LCHF and kidney stones

Mongolia

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I'm after some help please! I have been following the LCHF way of eating for 3 years and BS levels are largely stable and within the acceptable range. I know that this is working to keep my diabetes under control. However I have just been in hospital with kidney stones - painful! The consultant told me that once you have one, it is likely that you will keep producing them and I have been advised to cut down my fat and protein intake.o_O I'm now rather confused as to what I actually can eat! Has anyone else on LCHF suffered with kidney stones? I'd be really grateful to know what you eat.:arghh:
 

Brunneria

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Hi @Mongolia

The reading I have done (I am NOT) an expert, led me to believe that dehydration is a primary cause of kidneys stones - but of course not the only cause! And dehydration is easy to achieve on a LC way of eating. Certainly I was recently surprised when I used some urine testing strips and they showed signs of dehydration , even though I thought my water intake was more than adequate. I now drink EVEN more.

I know that @Grateful and @andcol have experienced kidney stones recently, they may be able to offer first hand advice.
 

Mongolia

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Hi @Mongolia

The reading I have done (I am NOT) an expert, led me to believe that dehydration is a primary cause of kidneys stones - but of course not the only cause! And dehydration is easy to achieve on a LC way of eating. Certainly I was recently surprised when I used some urine testing strips and they showed signs of dehydration , even though I thought my water intake was more than adequate. I now drink EVEN more.

I know that @Grateful and @andcol have experienced kidney stones recently, they may be able to offer first hand advice.
Hi Brunneria, thank you for this. Yes, the first piece of advice I was given by the consultant was to drink more water as proper hydration is the most important factor in preventing kidney stones. It's just not that easy to drink lots being a teacher, as I can't just dash off to the toilet during a 1.5 hour lesson:wideyed: Maybe I can just turn my desk chair into a commode?!:D Only joking, I know I must drink more so that will be top of my list of things to do. Have been doing some more reading and the advice seems to be to cut down salt intake (which isn't big anyway), and eat foods low in oxalates which cuts out quite a few things I rely on for LCHF. Will keep researching and hope that someone can help me out with some more advice.
 

Grateful

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I started getting kidney stones a few months after my T2 diagnosis prompted me to go on low-carb diet. At the time I had greatly stepped up my exercise, without hydrating enough. After the first stone episode, I greatly increased my water/fluid intake to a minimum of 4 liters per day (this takes quite a lot of dedication to achieve). I also reduced oxalate-containing foods, stopped taking a calcium supplement, and added a large glass of freshly squeezed lemonade to my lunch. Despite all of this, I had another stone episode about five months later. After that, the specialist ordered a "24-hour urine test" which showed that the calcium level in my urine is incredibly high (it came in at 430, while a normal reading is 250 or below). This, the doctor says, likely explains why I continued to get kidney stones. He put me on a low-sodium diet, which he said will help, but is unlikely on its own to bring down the urine-calcium level enough. We are doing another 24-hour urine test next month to get a new calcium reading.

That doctor, as well as another kidney specialist I have consulted, are both pessimistic that the low-sodium diet will be sufficient. They want to add a diuretic drug call a thiazide, which although primarily used to treat high blood pressure, is also effective in lowering urine calcium levels. I am battling this tooth and nail, but remain open-minded for the time being. I do not have any signs of underlying kidney disease, so the kidney stones are just a big (and very painful) nuisance. If they turn out to be only occasional, I would rather put up with them than take a fairly strong drug for the rest of my life. I also want to continue in drug-free mode for a while to make absolutely sure that the kidney stone issue is chronic, rather than just something that happened a few times and could never happen again.

Hope this helps! For what it's worth, neither of my two kidney specialists is terribly interested in the low-carb issue. Also, because I never had a 24-hour urine test before now, I have no idea whether my high urine calcium is a lifetime issue, or whether it only started recently.
 
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jcbman

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I'd take the drugs.

