Oxalates & Kidney stones | Dr. David Goldfarb, MD
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- Опубликовано: 19 июн 2024
- Nephrologist Dr. David Goldfarb, MD goes over the science on kidney stones and oxalates.
Dr. Goldfarb on Twitter: @weddellite
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Facebook: / drgilcarvalho
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Disclaimer: The contents are for informational purposes only, not intended as medical advice nor to replace medical care. Never disregard medical advice because of information in Nutrition Made Simple.
#NutritionMadeSimple #GilCarvalho
0:00 Intro
2:02 Why do kidney stones form?
14:57 Age of onset & symptoms
20:02 Oxalate sources
27:04 Oxalate conditions
35:02 Oxalates & the microbiome
40:33 Citrate & calcium
45:15 Animal protein
50:53 Diet for kidney stone prevention
57:38 Supplements
1:04:49 What to do if you're passing a kidney stone
First, as a kidney stone former I found this conversation very helpful. However, my own experience makes me skeptical of the meat protein hypothesis. I consumed a plant based diet for over 2 years . I had a kidney stone episode in 2014. A scan revealed 9 stones. A large one was lodged and was removed. Another became lodged and had to be similarly removed a few months later. My urologist had me spend time with a dietitian who had some knowledge of oxalates and kidney stone formation. My plant based diet was loaded with high oxalate foods.
The dietitian advised cutting back on some high oxalate foods like almond milk spinach etc., adding more citrus ,drinking more fluids, and taking a calcium citrate supplement. All that seems to fit with what I heard in this conversation. I just can’t get my thick head around the meat protein concept. After my own experience, I refuse to go back to high oxalate legumes and nuts for protein.
Oxalates aren’t a defense mechanism-how would that work? They make you hurt after ten years?. Oxalates from food are bound to minerals so your body doesn’t absorb them from foods. Free oxalates in the body like the blood bind to excess calcium from Animal foods. Animal proteins also cause kidney failure and cause Uric acid kidney stones. Almost all the cases of kidney stone each year aren’t from people eating too many plants. In fact fiber and plant foods help reduce kidney stones.
If you want to know about the real causes of kidney stones and oxalic acid leaner from someone who knows what he’s talking about:
ruclips.net/video/ZXrNH9urLEM/видео.html
I have a similar question. Would be great to have a more in-depth analysis on the meat aspect. I do understand the acidity factor though.
The speaker literally says that most oxalate comes directly from plants, and goes on to show which high oxalate foods do it. Half of the video is dedicated to that. Animal protein and animal foods contribute to a different type of stones, uric acid (disease of kings). Did you guys even watch the video?
@@Anna-mv9ew I have a feeling many of them hadn't watched the video; they're just looking for a chance to say, "See? What more proof do you need that a plant based diet is bad for you?". Anecdotes about how people had stopped eating this or that, after having had multiple stones, don't equal usable information, to me, because my guess is these things are so multifactorial, that ppl can't be sure if they wouldn't have still gotten a stone, if they could have gone back in time and changed their diets. I'm sure glad I'm at about 50/50 plant and animal protein intake, when faced with things like this. I could point out how I always drink a lot of water after I eat certain foods, to help my kidneys work better, so I can feel smart. Or how I drink fizzy lemon water. Nobody's interested, because, what if that, HADN'T helped me avoid kidney stones, in all this time? I don't know that.
dairy
Thanks for having such a knowledgeable and sensible guest on to clear this subject up!
First kidney stone at 59 and they found several more. I had become vegan about 3 years prior, stopped eating milk products, eating lots of spinach and drinking like a gallon of unsweet ice tea a day because I thought it was healthy. and almonds so wonder if it was just the perfect combo for kidney stones. I added calcium back to my diet and lemon juice periodically. At my one year check up no change so hopefully adding dairy back and cutting back on oxalate will take care if it.
It probably wasn't being vegan but overdosing on spinach and ice tea. Maybe avoid spinach or boil it and discard water.
