Monday, December 11, 2017
PQQ and CoQ10 reverse mitochondrial dysfunction plus chronic disease symptoms
(NaturalHealth365) We all know that chronic degenerative diseases like, heart disease, type 2 diabetes, Alzheimer’s and stroke are a leading cause of death and disability – throughout the world. For example, in the United States, almost half of all adults suffer from one form or another of chronic disease – and a quarter of all adults suffer from two or more. Yet, we almost never hear Western medicine talk about a major contributor to poor health – mitochondrial dysfunction.
In fact, research has clearly shown that mitochondrial dysfunction – a product of aging (or overexposure to toxins, even inside the womb) – is a common thread uniting all of these deadly conditions. The good news is that a pair of nutrients – CoQ10 and PQQ – can effectively combat these health problems by protecting and even regenerating the body’s store of indispensable mitochondria.
Lifesaving NEWS: Researchers have found that mitochondria dysfunction threatens our quality of your life and can be repaired
Mitochondria are tiny structures inside cells that are responsible for breaking down nutrients and creating power and energy. Each human cell contains between 2 and 2,500 of these organelles, but their numbers decrease and their functionality wanes with age. In fact, researchers have found 50 percent more mitochondrial damage in the brain cells of people over 70, as compared to those of middle-aged individuals.
To be clear: your general health, energy level – and even the length and quality of life itself – are strongly linked to the amount of existing mitochondria, and how efficiently they work. Obviously, it is desirable to increase the number, status and survival of these tiny cell structures.
But how, exactly, do we do this?
Research has so far revealed two ways to boost mitochondrial health: rigorous physical exercise and calorie restriction of the type achieved by intermittent fasting. Unfortunately, not everybody has the inclination, willpower or physical ability to do this consistently.
As it turns out, there just might be an easier and more practical way to support mitochondrial health. And, a substance called PQQ is the key.
PQQ may comprise a virtual “fountain of youth”
Coenzyme pyrroloquinone quinone, or PQQ, is a vitamin-like essential micronutrient with powerful antioxidant capabilities. PQQ not only assists mitochondria in creating bioenergy, but it protects them from destructive oxidative stress. In addition, it is a powerful growth factor, working with other enzymes to promote the growth, development, differentiation, and longevity of cells.
In animal studies, researchers have found that being deprived of dietary PQQ causes stunted growth, immune system defects, impaired reproductive capability and fewer mitochondria in cells and tissues. When the deficiency was corrected, these effects were reversed.
In addition to protecting mitochondria from oxidative damage caused by free radicals, PQQ actually promotes mitochondrial biogenesis. This means that the nutrient is capable of helping the body regenerate fresh mitochondria, thereby reversing cellular aging and theoretically prolonging life – an amazing benefit.
Neuroprotective PQQ prevents Alzheimer’s disease and supports memory function
Studies have shown that PQQ protects memory and cognition, while helping to shield the brain against the effects of environmental toxins such as mercury. In fact, PQQ has been shown to reverse cognitive impairment caused by oxidative stress.
In addition, this hard-working enzyme combats chemicals that may trigger neurodegenerative diseases. Studies have shown that PQQ halts the formation of alpha-synuclein and beta-amyloid, two proteins strongly associated with Alzheimer’s disease.
Clinical trials support PQQ’s potential for improving cognition, memory and mood. A double-blind clinical trial published in Functional Foods in Health and Disease showed that 20 mg a day of PQQ improved cognition in middle-aged and elderly participants – as well as increasing vigor and reducing fatigue, tension, anxiety, depression and confusion.
PQQ’s potent antioxidant properties also give it the ability to suppress ischemia-reperfusion injury, a type of damage to brain tissues that occurs after a stroke.
PQQ evaluated as “superior” to prescription medication in preventing heart attack-related damage
And PQQ’s lifesaving benefits don’t stop with the brain. Preserving and enhancing mitochondrial function helps heart muscle cells resist oxidative stress, thereby supporting heart health and helping to ward off heart attack.
The enzyme also helps to prevent ischemia-reperfusion injury after a heart attack has occurred – regardless of whether it was given before or after the event.
When it comes to preventing reperfusion damage, studies have shown that PQQ works in a way similar to metoprolol, a pharmaceutical beta blocker typically administered after a heart attack.
In fact, in a study performed at the VA Medical Center at UC San Francisco, PQQ outperformed metoprolol in increasing mitochondrial energy-producing functions, reducing lipid peroxidation and protecting mitochondria from reperfusion injury – leading researchers to note the clear superiority of PQQ over the conventional medication.
Where does CoQ10 fit into the picture?
CoQ10, another vitamin-like enzyme that helps to convert fuel into energy, has long impressed researchers with its beneficial effects. Like PQQ, CoQ10 is credited by scientists with the ability to optimize and facilitate mitochondrial function – and it is often used to reduce risk of heart attack and heart failure.
When combined, the two enzymes are synergistic – meaning each potentiates the effects and benefits of the other. For example, in one study, researchers noted significant improvements in cognition for participants given 20 mg of PQQ a day. But when a dosage of 300 mg of CoQ10 was added, the results went from “significant” to “dramatic.”
How can I make PQQ and CoQ10 work for me?
Foods that are particularly rich in PQQ include organic fruits and vegetables such parsley, papaya, kiwi fruit, tofu and green peppers – to the tune of 2 to 3 micrograms per 100-gram serving. You can also obtain roughly the same amount from a 4-ounce serving of green tea.
CoQ10 is found in grass-fed beef, sardines and organ meats such as liver – as well as in organic cruciferous vegetables such as broccoli and cauliflower.
Both PQQ and CoQ10 are also available as supplements. Integrative healthcare providers tend to recommend dosages ranging from 10 to 20 mg per day for PQQ, and 60 to 400 mg per day for CoQ10. If you are interested in supplementing, we suggest you talk to a trusted medical professional to help figure out what’s best for you.
This “dynamic duo” of coenzymes is being credited by researchers for helping ward off virtually all the killer chronic diseases that threaten human health. As a bonus: PQQ and CoQ10 may also help you jumpstart your metabolism and (obviously) improve your overall energy levels – not a bad pay-off for simply ingesting these two safe, natural nutrients.
Editor’s note: The NaturalHealth365 Store offers the most comprehensive, plant-based formula to support mitochondrial function and performance. Click here to order today!
*And, yes, your purchase helps to support our operations at NaturalHealth365. Thank you.
Sources for this article include:
The Dark and Light Side of Food As Information (Dietary RNAs Directly Impact Gene Expression)
Posted on: Sunday, December 10th 2017 at 3:00 pm
Written By: Sayer Ji, Founder
This article is copyrighted by GreenMedInfo LLC, 2017
New insights in biology show that food is informational and can directly impact and even control the expression of your genes. The implications of this discovery are profound, and have both a light and dark side in need of deeper exploration...
A new study published in the journal BMC Genetics entitled, “Plant miRNAs found in human circulating system provide evidence of cross kingdom RNAi,” reveals that powerful little diet derived nucleic acids known as microRNAs (miRNAs), from commonly consumed plants, are present within the human circulatory system in what appear to be physiologically significant quantities. MiRNAs are comprised of ~ 22 nucleotide single strand non-coding RNAs, which regulate protein coding gene expression by interfering with messenger RNA’s ability to transcribe DNA into protein. This is why miRNAs are sometimes called RNA interference molecules.
The study found,
“...abundant plant miRNAs sequences from 410 human plasma small RNA sequencing data sets. One particular plant miRNA miR2910, conserved in fruits and vegetables, was found to present in high relative amount in the plasma samples. This miRNA, with same 6mer and 7mer-A1 target seed sequences as hsa-miR-4259 and hsa-miR-4715-5p, was predicted to target human JAK-STAT signaling pathway gene SPRY4 and transcription regulation genes.”
This discovery has profound implications, as the human JAK-STAT signalling pathway has a wide range of potential downstream effects. In fact, JAK-STAT transmits information from extracellular chemical signals to the cell nucleus resulting in DNA transcription and expression of genes involved in immunity, differentiation, proliferation, apoptosis -- all of which relate to cancer risk and oncogenesis. But this is just the tip of the miRNA iceberg. There have, in fact, been hundreds of these miRNAs identified in commonly consumed foods in the agrarian diet, and they appear to have the ability to match up with hundreds of human gene targets. The implications of this are profound, if not possibly devastating when it comes to GMO food technology.
It is now widely accepted among conventional biologists that miRNAs regulate most of the protein coding genes in mammals. In fact, the profound difference in complexity between higher life forms such as humans relative to, say, earthworms, is attributable to the higher level of RNA complexity within the so-called 'dark matter of the genome' (the ~ 98.5% of the human genome that does not code for proteins).
But what research like this brings to the table is the even more provocative possibility that our genetic and epigenetic wellbeing may be wholly dependent on miRNAs existing outside of us within the gene-regulatory miRNAs embedded within our diet.
Can you imagine the difference between an evolutionarily conserved ancestral diet and a modern one comprised of synthetic components and highly processed GMO cereal grasses?
The New Epigenetic/Nutritional Paradigm: Cross-Kingdom Communication
The idea that the plants and animals we eat contribute to modulating the expression of our genome is known as cross-kingdom or inter-species genentic communication, and represents a significant departure from the classical view that the genetic infrastructure of species were closed off, hermetically sealed within the cell nucleus, and could not be accessed epigenetically from the outside in. We've moved from this atomistic, monadistic view to an open access one, where miRNAs operate like software upon the hardwired protein-coding sequences within a species' genome, making for a much more complex and interdependent web of relationships, reminiscent of the Gaian concept of a biospheric interconnectivity between all the biotic elements of the Earth. As I discuss in another article,
"...this more "open access" model would permit species to alter and affect another's phenotype in real-time, along with potentially altering its long-term evolutionary trajectory by affecting epigenetic inheritance patterns. This speaks to a co-evolutionary and co-operative model, with all areas of the tree of life, co-developing in a highly complex and seemingly highly intelligent, carefully orchestrated manner."
And so, if plant derived miRNAs can survive cooking and digestion, as appears to be the case, and can accumulate in physiologically significant quantities, they will therefore alter gene expression, introducing the novel concept that mammalian genomes may have, in fact, evolved to outsource some of their regulation to nutrigenomic dimensions within their dietary milieux.
This, of course, has profound implications, such as validating the concept that an evolutionarily appropriate diet -- e.g. Paleo diet -- would help to assure the optimal expression of the human genome. Conversely, the use of RNA interference technology by biotech corporations, such as Monsanto/Dow’s newly EPA approved RNAi corn, could have biologically devastating consequences to the health and wellbeing of those fed or exposed to its altered miRNA profiles. To learn more about this concerning possibility, read (and please share) my report: The GMO Agenda Takes a Menacing Leap Forward with EPA’s Silent Approval of Monsanto/Dow’s RNAi Corn
In a previous report, we discussed the profound implications of this research in understanding how food not just a source of caloric energy and molecular building blocks, but is also a source of potent gene-regulatory information.
For further information on the implications of this research to human nutrition, physiology, and medicine, read our previous articles on the topic:
- Amazing Food Science Discovery: Edible Plants 'Talk' To Animal Cells, Promote Healing
- Genetic Dark Matter and the Return of the Goddess
- Are MicroRNAs from Plants the Future of Healing with Food?
