Oh, I– I have to say this question… So, it– it is what his doctor– his doctor said, "If you don't have access. If you don't have access." We know that calcium supplements in pill form can cause kidney stones.
There's many research papers on this. So we know that's the case. Here's specifics.
Number one, people take Tums like candy. We've talked about this. If you go to buy Tums at the grocery store or the drugstore, the package will boast, "Now 1,000 mg per of calcium per pill!" So people are like, "Ooh, that's great!" Cause nobody knows anything about this stuff.
And they keep upping the calcium carbonate in these pills because it's effective when you have acid reflux. You will get immediate relief pretty quick. Pretty quick, if not immediate.
So they're highly effective. But along with those packages should also say risk of kidney stones because it's a problem. Also, taking too much supplemental calcium, like in antacids, can cause hypercalcemia, too much calcium, too much calcium in the blood.
So there's issues with it. Remember, his doctor said, "If you don't have access." I'm not taking– I have a history of kidney stone formers. I'm not taking Tums.
I'm not doing it. If– I'm going to be very careful here– if– I'm a nurse and I do not override your doctor's orders. You want to take that risk, please feel free.
Yes, I understand that Dr. Coe says on his website you could, as a last resort, you could take calcium supplements with food, no more than 500 mg at a time. You could.
You could. And your risk of stones may not increase, may not, may not, depending on how you absorb things. So if you want to take that chance, you can.
You're all grown. Would I do it with a history of kidney stones in my family? No, I would not.
But again, I'm going to be very specific here. Jill, what do I do when I'm having extreme– You know, every time I eat fill-in-the-blank, I get GERD. First of all, I'm going to say stop eating fill-in-the-blank, whatever that is for you.
Stop eating that! That would be the number one thing. "Oh, Jill, you're so annoying!
I want to have it sometimes." Sorry. You know, whenever I tape, I get 27 texts in a row. Look at this.
Hold on. I swear to God. So if you wanted to take, say I was having extreme acid reflux of something, if I– if I wanted to get rid of it because I was dying in pain, I would take a little bit of an antacid.
I might take a Gaviscon. Yes, there's stuff in there, too, calcium in there. I may take a Tums.
I may– a bit of it, a bit of it, just enough to curb my problem. So if you were going to take a Tums, you know, once, twice a month, I'm not– no one's forming a stone with that. We're talking about the over-abuse of things like antacids that have a lot of excess calcium carbonate or calcium in it, period.
Calcium supplements, when taken in excess, can increase your stone risks. I've had many patients when they do their urine collection, they were on calcium supplements and their urine calcium was very high. That is a stone risk, high urine calcium.
Don't know if you have high urine calcium, please get a 24-hour urine collection. So his specific scenario is the doctor said if you're in a bind, take a cal– take the Tums, take half of one, cause we know research also says up to 500 mg at a time. Don't do more than that cause we don't absorb it that great.
We don't want the excess in the urine. So could you do that and not get a kidney stone? You could.
But I don't know. I– I'd almost rather not even get– I'd rather take nothing. Most of you haven't had any calcium in 50 years.
Now all of a sudden you're worried about it with every little thing you eat. It doesn't work that way. Do your best to get your calcium needs met.
It is best by food. Best by food, where it's naturally occurring. After that, you have, for people who don't use dairy, you have the supplemented milks.
Is it– are those better than naturally occurring calcium products? No. Is it better than a pill?
Yes. Typically, the reason is, cause people will say, "Well, that's a form of calcium in there. That's a supplement, too." But with those milks will come the instructions that no more than 500 mg at a time, take– drink those milks with food, just don't drink it, cause it is a supplement.
I have people who– so many people in my practice, that is what they're using for the calcium needs. They're using the non-dairy milks. I'm not seeing high urine calcium markers on their urine.
I'm not seeing that. I'm not. So I guess what I'm saying is, for those people that are going to be annoyed, "What am I supposed to do for my reflux?" Don't eat the foods that are bothering you.
There's– that's number one. But number two, there's many different reasons. There's illnesses, there's medications, there's many different reasons people have reflux.
Talk to your doctor to see what is best for you. If the doctor says something like Tums, in the rare occasion that you have something and you need to take it, you know, again, taking half a Tums with food, typically when you're having huge GERD problems, you don't want to take it with food, but, you know, taking a little bit of a Tums just to get that horrible feeling away, I'm not worried about that.
I'm worried about the people that are downing 10 Tums a day. And they will tell me they were eating it like Pez candy. That's why they got a kidney stone, not just because they took a Tums here and there.
I'm not worried about that. I don't like the use of Tums as– when– when you do have access to up– to other forms of calcium. I just don't like that– the practice of that.
Again, everybody's grown, you'll do what you want to do. You may say it's a lot easier for me to down a Tums, 500 mg, with my lunch than it is to grab some milk or non-dairy milk. Do it– do that.
When you get your urine collection done, see how it's affecting you. That's all I can say, because we all absorb things differently, too. So if you're somebody who's going to be like going to think, "You know, I– I don't really care what you say.
My doctor said I can do it." Please follow your doctor's orders then. But I would suggest you doing a urine collection then, too. I would– I would– I always tell people, if there's things you're doing that may make you a little nervous that you're increasing your stone risk, please do that while you're doing a urine collection so you can see for yourself.
Maybe, his name was Lewis, maybe Lewis can handle 500 mg a– a Tums once a day, no problem. Somebody right after him, not so much. So we've got to be very careful with the use of any kind of pill supplements if you are going to take them, and I'm aware cause I wrote that article with Dr.
Coe about supplements and, taking your calcium needs from supplements. If– there's some people who have parathyroid issues, malabsorption issues, bariatric, malabsorption issues specifically from their surgeries, those people have to take a hell of a lot of calcium cause they're not absorbing calcium. They're not absorbing a lot of things.
So you can, you must take those things with food and not over 500 mg at a time unless a doctor has told you specifically that's okay for you. Because again, people with malabsorption issues may need to take more than that. That is between you and your doctor.
For kidney stone formers in general, it is very important to get your calcium from food and drink. That's where we want you to start. You know, people will say, "Well, I'm going on vacation.
Maybe they won't have yogurt or whatever." You know, again, I will also say this. You could take a chance taking Tums during your vacation, or you could just do your very best because, again, most of you haven't gotten calcium for decades of your life. One week is not causing a stone for you.
It's just not. So, you know, I don't– I don't know what to say about that advice. I've done this for a very, very long time.
The advice has always been supplement is the very, very last form of calcium that you want to do. You'll note I can't tell you how many people have osteoporosis. Doctor puts them on calcium supplements.
Two years later, kidney stone. Let's start patients, for whatever they're trying to do in order to get enough calcium, from natural sources first. That's what would be ideal, especially for stone formers, okay?
Does that make sense, Jeff?