I've passed a kidney stone, broken metacarpals, ribs and a forearm, almost totally severed a finger, suffered from nerve pain from prolapsed disks, bad toothache and migrains that leave me vomiting in the dark for hours.
Number 2 is migraines but for me the no.1 for pain was passing a kidney stone, the pain is brilliant, spectacular, had me writhing, moaning and gasping for hours and driving at 2am, swerving all over the road, pushing a dent in to the roof by pushing down against the pain as I "drove", absolutely of my mind, to the hospital (do NOT do this, thank the stars the roads were empty) then finally passing out in the hospital.
When the beautiful staff at the hospital checked me out the next day I went home to find that I must have kicked the bathroom cabinet to pieces whilst writhing on the toilet, finding it destroyed but not remembering destroying it.
I'm sure it's not always this bad but I would not wish a kidney stone on anyone.
Brother! I’m sorry you had to go through that. That’s my worst nightmare. I’ve had a blockage in my urinary tract due to scar tissue from a surgery as an infant. My son had the same surgery. If I get a stone and I don’t shoot myself then Lord help me keep me away from knives. The scene will be violent.
I just love your videos. You always provide such amazing information. And you taught me how to do my own research through scientific papers and articles. That's something that I wish more and more people could learn to do.
Endless respect for this channel. Figuring out nutrition as a layman is so often a headache. Gil and guests like this add some much needed clarity.
I have been binge watching this RUclips channel. Almost makes me want to be a doctor.
I was getting uric acid kidney stones until about 20 years ago and had to have multiple lithotripies and two surgeries for stones too large to pass. It was unbearable pain and would hit out of nowhere causing me to drop to my knees. I went to several urologists trying to get relief but nothing stopped them from coming back. Finally I had an elderly urologist tell me to stop drinking iced tea and start drinking fresh lemonade. He told me the southeast was known as the kidney stone belt when he was young. I haven't had another kidney stone (or glass of tea) since first visiting him in 2002.
Must be something in the water.
@susanwright1999 what?!
@@jellybeanvinkler4878 There are 2 types of kidney stones, calcium and uric acid. Apparently there is something in iced tea that can cause a buildup of uric acid and citrus acid can desolve them. He said that is why so many people put lemon in their tea. I told him I didn't like lemon in my tea and he said "Thanks why you have kidney stones. Do you like lemonade?" I answered yes and he told me to switch to lemonade and see what happens. Haven't had another stone since.
I wish it was that easy....it's not. It's not a Southeast thing because "sweet tea" in that reason, there are equivalents as it's oxalates.I grew up in a mediterranean family so, lemon water was our drink - period. Always. What are also big issues? Nuts. It helped me keep my blood sugars stable which that condition happened a tetanus shot in my childhood. I know that pain. No one else can claim to know and when people say "it's like giving birth"...giving birth, there is at least endorphins, adrenaline and a new life at the end of the tunnel. This ain't, right?
Old school doctors use their HEAD. Today, they use 'google' and it's scary. I worked in healthcare.
What else helps, but "check with your doctor".... magnesium as it binds.
Occupational kidney stones....healthcare workers. We aren't allowed to have water at the nurses station. I was about to have my work place pay the bills. Or IV fluids and a Foley catheter.
@@jellybeanvinkler4878 joke?
Absolute respect and love to this channel. I am 15 min into this interview and I have learned more about my condition than through the rest of my life. ❤
you need to get out more often
Thanks for doing this. Not only the right guest but your questions were spot on. The only missing question (unless I missed it) was about legumes (notwithstanding his anecdote of the guy who ate a jar of peanut butter every day). Was curious to hear his views on lentils, chickpeas, beans.
A little bit of necroposting, but whatever. Legumes are not that high in oxalates, so there's no need to worry too much.
