It is estimated that about 350,000 Americans visit the emergency room each year to deal with kidney stones. About three-quarters of the stones are made up of calcium oxalate. Perplexing little things—why are they so afflicting? To understand what causes stones and, how to prevent or to treat them, we need to look have a little understanding of the kidneys. I’ll try not to bore you.
A quick look at the western functions of the kidneys
The bladder and kidneys broadly comprise the urinary system. To over simplify, the kidney’s job is to filter blood and excrete waste via the bladder. Urine is made up of about 95% water. The remaining 5% is acidic solids including uric acid, ammonia, creatin, sodium and potassium. As blood is filtered through the nephrons of the kidneys, acids and toxins are removed and usable minerals, vitamins and fluids are reabsorbed. When everything is running smooth, this process helps to maintain the proper pH balance in the body. When it’s not, we become toxic. In a desire to regulate the body will try and find something to do the toxins or excess—stones are one way the body tries to manage the excess.
Even though we will discuss Asian medicine’s approach to kidney stones, covering the general functions of the Kidney’s is a bit too complicated and abstract to tackle in this short blog–we will get to that another day–back to stones.
What are kidney stones?
Kidney stones are solid lumps that are formed in the kidneys. They are made up of uric acid, calcium oxalate, and other crystals. The stones vary in size from minuscule, which can pass easily through the system without pain, to 8 mm in diameter. Larger stones often lead to pain, urinary blockage, bleeding and emergency intervention. The stones are usually painless unless they dislodge or become stuck in part of the urinary tract—ouch.
What causes kidney stones?
Stones are formed in the body because improper fluid and solution transformation and excretion. Stones are made up of concentrates such as oxalate, calcium and phosphorus. Excess levels of these substance either due to increase dietary intake, insufficient water intake or inappropriate organ functioning can lead to stone formation. I’ll be honest–it’s usually a combination of all three…
There are four types of stones
- Calcium stones–The most common type accounts for ¾ of all stones. Formed from calcium oxalate.
- Struvite stones—Most commonly found in women with frequent urinary tract infections.
- Uric acid stones—Seen in gout and genetic disorders, this type of stone arises from improper protein metabolism.
- Cystine stones—Least frequent form of stones. They are caused by a genetic disorder.
Who is at risk?
Certain genetic and predispositions can lead to increased risk of stone formation including those with:
- Family history of kidney disease or disorder
- Kidney disease or dysfunction caused by medication
- Kidney dysfunction caused by serious illness
- Hypercalcirua–too much calcium in the urine. This disposition will lead to formation of stones that are calcium based.
- Cystic kidney diseases lead to cysts filled with fluid that form and solidify.
- Thyroid and parathyroid imbalances can lead to excess calcium in the blood.
- Renal tubular acidosis—a kidney disorder that causes the kidneys to fail to release acids into the urine. You become toxic and the stones form
- IBS or other chronic bowel disorder
- Gastro intestinal disorders
- Overuse of calcium-based anacids—no, Tums are not the answer.
- Overuse of diuretics
- Anti-seizure medications
- Low fiber diets
- High alcohol consumption
- High refined carbohydrate diets
- Excess fat in the diet
- Excess animal protein
The causes of kidney stones according to Asian medicine
Like any other disease or disharmony Asian medicine is going to look at each individual, not just symptoms, but lifestyle behaviors, constitution and habits. Using tongue and pulse assessment, detailed questioning and palpation the Asian medicine practitioner seeks not just the symptoms but the underlying cause of the pattern then treatment is honed to the individual.
When you shift to thinking of stones through the Asian medicine lense we start with the following assessment–
Stones are accumulation–most often of damp heat
Okay, what causes accumulations? Accumulations arise because we have too much of something. Often times there will be a deficiency pattern either at the root or now resulting from taking in too much excess.
We know we have to break up the stones, and there are some foods and herbs that can start that without any other assessment. However, the goal is not to merely treat the symptoms but to find out the root cause—why are they being made in the first place and treat there too. It is common for anyone who is building masses like stones to have other accumulations like cysts, fibroids and tumors.
Stones can be viewed as one of the prosperity diseases. Rarely are they seen in cultures where the diet are low in processed, refined, rich and heavy in fats and animal proteins.
Common Asian patterns underlying accumulations like stones.
- Kidney Yin/Jing deficiency
- Spleen Yang Xu and dampness
- Gall Bladder Damp Heat
- Bladder Yang Xu
- If there is accumulation, there will be stagnation so Liver’s function of free and easy flow must be promoted
Treatment is to dissolve hard masses, drain dampness/phlegm and promote Qi flow.
From there the practitioner will focus the treatment to the individual’s constitution and pattern. However, even without having a complete assessment—we can start with nutrition.
