LISTS – AND LISTS
I know you are all looking for THE list. Here is one from a reliable source I have have downloaded on my site to a separate document so it opens with one click.
The reliable source, as it turns out, needed some updating. Dr Ross Holmes, professor, School of Medicine, University of Alabama, was kind enough to review the work of Dr. Michael Liebman who is a professor of Human Nutrition and Food Option at University of Wyoming and determine which food entries on the Harvard list needed changing. We cannot change the original but we have updated our lists accordingly and annotated updates with *** marks. So the lists here are the most recently edited available at present.Fred Coe and I have updates and annotated the list for those with a tendency to perfectionism: Updated table of oxalate foods. Set it at 50% for easier reading. Get yourself acquainted with the lists. They will tell you much of what you need to know. A lot of it will even surprise you. You are not as restricted as you think you are or as you have been told.
A more dramatic list is the 177 high oxalate foods we distilled out of the big list. Here are culprits! Not on this list? Probably not very high in oxalate so far as we know – with perhaps a few exceptions. Note that quantity is critical. For example black pepper is high in oxalate but the amounts used are small enough that total oxalate intake from it is negligible.
Eating a low oxalate diet can be overwhelming and difficult to incorporate into your daily life. I just released a course called The Kidney Stone Prevention Course to help you understand how to implement your physician’s prescribed treatment plans.
LET’S DIVIDE AND CONQUER
FOODS TO WORRY ABOUT
A List of Concerning Foods
We have created two graphs for this article. Of the 177 foods on our master list, many are of concern but can be used in your diet if you control the portion size and how often you use them. There are 30 of them that are worrisome enough to deserve special attention.
Here are the 30. The graph shows mg of oxalate in a common portion. The details of the portions are in the complete list. The foods have in common that all contain at least 40 mg/serving. All other foods for which we have reliable data have less oxalate per serving.
Your budget is about 100 mg/day.
What does this graph mean? Does it mean you can never have chocolate, or a baked potato?
No.
It means if you want to use your whole budget on a treat, do it, but keep track and make sure you do not overspend in any meal or in any one day. Have your baked potato, but maybe share half with your partner. Or, have some hot chocolate but make it with milk because calcium helps reduce oxalate absorption. Eat your cashew nuts, but pay attention to how many. If one handful leads to ten, you cannot have them.
FOODS TO AVOID
The graph to the left is of the very few dangerously high oxalate foods.
There are only six foods, but spinach, being worst of all, has two entries. Be careful of this plot because of its range. It begins at 100 mg/portion and rises to 755 mg/portion in only 7 steps, so the distance from miso soup to spinach is about a 7 fold increase.
Rhubarb and spinach are so high you just cannot eat them. Rice bran is something few will miss, the same for buckwheat groats.
People like almonds but have a hard time controlling portion size. If you can keep it to 11 almonds a day – the portion size that gives 122 mg of oxalate, alright. Otherwise stay away from them.
If you have to eat any of these foods, caution is hardly a strong enough word.
Are you sure you need to eat them?
Why?
WHAT ARE WE SAYING?
We are saying that oxalate is common in foods, and that you have to be careful, but care is a scarce resource. How much care can you give every bite? The graphs say if you eat moderately high oxalate foods – the first graph – be careful.
Watch portions.
If you are eating one of the six dangerously high oxalate foods, stop eating it.
It is too hard to be careful with those six foods. They have too much oxalate for most of you to handle. So, just say no.
WHY BELIEVE OUR DATA?
These data arose from a major effort at the Harvard School of Public Health. A world class expert has curated it twice. Harvard can be wrong and so can Ross Holmes, but both will tend to be wrong less often than the average persons who attempt to put complex data into the public domain. We have always appreciated comments, and if anyone has a peer reviewed publication with different food oxalate levels than ours, we will read the paper and see if it warrants our making a change.
Medical research is endlessly argumentative, and food oxalate is no exception. A recent paper contrasts findings from 6 websites and 2 applications and finds some wide variations. Of the sites, the Harvard site – used here as our reference, and the Wake Forest site – which is a legacy of an outstanding investigative group have most standing with me. Leaf through the comparisons between them in the 4 charts and in the large table at the very end. On the whole differences are modest. The hyperoxaluria and oxalosis list from the paper has been withdrawn from their site.
DO YOU NEED A LIST?
Sure, a list is nice. But we helping you here. Lists can run on to hundreds of foods. The picture is meant for focus. Here are the ones to focus on.
Many of you leave the doctor’s office thinking you will never be able to eat a fruit or vegetable again. If that wasn’t bad enough chocolate and nuts are gone, too. Some of this sadly is true, most of it is not. I am here to bring you good news: Almost everything, high oxalate or not, can be incorporated into your diet safely.
Do you need a low oxalate diet? You may if your stones contain calcium oxalate crystals and your urine oxalate is high enough to pose risk.
If you do need a low oxalate diet, what is your goal? Less than 100 mg of diet oxalate is good; less than 50 mg is ideal.
If you want to read some of the science about urine oxalate and risk of stones and about how we get to the diet oxalate goals, it is summarized at the end of this article.
Here we assume you do need to lower the oxalate in your diet.
CALCIUM FIRST
Low calcium diets can raise urine oxalate, and the solution may be as simple as a proper calcium intake. There is every reason for stone formers to eat 1000 mg of calcium daily to protect their bones. The common hypercalciuria of calcium stone formers puts bones at special risk when diet calcium is low.
Before changing your whole life around, ask yourself if you are avoiding calcium foods. If so, add them back and ask your doctor to check your urine oxalate again. It may fall enough that a low oxalate diet is not necessary.
If low calcium intake is not your problem, and you need a low oxalate diet, here is my take on how to do it.
WHAT IS THE DIET OXALATE GOAL?
Typical diets contain upward of 200 – 300 mg of oxalate. For stone prevention, a reasonable goal is below 100 mg of oxalate daily. An ideal would be about 50 mg daily if that can be accomplished.
To get there, consider the oxalate contents in common serving portions of all of the foods, and make up a plan for yourself.
FRUITS
FRESH
Everyone who comes to me is very unhappy thinking they can never have a berry again. This is Baloney. The only berry that is very high in oxalate is raspberries (look at the list). On the other hand, people do not realize avocado, oranges, dates, and even grapefruit and kiwi are very high and need caution.
This doesn’t mean you can never have these healthy treats. If you incorporate any of these high oxalate fruits into your morning yogurt you can reduce some of the effects of the oxalate content.
Also look at your portion sizes. You really cannot eat a lot at any one time. Dates are not a good bargain: One date is 24 mg!
CANNED OR DRIED
Canned pineapple is a problem.
Dried fruits have to be a worry because the water is taken out, so a ‘portion’ of dried fruit can be gigantic in oxalate content. Figs, pineapple and prunes are standouts. Just think: 1/2 cup of dried pineapple is 30 mg – not a lot of fruit for a lot of oxalate. If you want dried fruit, think about apples, apricots, and cranberry as lower oxalate options.
VEGETABLES
Spinach and rhubarb are standouts; stay away.
Other vegetables you need to be aware of are tomato sauce, turnips, okra, and yams (sweet potatoes) along with beans of different sorts.
I am not in the business of taking healthy foods away from people. But in the cases above you really must limit; there is just too much oxalate and these foods do not pair well with high calcium foods the way fruits can be mixed right into your yogurt or cereal and milk.
Many of you have been told to stay away from all green leafy vegetables. This is not true. Look at the list. There are plenty of salad options still available for you including kale. Even though tomato sauce is high in oxalate (see below) that is because of concentration. A whole medium tomato is only 7 mg and who eats more than one at a time?
Many of the salad vegetables are so low in oxalate they are freebies. Eat what you want.
POTATOES
These are Trouble! I put them into their own separate group even though they are vegetables.
From french fries to baked potatoes they are very high oxalate items. One ounce of potato chips has 21 mg of oxalate and who eats one ounce? Not I. Baked potatoes are terrible. One comes in at just under 100 mg of oxalate. Mixing sour cream into the potato will not help much; one tablespoon of sour cream contains only 14 mg of calcium. One ounce of cheddar cheese contains 200 mg of calcium, which could help, but it increases calories, salt and fat. But all in all, why struggle so hard? Potatoes are not ideal for stone formers.
DAIRY PRODUCTS
They have no oxalate. They are your main source of calcium. Use them. They can add a lot of salt – cheeses – and can be caloric. But they reduce oxalate absorption and preserve your bones.
For a stone former who has to watch salt intake, increase calcium intake, and lower oxalate intake, here is how to do that. You cannot have as much cheese as you want because of the salt. So portion sizes are very important. Yogurt, milk, even ice cream are good bargains – modest sodium and high calcium. These are a great place to add in a wee bit of chocolate – high oxalate foods – for those of you who cannot live without these high oxalate treats.
BREADS AND GRAINS
Some of the basic ingredients to make these foods are very high. White flour and brown rice flour are high in oxalate so everything you make from them will be high.
BREADS
Even so, as far as kidney stones go, breads are mainly alright because of portion size: not that much flour so one slice is 5-8 mg. French toast and New York style bagels top the list at 13 mg for two slices and 40 mg for one bagel – as much as anyone will eat of either food.
PASTA RICE AND GRAINS
Spaghetti, one cup cooked is 11 mg and most of us eat more than one cup.
Buckwheat groats, one cup cooked is 133 mg – I don’t see many of you saying ‘darn it’ or taking to your bed, but beware. Millet and bulger, wheat berries, rice bran, corn grits, and corn meal, these are widely used and are high. If you are using these, be thoughtful.
Here are some low oxalate options in this category: White rice, hummus, corn flour, corn bran, flax seed, and oat bran are popular and safe.
