I am a 49 year old woman who had very good bone density when checked three years ago. I have two small kidney stones (which were discovered during an abodminal scan but have never given me problems.) I used to take calcium supplements daily, but when the kidney stones were discovered a year ago, the doctor advised me not to take them anymore. Is this sound advice?

We are addressing three problems here.

1. You have mentioned your age. Are your periods regular?

  During reproductive age, the woman is protected for bone by the estrogens. This protective effect is reduced or lost in peri-menopausal and post menopausal stage. Then the bone becomes osteopenic or osteoporotic.

2. Kidney stone if non obstructive may pass out without any symptoms. If obstruction occurs for any duration then it causes severe colicky pain. Or infection may occur and draw attention to the silent stone (calculus).

3. Following is the opinion of the authorities in the field regarding the renal stones and diet:

 -The etiology of this disorder is multi-factorial and is strongly related to dietary lifestyle habits or practices.

Dietary Habits. Fluid restriction or dehydration may cause kidney stone formation. Dietary intake that is high in sodium, oxalate, fat, protein, sugar, unrefined carbohydrates, and ascorbic acid (vitamin C) has been linked to stone formation. Low intake of citrus fruits can result in hypocitraturia, which may increase an individual's risk for developing stones.

-Causes of nephrolithiasis (stones) are many and in a person need to be found out. And the treatment depends on the cause.

But what ever the cause, some basic principles of medical treatment are there.

Hypercalciuria (General)

Besides treating underlying disease, management of hypercalciuria includes:

  • Low calcium diet (about 400 mg calcium).

  • Distilled water, if high calcium content in water supply

  • Limit vitamin C (< 0.5g/day).

  • High sodium intake

  • Thiazide diuretics

  • Cellulose phosphate

  • Orthophosphate

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If you would like to know more about your condition, please go through the following references:

1. Urolithiasis/Nephrolithiasis: What's It All About?- Posted 01/17/2006

Medscape.

2. Nephrolithiasis: Calcium-Containing Stones

From ACP Medicine Online

Posted 10/01/2002

Dietary Influences

3. The recommendation for calcium restriction has been called into question by recent work that has showed that calcium intake was inversely correlated with likelihood of stone recurrence.[38] This work showed that a low sodium, low animal protein diet with normal dietary calcium intake was more effective in preventing stone recurrence than the traditional low calcium diet.- Advances in the Management of Urinary Stone Disease Jan 2006

 

Regards,

G. Amladi, MD