The Role Of Functional Medicine In The Prevention Of Co-Morbidities Written by Deborah Freudenmann BHSc The last few decades have witnessed a sharp rise in
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Deborah Freudenmann BHSc
The kidneys are vital organs of the body that help in the removal of toxins, waste products, and excess fluids from our blood through urine. When you have too much waste or toxins or not enough fluid in the blood, this can lead to a build-up of waste in the system. The result? Kidney stones.
Understanding kidney stones and how they develop is key to preventing this painful condition from reoccurring.
In this article, you will discover the underlying mechanisms behind kidney stone formation, as well as some unique lifestyle and dietary suggestions to help you prevent kidney stones in the future.
Kidney stones, sometimes called renal calculi, are hard deposits made from salts and minerals formed inside the kidneys. They can affect any part of the urinary tract including the kidneys, ureters, bladder, and the urethra. Most kidney stones (about 80%) are of the calcium oxalate variety, but kidney stones can be made of other substances as well.
Kidney stones are formed when the urine is concentrated, which allows salts and minerals to crystallise or stick together. This tends to occur when there are high levels of waste products, or not enough fluids to properly process waste.
As we’ve discussed, kidney stones form when the urine contains a higher amount of crystal-forming substances such as calcium, uric acid, and oxalate than the fluids in the urine can dilute.
Higher urinary calcium levels, increased uric acid levels, hyperoxaluria, and increased sodium intake are considered the most common causes of kidney stones. This build-up tends to be the result of a diet that lacks nutrition, certain health issues, or metabolic abnormalities. Let’s review some of the main reasons kidney stones form.
Diets rich in protein, salts, and glucose can affect the body’s hydration levels and lead to higher concentrations of waste products. This can cause build up in the kidneys and lead to stones.
Taking very high doses of vitamin D, or those with metabolic dysfunctions such as insulin resistance can also see a higher risk for kidney stones. These conditions increase the concentrations of calcium and oxalate in urine thus increasing the risk of these stones.
High fructose consumption is linked with higher excretion rates of calcium, oxalates, and uric acid, all of which are associated with an increased risk of kidney stones. Research shows that those individuals with high fructose intakes (such as with soft drinks and processed sweets) are at greater risk of developing kidney stones.
Some soft drinks also include phosphoric acid, which significantly increases calcium excretion – and therefore kidney stone formation. Soft drinks and sweet teas are perhaps the biggest dietary causes of kidney stone formation because of these high levels of fructose and phosphoric acid.
Chronic dehydration is a leading cause of kidney stones. With reduced fluid intake, the kidneys are forced to make the urine more concentrated. This results in the build-up of waste products, a higher chance for crystallization, and an increased risk of developing kidney stones.
Candida overgrowth can also increase the risk of stones. Yeast species such as candida produce oxalates as part of their normal metabolism, so those with chronic yeast overgrowth challenges may suffer from oxalate overload.
The risk of kidney stones is also increased in those with inflammatory bowel diseases or inflammation in the urinary tract. In these instances, there is an increased calcium absorption in the intestine which leads to increased urinary calcium.
Hypocitraturia or a low level of citrates in the blood is another risk factor for the development of calcium kidney stones. Citrates prevent crystals from sticking together, thus creating an unfavourable environment for the formation of kidney stones. Citrates also reduce the saturation of calcium oxalate in urine thus preventing stones.
Those who have poor gallbladder health, who have removed their gallbladder, who’ve undergone gastric bypass, or who have poor bile production may struggle with kidney stones. Why? Because these conditions affect the bile flow. When there is insufficient bile flow, unabsorbed fats tend to bind with calcium in the gastrointestinal tract. As a result, there is excessive oxalic acid absorption in the gut which leads to stone formation. Normally, dietary calcium would bind readily with oxalate and prevent this excessive absorption.
The treatment of this condition depends on the type of stone, as this will help to determine the possible root cause and identify other risk factors. In addition to treatment, this also may provide clues on how to prevent these stones from reoccurring.
