Catch 22

I have been practicing Dr. B’s diet for over 2 years and have lost weight and brought my BG down as well as my A1c. Here’s the catch: Over the past year I have been passing kidney stones quite often. There have been a couple incidents where I required pain meds to mange the passing. This summer my doctor did some blood and urine tests and it shows that I have elevated calcium and oxalate which is why I am forming so many stones. The dietician and other research says that I should be eating small amounts of protein, my main staple in my current diet. So, I have to choose, high-protein, low-carb or low-protein, high carb. I am really afraid to add more carbs (pasta, rice, bread) to my diet in fear that I will gain weight and elevate my BG levels.
Any of you experience or hear of this dilemma?

About how much protein are you eating now? Dr. B advises moderate protein. I eat 30-35 carbs without eating a lot of protein, but I’m a small person. Seems that you could raise carbs a bit without a major problem. How much protein does your doctor recommend? Do you eat foods that are high in oxalates & did he suggest that eliminating these would help? It may not be solely a protein problem.

Dr. B’s diet is more properly described and low carb, moderate protein, high fat. So the thing to add is fat not pasta rice and bread. There are lots of studies showing that this higher fat content is not dangerous as long as you keep your carbs low. High protein is not good for you, just Google “rabbit starvation”

Why don’t you submit this to Dr. B himself to answer on his next teleseminar on Oct 26th? You can post the question on the AskDrB site.

Personally, I think the protein recommendations are whacked. They are based on the idea that excess protein leads to highly acid urine. If you hydrate well, you should not have highly acidic urine. You can use simple ph test strips to check. Urine normally varies between 4.6 and 8. If you are between 6-8, then you are probably fine and should continue your current levels of protein.

See what Dr. B says.

I have no idea if these things would cause kidney stones, but I did notice that Dr. Bernstein’s book still allows soy products and doesn’t stress food quality (because the overall goal is blood sugar control). I had read a lot about the paleo diet before finding Dr. Bertstein’s book, so I do a combo of low carb + good quality (no fruit), and I avoid soy and legumes and any type of vegetable oil. I notice that even if I eat a low carb meal, but it’s been cooked in lots of vegetable oil at a restaurant, I immediately feel icky. If you’re still eating vegetable oils or soy products, I’m wondering if these could be contributors? Do you eat out a lot, or cook mainly at home? There could be mystery things sneaking into your diet that you aren’t aware of. Just some random ideas from me and things to think about.

I agree that implementing starchy carbs does not seem like a good solution because it will be more difficult to keep steady blood sugar levels (though some non-diabetics do okay with a bit of rice and potatoes - not wheat/gluten in their diet). I have also heard it’s really difficult to “overdose” on protein (though possible, of course).

I think it would be awesome to ask Dr. B himself as bsc suggested! Congrats on 2 years of success and bringing your A1C down :slight_smile:

Bsc could be on to something with the hydration issue, it seems that I read somewhere that people who don’t drink enough water/liquids have problems with kidney stones.

On a typical day I would say I would be over 50 g (I usually have 25 for breakfast with less than 10 carbs) I agree that it may not be only the protein but other issues. What I read just points to excess protein intake can increase uric acid and oxalate. I have cut down on foods with high oxalate but need to refine it a bit. After spending so much time trying to regulate my BG with diet, I now have to worry about the other diets. REcently I have thought that kidney stones won’t kill me like high BG will (at least the complications from it). Thanks always for your insight.

I have enjoyed the increase in fat (flavor) and am glad that it is not a problem. I am going to have to work on adding more. Thanks for the reply

Thanks for the suggestion, I sent it to them for the next podcast. (Does anyone know how to get old episodes of that podcast?) I will consider testing the pH. thanks.

I have always been terrible about drinking enough water. I know I need to increase that. Water doesn’t seem to stay in my more than an hour though. I hate the constant urination trips.

So why no fruit? Doesn’t an apple a day keep the Dr away?
No oil? No olive oil? What do I put on my salads then? Soy? Occasionally some tofu but nothing else, I think.
Thanks for the reply, joeynicole.

