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Gabriel identifies stone type (calcium oxalate most common 80%, uric acid 10%, struvite—infection stones, cystine—rare genetic) and addresses root cause.
Gabriel identifies stone type (calcium oxalate most common 80%, uric acid 10%, struvite—infection stones, cystine—rare genetic) and addresses root cause. Protocol: 1) Adequate hydration (most important—2.5-3L fluid/day, urine should be pale yellow), 2) Dietary modifications based on stone type, 3) Address metabolic abnormalities (24-hour urine collection identifies specific risk factors), 4) Citrate supplementation (prevents stone formation), 5) Support gut health (Oxalobacter formigenes), 6) Consider medical expulsion therapy or lithotripsy for large stones, 7) Prevent recurrence (50% recur within 5 years without intervention). Prevention is key—addressing root cause prevents future stones.
Standard Treatment
Acute stone: Pain management (NSAIDs, opioids), Medical expulsion therapy (tamsulosin—Flomax for stones 5-10mm), Hydration, Strain urine; Stone removal (if large or not passing): Extracorporeal shockwave lithotripsy (ESWL), Ureteroscopy with laser lithotripsy, Percutaneous nephrolithotomy (for large stones); Prevention: Increase fluid intake, Dietary modifications, Thiazide diuretics (for hypercalciuria), Potassium citrate (for hypocitraturia), Allopurinol (for hyperuricosuria), Antibiotics (for struvite stones).
The Problem
Acute pain management: opioids effective but addictive, constipation (worsens pain), NSAIDs effective but GI/kidney side effects, Medical expulsion therapy (tamsulosin—Flomax): effective for stones 5-10mm (increases passage 65-90%) but side effects (dizziness, orthostatic hypotension, retrograde ejaculation), not helpful for stones <5mm (pass spontaneously anyway) or >10mm (too large), Lithotripsy (ESWL): non-invasive but only 70-90% success (some stones don't break, fragments may not pass, may need repeat procedure), discomfort, hematuria, flank bruising, steinstrasse (stone street—fragments obstruct ureter, requires additional procedure), not effective for all stone types (cystine resistant), Ureteroscopy: invasive (scope through urethra), risks (ureteral injury, stricture, infection, bleeding), expensive, Thiazide diuretics for hypercalciuria: effective (reduce calcium excretion) but side effects (electrolyte imbalances, dizziness, increased uric acid—can cause gout, erectile dysfunction), Allopurinol for hyperuricosuria: effective (lowers uric acid) but side effects (rash, GI upset, rare severe reactions—Stevens-Johnson syndrome), Conventional doesn't emphasize: hydration (most important—many patients not counseled adequately, goal 2.5-3L fluid/day), dietary calcium adequate (paradoxically protective—low calcium diet increases stone risk, but many patients told to avoid calcium), 24-hour urine collection (identifies specific metabolic abnormalities, guides targeted treatment—often not ordered, generic advice given instead), potassium citrate supplementation (proven to reduce recurrence 50-80%—underutilized, often not offered), magnesium supplementation (binds oxalate, reduces absorption), gut health (Oxalobacter formigenes—bacteria that degrades oxalate, often depleted after antibiotics, restoring may help), natural stone breakers (Chanca Piedra—traditional herb, some evidence effective), Many patients suffer recurrent stones without proper prevention: 50% recur within 5 years without intervention, yet prevention often inadequate—generic 'drink more water' advice insufficient, need 24-hour urine collection to identify specific risk factors, targeted dietary and supplement interventions based on results—dramatically reduces recurrence, Stone composition guides prevention (calcium oxalate vs uric acid vs struvite require different approaches)—stone analysis critical, catch and analyze any passed stones.
