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Taking low oxalate diet due to kidney stones, calcium due to osteoporosis. Alternate solution?

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General & Family Physician
Practicing since : 1978
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Hello, I am to be on a low oxalate diet/low sodium due to kidney stones, am to eat calcium due to osteoporosis and would like to eat a heart healthy diet due to almost everyone in my family having had or have heart issues. The low oxalate diet/low sodium and XXXXXXX calcium diets seem impossible to align (ie: dark leafy vegetables are high calcium and high oxalate)and still eat nutritionally for heart or overall health. Some of the internet sites don't even agree when listing foods on their oxalate charts. My doctors say eat things in "moderation XXXXXXX but it's still very hard! Do you have any suggestions? Thank you!
Posted Thu, 7 Feb 2013 in General Health
Answered by Dr. Pavan Kumar Gupta 5 hours later
Thanks for the query.
I know it becomes a real nightmare for a patient as to what step should be taken in such a situation.I would like to place few facts in front of you.
1...Despite the fact that calcium is a major component of 75% of stones, excessive calcium intake is very rarely the cause of stone formation. In fact, several studies have shown that restricting calcium intake in most stone formers actually increases the number of stones they develop. This appears to happen because when less calcium is ingested, it becomes easier for oxalate (which normally binds with calcium in the gut) to be absorbed. Higher levels of oxalate in the urine then lead to an increase in stone risk.

2...If you can, it is better for you to get your calcium from dietary sources instead of calcium supplements. This is because supplements can increase your risk of stones slightly
Many  studies have come to conclusions and their  recommendation is  to maintain a normal dietary calcium intake but to try to avoid calcium supplements if possible. This is in contrast to older recommendations previously given to kidney stone formers to reduce their calcium intake.

3...The two most common types of calcium supplements are calcium carbonate and calcium citrate.One should consume calcium citrate as it is more easily digested and can be taken on an empty stomach. 

Calcium citrate is preferred for stone formers because it has the stone friendly benefit of also increasing urinary citrate concentrations. Citrate is an inhibitor of stones, which makes it more difficult for calcium based stones to form.

4...Researchers have found that taking calcium supplements with meals appears to be better than taking supplements by themselves in regards to stone formation. This makes more calcium to be available in the gut which then helps in binding the oxalate present in the food.

So my advise to you is to have increased dietary intake of calcium through natural foods and if a supplement is required,then take calcium citrate instead of calcium carbonate.

I hope it helps however you may revert to me for any further query.
Best of luck
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