Many of you will leave your doctor’s office with questions about foods and kidney stone prevention. You will go home. You will sit down at your desk and the Googling will begin. Here is a spot for you to ask me anything you like about this topic. We already have things on this site about salt, oxalate, and calcium but this space is for specific issues for anyone who comes.
FOODS
Hello,
I have reason to suspect calcium oxalate (and iron oxalate?) is depositing in my joints and skin, causing both psoriasis and psoriatic arthritis.
There is a rabbit warren of research that has led me to this but any insight you can offer would be wonderful.
My psoriasis flares (I think) with high oxalate foods. I also have hemachromatosis (high iron). I have read oxalates can also bind with iron. I’ve also read a study that showed an abnormal (high in regions) calcium gradient in skin layers for psoriasis sufferers.
Assuming my theroy is correct, I’ve found it difficult to learn how to help chrystalised oxalate to dissolve or disperse – ideally from my SI joint.
I also have a salicylate allergy. Like oxalate, salicylates are phenols. I have found supplementing with MSM to immediately ease the salicylate itching.
Does your research scope venture outside kidney stones and can you offer anything you may have stumbled on along these lines?
I also think it have the MTHFR gene mutation as these symptoms overlap with symptoms of people with this gene defect.
Thank you, Rob
Hi Rob, Unfortunately my expertise does not extend into these areas so I would be remiss offering any opinions or advice. I am sorry I cannot help more. Regards, Fred Coe
Hello Dr. Coe and Jill,
I found your resources educational and a great support to navigate my very new journey as a stone former. I am overwhelmed by the new lifestyle that I need to turn towards going forward. I found the list of high oxalate foods on Jill’s website helpful. Will it be possible for you to comment on whether certain ethnic foods (not typically part of the SAD diet) are high oxalate or not. For instance, in Indian cuisines, we use a lot of white poppy paste, something I love. I usually use about a quarter cup of poppy seed paste for my recipes. But I don’t know if it is high oxalate. Can you tell if it is safe to consume? Similarly, what is the oxalate level in foods such as paneer (Indian cheese), moringa leaves, foxnuts (aka makhana in Hindi), ivy gourd, bitter gourd, kidney beans, chickpeas, malabar spinach (different from the regular spinach we get in the US), fenugreek leaves, various kinds of lentils (moong, red lentils, black lentils, split pigeon peas)? We eat lentils everyday which is a rich source of protein. I am puzzled about whether I should consume these lentils anymore.
Finally, should one need to gradually minimize the consumption of high oxalate foods or can one stop most of these food suddenly? I have come across forums that talk about the body “dumping” as a result of switching away from high oxalate foods. Is this correct information? I would like to hear what you have to say about this.
Thank you!
Sue
Hi Sue,
Here is what we say about not knowing the oxalate in a food: https://youtu.be/5fM4hO4dA9s
And here is what is said about dumping: https://youtu.be/FoPghwt3sp8
Lots of great info on the YouTube channel!
jill
Excellent resourceful site. I am VERY grateful this exists. Along with your constant devotion of yours.
I take sachets of Potassium Citrate (32Meq). If after or before that I eat dairy (like Greek Yoghurt), will the citrate bind with the calcium in the GI tract and prevent the calcium absorption (along with the citrate)?
In other words, should I avoid eating something containing calcium in temporal proximity with receiving Potassium Citrate? If yes, how long is reasonable to wait?
Thank you, Steve.
Hi Steve, I do not think citrate will interfere with calcium absorption. But why not take the medication a bit away from meals – an hour or more – to be sure. Calcium citrate is a not uncommon calcium supplement and the calcium is absorbed, so I have little concern either way. Fred
Hello Jill,
I see peas are considered a low oxalate food on your list, what about sugar snap peas? Does the edible pod make a difference? I’m hoping not! Thanks.
Hi Bill,
Not too worried about the outer shell. Eat in normal portion size and get your calcium needs met each day.
j
So Confused! Every chart I have seen say that Pineapple Juice is very high in oxalate. I have stored due to covid maybe 40 8 oz of dole pineapple juice I was getting ready to donate to a local charity. I have been following a really low oxalate diet successfully and weight dropping, no cravings. Are you sure Pineapple Juice is Low in oxalates? Please verify it would be so helpful since I really like it ..Thank you, Gloria
Hi Gloria,
We follow the Harvard list. Get yours here: kidneystonediet.com/start
It says 8 ounce of pineapple juice is 3 of oxalate.
Watch for sugar in juice.
j
63 year old female here. A decade and a half ago I had a calcium oxalate stone retrieved from my ureter. The urologist told me NOTHING about what to do to prevent a recurrence, nor did my primary care doctor. A hypothesis I had about acyclovir contributing was never tested, as the stone was not tested for any medications despite my repeated requests. I googled a bunch, and decided that my year-long habit of having a 20+ oz cup of strong iced tea at Burger King en route to work each morning might have contributed to the stone formation. I rarely drink tea any more.