MEAT PRODUCTS
Since oxalate is only found in plant foods, all the meats are safe. Fish, too.
For our vegetarian friends, tofu and veggie burgers are very high.
NUTS AND SEEDS
These are just dangerous for two reasons.
Obviously they are very high in oxalate.
Secondly, I don’t know anybody who just has a few nuts at a time.
Just like chips no one eats one – the whole jar is more like it.
But, for one cup of pumpkin sunflower or flax seeds the highest is only 17 mg of oxalate and none for flax. For those of you who love foods in this category seeds are the better choice and they can be sprinkled on yogurt and ice cream.
SWEET STUFF
I have good news for my chocolate lovers. I know most of you have been sent home with a list and chocolate is high on it. But if you look at the numbers nuts are a lot worse than chocolate. Chocolate can be mixed in with dairy products, too, so as to reduce oxalate absorption.
Even so I do want to point out that half a brownie is on the high side, and who eats one half?
You can still satisfy your sugar craving but pay attention to your portion size.
Keep in mind, however, that sugar loads increase urine calcium loss which increases stone risk, so there are two reasons why this food group can be a problem.
But even without chocolate, you eat a lot of flour when you eat a piece of cake, so cake can be a problem – about 15 mg per piece, like french toast. Pies are half the risk because of their fillings – unless they are chocolate pies!
CRACKERS AND CHIPS
The big enemy here is potato chips. A one ounce serving contains a whopping 21 mg of oxalate. I repeat: A one ounce serving.
Your best bet in this category if you’re looking for something crunchy is corn chips – one ounce is 7 mg, popcorn – one cup is 5 mg, and pretzels, one ounce is 5 mg.
Crackers are OK mainly because they are small and the amount of flour is not that much.
BEVERAGES
PLANT SOURCES
Hot chocolate is the clear loser at 65 mg per cup; carrot juice is the runner up at 27 mg per one cup. Lemonade, tea, tomato juices, rice dream and the like are better but still high. The are 15 – 18 mg per serving. Lemonade – frozen concentrate – is 16 mg per 8 ounces so be careful about this as a source of citrate.
Soy milk, for those of you who prefer it, is not a good option. It is very high at 20 mg per cup. We have no data from standard sources for rice milk, cashew milk, and coconut milk; almonds are high in oxalate so the almond milk product will certainly be high.
Tea is so commonly used, here are the details. If you brew your own tea it is high in oxalate. The longer you steep your tea, the more oxalate it will have in it. If you use a sweetened instant iced tea one cup has 0 mg of oxalate.
Here are some juices that are low in oxalate and better substitutes: Apple juice, apricot juice, orange juice, grapefruit juice, grape juice. For all the lemonade drinkers, diet lemonade is low in oxalate.
Here is something very important: Coffee is oxalate free – almost, 1 mg for a cup (2 mg/cup for decaf). We already told you that coffee drinkers have a reduced stone risk, so lets debunk the coffee myth here: Drink it as you wish.
DAIRY SOURCES
Everything is good except chocolate milk. Even that is only 7 mg a cup for a sweet treat here and there.
ALCOHOL
What tops the list in this category is a can of beer: 4 mg of oxalate. All the rest are low and, frankly, the oxalate in a can of beer comes with a lot of fluid. This is not the problem area for stone formers.
WATER
If I didn’t say this to you I could not sleep well tonight. Water is the clear winner in this whole category. It is free of calories, sugar, and oxalate. Please use it as your main beverage and supplement with the items above.
SPREADS AND SAUCES
Chocolate, miso, peanut butter, and tahini are all high.
SOUPS
Miso soups is extremely high – 111 mg/cup. Lentil soup is high, and so is clam chowder – the potatoes.
BREAKFAST FOODS
This is a dangerous meal if you are a cereal lover. Many cereals are high in oxalate. I am afraid you need to look them up in the list by brand. Unfortunately the healthier cereals are highest in oxalate because they contain more plant based ingredients. Probably having milk in your cereal is wise, but we have no data to show.
Eating a low oxalate diet can be overwhelming and difficult to incorporate into your daily life. I just released a course called The Kidney Stone Prevention Course to help you understand how to implement your physician’s prescribed treatment plans.
HOW DO WE MANAGE ALL THIS?
The first thing you need to do is to learn and remember what are the highest oxalate foods and beverages. Without this in mind it is impossible to shop and cook intelligently. Here is a short list of the highest oxalate foods all in one place.
BREAKFAST
For those of you who love cereal because it is quick and easy check out the list and see if the one you love is high in oxalate. If it is, choose the next best one with lower oxalate. Put milk in the cereal.
Alternatives to cereal that are also quick and easy: Yogurt or cottage cheese and fruit. The only fruits to worry about are raspberries because no one puts oranges on their yogurt. Bananas, peaches, blueberries and strawberries are perfect toppings.
More trouble, but no oxalate, eggs any way at all. Boil a batch on Sunday and have them for the week for breakfast, and snacks, too.
Your breakfast coffee is free and so is your water. For juices use orange, apple, pineapple, grapefruit – all great. If you want tea, don’t steep more than a minute and consider adding milk to it. Green tea is better than black.
LUNCH
Typically you are grabbing a salad or a sandwich for lunch, so what now? Many clients tell me they no longer eat salads because their physicians told them to stop all green leafy vegetables.
I’m bringing salads back to you.
Arugula, iceberg, romaine lettuces, and kale, are fine as your base. Stay away from spinach. Here are good toppings. Cauliflower, corn, cucumber, mushrooms, onions, peas, scallions, squash and zucchini are all fine. Tomatoes are fine, too; it is only the sauce that is high. Broccoli and green pepper are moderately high so watch the portion size.
Sandwiches will cost you between 12 and 16 mg of oxalate depending on the bread you are using – 2 slices. This doesn’t mean you can never have a sandwich, it just means you have to keep track of how much. You can have 50 to 100 mg daily. What goes inside between the two slices of bread is usually cheeses and meats which are oxalate free. So sandwiches are not something to be afraid of.
SUPPER
Beef, chicken and fish are all fine, and those the main courses for most of us. You will run into problems if you are a pasta or potato eater. If you are you need to limit the amount of times you have these foods each week and also the quantity each time you use them. Substitutes are a problem: White rice is a nice substitute for potatoes but there are few others. It is more veggies that have to fill in – very healthy but not as much fun.
Here is a recipe for cauliflower – ‘mashed potatoes’ you will like and even think, sometimes, is the real thing. There are many versions on the web, choose the one that makes you happy but be careful about the ingredients.
There is also quinoa which is not on our lists, but may well be high. A recent scientific article on this plant does not give oxalate contents which suggests they are not reliably known.
I have recently put together a private FB page called THE Kidney Stone Diet. It is a group that helps educate you on your physician prescribed treatment plans. As you can imagine, oxalate comes up in many posts. I moderate it to keep it clinically sound. Come on over and join the discussion!
URINE OXALATE AND RISK OF KIDNEY STONES
I promised you some science – here it is for those interested. It concerns only highlights from the food – urine oxalate research recently performed and seemingly germane to the problem of how stone formers should control oxalate intake.
The most useful data about urine oxalate we have so far is from three cohorts studied by Dr. Gary Curhan. Two are cohorts of nurses one a cohort of physicians. These people have kept track of many aspects of diet and health for decades, and among their records are onset of kidney stones.
As he did for urine calcium, Curhan measured urine oxalate in properly selected subgroups from each cohort, including people who did and did not begin forming stones. From these samples he could calculate the relative risk of new onset of stones in relation to 24 hour urine oxalate excretion.
The two nurse cohorts are red, the physicians – all men – are blue. The dotted line at 1 is the risk threshold: Above that line, risk is present.
The top of each crosshatched bar shows the mean relative risk for each of the five urine oxalate ranges. Clearly the mean goes up as urine oxalate goes up.
But the mean relative risk has a range of uncertainty around it. The bottom of the solid portion of each bar is the lower 95th percentile for that range of uncertainty. When that bottom lies above 1, risk is very likely to be present.
For both the women and men groups, that point is reached between 25 and 30 mg of urine oxalate a day. Therefore one wants to try to get urine oxalate below 30 mg daily and even lower, below 25 mg daily if possible. The average urine oxalate excretion among the women in this study was close – 26 and 28 mg/day for those who did not form stones and just a bit higher for those who did – 28 and 30 mg per day. The men are a problem: 39 and 41 mg/day for those who did not and those who did form stones.
This is not diet oxalate, it is urine oxalate. Urine oxalate is how much the body makes and how much is absorbed from foods. Mostly, we can control only the second part – how much is in the food.
HOW MUCH DIET OXALATE DAILY
All dietary advice depends on having a reasonable goal in mind for oxalate intake. My goal of 50 – 100 mg of oxalate from food daily is not unreasonable given the research that has been done in normal people and stone formers.
Holmes and colleagues found a urine excretion of oxalate of about 10 mg/gm urine creatinine in normal 
people eating a synthetic oxalate free high calcium diet (graph at left). As diet oxalate increased, urine oxalate rose from 0 to 10 mg/2500 kcal/d, urine oxalate rose steeply from 10 to 14 mg/gm urine creatinine. It rose more slowly, from 14 to barely 15 mg/gm urine creatinine as diet oxalate was increased to 50 mg/2500 kcal/d, and more or less at the same slope thereafter so that an increase from 50 mg/2500 kcal/d up to 250 mg/2500 kcal/d increased urine oxalate only from 14 to 18. The closed symbols are whole food the open symbols synthetic diets.
From this work the percent oxalate absorption could be calculated as around 10 – 15% and the contribution of diet oxalate to urine oxalate excretion as around 25 – 40% when intake of oxalate was between 50 and 350 mg/2500 kcal. Therefore one can consider a whole food 1000 mg calcium 50 mg oxalate as a usable low oxalate diet, and a 150 – 250 mg oxalate diet as relatively high.
