Kidney Stones and a Vegan Diet

Question:

I am 19 years old and I get chronic kidney stones. I have had over 30 or so (I lost count). I have been vegetarian for over a year and vegan for four or so months. I cannot eat high oxalate foods which is confusing because they are the healthy foods I am supposed to eat while being vegan! I drink three liters of water a day and barely eat any foods high in sodium. Once I became vegan I got more stones (having to pass them). It went from every two months to once a month to every two weeks. I really want to stay vegan because I know how much healthier it is but I cannot deal with all of this pain. Any information you can give me would be greatly appreciated. I have gone to a urologist but she hasn’t given me any helpful information and right now I am just so frustrated I want to give up. So please help!

Answer:

Assuming your stones are oxalate stones, I would say that doing two things could help:

1. As it sounds like you’re doing, avoid the high-oxalate vegetables ‒ spinach, swiss chard, and beet greens. Kale, broccoli, collard greens, mustard greens, turnip greens, and bok choy should all be safe. According to the Mayo Clinic, you should also limit or avoid rhubarb, beets, okra, sweet potatoes, nuts, tea, chocolate and soy products. Yikes – that’s no fun. But maybe if you cut them all out, you could then slowly add back in small amounts of nuts and soy products and see if they are safe for you.

2. Consider a calcium supplement with meals. Calcium can bind oxalates and cause them to be excreted in your feces, but you should ask your doctor about this before doing it. Here is some more info on this:

mayoclinic.com/health/kidney-stones/ds00282/dsection=prevention

Follow-up:

I am mainly concerned that with all these restrictions I will not be able to receive all the essential nutrients I will need. I eat mostly nuts and beans to receive protein and those are some things I can’t eat.

Answer:

Have you seen ohf.org/docs/Oxalate2008.pdf

It lists beans as being moderately high in oxalates. I would think that you could eat small amounts of beans without it being a problem.

Unfortunately, it looks like quinoa (a non-legume, non-nut source of vegan protein) is high in oxalates:

whfoods.com/genpage.php?dbid=142&tname=foodspice

42 Responses to “Kidney Stones and a Vegan Diet”

  1. Veeg Says:

    How about a vegan protein powder like hemp? Not sure about the oxalate levels though.

  2. Christina Beymer Says:

    You know, this article linked below outlines how the health argument fails veganism. But it really fails animals. Animals are the concern here.

    http://www.theveganrd.com/2010/11/how-the-health-argument-fails-veganism.html

    This 19 year old wrote, “I really want to stay vegan because I know how much healthier”. It’s plain to see that it’s not healthy for him. It’s good for me, for you, but not him.

    The vegan diet as the healthiest diet for all, no such diet exists. For this 19 year old, it’s not working for him. He needs to work with a nutritionist who has ONLY his client’s health concerns at heart. Even if that means eating meat, eggs, and dairy. This man should not suffer.

  3. LynnCS Says:

    It’s so important for you to get the latest, clear info on studies about protein in the diet. Read “The China Study.” It is the best start to getting clear on what the human body needs to use to encourage it’s own healthy activity. Most of our body’s healthy activity is self induced. We need energy and to be active. Stop eating the known bad actors to begin with. Watch Dr. Robert Morse’s videos and get into fruit and juices. Watch some of Liferegenerator’s videos. There are enough to keep you busy learning about juicing for a long time. Clean the body of excess proteins and calciums. You’ll be ok. Keep going, don’t give up. You can do it.

  4. cella Says:

    I’m vegan and I’ve had recurring kidney stones too. My doc put me on postassium citrate, which is supposed to make an “inhospitable environment” for kidney stones. Is this something his doc has discussed?

  5. Veeg Says:

    “He needs to work with a nutritionist who has ONLY his client’s health concerns at heart. ”

    He says that he really wants to remain vegan, so he needs to work with a nutritionist who respects that and at least attempts to design a low oxalate vegan diet for him. For many committed vegans, consuming meat, dairy and eggs could create great stress, and thus negatively affect health. There are a variety of low oxalate plant foods. I would think a competent nutritionist could create, and fine tine, a special vegan diet for this man to meet all his nutrtional needs.

  6. Jack Norris RD Says:

    Just fyi, the person is a woman, not a man.