Every question I had was answered. You are incredibly thorough, Gil! Even when I had a new question or even objection during the video, it was addressed later in the video. You don't miss anything. Like how I was going to say it IS possible to dissolve a stone because I did it once with Earl Gray tea (bergamot) and fresh lemon juice, he later clarified that uric acid and cysteine stones can be dissolved. Mine was most likely a uric acid stone from excessive beer consumption. Many of my favorite foods have oxalates. It's good to know that my plant-predominant diet checks this box too.
And the one stone I ever had occurred at age 44. I just figured I'd throw that out there since age for first stone was discussed. I was honestly surprised it tended to occur so young. I would have thought middle or later age would be more typical.
I have heard that people that had stones used lemon juice and olive oil to reduce the stones and pass them out in the urine
This is such a high quality interview. I have this one pegged to listen to several times in the coming weeks, and to take notes.
This is brilliant pathophysiology presented simply....and more advanced than anything in a textbook.
Thankyou so much Gil for adding consistent quality to the internet.
You are in my top 3 youtube channels now.
(I am a clinical physiotherapist and physiologist, and am attempting to get the physio profession to understand nutrition cannot be excluded from therapy for 100% of musculoskeletal, neurological, and autoimmune disease!)
Can I ask what your other top RUclips sites are?
Me too@@dilettanter
Every time a question popped into my head, you asked the good doctor. Great interview!
Nothing worked for my calcium oxalate kidney stones. I had 20 years of multiple trips to the emergency room and lithotripsy. I noticed that my urine formed visible stones when left at room temperature in a jar overnight. I began taking Garcinia Cambogia 600 mg twice a day about a year ago, and I no longer have any stones. My urine also no longer forms stones at room temperature.
John Froelich, MD
Glad to have found this channel!!!! Please keep making your science back videos, you ARE saving lives including mine!
Excellent and comprehensive presentation! Thank you.
Brilliant, and excedingly helpful for me. You answered so-o-o many questions I have had for awhile. Saved the link to my desktop and will be reviewing it often. Thank you so much!
That last bit from Dr Goldfarb was absolutely the most useful information to me--probably the only info I didn't already have: if you have a stone that is blocking passage of fluid through the ureter, do NOT drink a lot of water to try to force it through the ureter; that won't work. Because it is counter-intuitive, it is highly valuable information. As a kidney stone former myself, I thought (and was told by my former GP) the opposite: to drink more water to help pass it! I'm grateful to have that clarified. BTW, I recently passed two very large kidney stones that were evidently stuck near the bottom of the ureter and then later stuck at the top of the urethra (pain in the lower groin area and constant nagging urgency to pee). How did I finally pass them: drinking an 84-ounce jug of pureed lemon-water (1 whole lemon or lime blended with skin on mixed in 78 ounces of water) with two tablespoons of apple cider vinegar. The stones both passed within a couple of days after starting this regimen. If the stones were at the top of the ureter, I'm sure Dr Goldfarb's advice would have applied. At the bottom, where the pain is not as acute, the water-forcing regimen actually worked. YMMV. I'm not a doctor, so don't listen to me. :)
BTW, I still drink a jug of lemon water every day to prevent future stones. It's the best kidney stone advice I've ever found.
I think if the stone is only PARTIALLY blocking the ureter the extra drinking might help pass it out. But if it's totally blocking the ureter the extra water will back up into the kidney and cause more harm. At least this was my experience
What caused my young sharp kidney stone to pass, was I was having pain in my groin and they had me drink so much water to check my bladder and it was so full and painful, and I passed the kidney that night at the ER. I'm allergic to pain killers, so that was fun. I've had two children and the awful thing was there was no baby at the end, but felt quit similar. lol For men, I feel for you!!!
So good. Love Dr. Goldfarb!
I must say that this is one of the most, if not the most, informative, knowledgeable, myth-busting, eye-opening and useful videos I have ever seen - And I have seen a lot!
Thank you for creating this and sharing it with us!
Great conversation. Good questions and well explained answers. Very informative. Thankyou Gil and David.