The balance between diet calcium and diet oxalate does not matter greatly if diet calcium is high. Among normal men and women eating 1000 mg/day of calcium and 750 mg/day of food oxalate, 24 hour urine calcium was about 110 mg/day and oxalate about 44 mg/day.
If the calcium oxalate balance is altered so calcium intake is 400 mg and 20 mg of oxalate at breakfast and lunch, and 200 mg of calcium and 710 mg of oxalate at dinner, as compared with simply 333 mg of calcium and 250 mg of oxalate in all 3 daily meals, urine oxalate is lower after the high calcium low oxalate meals, but only slightly higher after the high oxalate low calcium evening meal than when calcium and oxalate intakes were balanced. This means that when diet calcium is at least 1000 mg daily the balance of calcium to oxalate within any one meal is not likely to affect stone risk.
Seiner and colleagues make clear that stone formers are different from normal people. They divided male and female stone formers into 2 groups of 93 people each, one with urine oxalate above 0.5 mmol (~50 mg) of urine oxalate daily and the other with urine oxalate below 0.4 mmol (~40 mg) daily. They found virtually identical calcium and oxalate intakes: 845 vs. 812 calcium and 101 vs. 130 mg daily of oxalate respectively in the lower and higher urine oxalate groups. But the below 0.4 mmol group excreted only 27 mg of oxalate daily on average, whereas the high oxalate group excreted 64 mg daily. In other words diet was not responsible for the higher urine oxalate excretion, suggesting a difference of oxalate absorption. Those prone to high oxalate excretion seem, therefore, to most need diet modification.
Knight and colleagues found a wide range of oxalate absorption among 38 calcium oxalate stone formers eating a self choice diet. Urine oxalate excretion (vertical axis) varied with percent of diet oxalate absorbed (horizontal axis). The mean absorption centered around 5%; a few outliers absorbed over 15% up to 25%. This supports what Seiner found – some stone formers will have urine oxalate levels very responsive to diet oxalate and sans a research protocol we will not know. This is another good reason to keep diet oxalate low – 50 to 100 mg if possible.
PROTEIN AND GELATIN
Diet protein intake does not affect urine oxalate excretion. In 11 normal people fed a 1000 mg calcium, 51 mg oxalate, 3000 mg sodium fixed diet, varying protein intake from 0.6 to 1.6 gm/kg/day – a very wide range – did not alter urine oxalate appreciably (mean values were 23, 23, and 25 mg daily for the three protein intakes) even though oxalate precursors like glycolate rose markedly (25, 22, and 46, mg daily).
Jello is a source of hydroxyproline which converts to glycolate and oxalate, and oral loading with gelatin can raise urine oxalate. Ten normal people eating a 1000 mg calcium, 150 mg oxalate diet (typical normal level) were fed supplemental gelatin as one quarter of daily protein intake. Urine oxalate was 24 mg daily vs. 17 mg daily when the same diet was supplemented with whey protein – containing little hydroxyproline – as a control. So lots of jello is not an ideal plan for stone formers.
Where does this leave us about how much oxalate is alright for a day. If diet calcium is high, as it should be, at about 1000 mg, then one should try to limit diet oxalate below 100 mg daily. Perhaps this is most important in those patients whose baseline oxalate excretions are higher – in the range of above 40 mg daily.
Eating a low oxalate diet can be overwhelming and difficult to incorporate into your daily life.
For those who need special help, I run an online course: The Kidney Stone Prevention Course to help you understand how to implement your physician’s prescribed treatment plans.
Thank you so much for this information. Years ago I was handed a pamphlet but it was so obscure I couldn’t tell what I could eat and what I couldn’t, to be honest I just gave up in frustration. I have MSK with non-obstructing calculi so stones have only been a problem that one time…Would avoiding oxalates slow the production of the calculi?
Dear Kathleen, you are clever to have even found this article which is a draft and not even linked to the front pages of the site! It is not so hard to eat a moderated oxalate diet, as Jill Harris points out. Whether or not you should do this depends on the crystals in your stones. If they are all calcium phosphates, it is not so important; if they are calcium oxalate it is. Likewise for your 24 hour urine studies: Is your urine oxalate above normal?? If not, why bother? Finally, there is the matter of diet calcium. If your urine oxalate is high, to me the first step is a high calcium diet – 1000 mg daily. If that lowers your urine oxalate, perhaps other diet changes are not needed. Regards, Fred Coe
Dear Dr Coe, I found my test results and they were on the low end of normal for oxalates so I guess I’m ok there 🙂 . The only “high” levels were brushite and monosodium urate so I’ll check your articles for info on them. Thank you again for all the wonderful information , in this article and your other ones, Sincerely, Kathleen
Hi Kathleen, I wish I already had a proper article on the special problem of calcium phosphate stones, but basically they occur because of idiopathic hypercalciuria and too high a urine pH. High fluids, high calcium diet, low diet sodium, and perhaps thiazide diuretics will often be very effective, and that is what your physician has probably already considered. Regards, Fred Coe
I have MSK. Does that alter my diet? I have been told not to eat meat. I am on low salt because of the MSK. Is that right?
Hi Loree, MSK is widely overdiagnosed. Treatment requires complete evaluation as in any stone disease. Any stones passed need analysis. All the best, Fred Coe
Dear Dr. Coe and, and Jill Harris,
Thank you for the article and thorough information on eating to reduce oxalates. I came prepared today to ask a couple of questions regarding the type of stones that my body produces but have had a few of them answered in responses to Kathleen Tega’s questions.
I was told by my nephrologist to take 1200mg of elemental calcium a day and also some calcium with every meal. Would this still help my bone calcium, even while producing calcium phosphate stones?
And in the future, is it a possibility for lists and information on what to eat to reduce phospates in ones diet? I will go back to the article and read more on having calcium in your diet. As you might remember my stones are calcium phosphate (brushite & apatite).
Thank you for your consideration in this matter.
Sincerely, Laura Mac Donald -Bousada
Hi Laura, 1200 mg of total calcium is very ideal and you use it this way. About 400 mg with each meal, never between meals. The total should be food calcium to the best extent possible then add in supplements only as necessary. Excessive phosphate in the diet is largely from cola drinks. All living things have a lot of phosphate, so you will get about 600 or so mg/day just eating. Perhaps we need an article on high phosphate. Certainly we need one on how to get food calcium with a minimum of food sodium. Your big problem will always be the higher urine pH which cannot be changed that I know of. Low diet sodium – 1500 mg, very high urine volume – 3 liters spread out over the day – and medications as needed to lower urine calcium further are compatible with the high diet calcium you need for your bones. Regards, Fred Coe
My partner is getting kidney stones regularly. Mostly Calcium hydrogen phosphate. He has had 24hr urine analysis and nothing showing as out of the ordinary. Aside from drinking “lots of water”, what else can he do to try and reduce the number of stones he is producing? Low Salt, High Calcium?
Hi Tracy, Calcium hydrogen phosphate sounds like brushite – calcium monohydrogen phosphate, and if so such stones are special. Firstly they respond poorly to shock wave lithotripsy so other surgical means are best should he need management of stones. For prevention, I doubt his urine chemistries are really normal. Usually urine calcium is high – above 200 mg daily – and the pH of the urine likewise a bit high 6.3 or more. Brushite stones are nasty in that crystals can plug the kidney tubules, and the numbers of stones can be large. Yes, high fluids are important and given the kind of stones 3 liters of urine – 3.5 to even 4 liters of intake worthwhile. Yes, very low sodium is worthwhile, 1500 mg daily. Brushite stone formers are enough of a problem I often use thiazide type diuretics if fluids and low sodium are not enough to stop their forming. Modern 24 hour urine testing shows supersaturations with respect to brushite – calcium phosphate – and the goal is to drive that supersaturation below 1. Likewise fluids need to be even throughout the day leaving few or no dry spells when urine becomes concentrated. Fred Coe
The oxalate content of most foods pales in comparison to that of SPINACH. Much as I like it, I will try not to ever eat it again
Very wise, Ludwig! Regards, Fred
Does Crystal light Lemonade qualify as “diet lemonade is low in oxalate”?
Hi Robert, A great question. I hope so. No data that I know of. But the sweetener may be stevia which is high in oxalate. I will ask my colleague Dr Ross Holmes who is a food oxalate expert and see if he knows. Best, Fred PS Dr Holmes never studied this beverage but Jill Harris points out that aspartame is the sweetener. FLC
Hello Robert,
The sweetener in Crystal Lite is aspartame. Not plant derived, but lab derived. So there should be NO oxalate in it.
Just had my first brush with a kidney stone. After reading through the big list of foods and their oxalate levels, I’m a little disheartened. Turns out that some staples in my diet for the past couple of years – raw spinach, nuts, avocado, and stevia, among others – are real culprits according to that list. I added nuts and avocados into my diet, since they are otherwise supposed to be very good for people. And I turned to Stevia in order to avoid sugar (personal issue with it) and artificial sweeteners, because of so much controversy around them. In addition, I have trouble getting enough fluids, because if I drink water or other liquids that require little or not breakdown in the body with my meals or too soon afterward, I get some nasty indigestion. SO…..let’s start with the Stevia. If I don’t want to or can’t use much “real” sugar and want to avoid artificial sweeteners, what on earth is left? Xylitol? Or is that bad too?
Dear Jim,
I hear the frustration in your words- I am sorry you have stones and also that the foods you enjoy so much are high on the list. First off I must ask if you did a 24 hour urine and are you sure you have an oxalate issue? Meaning- did the results come back with high levels of oxalate? Many stone formers start limiting foods without ever doing a 24 hour urine collection.
