In this conversation, Jeff Sarris and Jill Harris discuss the relationship between calcium and kidney stones, emphasizing the importance of calcium in preventing kidney stones rather than dissolving them. Jill shares insights from her nearly 30 years of experience in helping patients manage kidney stones, highlighting the significance of urine tests to understand calcium levels. The discussion also covers dietary recommendations, the role of calcium in bone health, and the broader benefits of following a kidney stone diet.
What Tests Exactly Should My Doctor Order for the 24-Hour Urine Collection?
Takeaways
- Calcium does not dissolve kidney stones but helps prevent them.
- A 24-hour urine collection is essential for understanding calcium levels.
- High urine calcium can lead to kidney stones, and diet plays a crucial role.
- Calcium is vital for bone health, especially as one ages.
- Pairing calcium with high oxalate foods can help reduce oxalate absorption.
- Dietary changes can lead to reduced need for medications.
- The kidney stone diet promotes overall health, not just stone prevention.
- Non-dairy sources of calcium are available for those who avoid dairy.
- Lowering salt and sugar intake is beneficial for kidney health.
- Education and awareness about kidney stones can empower patients.
00:00 Understanding Calcium and Kidney Stones
06:05 The Role of Diet in Kidney Stone Prevention
11:35 Community and Resources for Kidney Stone Management
Jeff Sarris (00:00):
Calcium may dissolve kidney stones? Let’s talk about that.
Jill has been at this for nearly 30 years now, preventing kidney stones for thousands and thousands of patients. And today we’re talking about calcium. We’re talking about dissolving kidney stones, calcium. What are we actually talking about here?
Will Calcium Dissolve Stones? No. Will It Prevent Them? Yes.
Jill (00:19):
Well, you know, I get all kinds of crazy questions in my line of work. And so there’s some people out there that actually think that their doctor told them to do something with calcium because it’s going to help dissolve stones instead of lessen stone risk. So you know, are they going to dissolve kidney stones? Well, no. Are they going to help prevent kidney stones? Yes. Now you could say, “My stone is calcium based.” You could also say this, “Jill, I have too much calcium in my urine. Why would I want to get more calcium?” This is also a very common question.
For those of you who have high urine calcium and you’re only going to know that you have that because you have done a urine collection, a 24-hour urine collection, the whole reason I beg you guys to get your doctor to order that. And if your doctor says no, find another doctor that will order it. I have a blog post at kidneystonediet.com on the exact test. This is what it’s titled. “What test exactly do I need for a 24-hour urine collection?” Something like that. You need to get that test done because many of you are being told that you’re a kidney stone former, but that you’re just always going to be, but that’s because no one’s tested your urine and they don’t know that you have high urine calcium. And that’s one of the biggest reasons people are making kidney stones. So it really kills me that doctors don’t order these tests. And I think a lot of doctors don’t order them because they don’t know what to do with them when they come back. But see, you have me. So all day long, I’m helping people understand their urine collection so they can have better doctor office visits and talk to their doctor about it educated.
Why You Need Calcium
So the whole calcium thing. The reason you need enough calcium, and this is a thousand milligrams for women and men and 1200 milligrams of calcium per day for postmenopausal women, do not go over those goals. You need that much because you have bones and you need to make sure they stay strong. I’ll be 62 in a few weeks and I want to get out of my chair in a few years. So it’s very important to me to be able to keep my strength, because as you get older, it flies away if you don’t take care of it. So calcium is important for bone health.
And then in kidney stones, what it does is it lowers urine oxalate. So when you have calcium paired along with something that’s higher in oxalate, like sweet potato, instead of all that oxalate absorbing into your body, the oxalate from the sweet potato, if you have it with a non-dairy milk or a milk, some calcium based product, when you have it with the higher oxalate product, at the same time, not two hours later, at the same time, then oxalate and calcium go through general metabolism. They meet each other in the small intestine. They join. They leave through the stool. If there’s no calcium there, because most of you, if any of you, get enough calcium every day, and you certainly are pairing it with, you know, maybe spinach or whatever, because you don’t know anything about this yet. You know, it’s very easy to, you have the oxalate food, like a spinach salad, of course you didn’t have calcium, so spinach cannot leave through the stool. The oxalate gets reabsorbed back into your blood. I think I kind of said that right, whatever. I think I did.
So the sweet potato breaks down, we have some oxalate as a waste product, it goes through the regular general metabolism process it gets to your intestine. It’s looking for calcium, but you didn’t have any calcium. So now the small intestine is reabsorbing that oxalate and that’s how you get higher oxalate levels. That’s a Jill explanation, which tends to be crude, but everybody can understand it. Okay, of course for real scientific explanations. You guys can go to my mentor site Fred Coe. That’s COE. And his website is kidneystone.uchicago.edu. All the science lives there. I’m the interpreter of that science. OK?
Jeff Sarris (04:41):
Yeah, and just to be aware, it is science heavy. It is like you have to love that degree because Fred is a scientist, a researcher for years in this topic. So he’s speaking in that vein, but it’s, I mean, it’s super helpful when you want to dive very deep, but just be warned.
Jill (04:46):
It is very exciting as scientists. Yes. Yes, he’s a nephrologist and he’s actually in a couple weeks. He’s, it starts with an F. I forget how you say this because it’s in a different language, but he is being honored. He’s 88 years old. He is being honored and there’s hundreds of people coming from all over the country to honor him for his work that he has done as a nephrologist and researcher for all these decades in kidney stone. So I’m going to see a lot of my doctor friends because most a lot of my business comes from doctor referrals because they don’t know, you know, they’re not reading these urine collections the way I will. Or and talk about diet is the real thing, right? So that’s where I come in. But yeah, so he’s being honored. It’s going to be it’s going to be really special. It really is. I’m really looking forward to that. And he earns it. That man, he’s 88. He works seven days a week. Once in a while, his wife makes him take a day off. But he is passionate about what he does. What are we talking about?