Absolutely fantastic, informative video. Thank you, Dr. Goldfarb for sharing your knowledge so freely. And nice work, Gil.
I have to say the video of Dr. Goldfarb ranks up there with the best lectures on any scientific/medical subject I have ever watched from beginning to end without a pause. I wish all of my college professors would have had the command and clarity of their disciplines as Dr. Goldfarb. I am normally a very visual learner, but as you said Gil this was a masterclass presentation. Even without his “chalkboard” his presentation was flawless as he has the ability to elevate his audience to his level, or present the information to their level without talking down to them. Gil I really want to commend you for being a voice of reason on the internet. Your use of evidence based science and more importantly, to me, your exclusion of ad hominem argument is so refreshing that it almost feels like a new form of logic…..lol!!! Cheers to you, Donn Li Pera
@
Nutrition Made Simple You are definitely my top favorite medical informative individual my good man! You only show well rounded observable facts!
Excellent video! I learned so much and my Father was a stone former. Thank you and keep these coming!👏🏻❤️
Wow. Thank you sir. I needed to hear this. Truly, I appreciate your knowledge.
This is invaluable information that you gave us, one of the best channels about nutrition on youtube
Excellent information. Thank you!
Thanks so much for doing this one… fantastic conversation and immensely valuable ❤
Enjoyed every minutes… Really great interview!
Thank you!
Love this. I am one of those that don't have kidney stones, but my soft tissue is full of what appears to be calcium oxalate deposits. A decade ago I passed a sharp kidney stone. Docs told me not to worry about cutting out oxalates after urine tests. They said it was a fluke. Two years later, I had a gravel pit in both kidneys and several stones in my ureter. It was a long few years of a lot of lemonade; thankfully not one kidney stone was detected a few years later, but I do now have an allergy to lemons. Great! But I'm so happy it worked. Recently, I added more plant foods-keeping my oxalates about 65-80 never eating nuts or spinach again or any of the really high ox foods. Keeping track and lowering my calcium to just a few tablespoons of dairy a day. I did well for years until one day I got the bill and I ended up in the ER-they were sure it was a kidney stone-I had severe back pain! No kidney stones this time. Whew! Probably because I'm on a few hundred milligrams of Potassium Citrate daily, but who knows for sure. But they did find lots of calcium deposits in my back and right hip. ER doctor said they feel if they did an all body x-ray they believe they would've found more because I had explained that certain foods that had medium oxalate were causing my feet and teeth to hurt so horribly that I ended up in oral surgeon's office with what we thought was an abscessed tooth that caused severe nose bleeds, but ended up being more calcium oxalates in my sinus and gums. Anyhow I ended up on a walker for about 10 days after this ER visit. I went low oxalate slowly and slowly it got better. The daily nose bleeds from my painful teeth stopped as well. But now if I eat just 65-70 oxalates a day, within a few weeks all the nose bleeds, hip, feet, teeth and back pain come back. I'm so hungry! lol But I can't eat any plant proteins, so that surprised me that Dr. Goldfarb recommends plant protein. I eat 3 salads a day, bok chow, romaine, arugula and microgreens. I basically eat to have vegetables, but I have tried a few of the plant proteins and boy they just hurt! I will have to keep track of my urine PH now. But I only eat a few ounces of meat with two meals a day and I can't handle too much fat either, which I'm sure doesn't help the oxalates. But love this information. Just putting this out there in case anyone thinks it only affects the kidneys. I'm a poster child for the oxalic acid ripping apart the body. I miss oxalate foods so much. But it's taking me years to realize this is not worth it. I think plants are healthy and some of them are literally damaging my body.
Do you think maybe sibo or gut dysbiosis accompanied with leaky gut could be the issue. If you don't have the gut bacteria to process the oxalate and have excess oxalate penetrating the gut barrier where is shouldn't that could make sense. Just a random thought of but i could be completely off base.
Great stuff. Very good questions.
So informative! Thank you!
Great information, thank you!