Fructose is particularly problematic because it’s metabolized by the liver. Berries in moderation don’t effect me adversely because they’re relatively low in fructose.

Extra virgin olive oil is fine & healthy for salads… Nut & seed oils are great. Other vegetable oils aren’t. When heated, polyunsaturated vegetable oils are unhealthy. Only saturated fats are stable when exposed to high temperatures. For cooking, I use butter & virgin coconut oil.

Another thing to look at is your magnesium level because low magnesium contributes to stone formation. Serum magnesium tests aren’t reliable. I can’t recall what the best test is for this right now & I’ll get back to you with about this. Magnesium deficiency isn’t unusual, especially if you eat a lot of dairy.

Good suggestion to drink more water, even though it’s a pain to have to pee frequently.

Here’s a good protein calculator from Jenny’s bloodsugar101 site

Unfortunately, the old episodes are not freely available. There is a post up for about a month in podcast, but then it is taken down. If you really are a devotee of Dr. B, you can join his Bernstein Connection for a fee. I believe all his previous teleseminars are available to members. I have never joined, so I really can’t provide you with any more info. Perhaps someone else here is a member.

You said it best! Thanks Gerri! We use mostly rendered bacon lard for cooking, olive oil for salad dressings, and melted kerrygold butters for roasting veggies.

I agree about the magnesium - it’s one of only 2 supplements we take in our house (that & vitamin D). Another great effect of adding magnesium is that it also helps you sleep really well. I guess it’s not as prevalent in our soil as it used to be so it’s difficult to get naturally.

Todd, I’m in a Catch-22, too. I should be on a plant based diet for my autoimmue issues, but that’s impossible to do and stick to Dr. B’s parameters. I’ve been lc ever since diabetes ever came into the discussion before official diagnosis. Then, because I had Cushing’s Syndrome from an adrenal tumor, I have residual myopathy and am supposed to be on a high protein diet. If I error, I eat too much protein. I don’t do carbs other than those on Dr. B’s list.

Hi Todd,

I'm just reading the new edition of Dr. Bernstein's "Diabetes Solution", which came out November 1. In connection with Gerri's post mentioning magnesium:

Dr. Bernstein (page 259) says that the test should be for "red blood cell magnesium."

Best wishes in finding a solution for your diet!


I just read through a major portion of The Diabetes Solution this past weekend. I remembered seeing something about kidney stones in the book, so I just went and looked it up. I have the March 2007 edition, and in the middle of page 180, Bernstein recommends calcium citrate as he says it is well absorbed in the gut and inhibits the formation of kidney stones. Hope this helps and so sorry that you have been having issues.


Wow, Gail, nice work. The Dr put me on Tums which is Carbon Carbonate and he said that it will do the same thing you mentioned. I take one tab at breakfast and one at dinner (suppose to take one at lunch but I couldn't work it into my schedule). So far, so good. I am real glad Dr. B recommends "basically" the same. Thanks so much. I am going to have to bust out the book and have a reread.

Hey, Todd,
I have had T1 for over 30 yrs. Have had two very painful kidney stone experiences, the last one a little over a year ago in October. They also said my urine was high in oxalate and recommended a low oxalate diet. The high oxalat foods are all my favorites:! coffee, tea, peanuts & peanut butter, nuts, chocolate, cola drinks! I eliminated diet Coke - I prob was up to 64 oz a day by that point - and peanut/butter, the foods on the list of which I consumed the largest quantities. I haven't had any probs with stones since. Maybe a similar change would allow you to keep your protein?

Hell's Bell's M8 how on earth will you work through that? I wish you a full recovery from the stones!
How does anyone count carb's anyway?
I'm Catch 22 like you only I have heart disease as well ++++plus!
Food is just a mine field, but I wont put up with stones as well! I'm not able to follow anyone particular diet. Yesterday I shot from 101 to 227 after having a cup of tea with fat free milk (saccharine) and eating an apple an hour later! I get really giddy and have unpleasant feelings if my BS drops below 90ish!