Kidney stones are one of the most common disorders of the urinary tract, reported to affect about 12 percent of men and 5 percent of women over their lifetime.
Certain factors appear to increase the risk of kidney stones, such as a high-animal-fat diet with resulting increased urinary acidity; low fiber intake; low fluid intake; gout (high uric acid levels); high blood pressure, family history; being overweight; and inflammatory bowel diseases such as Crohn's disease and ulcerative colitis. There is no conclusive evidence that calcium supplements or foods containing oxalates increase the risk of kidney stones. High doses of vitamin C may aggravate kidney stone development in susceptible individuals.
In the case of gallbladder stones, a low-fat, low-cholesterol diet is advisable to prevent gallstone formation, but some susceptible individuals may develop gallstones even when consuming a healthy diet.
Patients who develop kidney or gallbladder stones may wish to take a combination supplement containing ingredients shown to help dissolve stones and prevent their recurrence. The best evidence in this regard suggests supplementation with the herb Chanca piedra, vitamin B6 and magnesium.
Chanca piedra is a popular South American herb that has been used to dissolve and eliminate kidney stones and gallbladder stones. The English translation for Chanca piedra is "stone crusher." Recent scientific evidence has provided solid evidence of this therapeutic effect. A 2006 Brazilian study showed that the therapeutic effect of Chanca piedra may be due to its ability to modify the shape and texture of stones (calculi) to a smoother and more fragile form, which would allow for easier elimination and/or dissolution of the stones.1
Another study demonstrated that Chanca piedra has an inhibitory effect on crystal growth and aggregation in human urine, which may inhibit stone formation, acting as an important part of a prevention strategy in those with a past history of kidney stones.2
A 2006 study involving 150 patients with kidney stones tested the efficacy of Chanca piedra supplementation in patients administered shock-wave therapy. Shock-wave therapy (delivered from outside the body) breaks down stones to facilitate their elimination. Upon completion of this therapy, approximately half of the patients were given 2 grams of Chanca piedra every day for 30 days. The remainder of the group did not take the herb and acted as controls. Stone clearance was assessed after 30, 60, 90 and 180 days by abdominal X-ray and ultrasound scan. The herb-supplemented patients were shown to have a stone-free rate 10-23 percent higher than the control group.3
As an aside, Chanca piedra has also been shown to increase the urinary excretion of uric acid; thus, it may also be helpful in the management of gout and hyperuricemia.4
Vitamin B6 and magnesium: Supplementation with vitamin B6 and magnesium has also shown positive effects in preventing the recurrence of kidney stones. In a landmark study, 149 patients with longstanding recurrent kidney stones (calcium oxalate and mixed calcium oxalate/calcium phosphate) received 100 mg of magnesium three times a day and 10 mg of pyridoxine (vitamin B6) once a day for 4.5-6 years. The mean rate of stone formation fell by 92.3 percent, from 1.3 stones per patient per year prior to the study to 0.10 stones per patient per year during the study. No significant side effects occurred.5 Other studies have shown that using various forms of magnesium alone can prevent the recurrence of kidney stones in previous sufferers.6-7
Based on the research summarized above, in patients with existing kidney or gallbladder stones and no medical treatment currently planned, I suggest patients make appropriate dietary changes, drink more water (for kidney stones) and take a supplement twice per day containing therapeutic dosages of Chanca piedra, vitamin B6 and magnesium.
2011年3月22日星期二
Calcium: Myths and misconceptions
Calcium is no stranger to controversy, and its important role is often tarnished by unfounded contradiction. Its silent participation in troubled waters put its reputation in jeorpardy, wrongly accused of misdeeds it has not committed.
The guilty verdict dished out is often based on circumstantial evidence of its presence at the "crime scene". The most common type of kidney stone is composed of calcium oxalate. A senior citizen who has seen some miles often has opaque calcification of the artery leaving the heart (aorta) in a chest x-ray. In cardiovascular disease, the underlying fires of inflammation within the artery walls instigates deposition of calcium, making it an indirect predictor of the No.1 killer.
