s What Really Causes Kidney Stones (And Why Vitamin C Does Not) | I2P: Information to Pharmacists - Archive
Publication Date 01/02/2013         Volume. 5 No. 1   
Information to Pharmacists

Editorial

From the desk of the editor

Well 2013 has certainly begun and I must admit it has been hard to get out of “holiday mode” and back into “pharmacy mode”.
This year is looking quite challenging as many issues left in abeyance in 2012 are bubbling over , so I don’t anticipate a restful year.
One important issue we will cover for some time yet is the quality of drug  evidence in the Australian setting, and to kick off the debate the feature article  “Sense About Science”describes what is happening in the UK to help tidy up science in that country.
Comparisons have been made with the Australian experience and it seems that we have a long way to go before it can be regarded as “tidy”,

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News Flash

Newsflash Updates for February 2013

Newsflash Updates

Regular weekly updates that supplement the regular monthly homepage edition of i2P. 
Access and click on the title links that are illustrated.

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Feature Contribution

Sense About Science – or Up To Your Ankles in Waste Water

Neil Johnston

My recent holiday reading included catching up on subjects that have slipped off my radar, mainly because the issues themselves have adopted a lower profile.
Then an article in the 6Minutes e-publication caught my eye.
It concerned a UK initiative by a group called Sense About Science”, that has started a campaign to have all clinical trials registered and have the results published, while simultaneously urging the patients to boycott trials if the researchers cannot guarantee the findings will be made public.
They have published a petition (found at www.alltrials.net) and are encouraging people to sign it.
The petition has the support and backing of the BMJ, the James Lind Alliance and Ben Goldacre (author of Bad Pharma) and is designed to put pressure on researchers, pharmaceutical companies and institutions who are in a position to bury research data that may reflect on reputations and drug company profits.

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Face of Priceline - Australian of the Year 2013

Peter Sayers

Few would not recognise Ita Buttrose, an iconic Australian well-deserved of the Australian of the Year Award for 2013. The award was presented in Canberra on Australia Day (January 26 2013), by PM Julia Gillard.
And there must be a lot of backslapping going on in the Priceline camp for their recent signing of her to front for their 200 member pharmacy franchise.
Ita’s profile was already stellar, but with the added impetus of the Australian of the Year Award, the Priceline brand will now increase in value considerably.

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Determining needs and wants…

Joseph Conway

In pharmacy media commentary, I often come across the idea that we need to give people advice on what they need as opposed to what they want. This is understandable given that we have specialist knowledge on medication therapy and live our lives discussing health issues with patients and dispensing their medication. We get to know very intimate details about people and many pharmacists working in community pharmacy get to follow people as they grow older and are a tiny (but important) part of their lives sharing their health issues over ongoing chats at the dispensary counter if they choose to shop at our store.

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Is the ‘weekend’ an anachronism whose usefulness and relevance has passed?

Neil Retallick

When I taught Sunday School, which seems to be about a hundred years ago but was only about forty, we learned from the Bible that on the seventh day, God rested.
After all, he had been busy for six days.
I do not wish to belittle anybody’s religious beliefs in these comments but use them to focus attention on just how much our society has changed.
At the same time I was teaching Sunday School, the shops all closed at mid-day on Saturday and at 5.30pm during the week.
A trip into town to shop on the weekend meant getting up bright and early on Saturday morning and being at the bus stop by 8.30am at the latest.

Comments: 1

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Fitting Your Pharmacy for the Future - Funding & Depreciating for Best Tax Effect

Chris Foster

Editor's Note:
I2P will be developing a series on pharmacy designs - ideas and concepts in respect of clinical services spaces.
In designing such spaces it was realised very early in the exercise, that to be properly integrated in an Australian pharmacy setting it could not be just an “add-on” but a whole of pharmacy redesign.
Similarly with the introduction of automated dispensing machines (original packs and dose administration aids) it is important to design workflows properly to capture efficiencies, and this also entails a “whole of pharmacy” redesign.
2013 may be the year of decision in terms of the type of pharmacy design to house your market offering. To survive you need to be different and there is not a lot to differentiate one pharmacy from the other, even if you belong to a marketing group.

