How much calcium does it take to flush oxalate?

So how much calcium does it take to flush oxalate? Let's talk about that. 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, your kidney stone prevention nurse.

All righty. So today we have a question. If you're out there with a question, there's a link in the description and leave us a voice memo so we can feature you on a future episode.

But let's hear from Reeva. Good afternoon, my name is Reeva and I'm calling from New York State. And I just have two questions for Jill and Jeff.

I just started listening to your podcast and I love it. I am dealing with osteopenia. So, my question is with the calcium and oxalate, I was told that if you eat a high oxalate food and you take calcium, it does cancel out the oxalate, but you can't count the calcium towards your daily amount that you need.

I would like to know if this is true or not. And also, I was told most of the milk products that have added calcium, they use the calcium carbonate and that's not necessarily the most absorbable calcium. And lastly, what about green powder drinks?

Are they high in oxalate? Should you How does that How is that with oxalates, the green powder? Thank you so much and I look forward to hearing your answer.

Have a great day.

First of all, hi, Reeva. We're very happy that you like our show. We try.

We try, Reeva. Okay, so, Reeva, I know this what you told me, you have osteopenia, so okay. So, you know, Reeva, it's important that you're getting your calcium needs met.

You're not going to take calcium pills, cause we know that can increase stone risk, okay? And Reeva may say, "But my endocrinologist or my primary doctor told me to take pills." Tell that doctor, if that's the case, you're going to get it through food and drink. No doctor's ever said, "Oh my god, don't do that." The doctor's just automatically prescribe supplements, okay?

But for kidney stone formers, we don't want that. All right. So, the age-old question, and I never get sick of answering it, because it is so confusing for people.

And Reeva actually, if I remember what she said correctly, she said something I haven't heard. She said that when, you know, she knows that she's supposed to have calcium with higher oxalate foods, but she also heard that calcium doesn't count in her day. It do.

It does. It does. It does count in your day.

So, I don't want you thinking, okay, I had some peanut butter and now I'm going to have a glass of milk, and you don't have to use milk, you can use milk substitutes, but and now because there was oxalate in the peanut butter, I don't count that calcium to my total goals of 1,200 for postmenopausal or 1,000 for women who still get their period.

Yes, you do still count that calcium, okay? Let me tell you how this works. I think when we understand how this works in our body, we retain the information better.

At least, you know, when I was going through all my cancer stuff, and you know, I was scared and you know, all of that, you know, the doctors talk quickly and you're learning about all these things and you know, I always wish that my doctors or nurses would explain what was going in my body better so I would understand and be less anxious about everything.

So, from all the negative experiences I had going through my cancer, I really ramped up the way I teach patients. And one of the things I like to do is understand something so well, typically, I try my best, so that I can break it down, cause it's actually really complicated, break it down in ways in which that you guys understand why you're doing the things we're asking.

Because when you understand why instead of these arbitrary drink milk with this and drink and lower your oxalate, it's all too much. So, when you understand the reason why, I find I get more patient compliance and people just, you know, when they're having a bad day, they're like, "Oh, I got to do this, I'm so sick of it." But then when you know what's going on in your body, you're like, "I'm sick of it, but I'm going to do it anyway, cause I don't want that happening in my body." Okay.

So, let's explain the whole calcium oxalate why when we have calcium it lowers our oxalate. Now, if you had, and the I'm using all foods you can have on the Kidney Stone Diet, so let's use peanut butter. So, two tablespoons of peanut butter, it's less than 30 mg of oxalate, I keep it in the diet.

Have it. You just can't sit on the couch, get a jar of Jif and a spoon and sit there and watch your favorite program. You can't do that no more, I don't care if you're on keto.

Can't do it, it's too high in oxalate. But if you just love peanut butter and you want a tablespoon, have it, or two, have it, but you should pair it with calcium. If you just had the peanut butter, here's what's going on simply in your body.

You have the peanut butter, you eat it, it goes to your stomach, from your stomach it goes to the small intestine, from the small intestine nutrients are sent to your blood, the blood picks up stuff from the food, so your body gets all its nutrients, and it will take the oxalate out. So, the stomach breaks everything up, it goes to your small intestine, there's going to be oxalate in your small intestine, the blood is going to sop that up, it's going to get reabsorbed back into the body, that oxalate.

Now, if you had that peanut butter with say a glass of milk or flax milk or coconut milk, non-dairy coconut milk, whatever your choice is, if you had it with a calcium product, maybe you're putting it in Greek yogurt, you would have the calcium food and the peanut butter together, goes to your stomach, it moves down to the small intestine.

