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Information on the latest vitamin D news and research.

Find out more information on deficiency, supplementation, sun exposure, and how vitamin D relates to your health.

Effect of vitamin D supplementation among “kidney stone formers”

“If I have kidney stones, should I take vitamin D?” A recent study looked directly at this question in “stone formers,” who are people with a history of repetitive kidney stones. Dr. David Leaf of Columbia University Medical Center and a group of colleagues from Boston to Portland conducted this study on stone formers, who were also vitamin D deficient. If vitamin D causes kidney stones (a common belief), then how exactly do you treat vitamin D deficient stone formers?

Leaf DE, Korets R, Taylor EN, Tang J, Asplin JR, Goldfarb DS, Gupta M, Curhan GC. Effect of Vitamin D Repletion on Urinary Calcium Excretion among Kidney Stone Formers. Clin J Am Soc Nephrol. 2012 Mar 15.

As the thinking goes, if vitamin D increases urine calcium, then vitamin D is difficult to recommend, as most stone-formers have too much calcium in their urine. However, as the evidence from studies mount proving the benefits of vitamin D, physicians and patients with kidney stones are in a quandary. Should I treat vitamin D deficiency in stone formers or let them stay vitamin D deficient? The question is, does vitamin D increase urinary calcium?

First, the authors reviewed current research on whether physiological doses of vitamin D increase urinary calcium in non-stone formers. They concluded: “Multiple studies have examined the effects of vitamin D among non-stone former and have consistently failed to show an increase in urinary calcium excretion.” That is, in “normals,” vitamin D does not cause kidney stones.

Now their own research. The authors prospectively studied 29 vitamin D deficient stone formers, giving them all 50,000 IU/week of vitamin D2 for eight weeks. They collected multiple lab tests before and after treatment, including the amount of calcium in the urine. The average vitamin D levels before treatment was 17 ng/ml, which increased to 35 ng/ml after the 400,000 IU of vitamin D (50,000 IU/week for eight weeks). Remember this was D2; D3 would have increased vitamin D levels more, in theory.

None of the various measurements of kidney stone formation increased after the 400,000 IU of vitamin D. To quote the authors,

“In conclusion, our results suggest that vitamin D can be repleted in stone formers without causing an increase in urinary calcium excretion. Given the known benefits of vitamin D in maintaining bone health, the potential benefits for cardiovascular, autoimmune, and neoplastic disease, and the findings above indicating it is safe, we feel that vitamin D therapy, if otherwise indicated, should not be withheld simply on the basis of calcium stone disease or hypercalciuria.”

I want to remind readers of what I have written about kidney stones before: chronic acidosis combined with lack of potassium and magnesium in your diet is the most common cause of kidney stones. This line of thinking is based on, among other things, a double blind study on the use of potassium and magnesium in prevention of stones.

Ettinger B, Pak CY, Citron JT, Thomas C, Adams-Huet B, Vangessel A. Potassium-magnesium citrate is an effective prophylaxis against recurrent calcium oxalate nephrolithiasis. J Urol. 1997 Dec;158(6):2069-73.

So, in my opinion, a typical American diet is to blame for many cases of kidney stones; the lack of two minerals in diet (magnesium and potassium) and the lack of adequate fluid intake. If you have ever had a kidney stone, drink eight glasses of water per day and eat lots of vegetables, fruits, seeds, and nuts. As Dr. David Leaf showed, vitamin D is not to blame for your kidney stones.

  About: John Cannell, MD

Dr. John Cannell is founder of the Vitamin D Council. He has written many peer-reviewed papers on vitamin D and speaks frequently across the United States on the subject. Dr. Cannell holds an M.D. and has served the medical field as a general practitioner, emergency physician, and psychiatrist.

7 Responses to Effect of vitamin D supplementation among “kidney stone formers”

  1. Vitamin D might cause Kidney Stones WHEN you have you are taking an excessive amount of calcium. Easy to remember: 500 Calcium and 500 Magnesium
    Most people need to reduce Calcium and increase Magnesium
    See the many studies and graphs at
    http://www.vitamindwiki.com/tiki-index.php?page_id=623

  2. eelisabethpuur@gmail.com says:

    Interesting, here comes patient case no 30.
    But first, please tell me why are they using D2 in all studies?

