Vitamins & Supplements Home Related to Vitamins & Supplements Diet & Weight Management Study: Vitamin D Supplements May Not Raise Risk for Kidney Stones However, researchers found age, weight and gender are factors By Mary Elizabeth Dallas THURSDAY, Oct. 17 (HealthDay News) -- If fear of kidney stones is preventing you from using vitamin D supplements, a new study could ease your mind. Taking vitamin D does not increase the risk for kidney stones, the study found. People's age, gender and weight, however, may play a role in developing the condition. Previous research suggested that adequate levels of vitamin D might help protect against a number of diseases, including certain forms of cancer. "Our results may lessen concerns by individuals about taking vitamin D supplements, as no link was shown between such supplementation and an increased risk for kidney stones," study leader Cedric Garland, of the University of California, San Diego School of Medicine, said in a university news release.
The new study used data on more than 2,000 adults of all ages. After following the participants for 19 months, researchers found that only 13 people reported being diagnosed with a kidney stone during that time. The study, which appears Oct. 17 in the American Journal of Public Health, did show that being older or having a higher body-mass index (BMI) were both risk factors for this condition. BMI is a measurement of body fat based on height and weight. Men also are at greater risk for kidney stones than women, the study found. But vitamin D users are not, it suggested. "Mounting evidence indicates that a vitamin D serum level in the therapeutic range of 40 to 50 [nanograms per milliliter] is needed for substantial reduction in risk of many diseases, including breast and colorectal cancer," said Garland, an adjunct professor with the division of epidemiology in the department of family and preventive medicine. Garland added that supplements typically are needed to achieve this blood level of vitamin D.
People with a higher BMI need more vitamin D to gain its health benefits, he said.If you’ve ever had a kidney stone, you surely remember it. The pain can be unbearable, coming in waves until the tiny stone passes through your urinary plumbing and out of the body. For many, kidney stones aren’t a one-time thing: in about half of people who have had one, another appears within seven years without preventive measures. Preventing kidney stones isn’t complicated, but it does take some determination. Kidney stones form when certain chemicals become concentrated enough in the urine to form crystals. The crystals grow into larger masses (stones), which can make their way through the urinary tract. If the stone gets stuck somewhere and blocks the flow of urine, it causes pain. Most stones occur when calcium combines with one of two substances: oxalate or phosphorous. Stones can also form from uric acid, which forms as the body metabolizes protein. Preventing kidney stones means preventing the conditions that support their formation.
I asked Dr. Melanie Hoenig, an assistant professor of medicine at Harvard-affiliated Beth Israel Deaconess Medical Center, for the top ways to prevent kidney stones. Here are her recommendations: Drink plenty of water: Drinking extra water dilutes the substances in urine that lead to stones. Strive to drink enough fluids to pass 2 liters of urine a day, which is roughly eight standard 8-ounce cups. It may help to include some citrus beverages, like lemonade and orange juice. The citrate in these beverages helps block stone formation. Get the calcium you need: Getting too little calcium in your diet can cause oxalate levels to rise and cause kidney stones. To prevent this, make sure to take in an amount of calcium appropriate to your age. Ideally, obtain calcium from foods, since some studies have linked taking calcium supplements to kidney stones. Men 50 and older should get 1,000 milligrams (mg) of calcium per day, along with 800 to 1,000 international units (IU) of vitamin D to help the body absorb the calcium.
Reduce sodium: A high-sodium diet can trigger kidney stones because it increases the amount of calcium in your urine. So a low-sodium diet is recommended for the stone prone. Current guidelines suggest limiting total daily sodium intake to 2,300 mg. If sodium has contributed to kidney stones in the past, try to reduce your daily intake to 1,500 mg. This will also be good for your blood pressure and heart. Limit animal protein: Eating too much animal protein, such as red meat, poultry, eggs, and seafood, boosts the level of uric acid and could lead to kidney stones. A high-protein diet also reduces levels of citrate, the chemical in urine that helps prevent stones from forming. If you’re prone to stones, limit your daily meat intake to a quantity that is no bigger than a pack of playing cards. This is also a heart-healthy portion. Avoid stone-forming foods: Beets, chocolate, spinach, rhubarb, tea, and most nuts are rich in oxalate, and colas are rich in phosphate, both of which can contribute to kidney stones.
