Oxalate Q&A for preventing kidney stones

If you have kidney stones and you just discovered oxalate, you're going to have a lot of questions. Today we're going to dive in to all those questions.

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.

And I'm Jill Harris, your kidney stone prevention nurse. So happy to see you, Jeff. So happy to be here.

So happy to see you, too. Yeah, we're doing…

Working for the people!

Yeah, we're doing…

Working for the people.

Essentially a Q&A of sorts. We have a question from Kimberly that, what do you say we dive right in?

Let's go, baby!

And I queued it up a little bit in… It's a… It's a longer question.

We appreciate your question, Kimberly, and we just sort of… We're going to jump in, right here.

How do I know? You will be surprised to know that I put myself on a kidney stone diet the best way I knew how by researching online and self-diagnosing, and I lost 80 pounds since November of 2023. So I went from 350 pounds, I'm down to 275 right now, and I keep losing.

I must be doing something right, but you need to explain your oxalate Harvard list here that I printed off. Add a tag to it. How do we know how many oxalates a day to eat?

Is there some type of a formula that calculates how many oxalates are in a particular food? How do you know– How do they know that? How do they know how many oxalates in a food?

My problem is when I got my kidney stones diagnosed, they were 80% uric acid and 20% calcium oxalate. So what do you do? They put me on a medication called Allopurinol, which made my liver enzymes go wacky, so I had to go off of that.

They said that my uric acid is genetic. Well, that didn't seem right. So, yeah, I got a whole bunch of questions, but no urologist has any answers.

Anyhow, I'd like to know your take on the oxalate Harvard list that you give us. How many oxalates a day is reasonable? And how are the oxalates calculated?

How do they come up with that number? My name is Kimberly, Valparaiso, Indiana.

Kimberly, very robust! Kimberly woke me up. Happy to meet you, Kimberly.

Well, there's lots of things. First of all, the food list is just the list from Harvard, and there's the numbers. Okay?

So, you know, we don't expect people to print it, quite frankly, because we have the… Because it would be expensive. We have the oxalates searchable list right on the website.

You can even put that on your phone like a little app if you go to kidneystonediet.com/help, so you don't have to be scroll– you know, looking at all that paperwork.

But, all over my website, you will see, if you go to my blog, Kimberly, you'll see how do we know how much oxalate's in food? Why do oxalates vary? Why do…

Why should we trust Harvard? Lots of things in the blog. Just go right over to kidneystonediet.com, the blog.

Kimberly, you'll have so much information, you'll be like, "Oh, my god, I'm already sick of her." Okay, so go to the blog at kidneystonediet.com.

And all over my website, and all in the blog, and in the… On the start page, you will have the Kidney Stone Diet goals: the water goal, the calcium goal, the meat goal, the oxalate goal, which is 100 per day unless your doctor has told you otherwise. And the only reason a doctor would say otherwise is if you were a bariatric patient, which I don't think you are, 'cause you did not say that.

And then there's the salt and the sugar goal. So 100 grams of oxalate a day. How they know, the– the scientists study the oxalate.

It's actually very complicated and very expensive to do that, and that's how we know what the values are.

A very common question is, "Jill, why are there so many different… Why– why do oxalate lists vary?" Again, kidneystonediet.com, the blog. I have an article that will explain it.

Because some scientists are a little better, some scientists are not, the instruments used, there's all different kinds of things. But mostly, Kimberly, it's because every single plant is grown in a different kind of soil, in a different environment, and so you're going to have different things in the soil. So oxalate will depend on where the plant was grown, 'cause it's only in plants.

That's Finn. I'm boring him. He's like, "Are you talking about oxalate on a Sunday, Mom?"

So it will depend on where the plant was grown, what the growing conditions were, blah, blah, blah. So every time you pick out a beet, maybe you get some beets in Mexico, maybe you get some beets in California, you're going to have different oxalate levels. And this is why I give the advice: have all food in normal portion sizes, even the ones that are healthy.

Don't overeat them day in and day out in any amount you want. Just don't. Because just say, as we know, a couple years ago, Harvard restudied some foods, and there's some differing amounts.

A lot of foods were lower. Were they wrong the first time? No, they just plucked a different plant out of a different environment, and now the oxalate in that plant was lower than the first time they studied it maybe somewhere else.

So everybody wants a perfect number for each and every food. It's impossible. It's impossible.

Just like we are all very different human beings with a different genetic makeup, so are these plants. They're growing, their environment, you know, is different, and so they will have different oxalate levels. And this is why I say what I just said.

Eat all foods within normal portion sizes. Don't overeat healthy foods like almond products. People go on keto and paleo, and they overdo those really high-oxalate foods like spinach and almond products and all the things.

And even bigger than that, they're not getting their calcium needs met. So when we get our calcium needs met, that's just another way to lower your in oxalate. So that must happen, too.

And the goals, again, for all of these things are at kidneystonediet.com, the start page. And also the blog, it's all over. So there's that.

You said, so– so, Kimberly, you said, "You're going to be surprised." I'm not surprised you lost weight, because all my patients do, for the most part, because they get a kidney stone, I work with them, they understand the Kidney Stone Diet goals, and we did not work together, Kimberly, but you started researching. You don't have to work with me to do this.

You'll get there a hell of a lot faster, because I'll give you all the answers, so you don't have to be hunting for them.

