Does alkaline water help kidney stone patients?

This week, Jill answers a listener question about drinking alkaline water for kidney stone prevention.

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.

Jeff Sarris: I like that last time you said we’re not related, have more people thought that we were?

Jill Harris: Oh, I just get that nonstop. Well, you know, Sarris, and Harris. I mean, I get it, right. Yeah, non-stop. “Your son is so handsome!” “He’s not my son. Thank, though! He is handsome, but he’s not my son.” If he was my my partner, I’d certainly be a cougar.

Jeff Sarris: But it is funny because like, our names are so–I mean, start with a “J,” four characters, and with “-arris.” Like, it’s so close.

Jill Harris: Whenever I’m writing your name, I’m like, it’s so funny. Right?

Jeff Sarris: Yeah. But, anyway, real quick: I know there’s more to it. Maybe we’ll dive into it later, but you have a new puppy now.

Jill Harris: Oh my God! So, I’m just gonna–so last week’s newsletter I did. So, this is how it started–and everybody here can relate to this, or not everybody, but a lot of people. So we all know, my beloved Luke died. And I said, “Oh, hell no, I’m not getting another dog. Nope, nope. Nothing will take the place of my Luke. Nope. And I’m certainly not getting a puppy.” Well, four months later, six months later, whatever it is, I got a little puppy. His name is Finn. My son named him Finn and he’s a mini bernedoodle. So, last week, it rained every single day. Wait, let me back up. Let me back up. So, I got the mini bernedoodle, okay?

Jeff Sarris: And is that like a St. Bernard-doodle?

Jill Harris: It’s a bernese mountain dog and a poodle.

Jeff Sarris: Gotcha! Okay.

Jill Harris: And, so, before I got him, I was on YouTube because look! I’m a fan of YouTube. I’ve learned so much stuff. This is why we do this channel so you can learn so much stuff on kidney stone prevention. So I’m researching, I’m on my McCann’s training, who I love so much, okay? They’re fabulous. They give away all this free stuff, like we do. So I really value them, and they seem great. So, I watched hours–and when I’m telling you, my son would go by and go, “Oh, god, she’s still watching those stupid videos.” I mean, hours. By the time Finn came, I thought I was a certified trainer in dog training.

I was like, “I got this. I got this!” Finn is going to be potty trained in 48 hours. When I tell you that’s what I thought, I mean it. 48 hours tops, probably 27 hours. So, I pick him up last Monday and the rain and the cold in Chicago, the first week of May was relentless. So, here is a six pound dog and I’m like, “Let’s go potty. Let’s go potty.” I bring him out. He looks at me, in the rain, he’s not happy. He’s a baby. I’m like, “Go potty, go potty, go potty!”

I have my very valuable treat to give him, “Go potty, go potty!” He looks at me, he sits on the ground, he does nothing. I bring him in. I’m like, “Oh my god!” So this would happen like 50 times a day. And, so the reason I’m telling this story–and Jeff doesn’t know this–but there’s a reason and this is what the newsletter was about, I spend so much time telling patients that lifestyle changes do not happen overnight. The diet industry wants us to believe that you just read this pamphlet and you’ll be skinny mini in a week.

It takes a long time to get your head around all the changes you need to make then all the obstacles that come up. For Mother’s Day, I went over my mom’s house and she is trying to lose a little weight right now and my sister got her her favorite pizza. And I’m bringing this up because it’s a real-life scenario. So, it’s Mother’s Day. It’s her most beautiful favorite pizza. She has it twice a year, but she’s watching her weight. And you could see her like, “I want it. I better not. I want it.” So real life obstacles come back, you know, keep coming, right?

So, lifestyle changes are hard. I scream it every single day, all day long. So here I am with this little baby, tiny, teeny, six pound dog shocked that he didn’t get his galoshes. put on his raincoat, pop open an umbrella, and say, “See in five minutes. I’ll be right back!” I mean, I don’t know what I was thinking. So I’m calling myself out. First of all, I said to him, like, “What the heck? Why are you peeing in the house?” He’s like, “Well, did you see the weather outside? It’s ridiculous.” I said, “I know, but I’m really trying here.” He said, “I’m a baby!” So just like Luke, I talked to Finn.