Sayer Ji is founder of Greenmedinfo.com, a reviewer at the International Journal of Human Nutrition and Functional Medicine, Co-founder and CEO of Systome Biomed, Vice Chairman of the Board of the National Health Federation, Steering Committee Member of the Global Non-GMO Foundation.
Sunday, December 10, 2017
The Importance of Electromagnetic Field Remediation In the Treatment of Chronic Disease
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- According to Dr. Dietrich Klinghardt, women should take drastic steps to lower their EMF exposure during pregnancy to reduce the risk of having an autistic child
- Microwave radiation from cellphones, Wi-Fi routers and similar devices concentrate twentyfold in the womb, meaning whatever the reading is outside the womb, the measurement will be 20 times higher inside the mother
- Klinghardt found the average exposure of an autistic child to high frequency electric fields from household currents and microwaves from cellphones and other wireless technologies was twentyfold higher than that of the non-autistic children
- Nonionizing cellphone microwave radiation has also been linked to Alzheimer’s and infertility, especially in men, both of which, like autism, are rocketing skyward in terms of prevalence
- One of the best strategies is to eliminate exposure to ELF electric fields during sleep, as this is a most important time for your brain. Details on how to do this, as well as many other remediation strategies, are discussed
By Dr. Mercola
Electromagnetic fields (EMFs) are one of the most pernicious threats to your health. The question is, how do you limit your exposure to healthier levels? Dr. Dietrich Klinghardt, one of my longtime mentors, was instrumental in educating me about the influence of EMFs on health. Klinghardt, who founded the Sophia Health Institute1 in 2012 where he's still actively involved in the treatment of patients, will not even take you on as a new patient unless you agree to address your EMF exposure. He's that convinced of its influence.
In Germany, which is where Klinghardt hails from, they’ve been using beneficial pulsed EMF for healing purposes since the late 1800s. Even in high school, they were made aware of the fact that disease-causing EMFs created by high power lines, high magnetic fields, and microwave signals were hazardous to health.
"We were made aware that we shouldn't sleep next to an electric outlet; that we should not have any lights close to our bed or electric alarm clocks. That was already known in the 1960s," Klinghardt says. Once Klinghardt took up residence in the U.S., that background knowledge sort of fell by the wayside — until he began working with autistic children. At that point, the reality of EMF and its health effects came back to the fore.
"I was looking at this incredible crisis in autism and I started treating autistic kids in the late ‘90s and went to the medical meetings, the biomedical approaches to treat. What was entirely missing in those conferences was the aspect of electromagnetic fields that the child is [experiencing],” he says.
Excessive EMF Exposure During Pregnancy Raises Risk of Autism
Klinghardt conducted a pilot study in which he evaluated the EMF present in the bedroom where the mother slept during pregnancy. It turned out the average exposure of an autistic child to high frequency EMFs from household currents and microwaves from cellphones and other wireless technologies was twentyfold higher than that of the non-autistic children. Unfortunately, the study never made it into publication, but it convinced him that EMFs were an unacknowledged factor that contributes to autism.
Another study cited by Klinghardt shows that microwave radiation from cellphones, Wi-Fi routers and similar devices concentrate twentyfold in the womb, meaning whatever the reading is outside the womb, the measurement will be 20 times higher inside the mother. As noted by Klinghardt, “Unfortunately, the membranes around the womb have that strange effect in significantly concentrating the ambient EMFs that the mother is in, reaching levels that are not sustainable for human development.”
The real-world impact of EMFs is also evident in his clinical practice, as families with autistic children who take EMF remediation report seriously significant improvements. These findings have also made Klinghardt passionate about warning would-be parents about the importance of avoiding EMFs during pregnancy to reduce the risk of having an autistic child. Unfortunately, Americans have been slow to grasp the importance of such advice.
US Needs to Take EMF Exposure Seriously, Before It's Too Late
According to Klinghardt, Russia and Iran have some of the strictest rules governing the amplitude of cellphone radiation.
"My brother sent this [video] to me (and I have a Russian colleague working with me) of a lecture that Putin gave to his assembly [where he] basically said, 'We do not need to go to war with America. America is committing collective suicide by the way they are using electricity. We just have to wait until they are all in the psychiatric hospital.' That was Putin pretty much verbatim translated …
[Putin] wants Russia to be a strong nation again, and so he is doing it differently. He is doing it by limiting the electromagnetic exposures, knowing it's going to create a whole different crop of children that are going to grow up to be intelligent, to be leaders in the world, to be scientists.
[The U.S. is] a dying nation, basically, because of the way we are fluoridating the water, the way we have adapted the vaccine program, the electro-smog. We've created a perfect storm to dumb down a whole nation."
But autism is not the only problem exacerbated by uncontrolled EMF exposure. This kind of nonionizing radiation has also been linked to Alzheimer’s and infertility, especially in men, and all three of these problems are rocketing skyward in terms of prevalence. At their current trajectories, society as we know it will eventually cease to function.
The Threat of Human Extinction Is All Too Real
According to Klinghardt, Barrie Trower, a leading scientist for the British MI6, explored the effects of microwaves on human health by exposing children living in orphanages to various frequencies and levels. This research was later brought into psychiatric hospitals, where they discovered you can sterilize an entire population by exposing them to 2.4 gigahertz (GHz) — the same carrier frequency now used in Western countries for cellphone services.
“It's estimated that over two or three generations of exposure, ongoing exposure to the same cellphone radiation that we're using now, we will all be sterile and we will basically die out as a species,” he says. Klinghardt also cites research by Olle Johansson2 (whom I interviewed in 2008), a neuroscientist and tenured professor at the Karolinska Institute in Sweden, in which he found that areas with the highest density of Alzheimer’s disease in Sweden were directly correlated to the areas with the highest EMF exposures.
Johansson has issued warnings about cellphone radiation for over a decade now, and has come under intense pressure to resign from Karolinska, as the cellphone industry has threatened to withdraw its funding to the institute if he remains. Johansson is currently asking for private donations to continue his work on EMF.3
Practical Nighttime Remediation Strategies
One of the best prevention strategies I've found so far is to eliminate exposure to extremely low frequency (ELF; frequencies in the 50 to 60 Hz range) electric and magnetic fields during sleep, as this is a most important time for your brain. During deep sleep, your brain's glymphatic system is activated, allowing it to detoxify and eliminate accumulated waste products, including amyloid-beta proteins, which are a hallmark of Alzheimer's disease.
In most areas, the only way to do that is by turning off the electricity to your bedroom by flipping the circuit breaker. Exceptions include Chicago and New York, as the building codes there require all electrical wires to be in a conduit. As a result, if you live in either of these places, all you need to do is unplug your electronic equipment. You do not have to turn off your electricity, which makes it a whole lot easier to remediate EMF.
If you are ill or pregnant, you'd be wise to follow Klinghardt's stricter recommendation, which is to shut down electricity in the entire house — with the exception of your refrigerator, air conditioning or heating, and any essential medical equipment — not just the circuitry in your bedroom. Klinghardt explains:
"Electric fields are very funny. You can switch off the electric field in your bedroom and have it on two rooms away, and through induction, the field can still jump from one circuitry to the next one and you can still be in a really bad field. We are talking about body voltage — that's sort of what builds up in your system when you're in a field of the low-frequency, the 60 Hz field from a household current. At nighttime, we want the fuses off …
[I]f possible, spend a few hundred dollars and get a remote switch installed properly, so that from your bed you can click a button and it switches off the fuses at the fuse box. That's No. 1. Secondly, [if] you are in an apartment building and you have people below, next to you, above you, my first line of advice is to move if possible.
If it is not possible, you can create a protective wall against the neighbor simply by using aluminum foil, the sparkly, more shiny side toward the neighbor. The entire wall needs to be covered.
You can also do that with the floor toward the person below you, but it needs to be earthed. There needs to be an alligator clip on it … conducted into the wall outlet into the earth. This works beautifully [against] microwaves — [blocking] the cellphone router that the neighbor has underneath you, above you, next to you …
The earthing is for the low-frequency fields (low-frequency emitting devices). It's a practical solution we often have to do because it costs at best one or two rolls of aluminum foil, plus a cable from RadioShack, so you can do that for less than $20 …"
The Worst Culprits Are Right Inside Your Own Home
It’s important to realize that if you have a Wi-Fi router, you have a cellphone tower inside your home. Ideally, you’d eliminate your Wi-Fi and simply use a wired connection. If you absolutely must have a router, you can place it inside a shielded bag when not in use. You can find shielded items online, or make your own using Swiss Shield fabric.
Be aware that some other forms of radiation can be very difficult to shield against. This includes frequencies in the 400,000 Hz range that police and fire departments are using. If you live close to a police or fire station and have developed health problems since you moved in, moving would be your best option, as this wavelength is virtually impossible to shield with any known technology. For most people, however, the worst exposure is your household electrical currents, your cellphone (when not in airplane mode) and Wi-Fi router.
Another important point to remember is that EMF will affect you regardless of whether you actually feel it or not. Those who are electrosensitive are physically aware of their exposure, but regardless of sensitivity, the disease rates are the same. On average, a person will experience biological effects from a cellphone at a distance of 12 feet.
Using a meter, I discovered I was still exposed to unhealthy levels at a distance of 30 feet, so when I'm not using my cellphone, I always keep it in airplane mode and/or inside a Faraday bag.
According to Klinghardt, the degree to which patients report improvement of their conditions directly correlates to their EMF mitigation efforts. Those who report no improvement at their four-month checkup have done little or nothing to mitigate their exposure, whereas those who report significant improvements have taken proactive steps. "It's black and white," he says.
Reducing your EMF exposure during the daytime is trickier, as most of us need to use electronics during the daytime, and move about in areas that are Wi-Fi enabled. For seriously ill patients, Klinghardt recommends using Stetzer filters to decrease the level of dirty electricity or electromagnetic interference that being generated. You can also take these with you to work.
Also reconsider your use of compact fluorescent light (CFL) bulbs, as they emit microwaves. "Every (CFL) lightbulb is like a small cellphone tower emitting at those frequencies, which is absolutely devastating to the health of people," Klinghardt says. "Those need to go and they need to be replaced with the old (incandescent) light bulbs.
They are safe. They cost more in electricity, but the cost to health that people have by [using] CFLs is a million times more than what you save on electricity.” Light-emitting diodes (LEDs) are also best avoided.
As for internet, opt for a wired Ethernet connection and remove your Wi-Fi. When not in use, make sure your cellphone is in airplane mode and/or inside a shielded Faraday bag. When you do use a cellphone, you can reduce your exposure by texting (and keeping it short) or using Blue Tube (air tube) headphones so you can keep the phone further away from your body. Avoid wearing a Bluetooth earpiece and standard headphones, as they conduct the electric field right into your brain through your ears.
"In general, people should go back and insist on having land lines in their homes and at work and use that as much as possible. Only use the cellphone as an emergency device or for texting," Klinghardt says. "Lastly, there's the protective clothing. LessEMF.com is a good website that has all of that, including the full burqa …
[T]here are very attractive T-shirts, there is underwear. That's the minimum I require of my patients with neurological disease and autistic kids; they need to wear that 24/7, and that has made a huge difference … By protecting your larger part of the body with the T-shirt, you get more benefits for your brain than when, for example, you wear a [shielded] cap on your head."