  7. Christina Beymer Says:

    She only indicates that the reason she is vegan and wants to remain so because it’s the “healthiest’ diet. She says nothing of animals. “I really want to stay vegan because I know how much healthier it is but I cannot deal with all of this pain.” In her case she should eat what she needs to eat to not be in pain. Many vegans for animals would do ANYTHING to not consume animals, even if that means limiting their food choices severely, this person does not appear to be one of them.

  8. Christina Beymer Says:

    Ginny has someone on her blog comments doing it:

    Hi. My doctor did not give me a specific number; he provided me a list (which came from a company that has a dedicated RN who’s worked with oxalate diets for years) and advised me to avoid any food in the ‘high’ category. As the list was geared toward a general omnivore, I did hours of research of my own. There are some protein sources that are OK, especially lentils, garbanzos, and black-eyed peas, and I’ve been finding a variety of ways to cook them. I also do a non-GMO pea protein isolate. However, I’m always looking for additional options.

    Thanks for your help. http://www.theveganrd.com/2011/01/vegan-food-guide-protein-and-new-book.html

  9. Joel Kerr Says:

    Christina, keep in mind that this person had the kidney stone problem for years before becomming vegan. Also, I think you are mis-interpreting Ginny’s blog post. She is in no way discouraging a vegan diet. Also, it doesn’t say anywhere in there that an optimal diet includes eating meat. If there was NO other way for the woman here with kidney stones to be healthy without meat, then I would agree with you, but I would call that a last resort option. Many people who like to call themselves “doctors” easily fall back on this flawed argument that you somehow need meat to be heatlhy, and “prescribe” meat eating, when what they really need to be doing is prescribing a vegan diet for every other patient they see.

  10. Christina Beymer Says:

    Magnesium deficiency

    The only reason my mother is thriving after being diagnosed with brain cancer and not dying from it in November last year is because we did our own research and experimentation. Her primary care MD, who was sure she’d be dead for her January checkup, saw her last week. He is so amazed that he wants to work with the Filipino doctor my mother is using. For all of 50 bucks this Filipino MD designed a treatment that has made her amazingly better, and there was no chemo, puking, or suffering involved.

    I say this because I noticed with the cancer sufferers and others with painful or fear inducing diseases or health issues, which is relative to the person, that they have trouble (as is expected) seeing the other side of it.

    Low magnesium is common among kidney stone sufferers. Many people who have recurring kidney stones have benefited by taking Magnesium citrate powder and not even adjusting their respective diets. Mom takes Natural Calm. There’s types of Magnesium that are more or less bioavailable, this one is made from magnesium citrate.

    There’s a book that is recommended at the clinic where my mom gets IV glutathione: The Magnesium Factor. This book covers how it helps treat and cure many people from kidney stones among many other things.

    This is from a 1967 study:

    Harvard researchers found that taking 180 mg of magnesium along with 10 mg of vitamin B6 daily reduced stone formation by 92.3 percent per year! Another study showed about a 90 percent reduction with magnesium alone (500 mg daily).

    Link: http://www.ajcn.org/content/20/5/393

    POTASSIUM-MAGNESIUM CITRATE IS AN EFFECTIVE PROPHYLAXIS AGAINST RECURRENT CALCIUM OXALATE NEPHROLITHIASIS

    New calculi formed in 63.6% of subjects receiving placebo and in 12.9% of subjects receiving potassium-magnesium citrate. When compared with placebo, the relative risk of treatment failure for potassium-magnesium citrate was 0.16 (95% confidence interval 0.05 to 0.46). potassium-magnesium citrate had a statistically significant effect (relative risk 0.10, 95% confidence interval 0.03 to 0.36) even after adjustment for possible confounders, including age, pretreatment calculous event rate and urinary biochemical abnormalities.

    http://www.jurology.com/article/PIIS0022534701681552/abstract

  11. Christina Beymer Says:

    If vegans were to follow Jack’s advice on higher protein, his recommendations for vitamin D (or higher), and B12 of course, plus adding fat and cooking certain vegetables in that fat, then many issues from the vegan diet could be avoided. Unfortunately the authority on the vegan diet fallen to those who don’t even think B12 is important and fringe nut jobs who harm animals with their cult behavior. As far as being the healthiest diet for all, no such diet exists. From my own experience, it’s been dandy for me, but some people can’t hack it for whatever reason. I remember reading The China Study in 05 and re: B12, don’t bother taking a supplement is essentially the message. So I stopped taking it. Right around the same time I met Howard Lyman who said he also doesn’t take a supplement. I take one now! Fortunately I have a Red Star Nutritional Yeast addiction, so I didn’t have issues.

