Natural supplements for kidney
stone prevention
There's little research in this area, but when I come across more information I
will make sure to update this section. For now, I have come across preliminary
research that certain
supplements may be helpful. These include aloe vera, probiotics, and IP6.
Q. I have a kidney stone.
The urologist says it'll take several treatments and possibly months to break it
up and pass so it will be surgically removed. Would taking cranberry extract be
of benefit?
A. Cranberry extract would not reduce the size of the stone but it
is of benefit to the urinary tract system.
PLoS One. 2016. Mechanistic Insights into the Antilithiatic Proteins from Terminalia arjuna: A Proteomic Approach in Urolithiasis.
Diet and lifestyle options to prevent formation, how
to reduce the risk
Drink plenty of water every day.
Drinking large amounts of fluids -- 8 glasses a day or more -- is recommended.
A homemade lemonade concoction is effective at
raising stone-formers' urine citrate levels, use stevia to sweeten rather than
sugar. Sugary sodas and fruit punches are
not advised, they raise the risk rather than decrease it.
Just a little exercise each week -- jogging
for an hour or walking for about three hours -- can reduce the risk,
American Society of Nephrology, news release, 2013.
Increase your intake of foods with
phytic acid.
People who are prone to
kidney stones should limit their caffeine intake. When investigators gave people
with a history of kidney stones a dose of caffeine equivalent to that found in
two cups of coffee, they began to excrete more calcium in their urine, putting
them at increased risk of forming kidney stones.
Magnesium intake may decrease the risk for kidney stones.
Very large doses of vitamin C intake over several years increases the risk.
The role of calcium intake and kidney stone formation is difficult to
interpret. In older women and men increased dietary intake of calcium,
potassium, and total fluid reduces the risk of kidney stone formation, while
supplemental calcium, sodium, animal protein, and sucrose may increase the risk.
People with a history of kidney stones may have a higher risk of
recurrence if they use calcium supplements, 2015, American Society of
Nephrology meeting, San Diego.
Following a diet low in animal protein
and low salt helps reduce the recurrence of calcium oxalate stones. Most people with
calcium stones have a condition called hypercalciuria, in which excess calcium is excreted
in the urine. Thiazide diuretics such as trichlormethiazide reduce new stone formation in
such people.
A high
level of oxalate in the urine, which contributes to calcium stone formation, may result
from excess consumption of foods high in oxalate, such as rhubarb, spinach, cocoa and
chocolate, walnuts, and tea, or from certain intestinal disorders.
A diet widely recommended for lowering blood pressure reduces the risk of developing kidney stones. The diet, known as Dietary Approaches to Stop Hypertension (DASH), recommends eating plenty of fruits, vegetables and whole grains, and moderate amounts of low-fat dairy and lean meat and fish. In one study, adults with the most DASH-like diets had a 40 percent lower risk compared with those whose eating habits least emulated the DASH diet. Journal of the American Society of Nephrology, 2009.
The incidence of urolithiasis is higher in geographic areas with populations having low fruit and high sugar intake. Urolithiasis. 2013. The association between the incidence of urolithiasis and nutrition based on Japanese National Health and Nutrition Surveys.
Obese people are more likely to develop kidney stones than normal weight individuals, but severe obesity doesn't seem to further increase risk. The Journal of Urology, 2010.
Caffeine is found in coffee, tea, soft drinks, and energy drinks. Studies have found contradictory effects of caffeine on kidney stone risk. Although it has a diuretic effect on enhancing urinary output, it may slightly increase the stone risk index. However, most recent studies indicate a preventive role of caffeine in kidney stone disease.
IP5, phytic acid, and
kidney stones
I received an email from a health reporter that asked, "I'm doing an
article on kidney stones, and would love to include a quote from you.
Specifically, I'm looking at the role of IP-6 in preventing kidney stone
formation. How does it work? What's the recommended dosage? Any other
supplements that may be helpful in preventing kidney stone formations?"
