In this episode of the Kidney Stone Diet Podcast Jill Harris answers a listener question about their urine analysis and why they are still producing stones despite good test results.
Have a question? Leave us a voicemail at (773) 789-8763.
Stop Kidney Stones Once and For All
- Kidney Stone Prevention Course
- Kidney Stone Diet Meal Plans
- 24 Hour Urine Collection Analysis
- Private Coaching
Kidney Stone Diet Resources
Find more episodes of the Kidney Stone Diet Podcast here.
Who is Jill Harris?
Jill is a nurse and health coach that specializes in educating patients on kidney stone prevention. For more than 20 years she’s helped patients understand that kidney stones can be prevented with the right treatment plan. It’s one thing to be told to lower oxalate or drink more water, but HOW do you do it? That’s where she comes in. Through the educational resources at kidneystonediet.com, stone formers can learn everything they need to know to significantly lower new stone risk.
Who is Jeff Sarris?
Jeff’s co-founder of SPYR, a branding agency based out of Chicago, where he and his business partner Dave help awesome people like Jill create online platforms that make an impact. He’s also a certified health coach, Executive Producer of the Netflix documentary Minimalism, and host of the Starting Now podcast.
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Welcome back to the Kidney Stone Diet Podcast, the show by 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.
We are here again with another listener question. And 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. If you have a question, be sure to call in, leave us a voicemail, and we will play it on a future episode. Let’s dive right into this week’s question.
Hi, yeah, my name is Monique and I have a question for Jill. I tested negative on two 24 hour urine tests after two kidney stones had to be surgically removed. But two years apart from each other and both tests were negative. Basically, he said I was not a stone former. So, wondering how that is possible. If I test no- to low-oxalate, how can I still form kidney stones? Thank you.
I have to be careful here. What I want to say, and what I’m going to say, may be two different things, but Monique will get her answer. But I have to be careful.
Monique said her test was negative. So, at first I was like, is she talking about a urine analysis? Is she talking about a pee-in-the-cup kind of tests that you just do at the doctor’s office? But then she did say 24-hour urine collection.
So, her doctor says everything’s fine. Oxalates are low. She’s not a stone maker. But Monique’s scratching her head because she’s like, well, I’ve made two stones now! The question why am I a stone maker? Well, just because one’s oxalate is low does not mean they are not a stone maker. There are many, many different factors we must look at.
Also, sometimes when I see a patient’s urine collection, it’ll look like a the results from a baby. Meaning that PRIOR to the urine collection, they got rid of the spinach and the amonds. They drank like a fish. They didn’t eat any salt or sugar. They basically ate notebook paper all day long and that was it. So when I see these results, because I’ve been doing this for 21 year, I’m like…”Okay, Charles, do you USUALLY drink five liters and pee out five liters of water every day? Do you always have 800 milligrams of salt every day? You never eat sugar?”
The response is usually “No, I changed everything. I know you say to eat like I normally do when I was making stones, but I didn’t want to hear it from the doctor. 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 my questions are, Monique, did you eat and drink normally before the urine collection? Or, had you already changed some of the things you were doing so when the doctor saw the report, you’d already begun to make adjustments that might impact the results.
Of course, the doctor is going to say “All looks good here, you’re not a stone maker. I don’t know what’s going on.” This is not a knock against any doctor but remember, the doctor or urologist or surgeon that you’re speaking to may not be the most well versed on some of the results they’re looking at. These 24-hour urine collection results are tricky to read.
Or it could be exactly what the doctor said, everything looks great, because you already upped your water, you already got rid of spinach. He or she only sees what’s on that collection and 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. If you already started making changes to diet, that would show up in the results.
It’s rare that I see a first urine collection and say you’re not a stone former. We need to see a follow-up test to know if you really have decreased risk of stones.
If you’ve made a lot of dietary changes and you’ve upped your fluids, and you’re getting enough calcium, and you took away the beets and spinach and almonds and almond milk and almond flour, and all the things that are my high oxalate, you can really turn things around.
So, this is a little confusing. Also, people get very frightened. I mean, if you make a stone and you’ve had the intense pain that most people get with stones, no one has to tell you twice to get rid of that spinach smoothly 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.
The point is people change things before they do the urine collection. I’d like to know more from Monique. Did you already change your diet and fluid before you did that urine collection? That would be the first question I’d ask and we’d go from there. And, again, WHO interprets the results matters. It’s possible someone is just looking at the oxalate and there’s a lot more to kidney stone prevention than oxalate.
We’ve dove into so many different topics on this podcast that really apply to stones, whether it’s sugar and sodium, and uric acid, and all these other things, and there are so many variables other than oxalate alone. As you said, Dr. Google is like “Oh, that’s it. That’s all you need to worry about.”
Right! And, 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 from all fruits and vegetables because plant foods have oxalate right?
So these urine collection results, they can be overwhelming because there’re so many values to look at and putting them all together is tough—kidney stone disease is complicated. And, the people that are dealing with kidney stone disease are really busy. Surgeons are doing surgeries. God bless them, we need them. When we do get stones, we need experts to take them out of us. But urine collections are not easy to interpret and so it makes sense that there are discrepancies.
For sure. And, that’s why you offer the urine analysis service on your website—KidneyStoneDiet.com. This is to help people better navigate their doctor’s appointments and understand what to ask so they can have productive doctor visits?
I think the more patients understand kidney stone disease and their values from their lab report, the more educated discussion they can have with their doctors. Doctors love when patients are educated and 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. I’m just telling you what my experience has shown me and I can’t tell you how many patients say that to me and I’m gonna 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.” I still get my way with dietary changes, right.
Thanks, Monique, for your question. And 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.
Hope 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—I know your days are packed with people both through the course in the group setting, but also in the one-on-ones—you’re always going.
Yep, I’m always going. And I love it, quite frankly. I’ll just put this in here too. There’s a definite correlation between being overweight and getting kidney stones. So the other passion I have is helping people lose weight. You can actually do a private with me, and you’ll get all the things that we talk about in the Kidney Stone Diet Course that also help people lose weight. Go to the Praise page 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 life at 400 pounds. They want to start living a healthier lifestyle and I give them the practical and common-sense tools to do it. I love working with people to lose weight—that’s a huge passion of mine and has been for decades.
And moving forward there may even be some other fitness-related offerings as we further develop the platform and try to help in as many ways as we can. Definitely head over to kidneystonediet.com and check it all out.
Thanks again for listening. If you have any friends or family or anyone you know who is suffering from kidney stones, be sure to tell them about the show so we can reach as many people as possible.