  12. Jack Norris RD Says:

    LynnCS,

    I just reread the pages on kidney stones in The China Study. It is basically arguing that animal protein is the cause of most kidney stones. In the case of the person in question, who went vegan and had their rate of stones increase, I do not think The China Study has much to offer.

  13. Donna Says:

    She was only vegan for four months. I’m not doctor, but were those stones already there and now she’s passing them?

    She didn’t say vegan was the “healthiest” diet, you are misquoting her! She said “healthier”. Not the same.

  14. Jack Norris RD Says:

    Donna,

    Good question. I just found this great resource from The Cleveland Clinic: Online Health Chat with Dr. Manoj Monga, Kidney Stones: Your Questions Answered.

    At the very end, Dr. Monga says, “The “life” of a kidney stone is highly variable. I have seen large stones (3-4 cm) form within three months. On the other hand, many stones form over the course of years, and may never pass.”

    Another thing Dr. Monga mentions is that high sodium intake can cause kidney stones.

  15. Reid Masselink Says:

    I am following a low oxalate, low fat, vegan diet for RA and microscopic colitis (low fat vegan immediately helped my MC but after two years my RA got much worse, after much experimenting I figured out I was reacting to oxalates). This is how I do it: 1. join the yahoo group “trying low oxalates” they have all sorts of resources including a very up to date spreadsheet with hundreds, maybe thousands of foods and food products listed they have tested (other lists on internet are not always reliable. 2. White rice, usually a health no-no but this is my low oxalate staple to get enough calories. 3. to the white rice I add small amounts of low oxalate legumes like black eyed peas, pigeon peas, red lentils (I don’t tolerate the latter but they are low oxalate). 4. I eat lots of low oxalate veggies like squash, and cabbage, bok choy, etc. 5. I eat a couple of pieces of low oxalate fruit per day too (usually at breakfast with rice). I hope all this helps.

  16. Carrie Harnish Says:

    Thanks for all of the posts! I’m interested in learning more about kidney stones and vegans if anyone is willing to talk!

  17. Michael Bellinger Says:

    I have some good news for you. There is another natural food ‘cure’ that will help to prevent new kidney stones. The solution is to drink a glass of orange juice daily. I found this story online and then went searching for the JASN (Clinical Journal of the American Society of Nephrology) to see if it was real or just wishful thinking.

    Most people know about drinking lemon juice in water to help reduce stone formation. The study was done with two groups, one group drank lemon juice, the other group drank orange juice. The results were that lemon juice didn’t work because the digestion process interfered with the citrate’s beneficial effects and was not at all effective. But the group that drank orange juice daily actually showed reduced formation of new stones. They say it’s due to the potassium in the orage juice.

    The links:

    The online story I found:
    Keep Kidney Stones Away With Orange Juice, Not Lemonade
    http://www.medicalnewstoday.com/releases/50980.php

    The actual CJASN journal report mentioned in the story (was not published the same month as mentioned in that story, it was later): http://cjasn.asnjournals.org/content/1/6/1269.full

    Also, Dr. Julian Whitaker mentions using magnesium and Vitamin B6 as his regimen for avoiding his tendency to form new kidney stones.

    His site link: http://www.drwhitaker.com/magnesium-for-kidney-stones

    Good luck, I need it too.

  18. Jeng Says:

    I have read somewhere, I vaguely remember, that drinking too much water washes
    out something that may lead to or exacerbate kidney stones (in some people). Also, Steve Jobs had painful kidney stones and he was vegan (and evidently fruitarianish for a number of years) – not only omnivores/meat eaters get kidney stones (as you pointed out the China Study indicates). Jobs’ kidney stone situation was what allowed doctors to discover his pancreatic cancer.

