DEAR DR. ROACH: I am a regular blood donor. In the 7-10 days before a donation, I take iron supplements to ensure that my hemoglobin count is sufficient enough to give blood. However, I now think that I have developed what appears to be a mild case of gout in my ankle and wonder whether there could be a connection. I have no other risk factors for gout. — S.C.

ANSWER: You are right that there is a connection. People who are taking iron supplements or who have high levels of ferritin (the main iron-binding protein in the blood) are more susceptible to gout. It’s thought that the iron temporarily increases oxidative stress in the blood, which may trigger gout.

The enzyme xanthene oxidase is stimulated by the blood, leading to higher levels of uric acid in the blood, which could trigger a crisis by causing crystals to form. (Uric acid crystals are more likely to form in cool areas, which is why the foot and hands — and occasionally the tips of the ears — are common sites for gouty crystals.)

You might consider lower doses throughout the month rather than higher doses in the week or so before a donation. You might also try to cut down or avoid risky foods for gout such as shellfish, beer, sugary drinks and red meat.

DEAR DR. ROACH: I recently had a medical event that prevents me from consuming any alcohol. I often see zero-alcohol beers; are these safe for me? My favorite brand says that it uses cold filtration and is 0.0% alcohol. Is there a way of confirming that they really are alcohol-free? — R.C.

ANSWER: Alcohol can be a problem for people with many different medical conditions. Alcohol-free versions of beer and wine can be enjoyable and make social situations less awkward.

There are several different ways of making beer alcohol-free. With reverse osmosis (also called cold filtration), alcohol and water are removed from the regularly made beer. Then the water is added back in to make a brew that is very much like the original beer but with very little or no alcohol. (Many are less than 0.5%, but some are even less than 0.01%. This is less alcohol than you will get in a ripe banana.)

The quality control in the manufacturing process of a commercial brewery is so good that I would be confident in the minimal alcohol content of a beer that is labeled 0.0%.

DR. ROACH WRITES: I am sometimes asked whether my answers use a generative AI program such as ChatGPT. They do not. All my answers are 100% written by me, and I do not use generative AI at all to write.

I have used a program called OpenEvidence, which is very good at identifying and summarizing relevant research papers for the topics that I am writing on. But I always read the original papers as even excellent programs cannot understand literature as well as a trained expert.

The day may come when AI outperforms humans in many areas, but until then, I try to combine the latest research with my experience of taking care of patients.