None of the above is the direct result of calcium causing mischief, but merely its response to disease and injury.
Calcium101
Calcium is the most abundant mineral in the body, and if it were possible to gather it all in a bag, it will weigh about a kilogram. About 99% is banked in the bones and teeth, and only 1% circulates freely in the blood, within cells, and the fluid between cells.
Calcium has an undeniable role in building up bone density, giving strength and integrity to our supporting framework. What many are unaware of is the myriad other cellular functions of calcium that keep us alive.
It plays a constant role in controlling traffic of incoming supplies of nutrients and the exit of biochemical wastes from the cells, the making of hormones, and the transmission of messages from one nerve cell (neurons) to another.
Last, but not least, is its involvement in muscle contractions, working in concert with another important player, magnesium, in the cellular "see-saw" where one comes in and the other goes out, alternating between muscle contractions and relaxation.
The daily movement of calcium commences with ingestion, where after dispersion and absorption in the gut, it meanders its way to the bones to build up "hardness", while a small portion is utilised for metabolic functions.
When demand exceeds supply, the mineral is withdrawn from the bone bank, the bones.
Installed within us is an automatic alarm system that keeps calcium levels within a physiologic range. Failure of this hardware will lead to disease if the calcium levels swing too high or drops too low.
Behind the thyroid in the neck is a gland (parathyroid) that secretes parathyroid hormones, which elevates blood calcium when its level drops, mobilising the shift from the bones into the circulation. Calcitonin is another regulatory hormone that moves calcium back into the bones.
Active vitamin D is the gatekeeper to the entrance of calcium, its presence being a prerequisite for effective absorption of the mineral. The dietary precursor of vitamin D is activated in a three-step process, with the initial ignition in the skin, aided by sun exposure, thus earning the label "sunshine vitamin".
A second process occurs in the liver, and the final step of activation is effected by the kidneys. Lack of sun exposure, liver or kidney disease will lead to poor calcium absorption, auguring the development of porous bones (osteoporosis).
Consumption matters
The average daily diet confers 350mg to 400mg of calcium. Gulping down a glass of milk adds another 250mg of calcium. However, absorption of dietary calcium is only about 40%. Infants to children aged five years require 300mg to 600mg calcium daily; those six to 10 years old require 800mg; those 11 to 18 years require 1,300mg; 19- to 50-year-olds require 1,000mg; those above 50 years/pregnant/lactating require 1,200mg; while perimenopausal women require 1,500mg. (The safe upper limit for children and adults is 2,500mg per day).
Calcium rich foods include dairy products (milk, cheese, yoghurt, eggs), tofu, sardines, and vegetables like cabbages, kale, and broccoli. One may also choose a "good" calcium supplement in the right dosage and right form to meet the dietary shortfall.
Calcium supplements are the most widely used and prescribed mineral supplement, and confusion abounds in choosing the right type, based on dose, form, and combination.
The capacity to absorb calcium from the gut is limited to 500mg at one pass. The most common and cheapest form is calcium carbonate (inorganic salt), and the absorption rate is about 30%, whereas calcium citrate is said to be better absorbed.
As the former enters the cavernous stomach, it drops into a pit of acid juices (hydrochloric acid), which react with the carbonate to form a "champagne-like" foam. Calcium carbonate has the notorious tendency to cause heartburn.
Subsequently, the partly dissolved tablet exits the stomach into the first part of the small intestines, where further down is a short segment that acts as the window of absorption. The activated form of vitamin D brokers the entry of calcium into the cells by a process called active transport, akin to an electrical pump.
Even as the remnants of calcium leave the site of active absorption, some still manage to gain entry by a different manner, called passive diffusion, and the rest makes its way to the rear exit.
If much of the calcium is poorly absorbed, the result is unpleasant constipation.
Other forms of calcium tablets include calcium gluconate and lactate.
There is such a complex interplay of factors that scientists are not in total agreement about calcium requirements. Even if adequate calcium is made available to the body, there is no guarantee that it will be incorporated into the scaffolding of the bone’s architecture.