As an aging, increasingly sedentary white female, I was concerned about osteoporosis risk, and an annual screening by my employer showed I was deficient in vitamin D, so I wanted to supplement my calcium and vitamin D intake, but I surely did not want another stone. I’ve been taking calcium/magnesium citrate and vitamin D. I haven’t had any more stone symptoms, but I am curious, based on the chemistry of it all, what net effect would be expected on calcium oxalate stone formation if one takes supplemental calcium and magnesium citrate and vitamin D?
Thanks,
Rebeccah
Hi Rebeccah, We know the stone was calcium oxalate. The US analytical systems almost all use infrared spectroscopy and drug stones show up in the tracings. The tea might increase oxalate, or not. The Given the stone, I would want actual measurements, and here is my best offering on how to proceed. See if your physicians are agreeable. Sans measurements we are guessing. Regards, Fred Coe
Hi Jill, my question is this.
I’ve been told that the kidney stones that I have are calcium oxalate stones. Have had them removed 2x and am told I have more small ones forming. I am hydrating well with lemon water and acceptable herbal teas. Here’s the problem, I have a twisted colon, and since eliminating psyllium finer from my diet I am not having regular and healthy bowel movements. My belly is distended and I am experiencing the occasional explosive movements. Can I return to use psyllium if I use it in milk? I’m very concerned with this.
Thank you
Hi Donna,
I too use psyllium due to my rectal cancer and side effects from all my surgeries. Sometimes one medical condition needs to take precedent over another. I would take the husk and def take with calcium containing bef since we don’t know its oxalate level.
j
Hello Dr. Coe:
I would like to obtain the core of my calcium from drinking milk (two percent skim milk or full skim milk) during lunch (one glass) and dinner (two glasses) along with Greek Non-Fat Plain Yogurt when hungry in the afternoon or at night.
Is there something wrong with getting most of my calcium from skim milk during meals? It seems such a nice and easy way to do it but I have never seen it recommended and yet that is how all middle class American kids grew up (well maybe with whole rather than skim). THANK YOU EVER SO MUCH FOR ALL YOUR RESEARCH AND SHARING.
I had a large oxalate stone removed six months ago and am working on a comfortable health stoner diet. I had been exceeding healthy does of calcium as treatment for my osteoporosis. Based on my understanding of your generous website, I must have been or may be a patient with idiopathic hypercalciuria (IH).
I now follow rules: 3 liters of water, 1000-1200 calcium daily in a good diet that does include other calcium sources occasionally, low salt, low-moderate protein, low pure sugar, low oxalate.
Hi Susan, Be sure your diet sodium is around 1500 mg/d or the extra calcium may just raise urine calcium. Use 24 hour testing before embarking on diet change to be sure that is wrong with you. Here is a good reference. Regards, Fred Coe
Hello Dr. Coe and Jill,
I have a history of oxalate stones and recently had an appointment with a new urologist. I explained my history and mentioned that I was following a low oxalate diet. He replied that he did not recommend such a diet for his patients, because it eliminated so many healthy foods. I was pretty shocked by this answer. I don’t intend to drop the diet I’m on. But it made me wonder why a relatively young doctor (Johns Hopkins University School of Medicine (Baltimore, MD) and a residency at Northwestern Feinberg School of Medicine (Chicago, IL) Urology) would take such a position. Do these schools not go into preventative practices?
Hi David, Diet oxalate is not always important, depending on the cause of the stones. I imagine you have been properly evaluated.Perhaps your urine oxalate is normal and the emphasis lies elsewhere, urine calcium, perhaps, or citrate. Take a look at your own 24 hour urine studies and see if that is the case. Stones do have causes, however, and prevention is indeed taught at both schools you mention. Regards, Fred
What’s the thinking on potato starch (eg in vegan cheese) and oxalate?
Hi Sarah,
It would be on the higher side, but remember, portion not perfection. Go here for oxalate lists and faq’s. kidneystonediet.com/oxalate-list
Nurse Jill
This is a bit off the food topic, but do drugs to treat GERD & acid refllux (e.g.PPIs and Pepcid) contribute to stone formation?
Hi Jerry, I do not believe these drugs cause stones but can lead to kidney disease – as can stones themselves. So long term use is not advisable. Regards, Fred Coe
Your site is a great resource. Thank you for all the information. I have had calcium oxalate stones in the past and I am also developing arthritis. All of my labs show that my calcium is in a good range. My question is related to calcium carbonate which I find as an ingredient in many foods such as oat milk and also in antacids. Does Calcium Carbonate fit in the same category as calcium that should be monitored for intake to mitigate stone formation? Any thoughts on this would be very helpful. Thank you
Hi Chloe, given stones you might want to be sure your evaluation is complete. Here is my best on that. The arthritis raises questions about possible systemic causes of stone your physicians might want to consider. Calcium carbonate from antacids can cause stones, from foods, no. Regards, Fred Coe
Dr Coe – what are your thoughts on a vegetarian diet and stone formation? Additionally, I am thinking of switching from coffee to tea – any thoughts on this also?
Thank you
Chloe
Hi Chloe, tea can have oxalate in it, and veggies likewise, but if your diet is complete – dairy products – that can help. The main thing is that vegetarian diets are complex, and if you are a stone former I would advise seeking help with the plan. Jill Harris is an excellent source. Regards, Fred Coe