So, it takes a minute. I also had a patient that said, “You know what, Jill? You’re on his time. You’re on puppy time, not Jill time anymore. So you better knock that off, too.” And she changed my whole thinking around it. And she’s one of my students in the Kidney Stone Prevention Course. I said, “Thank you. Thank you so much!” And so that changed my expectations. We have these expectations what a relationship should be, how much a house should cost, what groceries should cost, things that are way out of hand these days-what gas should cost! So we’re kind of shocked when things are not like what we expect it to be. It’s very disturbing.

And lifestyle changes are the same thing. It’s hard. Potty training a dog is hard, and it’s going to take time. So, besides that story, he’s adorable. Go to the Facebook page, go to my Instagram, go to TikTok. He’s all over social media. He’s adorable. I love him. He’s challenging for an old broad like me, but he’s adorable. So, you know, it’s just an exciting time, but it’s a hard time. And that is also what a lifestyle change is. I’m looking at it like, “God, when he is trained, it’s going to be so awesome to have a new best friend, you know, another best friend.” And for lifestyle change, it’s like, “Wow, this really is difficult right now I’m trying to get my head around it.”

But you know, me eating healthier, meaning you viewer, you eating healthier, the outcome of that is going to be awesome: better health, in most cases; lower weight if you need to lower weight; a better attitude about health, in general, and how good you feel; more confidence. All the things! Not confidence because you lost weight, perhaps, but confidence that you’ve got your eating under control, or you got the knowledge base for how to proceed with any health-related things you’re trying to seek out. And, you know, it just starts feeling good, but you gotta give it time. So, I sat down with myself, and I’m like, “Boy, you got to really listen to what you’re saying to everybody all day.” And so it has changed the way–and also it’s going to be very sunny and almost 80 every day this week, so that helps, too. It was really the rain as well. Yeah, but what a joy! What a joy, pure joy.

Those little legs. It’s ridiculous!

He looks like a potato! He looks like a hairy baked potato, waddling around! Yeah, he’s just this little round body with these tiny legs.

Jeff Sarris: Do you know how big he’ll probably get?

Jill Harris: Yeah, he should get like 30-35 pounds, so a good size for this apartment, you know, because I don’t want a tiny dog. I’m very, you know, I’m rough. I’d probably step on him. I’m not the petite kind of lady kind of girl. You know what I mean? So I need a little girth. He’ll be about 35 pounds, so we’ll see. It’s gonna be an exciting ride.

Jeff Sarris: Yeah, that’s a huge change. I couldn’t imagine having to train them, like potty train them or whatever, to go outside. That is a big task. So I commend for that!

Jill Harris: You’re getting up in the middle of the night. You’re getting up in the middle of the night! He can’t hold his bladder. He’s a pound, I mean, you know, six pounds so he can’t hold his urine. So, I’m like, “Okay, so here I am talking about going to the potty all day with kidney stone formers. I’m talking about it all day with my dog. I’m talking about pee, pee, pee all day long and night now!” It’s a lot of fun, though!

So, on that note…

On that note, transition, yeah!

Jeff Sarris: I think this is actually perfect because this question this week is related to urine collection. So, why don’t we fire this up?

Jill Harris: Perfect!

Listener Voicemail: Hello, my name is Kayley and I am from Fort Worth, Texas. I was curious of, first, when y’all are going to do this raffle because I’m definitely interested. I will be doing the interview anyway. But also I just was curious, my results came back from my 48 hour urine test and it had said that my urine acidity on the pH scale was obviously acidic, 5.5, I believe. So I was curious, is it worth it and does it actually work to drink alkaline water to help with that? Will that help with the acidity of my urine and is it worth investing in alkaline water? So, that’s my question.

Does Alkaline Water Protect Against Kidney Stones?

Jill Harris: It’s a good question. So, now, is everyone expecting me to answer it? Guess I will. Okay, so, listen carefully: in general, I’m not a fan of alkaline water. Kayley has done a urine collection, and she knows her urine pH. Many people come to me and say, “I’m going to start drinking alkaline water because I heard that prevents kidney stones.” No, it does not prevent kidney stones. Some of you are walking around already with high urine pH. You don’t know that because you haven’t done a urine collection. You’re just naturally running around–and older woman like me, as we get older, our urine pH can climb up. We don’t know why, but it can. We don’t care about it, unless somebody has too high of urine calcium, and they’re not drinking enough water.