If you know you have high amounts of oxalate in your urine, then yes, you must limit those foods that you are enjoying most. But Jim, remember, it doesn’t mean you can never have them. Incorporate them into your diet here and there. Stevia is a problem. At 42 mg for one teaspoon, you MUST limit. If your oxalate needs to be limited I would rather see you have it with a healthy avocado, then taken all up at once with stevia. I understand that you have a “personal issue” with table sugar, but it does not increase urinary oxalate and you might want to reconsider using it.
Xylitol is derived from Birch trees and may be high in oxalate.
Let me know if your urinary oxalate levels are known and if so, how high are they? You may not have to limit as much as you think.
Thanks for writing-
Jill
looking for healthy meals for my husband he needs a low oxalate diet , low calcium diet , low uric acid he also has high blood pressure please , please help thanks so much
Hi Mary, For reduced oxalate diet, try this article by Jill Harris. I do not think you mean a low calcium diet; there is no reason ever to follow such a diet. I think you meant a lower sodium diet – good for stone prevention and lowering blood pressure. Low uric acid diet means lower intake of meats; it is hard to combine that with low oxalate diet, and if this is for stones, I would concentrate on the oxalate first. Regards, Fred Coe
Hi Mary,
Thanks for the awesome question. When a patient is asked to incorporate all the dietary changes your husband has been asked to do, it can be confusing and frustrating. Let me see if I can help a bit.
First off, as Dr. Coe has said, lowering oxalate and meat intake can be daunting. I, too, would start with limiting the high oxalate items from his diet. Did you find some on the list that he has been eating and are really high?
Secondly, when lowering meat consumption, the first thing you should do it lessen the portion size. Typically we eat way more than we should. That deck of card analogy that everyone points too when serving meat is very little. Most people are eating three times that. Ask him to eat less meat at each sitting and see if that helps. People I have helped never have to give up meat, but they do have to cut down on portion size. What is a average portion size for him?
Thirdly, no one should be limiting calcium. If your husband is eating too much meat, he is also probably eating too much sodium. If you can, give a bit more details and lets go from there.
Hope this helps,
Jill
Hello,
My husband was recently told that he has calcification in his kidneys and likely passed a stone. (a lil blood in his urine, fever, problem urinating) they did a CT scan and said they didnt seen any stones just the calcification. They told him to limit salt, certain high oxolate foods, alcohol AND foods containing calcium, like dairy foods. We understood that to mean NOT to eat dairy or foods containing alot of calcium. did we misunderstand? the dr told him to look up kindey stone diets, but they all say you SHOULD eat calcium. we’re confused. can you clarify? thanks!
Hi Renee, He should have 24 hour urine testing and diet is planned from those results. High calcium intake works well in some cases but needs to be combined with reduced sodium as well. There is confusion here, so perhaps you might do best beginning here. See if the first few chapters help. Regards, Fred Coe
Renee,
Please make sure your hubby gets his 1,000mg/day of calcium. His stones and bones will thank him.
Best, Jill
P.S. You need to get yours too!
In the list of foods by type, a number of items are marked with an asterisk (raw carrots, for example). I’m wondering what the asterisk signifies. I’m particularly concerned about what the asterisk means with regard to stevia, because I use a small amount of stevia in my water and lemon juice mix. Thank you
Hi, In the article I mentioned that these tables are updated with the newest values available. Asterisks show updated values. I had to make this annotation because the source tables are from Harvard – also mentioned in the article – and I could not alter their data without a notation. I will make a note on the tables about the asterisks, Regards, Fred Coe
I have been having stones since 1995 approx. two a month. I have tried all kind of diets from low O.xalate, low calcium and so on. My question is why does the low Oxalate lists keep changing with different Doctors I receive a new list and it will be totally different from the last list I received, why is this? Whom should I believe? lately my stones have been quicker to pass since I started potassium citrate
Hi Robert, First of all, be sure you need a low oxalate diet. Your stones need to have appreciable amounts of calcium oxalate in them and your urine oxalate should be in a region that confers risk of stones – above 25 mg daily. If so, the lists on this site are perhaps the best curated. The primary source is from the Harvard School of Public health, as noted in the article. Professor Ross Holmes, who has devoted a lot of his career to measurement of food oxalate added to and modified the list from other newer sources. A review of lists on the web indeed confirm your concerns about variability, which is why we have worked as well as possible to produce these present ones. The National Institutes of Health has not been very enthusiastic about funding food oxalate measurements, and they are not mandated by Federal law, so it is a bit hard going. Regards, Fred Coe
Can drinking lots of water overcome some dietary oxylate? Can soaking in excess water reduce oxylate in cut up plant foods?
I expect the beet tops or greens are high in oxylate, but what about beet bottoms? The list just say “beets” but not the plant part.
Chicken Enchiladas are confusing – corn tortillas are moderate for oxylate, chicken and cheese are not a problem, main ingredients for salsa verde are not on the list (tomatillos, serrano peppers) – why on the naughty list?
On stevia, I am not a big user, but the packets I have noticed do not contain a teaspoon and have been cut with maltodextrin or similar bulking powder, as is common for high intensity sweeteners. Was it retail powder that was tested or 100% stevia, because these are not identical.
Thanks for the great website – it is a jungle out there, trying to do the right thing, often in the face of disparate advice.
Hi Anita, I do not know about beets; the history of the list is as in my article, and I do not do this kind of research. I suspect the enchiladas are high in fact and those who measured did not take them apart to see why. Stevia is not a big issue because amounts – as you are pointing out – are not large. As for water, the only problem with oxalate is in calcium oxalate stone formers, and the only desire is to lower the urine oxalate concentration to lower the urine calcium oxalate supersaturation. So lots of water is always useful as it dilutes the calcium oxalate salts. As for soaking vegetables, I am doubtful as the oxalate is usually stored as calcium oxalate with is very insoluble. Boiling might help but I have no data. I believe Jill will also answer this, and she may have more to say. Regards, Fred Coe
Hi Anita,
I concur with Dr. Coe as far as no one has tested or deconstructed the ingredients of the enchilada. That being said, having a couple is not going to cause chaos. Have a few here and there. Drink extra water when you do and the cheese will add some protection by providing you with some calcium to bind with oxalate in the small intestine.
Beets- eat them sparingly… all parts. I don’t think the oxalate particular likes one part of it and not the other. If it is on the higher side, than it is the whole beet.
Having veggies soak in water is not going to lower the oxalate level. Choose ones that are lower more and eat the ones that are higher less. Not rocket science, but always bears repeating.
I am not sure which they tested, the packet or pure stevia. I would lessen my use of it either way. It is high, but a tiny bit will not hurt. If you must use sweetner, go for real sugar. Calories yes, but oxalate no.
Hope this helps a bit, if not we are here.
Yours-
Jill
Thanks for the very useful information. Thanks for helping it all make sense.
It is our distinct pleasure.
Warmly,
Jill
It seems like the low oxylate diet is good for the kidney but not very good for the bowel or heart. Is a fiber supplement ok? Also does this same thing go for MSK people like me?Thank you for all of this great info. I wish I lived in Chicago. I’d go over there and give you all hugs.
Having recently been through my second episode of kidney stones, and learning that my healthy diet is very high in oxalates, I have been trying to educate myself on what foods to avoid. I have seen at least a half dozen lists, all from “reliable sources,” and am very overwhelmed. How is one to know which list from a “reliable source” is actually the most reliable?
It wouldn’t matter if they were all in agreement, but unfortunately they aren’t. For example, avocados and pumpkin seeds are high on the list linked in this article, but low on most others that I have seen. Blueberries, raspberries, kale, fig bars…all low or very low on this list, but high to very high on others. I think I have seen oat meal, which I eat every day, rated in every category on one list or another.
Thankfully there are some foods that are low on all lists, so I suppose I will have to make do with a well-rounded diet of alfalfa sprouts, meat, cheese, and melon.
Confused and frustrated,
Matt
Hi Matt, I guess perfect knowledge is hard to obtain. The lists here began at Harvard with a lot of effort at measurement and collecting data. Professor Ross Holmes, who is about the best modern expert in food oxalate then helped me update the Harvard lists with what he thought were the best available measurements. So, for what it is worth, he and I would say we did about as well as available data allow. Other sites are known to us, and we believe most disagreements reflect errors on those sites. This is not arrogance, but simply that between him and I we have access to most of the measurements, and have put them here. There is no hidden cache of other measurements one can draw on to make alternative lists. We wish there was more funding to allow more food oxalate measurements, but there is not. It is not attractive to funding agencies and food companies have no reason to do this. Regards, Fred Coe
Thank you for the response. Yes, perfect knowledge is likely impossible, though something we all want. It’s a little demoralizing to discover that some foods that I thought I could still enjoy, such as avocados, pumpkin seeds, and oranges, should probably be avoided. On the other hand, it may be okay to consume kale, blueberries, and oatmeal, which I thought I needed to eliminate.
Unless I am missing it, I do not see coconut on this list at all. Most studies that I have read indicate that it falls into the low oxalate category. Should I be skeptical?
Hi Matt, I guess no one has measured oxalate in coconut. I doubt there will be much but who can tell? Regards, Fred Coe
Keeping calcium high helps but magnesium and pomegranate juice seem to help as an insurance policy…..
Are any artificial sweeteners okay to use? I really enjoy homemade lemonade. I’ve been using Truvia in my lemonade and coffee but on the ingredient list it has Stevia leaf extract. Is Truvia or another artificial sweetener low in oxalate? I really don’t need the extra calories using sugar when add.
Thanks!
Lauren
Hi Lauren, Unless it is on the lists attached to the article the oxalate content is not known. There is only so much available. Regards, Fred Coe
Thank you so much for this article! My doctor gave me minimal information about my new diet to reduce the chance of more kidney stones and the conflicting information on the Web is almost impossible to wade through.
