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 been advised to raise my potassium citrate levels. Could you please suggest the best diet for this, along with any thoughts on efficacy of supplement pills? Thank you
Hi Brian, The kidney stone diet is a good first step. If that is not enough, one can add potassium citrate pills. The secret of the diet is 5 servings of fruits and veggies daily, but that must be accompanied by a proper balance of calcium and sodium intakes as in the article. Regards, Fred Coe
My kidney stone was 7mm. It was 70% Calcium Phosphate, 20%magnesium phosphate an 10% Calcium carbonate. My urine, in the 24 hour test was acid, and the doctor said my body is releasing calcium and potassium into it. He prescribed potassium Citrate and chlorthalidone. Both are diaretics. My blood pressure is on the low side of normal. I also have collagenous collitus, which has symptoms similar to irritable bowel. I am concerned because on my first nightI took Potassium Citrate and got up to urinate 8 times. Today, My abdomen was bloated and gassy. I want to prevent kidney stones but I’m not sure I can handle the treatment. I have been strictly following the fodmap diet and the has reduced the gas and frequency of bowel movements. I will try the drugs again tomorrow. I did not take the 3d dose of potassium citrate because of my experience last night. Any advice would be much appreciated.
Hi Anne, You have a calcium phosphate stone,, yet your 24 hour urine showed an acid pH; that is not a simple matter. Calcium phosphate stones form in alkaline urine. Magnesium phosphate is unusual in stones; did the report possibly say magnesium ammonium phosphate – struvite? That would be from infection. See if you can clarify the stone type better. As for chlorthalidone, it is reasonable for increased urine calcium; potassium citrate can replace losses of potassium from the diuretic, and if your urine is acidic, it will raise the urine to a more alkaline state. It is not a diuretic. If you cannot tolerate potassium citrate, your physician can replace potassium with potassium chloride, as needed. S/He knows that, I am sure. Here is more to read about stone prevention. Regards, Fred Coe
Hello Dr. Coe,
Your Website is a blessing. I can find helpful and clear cut information on low oxalate diet. I have had 2 occurrences of kidney stone within 10 years of each other. The last one was brutal. I passed the stone each time and it was a calcium oxalate stone. Being a vegetarian it has been a difficult task weeding through appropriate foods. I also need to watch my cholesterol this can be tricky. My question: I am confused about oat bran vs rolled oats. Are they the same in oxalate content and is it safe to eat raw rolled oats that have been soaked in 2% Vit D and calcium fortified milk? Thank You
Angela
Hi Angela, Just because your stone was calcium oxalate, does not mean that low oxalate diet is what you need. If you eat enough dairy so the calcium can prevent oxalate absorption, oxalate diet is much easier. You may have other problems as well, so you need a full evaluation. Here is a good place to start reading. Regards, Fred Coe
Hi Angela, I thought I answered this but perhaps it was lost. Low oxalate diet is only important when urine oxalate is high. The stone analysis does not tell you that, you need 24 hour urine testing. Even if it is high a proper diet calcium intake will lower it a lot so the diet is easier to follow. Here is a good reference for you to consider. Be sure you have been properly evaluated before deciding on treatment. Regards, Fred Coe
Hello:
I am a stone former, 3 times in 20 yrs. The last one was 5mm and lasered out. These stones are calcium/oxalate/ phosphate type. I have for the last year been following a reasonably low oxalate diet meaning I have been diligent on what I eat. The guide on this website has been a huge help and much appreciated for sure. My question is, should I be able to consume “sprouted wheat bread” as opposed to whole grain/wheat type breads?
Thankyou very much.
Hi Ken, A low oxalate diet is certainly not a bad idea, but usually one does not have to be too picky. Here is an article about how oxalate fits into a more comprehensive approach. Given the kidney stone diet, the issue of sprouted vs whole grain becomes much less important. Regards, Fred Coe
I’ve just had surgery to remove my first kidney stone. (This site is a treasure trove of information, thank you.)
I notice the list of high-oxalate foods rates avocados “very high,” which seems to indicate they should be avoided. However, a prominent avocado website states the following in their Health & Benefits section:
“Avocados have a high potassium content that decreases urinary calcium excretion, and lowers the risk of stones forming in the kidneys.”
Is this just marketing gloss? Or does the apparent conflict have something to do with different types of stones? It’s a bit confusing, and avocados have been an important part of my diet, so any light you can shed would be terrific.
Thanks in advance!
Hi Paul,
You can absolutely eat avocados. Please read this article that also has a safe list based upon the Harvard list.https://jillharriscoaching.com/good-oxalate-list/
The article will explain the reason I released this safe list.