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Ransomware - The New Kid on the Block

Steve Jenkin

Editor's Note:
Late in 2012, a medical practice on the Gold Coast of Queensland came under cyber attack in a unique way.
Instead of patient data being stolen, it was kidnapped in place, by encrypting all practice data so that it could not be read.
A key was then offered at a price so that the data could be opened.
Thus was born "Ransomware", and a a new threat had emerged.
i2P asked Steve Jenkin, our resident IT expert to give some insights to this new threat and what precautions we might all need, to eliminate this new approach to hacking.
If you need an incentive, just imagine if your PBS claim data was locked up for a week and your ability to generate a claim was locked up for six weeks, plus all attendant costs in restoring your data.
Would you survive in your business?
This reference article by Steve is important enough to use as a checklist for your IT provider or for your IT consultant to utilise in the next complete review of your entire system.
Steve's comments follow:

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Workplace Pressure in Pharmacy

Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA

The psychological definition of stress is a feeling of strain and pressure.  Small amounts of stress may be desired, beneficial, and even healthy.  Positive stress helps improve performance.  It also plays a factor in motivation, adaptation, and reaction to the environment.  Excessive amounts of stress may lead to many problems in the body that could be harmful.  Symptoms may include a sense of being overwhelmed, feelings of anxiety, overall irritability, insecurity, nervousness, social withdrawal, loss of appetite, depression, panic attacks, exhaustion, high or low blood pressure, skin eruptions or rashes, insomnia, lack of sexual desire (sexual dysfunction), migraine and gastrointestinal difficulties (constipation or diarrhoea).  It may also cause more serious conditions such as heart problems.

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Arm Yourself For The Battle For The Mind

Barry Urquhart

Social media, and the internet in general, are largely “blind” media.
They can be frustrating, time-wasting and inefficient.
Entries and enquires about wide-ranging but pertinent topics, products and services elicit countless responses, most of which are irrelevant and unappealing. Information overload abounds.Use of SEO's (Search Engine Optimisers) simply cluster companies, brand and service names, among large, often spuriously ranked groupings.Being on the shopping list has very little quantifiable and lasting value. Nor does the standing of being “first amongst equals”.
Establishing and sustaining unique, differentiated presences in the marketplace is difficult.
In the brave and new world of digital, mobile, on-line, multi or omni-channel reality, the importance, nature and value of effective branding is deepened and broadened.

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Positive thinking has no negatives

Harvey Mackay

One of life's great annoyances is the tendency of folks who ask you to perform an impossible task, list the issues they foresee and the problems that have plagued previous attempts -- and then admonish you to "think positive."
Wow! Does that mean you are so good that you can achieve what no one else has? Or are you being set up to fail?   
Because I am an eternal optimist, I prefer to believe the first premise. Positive thinking is more than just a tagline. It changes the way we behave. And I firmly believe that when I am positive, it not only makes me better, but it also makes those around me better. I think that good attitudes are contagious. I want to start an epidemic!

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Feasting on Fat

Loretta Marron OAM BSc

With the Christmas and New Year opportunities to over-indulge, it was easy for girths to increase a little.
If so, it might be very difficult to lose those extra kilos.
Many advertised products and services allegedly help us lose fat without diet and exercise.
Most will fail; some might even be dangerous.

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Hanukkah, Oxygen Masks and Christmas

Mark Neuenschwander

I've been thinking about Hanukkah, oxygen masks, and the Christmas presents I am duty bound to muster for my kids and grandkids. Thank God dad asked for pajamas.
Today I’m flying from Las Vegas to Seattle. About the only thing I liked about Sin City was the fountain show at Bellagio, the Elvis Christmas songs that popped up here and there, and a pretty good keynote address by Bill Clinton. Just thinking of shopping makes me wonder if the cabin isn’t losing its pressure.

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Antioxidants Prevent Cancer and Some May Even Cure It

Staff Writer

Orthomolecular Medicine News Service, January 24, 2013

Antioxidants Prevent Cancer and Some May Even Cure It

Commentary by Steve Hickey, PhD

(OMNS Jan 24, 2013) It is widely accepted that antioxidants in the diet and supplements are one of the most effective ways of preventing cancer. Nevertheless, Dr. James Watson has recently suggested that antioxidants cause cancer and interfere with its treatment. James Watson is among the most renowned of living scientists. His work, together with that of others (Rosalind Franklin, Raymond Gosling, Frances Crick, and Maurice Wilkins) led to the discovery of the DNA double helix in 1953. Although his recent statement on antioxidants is misleading, the mainstream media has picked it up, which may cause some confusion.

