Kidney stones are incredibly painful and incredibly common. There are also numerous myths and half-truths floating around the internet regarding stones. With that in mind, I thought I would set the record straight on some of these:
- Dissolving stones: There are dozens of types of stones and only one of them, uric acid stones, can be dissolved by taking oral medications. Unfortunately, only 5-10% of all stones are uric acid stones. All other stones cannot be dissolved with oral medication so don’t fall for the latest greatest stone busting drug you read about on the internet; they rarely work!
- Medicines like tamsulosin help pass stones. This is a controversial statement as there are well designed randomized studies addressing this topic which have shown divergent results. Translation, I don’t know if the medicines work. I prescribe these to help pass stones (even though it’s not a FDA approved indication) as they have few side effects and if they help, great, but truth be told, the data is not perfect.
- Beer helps pass stones. I wish that were true. Staying well hydrated has been shown to both help reduce your risk of forming stones and helping patients pass stones but I can’t quote a study that shows that beer is a good thing. Having said that, there are lots of great breweries in Colorado to explore.
- Most stones are calcium based so decreasing your calcium intake will help prevent stones.Not exactly. While calcium oxalate stones are the most common type, if you decrease your calcium intake too much you are at risk of over-absorbing oxalate which can lead to more stones! How much calcium you need in your diet is a complicated discussion which is best had on an individualized patient to physician basis.
- Eliminating oxalate will decrease your risk of stone formation. Again, while it is true that calcium oxalate stones are the most common type of stones, most high oxalate foods are also high in magnesium, fiber or potassium which are all anti-stone formers so the truth depends greatly on your diet taken as a whole.
So what diet do I recommend? Unless a person is a recurrent stone former in which case I recommend a 24hr urinalysis so I can make specific patient specific dietary recommendations, the diet I recommend for first time stone formers is an American Heart Association heart healthy diet. Why? Most people die of heart disease and if I can reduce someone’s risk of heart disease, I’ve done them a favor.