1

votes

Why did this paleo diet cause my sister to get kidney stones?

Answered on August 19, 2014
Created May 04, 2012 at 1:06 PM

Hi PHers!

I know there have been a few questions about kidney stones here on the message board, but I haven't found any sources listed other than people's answers.

I just completed my Whole30 with my husband and had great success. My sister & her husband decided they were ready to get healthy and wanted to start paleo (YAY!!) after hearing all of the benefits that our family and others have experienced from eating this way.

They started with the Whole30 and ~1 week in my sister gets kidney stones. She goes to the doctor and they tell her it's from a "high animal protein diet". The Doc told her it can also happen from an increase oxylate in diet which can be caused by animal proteins, veggies, berries, nuts and seeds. WTF.

I feel so bad for her and she's feeling quite discouraged as her body appears to be rebelling from her wanting to eat healthy.

So finally the question - do you guys have any recommendations/sources I can pass along to her to help make the transiton easier? Surely there is a way for her to make this transition without having to endure the pain of stones...

Thanks for your insight and time. :) Happy Friday!

-Danielle

100fd85230060e754fc13394eee6d6f1

(18696)

on May 08, 2012
at 02:45 PM

Yes, I suspect that the major reason is the enforced dehydration. In that population, it can be prevented with potassium citrate supplementation.

543a65b3004bf5a51974fbdd60d666bb

(4493)

on May 05, 2012
at 09:18 AM

thx for sharing your story alzsunrise. it will be interesting to find out what the urine tests reveal. out of interest, may i ask (if you don't mind) 1. what is the usual color of your urine & 2. does it usually smell much? just wondering if any correlation could be made there. very simplistic i know. (i am not a doctor). thx

7d46858749ff63fd065e3e70a7e5ac6e

(318)

on May 04, 2012
at 05:20 PM

Unfortunately that makes sense as gout is the collection of uric acid in the joints... seems likely it could build up elsewhere. Talk about two very painful chronic health problems... :( Sorry to hear about your friend...

7d46858749ff63fd065e3e70a7e5ac6e

(318)

on May 04, 2012
at 05:13 PM

Thanks interrobung... I am doing a 24 hour urine collection today (what a pain but hopefully worth it!). The only time I ever passed one, I wasn't straining bc the ER misdiagnosed the stone as a back injury. I have had one get stuck in the ureter and cause hydronephrosis.. the surgery and stent from that was no fun so I plan on lithotripsy for the one I have now... but it means no analyzing the stone again!

Medium avatar

(1029)

on May 04, 2012
at 03:43 PM

I too have read about large doses of D increasing chances of stones (but not if you are merely getting rid of a deficiency). But I spoke to my urologist and the way to determine if D is contributing to causing the stones is to check your calcium level. If it is normal then D is not the culprit.

246ebf68e35743f62e5e187891b9cba0

(21420)

on May 04, 2012
at 03:01 PM

Thanks for the response Dave - I should say I'm more concerned Wikipedia would be a great source for Common Wisdumb health information, ala WebMD. Because of that, I would say you are right about the reduced water intake - add that to a ketogenic diet and you might be setting yourself up for kidney stones due to the increased oxalates from meat AND not enough water to dilute those oxalates... although I'm still quite skeptical of it being any function of ketosis, insofar as it is a side effect from two factors of protein and lack of water.

246ebf68e35743f62e5e187891b9cba0

(21420)

on May 04, 2012
at 02:56 PM

Seriously, whoever voted me down should at least have at least a modicum of courtesy of saying "why" they voted me down.

A968087cc1dd66d480749c02e4619ef4

(20436)

on May 04, 2012
at 02:26 PM

What? Wiki is not the universal bastion of truth??? (Was that snarky enough?). At least wiki has references that you can check out. And yes, kidney stones are a well known side effect of ketogenic diets for epilepsy. However, it may be due to the reduced water intake, which is no longer recommended.

8496289baf18c2d3e210740614dc9082

(1867)

on May 04, 2012
at 02:06 PM

You want to know what the stones are made of first. Some of the worst ones are ammonium-magnesium-phosphate (aka struvite), and you wouldn't want to exacerbate that pathological process on accident.