But if you start looking at my website and follow the goals that are there, you're going– Look, once you start lowering sugar, added sugar, once you– once you start lowering your sodium, well, you're going to be eating healthier foods, okay? So once you pay attention, because you never want to go through that hell again, of what you put in your mouth and how much you put in your mouth, of course you'll lose weight.

You see, many people will say, too, "Jill, I can't– I can't believe it. I cannot believe it. I'm not even trying to lose weight, and look at, it's coming off me!

You're a miracle! You're– you're the Tooth Fairy!" I ain't Santa Claus, folks!

Here's what happened: you're scared. You never want that pain again. You don't want no kidney stones stuck in the UVJ and stents and operations and all the things.

That's motivating. You start paying attention on how you nourish your body, and the weight falls off. You're not thinking about getting a skinny ass, you're not thinking about being skinny mini, you're not thinking about how you look in your dungarees no more, you care about your health.

You make that a priority, and weight will fall off, 'cause now you're paying attention to what you're doing. So I'm not surprised. I hear that every day from my patients.

Go to kidneystonediet.com, the praise page, and you'll hear about all the people that have lost weight, because now they're making their health a priority instead of how they look in a jumpsuit, okay? So, not shocked at all.

You said, Kimberly, your stone was 80% uric acid and 20% calcium oxalate. It doesn't sound like you've done a 24-hour urine collection. So we really don't know if this uric acid bit is genetic.

It could be from diet. Perhaps you were overeating meat protein, and remember, meat is anything that swims, flies, and runs. So I'm not just talking about red meat, because Kimberly's my age, and so, typically, people my age think, when we say cut down on meat, we're just thinking about red meat.

All meat, all meat, all meat.

So it could be you maybe were doing keto, it could be in your past, it could be you were doing paleo, it could be you were simply overeating, and that could be the case, since you were over 300 pounds, right? And now you've gotten your wake-up call, and now you're paying attention, and you've done a fabulous job by yourself, by the way.

God bless you. By yourself, doing the work, and you've lost all this weight. 80 pounds, I believe she said.

And that's amazing, because when you care about your health, you'll start doing the things that get you to where you need to be, so I do want to say congratulations. You're amazing. So.

So is it genetic? I don't know. You should get a urologist and do a 24-hour urine collection.

And yes, Allopurinol is a drug that people go on, and yes, it can affect things. All these drugs people have side effects. So it would be interesting, once you, Kimberly, please go to kidneystonediet.com, the start page, so you can see all of the Kidney Stone Diet goals.

If you just plug into Google "Jill Harris Kidney Stone Diet goals", you'll get them, so you can see all the things I'm asking you to do.

And I would highly suggest you get a 24-hour urine collection if you possibly can. I think it's a great phone call. I'm very proud of how hard you work.

Please take a few minutes to look at my blog. All my articles are simple, short, and sweet, and right to the point. So you– you can learn about why oxalates vary.

Google this: "Jill Harris why oxalates vary." Boom! You'll get the article, okay? Or, "Why should I listen to Harvard Jill Harris." Boom!

You'll get the article. You just put my name in there with oxalate, you'll get everything you want to know. But that's a short version of the things you asked me, and keep on trucking, sister.

You're doing an amazing job. Very proud of you. I hope everyone who is listening hears what Kimberly is doing and takes her lead.

That's it.

Yeah, it is very impressive. And, also, to just touch on the 24-hour urine collection one more time in that is the starting point. That is where you recommend everyone start because you need to know the cause.

You need to know why you're creating these stones to really put everything into practice in the correct way.

It's very important. I can't tell you how many people come to me, and they went to the urologist, they got their first stone, the doctor just says, "Suck on a lemon." a year later, the patient has another stone. And I'm like, "Well, where's your urine collection?" "Well, he said I didn't need one until I make another stone, and he said that all I need is lemon juice." Folks, if this was all about lemon juice, why is lemon juice generically prescribed for everybody?

I don't get it. Here's why I don't– well, we'll talk that about that in another video. There's plenty– look at my two– my tubes on, lemon.

Lemon! YouTube, whatever the hell we're on. You Spotify, you– just look at YouTube lemon, you'll– you'll see me with my name.

It's like, you know, I don't think that should be a generic order. Not everybody needs them. And then, why, I'm going to say it, because then people were like, "Well, I thought I was doing everything!

I was sucking on a lemon!" Oh, god. As if that's the only thing people need to do. So that's why it annoys me.

Could it be beneficial to some? Yes, but let's do a urine collection to see what the hell else. It's never just about a lemon.

I will tell you that. It's never just the lemon. It could be part of your treatment plan, but it ain't, by itself, the plan.

Thank you.

Yeah, and once you get that urine collection, if you want Jill's help in understanding your results, there is the urine analysis at kidneystonediet.com. And at kidneystonediet.com, you can find everything: the Kidney Stone Diet meal plans, the Kidney Stone Prevention Group, the course, absolutely everything you need to be on the right track to, just like Kimberly, improve your life.

And if you're out there with a question, the phone number is 773-789-8764. Previously, we had 8763. Just note that it is 773-789-8764.

And we'd love to feature your voice on a future episode. And I think, with that, we will wrap. Thanks for tuning in, and we'll see everyone next week.