Best, Jill
Hi, luv your site! New uric acid former here, female 76, 107 lb, 5’5″… 70% uric acid dihydrate + 30% ammonium acid urate, orange fragments 2.7 mg, no CT Scan, no pain. Recent Dexascan -2.7 bones. Anagrelide for high platelets. High Blood pressure AM’s. What is the fastest way to raise PH (7.4 in am and 5.5 during day). Nutritionist wants me to add dairy and eggs back… went vegan 2018, not working, too fatigued. How can I sign up for counseling? Live in NV 🙁 Thank you for all you do to help others! 🙂 mm
Hi Mercedes, Given uric acid stones you need potassium citrate to raise your urine pH reliably. The ammonium acid urate component suggests possible potassium loss, or diarrhea, because these stones occur when kidneys produce excessive ammonia. Your 24 hour urine testing will show if this is the case. Diet is not a workable treatment for uric acid stones. Jill harris is a good choice for kidney stone diet counseling. She works online and has written for this site. Regards, Fred Coe
Sorry, Dr. Coe, I was cut off… Does the counseling include beyond diet since you wrote that uric acid stones do not depend on diet? I would like to see you this October for the Kidney Stone Clinic and have requested an appointment with no reply as yet. Much appreciation again for your outstanding life work! Mercedes
Hi Mercedes, I included my email below, and suggest you just write to me so I can forward to the right people here. Counseling includes whatever you need to stop making the stones. Uric acid/urate stones all can be stopped. Regards, Fred Coe
Hi, Dr. Coe,
Thanks for your reply. My urologist would not give me the second, 24 hour urine test… 1300 ml volume… Just 1, that I rec’d back yesterday PM. Gosh, I am confused… calcium 65 low, phosphorous 354.9 low, uric acid normal 376, chloride 48 low, cystine quant, ur <.31 low, creatinine 648.7 low, ammonia 11 normal, ph 6.3 normal. Notes on test said problems may be due to inadequate fluid ingestion and low urine volume and yet, the volume is listed as normal on the test result sheet. I upped water yesterday to 1000 ml bottles of spring water. Last night I was up 5 times and voided 2000 ml. I am still bloated and uncomfortable today. Does the counseling with unusual uric acid/ammonia stone productions
Hi Mercedes, I think the urine may have been under-collected given the low creatinine total. I think that given your stone type coming here is not a bad idea. We are presently short a coordinator – hiring process is slow – so just email me directly and I can forward things to the persons who are making appointments: flcoe@uchicago.edu. Warm Regards, Fred Coe
Are psyllium husks low oxalate? I can’t remember. I’ve been using them for awhile now to keep regular because bran is out of the question.
Hi Jason,
We do not have researched numbers on them, but many of my patients use psyllium husks for constipation and do continue on with low urine oxalate levels. Of course they are getting their RDA of calcium each day as well.
Best, Jill
THANK YOU…‼️
Hi; I am newly diagnosed stone former – had uteroscopy for 3 small stones in left kidney and urete a month ago. Stone composition results were 60% calcium oxalate dehydrate; 20% calcium phosphate (hydroxy- and carbonate- apatite), and 20% ammonium acid urate. Results of 2 24-hr urine tests not back yet. My question is, can the ammonium acid urate be due to Interstitial Cystitis? I can get info for the calcium oxalate stones from your site, but don’t know anything about the others. What causes these (calcium phosphate and ammonium acid urate)? And what should I be doing to get rid of them? Thanks for your help and your wonderful site.
Hi Mary, the ammonium acid urate is an unusual crystal. Your 24 hour urine data will be a lot of help. Perhaps you have an infection with an organism that is producing ammonia in excess – usually that causes struvite crystals, but perhaps it might (though I never have encountered it) produce the ammonium urate. A more common reason is potassium depletion, laxative over use, or other form of diarrhea, or possibly a lab error in the stone analysis. The COD stone and calcium phosphate crystals suggest an alkaline urine with high calcium – this will show up in the analysis. Until then, we need to wait. Regards, Fred Coe
Hey!
I am currently trying to figure out if oxalates might be triggering my restless legs syndrome… As an athlete, I log everything I eat very strictly, and have noticed that the more oxalate I get, the more my resltess legs kick in, but I can only find anecdotes on any correlation there, so I’m just trying to figure this out myself…
I am currently figuring out what to eat, and your lists have helped a lot! Thank you!! One thing I feel is unclear, is the listings for oats. Can I still buy a bag of normal oat grains, and have a 100 grams of that for breakfast?
I’m not sure I need a really low oxalate diet, but I am making an effort to stay within normal ranges, because currently I’m getting huge amounts of it, with 400 grams of beans, 200 grams of beat root, loads of dates, spinach and cerials with bran etc., every single day.
Hi Yngve,
I am not aware that oxalate can cause restless leg. However, I would be concerned with the amount of oxalate you are eating in the high amounts you are choosing. I would consider lowering it if you need to and make sure you get enough calcium. I worry about any person eating the same foods over and over in large amounts. I am an advocate of eating a variety of healthy foods in smaller amounts, no matter what your medical condition is.
Best, Jill
There is no research on RLS and oxelate intake (and very litle research on RLS in general), but a lot of anecdotes about people who have lowered oxelates and gotten better. I have followed a low oxelate diet for a few days now, and my RLS symptoms are drastically reduced, and I am actually sleeping full nights again, thankfully.
The reason for my very narrow diet, is because I train a lot, and it’s very normal for body builders and athletes to have diets like that (with meat instead of beans though, but I like beans better, mostly for ethical reasons), to hit their macro nutrient needs. It’s fully possible to eat more varied than I have, but because of the higher protein needs, it can be a bit harder than with a diet where you basically only need to think about eating because you’re hungry some times.
Anyway, thanks to the list you have provided on your website, I am now able to have som control over my oxelate intake, and it has already helped me tremendously! Thank you so much for doing that work. I will continue testing out what amount of oxelate I can handle, but I am assuming a normal amount is ok, and that the problem has been my very huge intake of them. I still have very mild RLS symptoms, but they are so mild that I can easily ignore them. The last 3 days have been my first 3 days of full night rests, in several months <3
At age 69, I found out that I had a staghorn calculus in my right renal pelvis measuring 2.8 x 3 cm.2.8 x 3.0 . I had never had a kidney stone before. Percutaneous nephrolithotripsy was performed that has reduced the calculus to 1.1 x 1.9 cm. Stone analysis showed it to be 100% dahlite apetite. Litholink 24 hr. urine collection showed hypercalciuria – Ca 24 was 347, SS CaP 1.48, ph 6.249. I am on a low sodium diet, stopped taking all calcium supplements (get my calcium from cheese and yogurt only), drink (no sugar) cranberry juice daily (to change ph) and take 12.5 mg. of chlorthalidone, I also drink mega water. Most current 24 hr. urine showed lower scored: Ca24 is 199, SS CaP is 0.76, Ph is 6.114. One concern now is to continue lowering these scores. Since giving up all calcium supplements, I can not even take a 55+ women’s multivitamin anymore, because they all contain calcium. Other plain “women’s” vitamins that don’t have calcium do still contain Vitamin D ,whose ingredient is listed as “calcium pantothenate”.–is that still a form of calcium that I need to stay away from?
