Why do I have kidney stones when my urine test results found low to no oxalate?

SPYR.

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, and I am your kidney stone prevention nurse.

Yes, so we are here again with another listener question. And, yeah, like thanks to everyone who has left voicemails. Let me actually give you the number now because I forgot last time, but the phone number is 773-789-8763.

And if you have a question, like be sure to call in, leave us a voicemail, and we will play it on a future episode.

Yep.

So, I think we will It's about time to dive right into this week's question.

All right, let's go.

Hi, yeah. My name is Monique, and I have a question for Jill. I tested negative on two urine test 24-hour urine tests after two kidney stones had to be surgically removed, about two years apart from each other.

And both tests were negative. Basically, he said I was not a stone former. So, I'm wondering how that is possible if I test low no non to low oxalate and still can have kidney stones.

Thank you. Bye.

Another Monique. It's a popular name. Okay.

We've been That's two listeners that we've had for Monique. Okay, let's go, Monique. So,

I, you know, I have to be careful here. What I want to say and what I'm going to say maybe two different things. Monique will get her answer, but I have to be careful.

So,

So, here's what I'm going to say. So, you know, Monique said it was negative, her test. So, at first I was like, is she talking about a urine analysis?

Because meaning, is she talking about a pee in the pee in the cup kind of test that you just do at the doctor's office? But then she did say 24-hour urine collection.

So, even though

So, here's her story. She's like, "Okay, look, my doctor says everything's fine. My oxalate's low.

I'm not a stone maker." But Monique's scratching her head because she's like, "Well, I have two now, so I am I am a stone maker." The question is, por qué? Why? Why am I a stone maker?

Well, just because one's oxalate is low does that does not mean they are not a stone maker. There's many, many different factors to look at. Also, this is so very important.

Sometimes when I see patients' urine collections, it'll look like a baby did it, like the Easter bunny did it, like a perfect person did the urine collection. What do I mean by that? That means that they were They ate They ate They got rid of spinach and almonds.

They had their calcium. They drank like a fish. They didn't eat no salt, no sugar.

They barely ate notebook They basically ate notebook paper all day long, and that was it. So, when I see the result, I know, because I've been doing this for 21 years, I'm like, "Okay, look, Charles, I see this urine collection. I see it."

"It's great, isn't it, Jill?" "Yeah, it's great, but you tell me. Do you usually drink 5 L and pee out 5 L of water every day? Do you always have 800 mg of salt every day?

Do you never eat sugar?" "Well, Charles. Well, Charles. Well, no.

No, Jill, you caught me. No, I changed everything. I know you say to eat like I normally did when I was making stones, but I didn't want to hear it from the doctor.

Also, I knew, because after I made those stones, if you go on Dr. Google, everyone knows to ditch the spinach, so I wasn't going to eat my spinach smoothie that day. And it also says to get enough calcium, so I made sure I was drinking my milk that day." So, the point is

Monique, I'm not saying you did what Charles did, but I'm saying,

Did you eat and drink normally or had you already changed some of the things that you were doing? So, when the doctor saw the report, you'd already changed stuff. So, of course, the doctor's going to say, "All looks good here.

You're not a stone maker. I don't know what's going on." Or,

Or, and this is not against any doctor or anything else, but remember, the doctors are urologists, they're surgeons. Perhaps, they're not the most well-versed on some of the results that they're looking at because they're tricky to read these 24-hour urine collections, okay? So, you know, again, I want to watch what I'm saying here.

Could be that, you know, maybe just the oxalate was being looked at. I'm not sure. I haven't seen your urine collection.

Or, it could be exactly what the doctor said, "Everything looks great," because you already upped your water, you already got rid of spinach. So, he only sees or she only sees what's on that collection. Because remember,

What you do the day of your urine collection is what comes out in your urine. So, what you did last week could be total debauchery, okay? But you didn't do a urine collection on that day.

So, it matters if you had already changed things. So,

It's very rare that I see a urine collection that I say you're not a stone former, unless it's a follow-up test now. And now, the test the all the values show, "Boy,

You have really decreased your risk of stones now because you've made a lot of dietary changes, you've upped your fluids, you're now getting enough calcium, you took away the beets, and the spinach, and the almond flour, and the almonds, and the almond milk, and all the things that are high in oxalate, and you really turned things around." So, it can be a little It's compelling and confusing because a lot of patients already change their diet because they didn't know not to,

And nobody told them not to change it. And, also, people get very frightened. I mean, if you make a stone and you've had the intense pain that most do get with stones, you are never You are No one's going to have to tell you twice to get rid of that spinach smoothie because that pain is

Fresh in your head, and that lithotripsy, and those stents, and everything else that you're dealing with, well, you get rid of spinach, okay? So, I'm just saying, you know, people

Just change things before they do the urine collection. So, it would be interesting to know, and you can also, of course, leave another voicemail to go into that more, did you already change your diet and fluid before you did that urine collection?

That would be the first question I ask, and we one would go from there then. And the other thing is, you know, it actually depends on who is interpreting those results. That's all I will say, okay?

