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.
Hi, how about whole oats, oat groats and oat milk? I love these so please say they’re safe, lol 🙂
Hi Jean,
Oats are fine. But remember, it is not only what we eat but how much of it and how many times per week ALONG with not getting enough calcium in your diet. If people only ate one handful of almonds, not ten and one spinach smoothie a week not 7, along with getting their calcium they would not have had an oxalate problem. Eat a variety of foods in normal portion size. That is the name of the game. I have so much free stuff on my site about oxalate and the kidney stone diet. Check it out at kidneystonediet.com/start
Best, Jill
I passed a couple of small stones about 12 years ago. There was some discomfort. On February 6, 2021. I began having pain in my lower left abdominal area that elevated drastically over a about a 30 minute period. My husband had me transported by ambulance to the hospital because we had no idea what was wrong. I had 2 children with no pain meds 40+ year ago…. that was entertainment in comparison to the the 2mm kidney stone that actually ruptured a tube coming out of my kidney to my bladder. I don’t want to EVER experience that kind of pain again. I’m in the process of scheduling a CT scan, blood tests, etc. through my urologist. She mentioned that she will educate me on how to “pair” foods to help me absorb calcium. This article is VERY helpful. I would appreciate any advice I can get!
Hi Regena, Sorry!!! As for oxalate, it is an abnormal passion among physicians, and only one of the reasons people form calcium oxalate stones. Here is a general plan for evaluation and how to go about prevention. See what your physicians think. Regards, Fred Coe
Rain forest herb CHANCA PIEDRA dissolves kidney & Galls stones in hours…i got rid of 12 kidney stones, i had hyperparatyroidism….this uncommon condition gives you multiple stones over time. I didnt have to pass any, as a guy… im very grateful!! Make sure you get 100% pure CP (NO Fillers)
Hi Tim, I am posting your comment and am happy for you. But I do not believe the data supporting this remedy are very good. So I cannot recommend it in general. Fred
Thanks for this valuable resource. Do you recommend a home test to check for o oxalates in urine?
Hi Paulo, There is none for home. More: Most of the time urine oxalate is not the main cause of calcium oxalate stones. Get fully evaluated, get any stones analyzed you can. Plan prevention based on cause.
As a lifelong tea drinker who’s had a kidney stone, I’m regretfully storing my boxes of Earl Grey and Darjeeling until medical science finds a way for me to imbibe them without fear. In the meantime, are herbal teas, ginger tea, tisanes, etc. fair game, or are they also high in oxalate?
Hi Bruce, Probably, but not necessarily. Keep drinking for a while and get fully evaluated using serum and 24 hour urine testing, and see if it is oxalate – very often it is not the main problem and your tea likewise. Regards, Fred Coe
I am also concerned with cadmium. Foods often contain cadmium due to uptake of soil cadmium. Combined with cadmium in older paints, (I am an artist), I wonder about the intersection of oxalate rich and cadmium rich foods. (I just suffered idiopathic kidney failure and am concerned and curious about this possible confluence.) The YNHH HSF campus kidney team is flummoxed.
Hi Patricia, I do not know about cadmium – not part of my expertise. If oxalate caused your kidney failure biopsy of the kidney would show calcium oxalate crystals, and urine oxalate would be very high. I presume this was not the case. Regards, Fred Coe
I don’t understand how oranges are bad but orange juice is OK. Can you explain?
Hi Craig,
A very common question. I will be answering that exact one tomorrow on my YouTube channel. Kidney stone diet with jill harris. Follow me so you can learn lots of things about the diet. The juice is very watered down and contains no pith. That is where the oxalate hides.
Best, Jill
Hi Jill.
Is it safe to use ORANGE marmalade for calcium oxalate stone formers?
Hi Geoffrey,
You bet. I’d be more concerned with added sugar than oxalate.
Best, Jill
Hi Jennifer !
My name is Tracy . I do not get kidney stones. However I was just diagnosed with osteopenia at age 46. I also have celiac which prevents my body from getting the most of my Nutrients absorbed. My question is do I need to be on a low oxalate diet to get the best absorption out of my calcium . Obviously with this new diagnosis I am really working hard at taking in more calcium and weight bearing exercises so that my osteopenia doesn’t turn into osteoporosis down the road.
Thank you !