Hi Janet, Your stone is a highly carbonated hydroxyapatite of the kind that will form with hypercalciuria – your urine calcium is very high – and alkaline urine pH. I suspect that your calcium supplements in the past might have contained considerable alkali and worsened things. Be sure your blood calcium is absolutely normal (below 10.1 fasting) as older people can develop primary hyperparathyroidism. Your low urine sodium and chlorthalidone have done well, and I would continue, but you need diet calcium! You have a skeleton. Be sure foods provide at least 800 mg calcium and if your urine calcium rises lower the sodium as far as possible – 1000 mg/d is not beyond reach. The problem is the remnant in your lower pole, it is apt to grow, so I would prefer to get new ultra low dose CT scans every 6 months or so to be sure. Please see what your physicians think about all this, as only they are responsible for your case. Regards, Fred Coe
First of all, thank you for the very helpful site, which explains technical issues so clearly.
Second, a comment. Having just had a stone removed and now reviewing how I can change drinking and eating habits, and having looked around the internet, I have the impression that one of the tricky issues with nutrition is how foods interact with each other once they’re being digested.
Third a question: I’m trying to figure out if Rye bread is ok? There is a particular dark bread called ‘Pumpernickel’. It’s rather nice, and it would be nice not to have to drop it.
Hi Alan,
I don’t have studied numbers on Rye bread, but surely a slice or two can fit into your 100mg/day oxalate allowance. Please think about taking the course I offer on lifestyle changes. I have helped thousands of paitients understand how to make the changes. jillharriscoaching.com
Best, Jill
Please tell me if a urologist says to avoid calcium supplements, does that also mean to avoid Vitamin D supplements, too? I keep trying to find women’s vitamins that don’t contain Vitamin D–and it’s impossible. Please advise. (I had a calcium apatite (dahlite) staghorn stone that was only partially surgically removed. ) I am 70.
Hi Janet, Why are you to avoid calcium supplements? You need 800 mg of diet calcium a day for your bones, and if food is not sufficient you need supplements. I would review what is the cause of your stones, and how you are to balance the needs for stone prevention against the needs of bone mineral preservation. One can always get both. Here is an article on that subject. But what I do not know is what kind of stones you form and what your blood and urine studies have disclosed. That is where your physician can be very helpful. Regards, Fred Coe
i should have given you more information: Last year, at age 69, I was diagnosed with having a staghorn kidney stone (my first stone ever). It was 2.8 x 3.0 cm in the right renal pelvis. I had percutaneous nephrolithotripsy, which resulted in much of it being removed, except for a residual 1.9 x 1.1 cm. remaining. Stone analysis showed the stone to be Carbonate Apatite (Dahlite) 100%. My 24 hour urine results (11/12/2018) were: Vol was 2.55, SS CaOx was 4.33,
Ca24 was 347, Ox24 was 18, Cit24 was 899, SS CaP was 1.48, pH was 6.249, SS UA was 0.23, UA was 0.458, Sodium was 97, K24 was 35, Mg was 52, P24 was 0.788, Nh4 24 was 26, Cl24 was 77, Sul24 was 34, UUN 24 was 7.46, PCR was 1.1, Ca24/kg was 7.0 and Ca24/Cr24 was 395.
I was told to stop all calcium supplements and to get my calcium from foods (800 mg.). I now get my calcium from eating yogurt, low fat cheese, and low fat milk (in my cereal) daily. I stopped all calcium supplements I had been taking. I tweaked my (fairly healthy) diet to more low salt, low sugar, lower protein , and higher calcium. My urologist prescribed 25 mg. of Chlorthalodone, although I wanted to try the least amount initially, so am cut ting them in half and taking 12.5 mg. daily. I also am now drinking 3-4 oz. of unsweetened cranberry juice daily to help my Ph to be more acidic (had been more alkaline).
I had another 24 hours urine done several months later (4/28/2019) . Results showed Vol 24 was 2.40, SS CaOx was 3.33, Ca 24 went down and was now 199 (from 347), Ox 24 was 21, Cit was 693, SS CaP was down to 0.76 (from 1.48), pH was 6.114, SS UA was 0.30, UA 24 was 0.427, Na24 was 121, K24 was 56, Mg was 24, P24 was 0.865, Nh4 24 was 26, Cl24 was 114, Sul 24 was 39, UUN24 was 6.98, Pcr was 1.0, Cr24 was 802, Cr24/kg 15.4, Ca24/kg was 3.8 (from previous score of 7.0) and Ca24/Cr24 was 248 (from previous 395).
My lab work (performed 12/24/2018) showed normal scores , including normal ranges for PTH, Intact and calcium: 9.4, PTH, Intact Parathyroid Hormone: 46, Vitamin D 25-OH: 37, TSH: 3.35., glucose: 93, Calcium: 9.4, Potassium: 4.0., Sodium: 141 (I won’t type in everything.)