My favorite health channel.
That was an excellent interview!! Thanks!
Fantastic content. Much appreciated. You've made a positive impact on my life, once again .
Terrifically informative. And has made me concerned about some aspects of my diet I never bothered about before!
Thanks, Doctors. Best info-vid out there for people with my basic knowledge level. This really explained a few things.
He’s the best dr ever.
Amazing. Thank you for this. Vastly educational. Thank you for being summarized, laymen termed expert academic knowledge to us ordinary folks.
This channel deserves more views...
Excellent interview. The best I've seen on the topic.
This was a fantastic and informative interview. Thanks for asking for all the alternatives. Great info through to the end.
Thanks so so helpful for my vital health.
This is useful because the doctor is a specialist with very high knowledge. I can do several things to improve my risk since my Dad had some issues with oxalate stones. I can drink a bit more water and reduce my sodium a bit.
One of your best and most comprehensive interviews with an expert. I love all your content and patiently wait every Monday for your next interview/content. TY my wife had stones about a year and a half ago at age 63 for the first time. We have tweeked her diet and this just adds to the new information that will help insure or mitigate a reoccurrence.❤️
This is refreshing to hear about citrate and dairy products neutralizing the oxalates in spinach and chard.
So many spinach demonizing videos on youtube.
Hey :) Looking forward to the video, seeing the notification reminded me:
Would you consider making a video about the most popular preservatives and health outcomes? I haven't been able to find a great deal about it, from what I've seen the message seems to be they're either harmless or "in moderation they should be okay.. we think.." and it's not quite satisfying. If that's just where the science is at right now I have to accept that of course, but I'm just not scientifically literate enough to dig through the papers myself (if existing).
Would love videos on exercise (dietary means of improving performance as well as "optimal" cardio / resistance training) and also dental health. Big fan of all the covered topics as well
"How do you know you have a kidney stone?" Oh you will know lol. But seriously, that was incredibly helpful. So much information I've never heard before.
Only 13 min in, blown away! Love this channel ❤
Very informative discussion. Wish my doctors knew all this.
Find doctors that do --- naturopath, holistic who THINK. There is more to this. Calcium carbonate is also an issue and people drink a lot of "almond milk" which is CC and that is limestone.
Great video…thanks
My husband and I went plant based 18 months ago to help reduce our cholesterol levels but one of the biggest benefits has been that my husband stopped producing his yearly kidney stone. We stopped eating red meat, chicken, fish, dairy, gluten. We eat lots of vegetables, low salt, low sugar, salads, fruits.
that is wonderful. I think that people should know that meats and chicken and fish are very dense in particular calorie dense
Can we have some videos on stress, relaxation, concentration,sleep, anxiety and similar stuff :)
Excellent interview and topic as always
Superb video.
great video thank you
Awesome; thanks.
Thank you - very timely for me as I am grateful for fairly quick passage of a calcium oxalate kidney stone last week. I need lots of reminders to keep drinking water all day long. The emergency room doctor also said to eat less meat. My husband likes meat, so I’m simply reducing the quantity on my own plate.
Thanks man!
Thanks for your video . Reviewing other youtubers is especially helpful so that we do not get misleaded.
Never ceases to amaze me that the more knowledgeable the individual is the more gray areas and questions can sometimes arise, in contrast to the Pseudoscientist utube channels out there with massive followings that seem to have a black and white answer for everything.
Also my son who is frequently in hospital getting IV antibiotic treatment almost always has massive digestion issues afterwards to the point he needs pain relief.
Thank you, this answered SO many questions in my effort to reduce my chances of forming another stone in the future
0:35: 🎓 Dr. David Goldfarb, a nephrologist and Internal Medicine specialist, discusses kidney stones and oxalates.
6:09: 🍎 Fructose from whole fruits may not increase the risk of kidney stones due to the presence of inhibitors like malate and citrate, which are metabolized to bicarbonate and lead to more alkali and citrate in the urine.
