Posts Tagged ‘dehydration’

How Much Water Do You Really Need To Drink?

October 28, 2017

Andrew Siegel MD   10/28/17


Thank you Pixabay for above image

Many sources of information (mostly non-medical and of dubious reliability) dogmatically assert that humans need 8-12 glasses of water daily to stay hydrated and thrive. Today’s entry addresses the question of how much water you really need to drink in order to stay healthy.

Fact: Many take the 8-12 glass/day rule literally and as a result end up in urologists’ offices complaining of urinary urgency, frequency and often leakage. Clearly, the 8-12 rule is not appropriate for everyone! The truth of the matter is that although some urinary issues are brought on or worsened by insufficient fluid intake, including kidney stones and urinary infections, other urinary woes are brought on or worsened by excessive fluid intake, including the aforementioned “overactive bladder” symptoms.

Fact: Many foods have high water content and can be a significant source of water intake. In general, the healthier the diet (the more the fruit and veggie intake) the higher amount of dietary water.  For example, melons, citrus fruit, peaches, strawberries and raspberries are about 90% water, with most fruits over 80% water.  The same holds true for vegetables, with lettuce, tomatoes, cucumbers, celery, radishes and zucchini comprised of about 95% of water, with most veggies over 85% water.

Water is a vitally important component of our bodies, promoting optimal organ and cellular functioning, temperature regulation, nutrient and waste transportation, joint lubrication,  and facilitating the thousands of chemical reactions occurring within our bodies. 60% of our body weight is water, two-thirds of which is within our cells and one-third of which is in blood and tissues between cells. For a 165 lb. man, that translates to 100 lb. of water weight. For a 125 lb. woman, that translates to 75 lb. of water weight.

Our body needs water “equilibrium,” with water intake balancing water losses.  Most people need a total of 65-80 ounces daily, although this can vary greatly depending upon one’s size, the ambient temperature and level of physical activity.  Again, water intake comes from beverages and foods consumed, with many foods containing a great deal of water, particularly fruits and vegetables as mentioned, so the 65-80 ounces includes this source. Water losses are “sensible,” consisting of water in the urine and stool, and “insensible,” from skin (evaporation and sweating) and lungs (moisture exhaled).

The formula that doctors use for figuring out daily fluid requirements—especially useful for hospitalized patients not eating or drinking who depend totally on intravenous fluids—is 1500cc (50 ounces) for the first 20 kg (44 lb.) of weight, and an additional 200cc (7 ounces) for each additional 10 kg (22 lb.) of weight.  So, for a 125 lb. woman the daily fluid requirement is 2250 cc (75 ounces).  For a 165 lb. man, the daily requirement is 2600 cc (87 ounces).  It is important to understand that the 75 ounces of fluid requirement for the woman and the 87 ounce fluid requirement for the man in this example includes both beverages and food. If one has a very healthy diet with lots of fruits and vegetables, there will obviously be less need for drinking water and other beverages.

Fact: Caffeinated beverages (coffee, tea, colas, many energy and sports drinks and other sodas) as well as alcohol both have diuretic effects, causing you to urinate more volume than you take in. So, if you consume caffeine or alcohol, you will end up needing additional hydration to maintain equilibrium.

The other important factors with respect to water needs are ambient temperature and activity level. If you are reading or doing other sedentary activities in a cool room, your water requirements are significantly less than someone exercising vigorously in 90-degree temperatures.

Humans are extraordinarily sophisticated and well-engineered “machines.”  Your body lets you know when you are hungry, ill, sleepy and thirsty.  Paying attention to your thirst is one of the best ways of maintaining good hydration status.  Another great method is to pay attention to your urine color.  Depending on your hydration status, urine color can vary from deep amber to as clear as water.  If your urine is dark amber, you need to drink more as a lighter color is ideal and indicative of satisfactory hydration.

Some advantages of staying well-hydrated:

  • Avoids dehydration and all its consequences (this is pretty obvious)
  • Dilution of urine helps prevent kidney stones
  • Dilution of urine helps prevent urinary infections
  • Helps bowel regularity
  • Maintains hydrated and supple, less wrinkled skin
  • Helps keep weight down because of the filling effect of drinking; also, thirst can be confused with hunger and some people end up eating when they should be hydrating


  • Makes you urinate a lot, which is not good for those with overactive bladder symptoms

Wishing you the best of health,

2014-04-23 20:16:29

A new blog is posted weekly. To receive a free subscription with delivery to your email inbox visit the following link and click on “email subscription”:

Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community.