The combination of activated vitamin D, magnesium, boron, silicon, copper, zinc and other trace minerals are required for calcium to be translated into improved bone density. Calcium is like the brick, but to cement them together, we need at least 20 other known nutrients to form the mortar to glue it together.
Unfortunately, how many of us are cellular scientists, and how many supplement makers understand the science?
Amidst all this scientific jargon brews confused hearsay, misconceptions and myths. Perhaps this is the forum to address some common issues.
The guilty verdict dished out is often based on circumstantial evidence of its presence at the "crime scene". The most common type of kidney stone is composed of calcium oxalate. A senior citizen who has seen some miles often has opaque calcification of the artery leaving the heart (aorta) in a chest x-ray. In cardiovascular disease, the underlying fires of inflammation within the artery walls instigates deposition of calcium, making it an indirect predictor of the No.1 killer.
None of the above is the direct result of calcium causing mischief, but merely its response to disease and injury.
Calcium101
Calcium is the most abundant mineral in the body, and if it were possible to gather it all in a bag, it will weigh about a kilogram. About 99% is banked in the bones and teeth, and only 1% circulates freely in the blood, within cells, and the fluid between cells.
Calcium has an undeniable role in building up bone density, giving strength and integrity to our supporting framework. What many are unaware of is the myriad other cellular functions of calcium that keep us alive.
It plays a constant role in controlling traffic of incoming supplies of nutrients and the exit of biochemical wastes from the cells, the making of hormones, and the transmission of messages from one nerve cell (neurons) to another.
Last, but not least, is its involvement in muscle contractions, working in concert with another important player, magnesium, in the cellular "see-saw" where one comes in and the other goes out, alternating between muscle contractions and relaxation.
The daily movement of calcium commences with ingestion, where after dispersion and absorption in the gut, it meanders its way to the bones to build up "hardness", while a small portion is utilised for metabolic functions.
When demand exceeds supply, the mineral is withdrawn from the bone bank, the bones.
Installed within us is an automatic alarm system that keeps calcium levels within a physiologic range. Failure of this hardware will lead to disease if the calcium levels swing too high or drops too low.
Behind the thyroid in the neck is a gland (parathyroid) that secretes parathyroid hormones, which elevates blood calcium when its level drops, mobilising the shift from the bones into the circulation. Calcitonin is another regulatory hormone that moves calcium back into the bones.
Active vitamin D is the gatekeeper to the entrance of calcium, its presence being a prerequisite for effective absorption of the mineral. The dietary precursor of vitamin D is activated in a three-step process, with the initial ignition in the skin, aided by sun exposure, thus earning the label "sunshine vitamin".
A second process occurs in the liver, and the final step of activation is effected by the kidneys. Lack of sun exposure, liver or kidney disease will lead to poor calcium absorption, auguring the development of porous bones (osteoporosis).
Consumption matters
The average daily diet confers 350mg to 400mg of calcium. Gulping down a glass of milk adds another 250mg of calcium. However, absorption of dietary calcium is only about 40%. Infants to children aged five years require 300mg to 600mg calcium daily; those six to 10 years old require 800mg; those 11 to 18 years require 1,300mg; 19- to 50-year-olds require 1,000mg; those above 50 years/pregnant/lactating require 1,200mg; while perimenopausal women require 1,500mg. (The safe upper limit for children and adults is 2,500mg per day).
Calcium rich foods include dairy products (milk, cheese, yoghurt, eggs), tofu, sardines, and vegetables like cabbages, kale, and broccoli. One may also choose a "good" calcium supplement in the right dosage and right form to meet the dietary shortfall.
Calcium supplements are the most widely used and prescribed mineral supplement, and confusion abounds in choosing the right type, based on dose, form, and combination.
The capacity to absorb calcium from the gut is limited to 500mg at one pass. The most common and cheapest form is calcium carbonate (inorganic salt), and the absorption rate is about 30%, whereas calcium citrate is said to be better absorbed.
