Can Tomatoes Be a Trigger for Gout?

By Zina Semenovskaya, MD
Medically reviewed checkmarkMedically reviewed
December 14, 2021

More than nine million Americans live with gout, a painful form of arthritis that’s easily triggered by certain food and alcohol.

Left untreated, a gout flare-up can cause irreversible joint damage.

So if you have been diagnosed with gout or suspect that you have it, it’s important to understand which foods may trigger you.

Most people think of fat-laden meats as the main foods that trigger gout.

And while red meat and organ meats can cause flare-ups, other seemingly healthy foods—including tomatoes—can also trigger gout in certain people. 

Here, I’ll break down what gout is, the relationship between tomatoes and gout flares, other common foods that trigger gout to be aware of, and when to see a doctor if you have a gout attack.

While you may have to limit or eliminate certain foods from your diet for the sake of your joints, you can still enjoy a wide variety of delicious flavors.

What Is Gout?

Once called “the disease of kings”, gout is a type of arthritis that causes very painful, swollen joints. 

Gout happens when the body has too much uric acid.

This acid breaks down purines, chemicals found naturally in the body and also in certain foods. 

Depending on a person’s dietary choices and genetics, their body may either produce too much uric acid or not excrete enough uric acid.

When this happens, uric acid crystals can accumulate in the joints—most commonly the big toe—and cause the pain and inflammation of gout.

While there is no cure, gout is manageable and preventable with a proper diet and medication.

Tomatoes and Gout Flares

Eating a diet rich in foods high in purine can trigger gout.

High-purine foods include:

  • Red meat
  • Organ meats like liver
  • Seafood (particularly anchovies, sardines, mussels, scallops, trout, and tuna)
  • Alcohol
  • Beverages high in fructose

Although tomatoes are low in purine, some research suggests they may cause gout flares.

In a study of more than 2,000 people diagnosed with gout, 20% said that tomatoes were a trigger, making it the fourth most common trigger food reported. 

It’s unclear why tomato consumption causes gout flares in certain individuals.

Some scientists believe that because tomatoes contain high levels of glutamate—an amino acid that is often found in high-purine foods—they may stimulate or increase the creation of uric acid in some people.

Genetics likely plays a role in who responds this way to tomatoes.

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How to Tell If Tomatoes Are a Trigger

Gout flare-ups often happen suddenly at night.

If you eat tomatoes regularly and are experiencing any of the following symptoms in one or more joints, tomatoes may be a trigger food for you:

  • Pain
  • Redness
  • Swelling
  • Limited range of motion 

To determine if tomatoes are part of the problem, try eliminating all tomatoes and tomato-based products from your diet for 2-4 weeks.

Then add tomatoes back in and see how your body responds.

While you do this, it can help to keep a food journal to track details such as:

  • What you eat and drink
  • How much you eat and drink
  • The time of day you eat and drink
  • Any pain experienced, including where, when, and the intensity

If your gout symptoms improve or disappear when you stop eating tomatoes and then return or worsen when you begin to eat tomatoes again, the food is likely a trigger for you.

Other Foods to Avoid With Gout

Tomatoes aren’t the only food that may raise uric acid levels in some people.

If you have gout or experience gout flare-ups, consider avoiding or limiting the following common food triggers, all of which are high in purines:

  • Alcohol
  • High-fructose corn syrup (HFCS)
  • Wild game such as duck, veal, and venison
  • Organ meat such as liver or kidney
  • Shellfish, sardines, anchovies, tuna, cod, trout, and haddock 

When to See a Doctor

Gout attacks can occur suddenly and usually happen in one joint at a time, such as the big toe.

Other commonly affected joints include other toes, the ankle, and the knee.

Symptoms of a flare are typically very noticeable and include:

  • Intense pain
  • Inflammation
  • Swelling
  • Redness
  • Heat and tenderness
  • Limited range of motion

If you experience any of the above, contact a physician as soon as possible.

Without proper treatment, these symptoms can lead to worsening pain, more frequent episodes, or permanent joint damage.

How K Health Can Help

Did you know you can get affordable primary care with the K Health app?

Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.

Frequently Asked Questions

What does uric acid have to do with gout?
Gout is caused by a condition called hyperuricemia, which is the result of having too much uric acid in the blood. The body creates uric acid to break down purines that occur naturally in the body and in some foods we eat. But too much uric acid can cause the formation of uric acid crystals, which can get stuck on joints and soft tissues, causing pain and inflammation, called gout.
How can I start a food journal to find my triggers?
A food journal is an easy and effective way to identify possible dietary triggers. Note what you eat, when you eat, and how much you eat, along with any notable changes in pain, discomfort, mood, and energy. Discuss your journal with your healthcare provider or a registered dietitian, who can help you create a tasty eating plan to manage your gout and get all the nutrients you need.
Can tomatoes reduce inflammation?
Tomatoes may reduce inflammation. Tomatoes contain lycopene, a potent antioxidant that appears to have anti-inflammatory effects.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Zina Semenovskaya, MD

Dr. Semenovskaya specializes in emergency medicine, and received her medical degree from Weill Cornell Medical College. She is currently the medical director at Remote Emergency Medicine Consulting, LLC and splits her time working clinically as an emergency medicine attending in California and Alaska. She is the first of our doctors to be fluent in Russian.