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HMR Moratorium – Killing Jobs in Pharmacy

Joseph Conway

It’s no secret that the Pharmacy Guild has called for a moratorium on HMRs until the alleged abuse of a tiny minority of Independent Pharmacists potentially rorting the system is investigated and the system is changed to reduce the possibility of such rorting.
They say that this is necessary as the budget for HMR’s has been overrun and any potential rorting could put the viability of future pharmacy-centric programs at risk too.
The Guild want payments stopped so that the business rules behind HMR’s are “tightened” to stop this apparent rorting.
If there is actually rorting going on, then I think that it’s in all pharmacists’ interest to “fix” this issue.
I for one have nothing against tightening the rules to stop pharmacists “Warehousing” HMRs?
This is great.

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Part one -HMR Evolution

Neil Johnston

With the furore created when the PGA went to print stating that the funds available for HMR’s were almost exhausted, it created an instant “blame game” and conjecture as to what really lay behind the belated PGA announcement.
I came to a conclusion early that it was a result of PGA mismanagement as the immediate problem, but also coupled with an underlying systemic flaw that was the major problem.
Between them they impact and threaten the long term development and survival of the consultant pharmacist program.
It has prompted me to create an analysis of some aspects of the program to evaluate what has gone wrong.

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Part two - Fixing the HMR Flaws

Neil Johnston

The PGA has succeeded in upsetting a broad spectrum of pharmacists that includes all accredited pharmacists, some employer pharmacists (with designs on creating a business model with professional services at the core), and employee pharmacists who see job opportunities being squandered.
It is obvious that the “engine room” for consultant pharmacists (The Australian Association of Consultant Pharmacy) needs urgent reform and a new focus, or be replaced completely.
And the PGA should stop its interference.

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Part three - a Better Umbrealla Organisation

Neil Johnston

Because a workable umbrella model for management consultants already exists, it is suggested that this model be adapted for consultant pharmacist use.
The existing umbrella model established for consultant pharmacists would need to be altered dramatically and be opened up to other organisations e.g Consumer Health Forum, APESMA)
Or an entirely new organisation could be developed from scratch.
This is, in fact happening and is unrelated to any of my activities.
However, I am suggesting that the umbrella model of organisation provided by the Institute of Management Consultants (Australia) provides an excellent reference to adapt to a consultant pharmacist version.

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Thought Bubbles From a Book Group Refugee

Gerald Quigley

Editor's Note:
One night recently, I received the following email from Gerald:
"My wife has a book-group here. I’m locked in my study and inspired to write!"
That's good news for an editor/publisher - getting copy in on time well in advance!
Then followed (the same night), three separate and disparate thoughts that were not directly concerned with a pharmaceutical issue.
But they all had application for pharmacy improvement, with a bit of applied creativity.
As these "thought bubbles" wafted in over the Internet I began to wonder how I might splice them together with some editorial ingenuity.
The following is the result.

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What Really Causes Kidney Stones (And Why Vitamin C Does Not)

Staff Writer

Orthomolecular Medicine News Service, February 11, 2013

What Really Causes Kidney Stones
(And Why Vitamin C Does Not)

(OMNS Feb 11, 2013) A recent widely-publicized study claimed that vitamin C supplements increased the risk of developing kidney stones by nearly a factor of two.[1] The study stated that the stones were most likely formed from calcium oxalate, which can be formed in the presence of vitamin C (ascorbate), but it did not analyze the kidney stones of participants. Instead, it relied on a different study of kidney stones where ascorbate was not tested. This type of poorly organized study does not help the medical profession or the public, but instead causes confusion.

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For health's sake, time to take on food giants

Staff Writer


Food Industry marketing practices are increasingly being brought under the spotlight as are various other worrying problems regarding additives to manufactured food products, also how food is grown using genetically modified seed and the range of toxic herbicides and pesticides.
These latter substances now pollute the entire food chain and not enough is being done to protect our food chain.
Many illnesses can be traced back to ingestion of unnatural substances over a long period of time.
It's time to grow your own.

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Consultant Pharmacists Should Lead The Way - But They Have No Leaders.

Mark Coleman

Isn’t it time that consultant pharmacists took control of their own direction and carved out a future?
Or is the current system of a single-product (HMR) service controlled by the PGA and the PSA, sufficient to provide an interesting and creative future?
How can the aspirations of consultant pharmacists be serviced by an organisation controlled by two major pharmacy-political bodies, when one of them (PGA) is directly working against consultant pharmacist interests.