IP-6, also known as phytate, is is a carbohydrate found in cereal
grains, beans, brown rice, corn, sesame seeds, wheat bran, and other high
fiber foods. Dietary phytate is helpful in inhibiting crystallization of
calcium salts in the urine and consequently may reduce the risk of kidney
stone development. Does ingesting an IP-6 supplement help reduce the risk
for kidney stones? As of 2017, I have not come across such human
research. I am not aware of extensive, long term human studies that have
specifically looked at the reduction of kidney stones with the use of
natural supplements. However, magnesium is one option that shows promise.
I did a search on Medline for IP6, phytate, and kidney stones, and
came across these articles.
Phytate acts as an inhibitor in formation of
renal calculi.
Front Biosci. 2007.
The aim of this study was to assess the inhibitory action of phytate in
formation of renal calculi. Hypertension (induced by nicotine) combined
with hypercalcemia (induced by D vitamin) was used to induce calcification
in renal tissue in male Wistar rats that were fed a purified phytate free
diet. Phytate non-treated rats developed significant calcium deposits in
kidneys and papillae, as well as in kidney tubules and vessels, whereas
calcium deposits were absent in control and phytate treated rats.
Fragments of hydroxyapatite (HAP) calculi exhibited the capacity to induce
the growth of calcium salts on their surfaces. Presence of 1.5 mg/L of
phytate in the synthetic urine inhibited the formation of calcium oxalate
monohydrate on HAP renal calculi in normocalciuric conditions. The
findings show that the action of phytate as a crystallization inhibitor
takes place both in the intrapapillary tissue and urine.
Urinary phytate in calcium oxalate stone formers
and healthy people--dietary effects on phytate excretion.
Scand J Urol Nephrology. 2000. Laboratory of Renal Lithiasis Research, University of Balearic Islands, Palma de Mallorca,
Spain.
The phytate urinary levels in a group of active calcium oxalate stone
formers were studied and compared with those found in healthy people.
Urinary phytate was significantly lower for stone formers. If deficit of
the capacity to inhibit crystallization of calcium salts is considered an
important factor related to calcium stone formation, the excretion of low
phytate amounts could be an important risk factor in the development of
this type of renal calculi. The influence of dietary phytate on urinary
excretion was also studied. Clearly maintenance of a phytate-free diet
significantly decreased the urinary excretion of phytate (about 50% after
36 h). This demonstrated the importance of dietary phytate in maintaining
adequate urinary levels to permit effective crystallization inhibition of
calcium salts and consequently preventing renal stone development.
Phytate (IP6) is a powerful agent for preventing
calcifications in biological fluids: usefulness in renal lithiasis
treatment.
Anticancer Res. 1999. Laboratory of
Investigation into Renal Lithiasis, Faculty of Sciences, University of
Illes Balears, Palma de Mallorca, Spain.
The extraordinary capacity of phytate (myo-inositol hexaphosphate), a
substance present in blood, urine, interstitial and intracellular fluids,
to inhibit crystallization of calcium salts (oxalate and phosphate) is
discussed. Its role in preventing calcium renal stone formation is
specifically presented and discussed. "In vitro" and "in vivo"
experiments, as well as clinical studies clearly demonstrated that phytate
plays an important role as a crystallization inhibitor of calcium salts in
biological fluids and becomes a clear alternative in the treatment of
calcium oxalate renal lithiasis.
However, I could not find any human research where an IP-6 supplement was given for any length of time to determine if it reduced the risk for kidney stones.
Aloe vera
Fresh Aloe vera gel (100 g) contains 96 mg of citrate and 158 mg of tartrate.
This is mid-range for Thai fruits. Changes in chemical compositions of urine
after aloe consumption shows its potential for preventing kidney stone formation
among adults. J Med Assoc Thai. 2006 Aug. Effect of aloe vera on
healthy adult volunteers: changes in urinary composition. Department of
Pediatrics, Faculty of Medicine, Khon Kaen University, Thailand.
Asparagus extract has been studied
Asparagus
extract may reduce the risk.
