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Suggest Remedy For Kidney Stone

Posted on Tue, 3 Nov 2015

Question: I have bouts of kidney stones high calcium . Calcium 10.8 , 11.1. Vitamin d 11.6 and 22.6. When vitamin d goes up then calcium goes up. Path 19, 16.6 nd then 16. It seems as if when I pass a lot of stones calcium will drop some.

Answered by Dr. Rakesh Madhyastha (2 hours later)

Brief Answer:
Secodary hyperparathyroidism

Detailed Answer:
Hello

Thanks for the query

From the reports you have furnished it looks like you have secondary hyperparathyroidism because of over activity of parathyroid glands. I recommend you to get Parathyroid hormone levels tested and also scan of the parathyroid gland. It is best if you approach an endocrinologist for the same.

I hope i was of help, if you have any further queries please get back to me

Regards

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Rakesh Madhyastha (4 hours later)

My parathyroid was 19.6 and two weeks later was 16. I have had no high pth levels. How could that be. Endocrologist tells me I am a textbook case of parathyroid disease except for pth levels. I have a scan scheduled but from what I read there is a chance the scan won't detect an adeoma. Could it still be parathyroid with pth levels low?

Answered by Dr. Rakesh Madhyastha (12 hours later)

Brief Answer:
Stop hydrocholorothiazide

Detailed Answer:
Hello

Thanks for getting back with the clarification. With normal PTH I dont think this is a case of hyperparathyroidism. It is essential to have high PTH to diagnose hyperparathyroidism.
The reason for high calcium is hydrocholorothiazide, HCT causes raised calcium by increasing the absorption of calcium from the kidney. This important factor helps prevent kidney stones. However in your case it is important to stop HCT as your calcium levels are very high. Please approach your endocrinologist with my recommendation

If PTH levels were low then it cant be hyperparathyroidism

I hope I was of help, if you have any further queries please get back to me

Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Rakesh Madhyastha (47 minutes later)

I had a scan today. I had already stopped taking hct prior to the last 2 high calcium numbers. I don,t eat or drink anything with calcium in it. Whatever is causing all these problems are inter related. The fatigue is terrible. This has been going on for approx 8 years. I researched all the symptoms online and ended up on parathyroid.com The pth is the piece of the puzzle endo cannot seem to figure out. My symptoms are fatigue, heart palpitations, kidney stones, high calcium, low vitamin d , high cholesterol, high blood pressure . Had a stroke a year ago.never feel well
I am not sure how with all the kidney stones but my kidney function is good. I have had litho 7 times in 2 years.something has to be causing them.

Answered by Dr. Rakesh Madhyastha (22 hours later)

Brief Answer:
Recurrent stone former

Detailed Answer:
Hello

You fall under the catergory of recurrent stone formers. It is important that you undergo complete metabolic work up for the same. Here is what you should do

1. Get serum uric acid levels
2. 24 hour urinary oxalate, uric acid, calcium and phosphorus. This will give us an idea what type of stone it could be
3. I recommend you to have 'DASH diet', it is known to reduce the caclium oxalate stones, most likely you will be having calcium oxalate stones. DASH diet includes the following, A diet high in fruit, vegetables, whole grains, and low-fat dairy products and low in saturated fat, total fat, cholesterol, refined grains, sweets, and meat. This has shown to reduce the recurrence of stones significantly. ALso make sure you are well hydrated at all times

Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Rakesh Madhyastha (4 hours later)

Already done that. Cut out all high and medium oxlate foods.uric acid in normal range. Calcium high in 24 hour urine test. Drink excessive amounts of water. Approximately 64 ounces a day. The only other thing on blood test is liver enzymes a little high which from what I understand is characteristic of hypo. This has definitely been an ongoing process. Kidney stones are calcium oxlate. After litho they are better for a month or so and the process begins all over again. Lots of joint pain.

Answered by Dr. Rakesh Madhyastha (20 hours later)

Brief Answer:
Can re start hydrochlorothiazide

Detailed Answer:
Hello

Thanks for the query

You are doing everything right, I guess if I were to be your doctor I would re start Hydrocholorithiazide at a small dose once the calcium comes back to normal.
There is no other treatment option available for recurrent calcium oxalate, its only diet and HCT

Regards

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Above answer was peer-reviewed by : Dr. Raju A.T