Should I reduce oxalate even if my kidney stones are not calcium oxalate?

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Welcome back to the Kidney Stone Diet podcast, the show about reducing your risk for kidney stones and living your best life. I'm your host and fellow student, Jeff Sarris,

And I'm here, as always, with Jill. Jill Harris, the kidney stone prevention expert. So, how are you doing, Jill?

I'm doing great. I'm happy to be here and see in your beautiful, handsome face, Jeff. Hi.

So, today we are doing a

A question from the community. So, we're going to answer if our kidney stones are not calcium oxalate, should we still reduce oxalate? So,

There are a couple- a couple or a few types of kidney stones. So, what are those first to begin with?

Well, there's cystine stones. I talk about them first because they're very, very rare. So, you know, the majority of people do never have to worry about cystine stones.

That's a genetic issue, and there are cystinurics. Those are those patients. But they're very rare.

Then there are calcium oxalate stone formers, which most people have heard about because 80% of stones, so eight out of 10 people, make those types of stones. Eight out of 10 kidney stone formers

Will make those types of stones. There's uric acid stones, and they're typically a byproduct of eating too much meat. And meat is all meat, not just red meat.

And also genetic issues they are. And then there's calcium phosphate stone formers.

And so, you know, the majority, like I said, are calcium oxalate. So, mainly, I am talking about oxalate every day. But I think it's an excellent, excellent question because here's what I'll say about that.

And people may disagree with me, and that's fine. But I like to make sure So, when we're dealing with patients, when we're dealing with people trying to change their diet, I have noted in many years that when we tell them that something is safe

Or healthy, we as human beings tend to really dive deep into those things. So, people will say, "Well, Jill, I got uric acid stones. So, I'm just going to lower my meat.

I'm not going to worry about oxalate because those are not the type of stones I make." And I've I've heard doctors say, "You don't ever You don't ever have to worry about oxalate." But what people don't recognize in the background is, so when we're telling them not to worry about it, then whatever we're telling them to limit, they totally overdo the things they're allowed to do.

That's just human nature. Like, you take different diets. Keto is like, okay, cool,

You can't have carbs, but, you know, you can have as much fat as you want. And so, people are going to do that. We tend to overeat then even more.

Even though keto's a high-fat diet, a lot of patients come to me with keto with uric acid stones because they overate the protein in there, too. And that's simply because when we take away one thing, it's human nature that we're going to overeat the stuff we're allowed to have. Because we like to have a lot of stuff, mostly, most of us do.

So,

My feeling is this: I still tell people to be careful. It's not giving them free rein to eat as much oxalate as they want because I've definitely had uric acid stone formers that convert over to calcium oxalate stone formers. So, I always base my knowledge upon the follow-up test and the follow-up calls I get from patients.

And so I'll say, "Look, Henry, what happened?" "Well, Jill, you know, I know you said don't overeat spinach, but I was like I hung up and I said,

'I'm having spinach if I wanted. I don't make that kind of stone.'" And then Henry made a calcium oxalate stone. And then Henry's like, "Yeah, you were right." So, I'm not saying it will happen every time, but I alert my patients.

"Look,

Just remember not to do that, okay?" So, even for people who come to me just for weight loss, I'm like, you know, even though they may not have a kidney stone, I still warn them about overeating because when people are trying to lose weight, they're going to overeat almonds and spinach. That's what people do because they're healthier things, right?

So, I warn them of that. So, for sure. Anyway.

Yeah, and with almonds and spinach, that is sort of the go-to for smoothies. Like, the health smoothie.

It really is. Yes, almond milk, almond butter, almond flour, you know, especially if you're on keto. People yell at me.

They're like, "Jill, I'm doing keto. I lost 117 lbs." I get it, but you gained a stone. So, there's that.

And you can still stay on keto and remain stone-free. You just have to tweak some of the greens you're using. You can't use almond flour, almond, almond, almond, almond.

We need substitute flours now to use for those things. That's all. And by the way,

You need your calcium.

There's that.

Right.

Right.

Do you find that people tend to So, we've talked about a genetic component in the past, in a past episode. Do you find that people, when they have uric acid stones, say, they tend to be more prone to produce oxalate, calcium oxalate stones?

If they have uric acid stones, are they prone to have more calcium oxalate stones? Is that the question?

Yeah, like converting over. Do you think that seems to be

Well, you know, I wouldn't say that's the norm. No. I'm just saying that it has happened.

And so because it's happened enough, I remind my patients not to overdo the oxalate portion. I'm not saying it's definitely going to happen, but I'm saying let's be aware of that because I understand a little bit about human nature and dealing with so many people for so many years, especially particularly diet. And again, I just warn them.

I'm not saying it's definitely going to happen. I'm saying it can, and my goal for each and every person, if at all possible, is to never go through that hell again, ever. That is my job and duty as a nurse to try to make sure that never happens again for you, right?

Yeah, and even as an estimate, I mean, that's like, obviously, you don't have hard data, but that's a substantial amount to consider that you're seeing that many people who do convert over, which then also shows the importance of diet. Like really, as you said, where we can just tend to overeat the things that we think are healthy and going to make us healthy.

Yeah, and most people, honestly, and I'll say this throughout the podcast, most of us eat the same 15 foods a day. "Well, Jill, I've been eating this breakfast for 27 years." Well, listen, honestly, Helen, might you think about a different breakfast? There's a lot of food out there.

Guess what? You could even eat supper for breakfast if you wanted to because you could do whatever you want as long as it's healthy and within the terms of the Kidney Stone Diet, right? So, it's like, but we don't think about these things.

We want to treat food We want it to be automatic. We don't want to think about it. We just want it to be something we go on autopilot with.

I'm going to push back on that every single time. I can't think of anything more important than to give a little bit of thought, and I'm talking about 5 minutes or less a day,

On what you're nourishing your body with. There's that. Doesn't mean you can't have a margarita.

Doesn't mean that. Doesn't mean you can't have two Italian cookies, which is my favorite thing in the world, butter cookies with sprinkles. Doesn't mean that.

It means that most of the time you're eating healthy foods in a normal portion amount and varying them throughout the weeks and months, right? That's my goal.

Yeah, absolutely. I mean, just from our human nature, we wouldn't be gorging on one thing. Like, you talked about raspberries, and we wouldn't be having cases and cases of raspberries or pints or whatever they come in.

We would have a few because that's all you would ever find, so.

Exactly.

Yeah, it's important to think about sort of what our human nature is like, our actual biology is geared for.

I love that. I think, you know, I love kidney stones, but what I love is, as a health coach, too, is trying to make people aware of their patterns and their habits so they can try to create new ones. And here's what the diet industry doesn't want you to know.

That's freaking hard, people. It's hard to change. It's hard to create new habits.

But I promise you, once you learn how to do that, it then becomes second nature, just like your maybe unhealthy eating right now is second nature or what you thought was healthy for your body is second nature. You change it. It doesn't take that long, honestly.

And then you've you've got it down, honestly.

Yeah, well, I think this was a great answer to that question and a great another great episode, so I think we will wrap here. And anyone interested in diving deeper, as always, head on over to kidneystonediet.com where we have the Kidney Stone Prevention Course, we have the oxalate list, we have all sorts of resources there that can really help you on your journey.

And if you're enjoying the podcast, be sure to subscribe on Apple Podcast, Spotify, or watch on YouTube, and comments and reviews are always appreciated because it really helps people find us.

Yes.

So, yeah, thanks again, Jill. We will

Thanks, Jeff. I hope you have a great afternoon.

You, too. See ya.

Bye.