Tracy
Hi Tracy, Diet oxalate does not interfere with calcium absorption except if remarkably high – like massive spinach loads, so I see no reason to restrict oxalate per se. Regards, Fred Coe
So if one has a nice peanut butter and jelly sandwich (say 6 TBS of peanut butter) how many 8oz glasses of milk would one have to drink to neutralize the oxalate?
Hi Joe, I would guess one glass would do it – along with the sandwich. Fred
I am a vegetarian and eat very little dairy
No milk and no yogurt
What is a good way to add calcium?
Broccoli can only be eaten in moderation too
Thanks
Hi Maria,
I have a new article coming to my website any minute. Make sure you look for it here:https://kidneystonediet.com/blog/
Best, Jill
Hello I am hoping the excruciating pain I had last night meant I passed the stone. I was eating almonds and huge spinach salads everyday along with pumpkin seeds, chocolate, raspberries and avocados more than not. I am so bummed but I haven’t been eating much dairy at all so I have hope now that if I eat normal I will be okay and it was the surge in spinach salads. Anyways thank you I will avoid, limit and pray!
Hi Kiersty, If you are passing stones, do not assume it is your urine oxalate. Get evaluated as to the cause and treat what is actually wrong. Here is my best on this subject. Regards, Fred Coe
What’s the difference between a “New York Bagel” and a “Plain Bagel”? I see a big difference in oxalate content.
Maybe a “New York Bagel” is what I would call an “Everything Bagel”?
Hi Kevin.
The portion. NYC bagels are huge. You can certainly have them here and there. Make sure you know how to use the oxalate list by reading the article on my site here: kidneystonediet.com/start
Best, Jill
Hi, I had multi kidney stones biggest 5mm removed from one side,a year later I have accumulated more stones in both kidneys multiplied more so than first , tested and 100% calcium oxalate awaiting another operation to remove.
I’m an ex Bariatric patient so low fat diet is a must which normally consists of veg
I just need help to just a general list of foods I can definitely eat that are oxalate free please help
Hi Julie, I gather you had a bariatric surgery and form calcium oxalate stones. There is no evidence that low oxalate diet will help prevent your stones. Here is my best on your problem. What matters is urine volume above 2.5 liter/d, low diet fat – as you have done, and high diet calcium – 1000 mg/d either as foods or supplements. Often urine citrate is low and potassium citrate is a reasonable addition 20 mEq 2 – 3 times a day. The diet oxalate has little effect on urine oxalate after surgery, which is why efforts to lower it are the least effective – see the bariatric article above. Regards, Fred Coe
You are sorely mistaken and injuring yourself by avoiding fat. It is one of the healthiest things to eat. I eat 50% fat and 50% protein and have lost over 100 pounds without surgery. You are not being informed of the most recent research on diet. I strongly suggest you look into it. NO ONE can successfully lose and maintain weight loss by limiting calories. Keto/Carnivore are the ONLY healthy and permanent weight loss options.
Thank you for this very informative article. I just ended up having a ureterscopy to remove a 9mm stone. I am currently waiting for an analysis on the stone, but I suspect it may be calcium oxalate as there were calculate oxalates crystals found in a recent urinalysis. I never want to have a stone that large ever again.
Hi Cathy, You are reading the wrong article. Here is a good introduction to how to proceed. Take a look and see if it helps. Regards, Fred Coe
Thank you, Dr. Coe. I read the article that you had suggested. It was very helpful. When I see the urologist next month I will feel prepared to ask well thought out questions.
How much oxalate is in Almond Breeze almond milk and Oatley oat milk?
I struggle to find these oxalate values and can’t tolerate regular milk.
Hi Audrey,
The word is out on exactly how many almonds are used for almond milk, but since almonds are very high we just say stay away. There are plenty of other lower oxalate non dairy milks, like rice, oat, pea, and coconut.
Best, Jill
Ms Harris is there a particular reason you feel you need to consume a milk-like product? Can you think of any species other than humans that consume any dairy product other than breast milk in infancy? There isn’t any! Refer to Dr. Ken Berry’s book “Lies My Doctor Told Me” available on Amazon. A great and informative read. Best of luck.