10:49: ✅ Eating more calcium is associated with fewer kidney stones, according to a randomized trial and observational data.
16:45: 🌊 The video discusses the possibility of increased prevalence of kidney stones due to asymptomatic cases being discovered through ultrasounds or CAT scans.
21:29: 🥦 Boiling vegetables with high oxalate levels and discarding the water can help reduce oxalate intake, while consuming dairy and staying hydrated can aid in excreting oxalate.
26:47: 🥦 The video discusses the importance of having a balanced diet with fruits and vegetables that are low in oxalate for kidney stone prevention.
32:28: 🥬 Higher levels of oxalate in the urine may be associated with an increased risk of vascular disease.
37:59: 🧪 Current studies have shown that available products on store shelves do not effectively reduce urinary oxalate levels.
43:07: 🥛 For those who are lactose intolerant, alternatives to dairy include fortified orange juice or calcium citrate pills.
48:17: 💡 Overweight and metabolic derangements lead to a lower urine pH, which can be treated by alkalinizing the urine with citrate supplements.
54:24: 🍵 A diet high in fruits and vegetables can increase urine pH and citrate levels, reducing the risk of kidney stones.
59:23: 🍊 Taking vitamin C as a pill may not be beneficial, but consuming vitamin C-containing fruits and vegetables is protective.
1:04:33: 💎 Kidney stones can be dissolved if they are uric acid or cysteine stones, but calcium stones cannot be dissolved.
Recap by Tammy AI
Great Video!!
Gil thank you for these high quality videos, it takes time and effort to line up these guests and shoot and put together the end product. I appreciate your efforts in putting them together. I drink ACV, apple cider vinegar, to get my citrates. Anyone else do so, if so what’s your experience?
I had to stop ACV due to mold toxicity (overgrowth of bacteria and spores), and arsenic poisoning from tap water. I do lemon water, but always did from childhood as we're mediterranean.
This was very informative on Oxalates and kidney stones. Do you have such a video on Gallstones with the related expert on Gallbladder? That’s what I’m looking for. Thank you
I don’t know what to say except thank you for this video, I learned a lot about diet, oxalate, animal products, the question about the egg was fantastic. I was told to avoid egg white, the issue is there more than the yoke. Simply thank you 🙏 Internet was dumbing us everyday, such clear evidence base conversion is refreshing. My wish is million people to flow you and re-educated.
Definitely one of the best nutrition channels on youtube, thanks for the content Gill
Wow amazing
Damn, recently I've been eating a lot and I mean a lot of Almonds, Pistachios, blueberries, Almonds milk, sardines, salmon and green leafy vegetables. Up to 3000 calories of food, mostly almonds. Might have to change a bit but my urine also looks almost white, that might good sign of hydratation
The only thing that is high is almonds hemp seed has zero oxalate amd pumpkin seed is low other nutsare lower pecans are low. Roumaine lettuce and watercress have zero oxalate
Great interview! Only doctors should interview other doctors. Thank you, please do more of these!
In regards to citrate supplements, when should I take potassium citrate or calcium citrate? Is there a difference?
This whole thing about eating dairy is confusing. Why does the calcium need to come from dairy when plant-based eschews animal products? Can't we get calcium from other sources? If it HAS to be dairy, does the possible lower risk of kidney stones outweigh the other risks associated with dairy consumption? I suppose if you deal with kidney stones that's probably your bigger concern, though.
Great interview. Very informative. Something you didn't mention as a source of oxalates is gluten free flour and breads. Many of these gluten free flours use nut flour like almond flour.
Thank you so much Dr Goldfarb and Gil; learnt a lot from this! Would calcium from supplements be as effective as calcium from food to reduce the risk of kidney stones? (I am just confused about this as too high doses of calcium supplements could lead to deposits in the vasculature; could this combine with the oxalate and kind of backfire?)