My most recent labs (4/30/2019) were also in normal range except for a Carbon dioxide reading of 33 (had been 31), Glucose: 87 ( had been 93), Urea Nitrogen (BUN): 14, Creatinine: 0.61, Sodium:140, Potassium: 3.8, Chloride 99, Calcium 9.5,
I hope you can guide me and let me know if I’m on the right track. I see my urologist again in a few months and will have another KUB done to bring with me. My last KUB taken a few months ago, did not show any growth of the residual calculus. I am in excellent health otherwise, keep myself fit, weigh 117 lbs. and am 5’5″, still working part-time now as a preschool teacher. Thank you so much for all you do. Your advice means so much to me. –Janet
Hi Janet, Bravo to your urologist who is doing what I would have done given your labs. The stone arose because of high urine calcium and high urine pH and perhaps calcium supplements added as most provide an alkali load. Tell your urologist I much admire what she/he has done! Regards, Fred Coe
I recently was obstructed with a calcium oxalate stone and a CT showed multiple stones in both kidneys. I previously ate a diet very high in oxalates, but I am now trying to follow a low oxalate diet. I eat Bob’s Red Mill quick-cooking steel cut oats for breakfast every morning and find the oxalate content in the literature for oats to be anywhere from zero to very high. Do you have an opinion about the content of oxalates in oatmeal? It seems like oat breads, cereals, cookies, etc are typically low, so I’m hoping oatmeal is as well.
Thank you
Hi Jeanie,
My patients enjoy oatmeal with a calcium-containing beverage. Not a problem. Here is a great article to help:https://jillharriscoaching.com/good-oxalate-list/
Best, Jill
Hi Jill, is this where i ask questions on site please? Regards Gaye
Hi gaye, I am answering for Jill – you surely can ask here if this the area that interests you. Regards, Fred Coe
Hello,
I had a 25mm kindey stone in my right kidney removed last September, just recently did a 24 hour urine and my oxalate level was 54 so my urologist told me to start eating foods that are low in oxalates, I am having a hard time with this and was wondering if lentils are okay to eat and if Ripple pea milk is okay to drink? it is plant based. Also I use almond flour to bake with can you give me any other suggestions? Also I have an egg intolerance so I am having a hard time with breakfast ideas. Any help would be greatly appreciated!
Thank You
Hi Liz, That is a high urine oxalate, and possibly low calcium diet played a role in it. Here is a good article on that subject. Here is an article on low oxalate diet. Between them you may indeed find what you need. REgards, Fred Coe
To remove the oxalate in natural vegetation, for example beets, sweet potatoes, chard greens ect, why not grow the vegetation in glass containers and avoid using food plant with anything that has oxalates. Cause even organic compost has oxalates. And the oxalate could be coming from the plants food. However if we were to start using let’s say like soaked carrots or soaked white rice soaked in water as plant food along with maybe like himalaya salt for natural growth of the vegetation that would be a form of removing the oxalates, no? If successful, eventually have the seeds of that vegetation grown naturally in the earth’s soil. Obviously there would be other things to consider as well as factors. Including a good movement forward for plant food. I know that having more calcium intake helps the body rid it of the oxalates but then there is the factor of the emzines in milk to address. I am currently drinking soy milk to assist with this however I would like to eat naturally produce earth vegetation without the stress it currently has. What is your opinion about this?
Hi Heather, Plants make oxalate as an energy storage molecule. It is a 2 carbon fatty acid, and many plants crystallized it with calcium for optimal packing. Soy milk may have a lot of oxalate, by the way. As for you, do you have an oxalate problem? You can only tell from 24 hour urine testing. Regards, Fred Coe
I need to take a lutein & zeaxanthin supplement for my eyes. However the two that were suggested have additional ingredients. One has saffron and the other has black currant extract. Do you know if saffron and black currant extract are high oxalate? Thank you for your time, Lori
Hi LOri, I doubt the amounts of these will have significant effect on stone formation. Regards, Fred Coe
My litholink test came back all in green colors except for my PH 6.6 which was in red. How do I reduce my PH? I was taking magnesium citrate every evening because I was told it was a preventive for stones, however the litholink said citrate and bicarbonate should be avoided. I stopped taking the magnesium citrate. I also drink 1.5 liters of Fiji Water per day would that be the bicarbonate? or make my PH high?
Hi Lori, the magnesium citrate will raise urine pH and there are no reliable data to confirm that it prevents stones. You might want to step back and think if you have been properly evaluated in all ways, and if treatment has been tailored to your needs. Here is a good introduction, and here is another. Regards, Fred Coe
Dr. Coe & Jill thank you very much for your help. I have been asking you many questions because I just moved from Colorado to Southern New Jersey to take care of a loved one. I have not been able to find urologists that take Tricare. One I found would not analyze any of my stones and gave me a low oxalate sheet that was from 2002. I have read all of the literature you sent me online. I stopped the magnesium citrate and Fiji water. I did request two 24 hour urine tests as you mentioned from the urologist. In the meantime I have reduced my sodium and sugar consumption. I drink 3-3.5 liters a day of water. Is that too much? Would the crystal light lemonade be helpful to me? Is chamomile tea ok? I drink a cup every night. I never counted coffee in it and now I do. Also I added a small glass of OJ and a glass of milk to it. I read you can also have 5 ounce of wine so on some days I have it. I wish I lived in your area, I would love to have you as my doctor!
Hi Lori, You just cannot prevent stones without 24 hour urine and serum testing, and stone analyses. I would pursue physicians until I found someone to do both for you. Anything less will be an exercise in confusion. Right now you cannot order testing yourself. Regards, Fred Coe
I was wondering if there is a menu that I could follow, my stones are Calcium /oxalate and I am so confused on what to eat
Hi Rhonda,
You might want to think about joining the online course I offer. It makes sense you are confused with all the conflicting info we find on the internet. Go to my website at kidneystonediet.com. It takes time to figure this out but you will be thankful you did.
Best, Jill
I like to be sure I am including GREENS In my diet. I have had an occasion with Kidney Stone. I understand that “Hemp Powder” derived from (Hemp oil), runs high with oxalate however there are many other enticing benefits apart from the Classic “high”. Can I sprinkle Hemp Powder on my salads which also include yogurt as dressing?
