Limiting Foods With Calcium Oxalate
Kidney stones can consist of many different compounds, including uric acid, struvite, and cysteine. The most common type of kidney stone involves calcium oxalate.
One 2014 study examined nearly 44,000 kidney stones and found that 67% were composed predominately of calcium oxalate.
Doctors usually only recommend restricting oxalate intake to those at a high risk of kidney stones or those with high oxalate levels.
Consuming calcium alongside oxalate-rich foods may reduce the risk of kidney stones by binding the chemicals together before they reach the kidneys.
Foods that contain high levels of oxalate include:
- grapefruit and cranberry juice
What Really Causes Kidney Stones
A recent widely-publicized study claimed that vitamin C supplements increased the risk of developing kidney stones by nearly a factor of two. The study stated that the stones were most likely formed from calcium oxalate, which can be formed in the presence of vitamin C , but it did not analyze the kidney stones of participants. Instead, it relied on a different study of kidney stones where ascorbate was not tested. This type of poorly organized study does not help the medical profession or the public, but instead causes confusion.
The study followed 23,355 Swedish men for a decade. They were divided into two groups, one that did not take any supplements , and another that took supplements of vitamin C . The average diet for each group was tabulated, but not in much detail. Then the participants who got kidney stones in each group were tabulated, and the group that took vitamin C appeared to have a greater risk of kidney stones. The extra risk of kidney stones from ascorbate presented in the study is very low, 147 per 100,000 person-years, or only 0.15% per year.
Key points the media missed:
So we have a poorly designed study that did not determine what kind of stone was formed, or what caused the stones that were formed. These are serious flaws. Drawing conclusions from such a study can hardly be a good example of “evidence based medicine.”
Which Supplements Will I Need To Take
Depending on your health and other factors, your healthcare provider may recommend some of the following supplements:
- B Complex: B complex vitamins are grouped together, but each has a different job to do.
- One of the important functions of vitamin B6, B12 and folic acid is to work together with iron to prevent anemia.; If you have anemia, it means you do not have enough red blood cells. ;Red blood cells carry oxygen from your lungs to all parts of your body.;
- Additional B vitamins, called thiamine, riboflavin, pantothenic acid and niacin, can also be given as a supplement. These vitamins help to change the foods you eat into energy your body can use.
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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 can’t 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.
Linus Pauling Institute Recommendation
Combined evidence from metabolic, pharmacokinetic, and observational studies, and from randomized controlled trials supports consuming sufficient vitamin C to achieve plasma concentrations of at least 60 mol/L. While most generally healthy young adults can achieve these plasma concentrations with daily vitamin C intake of at least 200 mg/day, some individuals may have a lower vitamin C absorptive capacity than what is currently documented. Thus, the Linus Pauling Institute recommends a vitamin C intake of 400 mg daily for adults to ensure replete tissue concentrations ;;an amount substantially higher than the RDA yet with minimal risk of side effects.
This recommendation can be met through food if the diet includes at least several servings of vitamin C-rich fruit and vegetables as part of the daily recommended fruit and vegetable intake . Most multivitamin supplements provide at least 60 mg of vitamin C.
Originally written in 2000 by:Jane Higdon, Ph.D.;
Reviewed in December 2018 by:Anitra C. Carr, Ph.D.Department of Pathology & Biomedical ScienceUniversity of Otago
Copyright 2000-2021; Linus Pauling Institute
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Family History Of Kidney Stones Watch Those Megadoses Of Vitamin C
New York, NY – Kidney stones are a common problem, affecting about half a million people each year. Men are more prone to kidney stones than women — nearly four out of five sufferers are men. Dietary habits may sometimes increase the risk of developing kidney stones. If you or anyone in your family has had a kidney stone, consider the following:
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. The reason for this may be that, at high doses, a significant amount of vitamin C is converted to oxalate in the body. A large amount of oxalate would then be present in the urine where it could combine with calcium to form calcium oxalate stones. “People who are at risk for this problem should not take more than the recommended daily allowance of vitamin C as a supplement,” says Garabed Eknoyan, MD, president of the National Kidney Foundation.
Eating foods that are high in oxalate may also trigger kidney stone formation in people who are prone to develop calcium oxalate stones. The following foods have been shown to increase oxalate in the urine, and they should be avoided by these individuals: spinach, rhubarb, beets, nuts , chocolate, tea, wheat bran and strawberries.
COVID-19 patients can become kidney patients.
The Role Of Vitamin C In Preventing And Dissolving Kidney Stones
The calcium phosphate kidney stone can only exist in a urinary tract that is not acidic. Ascorbic acid acidifies the urine, thereby dissolving phosphate stones and preventing their formation.