Jeff Sarris (05:49):
But yeah, so just with calcium then, yeah, the importance is, yeah, we’re not talking as much about dissolving with kidney stones, preventing. We are removing the oxalate from the urine with calcium, with getting enough calcium, not too much and not too little.
High Urine Calcium: Why You Still Need More
Jill (06:07):
Right, and so for you guys that have high urine calcium, you could be very confused as to why you need more. Well, a lot of you, because you’re not following the Kidney Stone Diet goals, because you didn’t know about them yet, you were making your stone, eating high salt, eating high sugar stuff, eating too much meat products, and what happens is the three goals out of the six of the kidney stone diet, the salt and the added sugar and the meat protein are all there. They are in place to help lower urine calcium. Because when you eat too much sugar, added salt and meat, what happens is that is pulling calcium from your bone and dumping it into your urine. So you guys will have too much calcium in your urine and along with maybe you’re not drinking enough and you’re not peeing enough, so all these calcium crystals are sitting in there. Calcium is looking for oxalate, phosphate is looking for calcium, and all these little crystals find each other like magnets and form stones.
Understanding Idiopathic Hypercalciuria (IH)
So a lot of you will have something that’s called, it’s known simply as IH, but it stands for idiopathic hypercalciuria, which is a big fancy word that means Bobby has too much calcium in his urine, hypercalciuria, and idiopathic means there’s not a medical reason for this. We’ve ruled out diet, Bobby’s doing the diet. We’ve ruled out other medical conditions, parathyroid issues, vitamin D deficiency, all these things. And this patient still has high urine calcium. At that time it is diagnosed as IH. We have no medical reason for it. Slap on a diuretic. And that’s when Bobby will go on a diuretic. And that diuretic will help save calcium. It will keep calcium from being thrown into the urine like that.
So you always try diet first. If the diet isn’t working by itself. Lots of times this is genetic. It happens in families. This is why people say “Everybody in my family has it.” If they all did a urine collection, many of them or most of them would also have high urine calcium. So don’t you dare let a healthcare professional say, “Oh, you’re just a stone maker” and you haven’t done a urine collection. In my almost 30 years, I’ve never seen just somebody who’s a stone maker. I’ve looked at thousands of urine collections and me, I get more passionate about this because I’m a patient with all my bowel issues and cancer stuff. And I’m like, don’t ever say things to me that’s going to make me give up hope. That just drives me nuts because there is stuff that you can do. And plus the kidney stone diet is just a healthier diet.
The Bigger Picture of Health
So you want calcium because you want, forget about kidney stones, you want calcium because you’ve got to feed your skeleton and you can get non-dairy calcium sources. You don’t have to use dairy anymore. Okay. You can lower your salt and lowering added sugar. Everybody should be doing that for heart and kidney help. Okay. Getting enough fluids. Well, that’s the best. Moving around, lower oxalate, all of it, all of it will be on the healthier side for you in general.
I can’t tell you how many of my patients have gone off their metformin. They don’t take their blood pressure medications anymore simply because they got a kidney stone that scared the hell out of them and then they’re like, “Whatever you say, Jill, I’m doing.” Boom, boom, boom. The medicines disappear. Why? Because of me? No, because Bobby’s working his butt off now and now he doesn’t make new stones and also he doesn’t have high blood pressure and he feels better than he ever has. I know I’m boring myself. I’m sorry.
Jeff Sarris (10:10):
No, no, no. And just, yeah, on that too, it’s not, Jill has not said, “Stop taking this.” This is the doctor who would have prescribed this would then discover that the person no longer needs that medication.
Jill (10:23):
Yes, thank you, Jeff. Yeah, I’m not saying get off your… When you follow the kidney stone diet, most of you, you’ll go back to the doctor’s office, he’ll take your blood pressure, he’s like, “What are you doing? What are you doing, oh my God? Your blood pressure’s never been better. I don’t even think you need the meds.” And they’ll start weaning them off the blood pressure medications to make sure that they don’t need them. And then they get off of them. So thank you for bringing… I’m not telling you to get off meds, people. Thank you, Jeff. God bless.
Jeff Sarris (10:51):
No, never.
Jill (10:52):
Never ever you will listen to your doctor’s advice. But what I’m saying is the nice side effect of paying attention to what you put in your mouth will leave you with a heck of a lot, you see these pills. Instead of going from the big pill, I’m looking at pill boxes for those listening on Spotify or other places, you get rid of your pill boxes folks. I have it because I need vitamin D and B12. Otherwise, I don’t take any pills, Synthroid, but so that’s what I’m talking about folks. You need calcium. It will help lower your risk for kidney stones because it will lower urine oxalate and you need it because you have a skeleton.
Jeff Sarris (11:34):
Yeah, I think that is a perfect overview. And if you want to dive deep into everything kidney stone diet related, all the goals, the sodium, the sugars, the meat protein, all of the things that you need to consider, go to kidneystonediet.com and you can find all of that information right there. And even if you want to get a weekly email from Jill, absolutely free, right to your inbox, just drop your email address there on the homepage and you’ll hear from Jill every week.
Jill (12:02):
And we give a lot of special deals only to the newsletter folks. You know, there’s like 40,000 people on that newsletter.
Jeff Sarris (12:05):
Mm-hmm. Yeah, that brings everyone, it brings you into the community of like-minded people who are all in pursuit of the same thing, and that’s to prevent future stones. So with that, I think we’ll wrap and we’ll see you next week.
Jill (12:14):
Yes. Yes. Have a good week everybody.
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