Hi Deborah, Having calcium based skeletons, we need diet calcium sodium controlled diets, and the same for kidney stone prevention. It is hard to find high calcium foods that also have reasonable sodium levels. Milk products are by far the best sources. That is why the US diet recommendations always favor dairy products for all of us. Calcium supplements have major problems that you probably already know about. Although this site has a special focus on stone prevention, the US guidelines are for general health and guided by a large advisory group of nutrition scientists gathered every 5 years to review the issue. With all respect to Dr Berry, there are a lot of experts, and the use of dairy products is generally viewed as important for US nutrition by virtually all. There are reasons why milk products were not needed during evolutionary time, before farming and animal husbandry, but the diets then are very different from what we now consume. Regards, Fred Coe
Good Karma Flaxmilk + Protein Unsweetened
I find it hard to avoid lots of oxalate
food, one of my downside is that I make lots of Italian recipes and most of it has tomatoes like crushed, tomatoe soup and juice etc and also some with potatoes… What is the
worst for lasagna sauce or even spaghetti sauce to avoid, and potatoes well I do lots with mash potatoes but I can’t find anything to replace the potatoes with, is the mash less oxalate when boiled and also has milk makes a different. Thanks for your time.
Sylvie,
Of course you can still have your fav dishes. This is a portion game. Get your calcium each day and don’t over eat the worst offenders and when you do have a higher oxalate food, pair it with calcium. Go to my YouTube channel for lots of free info; The kidney stone diet with jill harris
Best, jill
Hi. I have a family member (a child) with high oxalate levels. This seems like a very comprehensive and researched list of foods with labeled oxalate numbers, which I have not seen elsewhere. There is much confusion about certain food items which I was previously advised were safe, but according to this list may not be as okay as I thought.
I have been struggling to create a healthy daily menu, taking into account what a young child is willing to eat (and avoid) to lower the oxalate levels. Is there any way I can set up an appointment or meeting with someone on your team who can contact me privately to help me with this?
Thank you very much.
Hi Nicky, high urine oxalate is rare in children. Perhaps this child has one of the rare causes of high urine oxalate, and if so diet is not the treatment. It requires very special kinds of care to avoid stones and kidney damage. I would find out about this. If you want us to discuss his care privately please call my secretary at 773 702 1475. Regards, Fred Coe
Hi Jill I found your site very helpful. I suffer from Lichen Sclerosus and was told that following a Low Oxalate diet can be helpful. I was having spinach smoothies every morning and eating boiled potatoes and lots of greens thinking it was a healthy low calorie diet. But I was suffering miserably. Following a Low Oxalate diet, my symptoms are few and most of the pain has subsided. It’s not a cure, just a way to help control and live with this problem. Is there an App that I can get so I can refer to it when I am out and about to quickly check before buying or ordering food? Thank you.
Hi Jill,
Thanks for this article. I’m curious about the protein findings here. If the research mentioned above does not show a big impact on oxalate excretion at levels up to 1.6g/kg how come the Kidney Stone Diet is protein limited to the lower end of the range in this study? Am I missing something about another reason protein should be limited in stone formers. I’ve seen this .6-1.6g/kg range in a couple studies and places on this website but the dietary recommendations appear to be the lower end of range and I’m not sure why. Thanks for clarifying.
Hi Amy, In fact, the problem of diet protein in stone disease has been clarified by some recent data. Take a look. US and world health place the proper diet protein intake at between 0.8-1.2 gm/kg/day. Higher values simply cause metabolism of the extra amino acids to glucose or merely to urea as a waste product. Urine oxalate is not influenced to any major extent by diet protein. Regards, Fred Coe
I am a carnivore meaning I eat only meat (protein and fat approx. 50-50) and I have polycystic kidney disease. My nephrologist prescribed allopurinol because my urine samples showed crystals but I never developed a kidney stone so I discontinued the medication. My kidney function actually improved from 31% to 44% when I changed my diet to all animal foods, including farm eggs. Good luck to you.
Hi Deborah, PCRD is a special case, as you know. This site does not provide guidance about it. In fact, protein and fat are probably not stone risks unless the diet protein is very much above nutritional needs. Regards, Fred Coe
I just spent over 3 weeks in the hospital with a mysterious case of sudden renal failure. We were told they’ve only seen three cases like this in the last 40 years. I was given two diets to follow. First the Renal Diet Food list, second the Low Oxalate Diet. So now I have to find foods that intersect both lists. Not impossible, but not trivial either!