As the former enters the cavernous stomach, it drops into a pit of acid juices (hydrochloric acid), which react with the carbonate to form a "champagne-like" foam. Calcium carbonate has the notorious tendency to cause heartburn.
Subsequently, the partly dissolved tablet exits the stomach into the first part of the small intestines, where further down is a short segment that acts as the window of absorption. The activated form of vitamin D brokers the entry of calcium into the cells by a process called active transport, akin to an electrical pump.
Even as the remnants of calcium leave the site of active absorption, some still manage to gain entry by a different manner, called passive diffusion, and the rest makes its way to the rear exit.
If much of the calcium is poorly absorbed, the result is unpleasant constipation.
Other forms of calcium tablets include calcium gluconate and lactate.
There is such a complex interplay of factors that scientists are not in total agreement about calcium requirements. Even if adequate calcium is made available to the body, there is no guarantee that it will be incorporated into the scaffolding of the bone’s architecture.
The combination of activated vitamin D, magnesium, boron, silicon, copper, zinc and other trace minerals are required for calcium to be translated into improved bone density. Calcium is like the brick, but to cement them together, we need at least 20 other known nutrients to form the mortar to glue it together.
Unfortunately, how many of us are cellular scientists, and how many supplement makers understand the science?
Amidst all this scientific jargon brews confused hearsay, misconceptions and myths. Perhaps this is the forum to address some common issues.
2011年3月7日星期一
Edwards aces thrill ride with Sprint Cup win in Las Vegas
Carl Edwards jumped off the Stratosphere Tower 10 days ago and flew with the Air
Force Thunderbirds on Thursday.
His latest adventure in Las Vegas was celebrating in Victory Lane on Sunday after
winning his second NASCAR Sprint Cup race in four years at Las Vegas Motor Speedway
before an estimated crowd of 140,000.
Quite the Vegas vacation, indeed.
"I've had a blast. I don't know what I'm going to do next weekend," Edwards said,
adding he plans to award the Kobalt Tools 400 winner's trophy to the Thunderbirds,
who he said inspired him.
The resident of Columbia, Mo., was flying high after winning for the 19th time in the
series and earning his Roush Fenway Racing team $401,541.
Edwards and crew chief Bob Osborne are the hottest duo in the series. They won the
last two races of 2010 and were second in the season-opening Daytona 500.
"This is the best start to a season that I've ever had," Edwards said. "We have been
performing really well, and it's just a joy to drive these race cars right now. The
Fords are back and are strong."
The victory was the seventh in 14 Las Vegas Cup races for Roush Fenway Racing.
Edwards, who won the 2008 Cup race here, finished 1.246 seconds ahead of Tony
Stewart, who led a race-best 163 of 267 laps in a Stewart-Haas Racing Chevrolet that
was clearly dominant.
Even Edwards doubted he would have won without a blunder by Stewart's team on lap
151. Stewart fell from first to 23rd when NASCAR assessed a stop-and-go penalty after
his car dragged a piece of equipment out of the pit box during a stop.
"We just gave one away today," Stewart said. "I don't even know what to say. We just
gave one away. (Our car) was the baddest thing on the West Coast today. Second
sucks."
Stewart regained the lead on lap 200 after his team saved time by changing two tires
and other front-runners took four. But that cost him on the last stop with 32 laps
remaining when he had to change four tires and Edwards took two and beat him onto the
track.
"It definitely didn't hurt the decision-making process to see them run extremely well
with two tires," Osborne said. "I thought our only opportunity was to leapfrog them
on the track and hope we could hold them off."
Stewart took the points lead through three races with 113, tying him with Kurt Busch,
who finished ninth after rebounding from a spin on lap 103. Edwards is third.
The last 32 laps provided the drama missing during the first 235, not counting a fire
when the engine in Kyle Busch's car detonated or Jeff Gordon's day ending when he
crashed into a wall.
After a record number of lead changes in the season's first two races, there were 21
on Sunday -- seven fewer than the track record -- and nearly all were products of pit
stops. Cars ran single file for nearly all the race with only a smattering of green-
flag lead changes.
For much of the day it would have been easier for a driver to pass a kidney stone
than another car.