Hi Jay.
Portion is always key. Have a bit of hemp, and with calcium food or beverage. There are other greens like kale that are fine to eat.
Best, Jill
1. In the food list it has Olive Oil & Vinegar but no serving size. Can you give that?
2.Stevia Sweetner 1 tsp Very High 42 mg. Is this the only sweetener to be concerned with? Does Monk Fruit sweetener go in the Artificial Sweetener 1 packet, very low 1 mg ?
3. I thought I was doing great with not having any stone issues in 4 years..But to my dismay, I have two large and numerous ones in each kidney. I am having laser treatment on Tuesday to get the one stuck in my tube and if possible, hit the large one behind it. If that cant be accomplished, the lithotripsy yet again! Can you make a special diet for me? I need No oxylates to under 50 a day, Keto friendly and careful with the Vitamin K due to Factor V (not on blood thinner)? Thank you for your time.
Waiting to hear if someone can help. I think Peggy and I were separated at birth. I have Leidens factor V (although now on low dose Eliquis– way better than Coumadin, Keto for 2 years.
Jill, I also have Diabetes Type 2. Friends have told me that I should try Juice 2 Pills to help combat Diabetes. Do you know anything about these pills and whether they ‘d have an impact on Oxolate and sodium intake?
Thanks
Hi Bob,
I am not a fan of pills of any sort when you can be eating wonderful fruits and veggies. Fruits that are high in fiber so as to control blood sugar are better than fruits without fiber, like grapes. I do not know the oxalate level of those pills and the sodium would be listed on the label I would think. The extra nutrients and fiber you get from food are much better for you and your Type 2 diabetes!
Thanks for writing, Jill
My stone composition is a mixture of calcium phosphate and calcium oxalate monohydrrate what is best supplyment to take.
Hi Liz, A reasonable but ideal question. You need 24 hour urine and fasting serum measurements to find out why you make these stones, and treatment directed against those abnormalities. Supplements taken at random are probably all worse than nothing. Here is a good article on treatment of the common stone. Here is a general introduction to stone prevention. Regards, Fred Coe
Do you have a newsletter or any other info that you send by email? I would like to be on your mailing list for what to what to eat and avoid if I am told that I need to avoid oxalates. I am exhausted trying to do research!! Doctors in Bakersfield are NO help and are over worked and dont seem to care. Thank you! 661 330 9390 debbieb0709@att.net
Hi Debbie,
We both send newsletters. You can sign up at the homepage of this site and I have a site too that you will find helpful here: kidneystonediet.com
Best, Jill
I live in south-central Pennsylvania. Are there any doctors or urologists in my area that use your approach to kidney stones? Or is it possible to see a physician at your location?
I’m very intrigued by the use of potassium citrate. I spoke to my primary care physician about it and she didn’t have a lot of information about it.
Hi Paul, U Penn in Philadelphia is a good place and your best bet. Regards, Fred
My special needs son has to be put on a low oxalate diet. He has Tuberous Sclerosis and some renal stone issues. He can only eat pureed food. I see conflicting designations for the following three vegetables. Can you clarify if low, medium or high oxalate for these three foods? (1) Pumpkin (already pureed-used for filling in a pumpkin pie). (2) Sliced white potatoes in a can (which will be pureed). (3) Baby food squash (orange color) in a jar. Thank you.
Hi Joe,
Harvard did not study these three particular foods that you inquire about. Other sources have said that pumpkin is on the lower side. I would assume that the potatoes are high and the squash would be ok. My patients eat both pumpkin and squash and do lower their oxalate levels, but more importantly, they are also getting their recommended calcium requirement met each day.
Best, Jill
Is Kidney COP Calcium Oxalate Protector effective?
Hi Paul,
Look at the label. It doesn’t save you from dietary changes, as it says you still must do that. It can be helpful if you have lower citrate. If not, not helpful to you. Doing a urine collection will let you know. Read this on potions and pills-https://kidneystonediet.com/kidney-stone-supplements-potions-and-pills/
Best, Jill
Hello – After being diagnosed with kidney stones and with a urine oxalate score of 128 (my dr said he has never seen such a high score) I was told to go online to reduce foods with high oxalate which led me here. I am already on a very limited diet for inflammation that I started in September which took out dairy, grains, beans, and sugar so what I was left with is a lot of foods apparently high in oxalate. I found the Harvard list and your safe list but just wondering why for instance on the Harvard list avocado is listed as very high oxalate value but on the safe list (as with some other foods like sweet potatoes) – is not all oxalate the same? Is that why some foods that are considered high on the Harvard list are still ok to eat? Thank you for your reply!
Hi Kim,
Please read the article that goes with the safe list. It explains why I made the safe list and how the original Harvard list can be confusing for patients because of the descriptors. Avocado is listed as “high” on the original list but it is on the “safe” list because if you are allowed to eat 100 mg/ox per day then 19mg of oxalate for a whole avocado is certainly within your daily limits. Getting your calcium needs met is even more important than the oxalate portion of this diet. I have seen many patients with your high oxalate level and it can be easily gotten down to lower than 30 when you implement all the aspects of the kidney stone diet.
Best, Jill
Thank you, that makes sense now. I didn’t get the 100 mg per day part. I missed reading that somehow. I will go back and re-read. I think I will keep a journal so I know I am staying within the 100 mark per day. With a score so high do I need to be below 100 or is 100 still ok? Thank you for your encouragement that you have had patients bring their levels down with these diet changes. I felt very discouraged after my call with the dr today. Especially, because I am already on such a limited diet with my inflammation issues, I didn’t know what else to eat. Thank you so much for providing this information for people! It is a blessing!