8496289baf18c2d3e210740614dc9082

(1867)

on May 04, 2012
at 02:03 PM

Insightful and accurate: +1. It's also worth noting that there are at least three varieties of kidney stones, based upon composition. They come from very different things, and are associated with very different (though overlapping) disease processes.

246ebf68e35743f62e5e187891b9cba0

(21420)

on May 04, 2012
at 02:02 PM

Wiki is a great resource for learning about health information! *Additional Snarky Comment Here*

246ebf68e35743f62e5e187891b9cba0

(21420)

on May 04, 2012
at 01:59 PM

Happens all the time alzsunrise - and your contribution is welcome as you are a Paleo sufferer of stones... I simply have a friend with gout, and he gets stones twice a year or so.

7d46858749ff63fd065e3e70a7e5ac6e

(318)

on May 04, 2012
at 01:51 PM

That is interesting... if you have chronic kidney stones would it be beneficial to supplement some magnesium even without the testing?

7d46858749ff63fd065e3e70a7e5ac6e

(318)

on May 04, 2012
at 01:50 PM

Sorry some of that was repeat info! A bunch of people responded in the time I took to type it lol

Ebcbbdcb8b727e69e06eaa102d49a84c

(1804)

on May 04, 2012
at 01:22 PM

That's a great point, Joshua. Thank you for responding.

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17 Answers

30
246ebf68e35743f62e5e187891b9cba0

(21420)

on May 04, 2012
at 01:20 PM

Well, without knowing what she was eating it is hard to say. And knowing that it's only 1 week in (kidney stones usually take months to form), would tell me that

The doc is under the impression she's been eating this way much longer.

or

The doc subscribes more towards Ornish/Oz ways of eating and feels that a diet centered on meat is inherently bad, and is using this malady as a way to convince your sister to stay away.

Needless to say, I've never seen real evidence that protein can cause kidney stones - what I have seen is a previous history with lots of soda (sodium+ caffeine), tea (caffeine), and dairy (increased calcium), when met with chronic dehydration (not drinking enough plain water along with the above beverages) can cause kidney stones.

That being said, I would say protein makes up 20% of my diet, and compared to most "fit" persons that I know, that's pretty low.

Many make the mistake of doing Paleo - while still subscribing to the low-fat mantras, so they eat lots of protein without any fat... chicken breasts, tuna, etc... If there was an existing issue with kidney stones (which usually take considerably longer than 1 week to form) then perhaps the extra strain of a high protein diet, or just the fact that her diet is cleaning up and her body is "flushing" toxins during the initial phase, then that would make sense.

But kidney stones after one week of eating high protein? I won't say it's impossible, but it is highly unlikely.

Get her drinking more water, and not drinking any major quantities of caffeinated beverages like iced tea (a cup or two of coffee is fine and won't dehydrate that bad, as long as she drinks plenty of water).

246ebf68e35743f62e5e187891b9cba0

(21420)

on May 04, 2012
at 02:56 PM

Seriously, whoever voted me down should at least have at least a modicum of courtesy of saying "why" they voted me down.

Ebcbbdcb8b727e69e06eaa102d49a84c

(1804)

on May 04, 2012
at 01:22 PM

That's a great point, Joshua. Thank you for responding.

8496289baf18c2d3e210740614dc9082

(1867)

on May 04, 2012
at 02:03 PM

Insightful and accurate: +1. It's also worth noting that there are at least three varieties of kidney stones, based upon composition. They come from very different things, and are associated with very different (though overlapping) disease processes.

18
7d46858749ff63fd065e3e70a7e5ac6e

on May 04, 2012
at 01:44 PM

So this isn't really from indepth medical knowledge but personal experience and research......I have had several episodes of kidney stones.... several while eating SAD and 2 while paleo (though they often take years to form so they may have formed pre-paleo for me). There are a variety of reasons why someone gets a kidney stone and unless she passed it, caught the stone in a strainer and had it analyzed there is no way to really know that it was from increased oxylate in her diet. That sounds like a hypothesis more than anything.

There are four kinds of stones (calcium, uric acid,struvite, and cystine) and they all come from different substances being high in the urine. You wouldn't be able to tell which one it was unless it was analyzed. I had all of my stones broken up or surgically removed so they were not analyzed and I was told there was no way to know what caused them. Ironically, I am doing a 24 hour urine collection today to try and determine what is running high in my urine as I have another stone now.

