Published: December 2, 2021 | 6 mins read
How to Combat Calcium Oxalate Kidney Stone Growth
The current assumption of most medical professionals is that calcium oxalate stones cannot dissolve. However, that is not the case. We recently came across a study investigating how calcium oxalate stones can actually dissolve inside the kidney.
So today’s blog will discuss the events leading to calcium oxalate stone formation. The primary purpose is to explain each step of the process so we can stop these stones from forming in the first place.
Understanding Calcium Oxalate Stones
There are two main sub-types of Calcium Oxalate stones. These are Calcium Oxalate Monohydrate (COM) and Calcium Oxalate Dihydrate (COD) stones.
COM is the most common type of stone in the United States. About 80% of the stones that are out there are COM stones. These stones are very, very dense. Notably, they appear cylindrical, circular, oval-shaped, or like a teardrop. Also, they are dark in color and hard in texture.
On the contrary, COD appears pale yellow, with a flat bottom but very spiky on the other sides. It looks like a hedgehog lying down on the ground. These stones are much less dense and have a higher degree of propensity to dissolve in the body while passing.
Surprisingly, all calcium oxalate stones start with a COD nucleus. And there are six events leading to this stone formation.
During this first event, particles, like oxalates, calcium ions, phosphate, etc., are floating around in your urine. Then, carbonated calcium will bind with oxalates, together with oxygen and two hydrogen atoms to produce a COD crystal.
Now, it is essential to know why these particles are floating around in the first place. This is what we call urine supersaturation. Think about putting sugar or salt into a water solution. If you put just enough in, you won’t have any little particles floating at the bottom or around inside the water. However, when you put too much in, you’ll start to see those floating crystals at the bottom of the glass. This is supersaturation, meaning the solution cannot absorb any more of the materials you’re putting in it. And that is where kidney stones, especially calcium oxalate stones, develop. It cannot develop without urine supersaturation. Thus, this is one of the things that we need to start fixing.
One thing we can do to combat this is limit the amount of oxalate-containing foods we eat. You can check our Oxalate Content in Foods PDF here for a comprehensive list of what to avoid in your diet. This will mostly solve the problem for most people. We can ingest more calcium and increase our hydration to move this stuff out of our system as often as possible.
In event two, the COD crystal will act like a magnet for more COD particles in your urine. The COD particles floating around will start sticking to this crystal, so it will begin to grow.
Again, these COD particles are due to the foods that we eat. Oxalate-rich foods such as leafy greens are among the notorious culprits. The body never utilizes oxalates so they go directly to our urine where they bind with calcium ions. That’s why we advise to eliminate oxalates in your diet. There are those out there who champion a low-oxalate diet (oxalate intake is less than 80mg daily). But, based on our experience, this is not enough due to the cumulative nature of oxalate. If you think you need professional help on your diet, you can check our Coaching Program here.
Moving into event three, the COD crystal starts to get eroded by much more dense COM crystals. More oxalates present in your urine is still the reason, and that’s because you eat green salads every single day or are in the habit of muching on potato chips or chocolate bars.
Unlike COD, COM is composed of only one hydrogen atom. These crystals are denser and more stable than COD. COM crystals will stick to the COD crystal, making it grow larger.
In event four, calcium oxalate starts to chip away from the dihydrate core. And then, on top of that, the monohydrate crystals pile on, and they start to layer. These layers form over time as the crystal gets continuously bathed in supersaturated urine.
The shape of the COM stone is somehow circular or oval, like a teardrop. This is due to the way it forms. This type of stone forms in the kidney’s calyx (cup-like structures) or pelvis (expanded upper end of the ureter), and it’s just floating around, like all these particles in suspension in the urine.
In general, the shape of a kidney stone depends on where it is formed in the kidney. And free forming ones, like COM, form cylindrical shapes. Meanwhile, those stones tucked away in a pocket or a nephron form edges or irregular shapes.
Interestingly, the dihydrate core starts to dissolve, making the center an empty void. It won’t completely go away, though. Sometimes, it completely disappears, and a pure COM stone remains. But often, you’ll see a mixed stone type with a dihydrate core but a hard exterior of COM.
Rings continue to build over time and then at one point, when the dihydrate core dissolves, it’ll start to get filled in by more COM. Thus, we will begin to see a pure COM stone.
Cutting the Root of COM Stones
Troubleshoot these stones when they’re still in the most susceptible stage. Because as they start to get layers of COM rings, things begin to get tough.
Again, urine supersaturation is the start of any COM stones. So if we can address urine supersaturation, we can eliminate or severely slow down the process of calcium oxalate stone formation.
You can do this by eliminating dietary oxalates, increasing calcium intake, and increasing your water intake up to 96 oz. daily. This will help you produce a urine output of 2.5 liters, which the American Urological Association (AUA) recommends. Also, don’t hold in your urine!
Introducing potassium citrate into your diet can help combat kidney stone formation too. The most bioavailable sources of potassium citrate are whole foods and herbs. Our body only recognizes natural citrate and not synthetic ones.
That’s why we only use naturally occurring citrate from organic lemons in our product, CLEANSE. There are many supplements out there that use synthetic forms of citrate. You’ll recognize synthetic citrate because they are simply labeled as it is – “potassium citrate.”
If you’re looking for more information on how you can combat calcium oxalate kidney stones, check out our Diet and Kidney Stones blog/video.