Hi Kim,
Think about taking my online course. It has helped many patients understand how to implement the Kidney Stone Diet. Right now I have temporarily slashed the price to help during the Covid-19 virus. kidneystonediet.com/course
If your doc has not advised otherwise, 100mg/oxalate should be fine, but remember. Getting your calcium is KEY in lowering oxalate-
Best, Jill
Hi Kim,
I understand how overwhelming and frustrating this all can be. Esp when you have other dietary restrictions. Getting your daily calcium is very important. Stay under 100. Most of my patients have no problem doing that.
Best, Jill
Hi Dr Coe. I hope you and your family are well.
I am trying to compile a list of high potassium, low oxalate foods. I am especially interested in breakfast foods, but frankly ANY assistance in this area would be helpful.
Thanks so much.
Hi Pamela,
You can get your potassium needs met by getting your share of low oxalate fruits and veggies. Check out the safe oxalate list I put together from the original Harvard list to show patients that there is plenty to eat.
Best, Jill
Hello,
I have a history of kidney stones. A couple of questions came up while looking at the Harvard list of oxalate content in foods, but I didn’t see a way to ask questions there and I’m hoping you can help.
First is about beans – I eat a lot of black beans and pinto beans, as indicated for my blood type, but neither made the Harvard list. Should I assume all beans are high in oxalate, or do you have access to specific information about those varieties? Secondly, does the oxalate content of nuts change with cooking/baking them? I’m primarily wondering about almonds, which I eat regularly.
Thank you,
Erik
Hi Erik, So sorry your comment got buried by a page change!! Beans are not much of an oxalate load. As for nuts, oxalate is impervious to baking, so unless you boil them to elute out the oxalate it will be there. ALmonds toasted are almonds. Regards, and apologies, Fred Coe
Hello, my kidney stone test reported finding my stone as carbonate appatite at 100%
my urologist was not sure if this is a calcium stone or not. Can you please send me any help or information on what type of stone this is? They report that I have 20-50 of them in both kidneys from my CT Scan. I am determined to resolve this health issue. Yet, I do not know if I should be moderating calcium or what other foods can cause such a drastic problem (that suddenly showed up). Thank you so much.
Hi Dee, I answered your question under Kidney Stone Analysis. Diet change needs to be properly guided by a diagnosis. Take a look at my other answer to you. Fred
I have been treated for hypOtension with increased sodium and now recommended low salt since I had a large kidney stone. How can these two diets be reconciled.
Hi Virginia,
Are there other reasons you have formed the stone? Have you had a 24 hour urine collection to see what your problem is?
Let me know,
Jill
I checked out the recipe for the bread and all of the ingredients are good except for the nuts as they are both high in oxalates. I assume you can use a lower oxalate nut in the recipe to decrease the amount of oxalates for the kidney stone formers out there.
Hi Katherine,
Your kitchen, your rules. Of course.
Jill
Hi Jill
Thanks for your very informative site. Candidly, I am so frustrated that I cannot find at your site or anyone’s who acknowledges and addresses in the DAIRY category what people who can’t have dairy are to do regarding getting enough calcium since many of the veggies are off the list or one has to be very wary. Can you please include us diary intolerant people and list foods that are low oxalate and high in calcium so we have some guidance please????? Thank you! Karla
Hi Karla,
On my website, I give all kinds of non dairy substitutions for calcium. kidneystonediet.com/calcium Also, most veggies are not off the list. Think of going to my FB page that gives tons of free info. Find it on FB at the kidney stone diet.
Jill
Jill…i have been told there are turmeric/curcurim extracts/capsules on the market with most of the Oxalates removed. I cant find any…do you know of some.
Had my ” stones” lasered out but want turmeric for other issues…
Thank you
Hi Tom,
I know of no such product.
j
Hello, can you please give me a definitive answer as to which is higher in oxalate…tempeh or tofu? The tofu info generally states that packed in magnesium is lower, but none I can find is packed solely in magnesium. Also confused about the miso information. Miso is generally a past which you can add to water to make a soup. The lists state a cup of miso…do they mean a cup of the soup? Is a tablespoon of miso safe? A different site states both miso and miso soup separately with the latter having more oxalate than the first which makes no sense to me. Can you please help clear this up for me? Thank you, Sheila
Hi Sheila,
Read this to learn not only about the lists but how to use them:https://kidneystonediet.com/good-oxalate-list/
jill
I have severe osteoporosis and take 600 mg of calcium citrate twice a day. I try to take the supplement in between meals so no food will bind to the calcium and block absorption. How much time has to pass if I eat foods that have oxalates or legumes( phytic acid) in order not to block the calcium? I am not worried about kidney stones just the osteoporosis.
Hi Joseph, In the best trial of calcium supplements for bone, they were given with meals. I would do it that way. Fred
The problem with that is that many foods bind with calcium and prevent it from being absorbed. Calcium citrate can be taken either with or without food. I have been taking calcium with food for 10 years but it doesn’t help. That is why I changed now to taking it in between meals. If someone knows how much time the oxalates or phytates take to pass through the intestine that would be great.
Hi Joseph, We have one trial, in women near menopause, in which diets were high and low calcium and sodium – 4 in all – each woman ate for about 8 weeks whereupon total calcium balance was measured. Taking calcium as calcium carbonate with food + low diet sodium gave positive bone calcium balance, so calcium was absorbed and retained. With high sodium it was absorbed but less well retained because of kidney losses. So at least one calcium form taken with meals was absorbed well, and foods binding not a problem. In many other balance studies over a century, calcium taken in meals, part of food itself, is always absorbed. So food per se does not importantly hinder absorption of food calcium. Calcium citrate is odd because of the special binding of calcium by citrate. Fred
I have a question I hope someone can answer (unable to find ANY answers via a web search).