How EMF Causes Harm
EMFs cause harm through a number of different mechanisms. As explained by Klinghardt, the radiation affects your microbiome, turning what might otherwise be beneficial microbes pathogenic. Research by Martin Pall also shows that microwave radiation activates your voltage-gated calcium channels (VGCCs) — channels in the outer membrane of your cells.
Once activated, the VGCCs open up, allowing an abnormal influx of calcium ions into the cell. This increased intracellular calcium and the accompanying increase in calcium signaling appears to be responsible for a majority of the damage that occurs. For more details on this, please see my previous interview with Pall. For this reason, natural calcium channel blockers such as magnesium can be helpful against EMF exposure, and it’s important to make sure you’re not magnesium deficient.
Magnesium threonate appears particularly beneficial as it acts as a potent anti-retroviral agent. Klinghardt recommends taking it to bowel tolerance, meaning you increase the dosage until you get slightly lose stools. For his patients, he always combines it with 12X calcium phosphate (calcium phosphoric), a homeopathic that helps modulate the calcium channels.
Environmental Impacts of EMF
Klinghardt also notes that electro-smog plays a significant role in the disappearance of bees and other crucial pollinators — that in combination with toxic pesticides and herbicides. And, as beneficial insects die off, disease-bearing ticks become more prevalent, as they turn out to be rather insensitive to cellphone radiation.
"The devastating thing is that what controlled the tick population in the past was birds. Birds eat ticks, but birds cannot live on ticks alone, they need all the other insects, and so there's been a dramatic disappearance in songbirds and insect-eating birds," Klinghardt says. "There's a dramatic reduction of [insects], but only where there's exposure to microwaves. We have German footage that shows trees, whole forests, dying just because a cellphone tower was put up.
The cellphone radiation, the way it's used right now is completely against life and it's compounded by the heavy metals that are in us, especially the aluminum that comes from the sky and from the air we breathe. We know that the glyphosate and atrazine and other herbicides, pesticides, along with [food] preservatives, all have a compounding effect in our body.
We have basically created a perfect storm, which we can still by eating organically, and by avoiding certain things, certain environments …"
I have become firmly convinced uncontrolled EMF exposure is a major, hidden factor that contributes to virtually all chronic disease, and hinders recovery. Klinghardt's clinical experience supports this view, as patients rarely get well unless or until they start taking EMF remediation seriously.
Keep in mind that if you are ill, simply reducing your cellphone use from several hours a day to just a few hours is not likely to go far enough. You really need to take more drastic steps to limit, and ideally eliminate electric and magnetic field exposure, at least at night.
Saturday, December 9, 2017
A Primer on Chronic Fatigue Syndrome
Posted on: Monday, January 12th 2015 at 1:15 pm
Written By: Courtney Craig
This article is copyrighted by GreenMedInfo LLC, 2015
With over a million Americans diagnosed Chronic Fatigue Syndrome it is important to identify natural solutions to alleviate suffering....
[Editor's note: this excellent review did not identify the role of retroviruses in CFS/ME syndrome. For a deeper appreciate for their role in the pathogenesis of CFS/ME read the book Plague, or listen to Greenmedinfo.com founder Sayer Ji's interview of its co-author, Judy Mikovits, PhD, on Fearless Parent Radio.]
Chronic Fatigue Syndrome, or CFS, is a serious illness with a terrible name.
CFS has been described as the flu that never goes away. Throughout the rest of the world, CFS is more accurately named Myalgic Encephalomyelitis, or ME. Many patients and clinicians have now adopted the combined term ME/CFS, with the belief that the name Chronic Fatigue Syndrome has the potential to cause harm to patients (1). Labeled with this diagnosis, patients are frequently dismissed from doctor's offices under a psychiatric cloud, or erroneously told to exercise back to health. However, the defining characteristic of ME/CFS that differentiates it from other conditions, depression included, is post-exertional malaise. A simple bout of mental or physical activity can trigger flu-like symptoms in patients with lasting effects.
Imagine a trip to the mailbox being enough to confine you to bed for the rest of the day ... or longer.
Despite growing numbers stricken -1 million Americans - research funding for the disease has remained paltry for nearly 3 decades. Many in mainstream medicine still do not accept the illness as organic, and all too often malign it with psychosomatic or conversion disorders. Worse still, many patients are not accepted by family or loved ones.
Is it any wonder then that a leading cause of death in this group of patients is suicide? (2)
Fatigue alone does not even begin to describe what a patient with ME/CFS experiences on a daily basis. Lack of understanding leads to onlookers assuming laziness, de-conditioning, or simply over-work. Yet, the fatigue felt has been compared to the level of fatigue experienced by end-stage cancer or HIV/AIDS patients. Severely debilitating symptoms afflict those with the illness: cognitive problems, pain, irritable bowel, autonomic dysfunction, sleep disturbance ... the list goes on. The larger impact of this illness is that disability due to ME/CFS is estimated to cost $9.1 billion in lost productivity every year in the US (3).
Research has not been able to pinpoint the exact cause or trigger for ME/CFS. A diagnostic marker remains elusive. However, many unique physiological signatures have been determined. As an example, abnormal cytokine and immune cells are hallmark findings (3). Certain cytokine patterns are thought to drive sickness behaviors and contribute to hypersensitivity to pain. Most patients also have limited natural killer (NK) cell number and function. This finding may be associated with increased rates of certain cancers in patients as well as harboring of opportunistic infections. Finally, patients have limited cardiopulmonary capacity and blood flow irregularities. These findings may explain the intolerance to exercise and depressive symptoms due to poor cerebral profusion (4,5).
Is It Autoimmune?
While not classically defined as an autoimmune disease, there are striking similarities between ME/CFS and conditions such as Multiple Sclerosis. In fact, as many as 60% of patients have a comorbid autoimmune diagnosis (6). The chronic or recurring viral infections common in many patients can induce autoimmunity by molecular mimicry and bystander activation (6). Similar to autoimmune conditions, viruses can flip a switch on the immune system leading to loss of "self" recognition. Others note the onset of illness following a vaccination, suggesting an autoimmune (auto-inflammatory) syndrome induced by adjuvants (7).
Is It In The Cells?
Many ME/CFS patients mind their mitochondria — the vitally important energy supply house of the cell. Numerous studies have demonstrated mitochondrial insufficiency in patients which is likely due to a vicious cycle of oxidative stress (8, 15). Inflammatory cytokines and other immune cells propagate reactive oxygen species that damage cellular membranes, myelin, and mitochondria. As a consequence, studies have noted severely depleted CoQ10 in patients suggesting mitochondrial dysfunction. This finding also supports the epidemiological evidence that ME/CFS patients are more prone to develop cardiovascular diseases, since CoQ10 is vital for heart health. Some reports have found congestive heart failure can occur 25 years earlier in ME/CFS patients than in the general population (8).
Is It In The Brain?
Advanced imaging studies in ME/CFS found widespread neuroinflammation in several key brain regions including the cingulate cortex, hippocampus, amygdala, thalamus, midbrain, and pons. Inflammation in these areas was 45%-199% times higher in ME/CFS patients than in healthy controls. Interestingly, the degree of neuroinflammation directly correlated with symptom severity (9). Larger studies are underway to determine which inflammatory marker is driving the vicious cycle of inflammation. At the moment, all eyes are on leptin. Leptin measured daily in a small cohort of patients was found to correlate with the degree of neuroinflammation. This inflammatory molecule released from fat tissue, can activate microglia in the brain which promotes neuroinflammation (10).
Still other studies have shown that ME/CFS patients have reduced white matter and abnormalities in gray matter, potentially offering additional clues to explain the cognitive difficulties and brain fog patients endure. Lastly, a recent study showed reduced Brain-Derived Neurotrophic Factor (BDNF) in ME/CFS patients that was far greater than in MS patients suggesting an obstacle in neurogenesis and plasticity (11).
Is It In The Gut?
Acclaimed virus hunter Dr. Ian Lipkin has launched a crowd-funded project to study the microbiome in ME/CFS. Putting aside the idea of viral etiology, Lipkin and his team at Columbia hope to find a unique dysbiotic signature in these patients (http://www.microbediscovery.org/). An exciting 2013 study in Belgian and Norwegian patients, found altered intestinal microbiota that may be linked to the pathogenesis of the illness (13).
Other researchers are also thinking about the role of the gut in this illness. A seminal paper from 2014 proposed that the latent viral infections harbored by ME/CFS patients can have major effects on cognitive function due to translocation via the vagus nerve (12). Could it be that viruses or bacteria harbored in the digestive tract of ME/CFS patients can exert effects on the brain using this cranial nerve as passageway?
How To Intervene
Just because ME/CFS remains a medical mystery should not suggest patients have no options for symptom relief. Without a FDA-approved medication for the illness, many patients look to integrative and functional medicine doctors to manage their most severe symptoms. With the information currently available, evidenced-based interventions can be applied.
It Starts With Food.
Undoing the cycle of inflammation can be best addressed by starting with an anti-inflammatory diet. This may provide modest relief of pain or fatigue in many patients. A nutrient-dense diet also provides abundant cofactors to promote energy production at the cellular level. Gut healing dietary strategies can also be utilized to ensure intestinal integrity and immune function. Many patients eliminate known gut irritants such as gluten, dairy, alcohol, and refined sugars (14).
Seldom is diet alone sufficient to make a substantial impact on severe ME/CFS. Most patients rely on a suitcase of supplements with the hope of finding the right combination. While research is slim in this arena, evidence grows for the need for mitochondrial nutrients as well as basic vitamin and mineral cofactors (15). One study showed significant improvement with just 2 months of supplementation with a multivitamin/multimineral (16).
Immune boosting nutrients are commonly utilized to support a healthy immune response, prevent viral reactivation, and improve NK cell function. These include such nutrients as transfer factors, medicinal mushrooms, and curcumin (17). Anti-inflammatory nutrients are also indicated including omega 3 oils, vitamin D, and antioxidants like resveratrol and EGCG.
Mind and Body
Few can relate to the hopelessness that comes from living with a chronic illness for decades. Patients wrestle with the bleak reality that they may never completely recover. Finding hope through healthy attitudes and habits is of vital importance for these patients. Learning to say no, allowing adequate time for rest, and carefully pacing throughout the day are the norm for a patient with ME/CFS (4). Cultivating acceptance and practicing mindfulness provide other tools patients can use to cope. Mindfulness meditation is now accepted as a practice that can impact brain health and reduce the physiological stress response. Mind-body practices help many patients achieve better sleep and promote a deeper level of healing.
Editor's note: this excellent review did not identify the role of retroviruses in CFS/ME syndrome. For a deeper appreciate for their role in the pathogenesis of CFS/ME read the book Plague, or listen to Greenmedinfo.com founder Sayer Ji's interview of its co-author, Judy Mikovits, PhD, on Fearless Parent Radio.