"Anybody out there today knew that passing was nearly impossible," said Denny Hamlin,
who probably passed the most. A post-qualifying engine change dropped him to the rear
of the 43-car field to start and he finished seventh.
"Hopefully when we come back here (Goodyear) will soften the tire up, and that's when
you'll see a lot of side-by-side action," Hamlin said.
Edwards, though, said excitement was not lacking from his vantage point.
"I can tell you, from the driver's seat there are no more exciting tracks to drive
on," he said of Las Vegas. "This place has a lot of character. You slide the car at
200 mph through the corner and there are multiple grooves.
"Some days we will have races that are more single file and some days we won't. I
think the savvy fans know what's going on."
Spoken like a driver who had just won the race.
Force Thunderbirds on Thursday.
His latest adventure in Las Vegas was celebrating in Victory Lane on Sunday after
winning his second NASCAR Sprint Cup race in four years at Las Vegas Motor Speedway
before an estimated crowd of 140,000.
Quite the Vegas vacation, indeed.
"I've had a blast. I don't know what I'm going to do next weekend," Edwards said,
adding he plans to award the Kobalt Tools 400 winner's trophy to the Thunderbirds,
who he said inspired him.
The resident of Columbia, Mo., was flying high after winning for the 19th time in the
series and earning his Roush Fenway Racing team $401,541.
Edwards and crew chief Bob Osborne are the hottest duo in the series. They won the
last two races of 2010 and were second in the season-opening Daytona 500.
"This is the best start to a season that I've ever had," Edwards said. "We have been
performing really well, and it's just a joy to drive these race cars right now. The
Fords are back and are strong."
The victory was the seventh in 14 Las Vegas Cup races for Roush Fenway Racing.
Edwards, who won the 2008 Cup race here, finished 1.246 seconds ahead of Tony
Stewart, who led a race-best 163 of 267 laps in a Stewart-Haas Racing Chevrolet that
was clearly dominant.
Even Edwards doubted he would have won without a blunder by Stewart's team on lap
151. Stewart fell from first to 23rd when NASCAR assessed a stop-and-go penalty after
his car dragged a piece of equipment out of the pit box during a stop.
"We just gave one away today," Stewart said. "I don't even know what to say. We just
gave one away. (Our car) was the baddest thing on the West Coast today. Second
sucks."
Stewart regained the lead on lap 200 after his team saved time by changing two tires
and other front-runners took four. But that cost him on the last stop with 32 laps
remaining when he had to change four tires and Edwards took two and beat him onto the
track.
"It definitely didn't hurt the decision-making process to see them run extremely well
with two tires," Osborne said. "I thought our only opportunity was to leapfrog them
on the track and hope we could hold them off."
Stewart took the points lead through three races with 113, tying him with Kurt Busch,
who finished ninth after rebounding from a spin on lap 103. Edwards is third.
The last 32 laps provided the drama missing during the first 235, not counting a fire
when the engine in Kyle Busch's car detonated or Jeff Gordon's day ending when he
crashed into a wall.
After a record number of lead changes in the season's first two races, there were 21
on Sunday -- seven fewer than the track record -- and nearly all were products of pit
stops. Cars ran single file for nearly all the race with only a smattering of green-
flag lead changes.
For much of the day it would have been easier for a driver to pass a kidney stone
than another car.
"Anybody out there today knew that passing was nearly impossible," said Denny Hamlin,
who probably passed the most. A post-qualifying engine change dropped him to the rear
of the 43-car field to start and he finished seventh.
"Hopefully when we come back here (Goodyear) will soften the tire up, and that's when
you'll see a lot of side-by-side action," Hamlin said.
Edwards, though, said excitement was not lacking from his vantage point.
"I can tell you, from the driver's seat there are no more exciting tracks to drive
on," he said of Las Vegas. "This place has a lot of character. You slide the car at
200 mph through the corner and there are multiple grooves.
"Some days we will have races that are more single file and some days we won't. I
think the savvy fans know what's going on."
Spoken like a driver who had just won the race.
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