Hypothyroidism, gout, certain medications, being chronically dehydrated, pregnancy, gastric bypass surgery, hereditary reasons, excess sugar consumption, even a UTI... there are TONS of reasons they can form. Hypercalciuria (high calcium in the urine) is the most common cause and is typically hereditary. This basically means that too much calcium from food is absorbed and excreted in urine. Usually you are just born with this predisposition.

Lastly, while it may be possible to have a kidney stone form in a week, from what I have read that is HIGHLY unlikely. Stones start small and gradually grow over time. They take months or years to get big and can hang out in the kidney and be asymptomatic for long periods of time before they move into the ureter (the point where they cause pain). It is most likely that your sister had this stone for some time but it was in the kidney not causing pain so it was never found. I have a large stone in my kidney now but I feel no pain at all from it.... if I hadn't passed another one recently and had at CT, I would have never known. My urologist said that it could become painful in an hour or in five years... there is no real understanding of when stones pass.

So, basically, I think it is pretty unlikely this stone came from one week of Whole 30 eating. Sometimes if you have a stone already and you increase fluid intake it can move the stone more quickly into the ureter/bladder so it is possible she sped up the process of passing an existing stone. Most likely it just happened to come at a sort of coincidental time. If I were her, I would continue on with Whole 30 and ask her urologist to perform a 24 hour urine collection to see if anything is high in her urine. That will give you much better answer than the "a few days of increased animal fat" hypothesis. After all, if that were the case, everyone eating a high animal fat diet/ketosis would be having them left and right and vegans would never get them and that is most definitely not the case!

7d46858749ff63fd065e3e70a7e5ac6e

(318)

on May 04, 2012
at 01:50 PM

Sorry some of that was repeat info! A bunch of people responded in the time I took to type it lol

246ebf68e35743f62e5e187891b9cba0

(21420)

on May 04, 2012
at 01:59 PM

Happens all the time alzsunrise - and your contribution is welcome as you are a Paleo sufferer of stones... I simply have a friend with gout, and he gets stones twice a year or so.

7d46858749ff63fd065e3e70a7e5ac6e

(318)

on May 04, 2012
at 05:20 PM

Unfortunately that makes sense as gout is the collection of uric acid in the joints... seems likely it could build up elsewhere. Talk about two very painful chronic health problems... :( Sorry to hear about your friend...

543a65b3004bf5a51974fbdd60d666bb

(4493)

on May 05, 2012
at 09:18 AM

thx for sharing your story alzsunrise. it will be interesting to find out what the urine tests reveal. out of interest, may i ask (if you don't mind) 1. what is the usual color of your urine & 2. does it usually smell much? just wondering if any correlation could be made there. very simplistic i know. (i am not a doctor). thx

6
Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on May 04, 2012
at 01:31 PM

The number one reason in my paleo patients is Magnesium deficiency. It needs to be assessed with an intracellular test like an exatest and not a serum Mg level.

8496289baf18c2d3e210740614dc9082

(1867)

on May 04, 2012
at 02:06 PM

You want to know what the stones are made of first. Some of the worst ones are ammonium-magnesium-phosphate (aka struvite), and you wouldn't want to exacerbate that pathological process on accident.

7d46858749ff63fd065e3e70a7e5ac6e

(318)

on May 04, 2012
at 05:13 PM

Thanks interrobung... I am doing a 24 hour urine collection today (what a pain but hopefully worth it!). The only time I ever passed one, I wasn't straining bc the ER misdiagnosed the stone as a back injury. I have had one get stuck in the ureter and cause hydronephrosis.. the surgery and stent from that was no fun so I plan on lithotripsy for the one I have now... but it means no analyzing the stone again!

7d46858749ff63fd065e3e70a7e5ac6e

(318)

on May 04, 2012
at 01:51 PM

That is interesting... if you have chronic kidney stones would it be beneficial to supplement some magnesium even without the testing?

4
A968087cc1dd66d480749c02e4619ef4

(20436)

on May 04, 2012
at 01:30 PM

Kidney stones are a possible side effect of long term use of a ketogenic diet. 1 week is not long term, so her kidney stones were probably in development already. Read wiki on ketogenic diet and have her get enough carbs to avoid ketosis for now.

