Are these leafy green vegetables causing your kidney stones?

Are leafy green vegetables causing your kidney stones? Let's talk about that. Welcome back to the Kidney Stone Diet podcast, the show about preventing kidney stones and living your best life.

I'm your host and fellow student, Jeff Sarris.

And I'm, Jill. And I'm Jill Harris, your kidney stone prevention nurse.

Yeah, so we're back at it today.

We're back at it, baby!

Yeah, and we have a question. Should we dive right in to the question?

Let's dive right in. Let me see.

Yeah, and if you're out there with a question, the number is 773-789-8764. But today, we are going to hear from Mary or Marie.

Marie, okay.

Hi, Jill and Jeff. I'm really grateful for all you do. In reference to kidney stones, I followed your suggestion of foods not to eat, such as almond and spinach.

I eat a very healthy diet, mostly plant-based, with some fish and yogurt. I exercise daily, and no salt and no refined sugar. I've had three 24-hour urine tests, six months apart.

I was told at one point to stop my calcium supplements, and my calcium did go down. I started keeping track of calcium intake through foods and, making sure I don't go over 1,200 milligrams. With eating a lot of greens, such as kale, collard greens, etc., my test of last month showed a slight increase in calcium.

So, I was wondering, should I not be eating so many greens? Is calcium from foods just as harmful to me? My second question, in reference to, my pH was 7.05.

It was considered a high alkaline. I thought a high alkaline diet was better than acidic, so I'm a little confused. Should I go back on my healthy fruits and vegetables and greens?

Thank you for understanding my questions, and I really appreciate you guys. You're both great. Have a happy New Year.

Thanks again, and it's Marie from Rhode Island. I love the name Marie. It's right up there with Angela to me because I'm very Italian.

Marie, Maria. Love Maria. No one asked, but that's what I'm thinking about right now.

Okay, so we have two questions, right, Jeff?

And Jeff's thinking to himself, "Did she remember?" I think I did. I write them down. Listen, I write it down.

Okay, so what I think I heard beautiful Marie say, basically, she enjoys a diet that's filled with plants, which I just love hearing. She also uses yogurt to get her calcium needs met along with other things, and she does fish as well. Good, because remember, it's hard to get enough protein on a very high fruit and vegetable diet.

So, she's probably including fish for that, also. She said that she had high urine calcium, she was told to get off the supplements. Of course, as we know, when you get off supplements, your urine calcium will be lowered.

So, that's great. Using calcium supplements will increase your kidney stone risk, so I'm glad to hear someone gave her good advice. And she's tracking calcium, she says, that, you know, basically, she doesn't go over the 1,200 milligrams a day, which we who do not get our periods anymore should not.

If you do still get your period, up to 1,000. But this doesn't mean we go over. You know, our body doesn't absorb calcium that great, okay?

So, we want to make sure we're not going over. She said this time she did have– and she's also, you know, very low sugar, salt kind of gal. Great.

She said she noticed that her urine calcium was a little elevated in this latest urine collection. So, I don't know what "little" means. Sounds like Marie knows what time it is, so I think a little means a little, right?

So, probably less than 20 points. But I really don't know, so I'm not going to assume. But here's what I'll say: She says she doesn't eat any salt, but, guys, there's salt in everything.

There's salt in plants as well because they're growing in the ground, and you're going to find calcium, sodium, you're going to find ox- oxalate, obviously, you're going to find that, okay, in the ground. Even milk will have salt in it. The cows ate stuff out of the ground, there's salt in that, and then it's in your milk.

Okay, so there is salt in your diet even if you're saying you're having zero salt. So, my first question, if I were looking at her urine collection, and I saw, she said she did a few of them, sounds like it went like this: Had the first urine collection, her urine calcium was high. Somebody told her, "Hey!

Lay off those pills, Marie!" So, the next urine collection, she laid off the pills, her urine calcium went down. Now, she's saying, "It's up again." So, the first thing if I were looking at her urine collection is I would look at the sodium. Maybe it's a little higher, not that because she's sprinkling salt everywhere, but she could have eaten a little bit more salt that day because, again, it's in everything we eat, even plants and veggies and fruits, there's a little bit in there.

So, it adds up, depending on how much food and drink went in her mouth. So, that could have risen it a little. Could it have been that she went over the 1,200, maybe?

Because could it be that she ate a bunch-load of vegetables that day? Meaning broccoli has like 100 milligrams of oxalate in, I think, 3 ounces of broccoli. So, if you're eating a pile of broccoli every day, that will add up, right?

So, I would never tell–

And that's of calcium, right?

Yeah. What did I say, honey?

Of oxalate.

God, what would I do without you? Seriously! Just when I think, "Too folksy, he's not paying attention." I actually, I'm not even going to say that was a mistake, I was just checking to see if you were paying attention, Jeff.

Perfect!

Let's go with that. So, so I'm never going to say– I'm going to say take away spinach, the highest oxalate foods, but I want everyone to get their plants in. Of course, I'm on a mission this year, 2025.

The minimum of three cups of veggies a day, one cup of fruit. Nobody here in America's getting that, so that's the minimum, okay? So, that's what we want.

So, what I would say to her is, it could be that you're eating so much, meaning the portions are so huge, perhaps that is you are going over the 1,200. But was your salt– so I'd like to know that, Marie. Was your salt a little higher?

And salt is listed under sodium, or it's listed under Na for sodium, it's the chemical num- name. So, and if you did a Litholink test, it will be under dietary factors. The first value, it will say Na24, so you can look if that's a Litholink test.

