Are fortified milks safe for kidney stones?

This week, Jill answers a common question: Why do we have to avoid calcium supplements when it’s safe to eat or drink calcium enriched foods?

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
And I’m Jill Harris your kidney stone prevention nurse. We have a mic. Now. The mic closer to your mouth. Okay.

Jeff Sarris
Now this is funny. I love love seeing the big smile when I’m doing the intro. But yeah, so we have another question coming from in the house.

Jill Harris
Yeah, people like you tell us the call every week, but you’re doing you’re monopolizing all the time. But this is for y’all. This is for you guys. Listen, this is on calcium supplements. And you know, it just dawned on me, there’s so much to talk about with kidney stone, stuff that sometimes the most obvious ones just aren’t talked about yet. So this one is going to be on calcium supplements because this is a really popular topic on the Facebook page. And it goes something like this, Jill, what’s the difference between taking calcium supplements and getting calcium through supplemented foods. While there is a difference, but let’s talk about this whole scenario. So as we get older, especially women who are postmenopausal like myself, at some point, we may get osteopenia that can lead to osteoporosis, or you’ve gotten a kidney stone.

So now you have doctors telling you to take 1200 milligram 1200 milligrams of calcium supplements, they say get 1200 milligrams of calcium, to ward off osteoporosis, postmenopausal women, and also to lower your kidney stone risk. This will help lower urine asked oxalate. So when a doctor says to a patient, start doing a supplement, if the doctor saying 1200 milligrams, they automatically are going to tell the patient they always say, take a supplement, almost always. And also, if a patient even if the doctor doesn’t say take a supplement, the patient automatically assumes that’s what they should do. All right. Now, when we get too much calcium, that can also pose a kidney stone risk. So why do kidney? Why do calcium supplements pose a risk? Number one, most people are taking them without food. That’s number one. Number two, they tend to be getting too much calcium from those supplements at once. And the body’s not absorbing them.

That’s a big deal. Also, the patient and the doctor are not considering that. Most people by happenstance are getting about 250 milligrams of calcium through food. So now a patient is taking 1200 milligrams through pills of calcium. And they’re getting over 200 milligrams of calcium through foods, whether it’s vegetables enriched, at least enriched milks, whatever. Studies will show that women specifically have a higher chance of heart attack if they’re getting more than 1400 milligrams of calcium. Okay, and buy pills. That’s not good. Okay, so you can get some calcium deposits. So there’s that, and I’m not going to go into that you can talk to your doctor about that. But the point is this. When we take so we don’t want calcium supplements in pill form for kidney stone formers, they’re not absorbed as well. So this is where people get a little crazy, because they’re like, Well, I’m not doing dairy girl, so I’m gonna have to use oat milk or flax milk or pea milk.

But they all are supplemented. So what’s the deal? Why are you saying those are oak? Oh, all okay. Well, number one, we’re not drinking three glasses all at once. So we’re drinking those supplemented milks throughout the day, so the body can absorb them better. Also, those milks are supplemented typically with other nutrients like vitamin D, or magnesium or phosphorus. That’s going to help you absorb that calcium better. All right, so those are safer than the pill form. For those reasons. That being said, dairy. Oh, no, she ain’t bringing up dairy cheese not doing that. I’m not having dairy. You don’t have to have dairy. I’m just saying a fact. Dairy has great calcium, and the most bio available, meaning the body will absorb it best. All right. So you do not have to have dairy in the form of like milk and yogurt, it has a lot of calcium in those products. So, if you enjoy dairy if dairy works for your body, if dairy works for your belief system, please have it, it’s the easiest way to get it. But you can also use the supplemented milks, I just want to make that clear the difference between the pills, and the supplemented milks are you will absorb the milk, the flax milk, the pea milk, all that much better than the pills, okay.

And so also, but this is very important too. So very important. Do not go over your calcium recommendation. 1000 milligrams for men and women 1200 milligrams of calcium a day for women who no longer get their period, do not go over so many humans, human beings are like more is better. And it’s not. Again, we don’t want all this excess calcium, your body may not absorb it that well for different reasons. So you want to get a spread throughout the day, never more than 500 milligrams at a time. Make sure your vitamin D is adequate. A blood test will tell you if it is or not, because that helps absorb it. And what else was I gonna say something else just like oh shit, she’s gonna screw less. No, hold on.

We’ve been recording a lot of things today. Oh, what you guys don’t also realize is there is calcium in fruits and vegetables bok choy, it adds about just as much calcium about a third of your daily requirements as in a serving of bok choy. So it’s very easy. Once you know, once you start getting calcium from dairy or supplemented milks, all of a sudden, you could be getting extra because you’re not realizing you’re getting. Like I said on an average, the regular person gets 200 250 milligrams of calcium a day through other foods. So notice that because we don’t want to go over our calcium goals every day. We don’t want that more is not better. Super important. I think I hit everything I want to make sure I did. I wrote notes on this one. Yep, I did dunk double up on DOS. Yes. So okay.

Jeff Sarris
And there is one thing I just wanted to jump into. I know, for regular listeners or viewers, they know calcium is something that can be a problem because people don’t have enough. But I know sort of a lot of the cliche, like a cliche, but sort of the general assumption is a calcium oxalate stone. Does that mean I have too much calcium? Great question. So like, I think maybe just can we just touch on that a little bit?

Jill Harris
Yeah, no, it does not mean that as a matter of fact. And also some people, which is a major risk for stones, will have too much calcium in their urine. And so they’ll ask me, Why are you telling me I need more calcium, if I have all this excess in my urine from my 24 hour urine collection report? In many cases, you could be losing it from your bones, for many different reasons, like too much salt, too much added sugar for many reasons. And that’s why you get a 24 hour urine collection. But what was your question?