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APESMA Campaigns for Pharmacist Lunch Hour Entitlements

Staff Writer

Australian pharmacists have been warned to carefully check exactly how much compensation they are getting for routinely working through lunch after an APESMA survey found 28 per cent of Australian pharmacists reported that they receive no financial compensation at all for the lack of a lunch break.
CEO of APESMA Chris Walton said working through every lunchtime was an unacceptable practice that could cause dangerous levels of fatigue.
APESMA has advised pharmacists who have signed any agreement to remove their lunch breaks to immediately ask their employer to itemise any compensation they are being paid in lieu of all award entitlements such as their lunch breaks.

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CHC Emphasises the Importance of Research

Staff Researcher

In light of a recent paper published in the Royal Society's Open Biology journal, proposing a theory that antioxidants can be detrimental in the late stages of cancer treatment, the Complementary Healthcare Council (CHC) of Australia emphasises the importance of clinical trials and studies into the prevention and treatment of cancer. Executive director of the CHC, Dr Wendy Morrow, highlighted this theory as being interesting and warranting more research.

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Advancing our understanding and treatment of motor impairment

Staff Researcher

NeuRA has secured significant funding to expand research into motor impairment, a problem that arises from many diseases and aging, and a growing public health challenge.
Everything the human body does requires movement, but our muscles—and our brain and nerves that control them—are often the first tissues attacked by a long list of disorders that includes stroke, spinal cord and brain injury, multiple sclerosis, Parkinson’s disease, musculoskeletal injury and cerebral palsy.Prof Simon Gandevia is an expert in the brain’s control of human movement at NeuRA (Neuroscience Research Australia) and will spearhead the nearly $7 million multidisciplinary program of study, funded by the National Health and Medical Research Council of Australia.

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PSA WELCOMES GOVERNMENT’S HMR ANNOUNCEMENT

Peter Waterman

Media releases issued from the office of Tania Pliberseck and the PSA arrived this morning.
What follows is the PSA take on recent events surrounding HMR managent.

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Pharmedia - The Vaccine Poll Hijacked by Pharmacists?

Neil Johnston

Editor's Note:
Professional services development was stymied when the AMA reneged on an agreement to support pharmacist vaccination clinics.
It has caused anger and unprofessional behavior has evolved on both sides.
It also appears that while the professional bodies of the AMA and the PGA attempt to disrupt each other, patients at large will become the eventual losers.
The PGA is central to other clinical service disruptions, even those within pharmacy involving contractor pharmacists.
This is damaging to an orderly development of clinical services in a pharmacy setting and demonstrates that current leaders of the PGA and the AMA are not fit to claim the title of "leader".
We asked Mark Coleman to provide commentary on an article recently published in Australian Doctor.

Comments: 2

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What Really Causes Kidney Stones (And Why Vitamin C Does Not)

Staff Writer

articles by this author...

Editing and Researching news and stories about global and local Pharmacy Issues

Orthomolecular Medicine News Service, February 11, 2013

What Really Causes Kidney Stones
(And Why Vitamin C Does Not)

(OMNS Feb 11, 2013) A recent widely-publicized study claimed that vitamin C supplements increased the risk of developing kidney stones by nearly a factor of two.[1] The study stated that the stones were most likely formed from calcium oxalate, which can be formed in the presence of vitamin C (ascorbate), but it did not analyze the kidney stones of participants. Instead, it relied on a different study of kidney stones where ascorbate was not tested. This type of poorly organized study does not help the medical profession or the public, but instead causes confusion.

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The study followed 23,355 Swedish men for a decade. They were divided into two groups, one that did not take any supplements (22,448), and another that took supplements of vitamin C (907). The average diet for each group was tabulated, but not in much detail. Then the participants who got kidney stones in each group were tabulated, and the group that took vitamin C appeared to have a greater risk of kidney stones. The extra risk of kidney stones from ascorbate presented in the study is very low, 147 per 100,000 person-years, or only 0.15% per year.

Key points the media missed:

* The number of kidney stones in the study participants who took ascorbate was very low (31 stones in over a decade), so the odds for statistical error in the study are fairly high.

* The study was observational. It simply tabulated the intake of vitamin C and the number of kidney stones to try to find an association between them.

* This method does not imply a causative factor because it was not a randomized controlled study, that is, vitamin C was not given to a group selected at random.

