This is the first of what may become a series of articles done as videos.
The site is now a reasonably complete knowledge base but many of the ideas are hard to get and there is a lack of overview materials that are integrative.
That is what I plan for these video articles to do.
This first one tells about how crystals form and how they form specifically in kidneys to create stones and nephrocalcinosis.
It draws upon many of the articles as a base and pulls them together into one narrative.
It also adds materials not found anywhere else on the site because best presented in a video format.
Please let me know what you think.
Regards, Fred Coe
Further Reading:
Organic Materials that Coat Crystals
Idiopathic Hypercalciuria – Another review of the nephron
Control of Urine Oxalate – Yet another view of the nephron
54 Responses to “Video Article: How Stones Form”
Ben Rosen
Hello , I just had another kidney Stone attack recently and had to go to emergency room. I hate kidney stones . It was a Oxloate stone . Have you heard anything about Chanca Piedra Tea ? It’s advertised as a stone breaking tea . Any thoughts?
Fredric L Coe, MD
Hi Ben, Chanca.. is most likely useless for stone prevention. I began some scholarship about it years ago and frankly dropped it for boredom. I should go back and write it up. If you have so many stones, a proper evaluation is SO important and treatment aimed at cause. I see you have 6 other comments on this site (the software does not let me review them – a big defect). If you have not considered this chapter, please consider it as a way forward. I am sad that someone who has been here is not more free of stones, and would like to do better. Best, Fred
Ben Rosen
Hello , thank you for your positive and information. Im just seeing this now . For some reason. My nephrologist had me do double 24 hour urine test . Wants me to lower my salt . Also non stop drinking water with crystal light . Also him and my endocrinologist put me on a medication jardians which will help me pee more often . He said Chanca there’s not enough of evidence . But he said I can try in small doses .
Fredric L Coe, MD
Hi Ben, I presume your urine calcium is high and sodium, as well. Jardiance (empagliflozin) is an inhibitor of kidney cell glucose reabsorption and used for heart failure, diabetes, and kidney disease. I do not know of a role in kidney stone prevention. I assume you have some one of these other reasons for using it. As for Chanca, there is no evidence for effectiveness. Regards, Fred Coe
Ben Rosen
Hello , I have lower level order line diabetic that is well managed along with other stuff like Hashimotos and primary ciliary dyskinesia. Never a dull moment . They said that for sugar purposes I don’t really need Jardiance. But they felt that it would cause me pee more also check out this article :
https://www.diabetesselfmanagement.com/news-research/2022/06/27/jardiance-linked-to-lower-kidney-stone-risk-in-type-2/
Fredric Coe, MD
Hi Ben, The drug is an inhibitor of the glucose transporters in the proximal tubule of the kidney and can lower blood glucose, help manage hypertension and perhaps protect against kidney disease progression. The article you quote is a fragment and too small for use. Quite possibly the drug may help with stones, but I cannot recommend it presently. Regards, Fred Coe
Ben Rosen
Ugh . Just had another kidney stone had to got to the emergency room last Saturday into Sunday . The pain was so bad . Lucky the the iv with fluids and pain meds helped . By Tuesday my stone finally passed .
My stone was Calcium Oxalate Dihydrate (Weddellite) 20%
Calcium Oxalate Monohydrate (Whewellite) 80% . It’s weight was 0.050 and about 6 mm. I hate these things . What do you think about chanca piedra to help stones ?
Fredric L Coe, MD
Hi Ben, There is a lot to do for prevention. Here is my best on the topic by way of an introduction. See if it works for you. Regards, Fred Coe
Laura
Very interesting! I suffered with over 50 kidney stones. I had to get rushed to a different state to get them pulled out one by one. After they were done they put a stent in each kidney. Just recently I recovered from sepsis and two months before that I had sepsis shock. After I recovered then they had to remove five more kidney stones. The kidney stone had ripped me internally and caused a blood infection which gave me sepsis. I just don’t understand how they don’t have medicine or some thing for this. My diet is fine except for my calcium and potassium is low. I am understanding how the process works but there has to be something that can be done. Very painful!!!! With having sepsis and a kidney stone I don’t even remember being in the ICU. Doctors aren’t telling me much But at least they are removing them
Fredric L Coe, MD
Dear Laura, you need to prevent more stones, and here is my best on that. The recurrent sepsis is very worrying, and suggests that your surgery must be unusually complicated. Regards, Fred Coe
Marv
Thank you! This video was exactly what I was looking for! I loved it and how you explained everything. I passed my 3rd crystal today and need to learn about prevention. How much is about diet snd how much about other factors?
I really like your style doc!
Marv
Fredric L Coe, MD
Hi Marv, I am glad it worked for you. Best, Fred
KJ
It appears to be the video link is broken.