Thanks for writing Barry. We are happy to help and glad you found the piece helpful.
Warmly,
Jill
Most sites I check list strawberries as high in oxalate your list does not which is right?
Hi Larry, Many sites say things that are not consistent with available scientific data. The listings here originated at Harvard as a compilation of best available data. The copy on this site has been corrected and updated as noted in the text. I curate at the level appropriate to a scientific review. That means I do not propose the articles and lists here are ‘right’, merely that they are as consistent as possible with measurements that have been made in a scientific manner. So, strawberries are – so far as one can tell – not so high in oxalate. Regards, Fred Coe
After my fourth lithotripsy—this one for an oxylate 11 mm stone just 8 months after another lithotripsy for a 7 mm stone in the same kidney—my doctor gave me, for the first time, a sheet on foods to avoid. 25 years of stones treated by three doctors, and no one had thought to mention this.
I am a vegetarian as a matter of conscience, and have been getting my protein from soy. I just learned that this is one of the worst foods I can eat. (Perhaps this is how I came up with an 11 mm stone in just 8 months.) What can I do to obtain complete protein without meat, soy, meat, and most legumes?
Hi Sherry, It may well be that urine oxalate is your problem and food oxalate your treatment but that would usually not be the complete story. Take a look at how prevention is supposed to work and be sure you are getting all of it. If you need a reduced oxalate diet, the article offers a lot of alternatives for veggies. Now, for the protein problem you are outside my expertise. Perhaps Jill can answer you. Can you use eggs, for example. Regards, Fred Coe
Thank you so much for the response, Dr. Coe. I am trying very stay vegan; I do not want to eat animal protein in any form. Thus my quandary. Going through the posted oxalate-content list, I don’t see any way to get complete protein in a low-oxalate, vegan diet. Perhaps Jill or another reader might respond to this. I feel lost and would sure appreciate any help I can get.
In the meantime I will go through the recommended material from the “Take a look at how prevention is supposed to work” link.
Oh–one technical comment re the website and this page: The use of purple for links makes them nearly indistinguishable from black text for red-green colorblind people. My husband is helping me and he didn’t even know there was a link there.
Thanks again.
Hi Sherry,
I see your problem. Do you know how high your oxalate actually is? Have you done a 24 hour urine collection? If so, tell me how high the oxalate level(s) are. We can then go from there. You may be able to eat more oxalate then you think in order to get the protein you need and also we can figure out ways you can safely incorporate oxalate without making new stones. Please post your oxalate values and if you don’t want to do it here, email me at jharris1019@gmail.com if you like.
Warmly,
Jill
Anyone have any feedback on Beer. I read what was mentioned above but some sites suggest dark beer and draft beer should be avoided but most bottled beer is ok. Also, any thoughts on coconut water?
Hi Marc, Beer is associated with reduced risk of stones. All are the same so far as we know. Fred Coe
Hi Marc-
I don’t have a reliable source of coconut and oxalate content. What I have read says it has a moderate amount. Have one a day and call it. The key to eating less oxalate is really you can have what you want in MODERATION, drink lots of water and a have your oxalate goodie with some milk if you are able. If you decide to have a food that has a lot of oxalate watch what you have for the rest of the day. You are not going to form a stone by eating a spinach salad for lunch. It is what you are doing day to day and over time that matters.
I write this knowing that everyone is concerned about oxalate. But if you follow my rule of everything in moderation and make sure you are getting enough calcium, watching your protein amounts, you will all be ok.
Also, drinking water is always key. ALWAYS.
Best,
Jill
Thanks. And, also thanks for this site. This is the most comprehensive, educational and informative site that I have found. I’ve had 5 stones to date and currently have one in my right kidney. Also, any thoughts on Beeltith, coconut milk or coconut water? Some ” unofficial studies” i have read about on line suggest that taking beelith, and/or drinking this (not tied together though – 2 independent things i have read) can reduce the actual size of existing stones or prevent stones. I’m suspect but thought I’d ask anyway..
I am suspect too, but have forward to Dr. Coe to see if he agrees. We will wait on what he has to say. There are no scientific studies on either one. But I am happy you asked. He may know something I don’t.
j
Hi Marc, vitamin B and Beelith have no trials. Just examples of treatment ideas that have come and gone. B vitamins are thought to lower urine oxalate excretion but in most people they have little effect. Coconuts are outside of my knowledge – but taste very good! I doubt anything can reduce the size of calcium stones – the crystals are usually too insoluble. Regards, Fred Coe
First of all thank you for the very helpful information. I’ve been battling kidney stones & a severe infection since entering the e.r. in december. My most recent 24 hour urine collection showed my oxalate level was 201, with the normal range between 20- 40. Is that as frightening a number as it looks? And my next question is regarding Crystal Lite peach tea. I drink a lot of it all day. Any ideas how high it would be? I’m not sure if it would be considered an “actual” tea. Since I drink a gallon of this daily & use it as a means to get my water in I’m very concerned . Thank you so much. I don’t know who else to ask.
Hi Nancy, Indeed a value of 201 is worrisome. If you have this as a real and consistent number – it needs to be checked in a high quality laboratory!! it requires expert attention as it might reflect significant disease and high risk of kidney injury. Do not delay in getting attention for this. Litholink is a very accurate laboratory source, and multiple measurements are indicated to be sure of the value. The main concern is primary hyperoxaluria which can be managed by experts. Regards, Fred Coe
I also have a hard time drinking enough water, but personally, I’ve found that adding a lemon slice to my glass makes a world of a difference!
I see tea listed as very high on the list, but it doesn’t say what type. Jill, is it good to avoid all brewed teas (green, black)?
If your oxalate is high, it is best to really limit your tea consumption. Green is better than black and makes a good substitute and also has healthy benefits.
Jill
What if you are unable to eat dairy, due to casein/whey (and, in my case, histamine) sensitivity? Can supplemental calcium citrate (paired with magnesium citrate 2:1) compensate for low dietary calcium intake? Does adequate (supplemental) K2 intake have any known impact on the rate of absorption, accumulation or excretion of dietary oxalates? Thank you.
Hi Karen, Lets assume you need a low oxalate diet – your 24 hour urines show an oxalate high enough to confer stone risk, and your stones contain calcium oxalate crystals. You can add a calcium supplement to your larger meals – the ones that contain higher oxalate content foods. Typical size would be 500 mg calcium. The supplement needs to be eaten with the food so the calcium can combine with oxalate in the bowel and prevent oxalate absorption. Vitamin K has no known effects on oxalate absorption. Regards, Fred Coe
Hello! So I am new to all of this and am trying to create meal plans. I usually make smoothies in the morning: banana, strawberries, orange, greek yogurt, skim milk, and peanut butter (I use protein powder or the real stuff) for the protein. Will this still be okay or what do I need to substitute out?
Thank you for your help! Also, do you know of any sites that have meal plans that are low in oxalate?
Hi Megan, The article links to very good oxalate lists, and you can use them as your guide. The big figure at the top of the article highlights the really high oxalate foods, too. I have asked Jill Harris to add an answer, as she is expert on diet plans. By the way, do you have a high urine oxalate excretion? Before you undertake all this be sure you do. Likewise, are your stones calcium oxalate? Prevention is not hard, but also is specific to the individual, so take a look at my summary of the matter. Regards, Fred Coe
Hi Megan,
As Dr. Coe has asked, it is important to know your oxalate values before you start limiting healthy foods from your diet. Let us know if you have done a 24 hour urine collection which will provide you with the values we are seeking. Your breakfast smoothie, although healthy, is high in oxalate. But this may not be of concern to you unless your oxalate levels are high.
I can definitely help you more specifically once you find out how high your oxalate is- that help will include meal plans too.
Thanks for writing and let us know if you have completed a 24 hour urine collection.
Jill
Hello, thank you for the very helpful information! I am wondering why OJ, grapefruit juice or okay, but not the whole fruits themselves? It seems like the juice would be a higher concentration than the whole fruit? Also, do you have any recommendations for low oxalate breakfast cereals? And lastly, are there any breads or pastas that you would recommend made from a different low oxalate grain? Thanks in advance!
Hi Natasha,
Glad you are finding the info helpful. We always appreciate your feedback. It is a bit odd that the fruit is higher, but I believe that is because the fruit juice has so much added water (which people often are surprised to find out)- as much as 88% added water.
The cereals NOT on the list can be eaten or go for something like eggs if you eat dairy. The pastas are high and so are your grains. There are no subs for them.
As a reminder to everyone, what is concerning is your daily consumption of high oxalate foods. Meaning- if you want to have some pasta, watch your oxalate consumption for the rest of day and drinks lots of water. You can have higher oxalate foods here and there if you eat a small portion, can combine it with a calcium rich food (like cereal and milk), and be mindful of the choices you make for the rest of the day.
Best I can offer you and hope that it helps.
Fondly,
Jill
Hello,
I just wanted to say the information I found here has been a revelation. I have been plagued with kidney stones for 8 years. The cause of the stones I I now realize has been my diet which was suggested by my doctor to lose weight. A quick question, is Greek yogurt high in oxalates? I need a protein option for breakfast. I used to eat Peanut Butter because I have egg allergies.
Thanks.
Hi Camille, I am glad the site is valuable for you. There is little oxalate in yogurt – none probably in common with most dairy products. About your stones, be sure you know their cause. Are they calcium oxalate? Have you been evaluated fully? Regards, Fred Coe
Hi Dr. Coe,
My first bout of stones in 2008 turned out to be Calcium Oxalate. The repeated episodes until now were protein based. I was advised to eliminate dairy from my diet and up the protein. Protein being soy, nuts, etc… The stones seemed to occur more and more and now I know why. I’m seeing my doctor within the next week to chart out a better diet plan that won’t result in more stones.