* This type of observational study is fraught with limitations that make its conclusion unreliable.
It contradicts previous studies that have clearly shown that high dose ascorbate does not cause kidney stones.[2-6]

* The study authors' conclusion that ascorbate caused the low rate of stones is likely due to a correlation between the choice of taking a vitamin C supplement with some other aspect of the participants' diet.

* The study could not determine the nature of this type of correlation, because it lacked a detailed study of each patient's diet and a chemical analysis of each stone to provide a hint about the probable cause.

So we have a poorly designed study that did not determine what kind of stone was formed, or what caused the stones that were formed. These are serious flaws. Drawing conclusions from such a study can hardly be a good example of "evidence based medicine."

Different Types of Kidney Stones (Renal Calculi)

There is a considerable variety of kidney stones. Here are five well-known ones:

1. Calcium phosphate stones are common and easily dissolve in urine acidified by vitamin C.

2. Calcium oxalate stones are also common but they do not dissolve in acid urine. We will discuss this type further below.

3. Magnesium ammonium phosphate (struvite) stones are much less common, often appearing after an infection. They dissolve in urine acidified by vitamin C.

4. Uric acid stones result from a problem metabolizing purines (the chemical base of adenine, xanthine, theobromine [in chocolate] and uric acid). They may form in a condition such as gout.

5. Cystine stones result from an hereditary inability to reabsorb cystine. Most children's stones are this type, and these are rare.

The Oxalate Oxymoron

The oxalate/vitamin C issue appears contradictory. Oxalate is in oxalate stones and oxalate stones are common. Ascorbate (the active ion in vitamin C) may slightly increase the body's production of oxalate. Yet, in practice, vitamin C does not increase oxalate stone formation. Emanuel Cheraskin, MD, DMD, Professor of Oral Medicine at the University of Alabama, explains why: "Vitamin C in the urine tends to bind calcium and decrease its free form. This means less chance of calcium's separating out as calcium oxalate (stones)."[7] Also, the diuretic effect of vitamin C reduces urine concentration of oxalate. Fast moving rivers deposit little silt. If on a consultation, a doctor advises that you are especially prone to forming oxalate stones, read the suggestions below before abandoning the benefits of vitamin C. Once again: vitamin C increases oxalate but inhibits the union of calcium and oxalate.

Oxalate is generated by many foods in the diet, including spinach (100-200 mg oxalate per ounce of spinach), rhubarb, and beets.[8-10] Tea and coffee are thought to be the largest source of oxalate in the diet of many people, up to 150-300 mg/day.[8,11] This is considerably more than would likely be generated by an ascorbate dose of 1000 mg/day.[5,12]

The study we are discussing didn't tabulate the participants' intake of oxalate, but on average they had relatively high intakes (several cups) of tea and coffee. It is possible that those who had kidney stones had them before the study started, or got them during the study, due to a particularly high intake of oxalate. For example, the participants that took vitamin C may have been trying to stay healthy, but the subset of those who got kidney stones might also have been trying to stay healthy by drinking a lot of tea or coffee, or eating green leafy vegetables such as spinach. Or they may have been older people who got dehydrated, which is also very common among men who are active outside during the summer. Among the most important factors in kidney stones is dehydration, especially among the elderly.[13]


Summarizing:

* Ascorbate in low or high doses generally does not cause significant increase in urinary oxalate.[2-6]

* Ascorbate tends to prevent formation of calcium oxalate kidney stones.[3,4]

* Risk factors for kidney stones include a history of hypertension, obesity, chronic dehydration, poor diet, and a low dietary intake of magnesium.

Magnesium

Kidney stones and magnesium deficiency share the same list of causes, including a diet high in sugar, alcohol, oxalates, and coffee. Magnesium has an important role in the prevention of kidney stone formation.[14] Magnesium stimulates production of calcitonin, which draws calcium out of the blood and soft tissues back into the bones, preventing some forms of arthritis and kidney stones. Magnesium suppresses parathyroid hormone, preventing it from breaking down bone. Magnesium converts vitamin D into its active form so that it can assist in calcium absorption. Magnesium is required to activate an enzyme that is necessary to form new bone. Magnesium regulates active calcium transport. All these factors help place calcium where it needs to be, and not in kidney stones.