Hi Patricia, I suspect from your comment that the kidney failure was from high oxalate that led to crystals of calcium oxalate in your kidneys. If this is true please let me know as this is a rare and complex situation. You can email me at coe@uchicago.edu. Fred Coe
I had a small 2mm kidney stone verified by CT scan a few months ago. I was advised to eat a
low oxalate diet. The list I followed said that meat and fish were low in oxalates and I began to eat more of these but developed another small stone stone quickly. The doctor said that a plant based diet was best and that animal proteins were actually worse for me due to the bioavailability of oxalates in meat was higher than in plants. The dietician said no more than 3oz of meat/fish 3 times a week. So now I eat mostly plants and dairy and eggs. Do you agree that the bioavailability of oxalates in animal protein means that a plant based diet is best for stone formers? And the only bean I eat now is black eyed peas which are low in oxalates unlike other beans.
Hi Deborah, Muscle – meat products – do not contain any oxalate. They contain amino acids that can convert to oxalate, but modern research has made clear these contribute negligibly to oxalate production. It is true that plants are excellent protection against stones, but also true that low protein diet is not at all protective. Here is an article that tells the whole meat plant story. You will note that oxalate does not even show up. Regards, Fred Coe
This has been the best resource I have found so far. I have been instructed to be on a low oxalate diet without any real support other than a low/medium/high list. I am already vegan, so limited already. I know this is doable, I just do not have the resources I need. Oxalates don’t show up on packaging or in My Fitness Pal, so it is difficult to calculate and keep track of. I have read that the same food grown in different soil can have widely varied numbers. I almost died this summer with a 12mm stone in one ureter and a 9mm in the other blocking my flow and infected abscesses in both my kidneys. I have changed my life, my fluid intake, weight, physical activity, and cut out spinach which was a favorite. I have created two new stones since November…4mm. I am beside myself. I have got to get a better understanding of this oxalate issue. I am always hungry and unsure what to eat until I finally break down and eat something I probably shouldn’t because it is all too hard to think about.
Hi mhstreeter, Do not panic. First, physicians give out oxalate lists to almost everyone, but not everyone needs to care. Take a look. Are your stones calcium oxalate, is your 24 hour urine oxalate really high? Of the total in the huge lists, a small number of foods are very high and you can do without them – look at the graphs in the article. Finally, diet calcium is the big deal in urine oxalate – 800 to 1000 mg of diet calcium a day will lower urine oxalate a lot, whatever the diet. Be sure you have been evaluated properly, and that you need to ponder the oxalate lists with so much fervor. Regards, Fred Coe
When you refer to diet calcium, you mean from food or food & supplements?
Hi Shameer, It can be either, but ideally from food. Fred Coe
Yes, my stones were calcium oxalate (70% calcium oxalate monohydrate 20% calcium oxalate dihydrate and 10% calcium phosphate) and my 24 hour urine oxalate was high both times it was done. I have left messages for my urogynocologist and Urology asking for more help, next steps etc with no response back. If you think you can be of help, I would appreciate it. I have access to all my test results electronically, so I can provide you with whatever numbers would help you to help me.
Hi Mary, Once I begin to offer detailed help I am practicing medicine, and that requires we meet – in person or via telemedicine. If that would help you, my clinical secretary is at 773 702 1475. She can arrange things for you. Otherwise, I would be offering advice in the absence of complete knowledge of your medical situation, and could do more harm than good. Regards, Fred Coe
I recently have had a 24 hour urine test and I have elevated, calcium, calcium phosphate saturation, high ph, high uric acid, high magnesium, high phosphorus, high urea nitrogen, high protein catabolic rate, calcium/kg body weight, calcium/creatine ratio, and low calcium oxalate saturation. can you help with suggestions?
Hi Rob, Probably you have genetic hypercalciuria, but possibly this 24 hour urine was over collected.Look at the total urine creatinine/kg body weight and be sure it is within the normal range for men. That urine calcium is high /gm creatinine certainly means urine calcium is high, and that is a common kidney stone cause. But the high phosphorus and urea suggest overcollection. The other possibility is too high a protein intake by a large margin. Regards, Fred Coe
I’m going to have to choose between kidney stones and starving to death. I’m pre-diabetic and disabled so cooking and prepping vegetables is difficult. I’m already 40 lbs UNDER weight. I was trying to keep my weight up with nuts and beans because I’m not allowed much grains or sugar. I’m just going to cry now and go to bed with no dinner.