In the small intestine, calcium and oxalate are bound together. That molecule is too big for the blood to sop back up. So, the next place it goes, the calcium and oxalate together, it goes through your small intestine, all that all those feet of intestine, and then it goes down to your colon and that extra oxalate instead of going back up into the bloodstream by itself because calcium took it with it, it goes it leaves the body through the stool.

And that's how we get rid of extra oxalate and that's why we're pairing our higher oxalate foods with calcium. Now, if you're having something that has 5 mg of oxalate, you don't have to be looking for some calcium. And people will always ask, "Well, what's that number, Jill, that I have to be looking for?" I'm making it up.

I'm always very honest about this. They're never going to put people in a lab and say, "Let's see how much oxalate Jane eats and Bill eats and calcium and let's see." Everyone absorbs things differently. So, they haven't studied this.

But I always tell patients anywhere between 20 and 30 mg of oxalate, you might want to have some calcium. Does it need to be a full glass of something? No, but at least a half.

You want 200, 300 mg of calcium to go with that, okay? And then that calcium does count towards your calcium goal for the day. Just because it's with the oxalate, it counts.

So, you don't have to separate that out, okay? There's that. Now, the other thing she asked about is calcium carbonate.

There's a little research that says calcium carbonate is less absorbable than other calcium sources, but not enough that there's any havoc. Most of the time they are substituting, if it's a plant food or calcium carbonate is used, but it counts towards your calcium. I would not worry about something like that overall.

I really wouldn't. Most of my a lot of my patients are using plant milks, they're doing just fine. In a lot of cases they have stopped their bone disease.

Also, they when I'm doing a consult with people, I really talk about weight training, which I do a lot of, I talk to them about that. Start weight training along with getting your calcium needs met. You can also reverse that osteopenia a little, by the way, folks.

Weight training is so important. Anyway, that's off the subject. So, I don't mind patients using the calcium carbonate.

That is what's in most plant milks, and you can find non-dairy milk sources at kidneystonediet.com. There's plenty of them if you don't use dairy. I personally use lactose-free dairy because I like getting protein as well, and that works for me.

And so, calcium is important when you're eating a higher oxalate food, but you don't have to be running to calcium for every nickel and dime of oxalate you're eating. Getting your overall calcium needs met through food and drink is really important, and you then may also say, "Well, if you're telling us no pills, Jill, those plant milks are supplements, what about those?" Google, Jill Kidney Stone Diet plant milks and you'll get a whole little article on why you can use those and not supplements.

And then the last thing, which I love talking about, Reeva, green powder drinks, are they high in oxalate? So, what I would do is turn it around, Buster Brown, and I would look in the ingredient list. There are a few green powder drinks that may not have spinach, that may have kale, and kale is lower oxalate, according to Harvard.

So, look at the ingredients. If they have high oxalate ingredients like spinach, that's a no. And but so, but did she say specifically green powders?

Isn't that what she said?

Yeah, she said green powders specifically.

Okay, so green powders, typically, are high oxalate foods in those green powders, I'm not a fan. Now, here's my little soapbox and I never win a lot of applause when I talk about this, but I talk about this on social media a lot, actually. Green powders, fiber gummies, these things I would rather people eat fruits and vegetables, if at all possible.

We don't get enough. Our country in the US really is low on fiber. We know it's really important for gut health.

We should be getting about 25 to 35 g of fiber a day, the average person's getting 12, and you don't do that in one day, you have to slowly and also get your water. But I would rather, Reeva, if you could, those green powders are green powders, eat your fruits and vegetables. A lot of people go to green powders because they don't want to eat fruits and vegetables, because it's more convenient.

But there's no way that a gummy or a green powder is ever, no matter what social influencer tells you, is going to be healthier than eating plant food itself. That's just, you know, I mean that's what science says, but I am really a proponent. People are sucking down gummies and these plant powders, these green powders, and, you know, number one, they get stones from the green powders cause they didn't think about it, you know, because they thought they were doing something healthy.

But I am always going to advocate be an advocate for fruits and vegetables, real life ones. Now, once in a while, if the green powder doesn't have high oxalate ingredients, and you can see if those ingredients are high by going to kidneystonediet.com and look at the oxalate list, but most of them, Reeva, are higher in oxalate, because most of them will have spinach.

Yeah, so I think that was a wonderful question. And if you have a question, yeah, if you have a question you can go in the description, click that link, press the button on your phone, and leave us a voice memo to feature you on a future episode. With that, I think we'll wrap.

Thanks again for tuning in and we'll see you next week.

Thank you, Reeva. Good luck with everything. Call us back and let us know how it's going.

Have a good week, everybody.