    I have been a stone former since more than 26 years. I have been through painful stone attacks, horrible laxations for X-rays – I do not want to remember, really. Finaly, the conclusion; I am a cronical stone former, my body can make my urine acid, but might not do so …
    If I collect 24-hour urine, especially the night portion is really loaded with crystals, maybe I should make a new 24 hour collection of urine? just for fun …

    Treatment was/is magnesium, I used our normal prescription-magnesium in Sweden, MgOH + drinking lots of water, at least 3 litres/24 hours. I kept myself stone-free ever since. But when I look back, I might have solved the problem in another way? About twelve years ago, I chained my way of eating, due to an accident, so I now eat a low carb, high fat, paleo style diet with plenty of SFA. I kept on with the water drinking and the magnesium. At least since 1995 I took 800 IU D3 + Ca 1000 mg, in year 2006, I started with 6000 IU D3, was observant about the kidney stones, also I learned that vitamin D would give me more stones! … about 2009, I started taking 50 000 IU D3 once a week.
    I changed my Mg about a yeaar ago, to a dolomite powder, means 3 gram = 5 mL = 660 mg Ca and 390 g Mg
    I take 6 g a day.

    I am still free of the kidney stones. I really do love the “N=1” self expriments, but it´s too painful even to remember, the kidney stones. But my change to a better diet, to the optimal diet might have cured me? Interesting thought.

    But as far as I am concerned, vitamin D3, in high doses do not give me back my kidney stones. I will not stop taking D3, as wonderful things happened to me, thanks to D3 and of course keep up with Mg (+ Ca), as I have a cronical nerve damage problem, that also needs the Mg

  3. steve says:

    eelisabethpuu,

    Is there any chance that you had sleep apnea and you treated it by losing weight with your better diet? There is some evidence that sleep apnea leads to stone formation and you mentioned that you had more stones in your nighttime urine collection.

  4. Tom says:

    Hello,

    Do not forget the primiive dietary inputs of human beings while evolving in the Congo for 5-7 million years. Fifty percent of the diet was fruit, and equatorial fruit contains more potassium citrate and potasium citrate prevents kidney stones.

    ===
    Can lemon juice be an alternative to potassium citrate in the treatment of urinary calcium stones in patients with hypocitraturia? A prospective randomized study
    B Aras, N Kalfazade, V Tuğcu, E Kemahlı… – Urological …, 2008 – Springer

    We suggest that lemon juice can be an alternative in the treatment of urinary calcium stones in patients with hypocitraturia. Additionally, dietary recommendations can increase effectiveness of the treatment.
    ===

    I suspect that stone formers have a higher primitive biological need for natural potassium citrate found in citrus which grows where humans evolved.

    Regards,
    Tom Olenio

  5. eelisabethpuur@gmail.com says:

    First, thank you for comments and new ideas

    Steve, no, no , I do not sleep on my back, I had none och still don´t have any sleep apnea.
    I had no overweight back then. I got these damned kidney stones 1985? I changed my diet because I got my nerve damaged in year 2000, couldn´t move like I did before and when I realised I had put on some weight, I knew I had to do someting, and here comes my lifestyle change, the same year. All I did back in 1985 was to take magnesium. But I think both my parents had kidney stones. Both dead, sorry.

    Tom, I do not know. Maybe I should try to get the results from the tests made, if they still excists? But I made some kind of test, the acidation-test and several 24-hours urine collectings, I do not remember the results, but really very much crystals and not only calcium, that I remember. After I had been in the “stone-cross”, the popular name of Extracorporeal shock wave lithotripsy (ESWL) I learned my lessons and have been free ever since.

    It is very painful and I promised myself, no more laxation, no more X-rays …
    I know I should be more curious , stop taking Mg and see what happens, but I can´t
    My nerve damage gives me cramps and very much extra pain if I do not take my magnesium. In periods I have been taking extra potassium, to minimize the cramps, but not the citrate-form.
    I know that we had potassium citrate as a prescription drug before, maybe I should check it up? try it?

    Thanks, regards Elisabeth

  6. eelisabethpuur@gmail.com says:

    Sorry, also thank you … hlahore@gmail.com
    I will take more Mg, just have to read about which one to buy, what combination, citrate?
    I have spent hours with this dilemma, too many opinions when it comes to Mg

  7. Overview Magnesium and vitamin D is at
    http://www.vitamindwiki.com/tiki-index.php?page_id=947
    It reviews all of the different kinds of Magnesium supplements
    – there are huge differences between them.
    Quick summary: 2 tablets of Magnesium Citrate to get 400 mg (of the Element, not the compound) is pretty good
    If Magnesium Citrate causes loose stools, there are many other forms such as Magnesium Malate
    Avoid the standard Magnesium Oxide – not very bio-available