KATHY!
I work with people everyday who have both issues. I can tailor all your needs to a very doable plan. When you are ready and able go to my site so I can help: kidneystonediet.com
In the protein study you cited, you said that gelatin was used for protein loading & the control was whey protein. Whey protein is high in calcium (115-200mg in a 27-28gm serving, depending on brand). Dietary calcium binds with oxalate in the gut resulting in lower urinary oxalate. I would rate that a poor study-unusable. If there is not a better protein study with gelatin, you cannot justify your conclusions. I would be interested in knowing more about effects of various levels of protein (meat or other) on urine oxalate levels, & especially on stone formation.
Hi V, I cannot find the original comment containing the study of interest. Is is in this article – on diet oxalate? If you could identify it I would be pleased to try to respond. Fred
I found your website extremely helpful. I too was lost like the others. Didn’t know what to eat. I have an oxalate stone but was never given direction other than drink 128oz of water, can add 4oz of fresh lemon juice to 60oz of water, limit salt intake(I don’t use salt), reduce animal protein & maintain normal calcium diet of 1200. I had to do research myself to understand how to eat. I requested to join your FB and look forward to learning more.
Hi MaryAnn, Probably the best general article on the calcium, sodium story is this one. For the protein potassium story, here. For a very broad look at prevention, this is my favorite. Regards, Fred Coe
Hi, As I’m research multiple different lists of oxalate content in foods, I’m finding conflicting or no info on the following items? Can you provide any insight?
No info: quinoa, jicama, eggplant
Conficting info: raw/cooked celery, avocado, asparagus, raspberries, blackberries, strawberries, apples?!, olives, turnip, carrots, raw, all-purpose flour, cornmeal, couscous, millet, cooked, white rice flour.
Thanks in advance for your help!
Hi Kelly,
Please go to my YouTube channel to find out why we use the Harvard list- The kidney stone diet with jill harris. As stated in the article we wrote on this website, we trust the researchers from Harvard, but also we know it works bc we see the follow up urines from patients who use it and they do indeed lower their oxalate. But the oxalate issue is so much more than a list. It is getting your daily calcium requirement as well.
Best, jill
I am so interested in learning more. I am currently just finishing up treatment for breast cancer. i have been told to try to eat as healthy and clean as possible because of a high reoccurrence rate. Add to this I am producing calcium oxalate stones like they are candy. I went to urologist today to find out all these things I am doing everyday on a plant based diet limiting meats is now a no-no for low oxalate diet. I just wanted to cry when I left the office today
Hi Laura, Given calcium oxalate renal stones, people and their physicians tend to jump toward diet oxalate, but that is not the best approach. Here is a good introduction to how you might want evaluation, and how you might want to plan long term prevention. Regards, Fred Coe
This is an excellent website and I very much appreciate your willingness to discuss and answer questions and comments. I have been diagnosed with oxalate kidney stones and also have celiac disease. I was also have a stool report pointing to gut imbalance. The previous oxalate lists were impossible, this is useful. I use lots of supplements and do my best at a limited diet. One question- does an oxalate kidney stone event cause burning in the urinary tract, and if so, what to do?
Hi Doreen, a kidney stone attack can cause anything from massive pain to nothing at all. If you have stones, your physicians need to be sure about new ones. I mean, in a stone former, any new pain is worthy of at least an ultrasound to be sure obstruction is not present. Be sure you get 24 hour urine studies to determine the cause of your stones, given bowel disease it is likely not all due to oxalate. Regards, Fred Coe
Hi Fred, this relates to my previous comment/question dated 3-17-2021. The article which contains the information regarding a study using whey protein vs gelatin is found here: https://kidneystones.uchicago.edu/how-to-eat-a-low-oxalate-diet/ The article was written by jharris. If you scroll to Protein and Gelatin the study described (with conclusion) is in the second paragraph which begins with the word Jello. No other study specifics (e.g. cite) are given.
