Be careful trusting TikTok for gout advice

A new paper in Rheumatology Advances in Practice, published by Oxford University Press, indicates that Tik Tok videos about gout are commonly misleading, inconsistent, or inaccurate.

Gout is a painful inflammatory arthritis caused by high urate in the blood that crystallizes and deposits in the joints. An estimated forty-one million people worldwide suffer from gout, with physicians diagnosing about seven million new cases a year. There are persistent gaps in awareness and understanding about gout among patients and the public. Although rheumatology guidelines recommend long-term urate-lowering therapy for effective gout management, gout remains poorly controlled among patients.

Some 98% of people aged 12 years or older use social media, and those with health conditions (52%) are more likely to share health information on the platforms. TikTok, with 1.2 billion users, is particularly influential in shaping public beliefs, perceptions, and behaviors. A recent survey of 1,172 women between the ages of 18 and 29 years found that about 70% intentionally sought health information on TikTok, while 92% came across it unintentionally.

Researchers here searched the term “gout” on the TikTok discover page and collected the first two hundred videos, found on December 5, 2024. The investigation revealed that people with gout or close family members were the most prevalent video presenters (27%), followed by health professionals (24%), and members of the public (23%). The main purpose of videos was to provide health advice (38%), share personal gout stories (20%), and sell products (19%).

Approximately 45% of videos mentioned risk factors for gout, with diet and lifestyle being the most common (90%). About 79% of TikTok videos addressed gout management in their content, with a focus on dietary advice. Some videos reported foods to avoid, such as one featuring a patient hospitalized for gout who said that viewers “can reduce your incidences of gout if you cut back on your salt, your alcohol, and your red meat.” Supplements, herbal or home remedies were also commonly referenced types of gout management, with videos promoting products such as “pills made from pure herbs, with no hormones and no side effects.”

Only seven of the TikTok videos discussed medications as a gout management approach, primarily recommending pain relief options such as steroids and non-steroidal anti-inflammatory drugs like colchicine, ibuprofen, and naproxen. The researchers found that only two TikTok videos mentioned long-term urate-lowering therapy for effective gout management, even though this is the standard, clinically verified treatment for gout recommended by rheumatologists.

In general, the investigators found that the TikToks studied lacked accurate information about urate production and gout-related risk factors, potentially leading to misconceptions about gout. Discussions of risk factors in videos also regularly depicted it as a disease primarily resulting from dietary factors that influenced urate levels. While diet and alcohol are risk factors for the disease, genetics, kidney impairment, and weight play a significantly greater role. Content focused solely on lifestyle and dietary risk factors portrayed gout as a personal choice, rather than caused by underlying factors.

The researchers emphasize that videos here related to gout management primarily platformed advice and treatments not aligned with clinically recommended, evidence-based approaches. Seventy-nine percent of videos in this study mentioned gout management, but dietary advice was the most common (53%), which has limited long-term effectiveness. Herbal remedies and supplements were also widespread gout management strategies presented here, with videos selling products and using imagery of health professionals in their content.

"TikTok has great potential as a tool to raise awareness around health issues such as gout and promote information that aligns with clinical guidelines," said the paper's lead author, Samuela ‘Ofanoa. "In an increasingly digital world, there is a need for more health professionals and organisations to seize the opportunity that social media platforms present, and create content that can counter misinformation and improve understanding about gout in our communities."

The paper, “Gout, TikTok and misleading information: A content analysis,” is available (at midnight on December 10th) at https://academic.oup.com/rheumap/article-lookup/doi/10.1093/rap/rkaf126.

Direct correspondence to: 
Samuela ‘Ofanoa
Pacific Health Section, University of Auckland
28 Park Avenue, Grafton
Auckland, 1023 NEW ZEALAND
s.ofanoa@auckland.ac.nz

To request a copy of the study, please contact:
Daniel Luzer 
daniel.luzer@oup.com