1 Tucker, ME. Does Chronic Fatigue Syndrome Need A New Name? NPR.org. 30 Jan 2014. Retrieved from http://www.npr.org/blogs/health/2014/01/29/268219979/does-chronic-fatigue-syndrome-need-a-new-name
2 Jason LA, Corradi K, Gress S, Williams S, Torres-Harding S. (2006) Causes of death among patients with chronic fatigue syndrome. Health Care Women Int. 27(7):615-26. http://www.ncbi.nlm.nih.gov/pubmed/16844674
3 Lattie EG, et al. (2012) Stress management skills, neuroimmune processes and fatigue levels in persons with chronic fatigue syndrome. Brain Behav Immun. 26(6):849-58. http://www.ncbi.nlm.nih.gov/pubmed/22417946
4 Klimas NG, Broderick G, Fletcher MA. (2012) Biomarkers for chronic fatigue. Brain Behav Immun. 2012 Nov;26(8):1202-10. http://www.ncbi.nlm.nih.gov/pubmed/22732129
5 Fletcher MA, et al. (2010) Biomarkers in chronic fatigue syndrome: evaluation of natural killer cell function and dipeptidyl peptidase IV/CD26. PLoS One. 5(5):e10817. http://www.ncbi.nlm.nih.gov/pubmed/20520837
6 Morris G, Berk M, Galecki P, Maes M. (2014) The emerging role of autoimmunity in myalgic encephalomyelitis/chronic fatigue syndrome (ME/cfs). Mol Neurobiol. 49(2):741-56. Epub 2013 Sep 26. http://www.ncbi.nlm.nih.gov/pubmed/24068616
7 Agmon-Levin N, et al. (2014) Chronic fatigue syndrome and fibromyalgia following immunization with the hepatitis B vaccine: another angle of the 'autoimmune (auto-inflammatory) syndrome induced by adjuvants' (ASIA). Immunol Res. 60(2-3):376-83. http://www.ncbi.nlm.nih.gov/pubmed/25427994
8 Maes M, Twisk FN. (2009) Why myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) may kill you: disorders in the inflammatory and oxidative and nitrosative stress (IO&NS) pathways may explain cardiovascular disorders in ME/CFS. Neuro Endocrinol Lett. 30(6):677-93. http://www.ncbi.nlm.nih.gov/pubmed/20038921
9 Nakatomi Y, et al. (2014) Neuroinflammation in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: An 11C-(R)-PK11195 PET Study. J Nucl Med. 55(6):945-950. [Epub ahead of print]. http://www.ncbi.nlm.nih.gov/pubmed/24665088
10 Stringer EA, et al. (2013) Daily cytokine fluctuations, driven by leptin, are associated with fatigue severity in chronic fatigue syndrome: evidence of inflammatory pathology. J Transl Med. 11:93. http://www.ncbi.nlm.nih.gov/pubmed/23570606
11 Sorenson M, Jason L, Peterson J, Herrington J, Mathews H (2014) Brain Derived Neurotrophic Factor is Decreased in Chronic Fatigue Syndrome and Multiple Sclerosis. J Neurol Neurophysiol S12:S2-013. http://omicsonline.org/open-access/brain-derived-neurotrophic-factor-is-decreased-in-chronic-fatigue-syndrome-and-multiple-sclerosis-2155-9562-S12-013.pdf
12 VanElzakker MB. (2013) Chronic fatigue syndrome from vagus nerve infection: a psychoneuroimmunological hypothesis. Med Hypotheses. 81(3):414-23. Epub 2013 Jun 19. http://www.ncbi.nlm.nih.gov/pubmed/23790471
13 Frémont M, Coomans D, Massart S, De Meirleir K. (2013) High-throughput 16S rRNA gene sequencing reveals alterations of intestinal microbiota in myalgic encephalomyelitis/chronic fatigue syndrome patients. Anaerobe. 22:50-6. Epub 2013 Jun 19. http://www.ncbi.nlm.nih.gov/pubmed/23791918
14 Trabal J., et al. (2012) Patterns of food avoidance in chronic fatigue syndrome: is there a case for dietary recommendations? Nutr Hosp. 27(2):659-62. http://www.ncbi.nlm.nih.gov/pubmed/22732998
15 Myhill S, Booth NE, McLaren-Howard J. (2013) Targeting mitochondrial dysfunction in the treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) - a clinical audit. Int J Clin Exp Med. 6(1):1-15. Epub 2012 Nov 20. http://www.ncbi.nlm.nih.gov/pubmed/23236553
16 Maric, D. et al. (2014) Multivitamin mineral supplementation in patients with chronic fatigue syndrome. Med Sci Monit. 20:47-53. http://www.ncbi.nlm.nih.gov/pubmed/24419360
17 Ellithorpe, RR., et al. (2014) Nutrient supplement enhances natural killer cell function in women with chronic fatigue syndrome and fibromyalgia: Preliminary Report. CLINICAL REPORT FROM THE INSTITUTE FOR MOLECULAR MEDICINE. http://bit.ly/1uy9e6S
First diagnosed with Chronic Fatigue Syndrome at age 16, my academic and career trajectory was fueled by the constant need to understand and overcome the illness. I received my clinical training at Palmer College of Chiropractic, Florida, completed an undergraduate study in exercise science at the College of William and Mary and am currently a nutrition diplomate candidate through the American Clinical Board of Nutrition.
Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of GreenMedInfo or its staff.
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Friday, December 8, 2017
Thursday, December 7, 2017
Calcium Oxalate Kidney and Bladder Stones
Treatment and prevention of calcium oxalate kidney and bladder stones
Article by CJ Puotinen and Mary Straus, published in the Whole Dog Journal, May 2010
- Calcium Oxalate Stones
- From Death Sentence to Discovery
- Water, the Key Ingredient
- Urinary pH
- Oxalates in Food
- Designing the Menu
- Preventive Medical Treatment
- The Stress Connection
- Oxalate Content of Various Foods
- A Stone Glossary
- Another Success Story
- Sample Recipe
Also see these related articles:
- Struvite Crystals & Stones
- Urate, Cystine and Other Less Common Urinary Stones
- Homemade Diets for Dogs
Photo of Leslie Bean with Fuzzerbear
Bladder and kidney stones are serious problems in dogs as well as people. These conditions – which are also known as uroliths or urinary calculi – can be excruciatingly painful as well as potentially fatal. Fortunately, informed caregivers can do much to prevent the formation of stones and in some cases actually help treat stones that develop.
Last month, we described struvite stones. Struvites contain magnesium, ammonium, and phosphate. They almost always occur in the bladder in combination with a bacterial infection and are most frequently found in small-breed females. Also see last month's article for what to watch for that might indicate your dog has stones.
This month, we examine calcium oxalate or CaOx stones.
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Calcium oxalate stones
CaOx stones occur in both the bladder (lower urinary tract) and kidneys (upper urinary tract) of male and female dogs. Most calcium oxalate uroliths are nephroliths (found in the kidney), and most of the affected patients are small-breed males. CaOx uroliths are radiopaque and most are easily seen on radiographs (X-rays).
Twenty-five years ago, struvites were the most common uroliths collected from canine patients, representing almost 80 percent of the total, while only 5 percent were calcium oxalate stones. The percentage of struvite uroliths found has declined while that of CaOx stones has risen, so that nearly half of all canine uroliths analyzed today are calcium oxalate stones. It’s unknown whether the incidence of struvite stones has decreased or if the change is due solely to an increase in calcium oxalate uroliths.
Similar changes have occurred in cats, but in that case, we have a good idea why. Twenty years ago, calcium oxalate stones were virtually unheard of in cats, who commonly formed sterile struvites. In an effort to reduce the risk of struvites, pet food manufacturers began adding urinary acidifiers while reducing the magnesium content of foods. This resulted in a reduced incidence of struvite stones, but calcium oxalate stones developed instead.
In addition to breed and sex, risk factors for CaOx stones include being overweight, under-exercised, neutered, and eating a dry food diet, which contributes to more concentrated urine. Small dogs are thought to be more susceptible because they drink less water relative to their size than large dogs do.
One risk factor is insufficient or abnormal nephrocalcin, a strongly acidic glycoprotein present in normal urine that inhibits calcium oxalate crystal growth. Dogs who produce normal and sufficient nephrocalcin have a reduced risk of developing calcium oxalate stones.
Certain prescription drugs contribute to the formation of CaOx uroliths. Prednisone and other cortisone-type medications prescribed for inflammatory illnesses such as arthritis, itchy skin, or inflammatory bowel disease, can contribute to the formation of CaOx stones. So can the diuretic drug furosemide (brand names Lasix or Salix), which is given to dogs with congestive heart failure. Thiazide-class diuretics are recommended in place of furosemide for dogs who are prone to forming CaOx stones.
Some nutritional supplements, such as vitamins C and D, are believed to contribute to the formation of oxalate stones.
Uroliths can develop in any breed, but the greatest number of calcium oxalate stones presented for analysis have come from Miniature Schnauzers, Bichon Frises, Standard Schnauzers, Lhasa Apsos, Shih Tzus, Yorkshire Terriers, Miniature Poodles, Pomeranians, Parson Russell Terriers, Papillons, Keeshonds, Samoyeds, Chihuahuas, Cairn Terriers, Maltese, Toy Poodles, West Highland White Terriers, Dachshunds, and mixed breeds.
Cocker Spaniels, German Shepherds, Golden Retrievers, and Labrador Retrievers are believed to be at decreased risk of CaOx stones.
In a study published in the American Journal of Veterinary Research in 2001, eight healthy Labrador Retrievers and eight healthy Miniature Schnauzers, all about three years old, were fed the same nutritionally complete dry dog food for 24 days while being monitored for calcium oxalate risk factors. The Miniature Schnauzers urinated significantly less often and had a higher urinary calcium concentration. These observations led researchers to conclude that important differences in urine composition exist between breeds fed the same diet.
Conventional veterinary practitioners tend to consider calcium oxalate stones irreversible, unaffected by diet or medical therapy, and untreatable except by surgery. They may attempt to remove small bladder stones by flushing the bladder with sterile saline, or perform shock wave or laser lithotripsy (processes that break stones into small pieces that can be flushed out or excreted in the dog’s urine). Surgery may not be necessary for stones that are clinically inactive (not growing or causing problems).
Uroliths pose a more serious problem for male dogs than females, because their urine travels through a hollow bone (os penis) that surrounds the urethra within the penis. The bone cannot stretch or expand to accommodate a stone traveling through it, and obstructions readily result.
For males with recurring stones, a surgical procedure called urethrostomy sends urine on a new path, avoiding the os penis. The urethrostomy creates a new urinary opening in the scrotum area. This type of surgery cannot be performed unless the dog is neutered; if he is intact, he can be neutered at the time of the urethrostomy.
In up to 60 percent of conventionally treated patients, calcium oxalate stones recur within three years. In dogs with Cushing’s Disease (hyperadrenocorticism) or excessive calcium in the blood (hypercalcemia), both of which predispose dogs to CaOx stones, the recurrence rate is faster. It’s important to treat these underlying causes, if found, to help prevent recurrence.
The recurrence rate among Bichons is higher than that of any other breed. In a study presented at the 2004 meeting of the American College of Veterinary Internal Medicine, 24 out of 33 Bichons had oxalate stone recurrence after cystotomy. During the first year after surgery, 37 percent of these patients had their first recurrence; by the end of the second year, 57 percent did; and by the end of the third year, 73 percent had at least one recurrence and some had more than one.
Calcium oxalate crystals are of concern, but their presence doesn’t necessarily mean your dog is at risk of forming stones. Crystals are significant only if found in fresh urine. Crystals that form when urine is refrigerated or analyzed more than 30 minutes after collection may be incidental and not indicative of a problem. Dogs with calcium oxalate crystals in fresh urine should be monitored, and if the finding continues, steps should be taken to reduce the risk of stone formation, particularly in breeds most commonly affected.