Hi V, I looked at the article – written some time ago – and found the link which unfortunately led to only the lead page of the journal, not the specific article. I am not sure of what we want to do here – jello and other sources of hydroxyproline raise oxalate production. Experimental change in diet protein does not alter urine oxalate – here is the primary research article.A recent article measured urine stone risk factors after whey protein ingestion and found no change in urine oxalate. I wrote the scientific portion of the oxalate article and it obviously needs some updating, but I hope this answers your question about jello and whey. Fred
Hi. Last spring I passed two small stones and lots of what my doctor called “gravel”. I made no dietary changes except drinking much more water and water with lemon. All was good until about a month ago. My bladder was very bloated and my urine had several small white stones(?) in it. After an ultrasound, nothing was in my kidneys or bladder. Also, my urine was fine.
How do I know what kind of stones I have if they are too small to be analyzed? What else should I be asking my doctor? And, can medications be causing stones to form?
Hi Donna, Collect what has passed and get it analyzed. If I had to guess I would suspect calcium phosphate stones, but that is a guess. No stone is too small to analyze. Medications can cause stones – your physician will know which ones relate to you. Calcium oxalate stones are not likely in your case – usually black and very small. Your physician might want to get a CT stone image, far more sensitive to stones than untrasound. Regards, Fred Coe
I noticed your lists show 4 different values for pancakes, 2 each for homemade and mix. The amount of oxalate in 4 pancakes varies from 37mg to 10mg, with homemade ranging from 22mg under breakfast items to 11 under breads. I think there must be an error here since, at least in homemade pancakes, the only standard pancake ingredients in your lists which contain oxalates are flour (17mg/cup) and milk (1mg/cup). Perhaps more information is needed here as to pancake size. Homemade pancakes can vary greatly in both pancake size and ingredient ratios but 1/4 cup of batter for a 4 inch pancake is fairly typical. If no fruit is added, my cookbook says that 1 cup flour plus 1 cup milk (plus the other very, low to no oxalate ingredients) produces about 8 of these pancakes. Thus ((17mg + 1mg) / 8) * 4 = 9mg for a 4 pancake serving. If you are using a frying pan instead of a griddle, chances are your pancakes are even smaller. A pancake containing 22mg would have to be amazingly huge and few people could eat 4 at one breakfast. I don’t see baking soda or baking powder in any of the lists, but since baking powder, at least, is likely in both recipes considered for this list, I doubt it could account for one recipe being double the other in oxalates. My guess is the typical 4 pancake breakfast, at least the homemade ones, contains somewhere in the 9 to 11 mg oxalate range assuming the listings for white flour and milk are correct. What could be in the mix that would jump the value to 37 mg for a 4 pancake serving?
Could the difference be in the types of flour used?
I have found your site very informative and appreciate all the effort you have put in in producing it.
HiTerry,
You can learn about flours here on my YouTube channel: The kidney stone diet with jill harris
And lots more there as well.
jill
Hi Terry,
We cannot speak for the discrepancy as Harvard did the studies. Could be the different types of flour used.
Best, Jill
Hi there, my son 6 years old had stones in both kedny left side was 11mm and right side was 13mm in December 2018 right side operation and April 2019 had left side but after 2 mothes of the second operation took him for check up the result was again grow up 4.5mm in the right side then the Dr (Nehprologest) started potassium sitrat tablets once a day up to naw dosen’t group still 4.6mm but I am giveing almost 1.5 liter water, juice.
Please I need your advoice for future food table
Hi Elham, Stones in a child almost always arise from high urine calcium or rare genetic causes. He needs proper evaluation with 24 hour urine testing and serum testing to be sure what is wrong, and also you need to know what the stone was made of. The rapid recurrence is worrisome and makes me think of cystinuria, or a severe increase in urine oxalate. Frankly, he should be seen at a pediatric referral center unless the answer is clear and forthcoming. At a minimum, he should be evaluated as in this introductory chapter. Regards, Fred Coe
Stone formation in a child could be a sign of Primary hyperoxalauria. Check out the Alnylam website to receive a genetic test. New medications are now available. Both my son and husband are being tested.
Hi, I have left this up as you seem to be a patient and not advertising a product. One should point out that Alnylam is only one commercial vendor, and genetic testing should be after high urine oxalate otherwise unexplained is documented. In children, the most common cause of stones is high urine calcium, high oxalate is rare. So a proper evaluation is important. Regards, Fred Coe
Where is turmeric in this article? It is reported to be many times worse.