One of magnesium's many jobs is to keep calcium in solution to prevent it from solidifying into crystals; even at times of dehydration, if there is sufficient magnesium, calcium will stay in solution. Magnesium is a pivotal treatment for kidney stones. If you don't have enough magnesium to help dissolve calcium, you will end up with various forms of calcification. This translates into stones, muscle spasms, fibrositis, fibromyalgia, and atherosclerosis (as in calcification of the arteries). Dr. George Bunce has clinically demonstrated the relationship between kidney stones and magnesium deficiency. As early as 1964, Bunce reported the benefits of administering a 420 mg dose of magnesium oxide per day to patients who had a history of frequent stone formation.[14,15] If poorly absorbed magnesium oxide works, other forms of better-absorbed magnesium will work better.

Calcium oxalate stones can effectively be prevented by getting an adequate amount of magnesium, either through foods high in magnesium (buckwheat, green vegetables, beans, nuts), or magnesium supplements. Take a magnesium supplement of at least the US RDA of 300-400 mg/day (more may be desirable in order to maintain an ideal 1:1 balance of magnesium to calcium). To prevent a laxative effect, take a supplement that is readily absorbable, such as magnesium citrate, chelate, malate, or chloride. Magnesium oxide, mentioned above, is cheap and widely available. However, magnesium oxide is only about 5% absorbed and thus acts mostly as a laxative. [14] Milk of magnesia (magnesium hydroxide) is even more of a laxative, and unsuitable for supplementation. Magnesium citrate is a good choice: easy to find, relatively inexpensive and well absorbed.

The Role of Vitamin C in Preventing and Dissolving Kidney Stones

The calcium phosphate kidney stone can only exist in a urinary tract that is not acidic. Ascorbic acid (vitamin C's most common form) acidifies the urine, thereby dissolving phosphate stones and preventing their formation.

Acidic urine will also dissolve magnesium ammonium phosphate stones, which would otherwise require surgical removal. These are the same struvite stones associated with urinary tract infections. Both the infection and the stone are easily cured with vitamin C in large doses. Both are virtually 100% preventable with daily consumption of much-greater-than-RDA amounts of ascorbic acid. A gorilla gets about 4,000 mg of vitamin C a day in its natural diet. The US RDA for humans is only 90 mg. The gorillas are unlikely to all be wrong.

The common calcium oxalate stone can form in an acidic urine whether one takes vitamin C or not. However, this type of stone can be prevented by adequate quantities of B-complex vitamins and magnesium. Any common B-complex supplement, twice daily, plus about 400 milligrams of magnesium, is usually adequate.

A Dozen Ways to Reduce Your Risk of Kidney Stones

1. Maximize fluid intake.[13] Especially drink fruit and vegetable juices. Orange, grape and carrot juices are high in citrates which inhibit both a buildup of uric acid and also stop calcium salts from forming. [16]

2. Control urine pH. Slightly acidic urine helps prevent urinary tract infections, dissolves both phosphate and struvite stones, and will not cause oxalate stones. And of course one way to make urine slightly acidic is to take vitamin C.

3. Avoid excessive oxalates by not eating (much) rhubarb, spinach, chocolate, or dark tea or coffee.

4. Lose weight. Being overweight is associated with substantially increased risk of kidney stones.[17]

5. Calcium is probably not the real culprit. Low calcium may itself cause calcium stones [18].

6. Most kidney stones are compounds of calcium and yet many Americans are calcium deficient. Instead of lowering calcium intake, reduce excess dietary phosphorous by avoiding carbonated soft drinks, especially colas. Cola soft drinks contain excessive quantities of phosphorous as phosphoric acid. This is the same acid that is used by dentists to dissolve tooth enamel before applying bonding resins.

7. Take a magnesium supplement of at least the US RDA of 300-400 mg/day. More may be desirable in order to maintain an ideal 1:1 balance of magnesium to calcium. Many people eating "modern" processed-food diets do not consume optimal quantities of magnesium.

8. Take a good B-complex vitamin supplement twice daily, which contains pyridoxine (vitamin B6). A deficiency of vitamin B6 produces kidney stones in experimental animals. Vitamin B6 deficiency is very common in humans. A vitamin B1 (thiamine) deficiency also is associated with stones. [19]

9. For uric acid/purine stones (gout), stop eating meat. Nutrition tables and textbooks indicate meats as the major dietary purine source. Natural treatment adds juice fasts and eating sour cherries. Increased vitamin C consumption helps by improving the urinary excretion of uric acid. [12]. For these stones, use buffered ascorbate "C".