Abnormalities related to calcium metabolism can lead to a higher risk of developing calcium stones in the kidneys. These stones are usually in the form of calcium oxalate crystals.
Oxalate in these stones can be absorbed from the diet, as some fruits and vegetables also have a high oxalate content (see below).
In other cases, they are formed by the liver. Those who have poor gallbladder health, who have removed their gallbladder, who’ve undergone gastric bypass, or who have poor bile production may struggle with excessive oxalic acid absorption via the gut.
Hence, avoiding the intake of oxalate-rich foods is advised to reduce the risk of developing calcium oxalate stone.
A high uric acid level is the second common cause of kidney stones. This type of stone forms when urine is acidic or when the diet comprises of purines that can increase the acidic pH of urine. The common purine-rich foods include meats, fish, and shellfish.
Type 2 diabetics and those who struggle with elevated blood sugar levels have an increased level of oxidative stress. This usually results in the formation of more uric acid. High blood sugar, itself, impairs the function of kidneys through oxidative stress. Then, the urinary acids such as uric acid and oxalic acid compete for reabsorption in the kidneys.
Uric acid crystals are common in people who have gout or those undergoing chemotherapy.
These are other types of kidney stones but not as common.
Functional medicine offers helpful diagnostic tests to get to the root of kidney stones. Let’s explore some of the ways we can use functional medicine to start the healing process:
Organic Acid Test, commonly known as OAT, measures the levels of organic compounds in urine that are produced in the body as a part of many vital biochemical pathways. A defect in a particular pathway can result in either accumulation or lowered levels of its by-products. Thus, measuring the levels of these markers can help to identify which metabolic process is blocked or compromised.
Blood tests can often help to reveal the causes of kidney stones, such as too much uric acid or calcium in the blood.
Urine tests can reveal a high level of fructose, thereby indicating the presence of possible risk factors linked to dietary habits.
The 24-hour urine test would reveal the presence of higher levels of stone-forming minerals in the urine like oxalate and uric acid, and too-low levels of stone-preventing substances like citrates.
Abdominal X-rays are usually helpful for detecting larger renal stones. Imaging tests such as ultrasound examination and CT scan of the abdomen are performed to detect smaller stones.
To prevent kidney stones, our primary goal is to reduce all forms of inflammation from the diet and lifestyle! Here are a few tips on how to achieve this in your daily life.
Adequate hydration is critical to prevent mineral build-up in the kidneys. It is by far the most pivotal lifestyle choice for the prevention of stones. Drinking at least 2 litres of water or fluids every day can make the urine less concentrated and prevent renal stones. Limit all consumption of tea and coffee. In regular tea/coffee drinkers, this can contribute to over 80% of total oxalate intake.
A major antagonist to calcium-based stones is citrate, which is found in citrus fruits! For stone prevention in someone prone to them, it is recommended to juice ½ of a fresh lemon into a glass of water at least twice daily. The high citric acid content will help bind with the calcium for easier excretion and prevent it from precipitating out into crystals. For those with stones who do not want to drink lemon juice, mineral citrate supplementation may be necessary.
Vitamin C is helpful, but only in moderation and the right balance. It has been shown that high doses of vitamin C without high doses of B6 can actually increase the oxalate content – which is what you want to avoid. Therefore, ensure that vitamin C supplementation is kept on the lower ranges.
A low oxalate diet is important for anyone who has had calcium oxalate kidney stones or is susceptible to them. This means restricting foods rich in oxalates such as rhubarb, okra, spinach, Swiss chard, beets, tea, chocolate, sweet potatoes, black pepper, nuts, and soy products can reduce the risk of calcium oxalate crystals. Boiling or steaming foods high in oxalate will help reduce their oxalate content.
Increased intake of these foods can result in hyperoxaluria or increased oxalate concentration in the urine causing kidney stones.
A low fructose diet can also help to reduce the risk of kidney stones. Patients should minimize their intake of foods containing sugars or carbohydrates in the form of fructose to prevent kidney stones.