Because there could be if someone is just looking at the oxalate, there's a lot more to kidney stone prevention than oxalate.

Oh, yeah. And we've dove into so many different topics that on this podcast that really apply to stones, whether it's sugar, and sodium, and uric acid, and all these other things. There's so many variables.

Yeah, oxalate alone from like you said, Dr. Google, oxalate is like, "Oh, that's it. That's all you need to worry about."

Right. Right. Well, 80% of stones are calcium oxalate, up to 80% of stones are calcium oxalate.

So, people always focus on that. Also, the word oxalate is triggering for people because they were just told they have a calcium oxalate stone, and oxalate is something we don't know about. So, it's intriguing, too, and all people think about is getting away all fruits and vegetables because plant foods have oxalate, right?

So, you know, it's

The urine collection results, they can be overwhelming because there's so many values to look at, putting them all together. It's the Kidney stone disease is it's complicated. And, you know, the people that are dealing with kidney stone disease are really busy surgeons.

So, they're doing surgeries. God bless them. We need them because when we do get stones, we need experts to take them out of us, right?

So, you know, it's tricky who's, you know, the urine and the urine collections are

They're they're not that easy to interpret lots of times. So, it makes sense that there's there's discrepancies and there's problems and, you know, stuff. Right.

Yeah, for sure. And that's why you offer the urine analysis service on your website, kidneystonediet.com, so you can help people better navigate that doctor's appointment and understand, yeah, what they like sort of you give them the toolkit to have a better doctor's visit.

Yes. And, you know, yes, to say to the doctor, "Hey, look at this one, or look at that one. What are we going to do about this?" So, I think the more patients understand about kidney stone disease and their values from their lab report, then they can go to their doctor's office with their lab report in hand and have a great, educated discussion.

Doctors love when patients are educated and, of course, kind when they're talking about what they've learned, and to have a productive conversation. Doctors like working with patients that are motivated to make lifestyle changes to better their health because I'm going to tell you guys, most people, that's very difficult for them.

Most people don't want to have to change their lifestyle. A lot of people would like to take a pill and not have to deal with lifestyle changes. Again, you may say, "Boy, that's" I'm just telling you what my experience tells me.

And I can't tell you how many patients say that to me, and I'm going to say, "Well,

I'm not your gal then, because we're going to work on lifestyle changes." And a lot of the medications used for kidney stone disease, they're not as effective unless you change some of your dietary habits anyway. So, as I always say, I still get my way with dietary changes, right?

Yeah. So, yeah, thanks Monique for your question. And if you

Great question, Monique.

Yeah, if you have a question and you would like your voicemail to be played and answered on the podcast, the phone number is 773-789-8763, and we will feature your question on a future episode. If you're enjoying the show, be sure to subscribe wherever you're listening, check out the YouTube channel, subscribe and hit the little bell to be notified when new episodes come out, which is every Tuesday morning.

And if you want a deep dive, head over to kidneystonediet.com where there are tons of free resources, the blog, the email newsletter that you send out every Saturday, and so much more along with the premium products like the prevention course, the meal plans, the urine analysis service, and even private coaching, which your days are packed

Yeah.

Working with people both in the through the course, in the group setting, but also in the one-on-one. Like you are you are always going.

Yep, I'm always going. And I love it, quite frankly. Also, and I'll just put this in here, too, what I love doing, too, is when there's two-fers.

So, a lot of patients come to me for kidney stone disease, obviously, but also, you know, there's there is a definite correlation between being overweight and getting kidney stones. So, the other passion I have is helping people lose weight. And so, you can actually do a private with me and you'll get all the things that we talk about in the Kidney Stone Diet also help people lose weight.

Go to the testimonials on my website. You'll see a lot of people have lost weight working with me. And that's only because they do the work, they make the hard changes, they are sick of living, you know, 400 lbs, they want to start living a healthier lifestyle, and I give them the practical and common sense tools, and no marketing junk and crazy You can eat whatever you want, you just have to not eat as much, maybe, you know?

And so, I love working with people losing weight, too. That's a huge passion of mine. Has been for just as many decades.

Very passionate about it.

Yeah, for sure. And moving forward, there may even be some other fitness-related offerings and things as we Yeah.

Yeah.

As we further develop the platform and try to help in as many ways as we can. So, definitely head over to kidneystonediet.com and check it all out. And thank you again for listening.

If you have any friends or family or anyone you know who's suffering with kidney stones, be sure to tell them about the show so we can reach as many people as possible. And I think that'll do it for this week. So,

Thanks, Monique!

Yeah. What was that?

Well, you know, it's a sunny day here in Chicago, and the motorcycles, and I live right on Lakeshore Drive, so, man, the motorcycles have been really doing something lately. It's been crazy. Like little gangs.

Yeah, nice. Yeah, it's been beautiful, beautiful outside. We're hitting the summer, so, yeah.

Well, thanks again for listening, and we will talk to you next time.

Bye!