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Whole food supplements by Standard Process
What's Included
Standard Process + Matter peptides
Hydration MOST IMPORTANT: 2.5-3 liters fluid/day (goal: urine output >2L/day, pale yellow urine), drink water throughout day, increase fluids in hot weather or with exercise, lemon water (citrate prevents stones), For calcium oxalate stones (80% of stones): adequate dietary calcium 1000-1200mg/day from food (binds oxalate in gut, prevents absorption—paradoxically protective, low calcium diet increases stone risk), avoid calcium supplements unless with meals, reduce high-oxalate foods (spinach, rhubarb, beets, swiss chard, almonds, cashews, chocolate, tea—if hyperoxaluria on 24-hour urine), increase citrate (lemon juice, orange juice, citrus fruits—alkalinizes urine, prevents crystallization), moderate animal protein (limit to 6-8 oz/day—high protein increases calcium and uric acid excretion), reduce sodium <2300mg/day (high sodium increases calcium excretion), adequate magnesium (nuts, seeds, whole grains, leafy greens—binds oxalate), For uric acid stones: low-purine diet (limit red meat, organ meats, shellfish, beer), alkalinize urine (eat more fruits and vegetables, potassium citrate), limit animal protein, For struvite stones (infection stones): treat underlying UTI, For cystine stones (rare genetic): high fluid intake 4L+/day, alkalinize urine, limit animal protein, General: adequate calcium from food, increase fruits and vegetables (alkalinize urine, provide citrate), limit salt, moderate protein, adequate hydration, avoid excessive vitamin C supplements, avoid excessive fructose (increases uric acid), limit sugar-sweetened beverages (increase stone risk), Coffee and tea paradoxically protective (despite oxalate in tea—fluid intake likely protective), Beer and wine in moderation may reduce risk (diuretic effect), grapefruit juice increases risk (avoid).
Hydration critical: drink 2.5-3L fluid/day (10-12 cups), spread throughout day, drink extra in hot weather or with exercise, urine should be pale yellow (dark yellow or amber means inadequate hydration), set reminders to drink water, carry water bottle, Prevent stone passage complications: if stone <5mm likely passes spontaneously (90% pass within 4 weeks), stay active (movement helps stone pass), strain urine (catch stone for analysis), medications for medical expulsion therapy (tamsulosin—Flomax, alpha-blocker relaxes ureter, increases passage rate 65-90% for stones 5-10mm, NSAIDs for pain), adequate pain control (passing stones extremely painful—don't suffer, use pain medications), hydration (paradoxically helps stone pass), For stones >10mm or failing to pass: lithotripsy (shockwave therapy—breaks stone into smaller pieces, 70-90% success, outpatient procedure, some discomfort), ureteroscopy (scope through urethra to bladder to ureter, retrieve or break stone, 90-95% success, outpatient), percutaneous nephrolithotomy (surgical removal through small back incision—for large stones >2cm, more invasive), Prevention after first stone CRITICAL (50% recur within 5 years without intervention): 24-hour urine collection (identifies specific metabolic abnormalities—guides targeted treatment), adequate hydration (most important), dietary modifications based on stone type, potassium citrate supplementation (proven to reduce recurrence 50-80%), magnesium supplementation, treat underlying conditions (gout, hyperparathyroidism, metabolic syndrome, recurrent UTIs), Weight loss if overweight (obesity increases stone risk), avoid rapid weight loss (increases uric acid), Treat underlying conditions: hyperparathyroidism (surgery if indicated), gout (lower uric acid), recurrent UTIs (increase stone risk—prophylactic antibiotics if needed), metabolic syndrome (weight loss, diet, exercise), Monitor: repeat imaging (ultrasound or CT) as indicated, repeat 24-hour urine after treatment changes (assess effectiveness).
Mind, Body & Spirit
True healing requires addressing all dimensions of health. These evidence-based practices complement physical treatment protocols.
Breathing exercises and mindfulness for acute stone passage pain.
Behavioral strategies to ensure adequate daily fluid intake for prevention.
Dietary acid load affects bone and kidney health despite stable blood pH
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