  19. Jack Norris RD Says:

    I had to remove “You could also eat seitan which is made from wheat which is very high in protein and low in oxalates,” from the post above. I may have been wrong on both accounts. Since various breads are low in oxalates, according the PDF linked to above, I must have assumed seitan would also be relatively low. That was not a good assumption. In looking today, I couldn’t verify the amount of oxalates in seitan, vital wheat gluten, or wheat gluten.

  20. Kelsey Says:

    My doctor has actually given me a sheet of low oxalate foods, but my biggest concern was my protein/iron intake. Unfortunately I am a huge sweet potato, green veggie and orange lover. Oranges are actually according to my sheet “moderately high” in oxalates. I had been on the paleo diet before my newest stones in April in an attempt to eat better and drinking large amounts of water. Neither did anything for me. Anyways, thank you for this article Jack. It has shed some insight on my situation a bit regarding my protein intake. I will just have to make sure I watch what I’m eating so I am getting enough of everything.

  21. brett y Says:

    Start drinking Tart Cherry Juice -Preferably freshly squeezed. That knocked out my kidney stones. After the juice worked I switched to Tart cherry pills. I take them once a day.
    In addition, I started getting my magnesium from water (gerolsteiner from Whole foods is high in magnesium)
    For the record, my kidney stones were high uric acid stones.

  22. Nell Says:

    I have just been told by a Cleveland Clinic Dr and a nutrition specialist to have dairy to bind to oxalates and cary them out. I am also to add lemon juice to my water, since I have low citric acid in my balder.
    I am having a very hard time drinking two liters of water a day and finding a good source of foods to eat. I am a vegetarian who has very high cholesterol. Finding something to eat is nearly impossible.

  23. Jack Norris RD Says:

    Neil,

    It’s the calcium from the dairy that binds the oxalates, so what about calcium fortified non-dairy milk or just a supplement?

    I have about a dozen emails in my inbox about oxalates and I hope to write something up to help people like you as my next big project.

  24. Amanda Says:

    Subbing. I’m vegan and cook for my family. My husband has been suffering for years with stones.

  25. Jack Norris RD Says:

    Amanda,

    I’m sorry to hear that. Are you asking for advice?

  26. Amanda Says:

    Jack. Thanks so much for inquiring. I went vegetarian in January and vegan in May. I want to ensure that I am not preparing high oxalate foods for my husband. I’m vegan, so my husband will generally eat what I prepare. He was vegetarian for many years and claimed he suffered much less while eating that way. I’m just wondering if there are any resources for low oxalate vegan recipes or meal planning. I don’t want my husband to be discouraged from the possibility of a vegan diet by issues like the fact that tofu is high in oxalate. I guess I’m just not so sure where to start. Thanks!

  27. Jack Norris RD Says:

    Amanda,

    Avoiding the high oxalate foods, taking a calcium citrate tablet with meals, and drinking plenty of fluids is probably the best way to prevent future calcium-oxalate kidney stones. Here is a list of high oxalate foods:

    http://foodandhealth.com/cpecourses/kidney.php#_Toc5424695

    For calcium-citrate, I don’t know what the ideal amount is to take, it hasn’t been studied that I have found. So I’d suggest a moderate intake of about 200 mg of calcium per meal (no more than 3 times a day).

  28. Amanda Says:

    Thanks for the info.
    What is the purpose of the calcium citrate with meals in preventing the formation of the stones?

  29. Jack Norris RD Says:

    Calcium binds oxalates in the digestive tract and you excrete them. Citrate prevents formation of calcium-oxalate stones in urine.

  30. Amanda Says:

    Would this be an issue given his blood work shows hypercalcemia?

  31. Jack Norris RD Says:

    Hi Amanda,

    I cannot advise you specifically regarding your husband. My recommendations are general recommendations for preventing calcium-oxalate stones (as I phrased them above). It sounds like your husband’s kidney stones are more complicated than your average oxalate-stone sufferer. He might have hyperparathyroidism. You would need to talk to his doctor about how concerned he needs to be about the oxalates in a vegan diet and please talk to a doctor before taking any of my recommendations. I’m sorry I can’t be of more help than this.

  32. Amanda Says:

    Gotcha! Thanks for the info.

