.
Many comments on this post are very concerned that shrimp is mentioned in this article. I'm here to remind you that I am writing this for Premier Catch, but as a Registered Dietitian Nutritionist qualified to provide evidence based insight on nutrition topics. Please remember that not all shrimp are the same, and the processing, and storage (and even what part of the shrimp eaten) will change the purine content. Purines aren't just one thing - they are several organic compounds that include adenine, guanine, xanthine, hypoxanthine, even caffeine and theobromine. Research and analysis from the Gout Foundation of Japan (where they eat a ton of seafood!) reminds us that two important points should be taken into consideration regarding nutritional therapy for gout or hyperuricemia with particular respect for the restriction of dietary purines. The first is the amount of total purines in the food, and the second is what types of purine bases are included. The consumption of foods that contain >200 mg/100 g of purines, especially with a high ratio of hypoxanthine, is considered to be a high risk for hyperuricemia. Please check out the article and tables here that list purine contents and classify these foods into high and low purine content groups rated 1-5 (1 is low, 5 is high) and you'll notice that many fish and shellfish are not rated 4 and 5, which is what they considered high at 200–300 mg+ /100 g of the food item. (100 grams is about 3.5 oz of a protein portion). Shout out to Chris C in the comments who found this research on their own! In the end, you know your body better than anyone else. But I challenge you to view food as a more complex chemistry that may actually allow you to eat more of these healthy foods than you think, even if you do struggle with gout.
A Note on High Purine Vegetables
There are some vegetables that have high purine content, but vegetables with high purines have not shown to have any significant effect on gout. It is recommended to continue eating all vegetables, including the high purine ones, since avoiding them has no significant effect on flare ups.
Key Takeaways for Eating with Gout
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Gout is influenced by total purine intake and uric acid metabolism, not by individual foods in isolation
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Not all seafood is high in purines, and many wild-caught fish and shellfish can fit into a gout-friendly diet
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Salmon, certain types of tuna, and shrimp are lower in purines than commonly assumed when eaten in appropriate portions
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Food chemistry is complex, and both the amount and type of purines matter, not just whether a food contains purines
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Individual tolerance varies, and long-term dietary success often comes from informed moderation rather than complete avoidance