Hi Carol, It is not good. Turmeric has considerable absorbable oxalate.This reference concluded: “Conclusions: The percentage of oxalate that was water soluble differed markedly between cinnamon (6%) and turmeric (91%), which appeared to be the primary cause of the greater urinary oxalate excretion/oxalate absorption from turmeric. The consumption of supplemental doses of turmeric, but not cinnamon, can significantly increase urinary oxalate levels, thereby increasing risk of kidney stone formation in susceptible individuals.” I would need to revise this article and add it, and have not done so as yet. Many have noted this omission. Regards, Fred
I found this info very interesting I am currently experiencing a lot of macs symptoms and have been trying a low histamine diet but ate beets and immediately had a severe headache . Could I be experiencing high oxolates? I have joint pain, muscle pain, gut pain most recently headaches I’m gluten free for last year chest pain and also throat sensitivity like it’s closing in and slight cough after eating certain foods waiting to see immunologist byt I know it will be pills which I am not in favour of taking I also experience poor sleep and wake 3 times a night I take levothyroxine .075mg and hydrochlorothiazide 25 mg
Hi Bonny, I know of no links between urine oxalate and mycobacterium avian infection. Oxalate itself has no documented effects in humans apart from crystal formation. Likewise, low oxalate diet has no proven role in human health apart from crystal formation and stone disease. Regards, Fred Coe
Throat sensitivity and coughs are your thyroid acting up, which is related to histamine sensitivity. I’ve been going through the same thing and discovered I have hypothyroidism. I highly recommend getting your thyroid tested.
I’ve dealt with misdiagnosed joint and muscle pain for over 20 years, and insomnia almost my whole life. Last year, after doing my own research, I cut way back on products that contain purine, a natural substance abundant in animal protein (including fish) and beans. My pain is maybe 10% of what it was and my sleep is much better. If I eat something really bad (like half a tuna sandwich or a burrito with beans), the pain comes back and my sleep is poor for 3 or 4 days. Initially it took two weeks before the pain noticeably diminished. It costs nothing to try and maybe it will work for you.
Hi Jake, I know of no science to account for your experience, but I have put your comment up as I do for all patient experiences. Best, Fred
I am new to all of this and I am bothered that everyone says calcium is so important. I am lactose intolerant so what do I do?
Hi Helen, diet calcium can reduce urine oxalate, but you have to put everything in perspective. What are you trying to accomplish – kind of stone, causes of the stones in your particular care. Here is my best try at a review of how to go about deciding what to do. Take a look. Regards, Fred Coe
Aged cheese has a lot of calcium and after three months of aging has pretty much no lactose. Not too hard to find cheeses aged for a year or more.
Hello – Last November I learned I had 2 stones, one 16mm and one 6mm, which were removed by PCNL this January. The stones were 30% calcium oxalate and 70% calcium phosphate. My doctor did a 24-hour urine collection which came back absolutely normal with no evidence of any metabolic conditions. Would your thought be that my stones were mainly diet related then. I would say I was on a higher protein diet with minimal dairy intake for about 2 years prior to learning about my stones. Also ate a lot of spinach, which I discontinued once I learned about my stones. My doctor just said “keep doing what you’re doing” since the 24 hr collection results were so good. Not sure what to do other than follow diet guidelines you provide.
Hi Kathy, 70% calcium phosphate means that the urine supersaturation with calcium phosphate was high enough to cause such a stone. Is it true that your 24 hour urine CaP SS is below 1?? Your urine pH must be high, too – above 6.3. Alternatively, things were different when you made the stone – pregnancy is a good start, antacids? There is always something. Regards, Fred Coe
What about black pepper? What to season with.
Hi Mary, Black pepper is high in oxalate. There are so many alternatives. Take a look at , filled with ideas, and Jill is terrific. Fred
Greetings,
I have kidney stones and a kidney problem so I am trying to be kind to my kidneys with what I eat. At the same time I have noduls in my thyroids so I am trying to avoid goitrogenic foods….
Does any one have suggestions for greens — green vegetables that I can eat that will be safe BOTH in terms of oxalate content and in terms of being nongoistrogenic?
How is dill, mint, basil or parsley in terms of oxalate content? Perhaps I can have them for my greens –eating them fresh green— instead of kale for instance that is good for oxalates but bad in terms of being goistrogenic…..