General Nutritional Considerations for Kidney Stones
Reduce high oxalate foods–The current recommendations have been to reduce high oxalate foods as they will lead to oxalate stone formation. There is new evidence that is starting to point in the direction that this may not always be true. In fact, some of these reports are showing that the high oxalate foods in diet do show an increase in oxalate in the urine. This doesn’t necessarily mean you will get stones. It seems to depend on whether your body can process and remove the excess or not. While the research is still underway, it is still advisable to reduce or cut out high oxalates so the body has less to try to tackle. Common recommendations are to keep your diet at 40-50 mg or less of oxalate a day. The following is a list of common high oxalic acid foods–those that you would need to reduce.
- Beets (root & greens)
- Black beans
- Black tea
- Brazil nut
- Cannelini beans
- Collard greens
- Corn meal
- Green beans
- Great northern bean
- Hearts of palm
- Marshmallow root
- Milk thistle
- Navy beans
- Oil of oregano
- Pine nuts
- Pink beans
- Potato chips
- Red grapes
- Rice bran
- Sesame seeds
- Tomato (cooked)
- White bean
Decrease sugar—Another reason sugar is out. Sugar causes the body to excrete calcium to neutralize it. Meaning more calcium going through the kidneys.
Limit alcohol consumption—energetically hot, alcohol contributes to accumulation and toxicity.
Limit the bubbles–We like to drink our bubbly soda and spritzers. Aside from the the possible sugar, chemical, coloring and preservative content the bubbles themselves are a challenge for our bodies. Highly acidic, they require the body to use precious minerals to neutralize them. If you are making stones, you are to acidic–cut out the bubbles.
Reduce consumption of animal protein—rich meats are often seen as large components in kidney stone formation. 3-5 oz, 3-5 x a week of clean, lean meat is usually considered okay.
Reduce eggs—Rich, rich, rich. Eggs are highly nourishing, but too much will lead to accumulations of dampness. They promote growth and accumulation.
Reduce consumption of dairy—dairy creates phlegm damp and accumulations
Processed and refined foods—Deli foods, hot dogs and processed foods contain sodium, sugar, nitrites and other chemicals and preservatives that overly burden the system.
Increase fiber rich foods and complex carbohydrates--need a reminder of your fiber rich foods?
Increase water intake—You need about 2 litres a day. If you are athletic you may need more. Excess sweating or fluid loss also needs to be considered as something more may be going on.
Increase calcium-magnesium ratio foods
- Brown rice
- Dark chocolate
- Lima Beans
- Sesame Seeds
Check your calcium intake–It is not necessary to limit calcium intake as it actually inhibits oxalate absorption. That being said–dairy should be avoided as it’s nature is damp, cloying and it causes accumulations in excess. Get your calcium from from other sources like kelp.
Add in Vitamin B6—B6 reduces formation
Add in magnesium— proper levels of magnesium are essential for proper calcium absorption. 250-500 milligrams is needed in the body
Cranberries—Cranberries are a magic food for the kidneys and bladder. They contain quinic acid. Quinic acid binds with calcium and phosphate ions keeping them from coagulating and forming stones.
Add in foods that dissolve hard masses–This category specifically benefits the Bladder and Kidney by dissolving masses and lumps and helping to regulate the salty flavor and sodium in the body.
- Irish moss
- Sea weeds
- Wheat grass
Low Oxalate Foods–choose most of your foods from this category
- alfalfa sprouts
- asparagus (boiled)
- banana pepper
- fresh basil
- black eyed peas
- bok choy
- broccoli (boiled)
- broccoli raab
- cabbage (all kinds)
- daikon radish
- garbonzo beans
- green grape
- kale (1/2 cup, boiled at least 6 min)
- lettuce (all)
- lentils (1/4 c.)
- lima beans
- mung bean sprouts
- mustard greens (boiled)
- peas (boiled)
- plum, yellow
- pumpkin seed
- split pea
- snow peas
- sweet bell peppers (red, orange, yellow but NOT green)
- strawberry, less than 10
- yellow summer squash,
- Winter squash (acorn, butternut, pumpkin, etc)
- turnip (steamed or boiled),
- water chestnut
- wild rice
Medium Oxalate–don’t invite these to your plate too often
- artichoke (boiled)
- asparagus (steamed)
- Belgian endive
- broccoli (steamed)
- Brussels sprouts
- carrots (1/2 cup boiled)
- collard greens (boiled)
- grape leaves (one)
- grapefruit, white
- green onion
- jasmine rice
- jicama (peeled)
- kale (steamed 6 min)
- red onion
Remember, this is a good place to start but it is by no means as specific as we can get. For example–the needs of a client with kidney stones and diabetes will be different from that of a client who has stones and high blood pressure. The more we can hone to the individual, the better the results.