FOODS

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.

145 Responses to “FOODS”

  1. Suzanne Nocera

    Hello all. I’m a 60 yr old female. Last year I had 6 stones removed from my left kidney (ranging from 1mm to 9mm in size). The stone analysis report shows they are comprised of 40% calcium oxalate monohydrate, 20% calcium oxalate dihydrate, 40% calcium phosphate. When the ureteral stent was removed a week later, I was advised that my ua showed a slightly low citrate level, so just drink lemon in my water. Now, one year later, a ct scan shows 2 more stones in that same kidney! I have hypothyroidism (have taken armour thyroid for years). No other health issues. I’m perplexed as to why my body is making these stones. I’m left to do my own homework on this and would really appreciate some guidance here. The scientific information about the stones is interesting, but I really don’t understand it. Can you suggest changes I should be making in food, etc., or anything I should be looking at along with diet changes, please? Thanks much. Suzanne.

    Reply
    • Fredric Coe, MD

      Hi Suzanne, The high phosphate content of your stones means that prevention is perhaps more urgent than usual as this type recurs easily, the stones can be large, and crystals can plug kidney tubules. I doubt that your only 24 hour urine abnormality was a slight reduction of citrate, and as for lemons they have no proven role at all in treatment. I would advise an organized evaluation with serum and 24 hour urine testing, and a careful look to see what is the cause of stones so they can be prevented. The science is unavoidable, but your physicians are supposed to cope with it, not you. Here is a good article on the evaluation; here is a good general review of the topic. Regards, Fred Coe

      Reply
  2. Tim Dunlap

    I have had calcium oxalate stones four times over about 20 years, from several years to more than five years apart. They have all been all around 7mm. I don’t seem to get multiple stones, just one at a time.

    Reading your list of foods, I see I could remove some from my diet, like almonds. I had no idea. One you don’t seem to endorse, where others do, is putting lemon juice in your water? Am I correct that you don’t feel this is beneficial?

    I’ve always been interested in eating well, and try hard, but it seems everything is bad for you according to someone. I’m also concerned about cardiac health and have read Dr. Esselstyn’s book on preventing heart disease in which he promotes a vegan diet. It seems impossible to follow a vegan diet and avoid high oxalate foods. It’s all very confusing.

    Thanks,
    Tim

    Reply
    • Fredric Coe, MD

      Hi Tim, Having calcium oxalate stones does not mean that diet oxalate matters to you. You need serum and 24 hour urines to be sure what is the cause, and one treats based on what is really wrong. You are a good reader, I despise nostrums and remedies like adding lemon to water as being distractions from actual preventions that work. One needs to find the abnormalities and treat them, that is now possible and practical. Regards, Fred Coe

      Reply
  3. Josh C

    Hi,

    I’m having trouble forming an opinion on Chanca’s Piedra’s effectiveness in dissolving calcium oxalate stones.

    Although there are almost endless online testimonials of its ability to dissolve stones, occasionally I see a comment that says “you can’t dissolve calcium oxalate stones; only uric acid stones”. Yet, 80% of stones are calcium oxalate and there are hundreds of reviews saying that it absolutely does dissolve them, even if it doesn’t specifically call out calcium oxalate.

    Can you help me understand which side of the story is likely true?

    Thank you for your help.
    Josh

    Reply
    • Fredric Coe, MD

      Hi Josh, You are a good thinker. There are a lot of articles that say Chanca dissolves kidney stones but they are not scientific. Scientific is not a snobby idea but a practical one. A study to believe tests the stuff against some control with proper means for counting stones in kidneys and measuring changes in size. The readers and counters and patients all know nothing about whether they take the Chanca or a placebo. No one has done anything like that. What you read is anecdote and/or sales materials. This kind of study is how you might decide which refrigerator works better, so it is really important we get it right about a matter of our bodies. I know of nothing to dissolve calcium oxalate crystals in humans. I am willing to change my tune when I see a real study. A good criteria is PubMed; those studies are all at least acceptable science. Check out the Chanca – I did already. Regards, Fred