My question: Do flavored extracts contain any oxalates….very specifically Chocolate extract….but other fruit extracts as well ?
Any data offered would be greatly appreciated ! Thanks !
Hi Rob,
Extracts do not have oxalate.
Jill
Jill,
Thanks for your kind reply……really appreciate that, because I could find absolutely NO answers anywhere….thanks soooo much ! One last request : per chance could you provide me with a link(s) that would discuss the research and findings ? I would really love to see how they came to that conclusion. Thanks ! rob
Hi Jill and Dr. Coe,
My son Alex (Jill was a blessing for him on their call together) has been on Potassium Citrate for a little over 3 weeks.
He’s on a number of supplements (Multivitamin, K2, Zinc, D3, Magnesium Glycinate) – could any of these interfere with the Potassium and cause an interaction? He has been getting a little itchy on the bottom of his feet (though that could be unrelated). The Multi does have a small amount of Potassium Iodine in it (80mcg).
Thank you so much!!
Hi Sherry, I know of no reason why potassium citrate would interact with the medications and supplements you mention, nor cause his symptoms. Regards, Fred Coe
Thank you so very much! Too much conflicting information has made me extremely frustrated.
My reason for seeking a low oxalate diet is not related to kidney stones, which thankfully I have never had. I do however have a problem with systemic Candida overgrowth. I recently saw a practitioner who had me obtain a urine Organic Acids Test. The reference range for Arabinose, which is the fungal marker for Candida is <29 mmole/mol creatinine. My value was 58. The range for oxalic acid is 6.8-101 mmole/mol creatinine. My value was 167.
I was instructed to reduce my consumption of oxalates, as they were feeding the yeast, and immediately start on Nystatin, which I took for thrush I developed the last time I took an antibiotic.
This oxalate value is not surprising. Each week I pick up fresh food from a local organic farm. Winter foods are my favorites. My diet has consisted of spinach, collard, turnip, radish, and swiss chard greens, along with the radish and turnip roots, lettuces, sweet potatoes, apples with peanut butter or almond butter, brown rice, miso soup, lots of nuts and seeds and the occasional bite of chocolate. Basically everything I eat is high in oxalates.
My question is about soluble and insoluble oxalates. I think insoluble oxalates are the problem for kidney stone formers if I understood correctly. I think my problem may be with the soluble oxalates. My question is, how do I “tweak” the recommendations for my problem or is that even necessary?
Thank you for such an informative site. You are a “researcher’s” delight.
Any advice or insight you can give me would be greatly appreciated.
Hi Sandra, The most recent PubMed article I could find about vulvar inflammation all causes and oxalate was very negative about the association. A search for candida infection and oxalate got one paper. Of about 200 cases of inflammation and symptoms it refers to 14 cases treated with reduced oxalate diet + potassium citrate of which 2 improved. I hate to be negative but published data I could find do not support any important links between urine oxalate and candida infection or its treatments. Regards, Fred Coe
Hello everyone.
I’ve recently been diagnosed with a kidney stone. The issue I’m having is that the type of kidney stone I have(or had if it’s passed) is unknown. I’ve definitively been that person sitting in front of my computer searching every website and post I could find regarding foods and kidney stones. Which foods to eat? Which foods to stay away from? I’m confused because there’s so much conflicting information as to what the do’s and don’ts are. It’s twice as confusing for me, because I have no idea which type of stone I have. Do you have any advice on a “general” diet, which is beneficial, and safe for “all” types of stones?
Hi Tashia, To know the diet you need to know how the stone formed. It is a pity you could not find out the composition, but a full evaluation is not difficult and will tell you a lot about prevention. Take a look. Do not try to treat the stones with diet until you know what is causing them. Regards, Fred Coe
Hello. I am currently trying to follow 3 diets simultaneously. I have Celiac’s disease, Barrett’s Esophagus and now I have kidney stones. So my gluten free diet kept me at a healthy weight and I don’t eat anything that may cause reflux. My menu is already quite limited and now many of my staples cause stones. I make most of my meals from scratch so I know exactly what I’m ingesting. I make banana oat muffins with a few chocolate chips every week. I put in peanut butter, milk, applesauce and an egg. They have been my go-to for so long and it’s about the only I enjoy each day. I usually laugh and say I eat to survive and not enjoyment. I’m very unclear if gf whole grain oats are high in oxalates because your list says oatmeal is low but that whole grains are moderate to high. Can you clarify so I can continue to enjoy my breakfasts without worrying? Thanks
Hi Karen,
I help many patients put all their different diets together. It can be very daunting. I find that they limit themselves too much on the oxalate part. Come to my site for all kinds of free stuff that could help you: kidneystonediet.com/help
jill
This site is a great resource. I’m 39 male and just passed a stone. I don’t ever want to do that again so trying to take some steps to change diet… likely cause was a previous diet of spinach and nuts, everyday and in large quantities, and very little water.
I’m struggling to find protein for muscle building (I need to eat like 170-200g per day) on a low oxalate diet. Can you comment on the following:
Steel cut oatmeal with yougurt (I saw your previous post, so this seems ok)
Red lentil pasta (some sites say no lentils, others say ok if boiled (pasta is boiled), others say red but not white) – pls help!
Whey protein powder (~50g per day) – I’d mix with milk (no longer almond milk) and strawberry/bananas.
Thank you!
