Researchers from the Beijing University of Chinese Medicine studied 30 randomized controlled trials (RCT) that involved 44,972 participants over 20 years. Their meta-analysis of the data showed that supplements can modulate uric acid levels, oxidative stress and lipid metabolism.
“The results suggest that dietary supplements may serve as an adjunctive therapy for hyperuricemia and gout,” the they wrote in the journal Nutrition & Metabolism. “Specifically, a combination of vitamin C (250–500 mg/day) and probiotics is recommended for managing uric acid levels, and curcumin is advised for lipid regulation.”
A drug complement
Hyperuricemia (abnormally high uric acid levels in blood) and gout (a type of arthritis where joint pain, redness and swelling occur) are public health concerns that are affiliated with comorbidities like cardiovascular disease, chronic kidney disease and metabolic syndrome. Elevated levels of uric acid may cause dysfunction of the inner lining of blood and lymphatic vessels and promote oxidative stress, increasing cardiovascular disease risk.
“The pathogenesis of hyperuricemia is multifaceted, encompassing renal handling of uric acid, dietary influences and genetic predisposition,” the researchers explained.
“The kidneys are integral to the excretion of uric acid, with approximately two-thirds of uric acid being eliminated via renal pathways. Alterations in the reabsorption and secretion processes of uric acid by the renal tubules can influence the risk of developing gout.”
Managing hyperuricemia and gout requires drugs like allopurinol and febuxostat. These medications prevent gout attacks by blocking the formation of uric acid crystals. However, dietary supplements may also manage gout as research shows diet can influence the occurrence of the condition. For example, the Mediterranean diet diminishes cardiovascular risk factors, offering a protective effect in people with gout.
The researchers suggested that supplements may “effectively complement pharmacological interventions aimed at lowering uric acid levels and enhance the quality of life for patients experiencing hyperuricemia.”
Study details
Probiotics demonstrated considerable potential in reducing gout recurrence, followed by DKB114—a mixture of Chrysanthemum Indicum Linne Flower and Cinnamomum Cassia (L.) J. Presl Bark extracts—and vitamin C.
The researchers also investigated the Malondialdehyde (MDA) levels in study participants treated with dietary supplements. MDA is a marker of oxidative stress. In that context, two dietary supplements—vitamins C and E— showed significant advantages in terms of mean differences in MDA levels over conventional drug treatment or placebo. The study also found that a combination of vitamin B12 and folic acid demonstrates efficacy in reducing MDA content.
Regarding low-density lipoprotein (LDL) levels in participants receiving dietary supplements, the researchers noted that “curcumin exhibited significant advantages over vitamin E, vitamin C and cherries, with differences reaching statistical significance” and that ”curcumin appears to be the most effective therapy for reducing low-density lipoprotein levels in patients with hyperuricemia.” This was followed by DKB114, which also emerged as the best therapy to reduce triglycerides in participants with hyperuricemia.
A subgroup analysis demonstrated vitamin C with xanthine oxidase and tea polyphenols notably reduced serum uric acid levels in participants when compared to conventional therapy alone.
The researchers then analyzed sour cherry juice and cherry powder capsules, and they found that “the juice significantly elevated uric acid levels compared to the placebo, whereas the capsule form showed no significant effect.”
“This discrepancy may be attributed to the reliance of solid supplements, such as cherry powder capsules, on gastrointestinal disintegration and interactions with excipients,” they added suggested. “Specifically, starch-based fillers within capsules may dilute the active compounds, such as anthocyanins, thereby reducing their bioavailability.”
Although the researchers were able to identify which supplements have the most efficacy under certain biological conditions, they suggested that longitudinal RCTs can help determine ideal dosage, formulation and suitability for specific populations. This includes pregnant women and people with renal insufficiency.
Source: Nutrition & Metabolism. doi: doi.org/10.1186/s12986-025-00977-2. “The effectiveness and safety of specific dietary supplements in modulating uric acid levels, oxidative stress, and lipid metabolism in patients: a network meta-analysis of 13 interventions”. Authors: Guancheng Ye et al.
