Picture of milk in different sized jars with title: The best calcium sources for kidney stones

The Best Calcium Sources for Kidney Stones

No doubt about it, eating enough calcium is a critical part of a healthy diet for people who have calcium kidney stones. But, what is the best way to eat enough calcium?

*Please note that this post contains clearly identified affiliate links.  If you click on these link and choose to make a purchase, I may receive a commission (at no cost to you).

Why Is Calcium So Important?

Block Oxalate Absorption

It may seem counterintuitive to eat MORE calcium when you have calcium kidney stones. But, hear me out.

The first reason eating enough calcium is so important is to reduce how much oxalate is absorbed. (1)

Calcium loves to bind with oxalate – this is why it is the most common type of kidney stone. We can use that love to our advantage by pairing high calcium foods with meals. When calcium is eaten with healthy meals that have oxalate in them, calcium will bind with oxalate in the intestine. Bound oxalate cannot get absorbed into the body. In turn, this will reduce the amount of oxalate in our urine and reduce the risk of kidney stones.

Protect Your Bones

The second reason calcium is so important for people with calcium kidney stones is bone health. People who have calcium kidney stones are at greater risk of bone fractures and weak bones. (2)

Eating enough calcium and vitamin D can help keep bones healthy and strong.

How Much Calcium Do I Need?

People with calcium kidney stones need the same amount of calcium as the general population. It is just even more important that people with calcium kidney stones meet their calcium goals!

Aim for 1,000 – 1,200mg of calcium per day.(3) (4)

One serving of dairy has 200-300mg of calcium. Ideally, eat one serving of dairy with 3 meals per day. These 3 servings of dairy, combined with small amounts of calcium from other foods, is a good way to be pretty sure you are eating enough calcium.

One serving of dairy is:

  • 1 cup of milk or kefir
  • 3/4 cup of yogurt or low-sodium cottage cheese
  • 1 ounce of cheese – look for lower sodium cheeses like goat, mozzarella or Swiss

I’ve written a cookbook that includes dairy in all the recipes. I know that drinking milk with every meal can get boring!

Cow’s Milk Dairy First

When at all possible, I recommend cow’s milk dairy for people who have calcium kidney stones. Cow’s milk and dairy are, by far, the most calcium dense foods. And, dairy has lowered kidney stone risk in studies.(5)

If you have kidney disease in addition to kidney stones, the best milk for you might be different.

Skim vs. Whole Milk

The amount of fat in milk has little effect on the calcium amount. Skim, 1%, 2% and whole milk have basically the same amount of calcium.

Nutrition in 1 cup of skim, 2% and whole milk

The one exception is dairy with a very high fat content. Foods like cream, cream cheese and sour cream are much lower in calcium.

Of course, the higher the fat content, the higher the calories and fat. For most people, I recommend fat-free or low-fat dairy.

Tips for Lactose Intolerance

The most common reason for milk intolerance is difficulty digesting lactose. Lactose is a sugar found in dairy. We need an enzyme called lactase to digest lactose. Without enough lactase, dairy can cause gas, diarrhea, cramping and other uncomfortable symptoms.

Start Slowly

The good news is that you can train your body make lactase again! Rather than dive in with 3 servings of dairy per day, start with just one (or even a half!) serving each day. Assess your symptoms for a few weeks and go up from there.

Start with Cheese or Yogurt

Cheese and yogurt tend to have less lactose in them. People who cannot tolerate milk often can tolerate cheese or yogurt.

Try Low Lactose Milk

Lactaid* and other lactose free dairy is a great option for people who have kidney stones.

You can also try Lactaid* in pill form when you eat dairy.

Good Non-Dairy Calcium Sources for Kidney Stones

Of course, milk is not for everyone. Many people avoid dairy due to cultural, religious, ethical or environmental reasons.

Of note, dairy has not been shown to cause inflammation in rigorous scientific studies. In fact, dairy has been shown to be anti-inflammatory in some cases. (6)(7)(8)

Most plant-based and non-dairy milk substitutes are supplemented with calcium. Because we know that calcium supplements tend to increase urine calcium more than natural sources, this is somewhat of a concern. However, no research has investigated the difference in urine calcium after consumption of natural and calcium supplemented foods.

Some calcium is certainly better than no calcium. Calcium from both dairy and non-dairy sources has been shown to reduce the risk of kidney stones.(9)

For people with a history of calcium kidney stones, dairy substitutes made from these milks are good choices.

  • Rice Milk
  • Oat Milk
  • Coconut Milk
  • Hemp Milk
  • Pea Milk

Double check that the brand you buy is supplemented with calcium.