Thank you again.
Camille
Hi Camille-
As Dr. Coe said- perfect solution for breakfast! Also- we always say before you start changing your diet be sure to know if your oxalate level is high. You can find this out by doing a 24-hour urine collection. If you have not done one ask you urologist about ordering one for you-
Warmly-
Jill
Many thanks for your excellent information.
I’m a bit dismayed at the oxalate levels in wholemeal wheat. It looks like I’ll have to make my own bread from now on.
But from what? Can I use wholemeal oat and rye flour with say 20% strong refined wheat flour?
Hi-
Sure you can. All grains will have oxalate, but you can lower it by managing your recipes in a way that lessens the oxalate content. You can also eat the bread with some dairy and keep your water intake up.
Thanks for writing-
Jill
Many thanks for this amazing article, plus the spreadsheet. Been suffering from stones for over 15 years (Had to go to the hospital 3 times already!) and I always got very general instructions, and never the basic: Avoid high-oxalate foods. I just noticed I did so many things wrong (Like eating nuts, I love them to death) for so long, so I’m very optimistic that starting today, my kidney stone problems will start to go away.
Thank you!
Hi David, Be sure high urine oxalate is your only problem and that it is indeed a problem. Full evaluation is very important. Regards, Fred Coe
I am a cancer patient (neuroendrocrine carcinoma) along with other issues I have only 28″ left of my intestines so absorption of anything is poor. I have fast forming kidney stones that are always a big problem almost daily (hospitalized many times, had kidney stents etc) I was told to avoid lots of the same as you list (potatoes, nuts etc and add calcium) and to drink lemon water as much as possible. Do you have any other suggestions for me? Always looking for more food options as it is hard to maintain weight and energy levels.
Thanks
Dear Ted,
First off, I am sorry to hear about your cancer. I am also a cancer patient and understand how daunting that diagnosis and treatment can be to you and your loved ones.
Because you must have a hard time absorbing and keeping up with calories I am going to suggest a few things. Because of your shortened bowel I assume drinking or eating too much at any one time might lead to problems with absorption. So keeping this in mind we need to get you low oxalate foods that are high in calories and nutrient dense to keep your weight and nutrition levels up. For patients like you I recommend smoothies made with milk if you can tolerate milk. Bananas, blueberries and other low oxalate fruits are wonderful to use. Make smoothies for snacks as they can increase your calories count by a few hundred calories.
You must eat and drink small amounts but many times during the day. You can write me at jharris1019@gmail.com to get more specified info. I would need to know a few more things about how you are handling food right now to better help you.
Jot me a line and we can connect-
Jill
Jill,
Thank you for the advice. I love smoothies, would you recommend adding frozen yogurt to the smoothie as well to add calories, bulk and more calcium. Yes you are correct that if I eat or drink (especially drink) too much at any one time it leads to problems. So a basic smoothie of frozen yogurt, fresh banana, blueberries etc. and whole milk would be a good meal/snack option. What about a bagel (plain or raisin) with Cream cheese, will the cream cheese be enough to offset the oxcilates in the bagel (for the morning when I don’t have time to do eggs and bacon?
Hi Ted,
Please, if you can tolerate the lactose add milk or yogurt for sure! I had an ileostomy for 5 months while I was healing from a bowel surgery due to cancer and I know that if I drank too much at one time it was never good. So when you are making your smoothies, please drink it slowly so your body can absorb what you are trying to put into it.
I think that if you put cream cheese it will help. Other hints might be: just eat half a bagel so that alone will cut the oxalate. Maybe couple the bagel with low salt cottage cheese for even more calcium or a yogurt.
Continue writing if you need more help. Besides me loving my family and friends it is the main reason I am here on this earth.
J
I want to loose weight can you help me thank you
Hi Betty-
Of course I can but we would need to talk a bit before starting. Generically I can tell you and anyone else that wants to lose weight that you should get rid of all white foods and limit sweets. Limit your portion sizes, do not go back for seconds during meals and limit in between meal eating.
Do that and you are off to a good start-
For more jharris 1019@gmail.com is where you can find me!
Very best-
Jill
I have been advised to go on a low oxalate diet as I had been hospitalised due to raised calcium levels in my blood and the diagnosis was hypercalcaemia secondary to sarcoidosis. I was a big crisp eater, loving to snack on these when watching late night tv. Now I can obviously not do this on a low oxalate diet so I was eating corn chips/tortilla chips as I thought that this was lower because of the corn. Now I am not so sure after reading the list of foods. Also I was snacking on rice cakes. Is there anything at all I am able to munch on?!
Kind regards,
Nigel
Hi Nigel, Although oxalate is certainly a factor in stones, it sounds like you have a significant systemic disease as a cause of increased serum and I presume urine calcium – Sarcoidosis. Usually urine oxalate is the least of the problems in treatment. Our oxalate lists are as accurate as one can make them, so you can feel confident in their use. But I would hope more is being done in terms of treatment for both the stones and the sarcoidosis itself. Regards, Fred Coe
Hi Nigel,
Low oxalate versions of crunchy snack can include popcorn (air popped has the least amount of oxalate- about 4 mg/), triscuits, saltines and graham crackers. If it were up to me I would pick pop corn. Most satisfying with the least amount of calories and oxalate.
Hope that provides a bit of relief-
Jill
I was just prescribed a low oxalate / low calcium diet. But, I have a history of bowel obstructions and have a suggested restricted diet to combat that. It appears that one diet cancels out the other. Can you advise?
Hi Angelica,
Sorry to hear about the bowel obstructions. I have had bowel surgery myself and understand how frightening and real they are. As a nurse I never override doctor’s order, but in your case I just have to say that everyone should be eating a normal calcium diet. Getting around 1,000 mg/day is best for all of us and very importantly stone formers as a low calcium diet may increase your stone forming risk!
If you can be more specific I know I can help. Tell me the other diet you are on and we can go from there. I don’t want to assume!
Warmly,
Jil
Hi. Thanks for the great site. I have 2 questions. I noticed only 2 beans listed on the high oxalate pages, kidney and navy. Are there any dry beans that are low oxalate ? My first stone was calcium oxalate, I’m currently trying to pass another stone. I did have a 24 hour urine test but I wasn’t specifically given the results but I was handed a food list of high oxalate foods to avoid. Can you make calcium oxalate stones and have a normal level of oxalate a in your urine ? Thanks in advance.
Hi Miriam, I guess we only have what is on the list. Food oxalate measurements are poorly funded by the NIH and industry has no reason to want to do them. But, calcium oxalate stones certainly do not always have to do with high urine oxalate. Get your 24 hour test results and take a look. Much of the time it is about high urine calcium, and treatment is not about diet oxalate. . Regards, Fred Coe
Hi, I have calcium oxalate stones. 24hr results: Ca 86, Citrate 613, Oxalate 59, Tot Vol 1.9, Uric Acid 2.9. I’m want to try the advice to increase calcium and fluids to see how much that helps before making major diet changes. However, I am trying to figure out how “large” a meal should be in order to take supplemental calcium at the same time. The generic version of Citrical I have is 315 mg calcium per pill. Is it better to space these out by taking them with small meals/snacks so I take 3-4 separate smaller doses a day? Or would I be better served by taking 1-1/2 or 2 pills each at lunch and dinner? I don’t eat much at breakfast time.
Hi David, Your urine calcium is low, urine volume a bit low, and oxalate is high. I gather that you do not have bowel disease. The best start is to add calcium containing foods rather than supplements. They should provide 1,000 mg daily and can be apportioned among your two main meals. If you do not want to eat such foods, then 1,000 mg/day of supplements are alright, divided between your main meals, never alone. The purpose of the calcium is to bind oxalate and prevent its absorption and also to provide for your bones. When you have your new regime, retest. Regards, Fred Coe
Hello! Why would diet lemonade be okay and not frozen from concentrate? Is it because very little lemon juice is actually used? The frozen from concentrate is still high, even after water is added, correct?
I don’t see unsweetened ice tea on the lists and I see that sweetened is okay . . . I presume that unsweetened would be okay also?
Thanks!
Hi Natasha, You are right, it is that lemon juice has oxalate in it, and less of it is safer from an oxalate point of view. Unsweetened tea will no doubt be the same as sweetened. Measurements of food oxalate are hard to do, no one want to pay for them, and the lists try to stick to what has been measured, so sugar or not is assumed to be the same. Regards, Fred Coe
Hi, love your site, article and supporting lists and data! Being a sufferer of calcium oxalate stones for many years (a 6mm stone currently in left kidney), this is what I have been searching for – thanks so much! Sorry to see though that many of the foods I have been eating thinking they were low in oxalate are actually high. The list I have been using was given to me by my urologist and is based on research from AstraZeneca back in 2002! I guess a lot has changed since then. So, needless to say, I will be structuring my meals based on your list.
Also, your site focuses mainly on prevention. Do you plan to research and publish on the many treatments (more importantly, non-surgical) of existing stones? And if so, do you have an opinion on chanca piedra as a stone treament?
Thanks again!
