lemon water

Do you remember Eddie Murphy’s word of the day on Mr. Robinson’s Neighborhood on Saturday Night Live? Classic. So, boys and girls, our word for the day is: nephrolithiasis (nef-ro-le-thi-a-sis) or kidney stones. As per the Cleveland Clinic, kidney stones form when the urine is too rich in:

  • calcium oxalate
  • calcium phosphate
  • magnesium ammonium phosphate
  • uric acid
  • cysteine (due to a genetic disorder of 4 amino acids)

You can either view the urine as being too rich in these compounds or not dilute enough, meaning you need more urine output (which means you need to drink more water). Kidney stones are merely the end product of a process that takes some time to occur. It’s best to be proactive, and keep your kidneys healthy and sludge free; as kidney disease, beyond kidney stones, is very silent and can often only exhibit symptoms when the kidneys have lost 70-80% of their function.

I recently noticed a report in The Journal of Urology, Impact of Nutritional Factors on Incident Kidney Stone Formation, concerning the risk factors for kidney stones. I felt that some key aspects needed to be addressed and expounded upon.

Here are the basic findings:

In the study of 78,293 women from the Women’s Health Initiative Observational Study, 2.5% reported an incidence of kidney stone formation. Among these women the risk of kidney stones:

  • was decreased by 5 – 28% with higher DIETARY calcium intake
  • was decreased by 13 – 31% with higher water intake
  • was increased by 11 – 61% with higher dietary sodium intake, with the most pronounced effect in women with the highest intake
  •  was increased with higher body mass index, BMI
  • animal protein intake was not associated with nephrolithiasis

An article from 1983 entitled Nutrition Research, Urolithiasis – Nutritional Aspects, associated the increase in the incidence of kidney stones with “affluence”.

Increased ingestion of animal protein produces a significant increase in the urinary excretion of calcium, oxalate and uric acid…Oral carbohydrate loading increases urinary calcium and magnesium excretion…A rational, though not of proven efficacy, dietary approach to urolithiasis therapy includes restriction of animal protein, avoidance of excess oxalate ingestion, a normal calcium intake, and water intake sufficient to generate 2 liters of urine per day.

So it seems that protein ingestion and carbohydrate ingestion and foods rich in oxalate all contribute to kidney stones. How could this be, because it covers such a broad range of foods, many of them staples of a healthy diet?

Foods that are high in oxalates are:

  • Tea
  • Coffee
  • Cola drinks
  • Chocolate
  • Nuts
  • Soy products
  • Green leafy vegetables
  • Sweet potatoes
  • Celery
  • Berries
  • Tangerines

What to do? It’s definitely advisable to reduce your sodium levels, but I don’t necessarily mean mineral rich sea or unrefined salts, like Himalayan pink salt. I definitely mean the refined salt that is added to processed foods and regular table salt which contains anti-caking agents and in some countries, fluoride and sugar. The average intake of sodium in America is 3.7 to 5 grams per day, considerably higher than the recommended maximum of 2.3 grams. And the more excess salt consumed, the higher the risk. Try using herbs, fresh if possible, and spices, which can be of tremendous nutritional and health benefit, instead of all the salt.

Maintain a healthy weight, thereby avoiding another risk factor: high Body Mass Index (BMI). Uric acid stones, specifically, have been tied to the increase of obesity and metabolic syndrome. Achieving and maintaining a healthy weight can ward off a majority of diseases, including cancer, heart disease, diabetes, etc.

It’s absolutely imperative to maintain the correct hydration levels, as keeping your urine dilute will avoid supersaturation of the compounds that can potentially precipitate into kidney stones. Drinking fluids such as coconut water will help to maintain electrolyte balance due to their rich content of calcium, magnesium, phosphorus, and potassium.

Now what about dietary calcium, oxalates and minerals? It seems intuitive to me that the excess of compounds in our urine is actually because of deficiencies in our diets. Let me explain. Our bodies are best able to utilize vitamins and minerals in foods due to the synergy of the compounds in the whole food. This has been proven in many instances, such as the greater bioavailability of Vitamin C in kiwi than in supplements. For example, to build strong bones and teeth, we don’t just need calcium, we need a spectrum of minerals such as silica, boron, magnesium, zinc and Vitamin D and K, etc. If we do not have all of the “ingredients” available to create bone, the calcium will not work alone. Additionally, these compounds can prevent the crystallization of calcium into stones.