Jeff Sarris
So is the calcium oxalate stones purely because we have too much calcium?

Jill Harris
Well, it could be you’re taking in too much calcium through pills that is not being absorbed. So say you are on 1200 milligrams of calcium. It’s not being absorbed as well than other sources of calcium. That includes enriched non dairy milks. All right. So the point is this. Even though you make a calcium oxalate stones, it doesn’t mean that you’re getting too much calcium, but it could, there’s that, are you absorbing it properly. And there’s many reasons why you don’t absorb calcium, you’re taking too much. You’re taking calcium pills, your vitamin D is too low, you’re not following the kidney stone diet, and it’s pulling calcium from your bone into your urine, and you’re not paying enough. So this excess calcium is sitting there, and it’s looking for phosphate, and oxalate to bind with. That’s another reason why you have to drink a lot of water and flush that stuff out. Right. So it’s complicated once again, I want it so that’s an excellent question. Just because you make a calcium oxalate stone, doesn’t mean you’re getting it could be you’re not getting any calcium could be you’re getting too much calcium, and it could be you’re losing some calcium from your bone, right?

So there’s many different reasons and again, that’s why you need a 24 hour urine collection. But we all need calcium. It’s just that we don’t want too much and lots of times when doctors order and tell you To get 1200 milligrams of calcium, everyone runs right out and goes to the vitamin store and takes 12 milligrams of calcium every day. They don’t spread it out. They’re not having those supplements with food. And that’s where we run into trouble. It’s really, really important. I think that I think that I think I get everything I wanted to in that one. Okay, oh, and I just want to be extra sure of this. The advantages of enriched food versus the pills is that people tend to take the pills all at once, and we’re not going to absorb all that the enrich foods will typically come with other nutrients that help us absorb that calcium. One more thing.

People who have had gastric bypasses will be put on calcium pills. They just can’t get enough from food and they need that and they have malabsorption issues. So they will need the help of supplements. One more thing. If your doctor because I as a nurse, I do not override doctor’s orders. If a doctor has said listen, Susie, you’re you have osteoporosis, you gotta go on 1200 milligrams of calcium pills a day, I want you to say to your doctor, do you mind if I get through food? And then the doctor will be like, Oh, of course. So this happens, doctors just order the pills, because they’re that’s just what they do. But please ask your doctor, do your doctor can do you mind if I get this from food? I’ve heard that’s best.

And the doctor will of course say yes, I think the doctors just assume that. You know, it’s hard to get that because they don’t know where it is. They don’t have the time to talk about all the sources and all this. So everyone just grabs the pills and it is a known risk factor for kidney stones. So ditch the pills, get it through enriched milk or naturally from food. And we’re gonna do another video, not this session, but we’re gonna do another video on really great non dairy sources of calcium. So you know where to get that. Okay, you can also go to the blog, kidney stone diet.com, the blog, and that articles on there.

Jeff Sarris
Yeah, and like you said, compliance also is tough. So for a doctor to say, okay, change your diet. Good luck. It’s so hard, so much easier to say, okay, take 1000 milligrams a day or do whatever Absolutely. Compliance is just higher.

Jill Harris
It is it is. But then people take that information. And again, they’ll say, Oh, 1200, I’m going to 1800. I’ve worked with patients that they got their kidney stones because they were taking like 5000 milligrams of calcium a day. And also, there’s calcium and so many things that your breakfast cereal so there’s calcium and a lot of things, turn it around Buster Brown and look where calcium is orange juice, orange juice, tons. A lot of non dairy people will use orange juice, which is fine, but don’t be drinking all of it all day long. And Tums. People will use Joule when I got GERD, first of all, can you stop eating the food that’s causing the GERD there’s that. Of course, there’s other reasons people have reflux, and there’s medical conditions too. But people will just take Tums and you know, most people are like, Oh my God, I need like five of them. And so there’s 5000 milligrams of calcium right there, right? And they’re doing that a lot. So all this calcium is building up. It’s not healthy for you, it’s not good for you. The Tums are beautiful, though, when you do have GERD. But so my thing, if they work really well for you, I would take really take half a one and get the least amount of calcium ones available. They keep, you know, increasing the calcium dose of the times like that’s a great thing for kidney stone formers. It’s not. And it’s not just a great thing in general, we were not absorbing all that calcium. It’s great for reflux, but it’s not good for other things. So be careful. Like I said, it can raise the risk of heart disease for women, when you’re getting more than 1400 milligrams of calcium a day so important. Yeah.

Jeff Sarris
Well, I haven’t this will be a good one, especially in the future that will be this question again, today, and how there’ll be a place to direct people. And if you know anyone who’s asking about similar things, obviously send them here, send them to the channel, YouTube, on YouTube, just search for kidney stone diet. And for everyone who has subscribed, thank you so much. If you haven’t, just click that little subscribe button. If you click the bell, you’ll know every time a new video goes up. It all helps because we’re just hoping to reach as many people as we can with the scientific and actual experience driven data and information to get the best results. That’s all we want to do at the end of the day. And you can find all of this on YouTube, on the podcast, kidney stone diet podcast anywhere you listen. And on the website, kidney stone diet.com Where you have meal plans, that course you have the prevention group, you have absolutely everything that you need to find right there. So wonderful. Yeah. So thanks again for tuning in. And we will see you next week.

Jill Harris
Bye everybody.