Dairy Substitutes NOT Recommended for Kidney Stones

These dairy substitutes are made from foods high in oxalate. Because oxalate is water soluble, it is a fair assumption that any liquid made from these foods will contain oxalate.

Although not everyone with kidney stones needs to avoid oxalate, I would recommend steering clear of these options. Adding these milk substitutes 3 times per day could add a very large oxalate load.

I do not recommend these milk substitutes for people with calcium kidney stones:

  • Almond Milk
  • Cashew Milk
  • Soy Milk

Calcium From Plant Sources

Some plant foods are surprisingly high in calcium! These foods all have at least 60mg of calcium per serving (1 cup unless otherwise specified):

  • Collard greens
  • Spinach
  • Kale
  • Soybeans
  • Broccoli
  • Broccoli rabe
  • Chia seeds (2 tablespoons)
  • Tofu
  • Edamame
  • Okra
  • Sunflower seeds (1/4 cup)
  • Almonds

Italicized foods are higher in oxalate and not recommended for people with high urine oxalate levels.

However, the amount of calcium in most of these foods is still far less than dairy.

Calcium in 1 cup of raw kale vs. 1 cup of milk

Importantly, calcium from these plant foods is not absorbed as well compared to dairy. Many of these foods are high in oxalate. Calcium is already bound to oxalate (and other compounds called “phytates“), which reduces absorption. In addition, because calcium is already found to oxalate, it will not do as good a job of binding other oxalate in that meal.

However, eating lots of fruits and vegetables is critical for kidney stone prevention.(1) Including some high calcium veggies can absolutely help get your to our daily goal of 1,000 – 1,200mg of calcium.

Calcium Supplements

Many patients ask “why can’t I just take a calcium supplement?”. Although this may seem like an easy fix, calcium supplements are not always the best choice for people with kidney stones.

The concern with calcium supplements is that supplemental calcium is much more likely to raise urine calcium than calcium that naturally occurs in food. This is very problematic for kidney stone formers because high urine calcium is the most common cause of calcium kidney stones.(1)

However, calcium supplements may be warranted in some people with kidney stones. Especially if urine calcium is normal. Work with your doctor to figure out what is best for you.

Happy Eating!

Melanie

41 thoughts on “The Best Calcium Sources for Kidney Stones”

  1. Does Kidney stone nutrition school teaches/includes how to prevent kidney stone while maintaining a plant base diet for people that can’t do dairy or animal protein…..My issue is HyperOXalate, Hyperkalemia ,CKD 3b….. was avoiding food high in phos thus not doing dairy….got the low oxalate beans and nuts list but not sure if this option of protein puts me at risk for kidney stone…I’m trying to help kidney but not eating meat , less renal workload but the choices have oxalate…..I use to take yogurt to help this out now that I drop dairy this is not possible anymore……what to do?

    1. Melanie Betz MS, RD, CSR, CSG

      Absolutely! Kidney Stone Nutrition School doesn’t promote or endorse a single dietary pattern. Instead, it will help you understand what aspects of nutrition actually matter for stone prevention for YOU – and then how to apply them to a dietary pattern that you enjoy and works for you! I have had many students who follow a plant based diet for stone prevention with a LOT of success. There are actually plenty of benefits of a plant based diet for stone prevention!

  2. micaela beckwith

    If a person is taking a calcium supplement, isn’t calcium citrate helpful in reducing the possibility of kidney stones because of the citrate? Also, will lemon water be helpful to reduce the possibility of stones?
    Thanks again!

    1. Melanie Betz MS, RD, CSR, CSG

      Hello! The answer to this completely depends on your 24 hour urine test results. With high urine calcium, you definitely want to avoid ANY calcium supplementation. Lemon juice can be helpful for some people (again, depends on those urine test results) – but you need a pretty substantial amount of lemon juice to really move the needle for stone prevention. A wedge or two in water isn’t usually going to cut it. I help people prevent kidney stones with this personalized approach in Kidney Stone Nutrition School!

  3. If one avoids dairy, and green vegetables are not the best substitute as a calcium source with meals, can bone-in canned fish and crushed eggshells stand in fine? Yes, it’s safe to consume completely pulverized egg shells. They are reliably high in calcium, as one could assume. Additionally, what about ocean vegetables like seaweed? I am under the impression that most, if not all, seaweeds are low oxalate. I don’t know if that is accurate however. Thank you for your response.