Hydroxycitrate
It's too early to know for certain if the compound hydroxycitrate is a
preventive treatment for kidney stones, since extensive research in people
hasn't begun. Still, it could offer an alternative to potassium citrate, which
treats kidney stones but has side effects, as reported online Aug. 8 2016 in the
journal Nature. .
Probiotics
Patients with inflammatory bowel disease have a 10- to 100-fold increased risk
of nephrolithiasis, with enteric hyperoxaluria being the major risk factor for
these and other patients with fat malabsorptive states. Endogenous components of
the intestinal microflora can potentially limit dietary oxalate absorption.
Manipulation of gastrointestinal (GI) flora can influence urinary oxalate
excretion to reduce urinary supersaturation levels. These changes could have a
salutary effect on stone formation rates. Further studies will be needed to
establish the optimal dosing regimen. Kidney Int. 2005. Use of a
probiotic to decrease
enteric hyperoxaluria. Lieske JC, Goldfarb DS, De Simone C. Division
of Nephrology and Hypertension, Mayo Clinic, Mayo Hyperoxaluria Center, and Mayo
Complementary and Integrative Medicine Program, Rochester, Minnesota , USA.
Cause of kidney
stones
Recent studies suggest that the incidence of kidney stones is increasing,
both in the U.S. and worldwide, and data compiled by researchers at the Mayo
Clinic in Rochester, Minnesota, suggest that diabetes may be a predisposing
factor, particularly for kidney stones composed of uric acid. Overweight individuals are more likely to have more acidic urine, as
measured by a lower urinary pH, along with an increased risk of uric acid kidney
stones. Low fluid intake is another cause of kidney stone. Excessive caffeine
intake may increase calcium excretion through the kidneys, increasing the
likelihood of a stone.
Men who work in the steel industry and are exposed to
high temperatures are prone to develop kidney or urinary stones,. low levels of
citrate in urine occurred more often in men in the hot-area group than those in
the room-temperature group. Men in the hot-area group were also twice as likely
to have low urine volumes. Both these conditions are involved in stone
formation.
Kidney stones are on the rise in children, due in part to a poor
diet, physical inactivity, and rising rates of childhood obesity.
High dose
turmeric spice ingestion may increase the risk for oxalate stone
formation.
Hippokratia. 2013. Pathomechanisms of nephrolithiasis. In order for a stone to be formed, a solid phase needs to be first produced from microcrystals (the nucleus), which are formed from salts (and other substances) that are found dissolved in the urine (nucleosis of crystals). Afterwards, the crystals that constitute the core increase in size and link up with each other (incorporation). The main physiochemical factors that participate in the creation of the nucleus are the hypersaturation of urine, the lack of inhibitors of nucleosis and probably the organic substrate. In order for the increase in size and the incorporation of crystals to take place, hypersaturation, the lack of inhibitors, the organic substrate and the epitaxis, during which crystals of a substance are attached to the surface of other crystals of a different chemical structure (e.g. crystals of oxalic calcium onto crystals of uric acid) are needed. Various molecules have been found in urine, which modify to an important degree the adherence of crystals to the surface of epithelial cells. It also seems very likely that certain reactions of renal epithelial cells that follow the uptake of calcium oxalate monohydrate (COM) crystals are due to oxalate ions, which are released during the process of deconstruction of the intracellular crystals. From here, the crystals migrate in the median tissue, where an inflammatory reaction takes place and finally the crystals are destroyed. Macrophages gather in the crystals of the median tissue. The osteopontin which is related to the crystals acts as a chemotactic factor for the macrophages and therefore is perhaps involved in this process too. The uptake of crystals appears to be subjected to regulating mechanisms, as molecules which regulate the endocytosis of COM crystals, a process that is related to changes in the special components of the cytoskeleton, have been observed.
Treatment of kidney stones
Small stones that aren't causing symptoms, obstruction, or an infection usually
don't need to be treated. Drinking plenty of fluids increases urine production and helps
wash out some stones; once a stone is passed, no other immediate treatment is needed. The
pain of renal colic may be relieved with narcotic analgesics.