10. Persons with cystine stones (only 1% of all kidney stones) should follow a low methionine diet and use buffered vitamin C.

11. Kidney stones are associated with high sugar intake, so eat less (or no) added sugar. [20]

12. Infections can cause conditions that favor stone formation, such as overly concentrated urine (from fever sweating, vomiting or diarrhea). Practice good preventive health care, and it will pay you back with interest.

 

References:

1. Thomas LDK, Elinder CG, Tiselius HG, Wolk A, Akesson A. (2013) Ascorbic acid supplements and kidney stone incidence among men: A prospective study. Published Online: February 4, 2013. doi:10.1001/jamainternmed.2013.2296

2. Wandzilak TR, D'Andre SD, Davis PA, Williams HE (1994) Effect of high dose vitamin C on urinary oxalate levels. J Urology 151:834-837.

3. Hickey S, Saul AW. (2008) Vitamin C: The Real Story, the Remarkable and Controversial Healing Factor. Basic Health Publications ISBN-13: 9781591202233

4. Hickey S, Roberts H. (2005) Vitamin C does not cause kidney stones. http://orthomolecular.org/resources/omns/v01n07.shtml

5. Robitaille L, Mamer OA, Miller WH Jr, Levine M, Assouline S, Melnychuk D, Rousseau C, Hoffer LJ. Oxalic acid excretion after intravenous ascorbic acid administration. Metabolism. 2009 Feb;58(2):263-9. doi: 10.1016/j.metabol.2008.09.023.

6. Padayatty SJ, Sun AY, Chen Q, Espey MG, Drisko J, Levine M. (2010) Vitamin C: intravenous use by complementary and alternative medicine practitioners and adverse effects. PLoS One. 5(7):e11414. doi: 10.1371/journal.pone.0011414.

7. Cheraskin E, Ringsdorf, M Jr, Sisley E (1983) The Vitamin C Connection. Bantam Books. ISBN-13: 9780553244342

8. Noonan SC, Savage GP (1999) Oxalate content of foods and its effect on humans. Asia Pacific Journal of Clinical Nutrition. 8:64-74.

9. Kawazua Y, Okimurab M, Ishiic T, Yuid S. (2003) Varietal and seasonal differences in oxalate content of spinach. Scientia Horticulturae 97:203-210

10. Proietti S, Moscatello S, Famiani F, Battistelli A. (2009) Increase of ascorbic acid content and nutritional quality in spinach leaves during physiological acclimation to low temperature. Plant Physiol Biochem. 47(8):717-23.

11. Gasinska A, Gajewska D. (2007) Tea and coffee as the main sources of oxalate in diets of patients with kidney oxalate stones. ROCZN. PZH 58(1):61-67.

12. Pauling L. (2006) How to Live Longer And Feel Better. OSU Press ISBN-13: 9780870710964

13. Manz F, Wentz A. (2005) The importance of good hydration for the prevention of chronic diseases. Nutr Rev. 63(6 Pt 2):S2-S5.

14. Dean C. (2007) The Magnesium Miracle. Ballantine Books. ISBN-13: 9780345494580

15. Bunce GE, Li BW, Price NO, Greenstreet R. (1974) Distribution of calcium and magnesium in rat kidney homogenate fractions accompanying magnesium deficiency induced nephrocalcinosis. Exp Mol Pathol. 21(1):16-28.

16. Carper J. Orange juice may prevent kidney stones, Lancaster Intelligencer-Journal, Jan 5, 1994

17. Bagga HS, Chi T, Miller J, Stoller ML. (2013) New insights into the pathogenesis of renal calculi. Urol Clin North Am. 2013 Feb;40(1):1-12. doi: 10.1016/j.ucl.2012.09.006.

18. L. H. Smith, et al (1974) Medical evaluation of urolithiasis. Urological Clinics of North America. 1:2, 241-260.

19. Hagler L, Herman RH, (1973) Oxalate metabolism, II. American Journal of Clinical Nutrition, 26(8): 882-889.

20. J. A. Thom, et al (1978) The influence of refined carbohydrate on urinary calcium excretion. British Journal of Urology, 50(7): 459-464.

 

Nutritional Medicine is Orthomolecular Medicine

Orthomolecular medicine uses safe, effective nutritional therapy to fight illness. For more information: http://www.orthomolecular.org

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