Acidic urine will also dissolve magnesium ammonium phosphate stones, which would otherwise require surgical removal. These are the same struvite stones associated with urinary tract infections. Both the infection and the stone are easily cured with vitamin C in large doses. Both are virtually 100% preventable with daily consumption of much-greater-than-RDA amounts of ascorbic acid. A gorilla gets about 4,000 mg of vitamin C a day in its natural diet. The US RDA for humans is only 90 mg. The gorillas are unlikely to all be wrong.
The common calcium oxalate stone can form in an acidic urine whether one takes vitamin C or not. However, this type of stone can be prevented by adequate quantities of B-complex vitamins and magnesium. Any common B-complex supplement, twice daily, plus about 400 milligrams of magnesium, is usually adequate.
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Vitamin D Serum Levels And Vitamin D Prescription: A Link With Kidney Stones
Since calcitriol increases digestive calcium absorption and, at least temporarily, serum calcium levels, it should necessarily increase urine calcium excretion to maintain calcium homeostasis . The prescription of cholecalciferol or analogous treatments increases circulating levels of 25-hydroxyvitamin D, which may act with low affinity on VDR or be transformed into calcitriol, with a higher affinity to VDR . The production of calcitriol is fortunately limited by parathyroid hormone synthesis suppression, through calcium sensing receptors and calcitriol signalling in parathyroid cells. Since parathyroid hormone promotes renal calcium handling in the distal tubules, its suppression may also increase urinary calcium excretion.
Although there is a large consensus that high calcitriol levels increase urine calcium and kidney stone formation, whether serum 25-hydroxyvitamin D circulating levels or widespread vitamin D prescription could influence kidney stone formation is still debated.
Kidney Stones And Nutrition: How To Reduce Your Risk
Did you know that the formation of kidney stones and nutrition go hand-in-hand? Your diet and specific nutrients play a role in decreasing the risk of kidney stone formation.
Kidney stones form when substances become too concentrated in the urine.; These substances are generally in your urine and are excreted by your kidneys.; However, when the amount of these substances in the urine is too high, they form crystals.
There are other substances in the urine called inhibitors . Stone inhibitors help keep the crystals from sticking together. When the concentration of crystals is too high or the amount of inhibitors is too low, a kidney stone will form.
According to the National Kidney Foundation, one in ten people will develop a kidney stone during their life in the United States.; Men are more likely to have kidney stones than women, and Caucasians are more likely than African-Americans. The incidence of kidney stones peaks between 20 and 40 years of age. ;However, a stone can occur at any age.
In this article, we discuss the link between kidney stones and nutrition and share ways to reduce your risk.
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Why Do I Need Different Amounts Of Vitamins And Minerals
Having chronic kidney disease changes your need for some nutrients. Some of the reasons are:
- The waste products that build up in your body each day can change the way your body uses vitamins and minerals.
- Some of the medicines you take can change the way your body uses certain vitamins and minerals.
- Some vitamins are lost during dialysis treatment if you are on dialysis.
- Following a special diet for chronic kidney disease can mean you miss certain vitamins and minerals from foods.
- On days when you may not feel well enough to eat regular meals, you may not get enough daily vitamins and minerals.
Is Too Much Of A Multivitamin A Bad Thing
Patients should consult with their physician or pharmacist before taking any vitamins.
Healthy individuals can easily get enough vitamin C through diet alone. In fact, based on a 2000-calorie diet for healthy adults, half of one 2.5-oz package of Kelloggs Fruity Snacks provides 100% daily value of vitamin C. If you ate the entire package, it would provide 200% DV.
Is there a ramification for overdosing on vitamins like this?
If a patient is deficient in vitamins or minerals, diet-based solutions should be recommended first because they can provide many bioactive compounds and dietary fiber not found in supplements. If a patient isnt deficient in vitamins or minerals, theres insufficient data to suggest benefit from taking more than the daily recommended allowance of certain vitamin or mineral supplements.1
Vitamin C, vitamin B12, thiamin, niacin, riboflavin, tryptophan, pantothenic acid, biotin, and folic acid are all water-soluble vitamins and nutrients. Although the body adapts by absorbing only what it needs and excretes the excess in the urine, excretion decreases when study participants fast.2
Even though they arent stored in the body, water-soluble nutrients cant be presumed safe. In fact, too much vitamin B6 can cause nerve problems, too much vitamin C can cause kidney stones, and too much folic acid may mask vitamin B12 deficiency.2
How multivitamin overdose affects different parts of the body is displayed here3:
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And High Levels Of Calcium Can Result In Kidney Stones
According to Gallagher, hypercalciuria “can contribute to kidney stones,” he explained in a statement. That excess calcium in the urine can form salts that crystallize, resulting in kidney stones, the experts at Cincinnati Children’s Hospital Medical Center explain. “The use of calcium and vitamin D supplementation may not be as benign as previously thought,” Gallagher said.