If you suffer from stones, your doctor may advise you to avoid these foods or to consume them in smaller amounts. For everyone else, particular foods and drinks are unlikely to trigger kidney stones unless consumed in extremely high amounts. Some studies have shown that men who take high doses of vitamin C in the form of supplements are at slightly higher risk of kidney stones. That may be because the body converts vitamin C into oxalate. Related Information: Eat, Drink, and Be HealthyIn gloomy winter months it’s not just the warmth of the sun’s rays you miss — you may also suffer lower levels of vitamin D, the sunshine vitamin.Vitamin D is important for bone health — low levels are linked to fractures in adults and rickets in children. Last week, a report by the NHS advisory body the National Institute for Health and Care Excellence (NICE), said more people should be given vitamin D tablets to counter a hidden epidemic of deficiencyLast week, a report by the NHS advisory body the National Institute for Health and Care Excellence (NICE), said more people should be given vitamin D tablets to counter a hidden epidemic of deficiency
, with ten million people across England possibly affected.Many thousands rely on supplements on prescription to ensure their levels are adequate. Two years ago, the country’s chief medical officers highlighted the need for vitamin D to be given to pregnant and breastfeeding women, children under five and the elderly.Prescriptions soared as a result. However, NHS figures suggest the majority are being made up not with supplements licensed for medical use, but with food supplements that are not subjected to the same rigorous controls.Indeed, 59 per cent of the 190,000 prescriptions issued in England every month for vitamin D are being made up with unlicensed products, according to NHS Prescription Cost Analysis data for 2013.Experts warn this could lead to patients getting the wrong dose — they may continue to be deficient or end up with too much vitamin D (which leads to more calcium being absorbed from the gut, raising the risk of bone pain and kidney stones).‘It’s outrageous that unlicensed vitamin D products are prescribed when licensed ones are available,’ says Dr Peter Feldschreiber, a medical barrister and author of The Law And Regulation Of Medicines.‘
Patients are being put at risk because there’s no quality control. 'With a licensed medicine, all its ingredients are known, have been tested and their safety at the stated dose confirmed. 'But the content of unlicensed vitamin D products can vary hugely.’Some provide just 8 per cent of the stated dose, while others deliver 201 per cent, according to research published in Nutrition Health and Aging in 2013. Two years ago, the country’s chief medical officers highlighted the need for vitamin D to be given to pregnant and breastfeeding women, children under five and the elderly. Prescriptions soared as a resultDr Feldschreiber, a former senior medical assessor with the Medicines and Healthcare products Regulatory Agency (MHRA), says a sample analysed for a different study found ‘one product had only 14 per cent of the stated dose while another had 171 per cent’. The number of vitamin D prescriptions has risen by 8,000 per cent since 2008.The problem is that prescribers have only six licensed medicines at their disposal and they do not come in every dosing permutation, says Dr Brian Curwain, a clinical scientist and independent pharmaceutical consultant.
Licensed products come in doses of 800, 3,200, 10,000 and 25,000 international units. So when a GP writes a prescription for 1,000 units, that can be filled only by an unlicensed product.‘If the pharmacist wants to dispense the licensed 800 unit medicine instead, he’d have to ask the doctor if the prescription can be amended,’ says Dr Curwain. ‘Community pharmacists are often too busy, so the unlicensed product is dispensed.’He is also concerned that food supplement manufacturers can change the formulation of their product without notice.‘It looks the same, but the ingredients may include something you’re allergic to,’ he says.The Royal Pharmaceutical Society says the situation is ‘worrying’. So why does it continue?Surprisingly, licensed medications are 50 per cent cheaper than unlicensed products, says Dr Feldschreiber. The problem is that while licensed medicines fall within the MHRA’s remit, food supplements do not. Yet the Food Standards Agency claims they are not its responsibility, either.
A spokesman for the MHRA said: ‘NHS prescribing policy and practice is the responsibility of the Department of Health.’Meanwhile, a spokesman for the Department of Health said: ‘Where there is no licensed product to meet a patient’s needs, it is appropriate that prescribers can prescribe another product.’In its first draft of its new guidance in May, NICE made no mention of the importance of filling vitamin D prescriptions with licensed medicines, a decision that was criticised by the Royal Pharmaceutical Society.In its latest guidance, it urges the Department of Health to work with manufacturers to ensure licensed vitamin D products containing the recommended nutrient intake are available on prescription and supplements should undergo quality checks to ensure they contain the correct dose.However, there is no mention of who is responsible for carrying out such checks on the unlicensed ones on sale in the High Street.The good news is that from next year two additional licensed products — one of 400 units and another of 25,000 units — will be available.