Daily Lemon Water Lowers Serum Urate Levels in Patients With Hyperuricemia

A new study found that drinking lemon water for 6 weeks significantly reduced serum urate (SU) levels in participants with gout and hyperuricemia.1

“This is the first study that shows that lemon water has hypouricemic and alkalizing properties in gout and individuals with hyperuricemia,” wrote study investigator Biernat-Kaluza Edyta, MD, PhD, from the Rheumatological Clinic in Poland, and colleagues.1 “Lemon water may be helpful as an adjuvant hypouricemic therapy for gout and individuals with hyperuricemia.”

An elevated SU level over 6.8 mg d/L, otherwise known as hyperuricemia, raises the risk for gout development by promoting crystal deposition in and around the joints. Untreated deposition may lead to tophi formation and destructive arthritis, resulting in recurrent gout flares.

No cure exists for gout, but there are urate-lowering medications to prevent recurrent flares, tophi, and continued structural joint damage.2 However, these drugs can be poorly tolerated in certain patients and may be contraindicated in those with coexisting conditions, particularly in older adults. When it comes to gout medication, it tends to get worse before better; crystal disruption often triggers flares early in the treatment course, and the improvement can take up to 6 to 12 months.3

Investigators proposed a potential treatment for hyperuricemia: lemons.1

Lemons are highly acidic, with a pH of 2.3, due to their citric acid content, which gives them their characteristic sour taste. Despite this acidity, lemon juice can indirectly promote bicarbonate production in the body, helping to neutralize acids such as uric acid.1

A recent study investigated whether drinking freshly squeezed lemon juice in water could benefit individuals with hyperuricemia or gout by lowering SU levels and affecting urine pH and kidney function.1

For their retrospective analysis, investigators leveraged the medical records of patients with gout who visited 2 outpatient Polish rheumatology clinics. The sample included 90 patients, with 69% men and a median age of 49.2 years. Most participants had comorbidities (78.9%), including dyslipidemia (74.4%), hypertension (28.9%), hyperglycemia (18.9%), diabetes mellitus (12.2%), and ischemic heart disease (11.1%).1

Patients were categorized into 3 arms: group A (diagnosed with gout), group B (diagnosed with hyperuricemia with no gout), and group C (diagnosed with other conditions than gout; the controls). Investigators collected data on medical and medication histories, SU levels, glomerular filtration rate (GFR), and urine pH levels.

Each day, patients consumed a beverage of two squeezed lemons in 2 L of water, per provider recommendation. After 6 weeks, SU levels reduced from baseline in patients with gout (group A; mean reduction, 1.25 mg/dL) compared to patients with hyperuricemia but no gout (group B; mean reduction, 1.31 mg/dL; P =.03) and controls (group C; mean reduction, 0.85 mg/dL; P =.003). During the 6 weeks of drinking lemon water, no flares occurred in either group.1

Investigators also observed an increase in GFR among 8 patients with gout (1 to > 25 mL/min) compared to patients with hyperuricemia but no gout (8 to > 15 mL/min in 2 patients; P =.03) and controls (P =.0007).1

Furthermore, urine pH levels increased in the 3 groups: Participants with gout increased by 0 – 2 pH units (mean 1.17 pH units), those with hyperuricemia but no gout increased by 0 – 2 pH units (mean 1.3 pH units), and controls increased by 0 – 3.5 pH units (mean 1.13 pH units). However, the increased urine pH levels did not have a significant difference: group A vs B (P =.28), group A vs C (P =.8), and group B vs C (P =.2).1

“Lemon water might be an inexpensive, widely available, safe, and well-tolerated supporting therapeutic option for individuals with gout and hyperuricemia,” investigators concluded.1 “Large prospective randomized controlled trials of lemon water as adjuvant therapy in treating gout and hyperuricemia are warranted.”

References

1. Edyta BK, Brunetti L, Naomi S. Lemon Water Reduces Serum Urate Levels in Gout Patients and Individuals With Hyperuricemia-A Pilot Study. Int J Rheum Dis. 2025;28(12):e70488. doi:10.1111/1756-185x.70488

2. Gout Tophi. Cleveland Clinic. Accessed December 19, 2025. https://my.clevelandclinic.org/health/symptoms/gout-tophi-tophus

3. Why is Gout Such a Tough Out? Rheumatology Advisor. Published August 23, 2023. Accessed December 19, 2025. https://www.rheumatologyadvisor.com/news/why-is-gout-such-a-tough-out/#:~:text=Suffering%20the%20storm%20before%20the,many%20patients%20simply%20give%20up.