I guess if your getting stones, and showing bad on those strips, brittle bones could be a problem later on.
Weeing more won't stop that coming on.
 

andcol

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Hi I got kidney stones caused by a raised calcium level in my urine. That they have discovered is caused by sarcoidosis (autoimmune attack on my lungs) so nothing to do with low carb. Sarcoidosis/calcium and Vit-D levels are linked. My kidneys do a good job in that my calcium in the blood is ideal and was when I had the stones so I have to watch my calcium intake (keep it up) and my vit D (not too much) or I dissolve my own calcium or generate too much and cause stones. Not caused by low carb. I am told to drink lots though but also not to drink tea. Coffee is fine. I like tea (fav drink) so limit myself to one darjeeling per day now instead of a dozen. Now I drink a dozen coffees instead.

I think there where other foods I was told to limit but cant remember exactly; dark chocolate, tomotoes ring a bell but that may be wrong.
 
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sunspots

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Hello. I've had one large kidney stone and been LCHF for years now. Kidney stones can be made from various different substances and whilst good hydration will help prevent any type from forming the specifics regarding diet vary (if I remember rightly). I think protein excess is mainly a culprit in uric acid stones rather than other types. It would be best finding out what type of stones you had and taking it from there. :)
 

jcbman

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So,is the pattern LCHF causes high calcium, so you need to drink loads to keep flushing it through.

Really, does no one worry about brittle bones in old age then?
 

Mongolia

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845
Type of diabetes
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I started getting kidney stones a few months after my T2 diagnosis prompted me to go on low-carb diet. At the time I had greatly stepped up my exercise, without hydrating enough. After the first stone episode, I greatly increased my water/fluid intake to a minimum of 4 liters per day (this takes quite a lot of dedication to achieve). I also reduced oxalate-containing foods, stopped taking a calcium supplement, and added a large glass of freshly squeezed lemonade to my lunch. Despite all of this, I had another stone episode about five months later. After that, the specialist ordered a "24-hour urine test" which showed that the calcium level in my urine is incredibly high (it came in at 430, while a normal reading is 250 or below). This, the doctor says, likely explains why I continued to get kidney stones. He put me on a low-sodium diet, which he said will help, but is unlikely on its own to bring down the urine-calcium level enough. We are doing another 24-hour urine test next month to get a new calcium reading.

That doctor, as well as another kidney specialist I have consulted, are both pessimistic that the low-sodium diet will be sufficient. They want to add a diuretic drug call a thiazide, which although primarily used to treat high blood pressure, is also effective in lowering urine calcium levels. I am battling this tooth and nail, but remain open-minded for the time being. I do not have any signs of underlying kidney disease, so the kidney stones are just a big (and very painful) nuisance. If they turn out to be only occasional, I would rather put up with them than take a fairly strong drug for the rest of my life. I also want to continue in drug-free mode for a while to make absolutely sure that the kidney stone issue is chronic, rather than just something that happened a few times and could never happen again.

Hope this helps! For what it's worth, neither of my two kidney specialists is terribly interested in the low-carb issue. Also, because I never had a 24-hour urine test before now, I have no idea whether my high urine calcium is a lifetime issue, or whether it only started recently.
Thank you for this information @Grateful I had my first kidney stone episode in July. Scan in October showed the all clear. February and I'm struck down again. I struggle to drink 1L of water a day so I have no idea how you manage 4!! It is interesting that despite your diet changes, you still got more stones. I may ask my doctor for a 24-hour urine test to see if there is anything else underlying my stones. In the meantime I guess I'll just have to drink the water and try a low oxalates diet. Have you found that this is compatible with LCHF?
 

Mongolia

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:)
Hello. I've had one large kidney stone and been LCHF for years now. Kidney stones can be made from various different substances and whilst good hydration will help prevent any type from forming the specifics regarding diet vary (if I remember rightly). I think protein excess is mainly a culprit in uric acid stones rather than other types. It would be best finding out what type of stones you had and taking it from there. :)
Thank you for your reply:) I had calcium stones. I understand that I need to keep calcium levels up and eat calcium with any oxalates, in addition to drinking as much water as humanly possible!:wideyed: However I'm thinking that I might have to ask the doctor to do further tests to see if there is anything else going on.o_O
 
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Mongolia

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So,is the pattern LCHF causes high calcium, so you need to drink loads to keep flushing it through.