Respectfully
Hi Lale, The only way to plan a diet for kidney stones is to know why the stones form. Here is a guide as to how one can be reasonably sure. If you have reduced kidney function and stones matters are more complex but the cause of the stones is a very good place to start because some causes also affect the kidneys directly. Stones themselves may cause both kidney disease and hypertension. Regards, Fred Coe
Thank you so much
I have had an intestinal bi-pass over 40 years ago, which bi-passed my small intestine. I have calcium-oxalate stones. I went for 10 years with not needing to have a tone removed, but suddenly had to have 2 stones removed, 4 months apart. My doctor says the bi-pass is the fault, and no dieting will stop the stones. Is he correct?
Hi Barbara, Your physician is right. Bypass surgery does cause calcium oxalate stones – in part by raising urine oxalate excretion, and also other ways. There is also risk for kidney injury if urine oxalate levels are very high. You need complete 24 hour urine and serum measurements to determine your exact risks, and perhaps expert care to reduce stones and protect your kidneys. Low oxalate diet does not do much to lower urine oxalate in your condition. If you tell me where you live I can try to identify places where you can get consultative help. Regards, Fred Coe
I don’t see oatmeal on any of the lists. Is oatmeal low in oxalates? Lists are confusing because one will say bananas are medium. Your list says they are low.
Hi Josie,
My patients eat oatmeal and continue to lower their oxalate. Getting your daily calcium by foods is even more important. Oxalate values differ for various reason. Watch this video from my YouTubechannel for an even more in depth discussion: https://youtu.be/hHu5HFrUiGo
Best, Jill
I love potatoes more than anything. Surely a baked potato with a glass of milk would be fine?
Hi John, Potatoes have a lot of oxalate, but you are right (I think) that adding yogurt or sour cream, a common practice, into the potato might help. Fred
Why doesn’t the FDA put oxalate content on packaging of food? Especially since kidney stones are such a problem
Hi Phey, Good idea, likely to raise massive pushback from food producers – expensive to measure!! Fred
I don’t see much in the way of legumes in the list. Can you provide some values on oxalate content?
Hi Jennifer,
There are many beans that have not been studied by Harvard. Nobody got a stone from eating some beans. The probelm is many people overeat these healthy type of foods without any calcium in their diet. My patients eat beans within portion size and get their daily calcium. They continue to keep their oxalate low on follow up urine collections. Go to my site for your downloadable oxalate list: kidneystonediet.com/start
Best, Jill
Can you point me to any articles about dietary options for someone who must avoid both calcium oxalate and purine? I’m keeping my diet mostly in the eggs/dairy/salad arena but it’s difficult to dine outside my own kitchen.
Hi Jake,
Go to my website for so many dietary articles! kidneystonediet.com
Jill
Is urine stones caused by thyroid problems?
Hi Kelly, only from very severe thyroid overactivity or excessive thyroid hormone replacement. Fred
Are there any food ratings available that take account of calcium binding to oxalate? For example, chocolate ice cream probably rates pretty bad, becasue of the chocolate. Buth there is a large amount of clacium present also. If you take account of the cheese on a typical slice of pizza, it probably looks a lot better than if you just count the tomato sauce and the wheat crust.
Thanks!
Hi Mike, diet calcium indeed blocks oxalate absorption. Here is my best on that strategy. Regards, Fred Coe
Hi, since January 2021 all I have been doing is in and out of the ER and multiple kidney stone procedures. My Dr said I have 2 types of stones Calcium oxalate and Uric acid stones. I really do need a lot of help on what type of diet I should go on because I don’t want to go through this massive pains anymore. Each time I go to the bathroom and peed I feel like beach sands just came out of me. Thank you in advance
Hi MaryGrace, The uric acid part is causing the sand and most of the problem. Take a look. Uric acid stones / crystals are caused by overly acid urine and totally prevented by alkali to raise urine pH. Diet is useless for this – you need alkali. I a sure your physicians know about this, so perhaps you might bring it to their attention and get treated. While you wait, Crystal Light lemonade has about 20 mEq/liter of potassium alkali and is cheap and tasty – it may reduce the sand. But you really need more alkali than that. Regards, Fred Coe
Is quinoa high in oxalates?
Hi Rose,
It has not been studied, but my patients do continue to eat it in normal portion size and get their calcium needs met each day. Listen to the podcast on my YouTube channel. I did one on just this topic.https://youtu.be/EvlwRiIIg1k
Best, Jill