Calcium And Vitamin D Supplements May Increase Stone Risk
HOUSTON Calcium and vitamin D supplements appear to be associated with high calcium levels in the blood and urine, and this could increase the risk of kidney stones, according to a new study presented at The Endocrine Societys 94th Annual Meeting.
The use of calcium and vitamin D supplementation may not be as benign as previously thought, said principal investigator J. Christopher Gallagher, MD, Professor of Medicine and director of the Bone Metabolism Unit at Creighton University Medical Center, Omaha, Neb. Pending further information, people should not exceed the guidelines suggested by the Institute of Medicine, which are 800 international units of vitamin D, and 800-1,200 mg per day of calcium.
Dr. Gallagher and his colleagues studied 163 healthy, postmenopausal women aged 52-85 years. The women were randomly assigned to receive either a vitamin D supplement of 400, 800, 1,600, 2,400, 3,200, 4,000, or 4,800 IU a day or placebo. In this study, calcium intake was increased from an initial intake of 691 mg to 1,200-1,400 mg per day. The investigators measured urine and blood calcium levels at the beginning of the study, and then every three months for one year.
The mean baseline serum 25OHD level was 15.6 ng/mL. The level increased on the highest dose of vitamin D to 45 ng/mL. Mean baseline serum calcium level was 9.47 mg/dL. This increased to 9.52 mg/dL. The mean 24-hour urine calcium level was 142 mg. This increased to 186 mg, according to the researchers.
Is Ginger Good For Kidney Stones
Ginger has vitamin C, magnesium and other minerals that on regular consumption in the form of ginger tea can dissolve and prevent kidney stone formation. Ginger teas flush the kidneys and promote healthy blood pressure and also act as renal tonics to flush extra toxins and prevent bacteria build-up.
On Nutrition: Calcium And Kidney Stones
Rene from Racine, Wisconsin, writes: “I am hoping you can help me understand calcium supplements and the likelihood of kidney stones. For the first time in my 61 years, I had a kidney stone. I also have been diagnosed with osteopenia . I would like to take a calcium citrate supplement along with MK7 but read that citrate may increase stone formation. Can you advise and help clear up my confusion on calcium supplements for someone prone to kidney stones and osteopenia or recommend a reliable publication that I could understand? Thank you in advance.”
Nice to hear from you, Rene. I enjoyed your nice city back in 2016 while on a book tour. Your question is a good one.
To begin, the two most popular types of calcium supplements are calcium carbonate and calcium citrate. Calcium citrate’s absorption into the body does not rely as much on the release of stomach acid as does calcium carbonate. That means we can conveniently take calcium citrate supplements with or without meals.
Besides being well absorbed, there is also good evidence that calcium citrate supplements may prevent bone loss in older women. In fact, citrate is a major component of healthy bone.
And while we still don’t have all the answers, it is interesting that the use of citrate salts is a widely used treatment for kidney stones. We also need to remember other strategies to lower our risk for this painful condition: Drink plenty of fluids, cut back on salt and avoid caveman portions of meat.
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Calcium Intake And Urinary Stone Disease
Mathew D. Sorensen
Department of Urology, Urological Research Outcomes Collaboration, University of Washington School of Medicine, Seattle, Washington, USA
Abstract: Calcium homeostasis is a complicated and incompletely understood process that is primarily regulated through an interaction between the intestines, kidneys, and bones. Intestinal calcium absorption is determined by many factors including the amount of regular calcium intake, as well as vitamin D and parathyroid hormone levels. Intestinal calcium absorption is likely different between stone formers and non-stone formers, with higher levels of calcium absorption in those with a history of stones independent of their calcium intake. We no longer recommend dietary calcium restriction as this may lead to bone demineralization and an increase in stone formation. Practitioners need to continue to educate patients to maintain moderate dietary calcium intake. The effect of calcium supplementation on stone formation is currently controversial. It is likely that large doses of supplemental calcium, especially if taken separate from a meal, may lead to stone formation. When necessary, stone forming patients should be encouraged to take their calcium supplements with a meal and their stone disease should be monitored.
Keywords: Intestinal calcium absorption hypercalciuria dietary calcium intake calcium supplementation kidney stones nephrolithiasis
What Does Research Say
Research conducted on 91,731 nurses over a 12-year period found that while the women who used calcium supplements indeed had a higher risk of kidney stones, most of them were all taking their supplements separately from their meals.
Researchers of the study, published in the New England Journal of Medicine felt that this risk might be reduced by consuming the supplements with meals, particularly meals which contain the most oxalates, i.e., lunch and dinner.
Another study showed that supplementing with magnesium and potassium citrate can protect people with a history of kidney stones from forming fresh calcium oxalate kidney stones.