Maintaining a diet high in DIETARY calcium is one of the risk reduction strategies in the study. Calcium taken in the majority of supplements is not absorbed as efficiently as calcium found in food. Calcium must be properly balanced with other nutrients necessary for calcium absorption and re-absorption into the bones. If not properly balanced, calcium ends up being deposited in the soft tissues. Pathologists have reported that over 85% of all autopsies done on people over 65 demonstrate calcification of soft tissue within the body. So it seems the population does not suffer from calcium deficiency, but rather a condition whereby calcium is being deposited in the soft tissues due to nutrient imbalance. Taking supplements and not having sufficient minerals to metabolize it, can also cause the calcium to form into stones in the kidneys.

In the case of oxalate rich food, in order to utilize what we eat, our body will either require sufficient dietary calcium, will leach calcium from our bones or will precipitate the oxalates that could not be metabolized into kidney stones. The way to address this is not to necessarily remove green leafy vegetables from your diet, but to eat a variety of them and to make sure that you consume them in conjunction with calcium rich foods that will allow them to be metabolized in a balanced way. For example, collard greens have been found to be proportionately higher in calcium than milk, making them a good choice of greens. Don’t stick to a strict high oxalate “spinach as my greens” diet. Try one of the many kale varieties, or bitter greens which clear congestion in our livers. Organic yogurt, sardines, almonds, sesame seeds or tahini, raw cheese, or almonds are all good sources of dietary calcium that contain the additional nutrients that we require for proper assimilation. Additionally, I love this study showing that calcium rich marine hydro-colloids efficiently inhibit calcium oxalate  crystal growth and have the capacity to bind oxalate. This is exactly what my intuition had been telling me, as these marine colloids are seaweed, which, surprise, is incredibly high in mineral content. Apparently, this remains a mystery to the doctors who were still focused on a drug solution that would mimic seaweed. I don’t know, to me that study should have been splashed all over the place with the title of “Seaweed found to reduce kidney stone formation”.

There are many high protein diets that are popular currently, from Paleo to GAPS to Atkins. What about the idea that protein metabolism creates stress on the kidneys and greater excretion of calcium and oxalates and uric acid into the urine? It has been found that calcium excretion increases, but there is a minimal effect on oxalate excretion with a higher protein diet. For people who have kidney damage, compromised kidney function or blood work that indicates any kidney issues, a high protein diet can create problems. For people with normal kidney function, the kidneys adapt to the protein intake with alterations in renal size and function without indications of adverse effects.

So it boils down to:

  • drink more water
  • consume less salt
  • eat some seaweed
  • eat a varied, whole foods based, calcium and mineral rich diet
  • achieve and maintain a healthy weight and BMI
  • maintain optimal Vitamin D levels

From Healing with Whole Foods, one of my favorite references, find the following nutritional remedies:

Parsley: Promotes urination and dries watery mucoid condition; good for the treatment of obesity, mucus in the bladder, swollen glands and breasts, and stones in the bladder, kidney, or gall bladder.

Radish: A traditional Western remedy for gallstones and kidney and bladder stones consists of a tablespoon of grated radish taken daily for several weeks.

Traditional Chinese medicine describes the kidneys as the “palace of Fire and Water” (heart spirit and kidneys – water element), and the person with healthy, vital kidneys is active yet calm, courageous but gentle, accomplishes a great deal without stress, and balances assertive action with nurture.

From Prescription for Herbal Healing, another incredible resource:

Aloe juice, 1/2 cup daily for no more than 2 weeks slows the rate of crystal formation. Use aloe with caution, as it can be laxative, so although it can potentially be great for the digestive system, if you suffer from inflammation it can also exacerbate it. It may also affect the rate of absorption of  medications, due to its laxative properties. It is also passed into the milk of nursing mothers and should be avoided by them. Watch your reaction, and try one new healing concept at a time, to discern what works and what doesn’t work for your body.

Chanca piedra tincture dissolves calcium stones.

Marshmallow root tea helps cleanse the kidneys and expel stones.

A great juice to make to help your body maintain kidney health is cucumber, dandelion greens, lemon, fennel, small amount parsley, and carrots for sweetness, if you like. Ginger root is a wonderful anti-inflammatory and can be juiced or made into tea by boiling slices of the fresh root in water. Absolutely delicious!