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From death sentence to discovery
In 1997, Molly McMouse, a 14-year-old Lhasa Apso belonging to Leslie Bean of Houston, Texas, was diagnosed with very dense, inoperable calcium oxalate stones affecting both kidneys. Bean owned three more Lhasas – 15-year-old FuzzerBear, 13-year-old Peepers, and 11-year-old CB Wigglesworth – who were closely related to Molly. Fearful that her other dogs could be afflicted by the same condition, Bean had them tested, too, and was shattered when each received the same diagnosis.
“My husband and I were told that oxalates only proliferate in size and number,” she recalls, “and that as the calcification of their kidneys increased, all four of our dogs would die, probably within six to nine months.”
At the time, Bean was founding director of patient advocacy at the University of Texas MD Anderson Cancer Center, a position that helped her contact medical experts of every description. She checked with veterinarians, veterinary researchers, and directors of veterinary schools and laboratories around the country, only to receive the same sad news from all.
“Every one of them said these stones cannot be dissolved,” she says. “They all felt bad about it, but they agreed that the prognosis for my dogs was hopeless.”
Bean’s Lhasas had been on a premium, holistic food, but after their diagnoses, at the recommendation of their veterinarians, Bean put them on a low-protein, low-phosphorus, low-sodium prescription diet. The dogs disliked the new food and their to-the-floor show coats rapidly dulled.
At that point, Bean says, “I accepted the fact that my dogs were going to die but I wanted to make their final months as terrific as possible.” Tossing the prescription food, she began feeding fresh foods such as lamb and peas, chicken and rice, and beef and broccoli. “I figured if they had so little time, they were damned well going to enjoy what they ate,” she says, “and they loved it. I can still see them singing and dancing with joy when I carried their bowls to their places. Literally within two weeks they began acting more energetic, looked younger, had a spring in their step, and their eyes were clearer. Their coats looked better, too, and we soon had to cut almost an inch in length from each dog every month. Although that is common in young Lhasas in show coat, the rate of growth slows with age, so this was a really noticeable difference.”
Because oxalic acid forms strong mineral bonds that can become calcium oxalate crystals and eventually CaOx stones, Bean speculated that low-oxalate foods might help prevent the stones’ formation (see Oxalates in Food below), and she made those ingredients the foundation of her dogs’ menus.
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In the past, diets restricted in both protein and phosphorus were thought to reduce the risk of calcium oxalate formation. Studies found, however, that dietary phosphorus restriction increased calcium absorption and the risk of calcium oxalate formation, while higher levels of dietary protein reduced the risk of urolithiasis. Current recommendations for dogs prone to forming CaOx stones say that diets should not be restricted in protein, calcium, or phosphorus.
In February 2002, The American Journal of Veterinary Research published a study conducted at the University of Minnesota College of Veterinary Medicine’s Minnesota Urolith Center that compared dietary factors in canned food with the formation of calcium oxalate uroliths in dogs, with surprising results. Canned diets with the highest amount of carbohydrate were associated with an increased risk of CaOx urolith formation. Contrary to commonly accepted beliefs, the study concluded that “canned diets formulated to contain high amounts of protein, fat, calcium, phosphorus, magnesium, sodium, potassium, chloride, and moisture and a low amount of carbohydrate may minimize the risk of CaOx urolith formation in dogs.”
In contrast, both Hill’s Canine u/d and Royal Canin Urinary SO, often prescribed for dogs prone to forming CaOx stones, are extremely low in protein, and restrict calcium, phosphorus, magnesium, and potassium (Royal Canin is less restrictive than u/d). See The Side Effects of Low Protein Diets for more information.
At the beginning of her nutritional experiment, Bean reduced her dogs’ protein levels so much that they began to lose muscle mass.
“After much research, analysis, and discussion with my veterinarians,” she says, “I increased their protein levels to 33-40 percent of the total volume of food. They quickly regained their lost weight and muscle, and there were no further problems with muscle loss.”
As Bean discovered, it’s very important not to reduce protein too much. Even the most severely phosphorus-restricted diets for renal failure recommend feeding a minimum of 1 gram of protein per pound of body weight daily (as determined by a nutritional analysis, not grams of meat).
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As the Lhasas continued to thrive, their primary veterinarian, Jane Milan, encouraged Bean to return them for another ultrasound test to the veterinarian, a specialist in internal medicine, who had first diagnosed them. “I just didn’t want to hear bad news,” says Bean, “so I kept putting it off.”
Eight months after their diet change and past or near their predicted death dates, she made the appointment. “I was really nervous,” she says. “They looked terrific, but I had no way of knowing what was going on inside them. And the vet was with them for an unusually long time, which made me even more anxious.”
Finally the somber-looking veterinarian returned to the waiting room carrying two of the dogs and said, “I don’t know how to tell you this.”
Bean assumed that her other two dogs had died during their ultrasound tests and she nearly fainted, but the vet’s good news revived her. The calcium oxalate stones that had been ticking time bombs were nowhere to be found. That’s what caused the long delay – he could not at first believe his test results. “The two older dogs still had five tiny stones,” she says, “but they had shrunk to the size of pin-dots, and they soon disappeared.”
Despite the kidney damage already caused by their calcium oxalates, each of the already senior Lhasas lived several more years. FuzzerBear died at age 19, the other three lived to be 18, and frequent check-ups showed all four to be completely free from calcium oxalate stones for the rest of their lives.
At the suggestion of their veterinarians, Bean continued to study canine nutrition and assembled a set of guidelines that described her dogs’ regimen.
“I am not a veterinarian licensed to practice veterinary medicine in any state and make no claims or representations as such,” Bean reminds everyone. “I am simply a pet owner whose dogs suffered from intractable problems. I developed FuzzerFood, named for Fuzzerbear, based upon the independent research I conducted to help my own dogs. My discoveries are not intended to be veterinary advice, nor are they a drug, biologic, or other therapeutic or diagnostic substance or technique designed to replace a consultation with a qualified veterinarian.”
She recommends that owners of dogs with calcium oxalate stones work closely with their veterinarians, beginning with a baseline ultrasound, complete blood panel, and urinalysis. “Start now if you have not already,” she suggests, “to maintain records of blood work and urinalysis reports as well as your own notes as you go.”
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Water, the key ingredient
The most important thing you can do for a stone-prone dog is increase fluid consumption and opportunities to urinate. Urine becomes concentrated when insufficient fluids are consumed or when dogs are not able to relieve themselves and have to hold their urine for long periods. And concentrated urine contributes to supersaturation with minerals that can precipitate into crystals and lead to stones.
Update: See The Not So Secret Solution for Urinary Crystals in Pets for a veterinarian's advice: "Special diets limit certain minerals and manipulate the ingredients to create a urine pH (measurement of acidity or alkalinity) that is unfavorable for crystals and stones to form. Those of you with pets that have had multiple surgeries to remove bladder stones are well aware of the limitations of these diets to successfully prevent stone formation. The answer appears to be water, H2O, and more water."
One way to encourage dogs to increase their water consumption is to add salt to their food, but salt is controversial when it comes to calcium oxalate uroliths. Increasing dietary salt encourages the kidneys to excrete more calcium, raising urinary calcium levels.
One might predict that increased sodium would therefore lead to increased calcium oxalate formation, but that isn’t necessarily true. In a 2003 study, dogs were fed dry diets containing varying amounts of sodium. The diets that contained 300 mg sodium (about 1/8 teaspoon salt) per 100 calories significantly reduced urinary calcium oxalate supersaturation over diets containing 60 mg or even 200 mg sodium per 100 calories. Increased fluid consumption resulting from the thirst generated by additional salt probably offset the increase in calcium excretion. A human retrospective study published in 2009 concluded, “Increasing urine sodium does not appear to increase the risk of calcium oxalate nephrolithiasis (kidney stones).”
Bean, however, does not add salt to food. The majority of human studies indicate that adding salt is inadvisable, and many who elected to apply the FuzzerFood regimen for their own dogs were unsuccessful in attempts to dissolve or prevent recurrence of calcium oxalate stones when they departed from the guidelines Bean developed for her own dogs.
You can help your dog drink more by providing fresh water in clean dishes in several locations; changing the water frequently; adding small amounts of tuna water, salt-free or low-sodium broth, a favorite juice, or other flavoring agent to drinking water in addition to offering plain water; adding water to food; offering ice cubes as treats; using a pet water fountain to provide continuously filtered fresh running water; offering water at every opportunity; and carrying water and a portable bowl while hiking or traveling.
What type of water should you use? Bean prefers steam-distilled water because it contains no minerals that might combine with excess oxalic acid. Physicians she consulted with told her that both hard and soft water may increase the risk of calcium oxalate formation. Reverse-osmosis water filters remove 95 percent of minerals, making RO-filtered water nutritionally similar to distilled water.
Not all minerals in water contribute to kidney or bladder stones. In several studies conducted in the 1990s, human patients who formed calcium oxalate nephroliths drank a French mineral water containing high levels of calcium (202 parts per million) and magnesium (36 ppm). Nearly every risk factor for calcium oxalate nephroliths improved significantly. The same patients also drank local tap water and mineral water with low calcium/magnesium concentrations, neither of which improved the measured risk factors. The researchers concluded, “The risk of calcium oxalate stone formation can be significantly reduced by consumption of mineral water which is rich in calcium and magnesium.”
Other research on the effects of hard and soft water on urolith formation has shown mixed results regarding risk, possibly due to variations in mineral content and ratios, along with factors such as whether the water was given with or between meals. For this reason, distilled water may be safest, particularly for dogs with kidney stones or recurrent bladder stones.
Getting extra water into your dog is only part of the urolith-prevention strategy. Just as important is the frequent release of urine. Give your dog many opportunities to go outside during the day. If your dog is indoors alone or crated for hours each day, find a way to create a convenient elimination area using plastic, newspapers, towels, a patch of sod, or whatever you can devise to keep your dog from having to hold her urine for long periods.
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Calcium oxalate stones form in urine that is acidic, typically measuring between 5.0 and 6.5 on the pH scale. Calcium oxalate crystals are generally not sensitive to urinary pH, but marked acidification that induces metabolic acidosis can promote calcium oxalate stone formation due to increased urinary calcium concentration.
A common recommendation for dogs prone to forming calcium oxalate stones is to alkalize the body with foods or medications to bring the urinary pH closer to 7, which is neutral. Alkalizing the urine will not cause existing stones to dissolve but may help prevent new stones from forming. It’s important not to try to alkalize the urine too much, as this can lead to the formation of calcium phosphate stones.
You can monitor your dog’s urine by holding a pH test strip (see Resources) in the stream or by collecting urine in a paper cup or clean dish for testing.
But don’t be surprised if your dog’s urinary pH stays where it is. Leslie Bean describes her careful monitoring of her dogs’ urinary pH as a source of discouragement. “I thought that unless I could bring their pH higher, their stones would increase,” she says. “To the contrary, not only did they not increase, the stones dissolved. I learned that the key is to monitor the pH and know where you are, but not to panic if the urine stubbornly remains more acidic than you would like.”
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Oxalates in food
Oxalic acid is found in both plants and animals, with plants containing higher levels. It forms strong bonds with sodium, potassium, magnesium, and calcium, creating oxalate salts. The term “oxalate” usually refers to a salt of oxalic acid, one of which is calcium oxalate. Sodium and potassium oxalate salts are water-soluble, but calcium oxalate is not, and it is what forms CaOx uroliths.