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Should I Cut Out All Foods That Have Oxalate Or Calcium
No, this is a common mistake. Some people think that cutting out all foods that have oxalate or all foods with calcium will keep stones from forming. However, this approach is not healthy. It can lead to poor nutrition and can cause other health problems. A better plan? Eat and drink calcium and oxalate-rich foods together during a meal. Doing this helps oxalate and calcium bind to one another in the stomach and intestines before reaching the kidneys, making it less likely for kidney stones to form in the urine.
Plan Your Plate For Kidney Stones
Increase The Intake Of Vitamin D & Calcium
Vitamin D is an essential nutrient required for the proper absorption of calcium in the bones. If the body is getting low amounts of calcium, it can certainly level up the number of oxalates. It is always beneficial to intake calcium from foods like cheese, yogurt, seeds, nuts, tofu, cottage cheese, green leafy vegetables, etc., and avoid consuming the desired nutrient from other supplements.
Avoid Consumption of Carbonated Drinks
Carbonated and caffeinated drinks like cola contain high amounts of sugar and phosphate, which can again boost developing kidney stones. These carbonated drinks are added with sucrose and fructose syrups that can elevate the risk associated with kidney stone formation. Not only cola but even canned and packed juices can also generate the same results. Try to look at the label on the packaging that carries the nutritional information stating the amount of sugar added to the product. Its a healthy pick if you try to include foods that have less sugar quantity.
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Talk To Your Doctor About Preventative Medications
If youre prone to certain types of kidney stones, certain medications can help control the amount of that material present in your urine. The type of medication prescribed will depend on the type of stones you usually get.
- If you get calcium stones, a thiazide diuretic or phosphate may be beneficial.
- If you get uric acid stones, allopurinol can help reduce uric acid in your blood or urine.
- If you get struvite stones, long-term antibiotics may be used to help reduce the amount of bacteria present in your urine
- If you get cystine stones, capoten may help reduce the level of cystine in your urine
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HOW TO TAKE SUPPLEMENTS CORRECTLY
If you find your medicine cabinet filled with bottles youve lost track of, it may be time to review your supplementary routine. CNA Lifestyle spoke to the nutrition experts, who addressed some common but inaccurately held notions about taking supplements.
FALLACY #1: WHEN IN DOUBT, JUST GO FOR MULTIVITAMINS TO COVER ALL GROUNDS
We hate to break it to you but you may be better off eating proper meals instead. Multivitamins usually contain small amounts of vitamins and nutritional elements, but these can usually be obtained from a healthy diet, said Zoe Kong, principal pharmacist with the Department of Pharmacy at National University Hospital.
Moreover, supplements are necessary only when one has a proven medical deficiency from blood test results, said Patsy Soh, a dietitian with Mindful Nutrition. Or individuals who are lactose intolerant and cant take dairy products can benefit from a calcium pill.
Furthermore, there can be serious implications from taking multivitamins, said Kong. Taking multivitamins can be dangerous if youre on certain prescription drugs such as the blood-thinning warfarin as multivitamins with a high Vitamin K content can block the effect of the drug, she said.
Patients taking certain medications such as isotreinoin and acitretin, or who are pregnant, should also avoid taking multivitamins containing Vitamin A without consulting their healthcare provider.
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How Should My Kidney Stone Be Treated
Historically, the treatment of kidney stones required major surgery and was associated with long hospitalization and recovery periods. However, in recent years an improved understanding of kidney stone disease, along with advances in surgical technology, has led to the development of minimally invasive and even noninvasive treatments for people with kidney stones.
At Johns Hopkins, we believe that the treatment of a patients stones requires an approach that is unique to that individual. We offer a complete range of state-of-the-art treatment options, including ESWL , ureteroscopy and PERC, and we will discuss with you the advantages and disadvantages of each therapy as they apply to your situation. Our goal is to provide each patient with a clear understanding of the nature of their stone burden as well as the most appropriate course of treatment.
What Is The Scientific Evidence For Citrate
One form of citrate supplement, potassium citrate, was approved by the FDA in 1985 for the prevention of two kinds of kidney stones: calcium stones and uric acid stones.
In a 3-year,double-blind study of 57 people with a history of calcium stones and low urinary citrate levels, those given potassium citrate developed fewer kidney stones than they had previously. In comparison, the group givenplacebo had no change in their rate of stone formation.12
Potassium-magnesium citrate was studied in a 3-year trial involving 64 participants with a history of calcium oxalate stones.13 During the study, new stones formed in only 12.9% of those taking the potassium-magnesium citrate supplement, compared to 63.6% of those taking placebo. Benefits have been seen in other small studies as well.56,60
Citrate is available in the form of calcium citrate. Besides increasing citrate in the urine, this supplement has the advantage of being a readily absorbed form of calcium for those seeking to increase their calcium intake for other health reasons.14 However, calcium citrate has not yet been studied as a preventive for kidney stones.