Fredric L Coe
Hi KJ, Thanks. I will go in and figure out what went wrong. Fred
G Mead
Yes, I would like to see the video too. Thanks!
Fredric L Coe
Hi G Mead, I fixed the link and the video runs fine. I hope you like it. Fred
Ben Rosen
I just recently had a uric acid and uric acid dehyhdrate stone . I have also had calcium oxolate and calcium phosphate. Is this normal to have three types ?
Ben Rosen
I also have a citrate deficiency.
Fredric Coe, MD
Hi Ben, That is a common example of a stone forming trait. The same alkali that will prevent uric acid stones usually will raise the urine citrate. Regards, Fred Coe
Fredric Coe, MD
Hi Ben, Uric acid stones arise from an overly acidic urine pH and are corrected by raising that pH with alkali. Here is the article you want. The other stones have other causes, and the way to find them is via 24 hour urine testing. I would pursue this. Yes, all three crystal types can be formed by one person. Regards, Fred Coe
Nimesh
Dear Sir,
My wife had gone to gynecologist for the check and as per the report , TSH was 2.86 uIU/ml (Range : 0.2-4.2). The doctor prescribed her Tab Loette, Tab Melmet SR 500, Myocyst Sachet, Tab Esmocim 40 mg and Syp Lucid 2 TSF. After 1 year when she again check the TSH it was 5.750 uIU/ml (0.465-4.68), FT3 was 4.09 pg/ml (Range: 2.7-5.2) and FT4 was 1.29 ng/dL (Range: 0.78-2.19). The test for latter was done through ECLIA method. I am very tensed with the latter report. How can the TSH increase just in the span of 1 year.
Could you please tell me if the TSH could be reduced or bring it in normal range naturally .
Regards
Nimesh
Fredric Coe, MD
Hi Nimesh, I am afraid my site does not concern thyroid disease. I am not a thyroid expert and cannot comment on these data. Regards, Fred Coe
Jude
Hi Dr. Coe,
Thanks for the video. I was expecting information about prevention/ unpacking. Do we need to take more water? Dietry changes?
Thanks
Jude
Fredric Coe, MD
Hi Jude, Here is a good plan for stone prevention. The video was meant as an informational. Regards, Fred Coe
Stephen O'Mara
Hello Dr. Coe.
I just wanted to thank you for the interesting and informative video and your review of kidney stone formation and treatment. You have certainly expanded my lay understanding of kidney stones and all they entail. I have Crohn’s disease, diagnosed about 32 years ago, and I only recently became aware that Crohn’s patients are prolific stone producers. This came to my attention after some personal research following the passing of seven stones last year over a period of about four months. I managed to catch the seven I know of using a disposable filter cone. No surprise to you, I’m sure, they were found to be oxalate stones. Under the care of an endocrinologist starting last year, we are addressing this “stone problem” with daily doses of oral potassium chloride along with other lab values that ebb and flow with Crohn’s symptoms. Since I live in Canada, regular visits to the specialist and frequent monitoring of lab results for hematology and general chemistry, make managing all this easier. My Crohn’s and Type II diabetes, combined with various treatment therapies for them, sometimes makes it a challenge to address many serum and chemistry levels outside the norm, but it always helps me to know exactly what is going on and you’ve certainly helped me there.
Again, thank you.
Stephen
Fredric Coe, MD
Hi Stephen, IN Crohn’s’ disease, urine oxalate is often high and can be lowered with high calcium timed to go with meals. I have not as yet written the article on the disease. But the calcium effect on oxalate is here. I do not have comparable data for bowel disease, but I have lots of experience. It works. Regards, Fred Coe
Joy McCullers
really liked your presentation but found the back ground music very annoying
Fredric Coe, MD
Hi Joy, Thanks for the constructive criticism. I worry about it, too, and need to edit it out. It was my first venture into the medium. Regards, Fred
Solomon Lemma
Hi Dr. Coe,
Thank you for taking your time and help us understand the formation of the stones. I have passed four smaller, 3-4mm stones between 1998 and 2016, every 4 years. I pass the stones within 3 days of the attack. However i just had another 6mm stone within 1year and i had to go through painful surgery,(The stone result came back as came back Calcium Oxalate Dihydrate (Weddellite) 65% Carbonate Apatite (Dahllite) 35%) the only life style change i can remember in the last two years are high consumption of mixed nuts and from 5 glass of alcohol per week to no Alcohol at all. All tests came back normal except border line Uric Acid 7.2mg.
I can not thank you enough for all your assistance
Solomon
Fredric Coe, MD
Hi Solomon, I doubt the tests are normal, simply the normal ranges are too wide or possibly you have changed things yet again. Read your report yourself for starts. Your kind of stones go with relatively high urine calcium and pH. Regards, Fred Coe