Published: 16 February 2023
Disclaimer: No material on this website is intended to be a substitute for professional medical advice, diagnosis or treatment. All information provided is for informational purposes only.
Note: This article focuses on calcium oxalate stones.
Kidney stones are no joke! Even the smallest crystals can cause serious havoc to someone’s health and considerably decrease their quality of life.
In the US, about 11 percent of men and 6 percent of women have struggled with kidney stones at least once in their lifetime, with most cases being kidney stones of the calcium oxalate type.
Additionally, according to Roger L. Sur, MD, director of UC San Diego Comprehensive Kidney Stone Center, “there is a 50 percent chance of getting another stone within five to ten years if you’ve already had one.”
Low back and side pain, blood in the urine, urination changes, nausea, and abdominal pain are all common symptoms of kidney stones.
In some cases, kidney stones can even lead to blockage of the ureter, the tube that transports urine from the kidneys to the bladder, which can ultimately result in an infection.
It is imperative to seek medical attention if you encounter any of these symptoms, especially in case of fever. Proper diagnosis is key in order to better understand the nature of the stone and treat any possible infection.
That being said, success is the sum of small efforts and many researchers agree that unsweetened lemonade might be a beneficial ally for those who silently suffer from the sharp pains of clusters of crystals.
Lemonade Therapy : The Power of Citric Acid
Lemonade therapy is a preventative measure that aims at treating patients that are prone to kidney stones with citric acid, a natural inhibitor of kidney stones that can be found in citrus fruits, especially lemons and limes.
Indeed, according to Penniston et. al. (2008), “lemon and lime juice, both from the fresh fruit and from juice concentrates, provide more citric acid per liter than ready-to-consume grapefruit juice, ready-to-consume orange juice, and orange juice squeezed from the fruit.”
So how does it work?
Well, citric acid essentially has the potential to raise urine citrate which can not only bind to urinary calcium but also bind to calcium oxalate crystals, thus preventing their growth.
In terms of efficacy, a study conducted by Sur reveals that drinking four ounces of lemon juice diluted in two litres of water every day significantly decreases the rate of stone formation (going from 1.00 to 0.13 stones).
Interested in making your own blend? It’s as simple as 1, 2, 3!
Unsweetened Lemonade: Just What The Doctor Ordered!
This recipe, by experts Marshall Stoller, Steven Nakada and David Kang, calls for 2 main ingredients: water and lemon (or lime) juice. You can enjoy it unsweetened or add a little sweetener to cater it to your liking. It is, however, recommended to stay away from sugar to avoid the extra calories.
The ratio of water to lemon may vary from one recipe to another. I recommend starting with 1/2 cup of lemon juice for 7 cups of water if you have a very sensitive stomach.
Ingredients:
1 cup of concentrated lemon and/or lime juice
7 cups of water
(Optional) Honey or sweetener of your choice
(Optional) Lemon slices
Directions:
Add all the ingredients into a large pitcher or bottle and mix well. Drink throughout the day.
The RACGP (Royal Australian College of General Practitioners) also have their own recipe for lemonade therapy, which calls for “30 mL of real lemon juice, 190 mL of water and sweetener to taste”. They recommend drinking 2 to 3 glasses every day in an attempt to help prevent kidney stones.
Did you know? Hypertension and diabetes mellitus “are both independently associated with higher risk of developing kidney stones.”
Additional Steps To Consider For Optimal Results
- Cutting down on salty foods
One of the main things to consider when dealing with kidney stones is sodium intake. Why? Because a diet high in salt can lead to increased calcium excretion in the urine, which turns out to be the most common identifiable cause of calcium kidney stone disease.
The obvious culprits are foods such as chips, fries, fast food and processed meats, but there are also less apparent offenders such as packaged meals, sports drinks, cheese and some pasta sauces.
To cut down on your sodium intake, consider using fresh herbs and spices to help flavour your meals. Also avoid food products that list salt or sodium (including MSG) as one of their first five ingredients.
The Dietary Guidelines for Americans “recommends adults limit sodium intake to less than 2,300 mg per day.” For reference, that is equivalent to a single teaspoon of table salt! If you are age 51 or older or are dealing with chronic kidney disease, it is best to limit your daily sodium intake to 1,500 mg or less.
- Drinking enough water
Staying well hydrated is an essential part of the process. By increasing your water intake, you help to dilute the substances in your urine that contribute to kidney stone formation.