Really, does no one worry about brittle bones in old age then?
My understanding is that if you have calcium stones, you need to keep your calcium intake up. I have just been told to cut down on my fat and protein intake which is tricky on LCHF...
 

jcbman

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My understanding is that if you have calcium stones, you need to keep your calcium intake up. I have just been told to cut down on my fat and protein intake which is tricky on LCHF...

Yes, brittle bones aren't funny, ostio something if I remember.
Does keeping your calcium up work though, or does it just overload your kidneys, and make more stones, rather than helping keep your bones strong.
As you say, it's tricky to get a balance.
 

andcol

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So,is the pattern LCHF causes high calcium, so you need to drink loads to keep flushing it through.

Really, does no one worry about brittle bones in old age then?

I am not sure how you have linked Low Carb to high calcium. I think you are jumping to conclusions.
 

jcbman

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Interesting link although most of the experts seem to say that keto diets should not lead to more kidney stones. Not a whole lot about calcium though.

It'll never be an issue to me.
So I can't really say I have any interest.
Probably not a good site to take notice of?
 

Grateful

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Kidney stones can be made from various different substances and whilst good hydration will help prevent any type from forming the specifics regarding diet vary (if I remember rightly). I think protein excess is mainly a culprit in uric acid stones rather than other types. It would be best finding out what type of stones you had and taking it from there. :)

Both of my stones so far were the most common type: calcium oxalate. Uric acid stones, which I did not have, are apparently more common among T2 diabetics but that is not what I had.

Yes, I have been keeping my calcium intake up, although I did stop taking calcium supplement pills. My reasoning being that my kidney stone episodes began a few months after I started taking those calcium pills! (I had started taking the pills because I was worried about low calcium intake from eliminating milk when I went on LC diet.)

Concerning oxalates, I really wasn't consuming that much of them but cut down what I could. Cut out the spinach and other obvious sources.

Yes, it is a challenge trying to be low-fat/low-protein and LC all at the same time! Not to mention low-sodium which was added a few months ago, to control the urine calcium levels. My diet is rather bland now that I have given up cheese (which is relatively high sodium), olives (cured in high-sodium brine) and various other favourite foods.

The good news so far is that we are nearly into March which means nearly four months without another kidney stone. Long may it last. Late next month I will be doing another 24-hour urine test to see if the urine calcium has dropped any.
 

Mongolia

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Both of my stones so far were the most common type: calcium oxalate. Uric acid stones, which I did not have, are apparently more common among T2 diabetics but that is not what I had.

Yes, I have been keeping my calcium intake up, although I did stop taking calcium supplement pills. My reasoning being that my kidney stone episodes began a few months after I started taking those calcium pills! (I had started taking the pills because I was worried about low calcium intake from eliminating milk when I went on LC diet.)

Concerning oxalates, I really wasn't consuming that much of them but cut down what I could. Cut out the spinach and other obvious sources.

Yes, it is a challenge trying to be low-fat/low-protein and LC all at the same time! Not to mention low-sodium which was added a few months ago, to control the urine calcium levels. My diet is rather bland now that I have given up cheese (which is relatively high sodium), olives (cured in high-sodium brine) and various other favourite foods.

The good news so far is that we are nearly into March which means nearly four months without another kidney stone. Long may it last. Late next month I will be doing another 24-hour urine test to see if the urine calcium has dropped any.
Oh goodness, no cheese would mean it isn't worth eating anything, I practically live on the stuff! For low sodium, what amount do you look for on a packet to determine if it is low sodium?
 

Grateful

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Oh goodness, no cheese would mean it isn't worth eating anything, I practically live on the stuff! For low sodium, what amount do you look for on a packet to determine if it is low sodium?

I don't look at the labels much. Just about all the cooking is done from scratch. I looked up various cheeses on the Web and salt is a fairly essential ingredient in most of them, so I gave up cheese. I switched to using unsalted butter. I dropped the salty snacks such as olives, and greatly reduced the salt in the low-carb seed crackers that we bake. For most recipes, I stopped adding any salt while cooking. I checked my overall diet and found it was not all that high in sodium in the first place, so there was not much left to cut.

I'm not thrilled with this; apart from anything else sodium, in reasonable quantity, is an essential ingredient of a human diet. However if it does result in significantly lowered urine calcium (unlikely!) I would still prefer the rather draconian diet to taking a thiazide drug. We'll see.
 
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