Dr. Siegel has authored the following books that are available on Amazon, iBooks, Nook and Kobo:

 MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health

THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health 

PROMISCUOUS EATING: Understanding and Ending Our Self-Destructive Relationship with Food


These books are written for educated and discerning men and women who care about health, well-being, fitness and nutrition and enjoy feeling confident and strong.




A Lemon A Day Keeps The Urologist Away

July 25, 2015

Andrew Siegel MD  July 25, 2015


The Northeast USA has recently experienced oppressively hot weather –sizzling, steaming, scorching, sultry hot. This extreme weather has the same significance to urologist as a frigid and icy winter to an orthopedist–a harbinger of busier office hours. Ice drives patients with fractures in to see their bone specialists, but heat drives patients with kidney stones in to see their urologists. Summer is the “high season” for kidney stones, often brought on by dehydration from the stifling heat. The hotter the temperature, the greater the prevalence of kidney stones. To help prevent this very common and extremely painful condition, it is important to stay well hydrated by drinking lots of fluids. A sign of good hydration is dilute-appearing urine, which looks more like lemonade as opposed to apple cider, or for the beer drinkers, light American beer versus a rich, dark European brew. Lemons, being citrus fruits, contain citrate in high concentration, a well-known inhibitor of kidney stones.

I’m puzzled why the word “lemon”—representing such a lovely fruit—is often used with negative connotations, referring to a poorly functioning car or a challenging situation that can be overcome, turning “lemon into lemonade.” I suppose it’s because of its natural tartness. But au contraire, the lemon is a citrus superstar that is appealing to all of the senses…to the eyes with its vibrant sunshine color and oval shape, to the nose with its distinctive citrus aroma and to the sense of touch with its firm, textured outer peel and juicy, segmented inner flesh and to the sense of taste, with its unique tart and acidic flavor.

Lemons are low calorie nutritional powerhouses.  In addition to citrate, lemons contain fiber, potassium, copper, calcium, flavonoids, B vitamins, folate and other phytochemicals. Lemons are packed with Vitamin C, a formidable anti-oxidant that helps slow oxidative damage that occurs via the accumulation of byproducts of metabolism and damage from environmental toxins. This accumulation is called reactive oxygen species (also known as free radicals) and contributes to diseases, aging and ultimately death.

Squeeze one-quarter or one-half of a fresh lemon into water or seltzer on the rocks for a refreshing, extremely low-calorie, delicious drink that is so much better for you than sweetened beverages such as sodas, fruit juices and sports drinks. This serves as a powerful tonic for preventing kidney stones. Urologists often prescribe medications containing citrate to help prevent stones, but why not try the natural, first-line approach at ramping up levels of citrate before trying the pharmaceutical approach?

In addition to being an awesome fruit that is great squeezed into a drink, lemon juice is wonderful on fish, in chicken dishes and in salad dressings. Lemons are often used as an ingredient for aromatherapy and in cleansing products as well. If you have ever visited Italy, particularly the Amalfi Coast region, you probably recall an abundance of citrus groves and a lemon-based liqueur called Limoncello available everywhere.

Bottom Line: If an apple a day keeps the doctor away, then a lemon a day keeps the urologist away! 

Wishing you the best of health,

2014-04-23 20:16:29

A new blog is posted every week. To receive the blogs in your email in box go to the following link and click on “email subscription”:


July 20, 2013

Andrew Siegel, M.D. Blog #113

As I sit here writing, it is 100 degrees Fahrenheit in the New York metropolitan area. We are in the thick of an absolute hellish heat wave, as we have been for the past several weeks. I prefer the heat to winter frigidity, but current weather conditions make it very unpleasant to be outside and, more importantly, these temperatures can be downright dangerous to one’s health, causing an entire host of very unpleasant symptoms that if not attended to can result in heat stroke and even death.

I became dehydrated last weekend, a miserable incident that has happened a few times in my lifetime. It happened after cycling with my sister, her friend and a few of my friends. It was 95 degrees Fahrenheit and near 100% humidity. I picked up Michael in my wife’s hybrid SUV and with our two bikes on the rack headed to Fort Lee, parking near the George Washington Bridge. I consumed a bottle of water in the car while driving, because I knew it was going to be a scorcher, and had two full bottles on my bike of iced water and iced coconut water. Our group rode 45 or so very hilly miles that day. We did the Palisades Interstate Park starting at Fort Lee and then headed up north and exited the park to enter 9W. We cycled past the Tappan Zee Bridge and ended up at Nyack Beach State Park. We put in nearly 3 hours of cycling time, with a bunch of rest stops, totaling about 5 hours of outdoor exposure time. I really thought I could keep up with my water losses, but I was clearly in the wrong.