If you are well hydrated, your urine should appear very light yellow to clear. In an article for Harvard Health Blog, Daniel Pendick recommends drinking “enough fluids to pass 2 liters of urine a day, which is roughly eight standard 8-ounce cups.”
Avoid soft drinks at all cost, especially colas acidified with phosphoric acid, which has been associated with “urinary changes that promote kidney stones.”
If you find yourself getting bored of plain water, try alternating with unsweetened, sparkling water. You can also add lemon or lime slices to it for added benefits.
As mentioned by Stoots et al. (2021), “patients with kidney stone disease should be aware that the mineral content of water may influence stone formation and be mindful of the great variation that exists between different water brands.” According to the authors, “water with high bicarbonate content, for example, might be beneficial regarding kidney stone formation.”
- Eating calcium-rich foods
According to the National Kidney Foundation, “people with the lowest dietary calcium intake have an increased risk of kidney stones”. Therefore, despite having kidney stones made up of calcium, it is actually beneficial to consume products that contain calcium.
It all boils down to the ability of calcium to bind to oxalate before it reaches the kidneys, thus preventing the formation of further kidney stones. In other words, you have less chances of the oxalate binding to urinary calcium as oxalate concentrations in the urine are lowered.
- Limiting animal protein intake
Eating high quantities of animal proteins such as meat, seafood and eggs can significantly increase the risk for kidney stones due to the production of a more acidic urine.
In order to limit animal proteins, the NIDDK recommends integrating more plant-based sources such as “beans, dried peas, and lentils.”
- Avoiding foods rich in oxalate (or eating them in moderation in combination with calcium-rich foods)
High-oxalate foods such as beets, spinach, chocolate and peanuts can all contribute to kidney stone formation and should be avoided as much as possible, especially if you are trying to pass a kidney stone.
If you are struggling to keep chocolate out of your diet, try opting for a piece of chocolate with a glass of calcium-fortified plant-based milk (such as oat milk) to help restrict oxalate absorption. As for almond and cashew milk, Borin et al. (2021) recommend avoiding both as they “have more potential stone risk factors”.
Tea, particularly black tea, is also high in oxalate. However, a study published in 2013 reveals that drinks such as coffee, tea and orange juice were all associated with lower risks of kidney stones, as opposed to sugar-sweetened soda and punch which were linked with a higher risk of stone formation. For tea drinkers, there is also the option of enjoying a cup of herbal tea which usually has lower levels of oxalate.
- Maintaining movement and a healthy weight
As expected, regular physical activity and weight management play an important role in kidney health. In fact, a 2020 study suggests that people who get plenty of physical activity may be less likely to develop chronic kidney disease. If you are currently dealing with kidney stones, consider walking more often as it may help the stone to pass.
“There have been studies indicating an independent association between visceral obesity and kidney stone formation,” although it remains difficult to determine the range of impact it has on kidney stones due to its numerous co-morbidities.
That being said, it is also worth noting that some weight loss treatments may actually promote kidney stone formation.
Did you know? Hot showers and heating pads can provide natural pain relief for patients dealing with kidney stones.
Hydroxycitrate: A Promising New Therapy
In the last couple of years, another acid has been studied as a potential alternative treatment to citrate for kidney stones.
A 2016 study published in the journal Nature looked into the role of hydroxycitrate in slowing down the growth of calcium oxalate crystals and preventing further stone formation.
Scientists discovered the acid’s ability to dissolve calcium oxalate crystals by binding strongly to their surface, thus causing tension to their structure and releasing both calcium and oxalate.
The study believes that hydroxycitrate’s anticystal effects are more pronounced than that of citrate, with low concentrations of hydroxycitrate performing twice as well as citrate.
Additionally, a 2019 paper further reveals the ability of hydroxycitrate to be metabolized by the human body, thus potentially unaltering urine pH, as opposed to citrate therapy.
Hydroxycitric acid can be found in the rind of Garcinia cambogia, a pumpkin-shaped fruit, native to India and Southeast Asia.
Garcinia cambogia is used as a condiment and food preservative in many Asian countries. It also serves as a “flavourant in fish curries due to its sharp sour taste” and has been used as an appetite suppressant for centuries in Southeastern Asia.
The rind of Garcinia cambogia also appears in folk medicine to help manage several ailments including “piles, constipation, edema, rheumatism, intestinal parasites, and irregular menstruation.”
If you seem to have symptoms of kidney stones or someone you love is suffering from a similar condition, immediately seek medical care. Talk with your health care providers about any complementary health approaches you use.