It was first thought that citrate supplements were only helpful against kidney stones in individuals who didn’t excrete the normal amount of citrate in their urine.18 However, some researchers now suggest that citrate treatment may also be useful for those at risk for stones whose citrate excretion is normal.19
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Add Lemon To Your Water
This is a natural treatment that conventional nephrologists have gotten right. While lemon water is often touted as a cleansing or alkalizing drink, the main reason it is helpful in reducing stone formation is its citric acid content.
Citric acid inhibits stone formation and breaks up small stones that are beginning to form. It works in a few different ways. Citrate binds with calcium in the urine, reducing the amount of calcium available to form calcium oxalate stones. It also prevents tiny calcium oxalate crystals that are already in the kidneys from growing and massing together into larger stones. It also makes the urine less acidic, which inhibits the development of both calcium oxalate and uric acid stones.
Youll need about a half a cup of lemon juice added to water throughout the day to get the same benefits as taking a potassium citrate pill, which is one of the standard pharmaceutical treatments for kidney stones. You can either take this all in one shot, or spread your intake of the lemon juice throughout the day. Try adding half a cup of lemon or lime juice to a 32 ounce bottle of water and sip on it throughout the day. If you prefer, you can also try adding apple cider vinegar, which also contains citric acid and is an alkalizing addition to your beverages.
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Too Much Calcium Could Cause Kidney Heart Problems Researchers Say
Federal health officials recommend 1,000 milligrams of calcium per day for people younger than 50, but some are overdoing it.hide caption
When it comes to a healthy diet especially for women, and especially after menopause nutritionists, doctors, everybody it seems, will tell you: calcium, calcium, calcium.
Federal health officials recommend that women and men younger than 50 consume 1,000 milligrams of calcium per day. The recommendation goes up to 1,200 milligrams after age 70 for men and after menopause for women, when a major drop in estrogen causes bone loss.
So, in a culture that often considers “more” to be “better,” one might ask, if 1,200 milligrams of calcium is good, is 2,000 mg of calcium better?
No, says Dr. Ethel C. Siris, director of the Toni Stabile Osteoporosis Center at Columbia University Medical Center in New York. “You need enough you don’t need extra,” she says.
“Extra calcium does you no good, and there is a small risk that if you take too much you might get a kidney stone,” says Dr. Siris. That’s because the body can only handle 600 milligrams of calcium at once. Extra calcium can build up in the bloodstream and, when excreted through kidneys in urine, it can cause a kidney stone.
That’s been known for a while. But recently, a few studies raised concern that excess calcium may also calcify coronary arteries in susceptible individuals and even precipitate heart attack.
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Can You Take Calcium Supplements And Yet Avoid Kidney Stones
Yes. Taking your calcium supplement with oxalate-rich meals may help you reduce the risk of stones greatly. Calcium stones are formed when calcium supplements are taken away from food. But many of our foods like green vegetables and fruits contain oxalates, a group of chemicals that the calcium should ideally combine within the intestines and allow the body to absorb the mineral for all the right purposes strong bones, teeth, heart health, etc.
Can Certain Vitamins Cause Kidney Stones
Taking high doses of vitamin C supplements, such as 500 mg or more a day on a regular basis, has been shown to increase the risk of developing kidney stones in some people. This is particularly true in people who have had calcium oxalate stones in the past or who have a family history of these stones.
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Vitamin D And Kidney Stones: Lessons From Animal Models
Among the few animal models of kidney stone formation, the most interesting is certainly the genetic hypercalciuric stone-forming rat . This model has been obtained by inbreeding the most hypercalciuric progeny of successive generations of SpragueDawley rats . When fed on a standard diet, these rats have a dramatically higher urinary calcium excretion than controls and develop kidney stones made of calcium phosphate, or calcium oxalate with the addition of hydroxyproline to the diet . As in humans, hypercalciuria is a polygenic trait . This rat model is essential for addressing the pathophysiology of hypercalciuria. There is dramatically increased intestinal calcium absorption in GHS rats but also increased bone resorption and reduced renal tubular calcium reabsorption . These rats have increased biological activity of VDR in the bones and intestines and an increased VDR expression in the intestines, bones and kidneys. Calcitriol administration to GHS rats exacerbates calciuria by increasing intestinal calcium absorption but also bone resorption . These observations support the role of VDR in human hypercalciuria, but also the potential roles of calcitriol and VDR in bone demineralization which frequently affects kidney stone formers .
Calcium Supplements: Should You Take Them
When you were a child, your mom may have encouraged you to drink milk tobuild strong bones. But as an adult, youre much more likely to take acalcium supplement than down four glasses of milk a day to protect yourbone health. However you do it, getting enough calcium is a good idea,since women are far more likely than men to developosteoporosis a condition of weak and fragile bones that makes you prone to fractures:Of the 10 million Americans with osteoporosis, 80 percent are women.
But before you unwrap that chocolate-flavored calcium chew or swallow acalcium pill, you should know that taking calcium supplements may not behelping your bones at all. Even worse? The supplements may lead to majorhealth problems
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