  33. JohnnyD Says:

    At the age of 32, I decided to finally lose the gut I had from high school, live better, and put my money where my mouth is concerning my fondness for animals. I gradually adopted a vegan diet. I subbed out my sodas for tea and coffee, snacked on a handful of nuts instead of cheesy potato chips, substituting black bean burritos for my favorite steak burritos, found spinach to be my favorite salad green (despite hating the canned stuff) and rediscovered my childhood fondness for beets. And coupled with some light exercise, was starting to lose the weight. Then quite suddenly, I found myself writhing on the floor, sweating profusely, spending hours rubbing my sides for some semblance of relief, finally finding it in the ER when the morphine hit my bloodstream… An expensive scan later revealed I had, indeed, developed kidney stones. A couple weeks later, my newly found urologist asked me about my diet, and I defined the healthier changes I was making. I actually staggered when he said, “If you stay away from spinach, you and I can stay friends.” I was in shock when he handed me a list of high, moderate, and low oxalate foods, assuring me that I could still have bottled beer, of which I never drank, and white bread, which I now believed to be poison, and that meat, eggs, and cheese all had virtually no oxalate whatsoever, all of which I had sworn off a little over a month ago. It was too much. I couldn’t believe it. I felt condemned to die at the ripe old age of 50 due to obesity, cholesterol, blood pressure, and a colon stuffed with meat, if I was lucky to live that long… As I’m sure I don’t have to tell this group, veganism is more than just a diet, it’s also a philosophy, and once adopted, it’s very difficult to turn away from it. Finding my doctor’s list severely lacking, I went online to find more complete listings, and came up wanting. At least at this point in time, the research on oxalate content is varied, at best, but there is a bit of consensus on the extreme ends of the scale. It’s common advice to slowly remove oxalates from your diet, and then slowly reintroduce moderate-level oxalate foods later, but for anyone who has an episode with stones, the risk of going through another just isn’t worth it. For a while, I usually just skipped meals because I couldn’t find anything to eat that I felt was safe enough. I skipped a lot of meals… and eventually found myself back in the ER for severe potassium deficiency. I had to learn to eat on this diet. Eventually, after a lot of scouring for information, I’ve been able to piece together a fairly complete diet. It’s not perfect, but I’m still looking, and hoping for a lot more research to come. Here’s a bit of advice, and by all means, use your own discretion whether to use it or not.

    First and foremost, drink water. It’s the most obvious part of the diet that gets overlooked. For stone developers, 3 liters is recommended daily. I have a 20 oz filtered water bottle which gets me an approximate 3 liters after 5 refills. Now, be careful not to overdo it. I don’t have the exact number in front of me, but I believe 10 liters of water is considered lethal, but it’s a long way from 3… heck, it’s a long way just to 3…
    Coconut is your friend! Coconut meat, milk, and water will help you out a lot! So keep them stocked when you can. It may be called a nut, but it’s a drupe.
    Go melon in lieu of berries. Certain berries are high, the rest float between high, low, and moderate depending on the list you get. Melons are all dependably low.
    For hot drinks, apple cider and herbal teas. Oolong tea is great hot or iced.
    White Pepper, White Chocolate, White Rice.
    Legumes, Nuts, and Seeds are mostly out, but you can still have black-eyed peas, chestnuts, flaxseed, and peas. (Working on a low-oxalate black-eyed chili.)
    Greens, you have to be weary of, but lettuce and cabbage are okay.

    There’s a lot of fruit and veggies which are still low oxalate. I’m sure they’ve been mentioned, but the two lists I go to most often are from lowoxalate.info and ohf.org I recommend you compare them and plan your grocery list by them. If you want to keep a list on you for those times you have to dine away from home, I recommend you compile an abbreviated list of fruits and veg, omitting meats and miscellaneous, and focus on the highs and lows. If you let some moderates in from time to time, you should still be fine. As I said, the lists can barely agree on most of them anyway, so try not to go crazy over it. And even as a vegan, you might learn to forgive yourself for the occasional non-vegan source of calcium and protein. Believe me, you’re no healthier for depriving yourself for your philosophy.
    Hope this helped. Sorry it’s so long.

