
A large (7mm) kidney stone
While the low oxalate diet (or LOD as we often refer to it around here) is often the correct diet for someone who suffers from kidney stones, the only way to know for certain if it is the correct diet for a particular kidney stone sufferer is to have your stones analyzed. If your stones are made mostly (or entirely) from calcium oxalate, then this is definitely the kidney stone diet for you!
If your stones are comprised primarily of some other substance, such as uric acid, then you will likely need to pursue another type of kidney stone diet. If your stones are a mixture of calcium oxalate and another substance, then the LOD will help you avoid future kidney stones, but may not be the complete answer to your kidney stone problems.
The great news about this testing is that it’s simple, and often done as a matter of course when a person passes their first kidney stone (or has it surgically removed, in the case of stones too large to pass). So once you know the type of your kidney stone, it will be very easy to determine the correct kidney stone diet to help you avoid the suffering of future stones!
Incidentally, here is the breakdown of stone types by level of occurence:
| Percentage | Type of Stones |
| Roughly 80% | Calcium stones – calcium oxalate, calcium phosphate and other calcium-based compounds |
| 10%-15% | Struvite stones, also sometimes called “infection stones” |
| 5%-10% | Uric acid stones |
| <1% | Other rare types, such as cysteine stones and xanthine stones |
Types of Kidney Stone Diet
As seen above, roughly 80% of all kidney stones are comprised of calcium combined with another substance. Most commonly this substance is oxalate, which means that even if your stones weren’t tested, you have a very good probability of being able to benefit from the low oxalate diet. So even if you have no idea what “type” your stones were, it would be a great idea to grab a low oxalate food list, and give it a try. In fact, you may even want to try this diet even if your stones had no oxalate in them at all – I’ll come back to why in a moment. But fact remains that there is more than one type of kidney stone diet.
For example, if your stones are comprised primarily of uric acid, it is suggested that you cut down on the amount of meat you eat. This is because protein in the diet tends to have an acidifying effect on the urine. When the urine is sufficiently acidic, the opportunity arises for uric acid to precipitate out of the urine while it is still in the kidney, thus forming uric acid stones. That is not the only dietary modification recommended, but merely an illustration of one of the ways it differs from the kidney stone diet used for calcium oxalate stone formers.
Unfortunately for stone formers with struvite stones, there are no dietary recommendations which have had any proven effect on struvite stone formation. This is because struvite stones are formed when the kidney has been infected with a particular type of bacteria (called a urea-splitting bacteria). There are many bacteria which display this urea-splitting behavior, so probably the best diet for a struvite stone former would be one which keeps the body healthy and enables the immune system to fight off infection.
Folks who form the rarer types of stones are generally best served by addressing their underlying illness or genetic predisposition. For example, cystine stone formers who have intermediate cystinosis are generally treated with the drug cysteamine, as well as sodium citrate to help alkalinize the urine and blood. While some dietary modifications may also be suggested, they are generally not sufficient to address an underlying genetic disorder, so medical interventions are the primary method of dealing with such diseases, as well as their increased propensity for stone formation.
Why Try this Diet Even if My Stones Aren’t Calcium Oxalate?
The reason I recommend trying the diet no matter what type of kidney stones you have is this: I have seen over and over, people who have no known oxalate problem, but who begin the diet for some other reason, such as to help a child who is on the diet feel like they are not alone. Shortly after starting this diet, these people discover a latent oxalate issue they never knew they had! Their bodies enter detox mode, they begin “dumping” (which is our shorthand way of referring to “the oxalate detox process”), and eventually begin to see improvements in things like the general aches and pains that many of us simply attribute to aging. Others with better-defined conditions such as fibromyalgia see an improvement in their pain levels as well. While full remission is not always the result, you can bet these people are thankful they gave the diet a try!
This leads me to my next point, which is the fact that the low oxalate diet isn’t just a kidney stone diet. It is rapidly becoming a recognized treatment for many conditions, from autism to vulvodynia. Many folks find that once they’ve adapted to a low oxalate way of eating, a wide variety of nagging symptoms and complaints that they’ve had for years begin to disappear. Some believe this is due to the fact that some people are more sensitive to oxalates than others; I tend to be of the opinion that oxalate is always a toxin to the body, but since it is so common in the foods we eat, it is a “known entity”. That is to say, the body is familiar with this substance, and so has developed ways of dealing with it.
Regardless of the intricacies of how and why many bodies react to oxalates, one thing we know for certain is that the low oxalate diet gives the body an opportunity to rid itself of oxalates if there is an oxalate burden present. It therefore should come as no surprise that reducing such a dietary toxin results in any number of noticeable improvements. So while the low oxalate diet may or may not be the best kidney stone diet for your type of kidney stones, I hope you’ll give a thought to how it might benefit you to give your body a chance to detoxify itself.
Whether you’re interested in LOD because of kidney stones, or because of other issues you suspect might be helped by lowering the oxalate in your diet, please start your journey with my article on the basics of the low oxalate diet.
Can I ask a question about Calcium Citrate supplementation? If the calcium is good at mopping up the oxalate is there an increase risk of forming stones?
Rach
Rach,
The calcium citrate recommended for mopping up oxalate is taken with the hopes that it will bind with oxalates in the gut, BEFORE it is absorbed. I’m not positive, but I believe this operates on the believe that calcium oxalate, being a larger molecule than either calcium or oxalic acid alone, is less likely to be absorbed through the gut wall. So in theory, the bound calcium oxalate would not even enter the bloodstream, and therefore never pass through the kidneys. More testing of theories like this is definitely needed, so for now all we have is the anecdotal evidence that many folks report fewer oxalate-like symptoms when they take the calcium with/before their meals.
Hope this helps!
Michelle