What Fish is Not Allowed for Gout? A Guide to High-Purine Seafood

October 20, 2025 •

3 min read

According to the Arthritis Foundation, many common seafood items are high in purines and can significantly increase uric acid levels, triggering a gout flare. Understanding what fish is not allowed for gout is crucial for managing symptoms and maintaining a healthy diet.

Quick Summary

This article identifies specific fish and shellfish that are high in purines and should be avoided by individuals with gout to help manage uric acid levels and prevent painful flare-ups.

Key Points

Avoid High-Purine Fish: Fish and shellfish with the highest purine levels, such as anchovies, sardines, herring, mackerel, mussels, and scallops, should be avoided or severely limited.
Choose Low-to-Moderate Purine Fish: Safer seafood choices for a gout diet include fish like salmon, cod, tilapia, and flounder, which have lower purine concentrations.
Practice Portion Control: Even with moderate-purine fish like salmon, it's important to consume them in limited, small portions (2-3 ounces) to manage uric acid levels.
Watch for High-Purine Canned Fish: Canned seafood like sardines and anchovies are particularly problematic due to their concentrated purine content and should be avoided.
Prepare Fish with Caution: Opt for healthy cooking methods like boiling or steaming, and consider removing the skin of marine fish to reduce purine intake.
Consider Individual Tolerance: How a person with gout reacts to specific foods can vary, so monitoring personal triggers is also a critical part of managing the condition effectively.

The Connection Between Purines, Uric Acid, and Gout

Gout is a form of inflammatory arthritis characterized by sudden, severe attacks of pain, redness, and tenderness in the joints, most often the big toe. It is caused by hyperuricemia, a condition where excessive uric acid accumulates in the blood. Uric acid is a waste product formed when the body breaks down purines, naturally occurring compounds found in both the body and certain foods. When uric acid levels get too high, needle-like crystals can form in a joint, triggering a painful gout attack. Diet plays a significant role in managing gout, and certain foods, especially those high in purines, can exacerbate the condition.

Fish to Avoid: The Highest Purine Offenders

Certain fish and seafood are known to contain exceptionally high levels of purines and are considered high-risk for those with gout. These should be limited or, ideally, avoided altogether, especially during a gout flare or if you experience frequent attacks.

High-Purine Fin Fish

Anchovies: Canned or fresh, anchovies are among the most purine-dense fish available, with one source reporting 273 mg per 100g. Their high purine load makes them a top offender for triggering gout flare-ups.
Sardines: Also a very high-purine food, sardines, especially canned versions, are known to significantly raise uric acid levels.
Herring: Similar to anchovies and sardines, herring contains high levels of purines and should be avoided.
Mackerel: This oily fish is another high-purine option that can increase uric acid levels and should be removed from a gout-friendly diet.
Trout: Some trout varieties, particularly rainbow trout, are listed as high-purine and best avoided.

High-Purine Shellfish and Seafood

Mussels: These shellfish are very high in purines and are commonly cited as a food to avoid for gout patients.
Scallops: Another high-purine mollusk, scallops are known to aggravate gout symptoms.
Squid and Octopus: Both are often cited for their high purine content and should be approached with caution or avoided entirely.

Better Choices: Low-to-Moderate Purine Seafood

Fortunately, not all fish is off-limits for those with gout. Low-to-moderate purine fish can be enjoyed in moderation as part of a healthy diet.

Salmon: Rich in omega-3s, salmon has moderate purine levels and is generally considered a safer option when consumed in limited quantities.
Cod: This flaky white fish is low in purines and is a good choice for those managing gout.
Flounder: A low-to-moderate purine fish, flounder is a safe addition to a gout-conscious diet.
Tilapia: As a low-purine option, tilapia can be a regular part of a diet designed to prevent gout flares.
Haddock and Sole: These are other examples of low-purine fish that are generally considered safe for consumption.

Cooking and Preparation Tips for Gout-Friendly Fish

Even when choosing low-purine fish, preparation matters. Cooking methods can influence the purine content and overall health benefits of your meal.

Boiling, Poaching, or Steaming: These methods are preferable to frying, as they can help reduce some of the purine content, especially if the cooking water is discarded.
Remove Skin: Some studies suggest that the skin of fish, particularly marine species, can contain higher levels of purines. Removing the skin before cooking may be a beneficial practice.
Portion Control: The key to eating any moderate-purine fish is moderation. Aim for smaller portion sizes, typically 2-3 ounces, and limit overall intake.

Comparison of High vs. Low Purine Seafood


Seafood Type	Purine Level (approx. mg per 100g)	Gout Diet Recommendation
High Purine
Mussels	293 mg	Avoid
Anchovies	273 mg	Avoid
Sardines (canned)	480 mg	Avoid
Mackerel	150-825 mg range	Avoid
Herring	150-825 mg range	Avoid
Low-to-Moderate Purine
Salmon	177 mg (or lower, depending on type)	Limit/Moderate
Tuna	157 mg (moderate, some canned versions are lower)	Limit/Moderate
Cod	98 mg	Safe (Moderate)
Flounder	133 mg	Safe (Moderate)
Tilapia	50-150 mg range	Safe (Moderate)

Conclusion: Balancing Seafood in a Gout Diet

Successfully managing gout through diet involves understanding the purine content of the foods you eat. While some fish is not allowed for gout due to very high purine levels (like anchovies and sardines), other types can be safely included in moderation. By focusing on low-purine options, controlling portions, and avoiding the highest-purine offenders, individuals can enjoy the health benefits of seafood without increasing their risk of a painful flare-up. It is always best to consult with a healthcare provider or a registered dietitian for personalized dietary recommendations, especially as gout can affect individuals differently. Following broader dietary guidelines, such as those from the Mayo Clinic Gout Diet Guidelines, can be a useful strategy for overall gout management.

Frequently Asked Questions

The fish species considered highest in purines and generally not allowed for gout are anchovies, sardines, herring, and mackerel.

Shellfish like shrimp, crab, and lobster are moderately high in purines and should be consumed in limited amounts or avoided entirely, especially during a flare-up.

Salmon is a moderate-purine fish and can be included in a gout-friendly diet in small, controlled portions. It also provides beneficial omega-3 fatty acids.

Low-purine white fish like cod, sole, haddock, and tilapia are among the safest options for individuals with gout.

Yes, some studies suggest that boiling or steaming fish can slightly reduce its purine content, especially if the cooking water is not used in the meal.

Canned light tuna is considered a moderate-purine food and can typically be eaten in moderation. However, higher-purine versions or large quantities should be limited.

High-purine fish should be avoided because the body converts these purines into uric acid. High levels of uric acid can lead to the formation of urate crystals in the joints, causing a painful gout attack.