Urine pH and kidney stones

This week, Jill answers a listener question about urine pH and kidney stones.

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

Jill Harris: Hi, Jeff! And I’m Jill Harris, your kidney stone prevention nurse. I’m so happy to see you. I mean, we’ve already shot a show, but we’ve been talking about so many different htings, I didn’t say that to you yet!

Jeff Sarris: Oh, yeah, because we end up having, what, an hour conversation before we start recording because just everything’s going on, so it’s always a little different. But it’s always great to see you! And, again, the bright colored shirts, you’re really leaning into them and enjoying them, which is awesome. I love the “Eat responsibly.” And yes, there are so many different so many different options now! We have a listener question that we were going to do this week, so what do you say we dive right in?

Jill Harris: Let’s go, baby!

What’s the relationship between protein and urine pH levels?

Listener Voicemail: Hello, Jill and Jeff! I have a question about the relationship between protein and urine pH level. My specific questions are what sources of protein make the urine pH level become lower? What sources of protein make the urine pH level become higher? What sources of protein have no effect on the urine pH level? Sources of protein like eggs, milk, nuts, beans, different kinds of meat like fish, chicken and pork. I understand you have done some podcast episodes on protein, but I wanted to ask again about the specific relationship between protein in the urine pH level, particularly the different sources of protein and the urine pH level. Thank you. Thank you so much. Oh, my name? My nickname is stone former. Thank you. Thank you so much.

Jill Harris: Well, I’ll say this, it’s sad that his nickname is “stoneformer” because that tells me he’s making too many damn stones. So, I’m gonna, specifically, talk about meat. I know he asked about all protein sources. But here’s the deal. Why we care about the meat portion of the protein of the Kidney Stone Diet is because too much meat–and think of people who are on keto and paleo because when we take away carbs, we tend to overeat the foods we’re allowed to eat. In this case, vegetables and nuts, for sure, and meat protein. So, meat protein, lowers urine pH. It’s acidic. For kidney stone-formers, we worry about eating too much meat and that includes red meat. Even though everybody my age always thinks meat means red meat. “Jill, I don’t eat no meat! Just chicken and turkey and fish.” That’s all meat, so animal flesh is what we’re talking about.

When we too much animal flesh, it can lower our urine pH. Why do we care about that in kidney stone disease? Because crystals love an acidic environment. Also, there are some crystals that love a really alkaline environment. So people who make calcium oxalate stones and uric acid stones, they can have lower urine pHs. People who make calcium phosphate stones, they will have very high urine pHs or more alkaline. This is why all these alkaline waters in the world, people just drinking them thinking that they’re the healthiest thing in the world for them. If their urine is already on the basic side or alkaline side, and they’re making calcium phosphate stones, those waters are not helping them. And that’s the other reason why I don’t love a lot of products that people just generically take for kidney stones. I’m not going to name any brands, specifically, because I don’t think that’s the great to dog on them, but any brand that is saying they can stop stones or breakup stones by alkalinizing your urine, you may not need that.

You may be a calcium phosphate stone former and now you’re taking these pills or these drinks that are going to make your pH even higher! That’s not helping you! So those products, while they may help people have a have acidic urines, low urine pHs, that’s great. And a urine collection is going to tell you. Not just peeing on a strip. You want to see a 24 hour urine collection, an average for the day. How does your urine pH run? Lower, more acidic or higher, more alkaline. And having a really acidic urine will lead to calcium oxalate or uric acid stones. Having a really alkaline urine, high pH, is what can lead to calcium phosphate stones. The two factors that bring those things together is not just the urine pH, but also calcium, if there’s too much calcium in your urine. So, again, it’s complicated, people. So for stone formers question, when we eat too much fish, chicken, poultry, red meat, all of it that can lower or make our urine more acidic and crystals love that environment.

Varying your diet can help you!

Milk can tend to make our urine a little acidic too, because of lack lactic acid in it. But, again, you want to see what your urine does throughout the day. So some people will say, “Well, I’m not going to drink milk, if I already have a lower urine pH.” And I wouldn’t tell them to do that. I would say, “Can you increase your fruits and vegetables?” Because that will naturally raise your urine pH. So for patients that come to me that are saying, “Hey, my urine pH is a little low and my doctor told me to take these pills.” I’ll say, “Great if that’s what the doctor wants you to do,” because I certainly don’t override a doctor’s order as a nurse. But I’ll also say, “And, also, Billy Joe Bob, incorporating more fruits and vegetables will just naturally raise your pH.” Also, when we eat too much meat protein–and if you want to know what too much is go to kidneystonediet.com because we have a meat protein calculator on the website, in the blog, and it will help you figure out how much is right for you based upon your weight–so when we eat too many foods that are acidic, specifically meat protein, that can also lower our citric acid.

Citric acid is a molecule in our body and what it does is it surrounds calcium in the urine. It surrounds it like a shield so phosphate and oxalate cannot connect to her. So when we eat way too much meat protein, it will lower our urine pH and also cause our citric acid to become lower, too, thus leaving calcium unprotected in our urine and able to bind with these other stone forming crystals. So that’s just another important fact. Now, people will often take my words and do what they want with them. Listen to me, I’m not saying don’t eat meat protein. Please do. I do. Just don’t over eat it. And like I said, go to kidneystonediet.com and Jeff, I’m sure, will link it up here, how to figure out how much meat protein you can be eating. And then all other protein, if you eat enough fruits and vegetables, you really should balance everything out. I’m not going to go over every single protein and what the pH is. You can Google that. It’s very easy to Google nuts and milk and all the different sources, cheeses and things like that.

