Quick answer: The NHS lists dehydration as something that can trigger a gout attack. In winter many people drink less because they feel less thirsty, while alcohol and sugary drinks can raise uric acid and dry you out further. Drink plenty of fluids unless your GP has set a fluid limit, keep alcohol-free days, and during a flare rest the joint, use ice wrapped in a towel, and take prescribed medicines as directed — do not stop urate-lowering tablets during a flare unless your clinician says so.
Gout is an inflammatory arthritis caused by urate crystals in a joint. Attacks are often sudden, very painful and hot — commonly in the big toe or midfoot. This guide is about the winter job many people ask about: how dehydration, colder-weather drinking habits and festive alcohol can link to flares. It is educational information for people in the UK, not a diagnosis or a personal treatment plan. For the full condition overview see our gout hub and gout treatment overview.
What the NHS says about gout and dehydration
- Gout happens when there is too much uric acid (urate) in the blood, which can form crystals around joints
- Things that can trigger an attack include illness with a high temperature, drinking too much alcohol, a very large meal, getting dehydrated, injuring a joint, and some medicines
- During an attack, the NHS advises drinking lots of water unless a GP tells you not to, resting and raising the limb, and keeping the joint cool with an ice pack or bag of frozen peas wrapped in a towel for up to 20 minutes at a time
- Longer term, the NHS advises drinking plenty of fluids to avoid dehydration, having some alcohol-free days each week, and not drinking more than 14 units of alcohol a week
If you have kidney disease, heart failure or another condition with a fluid limit, follow the limit your team gave you — do not force extra drinks.
Why winter can make fluid habits harder
Cold weather does not cause gout by itself. What often changes in autumn and winter is how you drink and socialise:
- Less thirst outdoors: you may simply forget water when you are not hot
- Heating and dry air: indoor heating can leave your mouth dry while you still skip drinks
- Illness: a winter bug with fever is on the NHS trigger list for gout attacks
- Festive alcohol and sugary drinks: beer, spirits and sugar-sweetened soft drinks can raise uric acid and also dehydrate you
- Diuretics ("water tablets"): some blood-pressure or heart medicines increase uric acid; never stop them yourself — ask your GP or pharmacist if flares are frequent
If you are older, living with frailty, or need help getting to the kitchen, a drinks bottle within reach and a simple daily drinks plan matter more than willpower alone. Our gout, older people and hydration guide covers that overlap.
A practical winter drinks plan
- Keep a reusable bottle or jug where you sit, and aim for regular sips through the day rather than one huge evening catch-up
- Prefer water, sugar-free squash or tea and coffee in moderation; cut back on sugar-sweetened fizzy drinks and fruit drinks with added sugar
- If alcohol features at Christmas or New Year, plan alcohol-free days and avoid binge drinking — alcohol itself is a common gout trigger
- During a flare, prioritise water unless your GP has set a fluid limit; keep bedclothes off a very painful toe or foot if that helps
- If swallowing or getting drinks is hard because of other health problems, ask your GP, pharmacist or carer support about practical help
For food patterns around gout (not a miracle diet), see gout flare diet and foods to be careful with and the diet hub.
During a flare: what helps, what does not
- Take any medicine you have been prescribed for the attack as soon as possible — the NHS says it should start to work within about 2 days
- Rest and raise the limb; ice with a cloth barrier for up to 20 minutes at a time
- Drink lots of water unless told not to
- If you take long-term urate-lowering medicine such as allopurinol or febuxostat, keep taking it during a flare unless your clinician tells you to stop — stopping suddenly can make attacks more likely later. See our febuxostat guide and gout medication UK overview
- Do not start high-dose painkillers, steroids or colchicine yourself from someone else's leftover pack — ask a pharmacist or GP what is safe for you, especially if you have kidney, heart or stomach problems
When to get help
- See your GP if gout attacks keep returning, if you have never had your uric acid or medicines reviewed, or if winter flares are becoming more frequent
- A hot, very swollen joint with fever, or feeling systemically unwell, needs urgent clinical advice — a joint infection is an emergency and can look similar to a gout flare
- Call 999 if you cannot get up after a fall, cannot weight-bear, or have severe unexplained illness
- For urgent advice that is not an ambulance emergency, contact NHS 111 (NHS 24 on 111 in Scotland)
Frequently asked questions
Does cold weather cause gout?
Cold weather alone is not listed by the NHS as a cause. Dehydration, alcohol, large meals, illness with fever, joint injury and some medicines are the triggers to watch. Winter habits often change those factors.
How much should I drink if I have gout?
The NHS advises drinking plenty of fluids to avoid dehydration, and lots of water during an attack unless a GP says otherwise. Local NHS leaflets often suggest around 2 litres a day for people without a fluid restriction — follow your own team's advice if you have kidney or heart disease.
Should I stop allopurinol when I flare in winter?
Usually no. Urate-lowering medicine is meant to be taken regularly, including during flares, unless your clinician advises a change. Ask your GP, rheumatology team or pharmacist before stopping or skipping doses.
Sources and further reading
- NHS: Gout
- NHS: Dehydration
- NICE NG219: Gout — diagnosis and management
- Versus Arthritis: Gout (Arthritis UK / Versus Arthritis public information)
Educational information for people in the United Kingdom — not a diagnosis or personal medical advice. Charity no. 1218461. Pending clinical review. Everyone's situation is different, so always follow the advice of your own GP, pharmacist or rheumatology team. If you feel very unwell, call 999 or go to A&E. For urgent advice, contact NHS 111.
Continue with related help
- Gout hub — what gout is and how it is diagnosed
- Gout treatment — flares and longer-term urate lowering
- Gout medication UK — medicines overview
- Febuxostat guide — one urate-lowering option
- Gout flare diet — foods and drinks to be careful with
- Gout, older people and hydration — drinks when getting about is harder
- Cold home and arthritis — keep warm and keep moving
- Diet hub — eating well with joint conditions