  34. Yesenia Says:

    Thank you JohnnyD for those links. I am currently dealing with a7mm kidney stone with a ureteral stent scheduled for the shock lithotripsy next Monday. I have been began for about two years and am wondering if my diet has caused this issue. I have never had any issues with my kidneys my whole life. Since I don’t know the composition I can’t say for sure if it’s all diet related. However, our does highly concern me. Glad I found this site.

  35. Jack Norris RD Says:

    Yesenia and everyone,

    Stay tuned for a big article on oxalates that I will be publishing soon. I will make a blog post when I do. It’s been taking a long time and I apologize for that. I keep finding more and more papers that I need to read, but I’m hoping that the end is near and I’ll have it in the next week or so.

  36. Beverly Says:

    Should Vitamin D3 be excluded when taking Calcium Citrate for the purpose of binding oxalates in the intestines. Also should calcium to provide the nutrient calcium for bones, teeth, nerves, muscles, etc. be taken at non-meal times for the purpose of absorption?

  37. Jack Norris RD Says:

    Beverly,

    > Should Vitamin D3 be excluded when taking Calcium Citrate for the purpose of binding oxalates in the intestines.

    Taking vitamin D with calcium doesn’t do anything to increase calcium absorption (at that meal). Rather, your body has to absorb the D3 and then convert it to another form in the liver. Then, when your body senses the bones need more calcium, it converts the vitamin D yet again which leads to more calcium being absorbed from the intestines. So, the answer is “no.”

    > Also should calcium to provide the nutrient calcium for bones, teeth, nerves, muscles, etc. be taken at non-meal times for the purpose of absorption?

    That’s a good question. I think it’s better to take calcium with meals even for bones, though I cannot say that this is known beyond a shadow of a doubt. Even the calcium from spinach is absorbed at 5%, so a high oxalate meal cannot completely prevent calcium absorption.

  38. Beverly Says:

    Thank you very much! I have been trying to determine this. I am eating low oxalate and started taking calcium to bind oxalates and wondered if taking extra calcium would be required if I am binding calcium. I am sure there’s no way to know how much calcium is bound to oxalates as it would vary in individuals. What is the maximum calcium citrate I can take without harm. I am also vegan and the oxalates have removed so many of the highest value foods for a vegan diet. I also have high cholesterol with high LDL. I have a long history of kidney stones which began long before I quit eating meats and dairy and eggs. Vegan is very complex and requires intense meal planning. I recommend “Trying Low Oxalates” group. Their research includes up to date testing on foods. Foods tested earlier used a different method than is being used now. The other helpful resource for nutritional value of food is the website “World’s Healthiest Foods”! It has remarkable info on the micronutrients, macronutrients and phytonutrients, including all food groups, meats, dairy, legumes, seeds, nuts, etc. Since those of us are so limited in low oxalate foods that provide protein, this has proven to be a valuable resource and is is research based.

  39. Jack Norris RD Says:

    Beverly,

    > What is the maximum calcium citrate I can take without harm.

    Based on the research on calcium and heart disease, I’d keep calcium intake below 1400 mg/day.

  40. Beverly Says:

    Thank you. I really appreciate your help

  41. Bee Says:

    Johnnyd thanks for the info. Would u mind posting what a sample of ur daily diet looks like (a typical bf, lunch dinner, snacks) so that we can see how a vegan low ox diet can be concocted?

  42. Schoolmarm Says:

    This forum is very much appreciated. My last calcium oxalate kidney stone involved unsuccessful lithotripsy, a stint, and subsequent successful laser cystoscopy. I do not think I could endure a repeat of this ordeal and have tried to study everything I can find on very-low-isolate foods and meals. I will welcome the publication of the results of your research, Jack. My main difficulty is that I need to lose weight and eat very-low-isolate. Bacon, cheese, and steak may be low isolate, but like Bee, I need a meal plan rather than a list of high/low/very low isolate foods to track calories as well. I am looking for a low-isolate (hopefully very-low isolate) protein meal replacement shake to support weight loss. Ensure is supposedly low-isolate, but can be high in calories. A nutritionist representing Almased stated in an reply e-mail that it is a “low-isolate food.” I would appreciate knowing if anyone is aware of (1) a low-isolate “good tasting” protein shake as well as (2) a low calorie low-isolate meal plan.

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