In this episode, Jeff and Jill discuss the potential link between Tums (calcium supplements) and kidney stones. Jill emphasizes that taking excessive amounts of calcium supplements, such as Tums, can increase the risk of kidney stones. The importance of getting calcium from natural food sources is highlighted, and the need for testing, such as a urine collection, to determine individual risk factors is emphasized.
Takeaways
- Excessive intake of calcium supplements, like Tums, can increase the risk of kidney stones.
- Getting calcium from natural food sources is the best approach.
- Individuals with a history of kidney stones should be cautious about taking calcium supplements.
- Testing, such as a urine collection, can help determine individual risk factors for kidney stones.
Jeff Sarris
Will Tums cause kidney stones? Do I need to avoid taking Tums? Let’s talk about
What do you say we just jump in, but how have you been doing?
Jill Harris
Well, I haven’t been feeling too well, I’m not gonna lie. I’ve had a respiratory thing. And then today I had to wake up at the crack of butt to go get my mammocram, I call it mammocrams, at 7 am. You know you’re old when you’re going to doctor’s appointments at 7 am So I’m a little off today, I’m gonna tell people, but I’m gonna rally, because you know, as we all know, the show must go on. But other than that.
I mean life is good after the Harvard list has settled down. People are getting used to new oxalate numbers, not so many, but you know just the fact that there’s a new list. And I mean enjoying the beginning of summer here, how about you?
Jeff Sarris
I mean, I’ve enjoyed the last couple of days of sun and warmth. Really nice being outside all day, but it was crazy because I’m like, we already have so many mosquitoes. As soon as the sun went down, I was just eating up and I’m like, what is happening?
Jill Harris
Mosquitoes not too bad here in the city. I know you’re just a little out of the city. So, you know, it’s not as bad here at all. But I am waiting for the cicadas, man. I know everyone’s talking about them. I’m waiting for them. We’ll see what happens. Gonna be. No, I know the burbs have seen them. Have you?
Jeff Sarris
Have you not seen them yet? wow. Yeah, we have a lot of them. There were a couple in the house even, and they’re so big, so it’s a little daunting.
Jill Harris
Hell no, I’m saying right now if I see those red-eyed big wing things coming near me, I’m not gonna I’m not gonna fare well. I don’t like it. It’s it’s something to talk about though, you know.
Jeff Sarris
Yeah, something novel. But yeah, what do you say we dive into this question this week? It comes from Lewis.
Jill Harris
Let’s go!
Lewis.
I have to say this question. So it is what his doctor, his doctor said, if you don’t have access, if you don’t have access, we know that calcium supplements in pill form can cause kidney stones. There’s many research papers on this. So we know that that’s the case. Here’s specifics.
Number one. People take Tums like candy. I’ve talked about this. If you go to buy Tums at the grocery store or the drugstore, the package will boast now 1 ,000 milligrams of calcium per pill. So people are like, that’s great, because nobody knows anything about this stuff. And they keep upping the calcium carbonate in these pills because it’s effective when you have acid reflux. You get immediate relief pretty quick. Pretty quick, if not immediate. So they’re highly effective. But along with those packages should also say risk of kidney stones because it’s a problem. Also taking too much supplemental calcium like in ant acids can cause hypercalcemia, too much calcium in the blood. So there’s issues with it.
Remember his doctor said, if you don’t have access, I’m not taking, I have a history of kidney stone formers, I’m not taking Tums, I’m not doing it. If, I’m gonna be very careful here, if I am a nurse and I do not override your doctor’s orders, you wanna take that risk, please feel free. Yes, I understand that Dr. Coase has on his website, you could as a last resort, you could take calcium supplements with food. No more than 500 milligrams at a time. You could, and your risk of stones may not increase, may not, may not, depending on how you absorb things. So if you want to take that chance, you can, you’re all grown. Would I do it with a history of kidney stones in my family? No, I would not. But again, I’m gonna be very specific here.
Jill, what do I do when I’m having extreme, you know, every time I eat fill in the blank, I get GERD. First of all, I’m gonna say stop eating fill in the blank, whatever that is for you. Stop eating that. That would be the number one thing. Jill, you’re so annoying. I wanna have it sometimes. Sorry, you know, whenever I tape, I get 27 texts in a row. Look at this, hold on. I swear to God. So, if you wanted to take, say I was having an extreme acid reflux of something, if I wanted to get rid of that because I was dying in pain, I would take a little bit of an antacid. I might take a Gas X, yes there’s stuff in there too, calcium in there. I may take a Tums, I may, a bit of it, a bit of it, just enough to curb my problem. So if you were going to take a Tums, you know, once, twice a month. I’m not going to, no one’s forming a stone with that. We’re talking about the abuse of things like antacids that have a lot of excess calcium carbonate or calcium in it, period. Calcium supplements when taken in excess can increase your stone risks. I’ve had many patients when they do their urine collection, they were on calcium supplements and their urine calcium was very high. That is a stone risk. High urine calcium.
If you don’t know if you have high urine calcium, please get a 24 -hour urine collection.
So his specific scenario is the doctor said, if you’re in a bind, take the tums, take half of one, because we know research also says up to 500 milligrams at a time. Don’t do more than that because we don’t absorb it that great. We don’t want the excess in the urine. So could you do that and not get a kidney stone? You could.
But, I don’t know, I’d almost rather not even get, I’d rather take nothing. Most of you haven’t had any calcium in 50 years. Now all of a sudden you’re worried about it with every little thing you eat. It doesn’t work that way. Do your best to get your calcium needs met. It is best by food, best by food, where it’s naturally occurring. After that, you have, for people who don’t use dairy, you have the supplemented milks. Is it?
