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Calcium dilemma

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Itake a medication (for epilepsy) that makes me prone to kidney stones. I know one should take 600 mg of calcium daily, but won't that make me more likely to form kidney stones? Paul, via email

Since the most common type of kidney stones — calcium oxalate pebbles — are formed when calcium and oxalic acid hook up in urine, your question makes perfect sense. So the answer may sound a little crazy: Calcium pills, taken with meals, actually can be protective. Why? Calcium binds with oxalate in food, which keeps it from getting into the urinary tract.

There are other steps you can take to help prevent kidney stones. The most important is to drink quarts of water. The rule of thumb if you've had a kidney stone is at least three quarts a day (other fluids count, too). Every time you eat, drink a glass of water. Have a glass before you go to bed; if you get up during the night, have another glass. Drink moderate amounts of orange juice, lemonade, coffee, tea, wine and beer, too; all can deter stones. But water is your kidneys' best friend.

Salt is not. Sodium increases calcium in urine, which ups your chance of stones. Skip highly processed “salt bombs”: fast food, canned soups/vegetables, deli meats, pre-made frozen dishes, pizza, hot dogs, sausage. Grapefruit juice, cola and cranberry juice also may cause trouble. And avoid spinach, rhubarb, nuts and wheat bran; these normally healthy foods increase oxalate in urine, exactly what you don't need.


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