Symptoms of kidney stones include severe pain on either side of your lower back, a stomach ache that doesn’t go away, blood in the urine, nausea, vomiting, fever, chills, or urine that smells bad or looks cloudy, per the National Kidney Foundation .
Kidney Stones And Some Supplements May Not Be Healthy Mix
- Dr. keith Roach
Dear Dr. Roach I have been taking a multivitamin for years, and now one of my physicians wants me to take a vitamin that has NO vitamin D or calcium. He just removed kidney stones in two separate procedures. I cant find any vitamins like that. D.A.S.
Answer I completely agree that people with kidney stones should avoid calcium supplements. The transiently high levels of calcium after taking one cause the kidney to excrete a lot of that calcium, and that can cause a calcium crystal to grow, eventually forming a stone. Calcium that comes from the diet, on the other hand, does not induce such a spike in blood levels. Also, part of the calcium bonds with oxalate, preventing that chemical a major part of many kidney stones from being absorbed. High dietary calcium reduces the risk of stones.
The effect of vitamin D is not as clear. It seems that having low vitamin D is a risk for forming stones, so many experts will treat low vitamin D levels in people with kidney stones. I dont know your exact situation. It may be that your vitamin D level is normal or high, and you just dont need supplementation.
The most recent studies have consistently shown that most of the vitamins in a multivitamin tablet do not improve health or prevent illness, so I dont recommend multivitamins anymore. I would encourage a healthy diet with plenty of fresh fruits and vegetables. Save your money on the vitamin tablets.
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You Should Avoid Exceeding The Daily Suggested Guidelines For These Two Supplements
Due to the results of their study, the researchers caution that people should not exceed supplement guidelines suggested by the Institute of Medicine; maximum daily levels;are 600 to 800 international units of vitamin D and 800 to 1,200 milligrams of calcium.
“It is important to monitor blood and urine calcium levels in people who take these supplements on a long-term basis,” Gallagher said, noting that’s “rarely done in clinical practice.”
Certainly, you’ll want to do what you can to avoid kidney stonesin addition to being painful, they can increase the risk of kidney damage and of developing chronic kidney disease, according to the NKF.
Can Vitamin C Cause Kidney Stones
Sandra Adamson Fryhofer, MD
Hello. I’m Dr. Sandra Fryhofer. Welcome to Medicine Matters. The topic: Vitamin C supplements may cause kidney stones, according to a new study in JAMA Internal Medicine. Here’s why it matters.
Vitamin C is ascorbic acid. Some people take extra doses of vitamin C to prevent colds. Some take even more to treat them. Others may take it for other reasons. But if you’ve ever had a kidney stone, you may want to think twice about taking extra vitamin C supplements.
This study looked only at men and followed more than 22,000 men for more than 10 years. It found that those who took high doses of vitamin C supplements doubled their risk of getting a kidney stone. The increased risk was seen only in those taking extra doses of vitamin C and not in those taking just a multivitamin.
How much vitamin C is too much? Well, that’s not exactly clear. This study was done in Sweden, where most vitamin C supplements contain 1000 mg per tablet. The kidney stone risk was highest in those taking more than 7 vitamin C supplements per week.
Why the increased risk? As we know, kidney stones are often composed of calcium oxalate. When excess vitamin C is excreted by the body, it is usually in the oxalate form, and this may lead to more stones.
No link to stones was found for foods high in vitamin C. The caution applies only to vitamin C supplements and not to vitamin C found in foods.
For Medicine Matters, I’m Dr. Sandra Fryhofer.
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Factors That Increase Your Risk Of Kidney Stones
Kidney stones often have no single cause, and several factors may increase your risk for getting them. Some of these factors are listed below. They include:
Lack of water
You need to make enough pee to dilute the things that can turn into stones. If you donât drink enough or sweat too much, your pee may look dark. It should be pale yellow or clear.
If youâve had a stone before, you should make about 8 cups of urine a day. So aim to down about 10 cups of water daily, since you lose some fluids through sweat and breathing. Swap a glass of water for a citrus drink. The citrate in lemonade or orange juice can block stones from forming.