Avoiding alcohol and purine-rich foods such as organ meats, red meats, and legumes is important to avoid uric acid build-up. Avoiding high fructose corn syrup, agave nectar, honey and fruits due to the high fructose content is also important for these types of stones. However, unlike those with calcium stones, those who suffer from uric acid build-up do well on foods that are high in oxalates (spinach, kale, celery, beets, etc.) as they help to neutralise uric acid levels.
Reducing intake of sweeteners and refined carbohydrates isn’t just recommended – it’s necessary. Addressing insulin resistance is very important when preventing or reducing the occurrence of kidney stones. High blood sugar levels or imbalanced blood sugar levels cause inflammation in the kidneys, consequently increasing urinary calcium which essentially feeds the issue. High blood glucose can also increase blood levels of uric acid, which decreases the body’s ability to remove oxalate and therefore promoting stones further.
Reducing your processed salt intake helps to decrease fluid retention in the blood. This allows more fluids to pass through the kidneys and prevent dehydration. Swap out sodium and consume non-processed sea salt and pink salts. These are healthier for the body and help to support and optimise the passing of cellular fluids in and out of the cells.
PEMF therapy can promote and support the healing process of damaged or inflamed kidneys. Through the increased motion of ions and electrolytes, PEMF therapy can raise ATP levels and help kidney cells increase their energy and healing capabilities. In addition, PEMF therapy can open up the membrane channels of cells to help them absorb enough nutrients and remove metabolic waste easily and quickly.
Supplements can be incredibly helpful in managing kidney stones, but only when right for your unique situation. Please consult your local practitioner before you take any nutrients or herbs. If you do decide to proceed without a practitioner, do so at your own risk. We do not intend to treat, diagnose, or prescribe, this blog is merely educational and consulting with your practitioner is necessary.
Magnesium ensures that calcium is effectively utilised by the body. This mineral binds to oxalate in the digestive tract and inhibits the formation of calcium oxalate crystals in urine.
B vitamins are also important to help reduce free oxalate and uric acid production. Vitamin B6 (Pyridoxal-5-Phosphate) is key for glutathione synthesis, as well as oxalate metabolism and nerve health.
A high-quality supplement is recommended to take for magnesium as well as a methylated vitamin B complex to support the system. In terms of magnesium, I recommend magnesium citrate form which is great for oxalate stones.
Of course, consuming foods high in these nutrients is beneficial too. Magnesium can be found in almonds, cashews, cocoa, cod, eggs, figs, kelp, leafy greens, legumes, lima beans, parsnips, seeds, and more.
B vitamins are found in spinach, parsley, broccoli, beets, asparagus, offal meats, sweet potato, chicken, beef, fish, bananas, eggs, mustard greens, and more.
However, a lot of these foods are not recommended if you’re following a low oxalate diet. Stick to the choices that are high in B-vitamins and magnesium, but low in oxalates like bok choy, broccoli, cabbage, grass-fed butter, and flax seeds.
Studies have also shown that potassium citrate helps to reduce kidney stone formation. The combination of magnesium and potassium citrate may be more effective than either alone.
Vitamin K2 is critical to ensure that calcium is taken into the bone, rather than left in circulation to be excreted by the kidneys.
It is important to have a good balance of K2 and Vitamin D3. But, ensure that vitamin D3 levels and supplementation is not excessive, as high dosages of Vitamin D can actually draw more calcium into the body, and therefore increase the chance of kidney stones.
Although urinary tract infections do not always occur with kidney stones, in some cases the lack of urine drainage and inflammation from a stone obstruction can lead to an infection. D-mannose is a sugar that can be found in cranberries (among other things). D-mannose binds to the cells which line the urinary tract and prevent bacteria from adhering to the lining of the urinary tract.
Improving gut microbiome and bowel movements is key in supporting detoxification and general health. Probiotics offer a great way to support your gut health and microbiome.
The bacterial population of the gut may play an important role in oxalate breakdown and metabolism. Lactobacillus and Bifidobacteria strains may
Kidney stones are a troubling condition, and without the right support, they can recur again and again. Fight back with functional medicine and these healthy lifestyle tips to improve your kidney health and prevent future stones.
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