Hi Eric, so many lists are wrong! Partly things have changed. Partly, the lists are hard to put together and maintain. I focus on prevention because of what I do, but I have a brilliant young surgical colleague – Mike Borofsky – who writes on surgery. I am sure you have seen his articles. As for non surgical management of existing stones, there is not a lot of reliable data. Uric acid stones can be dissolved with alkali, of course, and cystine stones with fluids and cystine binding drugs. Such dissolution is by no means easy as the surface to volume ratio of visible stones is very low compared to the initial nuclei so it takes a lot of time and steady reduction of saturation to below solubility. As for chanca piedra, PubMed shows only 3 articles; none have to do with stones. WebMD shows a lot of unsupported hype about it which tells me it is not a reliable professional site despite the ‘MD’ name: Professional gets its data from PubMed, not advertisers. For example the link to the claim about this material and kidney stones takes one to the WebMD kidney stone health center that does in fact offer a few vanilla nostrums about the disease, but does not mention this treatment. PubMed is open to the world for free, and I would check out proposed stone treatments there. Regards, Fred Coe
I’ve been trying to use stevia as much as possible in lieu of aspartame. I see it is listed as a high oxalate food. What “sweetener” do you recommend? I use it mainly in my coffee.
Hi Myra,
I know you all might get mad at this reply, but I’m going to say it anyway. I find that sweeteners are always being researched and found out to be unhealthy for us in some way. I used to be a sweetener queen, but found that I craved sugar products even more. So one day I went cold turkey and started substituting real sugar for the sweetener. I only use a tiny bit for my coffee and although it was tough at first I now like my coffee less sweet. So yes, I am advocating that you might want to try just a bit of regular sugar….I am hoping one day soon I won’t even have to put the small amount of sugar and just drink it black. Crazy, huh?
Thanks for writing,
Jill
Hi there –
Every website I’ve seen says avocados and lemonade are fine, including the list from this site (from March 2016): https://groups.yahoo.com/neo/groups/Trying_Low_Oxalates/info
You also say hummus is fine, but it’s traditionally made with tahini, which is not ok.
I’m just concerned because I love avocados. I have oxalate kidney stones and feeling like everything I like is a no-go, as well as conflicting information from one place to the next is so frustrating. I hate living on a low oxalate diet. If I stayed away from everything I’d be miserable. So I stay away from the big time baddies (Spinach, soy, nuts, seeds, multi-grain stuff) and eat everything else on the naughty list (chocolate, potatoes of any kind, tomato sauce, etc.) in moderation and try to drink 68 oz of water every day. I haven’t had a stone in almost 2 years, and the last ones were because I accidentally ate a lot of something that had soy in it (non-dairy creamer) for a few months. I do have stones in my kidneys presently, but they’re staying put at least for now. Sorry to ramble, just feeling frustrated at the moment!
Hi Kate, The list here is good, so avocados are probably alright. Are you sure it is high urine oxalate that is causing your stones? There are a lot of causes. Be sure you have been fully evaluated and treated for all of your abnormalities – they need not all be about oxalate! Regards, Fred Coe
Thanks Dr. Coe. I appreciate your reply! I had the Litholink urine analysis done a few years ago and was told they were calcium oxalate stones, and they told me to be careful of oxalates. This was about 5-6 years ago.
So, re: avocados, the article and list here on this site is not correct, the list I linked to is correct, and I can continue eating avocados without fear? I just want to make sure I’m clear!
Again, thank you for taking the time to answer these questions. Its greatly appreciated.
Hi Kate, Did I misspeak? Avocados are number 96 on the list and classified as very high in oxalate, as noted. They did not make the chart on page one of the article which cuts off at 40 mg of oxalate per serving but 19 mg is a lot in a diet that is to contain no more than 50 mg of oxalate a day. Perhaps I wrote carelessly, but I just checked the list and am quite sure this is not a good food for you. Sorry if there has been confusion on my side. Regards, Fred Coe
Thanks you so much for this information.
Do you have any more specific advice for protein choices for vegetarians who have calcium oxalate kidney stones? Are all beans and all nuts high in oxalates?
Raw brussel sprouts are in the top 179, but cooked brussel sprouts are not listed. Are cooked (roasted, sauteed, steamed) brussel sprouts ok? I have the same question about carrots. Are cooked carrots ok?
Is corn bran ok, but corn grits and corn meal, not ok?
Thanks,
Judy
Hi Judy, I will leave this fone for Jill to answer. Regards, Fred Coe
Hi Judy,
All beans and nuts are high in oxalate according to the list. What you see on the list is what we know. If the products you ask about are not on the list they have not been studied and we cannot know for sure.
Some vegetarians eat dairy, if you do I suggest you add some to your diet for the calcium and protein. Also let me know if you eat fish. Some do, so let me know what specific vegetarian diet you are following.
Very Best,
Jill
I am watching Oxalate amounts for an itchy rash my daughter has had for several years. In one day of omitting Almonds from her (anti-candida diet) she is much better. Several of hi amt. foods on the list trigger her rash. They are what you eat with that diet veggies, greens, no dairy, nuts etc.. So thank you for adding stevia because it is a go to for those who fight Candida, now I see why she is not improving . There is definitely a connection.
Hi Yvonne, I am quite sure that foods can cause skin reactions but also sure that the simple chemical oxalate is not the culprit. It is something else in the foods that cause difficulties. Regards, Fred Coe
Thank you for your reply, but why else would a food cause an allergy or reaction if not for it’s toxins? One mans food is another mans poison correct? Isn’t that what oxalate is? a crystal forms in the body, the body tries to rid itself of it, maybe it can, maybe it cant depending on the overall toxic overload. it binds with calcium to try to move it through the body? Isn’t the skin a means of detoxification?
Hi Yvonne, Items in foods that cause reactions are usually larger than oxalate and susceptible to recognition by the immune systems. Oxalate itself is rather inert. Crystals of calcium oxalate are not removed through the skin. But in fact in the bowel lumen calcium is thought to bind with oxalate to prevent its being absorbed into the blood stream, so your image works in the other direction. Regards, Fred Coe
Thank you, as one desperate to find the cause of this rash, I appreciate narrowing down the possibilities. Anyway, it’s a great list I will share with those who have kidney stone problems.
Curious on all this..am trying a low oxalate diet but have a few questions?
Is ezekiel bread high on oxalate? Are oats? Is broccoli? These things r in my diet and trying to figure out if I need to eliminate them. I am also a big coffee drinker but I read that coffee is ok….organic brewed.
Thanks,
Josh
Hi Josh,
Thanks for writing. Ezekiel bread has not been studied, but I assume that it does have oxalate in it as it is made with a bunch of grains. Having a piece will not throw you over the edge, but be mindful. If you look at our list in the oxalate article, you will find links to all the high oxalate foods.
Very Best,
Jill
I have been looking at 4 Apps available for keeping track of the oxalate content in my diet to help me stay within the 50-100 mg/day. Do you have recommendations? if not an app other ways to easily track it on they fly during the day?
Thank you,
Dina
Dear Dina, I am afraid I have not checked any of them out. My concern is always the lists they use, which are not easy to track – inside the app. Sorry! Regards, Fred Coe
Dina,
I suggest patients track by looking at the list and understand what is really off limits (like spinach) and must be eaten sparingly, and then the other foods that have some oxalate just eat in smaller portions.
Unless you have a really high oxalate content you don’t have to be exact. It is more knowing to limit portion size and the quantity of times you eat higher oxalate products. If you have a day where you eat a lot of oxalate see if you can combine those foods with calcium foods for oxalate binding effect.
Let me know if this helps.
Jill
I eat a lot of bread and have some questions on oxalate content: a) does sprouting grains before making breads change the oxalate content? Ezekial Bread is an example of a commercial sprouted grain bread. b) any data on spelt, black beans or lima beans? or Hemp and Chia seeds that stores carry these days. c) your list has 8 oz of grapefruit juice as low, but a 1/2 fruit of grapefruit as very high?
Hi Jim, As you might have guessed, what is not on my lists I do not know. Anything I find out I put there, The juice has less oxalate than the fruit itself which I presume is because the oxalate is in the linings and rind. Regards, Fred Coe
I would like to know if quince has high Oxalate levels or not ? How about squeezing fresh lemon juice on some foods you eat or squeezing it in your water? Lastly some articles say it is good to drink lemonade and some say it is not, what do you suggest? Thank you.
Nasrine
Hi Nasrine, I do not find quince on the lists, so I do not know its oxalate content. Lemon juice on food will be neither good nor bad. Lemonade has some citrate which is good but usually not enough to matter, so it is not a serious treatment. Regards, Fred Coe
Hi Nasrine,
Not sure if you meant quinoa. If so, we do not have it on the list, but since it is a grain I would presume it does have some levels of oxalate. It has not been studied as it is a relatively newer grain people have been eating. Eat it in small portions.
Best,
Jill
Thank you SO much for this website and putting together this information — having it in a Google Doc is especially helpful. I’m 30 years old – had a kidney stone in college and just dealt with another one over these last two months. Not. Fun. My stone was primarily made of oxalate, so I’m just now digging into all of this oxalate food research. I was vegan for the last 4 years, so I’m definitely having to change things up. Anyway, thank you for what you do. It is greatly appreciated!
Hi Josh, I am glad it works for you. Regards, Fred Coe
Sorry – I had a follow-up question. I just had surgery to remove a kidney stone and my doctor told me to wait 4-5 months to do the 24 hour Litholink Test – he recommended to do the Two, 24-hours collections. I’m already planning to change my diet. Should I just do the test now before I change my diet? He said not to schedule a follow-up until 2-3 weeks after my test, so I’ll be seeing him late October…
Your doctor wants you to have recovered from the surgery and is prudent. Two are ideal. Do the diet you think is wonderful and see what it does for you. Regards, Fred Coe
Great synthesis of a ton of papers, thanks!
Any comments on vit D? Am told that pharmacologic doses are associated with hypercalciuria, lower doses not so.
Also would appreciate a comment on vit B6 to lower oxalate, and using extra citrate to decrease risk (lemon juice).
