I'm so happy we're doing this video, which tells me I really need to get a life and get out more. But I'm tickled. I'm tickled we're doing it because I've talked about this in other videos.
It's so very common. Many people got kidney stones because they overate things like spinach and almonds because spinach and almonds, I mean, every dietitian will say, "You want a snack? Have almonds." So, what we, as, and no, no shade against dietitians, almonds can be very healthy, but that directive and how patients interpret it is two different things.
Meaning, when a dietitian, when a nurse, when a doctor says, "Do this," if they're not specific, patients just take that directive and just make stuff up. Meaning, if you're a diabetic, and you were told to have almonds as snacks, you went to Costco, you got the unsalted bag of, of almonds, and you're eating them like there's no tomorrow.
Almonds, almonds, almonds, almonds, almonds, almonds, almonds. And also spinach. Overeating, overeating, overeating.
So, when a doctor says lower your sodium, a patient can do, you know, say they're eating 10,000 mg a day, they lowered it to 8,000, they lowered, quote unquote, their sodium. So, we as healthcare people have got, we've got to be a little bit more specific, and the Kidney Stone Diet goals, if nothing else, are really specific.
And in the Kidney Stone Diet goals, one of them is to lower sodium, and we're asking you to lower sodium because too much sodium increases urine calcium and decreases urine volume, which means you'll pee less if you're eating too much salt, and too much calcium gets pulled out of the bone and dumped into the urine when you eat too much salt for a lot of stone formers.
And so, we will say the goal of the Kidney Stone Diet, found at kidneystonediet.com, there's six goals, and one of the goals is to get your sodium to 1500. I have had many patients in the past, they do the urine collection, I go over the urine collection results with them, they 5,000 mg of sodium that day, their doctor told them to lower sodium, and I too will say, "You must lower your sodium.
We want it to be around 1,500 mg a day." And I'll talk more about that later. And patient says, "Okay." They do the follow-up test. Their sodium for that day on their 24-hour follow-up test is 400.
That's how much sodium they ate that day. The doctor screams at them. I scream at them.
What happens? The patient said, "Well, I lowered it." And I would say, "Well, remember I said the goal is 1500?" "I know, Jill, but I thought less would be even better, cuz I never want to get a stone again. But you know what else, Jill?
I've been real dizzy." Well, I guess you have, Connie! You will be dizzy. You will have symptoms of hyponatremia, which is low sodium in your blood.
You need sodium, folks. It makes your body work a heck of a lot better. Your heart, your everybody, you need sodium.
So, don't decrease your sodium less than that goal unless your doctor has said that's okay for you. But 1,500 is already pretty low. As most of you know who have a hard time getting to that.
This is such a common thing that when I talk to people on the phone, I actually say 1,500 to 2,000 is the goal, and I will say, "I'd rather you go a little higher than way under. Less is not better, just like more spinach is not better for stone formers, right, when you're trying to figure out your diet. So, no spinach for stone formers, but you know what I mean.
All right. There are actually some disease states where you all need maybe more, and this is where you need to talk to your doctor. People who have POTS— P as in Peter, O-T-S, POTS.
That's, that's a disease, and we want people to retain water in their blood vessels, okay, which elevates blood pressure to normal levels because these people can have really low blood pressure. So, if they go down to the 1,500, that may be a problem for them, okay? People who have, cystic fibrosis, those people can sweat a lot.
They will lose a lot of salt in their sweat. They may need a little bit more. Talk to your doctor.
People who are training, athletes, you're really, really, really sweating all the time, you may need more sodium than that to keep your salt levels because you're losing so much sodium through sweat. People who have Addison's disease, this is an adrenal insufficiency, and it's where the adrenal glands don't produce enough cortisol and aldosterone, and that can cause your body to lose salt.
So, that's really important. Talk to your doctor. And then there's this thing called Bartter syndrome, and that's a group of inherited kidney diseases, and that can lead to a excessive loss of chloride, potassium, and sodium.
So, you people may need, you patients may need more sodium than that. If you have any of those disease states, you should talk to your doctor about how much sodium you need to prevent those disease states from getting worse. You would not adhere, perhaps, maybe to the Kidney Stone Diet goals.
People who have eating disorders and are vomiting a lot because they're binge eating or using laxatives, again, to get rid of excess calories, you may be losing too much sodium. You may need to get more sodium. But if you're not eating that much, that's just a problem in and of itself, and I would tell you to increase calories.
But that's a whole thing because you have a eating disorder. You need a counselor, a licensed therapist dealing with eating disorders. There are certain medications like diuretics that are frequently used in kidney stone prevention to help lower urine calcium.
So, diuretics can have you lose too much sodium. Talk to your doctor, okay? Because diuretics, otherwise known as water pills, can make you pee, pee, pee, pee more, and then more salt is lost.
So, you may need a little bit more. So, discussing your salt needs with your doctor specifically. Some of you will still be just fine with the 1,500.
Some of you may need more. Consult with your doctor. That's the point of this, okay?
I— basically, Jeff, that's it.