So, if you have the combination of high urine pH, high urine calcium, and low urine volume–meaning you’re not drinking a lot–you will put yourself at risk for calcium phosphate stones. So there’s that scenario. Then there’s this scenario that people call me up and say, “I need a consult with you” or get in the Kidney Stone Prevention Course, they learn. They lower their urine calcium–after they talk to me–they start drinking more water–after they talk to me and do the work–but on their follow-up urine collection, they still have high urine pH. We won’t care. We won’t care because the other two risk factors are now better.

How Can I Test My Urine pH Level?

And even a lot of reports will say, “Hey, we see Kalyey–”I’m using her name– “we see Kayley’s urine pH is high, but her calcium and water are just fine, so she’s not at risk.” So there’s that. Now, do not generically start drinking, anybody, alkaline water because you don’t know if you’re walking around with a high urine pH and you don’t want to make that higher. So, a urine collection–you will hear me say this constantly–you must get a urine collection so you can see why you are forming stones. If a doctor says you don’t need it, say, “Dear doctor, I would like one because I want to know why I’m making kidney stones and then I’m going to do everything I possibly can to stop making them, so I would like that.” And once you say that the doctor typically orders it. Don’t take “no” for an answer, people.

You’re going to have to push back on that one. And I know that can be intimidating, but I’ve sent countless patients back and once they say what I just said they get that order taken care of. If your urologist doesn’t want to order it, then ask your primary, too. Any doctor or nurse practitioner or PA can order a urine collection. It doesn’t have to be a urologist. They may not know what to do with it after you get that, but that’s why I have the urine consult and then I can help you understand the report so you can talk to whatever doctor you’re dealing with, in an informed way so you even get somebody who’s not well versed in a better treatment plan. Kayley’s like, “Okay, am I gonna go to bed? Is she going to shut up about it? I don’t know what she’s talking about. She’s not answering my question!”

Okay, girl, here I go! So, Kayley, her urine pH is low. It’s low, it’s more acidic. So, it’s in the fives. That puts her at risk for calcium oxalate stones, and/or uric acid stones. So, if I were looking at her urine collection, my first question would be to her, well, I’d look at the dietary factors on her urine collection and I’d ask her some questions to figure out why is her urine pH that low? Is she eating too much meat protein because that can do it? Is she a pre-diabetic? Does she have diabetes? That will do it.

So, there’s different things that can bring her urine pH down, so that’s where I would start. The doctor, hopefully, will notice that her urine pH is low. And a urine pH that low, I wouldn’t waste your money on all that alkaline water. It’s not enough that’s going to bring it to where we want it to be, which is like around 6.1-6.2. That’s a happy factor. It’s not too high, it’s not too low for stone disease. Now, guys, don’t email me and say, “Jill my urine pH was 6.3.” I’m just saying happy factor 6.2. You have some wiggle room, but Kayley’s is much too low.

My Alternatives to Alkaline Water

Kidney stone crystals, or crystals in our urine, love an acidic environment. They just love it, so the doctor may talk to you about using a product called “Moonstone.” The doctor may talk to you about a product called “LithoLyte.” These are powders and potions you can put into your water that will increase your urine citrate and pH up more than an alkaline water will. So, what I’m trying to say is I wouldn’t spend all the money on the alkaline water because it’s very doubtful it would bring it up to where it needs to be.

And then my other question would be to you, my high priority question is, “Why is that pH so low? Do you have this, this and this as well?” So, that’s what I would ask. A lot of keto people have very low urine pH, Paleo people have lower urine pH because they’re focusing more on the meat, less on the vegetables, and so they’re really overeating meat and that can that can lower your urine pH. That can be a cause. So, there would be a reason. I would like to know why your urine pH is so low.

I would not invest in a ton of alkaline water. If you’re like, “But I’d like to.” Look, you can try that. It’s expensive, though, and you can do a follow-up test to see how much of that water–because you have to drink water anyway–how much would it raise your urine pH. It’s not going to raise it where you need to be. I think Electrolit and alkaline water, I think it’s a bunch of–I don’t believe in it, in my humble opinion. Don’t give me hate mail for saying it. I just think it’s a waste of money. If you want to increase your urine pH, you can also eat more fruits and vegetables. That will absolutely do it because they’re alkaline.