A968087cc1dd66d480749c02e4619ef4

(20436)

on May 04, 2012
at 02:26 PM

What? Wiki is not the universal bastion of truth??? (Was that snarky enough?). At least wiki has references that you can check out. And yes, kidney stones are a well known side effect of ketogenic diets for epilepsy. However, it may be due to the reduced water intake, which is no longer recommended.

246ebf68e35743f62e5e187891b9cba0

(21420)

on May 04, 2012
at 02:02 PM

Wiki is a great resource for learning about health information! *Additional Snarky Comment Here*

246ebf68e35743f62e5e187891b9cba0

(21420)

on May 04, 2012
at 03:01 PM

Thanks for the response Dave - I should say I'm more concerned Wikipedia would be a great source for Common Wisdumb health information, ala WebMD. Because of that, I would say you are right about the reduced water intake - add that to a ketogenic diet and you might be setting yourself up for kidney stones due to the increased oxalates from meat AND not enough water to dilute those oxalates... although I'm still quite skeptical of it being any function of ketosis, insofar as it is a side effect from two factors of protein and lack of water.

100fd85230060e754fc13394eee6d6f1

(18696)

on May 08, 2012
at 02:45 PM

Yes, I suspect that the major reason is the enforced dehydration. In that population, it can be prevented with potassium citrate supplementation.

3
1d952d225819b0229e93160a90bf9bf8

on May 04, 2012
at 01:29 PM

My girlfriend passed stones when she initially went gluten free.Was a one time thing,never happened again.She thinks her body was house cleaning.I never had the problem,but I can see where it would be possible.

3
Baa413654789b57f3579474ca7fa43d7

(2349)

on May 04, 2012
at 01:27 PM

There are different types of kidney stones that apparently have different causes. For example, calcium stones seemed to be linked to foods high in oxalate, where as uric acid stones are linked to high protein diets See here: http://www.mayoclinic.com/health/kidney-stones/ds00282/dsection=causes

In addition, most of what I've read suggests that no matter what you eat, a principle underlying cause is usually chronic dehydration. In other words, drink lots of water and you shouldn't have a problem.

Finally, I'm not a doctor, but I'm pretty sure it takes a lot longer than a week to form a kidney stone.

This study, which examined soldiers deploying to Kuwait, found a mean time of 93 days to form a stone in a hot desert environment. http://www.ncbi.nlm.nih.gov/pubmed/15711293

Sounds like it was just a coincidence that the dietary switch coincided with the kidney stone.

2
4886d3390cb1de913ecc198e72cc072c

on May 04, 2012
at 04:51 PM

Another theory is eating foods too high in oxalates can cause some people to have kidney stones. Foods like sweet or regular potatoes have very high levels of oxalates. Many people get immediate relief when changing their diets to Low Oxalates Diet (LOD).

2
7d3a7b532811b6cfa2de09acdf52d145

(610)

on May 04, 2012
at 02:47 PM

I was just reading some stuff about vitamine D, and found some stuff about kidney stones. Vitamine D seems to raise the chance of giving you kidney stones by 17%. Also eating too acidic (too much meat/grains and too little vegetables/fruit) will increase the chance: http://www.vitamindcouncil.org/news-archive/2006/vitamin-d-and-kidney-stones/ So eating the normal diet will have caused it more probably then the paleo diet.

Vitamine K2 might help to prevent it: http://www.preparemd.com/supplements-vitamins-categories-information/vitamin-k2-mk7-reduced-heart-attack/

And make sure you don't overdo in one of the vitamins, imbalancing like overdoing in vitamin D and not enough vitamin A can also cause things like kidney stones: http://vitamindwiki.com/tiki-index.php?page=Masterjohn%20on%20Tufts%20and%20vitamin%20A%20D%20and%20K%20%20April%202009

Medium avatar

(1029)

on May 04, 2012
at 03:43 PM

I too have read about large doses of D increasing chances of stones (but not if you are merely getting rid of a deficiency). But I spoke to my urologist and the way to determine if D is contributing to causing the stones is to check your calcium level. If it is normal then D is not the culprit.

1
C4ed6ba382aed2eefc18e7877999a5de

(1579)

on May 04, 2012
at 02:28 PM

Here's a good article from the Perfect Health Diet. http://perfecthealthdiet.com/?cat=89 Was your sister ketogenic? It could be that she would do better with some sweet potato and maybe a little fruit.