Often, a stone in the renal pelvis or uppermost part of the ureter that's ½ inch or less in diameter can be broken up by ultrasound waves (extracorporeal shock wave lithotripsy). The pieces of stone are then passed in the urine. Sometimes, a stone is removed through a small incision in the skin (percutaneous nephrolithotomy), followed by ultrasound treatment. Small stones in the lower part of the ureter may be removed by an endoscope (a small, flexible tube) inserted into the urethra and through the bladder.
Uric acid stones are sometimes dissolved gradually by making the urine more alkaline (for example, with potassium citrate), but other types of stones can't be removed this way. Rarely, larger stones that are causing an obstruction may need to be removed surgically.
Drinking diet soda?
Certain diet sodas may have the potential to prevent the most common type of
kidney stone. Researchers found that the diet versions of several popular
citrus-flavored sodas -- like 7Up, Sunkist and Sprite -- contained relatively
high amounts of a compound called citrate, which, in turn, is known to inhibit
the formation of calcium oxalate stones, the most common form of kidney stone.
One reason that certain people are prone to being "stone-formers" is that their
urine contains relatively little citrate. Dr. Brian H. Eisner, a urologist at
Massachusetts General Hospital in Boston says potassium citrate
supplements have long been a common treatment for preventing calcium oxalate
stones, as well as another type of stone called uric acid stones, in people who
are prone to them. The goal of the current study by Dr. Brian H. Eisner
was to see whether any commercially available drinks had a similar citrate
content. The study found citrus-based diet sodas -- including 7Up, Sunkist
Orange, Sprite, Fresca and Canada Dry ginger ale -- had somewhat higher citrate
levels than homemade lemonade. Dark colas, on the other hand, had little to no
citrate. Whether citrus-flavored diet sodas can actually help prevent kidney
stones is still unknown. Journal of Urology, online April 19, 2010.
Types of kidney stones and
various forms of treatment
Kidney stones come in a variety of forms: Calcium oxalate monohydrate
papillary, calcium oxalate monohydrate unattached, calcium oxalate
dihydrate, calcium oxalate dihydrate/hydroxyapatite, hydroxyapatite,
struvite infectious, brushite, uric acid, calcium oxalate/uric acid and
cystine.
Measures to prevent the formation of new
kidney stones vary, depending on
the composition of the existing stones. These stones are analyzed, and urine levels of
substances that can form stones are measured.
Rarely, calcium stones result from another disorder, such as
hyperparathyroidism, sarcoidosis, vitamin D toxicity, renal tubular acidosis, or cancer.
In such cases, the underlying disorder is treated.
For kidney stones that contain uric acid, a diet low in meat, fish, and poultry is
recommended, because these foods increase the level of uric acid in the urine. Allopurinol
may be given to reduce the production of uric acid. Potassium citrate may be given to make
the urine alkaline, because uric acid stones form when urine acidity increases. Drinking
large amounts of fluids also helps.
For struvite stones--which indicate a urinary tract infection--antibiotics are
given.
Struvite stones are a
mixture of magnesium, ammonium, and phosphate. They are also called infection
stones because they form only in infected urine.
Kidney Stone Treatment
complications
Shock wave lithotripsy (SWL) of renal and proximal ureteral stones
appears to increase the risk of hypertension and diabetes on long-term
follow-up. SWL may promote hypertension by causing scarring in the kidneys and
altering the secretion of blood pressure-modulating hormones. The link with
diabetes may relate to damage inflicted upon the pancreas, they add.
Symptom of kidney stones
Pain, usually extreme, is the first symptom. The pain
may begin suddenly as a stone moves in the urinary tract, causing irritation or
blockage. Typically, the beginning of a kidney stone symptom starts when a person feels a sharp, cramping pain in the back and side
around the area of the kidney, or in the lower abdomen. The pain may spread to
the groin. Sometimes a kidney stone symptom could include nausea or even vomiting.
When the stone is too large to pass easily, the pain
continues as the muscles in the wall of the tiny ureter try to squeeze the stone
along into the bladder. As a stone grows or moves, blood may be found in the
urine. As the stone moves down the ureter closer to the bladder, a person may
feel the need to urinate more often or feel a burning sensation during
urination.