Finally, here’s an interesting option – adjusting microbiome. Insufficient data, but why not? VSL3 is available mail order (used in this study – http://www.ncbi.nlm.nih.gov/pubmed/20224931); see also http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2396938/
Hi Edward, Very high 25 D intakes could raise urine calcium. B6 is not much of a treatment, and lemon juice is inefficient. The two papers are both from companies anxious to make something, and perhaps the first of them has some promise. But I would be sure that the crystals in your stones and the abnormalities in your urine are being considered, and is oxalate your key problem? Citrate? Calcium? There is some good science and it can be used if you have those few components in hand. Regards, Fred Coe
I am so confused and frustrated. No two lists of oxalate foods are the same! One says you can eat spinach and another says no spinach…and there are other foods too. Like no one agrees! Even my urologist says diet doesn’t affect stones. So this is where him and I disagree. So how does one choose a diet list? Take a chance? It is also hard because I am dairy and gluten free….thanks. I am hungry all the time!
Hi Chris-
You are confused and frustrated because it IS confusing and frustrating. Please know that spinach is one of the highest containing oxalate items. Since you are dairy free and gluten free I can see how frustrated you must feel.
First question for you. Have you done a 24 hour urine collection to see how high your oxalate is? If so, how high is it? Before I make suggestions it is best I know those two answers.
After that I can help-
Jill
Hi Jill. This is a new journey. I had severe kidney stones and an e coli infection 5 yrs ago and the urologist removed with litho. In January 2016 I was back in the er and again the kidneys were full of stones. 3 surgeries, 4 stents and I have been dealing with this since January! After these last surgeries, I figure that it is more than just water consumption. My urine was clear even on the day I went to the ER. There has to be something diet related. On the other hand my urologist says that diet does not contribute. I’ve asked him several times. So I am searching and reading on my own. I will call and ask if they do a urine collection to check the oxalates. Thanks for your quick reply.
Hi Chris..have you had your parathyroids checked out? My endocrinologist says that because my blood calcium level is high that one or more of my parathyroids can be the culprit. Once the parathyroid is removed my stones should not be an issue.
Chris-
This is a journey I wish you did not have to take. Please get a 24 hour urine collection done so that you can see what is causing your stones. It could be many things. You need to do that before you ask for diet changes or blood tests. When you get that done you will be able to find out WHY you are forming them. No point in changing diets if you don’t have to, but many times that is indeed the case. The results of the urine test will show what diet changes, if any, will need to be made.
Also, do drink more water. That is something all stone formers must do in order to keep your urine less saturated with stone forming crystals.
Let us all know how it goes once you get that test ordered and the results come back-
Best to you.
Jill
I have an appt with the urologist in July. He will check the xrays and see how the stones look. Then he might have me do the 24 hr urine testing. See you all later! Thanks for all the help.
Hi Chris,
My father battles with reoccurring calcium oxalate kidney stones and has tried following a low oxalate diet since his last occurrence (needing surgery) back in 2014. He’s found it easier to stay away from his favorite high oxalate foods (chocolate, beans, potatoes, cereal) by following a low oxalate, semi-paleo diet. Obviously avoiding the big threats like spinach and rhubarb. I know it’s incredibly frustrating and difficult to make radical changes to your diet. Being dairy and gluten free, maybe you can also look into this if your stones are also calcium oxalate.
Jill, what are you thoughts on semi paleo diets for calcium stone formers?
-Meekah
Hi Meekah,
It all depends on what your 24 hour urine collections say. Meaning, it just depends if your oxalate and protein levels are really high on your test, then I would say to watch how much proteins you are eating. When the values are known from your testing, discussing what to limit and why stems from testing.
If you are not eating too much protein, then typically it is ok. If you are not eating too much high oxalate foods, then it is ok. Has your father been tested?
Jill
Hi Jill,
He has been tested, but I can’t get a hold of his urine test results. However, his stone components were tested at:
61% calcium ox monohydrate
35% calcium ox dihydrate
1% calcium phosphate (carbonate form)
1% calcium phosphate (hydroxyl form)
2% protein
another at:
50% calcium ox monohydrate
40% calcium ox dihydrate
7% calcium phosphate (hydroxyl form)
3% protein
It will be interesting to see what his urine looks like after following this diet. I’ll ask that he follows up with this.
Hi,
I am so impressed with this website! I have a question about turmeric use. A medical study done in India showed that turmeric 1 g 2x/d (with black pepper supplement to boost the absorption of the turmeric) was as effective as ibuprofen 800 mg for the treatment of knee arthritis. This has been very effective pain control for me.
I had my first episode of kidney stone in Feb /16 at age 49. It was a 9 mm calcium oxalate stone that required laser ablation and stent placement. Original CT scan only showed 1 stone. I am in the midst of the 3 month follow up and kidney ultrasound showed multiple stones on the same side as the original with the largest being 8 mm. I wonder why I have all these stones when I have been drinking more and made diet changes. I have used turmeric for about 2 years but only added the black pepper supplement around 6 months ago when I read that turmeric is poorly absorbed when taken alone. An unscientific Internet search yielded differing opinions re turmeric with some suggesting it should not be used. I stopped using it with subsequent return of knee pain. I don’t want to return to long term NSAID use due to possible consequences re renal function. I just completed my 1st 24 h urine collection while off the turmeric. Results are pending. I’m wondering if I should restart the turmeric before the 2nd collection and see the result. Any thoughts re this and turmeric?
Thank you ( sorry this is so long) .
Dear Claudia, The pepper is a possible source of oxalate, about the turmeric I do not know but your idea of testing before and after sounds worthwhile. More important, with all these new stones, what else but oxalate is wrong in the 24 hour urine?? Are your blood tests normal? Stones are rarely from one thing, but usually a compound of several. REgards, Fred Coe
Blood tests are normal. Just submitted the 2nd 24 h urine….no word re results of the 1st yet so I can’t comment re urine oxalate levels ( yet). Stone composition was 100% calcium oxalate.
I was given 3 liter containers for urine collection but my 1 st sample was 4100 ml and the 2nd was 5475 ml. Is that an unusual amt? Also, I have been adding 1/2. squeezed lemon to fizzy water ( soda stream) because I thought lemon is supposed to help. Is that correct or should I not use so much lemon? By the way…no sweetener is used.
Hi Claudia, Given a calcium oxalate stone, wait for the 24 hour urine results and see what they show before chasing after remedies. Regards, Fred Coe
Hi, I am 59 and had my first kidney stones 18 months ago, which required three operations and stents. I was laid up in bed for 3 months in pain form the stents and unable to work. I changed my diet to avoid the very high oxalate foods immediately and have been drinking 2- 3 litres of water a day, no tea or coffees. The xrays then taken after the operations showed already new crystals were formed, ( between the first and second ops ) ,much to my urologists surprise. The tests results on the stones removed showed they were calcium, but the further tests done on them showed all was normal. So I was sent for blood tests and urine tests. Again all results showed totally normal. I then had more xrays in Feb this year, and they showed that the crystals from last year are now indeed new stone – three are 1mm and one is 4 mm. My urologist is totally puzzled and all he has said is to keep drinking the 3 litres of water a day. ( which I had done anyway all along). So now I have to have more xrays in August to see if these current stones have grown further. If yes, then I have to go back to hospital for those dreadful stents and three operations. As my internal plumbing is so narrow, then I am required to have stents in for 3 months. I totally beside myself at the prospect of being so sick and bedridden for another 3 months, and cancelling work, and then another month for post recovery. I was so weak from loss of blood from the stents and in such pain for all those months. I am usually a very fit person and naturally very lean.
I do not want to spend each year now potentially having to have kidney stone ops. By the way, my grandmother had kidney stones and died from the operation. I have seen a dietician and am very careful with what I eat and my body/urine is normal and alkaline. So why am I still forming stones when all tests show all normal?
Thankyou for reading this.
Hi Denita, There is a lot unclear about your situation. What were the stones made of. What does normal mean concerning your tests? Did you look at your results and see what they show? Take a look at how prevention needs to be conducted, and be sure you are doing all you can for yourself. Given rapid regrowth prevention is rather urgent. By the way, stones do not need to be removed just because they are there. It is pain, obstruction, infection, and bleeding that drive surgery. Regards, Fred Coe
Hi all! I’m 25 years old and have just had my 3rd kidney stone (first ones started about 4 years ago). This last one required litho to break it up and flush it out, and that stent was no walk in the park. All stones have been calcium based but different types. The latest one, I believe, was oxalate. Doc gave me ‘the list’ of foods to avoid and consume. I’ve been upping my water intake and am waiting for things to go back to normal before starting blood and 24 hour urine tests. I know in the past, I have had a blood test with my calcium levels in the normal range for my age group. I’m a little worried it could be a parathyroid issue, and it’ll get overlooked if my calcium levels are normal. I’ve read that they can appear normal if the body is leaching calcium out of the bones to make up for it? I just want to cover all bases because I am so tired of all these stones. I feel like I have a lot of symptoms that come with parathyroid issues, but self-diagnosis is pointless without test results. Fingers crossed for some results that give me answers!
Hi Jacqueline, Primary hyperparathyroidism virtually always produced an elevated serum, sometimes the increase is very subtle, and sometimes ionized calcium measurements help. Always have the blood drawn fasting, and if there is a suspicion the measurements are inexpensive so many can be made. If normal all the time, the disease is not at all likely. You should have 24 hour urine testing; PHPT almost always raises urine calcium, and perhaps you simply have idiopathic hypercalciuria. It is best to follow a plan for evaluation; here is one I like. Regards, Fred Coe
Hi Jacqueline,
It sounds like you are doing a really great job of getting yourself educated about your stones. Good for you. I see your doc gave you a list of foods to avoid, but remember, we don’t know the values yet from your lab results, so that list may not apply to you.
Great job on drinking more water, no matter what the results say, you will always have to be an avid water drinker.
For now we await the results. Let us know what they say!
Jill