1
7bf306ada57db47547e9da39a415edf6

(11214)

on May 04, 2012
at 02:14 PM

I've been paleo for at least three years. It isn't the paleo diet. People do tend to carry much less water around- indeed a lot of SAD people look like they have edema- so perhaps the switch simply made her condition manifest itself, but that's the extent of it.

1
63a390e394971bd87e12b706fdb8456e

(309)

on May 04, 2012
at 01:47 PM

Mine occurred when I was eating a vegetarian/vegan diet, and since going Paleo for almost a year, I haven't had any issues with my kidneys, including any UTIs which used to plague me for years. My diet is actually high in oxalates, but from my research, oxalates are produced by our bodies and only 10-15% accumulates because of our dietary intake. Kidney stones cannot be developed in a matter of a week. I know someone who has had one in her kidney for many years (she has biannual ultrasounds to moniter it). They don't give off pain or discomfort until they move/pass. I definitely would credit whatever the diet was before her switch to Paleo.

0
C8f9f471e86a6184568eb61a669dd36a

on February 19, 2013
at 08:58 AM

i know this may seems old to post.

but i think the cause of kidney stones is due to high levels of oxalates. that is when calcium and iron is combined and forms into crystals

the crystal stones grow bigger thus making the liver and kidneys take time and harder to receive nutrition for the body.

theres a list of food to eat and to avoid that has high levels of oxalates.

0
91e4a98f47dbf20f34cc1f52fbf0799b

(0)

on October 19, 2012
at 06:29 AM

9 years ago I was diagnosed with kidney stones and after undergoing lithotripsy (blasting them externally with sound waves) to break them small enough to pass through my system, the stones were collected and analysis revealed they were uric acid stones. I had been on the Atkins diet for less than 1 month before this occurred. I learned that excess uric acid in your system is caused by the ingestion of foods that breakdown into purines. The worst offenders are organ meats of any kind, anchovies, tuna and gravies. Other common foods that are moderate in purines (and part of any protien based diet) include chicken, beef, turkey, legumes, spinach, shellfish and tofu and should only be eaten in small amounts, like 2-3 ounces at a meal. The list of purine laden foods is quite extensive and its very difficult to maintain a healthy diet and lose weight if you are trying to limit your intake of purines. My liver could not tolerate a medication (allopurinol) that was available that might have reduced the output of purines. So I had to opt for the low purine diet for a couple of years. If your kidney stones were severe like mine, its a trade-off that you have to decide to make. There are some foods that I simply don't eat because its not worth the risk of precipitating a stone. I switched nephrologists about 6 years ago and my urine output is now monitored twice a year and sent for analysis. I've only precipitated 1 very small stone in the past 5 years. I am always very careful to balance my protien and carbs with lots of vegetables that are low in purines (some like spinach, peas and cauliflower are higher) and some fruits.

0
C7ee22f0c92ebb052894010c373ca31f

(85)

on September 24, 2012
at 02:05 PM

two weeks after going paleo I had my very first kidney stone attack. Unfortunately the stone crumbled in the ureter so they weren't able to analyze it, but what seems to be the overall consensus with those involved is that I probably had the stone for a long time in my kidney and changing my diet finally made my body healthy enough to purge the stone rather than cause the stone. Just the week before my attack my dad had his kidney removed because so many stones had accrued in his kidney that they pretty much shut it down completely and weren't able to be removed. I'm glad to have mine out of my system.

0
Af3e3615beba642bcafd0f21d64d74f7

on May 05, 2012
at 08:04 AM

1 week in is NOT ENOUGH TIME to develop stones, PERIOD. And that doctor is clearly misinformed.

0
31e596e3f9a1b3970357d5aa4e36054f

on May 05, 2012
at 07:19 AM

Its great to have this site that talks about kidney stones. Kidney disease is known to be the silent killer because its symptoms are not quite obvious. Which makes it one of the top 10 leading causes of death. If you want to know more about kidney disease, here's a link http://diseasedietcentral.com/

-1
0ccb4e629414e1a2745089acf2a86c48

on September 24, 2012
at 01:49 PM

It s actually a great and useful piece of info. I am glad that you simply shared this helpful information with us. Please stay us up to date like this. Thank you for sharing.

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