In recent years interest in low-oxalate diets has increased because of possible links between oxalates and human kidney stones, arthritis, fibromyalgia, female vulvar pain, autism and other pervasive developmental disorders, and chronic inflammation. As a result, there is growing demand for accurate data on the oxalate content of foods.
When Bean began her research 13 years ago, much of the information published about this subject was quite old. Eventually she found a small booklet published by the University of California at San Diego, “Oxalate Content of Select Foods,” which featured more current data and gave her a list of foods to include and avoid.
Today, the Oxalosis and Hyperoxaluria Foundation (see Resources) publishes an up-to-date list of foods and their oxalate content. Based on research from 2008 and revised as new figures become available, this report divides foods into very high, high, medium, and low levels of oxalates according to serving size (see Oxalate Content of Various Foods below).
The foods in Group 1 (very high-oxalate foods) are best avoided by dogs prone to calcium oxalate stones. Group 2 (high-oxalate) foods should also be avoided:
Group 3 foods have moderate oxalate levels. They can be fed in moderate amounts as long as calcium is also given with the meal. Group 4 (low-oxalate foods) are “green light” ingredients, and can be fed in any quantity, though they should still be combined with calcium. See the complete list, available through the Oxalosis and Hyperoxaluria Foundation (see Resources) for information about additional foods, including herbs, spices, combination foods, and beverages.
Some websites and publications incorrectly list meat, liver, other organ meats, shellfish, cheese, yogurt, broccoli, sardines, cherries, Brussels sprouts, olives, and strawberries as dangerous for CaOx-sensitive dogs, based on outdated information. All of those foods are actually low in oxalates.
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Designing the menu
Because it’s difficult to find commercial foods made without ingredients that are problematic for dogs prone to CaOx stones, home-prepared diets may produce the best results. For those who already feed a home-prepared diet to their dogs, the adjustments are simple. For those who are new to dog food preparation, designing an effective menu need not be complicated. Your dog’s food can be prepared along with your own meals or made in advance and refrigerated or frozen in single portions for later use.
Start by feeding different types of meat, poultry, eggs, fish, and dairy in order to provide a variety of flavors and nutrients. The food Bean feeds her dogs is about 40 percent protein by volume, but higher protein levels work well for many dogs. The rest of the diet should be low-oxalate grains and/or vegetables.
While Bean doesn’t include organ meats in her FuzzerFood guidelines, adding 1/2 ounce (about 1 tablespoon) of liver per pound of other foods will add valuable nutrients to a home-prepared diet.
Meat can be ground, cut into cubes, or served in a single piece, assuming the dog doesn’t have problems chewing. It can be fed raw or cooked. Because CaOx dogs on raw bone-based diets have continued to form stones, the FuzzerFood regimen does not include bones. Freeze-dried liver and similar dog treats are appropriate for training and special occasions. Avoid treats that contain high-oxalate ingredients, and factor treats into the daily food allotment of overweight dogs.
Boiling vegetables in water greatly reduces their oxalate content, while steaming reduces levels slightly. Of course, boiling reduces nutritional content, so it’s a trade-off. When you feed Group 3 (moderate-oxalate) vegetables, consider giving smaller amounts raw and larger amounts cooked. Adding digestive enzymes to food at serving time helps replace enzymes destroyed by heat.
Most 10-pound dogs need less than 1 cup of food by volume, while dogs weighing 50 pounds may need closer to 3 cups per day. Bean’s Lhasas maintain their 12- to 14-pound body weight on slightly more than 1 cup per day. The amount to feed will vary according to your dog’s activity level and the amount of low-calorie vegetables in the diet.
Because key supplements should be given twice a day with food, consider feeding both breakfast and dinner rather than one meal per day.
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In the past, calcium was thought to be a risk factor for the formation of calcium oxalate stones. Later studies found, however, that calcium binds oxalate and thus actually reduces the risk of calcium oxalate stones when given with meals.
When she spoke with urologists who deal with human kidney stones, Bean learned that supplementing homemade food with calcium citrate neutralizes oxalates in urine, so she began giving it to her dogs with meals while avoiding all other mineral supplements. “Citrate is an important natural inhibitor of calcium oxalate stones,” she says. “When calcium citrate is combined with food at mealtime, it helps absorb and bind excess oxalic acid in the gut. This bound oxalate cannot be absorbed and is excreted through the feces. This means that it does not get into the bloodstream or kidneys to cause stones.”
Pure calcium citrate powder is inexpensive and easy to use. Bean adds 300 to 350 mg of NOW brand Vegetarian Powdered Calcium Citrate to each 8 ounces (1/2 pound) of fresh food to balance the diet’s calcium:phosphorus ratio. Calcium citrate should only be added to homemade diets, or to the fresh portion of a combined diet, as commercial diets should already contain the right amount of calcium (though, unfortunately, they rarely use calcium citrate).
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For more than 40 years, the medical literature has reported on the success of a simple nutritional therapy for the prevention of calcium oxalate stones in humans using magnesium and vitamin B6. In studies published in The American Journal of Clinical Nutrition, The Journal of the American College of Nutrition, and other medical journals since 1967, patients with longstanding, recurrent calcium oxalate kidney stones received 200, 300, or 500 mg magnesium oxide with or without 10 mg pyridoxine (vitamin B6) daily for five years or more, during which their stone formation fell by over 90 percent When measured, their urine increased its ability to keep calcium oxalate in solution.
Because vitamin B6 deficiencies can contribute to an increase in oxalate production, many veterinarians prescribe this vitamin for dogs prone to CaOx stones. Severe vitamin B6 deficiencies may result from genetic disorders. Vitamin B6 is available as an oral supplement or by injection. Follow label directions or, if using a human product, give 1/4 of the total dose for each 25 pounds of body weight.
A B-complex supplement provides all of the needed B-family vitamins. Give 50 mg twice per day to dogs weighing 50 pounds or more, and one-fourth or half that amount to smaller dogs.
The FuzzerFood regimen includes Omega-3 fish or salmon oil, a B-complex vitamin, and vitamin E, with optional CoQ10, magnesium, glucosamine, digestive enzymes, and probiotics.
One study done on people showed that the urinary oxalate was greatly reduced using a high concentration of freeze-dried lactic acid bacteria (Lactobacillus acidophilus, L. plantarum, L. brevis, Streptococcus thermophilus, Bifidus infantis, with the last possibly being the most effective). Nature's Sunshine Probiotic Eleven (available at Amazon) and Sedona Labs Iflora (available at Amazon) contain all five of the named strains, while VSL#3 contains four of the five (also available at Amazon).
Updated informaion on probiotics: See Probiotic-induced reduction of gastrointestinal oxalate absorption in healthy subjects and Acute probiotic ingestion reduces gastrointestinal oxalate absorption in healthy subjects for human studies of VSL#3. Other studies indicate that Oxalobacter formigenes is the best known of the oxalate-degrading bacteria, including in dogs, but this species does not appear to be available in supplement form. In a study completed in 2012, Dr. Michael Murtaugh, from the University of Minnesota, determined that healthy dogs have higher quantities of three bacteria that degrade oxalate than do dogs prone to forming oxalate stones. The probiotic species are not named, but presumably include O. formigenes. Dr. Murtaugh now hopes to develop a probiotic containing bacteria that is capable of degrading oxalate and preventing formation of oxalate urinary stones.
Magnesium can have a laxative effect, so begin at the low end of the range, which is 3 to 5 mg per pound of body weight per day, divided into morning and evening doses and given with meals. Magnesium supplementation is contraindicated for dogs in renal failure, so if that is your dog’s condition, use this under your veterinarian’s supervision only as long as there are stones, then discontinue.
Bean does not use either vitamin C or vitamin D (including cod liver oil, which contains vitamin D) because vitamin C is said to convert to oxalate, thus possibly increasing the risk of stone formation, and vitamin D promotes calcium absorption that leads to increased urinary calcium. Most multi-vitamins contain vitamins C and D, so it’s important to read labels.
Supplements manufactured for human consumption come in a wider variety than do veterinary supplements, making it easier to find human products that avoid these ingredients. Adjust the recommended human dose for your dog by weight.
Some researchers have found that glucosamine supplements, which are commonly used for arthritis, may help prevent calcium oxalate crystals from adhering to the bladder wall. While this treatment is still speculative, glucosamine is safe to give and may be helpful in preventing CaOx bladder stone formation.
When Bean asked Traditional Chinese Medicine veterinarian Cory Stiles, DVM, for advice from that perspective, Dr. Stiles recommended Lysimachia-3, a traditional Chinese blend of three herbs, Jin Qian Cao or Desmodium, Hai Jin Sha or Lygodium Spores, and Ji Nei Jin or Gallus, which is designed to treat human digestive disorders, gall stones, and kidney stones.
“Lysimachia-3 comes in tablets,” says Bean, “which we crushed and mixed with food, or the tablet can be placed in a small amount of low-fat cream cheese, or the dog can simply be ‘pilled’ by putting it down the throat. My dogs had no objection to having these tablets crushed and mixed with their food, and Lhasas are notoriously picky.” Dr. Stiles’ recommended dose is 1 700-mg tablet per 25 pounds body weight given twice daily until stones are dissolved. Then give Lysimachia-3 daily for another month, then start using it every other day, then every three days, and if all looks good, dose it three times per week every other week, and finally, daily for one week out of every four to six weeks.
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Preventive medical treatment
Potassium citrate is a nutritional supplement that increases citrate levels in the urine, attracting calcium away from oxalates. When calcium binds to citrate, the resulting calcium citrate tends to remain dissolved instead of precipitating out as a mineral deposit.
Potassium citrate also has an alkalizing effect on the urine, which can help to prevent the formation of calcium oxalate stones, though it won’t dissolve existing stones. High blood potassium levels are dangerous, so a veterinarian’s supervision and follow-up blood tests are recommended when using potassium citrate. This supplement should usually not be given when dietary changes alone maintain the urine’s pH at 6.5 or above.
Calcium citrate achieves the same goals of alkalizing urine and binding oxalates without the risk of elevated potassium that can be posed by potassium citrate. That's why Bean considers calcium citrate a better option for her dogs’ homemade diets.
Dogs who continue to form stones despite other steps to minimize risk may be prescribed hydrochlorothiazide, a thiazide diuretic, to increase the amount of urine produced while reducing urinary calcium oxalate saturation.
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The stress connection
In addition to good food and ample water, dogs need a stable home life, active exercise, and interesting activities. Some researchers speculate that stress plays a role in the development of kidney and bladder stones. When changing your dog’s diet, do what you can to keep the introduction of new foods fun and stress-free. Fortunately, most dogs love fresh food. Just as importantly, do what you can to relax and let go of the stress that concern about your dog’s health brings to your own life. The more you and your best friend enjoy each other’s company with play, exercise, and shared quiet moments, the better you’ll both feel.
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The guidelines given here for feeding a homemade diet are the only way we know to prevent and treat calcium oxalate stones. See Homemade Diets for general information that you can modify as described above for dogs prone for forming CaOx stones.
For those who cannot feed a homemade diet, you could try feeding a prescription diet, but replace much of it with meat, eggs and dairy to increase the protein level and the quality of the overall diet. Add calcium citrate at the rate of 1,000 mg per pound of added fresh food. Also add a B-complex vitamin, probiotics and magnesium.