      Reply
  4. Lizzie Martinez

    Question. I am a nurse just diagnosed with kidney stone. I am type 2 DM, was not eating well or drinking water well, drinking a lot of caffeine coffee and tea, and diet ice tea. Diagnosed with a kidney stone. As a nurse, I reach out to many professionals in health care. One of the oncologists I work with looks at nutrition studies and practices vegan. He listens to nutritionfacts.org which is a physician who looks at all nutrition research and summarizes and for kidney stone prevention the two common themes is decreasing animal proteins and salt. ER doctor told me to stop drinking caffeine-coffee, tea and add lemon to my water as it helps to prevent kidney stones. Thirdly, I was just diagnosed with erosions in my stomach (would get upper abdomen distention, sudden nausea, and belching and epigastric tenderness, not burning-placed on protonix) had an overactive bladder and spasms and was told acid again a culprit and can coincide with acid reflex (put on uribel that improved QOL) and now two weeks later a kidney stone. Not sure if all interrelated. Thank you for any information. Trying to read and learn can be very confusing and I have cleaned up my diet. See urologist for first time tomorrow.

    Reply
  5. Lucy Gertner

    If one develops kidney stones only in one kidney and none in the other, does this imply the stones are not caused by one’s diet?

    Reply
    • Fredric Coe, MD

      Hi Lucy, No. Stones form by chance given risk – like car theft if you park in the wrong neighborhoods. So, prevention is the same. Regards, Fred Coe

      Reply
  6. CiCi

    Hi all, I’ve been dealing with awful kidney stones and mostly live in a developing country where I can’t access good medical care or do any modern testing.
    I do know, however, that my diet has been EXCEEDINGLY high in oxalates as most of those “chief offender” foods were my staple foods. I am reducing oxalates because I have had a lot of other awful symptoms which may be related as well. It’s also hot here so I’m sweating out my fluids/electrolytes as quickly as I replenish them, and I am dairy intolerant so I probably haven’t been getting enough calcium. I am also allergic to fish/shellfish and gluten intolerant (possibly celiac but we’ll never know; I can’t tolerate gluten long enough to find out), and have had low Vitamin D levels due to this (I assume).
    I’m wondering if supplements could balance me back out nutrition wise and prevent stones with sufficient electrolytes??
    I’ve also seen this enzyme which claims to break down oxalate and seems to have been very recently developed, and am wondering if you all have tried it or if you have any thoughts about whether it actually works and is safe. There was a study done (here: https://www.ncbi.nlm.nih.gov/pubmed/28322893 ) but I’m still wondering why it’s not recommended for pregnant women or children if it’s considered perfectly safe. And it is actually effective? It would be wonderful if it were! Thanks for any thoughts. I’ll be back in civilization for a visit soon, but as an overseas volunteer, I’ll want to first think really hard about spending any money on something which may or may not work.

    Reply
    • jharris

      Hi CiCi,
      It’s wonderful you are that you are volunteering your time overseas! The climate along with the dietary issues you describe are more than likely causing your stones. The first line of defense is to keep your fluids up, even more so since you are losing fluid in sweat. Use the oxalate list we give on this website and continue to lower the highest oxalate foods. Please try your best to seek out foods that have calcium in them and you can “Google” nondairy sources of calcium and see what you can do to get enough into your diet. We do indeed know about the enzyme you speak about. We can not endorse it at this time as it has only been tested in a “simulated gastric environment”. One still needs to follow a low oxalate diet when taking these. If there are further developments in the product we will inform you.
      Be well,
      Jill

      Reply
    • Fredric Coe, MD

      Hi CiCi, As my colleague mentioned oxalate treatments are all in testing phase and not actual drugs one can use. More important, you seem to be an active stone former and chose to live in a world sans testing and advanced medical care. Perhaps you could have proper testing when you come back for a break and establish what is really wrong with you. As for long term management and prevention under the conditions you mention, possibly a proper knowledge of cause will help. Right now, everything is vague and therefore unlikely to work. Your link is to a toxicity study in rats – very distant from patient care. Regards, Fred Coe

      Reply

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