Boerhavia diffusa, commonly known as Punarnava, is widely used in traditional Ayurvedic and other folk medicine systems for a variety of conditions, including gout. The rationale for its use in gout primarily stems from its reputed anti-inflammatory, diuretic, and uric acid-lowering properties described in classical Ayurvedic texts. Traditionally, it is believed to "rejuvenate" the body and help eliminate excess fluids and metabolic wastes, which aligns with the pathophysiology of gout (accumulation of uric acid crystals in joints).

Modern scientific studies on Boerhavia diffusa are limited, but some preclinical research supports its anti-inflammatory and uricosuric effects. For example, animal studies have demonstrated its capacity to reduce inflammation and promote uric acid excretion. However, clinical trials in humans specifically evaluating its efficacy for gout are lacking or of insufficient quality to draw firm conclusions. There is no robust, high-quality evidence from randomized controlled trials in humans to confirm its effectiveness for treating or preventing gout attacks.

In summary, the use of Boerhavia diffusa for gout is primarily justified by traditional medicine practices, with low-to-moderate preclinical evidence and a lack of strong clinical validation. Its use should be considered as adjunctive or complementary, and not as a replacement for evidence-based gout therapies.