Low-Purine Fish for Gout and Hyperuricemia
Limiting purine intake is conditionally recommended for patients with gout, regardless of disease activity (Class/strength: conditional; certainty: low) [1]. Lower–purine fish choices can be prioritized while higher–purine fish and seafood are limited [1], [2].
Fish With Lower Purine Content
The following fish are described as lower purine choices in comparative summaries of purine content:
- Cod [2]
- Haddock [2]
- Perch [2]
- Pike [2]
- Sole [2]
Fish to Limit for Purine Restriction
Higher–purine fish and seafood are described as substantially higher purine sources and are generally limited:
- Anchovies, trout, mackerel, herring, tuna, salmon, sardines [2]
- Shellfish and other specific seafood examples such as shrimp, mussels, scallops, and lobster are commonly listed among higher-purine seafood to avoid or limit [3]
Practical Dietary Framing for Fish Selection
Dietary guidance for gout emphasizes limiting purine-rich foods, with fish selection used to reduce purine exposure [1]. Specific avoid/limit lists often include certain fish types, so selecting fish from the lower-purine group while limiting higher-purine fish types is recommended [1], [2], [3].
Purine Restriction Within Overall Gout Management
Purine restriction is a lifestyle intervention that targets dietary flare triggers and should be integrated with urate-lowering therapy when indicated by disease severity and risk [1]. Medication decisions for hyperuricemia and gout are addressed separately from dietary purine restriction [1].