    1. Melanie Betz MS, RD, CSR, CSG

      Hi Bette! Bone-in fish could be a good option. I’d be careful with seaweed, as it is incredibly high in sodium. Ultimately, I can’t say what is best for you and what your priorities should be here without reviewing your 24-hour urine test results, medical history and current eating habits!

      1. Thank you so much. Yes, I forgot about the sodium content for a minute! Oops. I was just trying to think of food calcium sources, as opposed to supplements. It’s easy enough to switch to bone-in fish (and eggshells, which I have the go ahead on, based on my medical history).

  4. Claudia Sienko

    I am so glad I found you ! I have received conflicting advice from my providers.
    I have had two calcium oxalate stones. The 24 urine test shows I have high calcium. My doctor recommended a low oxalate diet. But after reading your article, I see that protein, sugar and salt are what I should cut back on. Am I correct?
    I am dairy intolerant. Lactose does not help… seems it’s the milk protein I can’t digest. Do I still need to find alternate sources to keep calcium in my diet.? I have been talking a calcium supplement when I consume a meal high in oxalates. ( I do avoid the highest oxalate foods like almonds and spinach).
    Thanks for your advice. You are doing a great service.
    Claudia

    1. Melanie Betz MS, RD, CSR, CSG

      Hi Claudia! Thank you for your kind words. I’m glad you’ve found me as well! That high urine calcium is actually the #1 cause of stones, so you aren’t alone. Yes, eating the right amount of protein, sugar and salt can all help reduce urine calcium. Without knowing what you are eating now, I can’t really say if you are eating too much of these things already. Calcium supplements should DEFINITELY be avoided for people with high urine calcium – they tend to raise urine calcium MUCH more than natural sources of calcium from food. If your urine oxalate wasn’t high, there really isn’t a good reason to avoid higher oxalate foods. I help people put all of this together, and know exactly what to eat based on their 24-hour urine test results, in my course – Kidney Stone Nutrition School. I think you would be a perfect candidate and I would love to help you!

  5. Hi, Melanie – I’m so happy to find you! You mentioned in your alkaline water article about some mineral waters having calcium, and there is a brand that was recommended to me that has 200 mg per bottle so I was going to try it to supplement my intake. But would you say that as a source of calcium it’s inferior to food? Thanks in advance!

    1. Melanie Betz MS, RD, CSR, CSG

      Wow! That is a lot of calcium. That calcium does (probably!) function more like calcium from a supplement than naturally occurring calcium. Here is more info about my thoughts about calcium supplements vs food vs supplemented foods!

  6. I am also vegan, no liquid oil and gluten free due to many medical challenges. My last 24 hr. test showed that my calcium was too low. I’ve tried plain, fat-free Greek yogurt on occasion (approx. 1/3 c daily), but I definitely can’t use it daily or in large quantities without serious issues. I notice you don’t mention whey powder. What are your thoughts regarding whey?

    Can calcium oxalate kidney stones cause CKD?

    1. Melanie Betz MS, RD, CSR, CSG

      Hi Reba! I really can’t comment if whey is right for you or not. Nutrition for stones is different for every person, depending on their 24 hour urine test. I’d work with a dietitian to see what is best for you! And yes, any type of kidney stone does increase your risk of kidney disease.

      1. So glad I found you. Just starting this journey. Still waiting on follow up appointments.
        That said, I have a general question. If a plant food, say almonds, is high in both calcium and oxalates, and the fact they are already bound up together makes it hard to extrapolate the calcium, wouldn’t they both just pass through the intestine making that food safe to eat? (Assuming that person is on low oxalate diet).
        Fyi, I’m an RN, and if I wasn’t 70 years old, I’d go back to school to become a registered dietician. It is such a fascinating subject. And now with all the microbiome stuff that didn’t even exist when I was in school.

        1. Melanie Betz MS, RD, CSR, CSG

          Hi Kim! Great question! The answer ultimately is we don’t know. IF high urine oxalate is an issue for you (it isn’t for most people with stones), there is likely not enough calcium in almonds to bind the VERY high oxalate content in the almonds. Although the research isn’t advanced enough for us to know the exact ratio of calcium to bind oxalate, we do know that urine oxalate goes up after eating almonds and spinach, specifically. There really is VERY little calcium in most plant foods, compared to dairy.

          I agree the microbiome stuff is FASCINATING – especially it’s role in kidney stones. There is just SO much to know. My thesis was actually about probiotics, so those little bacteria will always hold a special place in my heart!