Are those better than naturally occurring calcium products? No. Is it better than a pill? Yes. Typically, the reason is because people will say, well, that’s a form of calcium in there. That’s a supplement, too. But with those milks will come the instructions that no more than 500 milligrams at a time. Drink those milks with food. Just don’t drink it. It’s because it is a supplement.
I have so many people in my practice, that is what they’re using for the calcium needs. They’re using the non -dairy milks. I’m not seeing high urine calcium markers on their urine. I’m not seeing that. I’m not. So I guess what I’m saying is, for those people that are going to be annoyed, what am I supposed to do for my reflux? Don’t eat the foods that are bothering you. That’s number one. But number two, there’s many different reasons. There’s illnesses, there’s medications.
There’s many different reasons people have reflux. Talk to your doctor to see what is best for you. If the doctor says something like, Tums, in the rare occasion that you have something and you need to take it, you know, again, taking half a Tums with food, typically when you’re having huge GERD problems, you don’t want to take it with food, but you know, taking a little bit of a Tums just to get that horrible feeling away, I’m not worried about that.
I’m worried about the people that are downing 10 tums a day. And they will tell me they were eating it like Pez Candy. That’s why they got a kidney stone. Not just because they took a tums here and there. I’m not worried about that. I don’t like the use of tums as when you do have access to other forms of calcium. I just don’t like the practice of that. Again, everybody’s grown, you’ll do what you want to do. You may say it’s a lot easier for me to down a tums.
500 milligrams with my lunch than it is to grab some milk or non -dairy milk.
Do that when you get your urine collection done. See how it’s affecting you. That’s all I can say. Because we all absorb things differently too. So if you’re somebody who’s going to be like, going to think, you know, I don’t really care what you say, my doctor said I can do it, please follow your doctor’s orders then. But I would suggest you doing a urine collection then too. I always tell people, if there’s things you’re doing that may make you a little nervous that you’re increasing your stone rest—please do that while you’re doing your own collection. So you can see for yourself.
Maybe, his name was Lewis. Maybe Lewis can handle 500 milligrams a ton once a day. No problem. Somebody right after him? Not so much. So we’ve got to be very careful with the use of any kind of pill supplements if you are going to take them. And I’m aware, because I wrote that article with Dr. Coe about supplements and taking your calcium needs from supplements.
If there’s some people who have parathyroid issues, malabsorption issues, bariatric malabsorption issues specifically from their surgeries, those people have to take a hell of a lot of calcium because they’re not absorbing calcium. They’re not absorbing a lot of things. So you can, you must take those things with food and not over 500 milligrams at a time unless a doctor has told you specifically that that’s okay for you. Because again, people with malabsorption issues may need to take more than that. That is between you and your doctor. For kidney stone formers in general, it is very important to get your calcium from food and drink. That’s where we want you to start.
You know, people will say, well, I’m going on vacation. Maybe they won’t have yogurt or whatever. You know, again, I will also say this. You could take a chance taking Tums during your vacation, or you could just do your very best because again, most of you haven’t gotten calcium for decades of your life. One week is not causing a stone for it. It’s just not. So, you know, I don’t know what to say about that advice.
I’ve done this for a very very long time the advice has always been supplement is the very very last form of calcium that you want to do. You’ll note I can’t tell you how many people have osteoporosis, doctor puts them on calcium supplements, two years later kidney stone. Let’s start patients for whatever they’re trying to do in order to get enough calcium from natural sources first. That’s what would be ideal especially for stone formers.
Okay. Does that make sense, Jeff?
Jeff Sarris
Absolutely. And I think the testing part is something that I just wanted to just bring up one more time. I really liked that because if you are concerned, if you’re worried about it, that do you want a urine analysis, a urine collection, 24 hour urine collection, and then you can either review it on your own with your doctor or Jill also has a service called urine analysis where she will help you go through it. But having that information is so helpful because then you actually know the data of what’s happening within.
Jill Harris
I can’t even say how important that is. Many stone formers are just, they’re doing certain things because they have other illnesses and so they’re petrified. They’re like, I don’t know. And I’m just like, do a urine collection when you’re doing that. Just do it so you can see for yourself. People are like, I’m so afraid of oxalate. Have your 100 milligrams that day. Go higher that day. See what it’s gonna do. You’re gonna see. It’s gonna be fine. And people are like, my God, I’ve been worried all this time for nothing.
The urine collection, folks, will give you all the answers you need. If you’re trying to prevent kidney stones and you have not done that, I highly suggest you get your doctor to do it. There’s things in that urine collection that you would never know you have, like high urine calcium, unless you did a urine collection. When people come to me, they’re like, I’m a stone former. My doctor just said it. Has he ever done a urine collection? No, he says I don’t need it. They do a urine collection because I beg them to get it done.
high urine calcium. So you’re damn right that person would have been a stone maker the rest of their life. Not to mention have bone disease. Either they already have it and haven’t had a DEXA scan or when they do get their DEXA scan they see now they have osteopenia or osteoporosis. So osteoporosis is very important. I’m not just telling you guys, listen, I’m a patient myself. I don’t want to have to have any kind of test I don’t need. You need this. Get it done. That’s it.
Jeff Sarris
Yeah, I think that’s the perfect note to wrap on. So thanks again, Louis. If you’re out there with a question, the number is 773 -789 -8763. Again, this is the Kidney Stone Diet podcast. So if you want to dive deep into everything Kidney Stone Diet related, just head on over to kidneystonediet.com. You can work with Jill directly. You can join the course, which is a self-guided video course. There’s so many different options, but you can find all of that at kidneystonediet.com.
Thanks everyone for tuning in, for liking and subscribing, and we’ll see you next week.
Jill Harris
Thanks, Lewis. Great question.
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