Alternatively, you could try feeding a commercial diet that doesn't have any high-oxalate ingredients, along with the same supplements listed above. I'm not sure which commercial foods might be best to use, or whether any will work for stone-forming dogs. Canned foods usually are higher in protein and lower in carbohydrates (which is where you find most oxalates), but may be prohibitively expensive for large dogs. Frozen and refrigerated raw and cooked diets may also be an option, but are even more expensive than canned foods.
Halo Spot's Stew canned varieties use calcium citrate (although they also include dicalcium phosphate), with a couple of group 2 vegetables (mustard greens, sweet potato, barley), which are far down the ingredient list, meaning the amount must be small (there is less sweet potato than calcium).
Newman's Own Canned Beef Formulas varieties have no carbs at all and therefore essentially no oxalates, but use calcium carbonate rather than citrate.
Dr. Harvey's pre-mixes, designed to have meat added to make a complete diet, use calcium citrate but also include ingredients that are high in oxalates. Sweet potatoes are the first ingredient in his Veg-to-Bowl, and barley is the second ingredient in his Canine Health, and both contain other high-oxalate ingredients as well.
All commercial foods add vitamin D and none use calcium citrate exclusively to provide calcium, so it's possible these diets could cause problems even if you avoid high-oxalate ingredients.
In any case, you should do everything possible to encourage your dog to drink more water and urinate frequently. Pulsing Lysimachia-3 may also help to prevent stone formation (see Supplements above). Monitor your dog's urine frequently for calcium oxalate crystals and/or do x-rays to check for stones beginning to form.
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Oxalate Content of Various Foods
The Oxalosis and Hyperoxaluria Foundation publishes an up-to-date list of foods and their oxalate content. Based on research from 2008 and revised as new figures become available, this report divides foods into very high, high, medium, and low levels of oxalates according to serving size. See the complete list for information about additional foods, including herbs, spices, combination foods, and beverages.
Note that different sources provide differing information on oxalates. If you will be feeding a food regularly, you may want to check all the lists under Resources below for that food to further verify the oxalate content.
Soaking grains overnight and discarding the water, then boiling the grains (like pasta) and again discarding the water, can reduce oxalate content.
Group 1 (very high-oxalate foods) are best avoided by dogs prone to calcium oxalate stones:
- Bran cereal, almonds, buckwheat flour, beets, miso (fermented soy), mixed nuts, sesame seeds, tahini (sesame paste), parsley, rhubarb, spinach, and Swiss chard. Alfalfa and quinoa are also high in oxalates (not sure which group they belong in).
Group 2 (high-oxalate) foods should also be avoided:
- Nuts: cashews, hazelnuts or filberts, peanuts, peanut butter, and pecans.
- Vegetables: okra, collard greens, mustard greens, fried potatoes, sweet potatoes, and canned tomato paste.
- Legumes: black, white, great northern, navy, chili, and pink beans.
- Soy products: textured vegetable protein, soy milk, soy burger, soy yogurt, soy nuts, and soybeans.
- Fruit: figs, kiwi fruit, and dried apricots.
- Grains: barley, cornmeal, cream of wheat, whole wheat flour and spaghetti, brown rice flour, and wheat bran.
- Chocolate, which is toxic to dogs, is a high-oxalate food.
Group 3 foods have moderate oxalate levels. They can be fed in moderate amounts (see the complete list for serving sizes) as long as calcium is also given with the meal:
- Nuts and seeds: pistachios and walnuts (macadamia nuts are toxic to dogs).
- Vegetables: carrots, celery, green beans, boiled white potatoes without the skin, rutabaga, summer and winter squash, tomato sauce, and tomatoes. The Low Oxalate Cookbook (see Resources) shows that skinless red potatoes are considerably lower in oxalates than white or russet potatoes; all potatoes are lower in oxalates when the skin is removed.
- Legumes: kidney, pinto, and adzuki beans.
- Fruit: blackberries, blueberries, mandarin and other small oranges, mangos, and prunes. Note berries may be higher in oxalates, while mangos may be low.
- Grains: bulgar wheat, brown rice, elbow macaroni, egg noodles, spaghetti, pasta, rye flour, oats, and oatmeal.
Group 4 (low-oxalate foods) are “green light” ingredients. They can be fed in any quantity, though they should still be combined with calcium. Foods in boldface are particularly low in oxalates:
- Nuts and seeds: coconut, flax seeds, pumpkin and squash seeds, and sunflower seeds.
- Vegetables: artichokes, asparagus, avocado, broccoli, Brussels sprouts, cabbage, cauliflower, corn, cucumber, garlic, green or red peppers, lettuce, mushrooms, peas, canned pumpkin, sauerkraut, canned string beans, tomato juice, canned water chestnuts, and zucchini. (Onions should never be fed to dogs).
- Legumes: lima beans, black-eyed peas, garbanzo beans, lentils, and split peas. Lentils and garbanzo beans may have more oxalates. Split peas have more oxalates than regular peas.
- Fruit: apples, fresh apricots, bananas, cantaloupe, cherries, cranberries, grapefruit, lemons, lychee, melons of all types, nectarines, olives, oranges, papayas, passion fruit, peaches, pears, pineapple, plums, raspberries, strawberries, tangerines, and watermelon. (Neither grapes nor raisins should ever be fed to dogs).
- Grains: white bread, whole wheat bread, cornbread, hominy (corn grits), oat bran, rice noodles, semolina, white rice, corn and white flour tortillas, and wild rice.
- Fats: all fats and oils, including butter.
- Fish: all fish and seafood (shellfish).
- Dairy: all, including cheese, cottage cheese, cream, eggs, yogurt, ice cream, and sour cream.
- Meat: all meat and poultry, including organ meats, luncheon meats, sausage, and bacon.
- Sweeteners: all natural sweeteners, including sugar (not recommended for dogs) and honey.
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A Stone Glossary
Calculi (the plural of calculus)
blood in the urine, a symptom of urinary stone disease.
excessive calcium in the blood.
excessive urinary calcium excretion.
excessive oxalate in the urine.
a strongly acidic glycoprotein present in normal urine, which inhibits calcium oxalate crystal growth.
excessive accumulation of oxalate in the body because of kidney failure.
Urinary tract stone disease
also called urolithiasis, urinary stones, ureteral stones, bladder stones, urinary calculi, ureteral calculi, or urinary calculus disease.
aggregates of crystalline and occasionally noncrystalline solid substances that form in one or more locations within the urinary tract.
Signs of stones
Watch for blood in your dog’s urine, the frequent passing of small amounts of urine, “accidents” in house-trained dogs, straining to urinate while holding the position much longer than usual, licking the genital area more than usual, painful urination that causes your dog to yelp from discomfort, cloudy and foul-smelling urine that may contain blood or pus, tenderness in the bladder area, pain in the lower back, or fever and lethargy.
If you notice any of these symptoms, contact your veterinarian at once. A dog who strains and then releases a flood of urine may have just passed a stone and should be examined. If you can find the stone, take it with you so it can be accurately identified. A dog whose urine is completely blocked has a medical emergency; a plugged urethra can cause urine to back up into the system, resulting in kidney failure. The backup can also cause the dog’s bladder to stretch to the point of rupturing or damaging the bladder’s muscle tone, making it to empty completely.
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Another Success Story
In September 2008, Cosette, a Shih Tzu belonging to Atlanta-area dog trainer Cathy Bruce, was diagnosed with 20 calcium oxalate bladder stones. In an effort to avoid surgery, Bruce experimented with her dog’s diet. She was able to raise Cosette’s urinary pH slightly, but it never got above 7.0. Cosette disliked the new foods and lost a pound while follow-up X-rays (taken three and six months after diagnosis) showed no change.
In the summer of 2009, when Bruce began feeding a commercially prepared frozen raw diet. Cosette’s appetite returned and she regained the weight she had lost. At about the same time, with her veterinarian’s approval, Bruce began adding small amounts of potassium citrate to Cosette’s food. She had tried potassium citrate granules months before but Cosette wouldn’t eat any food they were mixed with. When the powder from Nature’s Farmacy potassium citrate capsules was added to her food, Cosette never noticed.
Soon the stones began to disappear, either because she passed them or they dissolved, and by March 2010, only four tiny uroliths remained. Cosette won’t be needing surgery!
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Here is a sample recipe that could be used for dogs prone to forming calcium oxalate stones. This recipe has a moderate amount of fat. Meat and eggs can be fed raw or cooked (the amount of meat is the same, but the starting weight is higher for raw foods due to having more moisture). Rice must be cooked. Vegetables should be either cooked or pureed in a food processor, blender, or juicer. Measurements are by weight, not volume (except for the cooked rice, which is given in cups). Use a small kitchen or postal scale for accuracy.
- 1 lb (raw) or 13 ounces (cooked) 90% lean ground beef
- 1 lb (raw) or 13 ounces (cooked) ground turkey with 7% fat, or chicken breast with skin, or dark meat chicken with half skin removed
- 3 ounces canned tuna, boneless salmon, or other oily fish without bones (use fish packed in water, don't use light tuna, and look for fish with the most fat you can find as long as it's not packed in oil)
- 3 large eggs
- 2 ounces beef liver
- 4 ounces plain yogurt
- 4 ounces cottage cheese
- 3 cups cooked white rice
- 15 ounces low-oxalate vegetables (e.g., 5 ounces broccoli, 5 ounces carrots, 5 ounces peas)
Nutritional analysis (more details available at NutritionData):
- 2222 grams cooked (4.9 pounds, 5.25 lbs raw)
- 2983 calories
- 299 grams protein (48% dry matter, 42% of calories from protein)
- 97 grams fat (16% dry matter, 29% of calories from fat, 32 grams of fat per 1,000 calories)
- 211 grams carbohydrates (34% dry matter, 29% of calories from carbohydrates)
- 2.9% dietary fiber
- 8,887 mg omega-6 fatty acids, 1,655 mg omega-3 fatty acids (ratio 5.4:1)
- This recipe includes both poultry and beef. If you prefer to make separate batches, you can use the same amount of poultry or beef and divide the amounts of everything else in half, or double the amount of poultry or beef per batch, leaving everything else the same. Similarly, you could use yogurt in one batch and cottage cheese in another.
- You can use whole milk, low-fat, or nonfat dairy products. Use lower-fat products for older dogs and those prone to pancreatitis or digestive upset. Younger, more active dogs will do better with higher-fat products.
- If you are feeding canned salmon or other oily, boneless fish (not tuna), you can increase the amount of fish in the recipe to 6 ounces and decrease the number of eggs to 2, if preferred.
- You can mix and match various low-oxalate vegetables as you want. Fresh or frozen vegetables are better than canned, which may be high in sodium. Vegetables are best digested if cooked or pureed in a food processor, blender, or juicer.
- It's OK to use chicken or turkey liver with a poultry batch and beef liver with a beef batch, but don't substitute chicken liver for beef liver more than half the time. Note some people prefer to feed freeze-dried beef liver as treats instead, which is likely OK.
- It's fine to include some fruits in the diet, such as banana, apple, and melon. Blackberries, blueberries, small oranges, and prunes are group 3 (moderate oxalate, feed in very limited amounts only), but most other fruit group 4 (low oxalate).