Yeah if you don't want to eat a calcium source with a high oxalate meals take a supplement. The calcium will bind with the oxalate and won't be absorbed, it will just become waste. Calcium and cholesterol go to damage in your arteries to fix it, you will scavenge the calcium if there is not enough in your diet, I do believe scavenging calcium will lead to more damage and more deposits.
It should be fine, you want the citrate type, either the daily dosage or less, and don’t forget to take the K2 MK7, since that prevents the calcium to build in your arteries
Just don't take calcium carbonate.. they're the bad ones..
Would be very interested in a video about the gallbladder/gallstones
Great interview. Would like to hear about gallstones too.
He mentioned a calcium fortified orange juice and not plant milks. Then he said that soy milk for example is ok because it’s not high in oxalates, but does this mean that he considers it a viable dairy replacement, as a calcium source? It would make sense, but it wasn’t really clear. Thanks!
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Nutrition Made Simple I do high oxalates and anti-inflammatory's for a reason. I also balance my oxalates with periodic fasting and K2 +Mk7 + organ meat!
Thank you so much what a great video very great knowledge he has this Doctor ``````````````WOW!!!!
Very interesting to hear. Once again the anti-nutrient rhetoric is debunked by an actual scientist :)
Great video. I am at risk for kidney stones at 68 even if i never got one, because cannot drink much water due to urinary symptoms caused by Urethral stricture and some nodules in normal volume prostate. In order to sleep I have to stop drinking at 17 time. In the urine there is a sedimetim like a white sand, probably oxalates. I started taking Potassium citrate a magnesiom a while ago and totally avoid spinach, almond, beets, red potatoes. My intake of oxalates come mainly from curcuma and dark chocolate, then cinnamon, ginger, for a total intake of 100 to 160 mg. per day. Do not eat meat and milk, but alternatively fatty fish and seasoned cheese with no more that one egg. What I fear is the kidney failure risk due to urinary retention and heart risk to to poor sleeping, but kidny stones can be a big problem because of uretthral stricture as a n emergency surgery intervention can be necessary.
I had my first experience with a small kidney stone at age 14. It was a terribly painful trip down the urethra, and I peed blood for about 3 days. I've heard it hit the toilet bowl when it came out. Over the next 5 years it happened 3 more times. I've learned my lesson, so since I was 20 I drink at least 4 liters of water or unsweetened tea every day, probably reaching around 5 liters of total fluid intake on average. I haven't had any other issue since I follow this regimen.
You could probably also drink unsweetened lemonade because of the citrate. God bless you that you can drink 4 L a day when I get up to 3 1/2 it is a lot
I would do the same but frequent pee ruins it.
I can barely drink 2L because of my peeing problem.
I was scheduled for my second lithotripsy procedure (having also gone having two stones removed surgically). It was a large stone that wasn't going anywhere. However, there was a long delay before doing the procedure. And during that time, I was put on Potassium Citrate to alkalinize my urine. And when I finally went back to the urologist, we did a CT scan, and the stone was gone! Amazing! (I have had a combination or uric acid and calcium oxalate stones, but this stone was likely to have a lot of uric acid.)
That is why we have the spinach dish called 'Palak(spinach) Paneer(fermented milk)'.
I guess the dish was invented and became popular for a reason.
One question. What's the difference between drinking calcium from dairy products, compared to getting calcium from let's say spinach, and then from fortified nondairy milks? Doesn't spinach have calcium too? Why would we need to add extra calcium to bind with the oxylates in the spinach?
it's just a matter of proportion. spinach contains calcium, but the amount of oxalate is such that a significant chunk will end up absorbed. if another source of calcium is ingested concurrently that amount goes down
@@NutritionMadeSimple I see! Thanks, that makes sense
@@Firebuck see the "calcium sources" section of the video, we specifically discuss dairy intolerance and alternative sources incl. plant milks, OJ etc
@@triptripp1873 numerous studies have shown there is no calcium that you can absorb from it as too much oxalic acid. So much so that it will steal some calcium from other foods as well. It is NET NEGATIVE for calcium. IMO it should be listed as a minus sign in front of the calcium. But it’s usually just a ‘lab test’ - calcium is in spinach. NOT a dietary source though, really.