All right. So, it could be. So, I'm just going to say be mindful of exactly.

If you're eating five cups of broccoli a day, maybe you want to get, you know, maybe you just want to pay attention to how much calcium you're actually getting. If you're using an app, it will track all that for you, so you can clearly see because I don't love taking away vegetables, folks, if we don't have to. So, and it all depends on how high her urine calcium was.

Was it over 200? Because we want it under 200 on a urine collection. Or was it the last time she did a urine collection 104, and now it's 108?

So, I don't know. I don't have real numbers here, so I'm very careful in what I say. And I'm not going to tell her to stop eating broccoli when I don't have real numbers.

So, Marie, feel free to call back, lovey. Okay, so that's that. Now, Marie also said, "By the way, sissy, my urine pH on my test is 7.05." That is a very high urine pH, and I'm sure the lab she worked with said, "Very high, very high." Marie's like, "What the hell?

Everything I read, an alkaline diet is gorgeous, but not necessarily for kidney stone formers, folks." So, some of you will have super high urine pH, and we won't care about that at all unless you have two other things: low urine volume, meaning you don't pee a lot, and high urine calcium. If you have those three things, you have an increased risk for calcium phosphate stones, okay?

So, if you just have the high urine pH, we won't care– we won't really care about that. But, Marie, this is exactly why I tell people, don't you dare suck on a lemon or start using Moonstone or start using Crystal Light to raise your pH level, like all the ads or all the websites say on kidney stone prevention sites, "Have lemon." Why?

If your pH is already high, now you're sucking on lemons all day, rotting out your teeth, and also increasing that pH that you don't even know is high because you haven't done a urine collection, and now you're making it higher, higher, higher. It's precisely why I say get a urine collection done before you start adding lemons and LithoLyte and potassium citrate and all the junk to raise a pH.

It may be making matters worse. So, yes, overall, an alkaline pH is better. But, again, there's alkaline, and then there's, "Holy Bruscemi, look at Marie's pH!

It's super high!" So, maybe she's sucking on lemon. Marie could be saying, "I'm not, sister. I'm not sucking on lemon." But she's on a very high veggie diet, so that could be making her pH higher.

But, again, if her urine calcium is under 200, and her fluids are over– her pee is over 2.5 and above, her urine volume, we won't care about that pH as much. But I still don't want somebody sucking on a lemon, okay, and making that worse. She also said, "I thought that was way better than acidic diet." A really acidic diet for kidney stone formers– diabetics have this, people with malabsorption have this, bariatric patients, Crohn's, colitis, IBD, IBS, all of it.

So, people with a very acidic urine, below six, you are at risk for uric acid stones and calcium oxalate stones. People who overeat meat, overeat meat, your pH will become very acidic, and that can make you more apt to form uric acid and calcium oxalate stones, okay? So, it's Goldilocks principle: we don't want too high, we don't want too low.

Boring, annoying Jill wants us right in the middle: 6, 6.1, 6.2, that's– those are great pHs. Anything over 6.2 on a urine collection is typi- typically going to be flagged. But, again, we won't care about it if your urine calcium is in the right level and you're peeing enough, okay?

So, I hope that makes sense. So, I so my advice for Marie, which I'll be careful in giving her because I actually don't have a urine collection in front of me, and that's why these consults that I do are so valuable. And you may say, "Yeah, girl, you're getting paid." Yes, I am, and I deserve every penny.

I've spent almost 30 years really understanding these tests. But what happens is, you get such a better doctor office visit and you really get on the best treatment plan, and you can say goodbye to stones, okay? So, my success rate is off the charts, okay?

So, I don't mind saying it's worth the money to get that urine consult at kidneystonediet.com. So, without looking at her urine collection, I would be very careful. Do I want her to give up vegetables?

No. If her calcium is getting too high because she's overeating the highest calcium vegetables, you know, track that for a for a minute, Marie, and see where you're going. Maybe you want to lessen the broccoli and add another veggie that's not going to have as much, that's not as calcium-rich, since you're doing such a good job with calcium.

And then as far as the alkaline pH, I'm not going to tell you to stop eating vegetables, of course. I'd I'd really care to know, like, how's your urine calcium? How's your urine volume?

Before that is ever talked about. Does that make sense, Jeff?

Yeah, it definitely does. And just to reiterate, the urine analysis consult at kidneystonediet.com is for your 24-hour urine collection. And getting that collection and having Jill break down exactly what everything means is what we were talking about in this entire episode.

So, even saying if it's Litholink, you're looking for the Na, like, all of those details that you might not know about, Jill is able, after doing going through thousands of collections with thousand thousands, excuse me, of patients over, yeah, 26, 27 years now, she can help you have that better result. So, if you want to find that, you want to find the Kidney Stone Prevention Course, we have the All-Access Pass at kidneystonediet.com, so you get access to all of the learning materials, the meal plans, and everything.

Or if you want the one-on-one with Jill, we have the 24-Hour Urine Collection Consult as well. But everything can be found at kidneystonediet.com. And–

Oh, yeah, and if you do the All-Access Pass, don't they get 20% off my private consults? I mean, that's a friggin' deal. Yeah.

Exactly. Yeah, so, yeah, once you're in on the All-Access, you get the discount for, yeah, for the one-on-ones. But, yeah, it's all it's all there at kidneystonediet.com.

So, I think with that, we'll wrap. Thanks again, Marie, for your question, and we'll see you next time.

Bye, Marie. Thank you.