But if you’re eating a well-rounded diet–I know how boring is that?–but if you are, fruits and vegetables, lean meats, you know getting your dairy or non-dairy calcium needs met and you’re eating a wide variety-not just oatmeal every day, not just broccoli every day not just rice every day as people tend to do. I know this because they tell me. “Jill, I’ve been eating the same foods for 20 years.” If we vary our diet, we don’t have as many problems as when we eat the same 10 foods that are causing the initial problems. So, if you want a more balanced pH, eat your fruits and vegetables, eat everything within normal portion size, but also there are some medical diseases that will lower your pH like diabetes. That’s a big one. So, when you’re diabetic, you tend to have lower urine pH. Medical conditions can affect your pH as well. So RTA-renal tubular acidosis-there’s many things and I’m not going to get into that here, because we mainly discuss diet, but there are other medical conditions.

People who have bowel disease, people who have malabsorption issues, they tend to have very acidic urines and low citrate. Those two things kind of go hand-in-hand, lower urine pHs and citrate, lower urine citrate. And so if you’re experiencing a lot of diarrhea and stuff, definitely, you will have acidic urine. Again, you know, you have to talk to each patient because many people will say, “Well, if they have low citrate, and a low urine pH, they really got to pound those fruits and vegetables.” Yeah, but if they have bowel disease, they may not be able to handle all that fiber. They may not be able to handle the acidity of the citrus foods and fruits. It’s so complicated, I cannot even tell you! So there is no size fits all here.

We do know that too much meat protein can lower urine pH. That’s why you should eat normal amounts and just eat your fruits and vegetables. That will help balance it out, too. There you go. And stone former, I don’t like that nickname! Next time you call or write in the comments, I want it to be non-stone former, please. And make sure you get a urine collection so you can see what’s going on. There’s no reason you should be nicknaming yourself “stone former.” I don’t like it, I don’t want you to form anymore.

Jeff Sarris: Yeah, and the urine analysis is also something that’s on the website at kidneystonediet.com. When you do the urine collection, Jill can help you break down and understand actually what the results are in a deeper way where then you can have a better doctor’s visit because you’re more more informed. So it’s a very valuable service. It’s on the site.

Jill Harris: Yeah, again, I made that service because when I was going through all my doctor appointments, they go so quickly. The values are thrown at you. You’re not educated enough to know what to ask at the time. And then, these days, good luck trying to get ahold of your doctor later on. So I made that from my experience. That service is based upon what I went through with all my cancer treatments and it’s very valuable for patients. I love that service because then I get to help them and then “here’s what all this means and then please talk to your doctor about these whatever points I give them, specifically.” And you tend to get better doctor appointments, too, because the doctor sees that you know what’s going on. So, it’s a wonderful service. It really is.

Jeff Sarris: Yeah, you know what’s going on and you want to make change because you’ve talked about that a lot. It’s hard to advise habit change to someone who isn’t ready for that. So, it tends to be a different path. But yeah, that was a great question and also, next time, hopefully, that nickname is changed. We would love to have that be a much better nickname in terms of your overall health and how you’re feeling. But thank you so much for the question. Again, if you have a question, the number is 773-789-8763. And we’d love to feature your voice on a future episode.

Again, we have a Patreon. People have asked how they can support the show and everything that Jill does without necessarily being in the group calls and this and that. So the Patreon doesn’t give you any more content. It’s just there because people have asked for a way to support so that’s patreon.com/kidneystonediet. And a recent patron, Ginny, we just wanted to thank you for joining. Again, there’s no pressure. There’s nothing in addition to the podcast. There’s no blog posts or anything. It’s purely there for the people who have asked, but, Ginny and everyone else, we really appreciate your support.

Jill Harris: We do! And, Ginny, I love you. That’s so sweet of you. I just can’t ever put and express how this community is so loving, and wonderful, and supportive to us as well. I love what I do and I think that shines through in whatever I do. It comes across because I love it and people are very appreciative. So to go above and beyond like Ginny did, I mean it’s just over-the-top. It’s wonderful and it’s very much appreciated because, quite frankly, all the free things we do, they cost money. It’s all of our time. It’s all Jeff’s time. It’s Dave’s time, our designer. I mean, it’s a lot of time, but we feel that it’s worth doing all this free stuff because not everybody can afford services.

So, as a nurse, it’s our duty to get you–look, as a patient myself, I know what medical bills are like. They never stop coming. It can be very overwhelming. So, the more free information we can put out there, the happier we are, too, quite frankly. But for somebody like you know Ginny to recognize that, well, it means the world to us. So, thank you so very much. You don’t have to do that, but we wanted an avenue because we get a lot of people that say, “What can we do?” And so we made the Patreon account. It’s there if you want it, and it’s there if you don’t want it.

Jeff Sarris: But with that, thank you again for your question. Thank you everyone for tuning in, liking, and subscribing, and sharing these episodes with with friends and people who need need this information. We’re just you’re trying to reach as many people as possible. But, with that, we will wrap. Thanks again and we will see you next time.

Jill Harris: Bye, non-stone former!