very good video and very informative plz if possible do a video on acne or skin care as general
Traditional gastronomy always adds dairy to high oxalate greens. Exs. are seen in any “higher-end” restaurant that serves goat cheese w/ a Swiss chard salad. Look how a major frozen food brand packages it’s spinach.. in the form of “creamed spinach”. Also w/ unpeeled nightshades; classic Italian restaurants pair raw sliced tomatoes w/ fresh mozzarella.
Beets/borscht get dollops of creme fraishe, a bit of cream w/each spoonful. IMO the lipids in dairy help w/oxalate binding/clearing …
Dr Gil, Would you consider making a "Buy me a coffee" link? (Or almond milk, or smoothie, etc...) I am so grateful for your content, delivery, integrity and research, and for the many ways they have improved my life, that I'd like to do something for you, and I'm sure many other followers would too. After receiving so much, it's just natural to want to give back. What do you think?
pay it forward :) donate to a deserving charity on our behalf :) it'll be a better use. we're doing ok ;)
best thing you can do to support us is share the content with everyone you know who may benefit!
thanks Steph!
ate 2g of calcium daily from dairy & eggshells & oxalates in potatoes, oranges & carrots still gave me issues..
everything started after hernia surgery, dehydration & low urine output due to meds maybe?
Ca with spinach, cocoa etc: yes, but you don't need dairy with all its problems. e.g. soy milk / yoghurt with Ca can be used.
Excellent interview. Thank you, Dr. Carvalho! I have a question: Dr. Goldfarb very briefly touched the issue Crohn´s and kidney disease. A friend of mine has a history of Crohn´s and now she has terrible GFR < 15. So basically she should already have dialysis in my opinion. Is there anything she can do to raise her GFR? Maybe by taking alkali citrates? Or would you say, that with that terrible GFR it´s already too late for that. Or is it something, that wouldn´t hurt and might be helpful? Thank you! I highly appreciate your channel!
Difficult spot Hannes. People with inflammatory bowel disease can often be "dehydrated" as the result of diarrhea and then the kidney function can get better with fluids and sodium. But Crohn can (infrequently) affect the kidney with inflammation and that can respond to glucocorticoids (prednisone). But if this is the result of nephrocalcinosis, deposits of calcium ihn the body of the kidney, as the result of enteric hyperoxaluria (fat binds calcium, leaving oxalate more absorbable), it's a very tough spot. More citrate can inhibit worsening, but if the urine oxalate is really high it may not help at all. At that GFR you're right that this can be irreversible. I have started 3 patients of my own on dialysis as the result of this sort of short bowel syndrome with high urine oxalate....despite my best efforts. Good luck to your friend.
@@davidgoldfarb9307 Thank you so much Dr. Goldfarb. Yes she has short bowel syndrome as most of her small intestines were removed years ago and diarrhea is a big issue. In the past 10 years Crohn´s seems to have been kept under control by an immune suppressant medication called Humira (Adalimumab). 1 year ago her GFR was 30, and I wonder if this massive deterioration might have to do with the medication, of if it´s just that at some point - with a long history of Crohn´s - everything deteriorates very quickly.
What about avocado and other plant sources of calcium? Many cannot manage dairy.
Regarding the Vitamin C studies... Did they only study synthetic ascorbic acid? Or did they also study the natural form, L-ascorbate?
I take CaMgZn tablets. Does doing so help reduce the risks? Especially after meals high in oxalates?
I heard potassium citrate and calcium citrate for the prevention of kidney stones but I’ve also heard magnesium citrate and lemons or limes from other sources so I’ll take it as all can work
Would magnesium citrate, taken primarily as a magnesium source, be in the usual supplementation doses secondarily also a good source of citrate to counteract vegetable oxalates?