Signs of a kidney stone include: extreme pain in the
back or side that will not go away, blood in the urine, vomiting, and fever and
chills.
Most kidneys stones are very small and pass without causing a symptom.
Can a kidney stone symptom include constipation or
diarrhea? Highly unlikely, the gastrointestinal symptom of kidney stone that
occurs most commonly is nausea and sometimes vomiting.
Research studies
If animal studies apply to
humans, people taking the weight loss drug Xenical might have an increased
likelihood of developing kidney stones, especially if they have a high intake of
oxalate-containing foods. Researchers from the Federal University of Sao Paulo,
Brazil, and the Karolinska Institute, Sweden, tested the effect of Xenical
(known generically as orlistat) in 39 adult rats that were given a diet rich in
oxalate alone or combined with fat (soy oil). With Xenical, oxalate levels in
the urine were four to eight times higher than the baseline value, "elevating
the risk of stone formation," the team reports in the August 2004 issue of
Kidney International.
Individuals with either calcium oxalate or calcium phosphate kidney stones should not take extra calcium on their own as suggested by previous research, but should check with their doctors to determine the dietary guidelines that work best for them, researchers at UT Southwestern Medical Center at Dallas have found. Articles published by UT Southwestern researchers in the November issue of Kidney International and the December issue of the Journal of Urology showed that urinary calcium - the amount of calcium in a person's urine - is an important contributing factor in the formation of both types of kidney stones. Earlier studies had downplayed the significance of calcium when compared to the levels of oxalate in urine, and even encouraged kidney stone patients to increase their dietary intake of calcium.
Supplements and herbs
for urinary tract infections
Herbs used in urinary
tract infections or
bladder
infections include
cranberry, available as a supplement in capsule form, and
bearberry.
Bladder stones
Surgical treatment for patients with bladder stones include open cystolithotomy,
percutaneous cystolithotomy, or cystoscopic laser lithotripsy with stone
extraction (cystolithalopaxy) -- using an instrument called a cystoscope to go
into the bladder from the urethra. Ultrasound, laser, or an instrument crushes
the stones and flushes them out of the bladder.
Rev Col Bras Cir. 2013.Surgical management of bladder stones: literature review. Different rates of calculus-free patients are described in each of them, as follows: extracorporeal shock wave lithotripsy (75-100%), transurethral cistolithotripsy (63-100%), percutaneous cistolithotripsy (89-100%) and open surgery (100 %). The percutaneous approach has lower morbidity, with similar results to the transurethral treatment, while extracorporeal lithotripsy has the lowest rate of elimination of calculi and is reserved for patients at high surgical risk.
BMC Res Notes. 2013. Squamous cell carcinoma of the bladder
in a female associated with multiple bladder stones. The association between
foreign bodies in the bladder and sqaumous cell carcinoma is well established.
Long-standing bladder stones have been implicated as a cause of squamous cell
carcinoma of the bladder.
Q. I am a receiver of your Newsletter and have
been diagnosed with two kidney stones.A VEGA test done indicated that most likely these are calcium oxalate
stones. I searched around in the internet to find a product for dissolving these
stones and came accros the website of Uriflow. I talked
to them and they said that one needs to take the product for at least three
months. The product contains the following herbs: Boerhaavia Diffusa, Cretaeva
Nurvala, Tribulus Terretris, Lawsonia Inermis, Bergenia Ligulata, Ficus Racemosa,
Didymocarpus Pedicellate, Achyranthes Aspera, Raphanus Sativus, Hemidesmus
Indicus, Aspaltum (the latter is not a herb and is supposed to contain bioactive
Benzonate within its mineral and shall have shown lithontripic effect). Since I
do not know any of these herbs, I would like to have your opinion on it. It is
safe to take these herbal mixture for a prolonged time?
A. I am not familiar with this product.
Does the
sex pill known as yohimbe,
a natural
alternative to
Viagra and other impotence drugs, influence the formation?
Not that I am aware of.
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