So less meat–normal meat portions–and have more fruits and vegetables. There’s plenty on a low-oxalate diet you can eat. You could also add a little lemon juice, but again, your pH is so low, I just don’t think it’s worth taking the chance of, you know, screwing up your teeth and losing tooth enamel with that. So that is a great question. I would talk to your doctor about what you’re going to do to raise that urine pH, and, hopefully, you’re going over your lab results with a doctor. I can’t tell you how many people do a urine collection and a doctor never goes over the urine collection with the patient.

So, the first time they talk to me, I’ll say, “Well, what did the doctor say after this first urine collection?” “Well, they didn’t go over it with me.” “Oh, okay.” But patients don’t know what they don’t know. They just assume a doctor is going to call, “Hello, Trixie, I got your urine collection here. Let’s go over it.” That doesn’t happen. That call’s not going to be made. Rarely, so it’s going to be up to you guys to keep your doctor engaged in the urine collections. I’m not saying all doctors don’t do that. I’m saying a lot don’t. So, you have to be your biggest advocate in all, not just kidney stones, in all your health, especially nowadays, where our healthcare system is, you know, tied up, backed up, right?

Jeff Sarris: Yeah, it’s hard to give the time to individual patients because everyone is so busy. But that’s also why I like to just mention on the site, at kidneystonediet.com, there is a resources section where you can find an actual, one-pager that helps you have better doctor’s visits. And it prepares you for what to anticipate and how to how to approach your doctor’s visit because it’s tough. We’re in pain, we’re suffering, and we want resolution, but we don’t know what we don’t know. Just exactly like you said.

Jill Harris: Yes, and also, I think, you know, there’s a lot of us, depending upon when you were born. I think the younger kids today, they’re just like, “I don’t care if it’s a doctor or not.” It was a more patriarchal kind of culture, so we as patients in our 50s, 60s, 70s, 80s, were kind of like, “Well, what do I know? He’s the doctor. I’m just gonna sit here and be quiet.” So, you can get very anxious and nervous and you don’t want to bother the doctor. There’s a lot of that thinking, too, with the older generation people. So, I just want to put that out there. Doctors typically enjoy patients that are engaged. Doctors typically welcome that and it keeps doctors and nurses like me on our toes when people ask questions.

So, you know, that’s one of the reasons I love when Jeff just says we’ll do questions today and I don’t know what’s going on. It keeps me on my toes and it keeps me engaged. I talk a lot about the same things all the time. So I’m just saying, if you’re with a good healthcare professional, they’ll encourage you to ask questions and even if they’re not encouraging you, most of them will be thrilled that they have a patient that cares about their health. Many people are in and out of offices, not saying much because they really don’t care. I’m just saying what my experience has been in the last, you know, decades.

And patients will tell me–I’d say, “Why did you wait, Bob, for 20 years before you made a phone call to figure this out?” He’s like, “I don’t want to change my lifestyle.” I hear that all the time. Until, finally, after you lose the kidney or all the other crappy things that happen to kidney stone patients, then, you know, then they start taking it seriously. Please don’t let that be you. Make sure when you get your first stone, you never get a second one, again. It’s the reason we’re doing this for you on this YouTube channel. Please listen to what we’re saying. Take the information. If you need more help with it, there are services. You can buy my services over at the website. There’s plenty of free opportunities on the website, a kidneystonediet.com.

There’s no reason why you can’t prevent kidney stones. Now, there’s a handful of you that have other illnesses that are predisposing you, but up to 80% of reoccurrence down. Okay, up to 80% reoccurrence. We don’t have to worry about stones up to 80% of the time if we really stay on our treatment plan. So, that’s a big number of people and a lot of people are getting stones–one in 11 1 in eleven of you are gonna get a stone. It’s very common, so heed our warning, listen to the YouTube channel, subscribe, and go to kidneystonediet.com for so much free information there.

Jeff Sarris: I think you encapsulated everything perfectly there. The only thing I want to add is if you have a question, the phone number is 773-789-8763 and we will have your voice on a future episode. But yeah, thank you, Kayley, for that question. If you also are curious about the urine analysis service–I’m blanking on words here!–I just popped it up on the screen, but you see right at the top, you have the urine analysis menu link where you can click through and learn more. That is a premium service, but, like Jill said, so many free resources on the website, but I’ll leave that to you to check out at kidneystonediet.com. Again, thank you for listening, thank you for watching, thank you for subscribing, and sharing this with people who can really benefit from learning about reducing their risk for kidney stones. I think we’ll wrap there and we will see you next week!

Jill Harris: Have a great week! Bye!