Hi Mark, Diet surely matters, but so does genetic factors, so be sure and get fully evaluated to find out why you made stones. The safest approach with additives such as you mention is to get an initial set of two 24 hour urines for baseline and then another after a month or two on the supplements(s) of choice looking at all stone risk factors. What you describe does not sound so safe. Whey powder protein can raise urine calcium and stone risk. Likewise for all other very high protein loads, so you may have to offset those risks with fluids, or reduced diet sodium. This is to say that what you want needs physician input and testing- guessing can lead you into more stones. Regards, Fred Coe
I am lost in this sea of information!!!! I am an oxilate kidney stone producer and lately my diet has been on a huge overhaul which makes getting enough food based calcium tricky…..Is there a particular calcium supplement that you recommend to increase my calcium intake? I am already taking indapamide with potassium and would love to add an appropriate calcium supplement to ensure I am getting enough.
Hi Danielle, I presume your physicians diagnosed high urine calcium as a cause of your stones and gave you these medications to lower it. Diet calcium should be 800 mg/d or more for your bones and to keep urine oxalate lower, and best from foods not supplements. Here is a good article on how to get a high calcium lowish sodium diet put together. Supplements are a second best, and need to be taken with meals. Regards, Fred Coe
Can you explain why cornmeal is high in oxalates and corn flour is not? Corn flour is cornmeal that is ground much finer. If anything, corn flour would contain more corn per volume and, therefore, be higher in oxalates.
Hi Marianna,
It is the concentration of the product that makes the difference.
Jill
That makes no sense at all. Fine-ground corn meal would be more concentrated than coarse corn meal, wouldn’t it?
Hi Kate,
It would one would think.
j
I’m poised to purchase corn flour and got stuck on this very question. The brand of organic corn flour I’m looking at says “whole grain” and “stone ground”, so of course it occurs to me that it may contain the same amount of oxalate as corn meal. And as is pointed out in this thread, one would think the finer the grind, the greater the concentration of oxalate. Is it possible to elaborate on why, or what kind of corn flour, is okay for a low-oxalate diet? Thank you!
Hi Andrea,
My experience has always guided my advice. Have your corn flour, watch portion, and get your calcium needs met. When you do your 24 hour urine collection you will see your oxalate will be just fine. Unless of course you have other issues other than what you are eating that could increase your urine oxalate.
j
Hi Andrea,
It doesn’t mean you can never have corn flour. You can eat most foods within portion size. The bigger issue is getting your daily calcium needs met. Make sure you do!
j
What is a high calcium plant based food to take at meal times to bind with the food’s oxalate and reduce the occurrence of CaOx stones?
Hi Al, the most reliable diet calcium sources are milk and other dairy products. Plants with a lot of calcium often have a lot of oxalate. Regards, Fred Coe
Thanks for the help, age 74, weight 235, 5’8, uric acid in blood mnormal. Stone was 80% uric 20% calcium. Doctors are VA Miami. i was taking Himalaya Boswellia for shoulder pain and movement. Please tell me i can start taking it again. VA Docs say its high in oxalate, Google won’t confirm.
Sincerely,
John
Hi John, Your main stone component is uric acid, not calcium oxalate, and uric acid forms when urine is too acid. Older age lowers urine pH – complex matter – and potassium citrate 10 mEq 2 tabs three times a day will raise urine pH and end your stone problem. Feel free to get the 60 mEq of alkali in any othr way you wish – Crystal light lemonade gives 20 mEq/liter, and there are a lot of OTC products but with much lower amounts of alkali per pill. The calcium oxalate crystals are probably being fostered by uric acid crystals and may well not come back. As for the stuff for your shoulder, I see no relation to stones. Regards, Fred Coe
I’m a 33-year-old female recently diagnosed with my first kidney stone (2 mm, no pain – it’s still in my kidney). I suspect this was caused by not staying hydrated, as well as possibly following a keto diet for the past few months. Since my diagnosis I have cut out regular coffee, drink 10-12 glasses of water daily, limit sodium to 1500mg or less, watch my animal protein intake, and avoid high-oxalate foods or pair them with dairy. Is there a way I can safely continue the keto diet (or at least for another 4-6 months)? If so, what should my daily protein intake be? I’m 5’1 and 145lbs and I’d like to lose 15-20 lbs.
Thank you for the wealth of information on this website – It’s very helpful!
Krista
Hi Krista, you pose a difficult issue. Given a stone and a desire to continue on an extreme diet, if you were my responsibility I would recommend 24 hour urine testing to determine what stone forming risks were present, and try to offset them despite the diet. Perhaps your physicians might want to try this as a way to mitigate risk of more stones. Regards, Fred Coe
I am 63 and was found to have microscopic hematuria and calcium oxalates crystals on two UAs, and two small stones on a CT. I was consuming a high oxalates diet, reduced my oxalate intake, and increased my fluid intake. My next UA showed no blood and no calcium oxalate crystals. Thereafter, the Litholink 24 hour urine oxalate level was 98, SS CaOx 10.04, and calcium 271. Would you recommend further evaluation for the high oxalate level, and if so, by whom? Would you recommend a more strict reduction in oxalate intake?
Thank you for your response.
Paul Olson
Hi Paul, If the 98 mg/d of oxalate was on a less oxalate loaded diet, I would have concerns for over production of oxalate. First I would repeat the 24 hour urine with care about oxalate intake; if high values persist the easiest route is genetic testing for one of the three primary hyperoxaluria conditions. I am sorry I have not written an article on this, but your physicians can order such testing. If the oxalate falls to more manageable levels, certainly well below 80 I would work with diet. Be careful about vitamin C which can convert to oxalate both as an artifact in the urine collection and also as a substrate for liver oxalate production. Regards, Fred Coe
Hello!
I would like to know if foods that are high in oxalate but also contain calcium such as spinach, almonds or sesame could be considered a little less harmful than others which don’t have this mineral. Eating them with other calcium-rich food would be advisable but, shouldn’t we count their calcium content too?
Thank you!
Hi Barbara,
The amount of oxalate in those foods is just too high. Better off without them and use your calcium needs for higher, but not highest oxalate foods.
Jill