          1. Any way I can read your thesis? I love reading research. Super enjoyed my research analysis class in college.

    1. Melanie Betz MS, RD, CSR, CSG

      Thank you so very much for the kind words! I’m so happy you find my stuff helpful!

  7. I thought Hemp is in the Medium to High oxalate catagory so am confused that Hemp milk is recommended.

    You don’t have Flax Milk listed here and thought it was as low as Pea milk.

    Also, I make my own vegan milk and am curious if it makes a difference.

    Thank you for your time in replying.

    1. Melanie Betz MS, RD, CSR, CSG

      Hello! According to my database, hemp is low in oxalate, so I recommend it. I take great care to only use reputable sources for oxalate amounts. I use the Harvard list first, and supplement from well trusted databases from there.
      Flax and pea milk would also be good choices.
      NONE of these plant milks are naturally high in calcium – they are supplemented. So, when you make your own at home, these would not be good sources of calcium.
      Hope that helps!

  8. GREAT article. I do realize that water kefir doesn’t have calcium but is homemade water kefir low, or high in oxalates.
    Thank you for any information you can provide.

    1. Melanie Betz MS, RD, CSR, CSG

      Thank you so much! Water kefir’s oxalate content would depend on what fruits are used to make it. Please do remember that oxalate is not the most important piece of kidney stone prevention! (Trying to take some of the stress out of the situation!) This article goes over what really makes a difference!

      1. Thank you kindly for responding to my questions. I am on a very high learning curb and so confused by all the information partly due to a TBI that challenges me and partly because the internet has a lot of contradictory information.
        Thank you again I truly appreciate all the information that you provide here.

  9. I’m confused about bran cereals. Are those made with oat bran high in oxalates? What dry cereals are low in oxalates? Thanks

  10. I also can’t drink a glass of milk, so since I like lattes I have started making my own version. I steam 1 cup of milk, add 1/2 teaspoon of instant coffee and 1/2 of teaspoon or less of sugar. That I can handle without gagging. It works for breakfast time.

      1. Melanie Betz MS, RD, CSR, CSG

        If your urine oxalate is VERY high (on a 24 hour urine test), it might be best to avoid instant coffee. BUT, I’d say for most people it is totally fine. Add some calcium to that coffee 🙂

  11. Milk of any kind makes me gag. I use cashew milk to cook with. I am vegetarian and have stomach issues limiting my ability to eat beans/lentils and many vegetables. I also have to eat a low fat diet and need a high amount of carbohydrates for high demand exercise. The low oxalate recommendations take away all the foods I currently eat leaving little left. Any suggestions. My favorite foods are nuts and chocolate. Vanilla foods aren’t even an option because I won’t eat them.

    1. Melanie Betz MS, RD, CSR, CSG

      Hi Virginia! Thank you for your comment. Without knowing your medical history and lab values, it difficult for me to make recommendations for you! I would encourage you to check out all aspects of healthy eating for kidney stones – it is MUCH more than oxalate and, for many people, oxalate is the least important part. I’ve found that many people over restrict oxalate and liberalizing this helps people realize there are many healthy fruits and vegetables they can eat! Hope that helps!

      1. Hi Melanie!
        String cheese is an awesome calcium choice and travels well too! Question: Is Stevia sweetener high in oxalate? Online charts are conflicting. Also, how about Monk Fruit Sweetener, is it high in oxalate? Thank you for being here for us! Kindest Regards, JJ 🦋

        1. Melanie Betz MS, RD, CSR, CSG

          Love it! String cheese is a GREAT source of calcium for kidney stones! Stevia (the plant) is high in oxalate. But, the consensus is that the the oxalate is removed in processing to make Stevia (the sweetener). So, I characterize it as low oxalate. Hope that helps!

          1. Thank you Melanie for the clarification on Stevia! Is there any information yet on Monk Fruit Sweetener’s oxalate content? I can’t find anything at all about it, even when typing it into PubMed search bars. Thank you! 🦋 JJ

          2. Melanie Betz MS, RD, CSR, CSG

            Hi JJ! I’m honestly not sure about monk fruit. I really wouldn’t worry about it. For sweeteners, we are generally using such a small amount it really isn’t going to make that much of a difference in the grand scheme of things! For most people, just avoiding the VERY high oxalate foods (along with getting enough calcium) is enough to bring urine oxalate down to safe levels!

  12. I love this article, thank you. I’ve never been a milk drinker and add strawberry powder to it so I can drink it. Otherwise, I do love calcium.

    1. Melanie Betz MS, RD, CSR, CSG

      Love it! Be careful of the sugar in powders like that. But, a small amount is likely fine!

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