- If you leave out any of the ingredients in the recipe, additional supplementation may be needed. For example:
- If you don't feed fish, you will need to give fish oil for omega-3 fatty acids and kelp for iodine. Give an amount of fish oil that provides 100 to 150 mg EPA and DHA per 10 pounds of body weight daily for healthy dogs, up to 300 mg for dogs with cancer, kidney disease, or inflammation due to allergies, arthritis, or other causes. Do not use cod liver oil, which is high in vitamin D. See below for iodine supplementation.
- If you don't feed dairy products, you should increase the amount of calcium added by about 15% and may also need to supplement with kelp for iodine (see below).
- If you don't feed poultry, you'll need to provide omega-6 fatty acids from plant oils.
- If you don't feed liver, the diet will be short on some minerals and B vitamins.
- Omitting eggs will leave the diet short on choline with a little less fat.
- Other nutrients may also be short if any foods are left out.
Amount to feed: See below for estimated amounts to feed adult dogs. The lower amounts are for senior, overweight, and less active dogs, while the higher amounts are for younger, more active dogs. Caloric needs can vary considerably between individual dogs, so always watch your dog's weight and adjust the amount fed as needed to keep your dog lean. If you find you are feeding less than the low amount shown below, you may need to add additional supplements to make sure your dog's nutritional needs are met.
- 5 pounds: feed 4.5 to 6 ounces (130 to 180 grams) daily (recipe will last 12 to 17 days)
- 10 pounds: feed 7.8 to 11 ounces (220 to 300 grams) daily (recipe will last 7 to 10 days)
- 20 pounds: feed 13 to 18 ounces (370 to 500 grams) daily (recipe will last 4 to 6 days)
- 30 pounds: feed 17 to 24 ounces (490 to 690 grams) daily (recipe will last 3 to 4.4 days)
- 40 pounds: feed 22 to 30 ounces (620 to 850 grams) daily (recipe will last 2.6 to 3.6 days)
- 50 pounds: feed 26 to 36 ounces (740 to 1,000 grams) daily (recipe will last 2.2 to 3 days)
- 60 pounds: feed 30 to 41 ounces (840 to 1150 grams) daily (recipe will last 1.9 to 2.6 days)
- 70 pounds: feed 33 to 46 ounces (950 to 1300 grams) daily (recipe will last 1.7 to 2.3 days)
- 80 pounds: feed 37 to 50 ounces (1050 to 1430 grams) daily (recipe will last 1.6 to 2.1 days)
- 90 pounds: feed 40 to 55 ounces (1150 to 1565 grams) daily (recipe will last 1.4 to 2 days)
- 100 pounds: feed 44 to 50 ounces (1240 to 1700 grams) daily (recipe will last 1.3 to 1.8 days)
- 120 pounds: feed 50 to 69 ounces (1420 to 1940 grams) daily (recipe will last 1.1 to 1.6 days)
- 140 pounds: feed 56 to 77 ounces (1600 to 2180 grams) daily (recipe will last 1 to 1.4 days)
- Calcium Citrate (required): add 2,400 to 3,000 mg calcium citrate to the entire recipe, or 500 to 625 mg per pound of food, or 30 to 40 mg per ounce, to provide a calcium to phosphorus ratio between 1:1 and 1.3:1. Calcium must be mixed in thoroughly so that the same amount will be given with each meal, or it may be easier to divide up the amount and add at mealtime. Sample products:
- Now Foods Calcium Citrate Powder: Label shows 600 mg calcium per 1.5 level teaspoons. Add 6 to 7.5 teaspoons calcium citrate powder for the entire recipe, or 1.2 to 1.5 level teaspoons per pound of food.
- Swanson Calcium Citrate Powder: 350 mg calcium per scoop, so add 6.3 to 8.5 scoops for the entire recipe, or 1 scoop per 250 to 350 grams (9 to 12 ounces) of food.
- Magnesium (recommended): This diet is a little short in magnesium (about 70 mg for the entire recipe), and dogs with calcium oxalate stones do better with added magnesium, such as 3 to 5 mg per pound of body weight daily, divided between meals. Too much magnesium can act as a laxative, so start small and increase gradually. Magnesium can be added at mealtime, or mixed in thoroughly with the whole recipe. Sample products:
- Food Science of Vermont Magnesium Aspartate: 50 mg magnesium plus small amounts of niacin and vitamin B6 (which is also considered good for calcium oxalate stones) per capsule
- Rugby Chelated Magnesium: 27 mg magnesium per tablet
- Now Foods Magnesium Citrate Powder: 315 mg magnesium per 1/2 level teaspoon
- Thorne Research Citramins: provides 90 mg magnesium per capsule, along with 100 mg calcium citrate plus other minerals (iodine, zinc, selenium, manganese, and a small amount of potassium citrate). Comes with or without copper and iron, either of which should be OK as long as you're not giving other supplements with those ingredients..
- Vitamin E (required): Give 1 to 2 IUs per pound of body weight daily (or can give more less often). Vitamin E can be given at mealtime or added to the recipe if it will not be stored more than a couple of weeks.
- Solgar Liquid Vitamin E: with mixed tocopherols (ideal): 20 IUs per drop
- Now Foods Vitamin E Liquid: 15 IUs per drop, also available in 1 oz size
- Iodine: (optional) It is hard to know how much iodine is in a homemade diet. This supplement may not be necessary since the recipe includes saltwater fish and yogurt (fish is very high in iodine and yogurt is somewhat high). Give no more than 100 mcg daily for a 10-pound dog, 180 mcg for a 25-pound dog, 300 mcg for a 50-pound dog, or 500 mcg for a 100-pound dog daily. Iodine can be added at mealtime or to the entire recipe. Sample products:
- Now Foods Kelp Tablets or Kelp Powder: 150 mcg iodine per tablet or 135 mcg per scoop
- Now Foods Potassium plus Iodine: 225 mcg iodine per tablet
- Nature's Life Icelandic Kelp: 225 mcg iodine per tablet
- Monica Segal Kelp: 1150 mcg iodine per teaspoon
- Lysimachia-3: pulsed, to help prevent and treat calcium oxalate stones as described in the Supplements section above. Add at feeding time. Required if you are trying to dissolve existing stones, but can be pulsed to prevent future stones from forming. If your dog has never formed stones, you might be able to get away with not using this supplement.
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K9KidneyDiet (Yahoo group), discussion group that deals with calcium oxalate stones as well as kidney disease.
Calcium citrate powder from NOW Foods (also available in tablet and capsule form). Sold in natural food stores and online. Available at Amazon.
Oxalate Content of Foods:
- The Oxalate Content of Food
- Dietary Changes to Prevent Oxalate Stones
- Low Oxalate Diet
- Oxalate Status Food Lists
The Low Oxalate Cookbook: Book 2, edited by Joanne Yount and Annie Gottlieb. VP Foundation, 2005.
Lysimachia-3 from Seven Forests (ITM, Institute for Traditional Medicine). Available directly from the manufacturer as well as online and through veterinarians. Currently unavailable at Amazon (as of September 2017), but appears to be available from Natural Nutritionals (100 tabs and 250 tabs), Dr. Shen's and Acupuncture Atlantar. According to veterinarian Marc Smith, Crystal Stone Formula from Jing Tang Herbal may be used as a replacement if needed.
Potassium Citrate Capsules from Nature's Farmacy.
- Nature's Sunshine Probiotic Eleven (available at Amazon)
- Sedona Labs Iflora (available at Amazon)
- VSL#3 (also available at Amazon).
pH Test Strips:
- Solid Gold pH test strips
- Micro Essential Laboratory pH test strips
- Also see my article on Struvites for more resources
Healthy control dogs are needed by the University of Minnesota College of Veterinary Medicine’s Minnesota Urolith Center for clinical trials. Readers living in the Minneapolis-St. Paul area may be interested in a trial testing an oxalate-degrading bacteria that treats calcium oxalate uroliths. As of August 2013, researchers are looking for purebred Miniature Schnauzers, Bichon Frise, Shih Tzus, Yorkshire Terriers, and Miniature Poodles with a history of calcium oxalate stones (Case group) OR are at least 8 years old and have never had calcium oxalate stones (Control group). For details about this and other clinical trials at the Center, see http://www.cvm.umn.edu/cic/current/samedicine/home.html.
Dr. Joe Bartges at the University of Tennessee College of Veterinary Medicine is conducting a number of ongoing studies involving different types of urinary stones. If you have a known stone-forming dog and might be interested in participating, see Clinical Studies for more information.
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Minnesota Urolith Center at the University of Minnesota College of Veterinary Medicine
- Canine Calcium Oxalate Uroliths
- Management of Mixed or Compound Uroliths Containing Calcium Oxalate and Struvite in Dogs
- Oxalate degrading bacteria in dogs (ongoing study)
- Oxalate Bladder Stones in the Dog
- Urolithiasis – Leaving No Stone Unturned
- Dennis J. Chew DVM, Diplomate ACVIM; The Ohio State University College of Veterinary Medicine, Columbus, Ohio USA, et. al. (Original site no longer available; contact me if you need a copy.)
- Calcium Oxalate Urolithiasis in the Canine Patient
- Calcium Oxalate Urolithiasis
- Kelly Gisselman, DVM, Cathy Langston, DVM, DACVIM, et al
- Experience with thiazide diuretics in calcium oxalate urolithiasis
- Effects of hydrochlorothiazide and diet in dogs with calcium oxalate urolithiasis
- Canine uroliths: Frequently asked questions and their answers
- Use of laser lithotripsy to treat urocystoliths in dogs: current status
- Fluid intake and epidemiology of urolithiasis
Nutrition and Calcium Oxalates:
- Nutritional Management of Canine Urolithiasis (Stevenson, Rutgers) from the Encyclopedia of Canine Clinical Nutrition
- Associations between dietary factors in canned food and formation of calcium oxalate uroliths in dogs.
- Association between dietary factors and calcium oxalate and magnesium ammonium phosphate urolithiasis in cats.
- Magnesium and vitamin B6 for kidney stone prevention
- Impact of Urine Sodium on Urine Risk Factors for Calcium Oxalate Nephrolithiasis
- The influence of dietary minerals on calcium oxalate kidney stones
- Vitamin C Supplementation and Urinary Oxalate Excretion
- Dietary and Holistic Treatment of Recurrent Calcium Oxalate Kidney Stones: Dietary Vitamin C in Beverages
- Ascorbic Acid Supplements and Kidney Stone Incidence Among Men: A Prospective Study
- Kidney stones: treatment and prevention
- Effect of Different Cooking Methods on Vegetable Oxalate Content
- Nutrition and Urolithiasis in Dogs and Cats
- Reduction of oxaluria after an oral course of lactic acid bacteria at high concentration.
- Vitamin C and Calcium Oxalate Stones
- Great quote: "I have lost count of the number of pets from which I have surgically removed stones that were on diets, supplements, or other therapies designed to prevent the stone formation of the type I removed."
Water and Calcium Oxalates:
- Water hardness and kidney stones
- Calcium nephrolithiasis: effect of water hardness on urinary electrolytes
- Comparative study of the influence of 3 types of mineral water in patients with idiopathic calcium lithiasis
- Current Trends in Urolith Submissions in Canada
- Analysis of 36,032 canine cases shows decline in struvite uroliths
- Analysis of 4495 canine and feline uroliths in the Benelux. A retrospective study: 1994–2004
- P. Picavet1, J. Detilleux2, S. Verschuren1, A. Sparkes3, J. Lulich4, C. Osborne4, L. Istasse5 and M. Diez5 (private copy)