We initially stopped for a breather near the police station in Alpine after a tough climb and the entire group was already drenched. Our next break was at the Community Market in Piermont for a water refill and a short recess. We turned around at Nyack Beach State Park and two of our group departed for home, but four of us stopped at the Runcible Spoon for a smoothie, a carbohydrate recharge, another water replenishment, and a nice break. Thereafter, our foursome maintained a well-executed pacing line for the remainder of the return trip, which was predominantly on Piermont Road, with a final rest stop before descending the hills of Tenafly. At this stop, all of us felt “not quite right.” My sister experienced chills and nausea; I felt incredibly hot and my pulse was racing away and our two friends were entirely relieved to be out of the saddle and the sun for a few minutes. During the final ascent, both of my quads experienced simultaneous cramps, but our group ultimately made it back intact. I ripped off my sweat-weighted cycling jersey and turned the AC in the SUV to max. As I drove home I felt light-headed and experienced a strange visual occurrence in which everything that was white in color appeared glaringly and strangely bright to me—kind of the way heaven is portrayed in movies!

When I arrived home, I felt out of sorts; I was exhausted and my heart was still racing and all I wanted to do was to lie down—I truly felt as if a truck had hit me! I couldn’t seem to find the keys to the SUV to return to my wife, hunted in vain for them, but ultimately discovered them tucked into the front waist of my cycling shorts—clearly I was not playing with a full deck!

I had a mid-afternoon lunch, drank almost two more bottles of water and mustered up the energy to shower. I headed to the couch, where I proceeded to read the Sunday paper. I developed an awful headache and took a few Motrin with some more water. My family was supposed to go out for dinner that evening, but I felt so sluggish that I just wasn’t up for it. After having take-in Chinese food for dinner (certain to rebalance my sodium deficit!) I spent the evening on the couch, watching “The Borgias” and “Prison Break.” By 9PM I realized that I hadn’t urinated in 12 hours. When I did, the urine was dark and concentrated. Ultimately, after a pretty decent night’s sleep, I was back to normal in every respect. However, in retrospect, I recognized that I had suffered with dehydration, a very dangerous problem that has the potential to kill human beings.

Dehydration is a state in which there is excessive loss of body water and therefore a disturbance in our metabolic processes and functions. As a result of excessive fluid loss, there is decreased blood volume (hypovolemia) and consequently, lower blood pressure and a faster heart rate with less delivery of oxygen and other nutrients to our tissues, and less removal of waste products. Under these circumstances, it is common to experience “orthostatic” changes—feeling light-headed and dizzy when arising from a supine or sitting position. Often one experiences a dry mouth and profound and sometimes insatiable thirst. It is typical to feel nauseated, sleepy, lethargic, fatigued and generally awful, not dissimilar to the sensation of being hung over. Mental confusion and even delirium are real possibilities. One’s urine becomes very dark and concentrated as the kidneys make every effort to reabsorb water back into the body. Urine production therefore becomes minimal. Skin can lose its healthy consistency, becoming dry, shriveled and much less elastic. Sweating and tearing can cease and body weight can drop significantly. 60% of our body weight is water, of which two-thirds is within cells and one-third in our blood and interstitial fluid (fluid between our cells). For a 70 kg man, that amounts to 42 kg of water. It doesn’t take too much in the way of fluid losses to throw one over the brink into dehydration. The long and the short of it is that dehydration can and will negatively affect every cell, tissue and organ in the body.

Dehydration can severely impact one’s athletic performance. Endurance athletes such as marathon runners and cyclists are particularly susceptible because of the amount of time they spend exercising and the extent of sweating that comes with the territory. Dehydration is cumulative, such that a fluid deficit from a previous day’s effort carries over to the next day. Exercising in high altitude areas increases the degree of the risk. The greater the temperature, the greater the risk, and the same goes for humidity, since sweat cannot evaporate as efficiently under severely humid conditions as it can under dry ambient conditions.

Tips To Avoid Dehydration
• Don’t be a fool like me and spend hours doing a strenuous endurance event when it is ridiculously hot and humid out. In the circumstances of really high temperature and humidity, go to the gym or for a swim to get your exercise dose.
• Hydrate, hydrate, hydrate…the best endpoint is urine approaching the color of water; if it looks like apple cider it is a sign of dehydration. Drink abundantly before, during, and after exertional activities.
• Wear light gear that wicks the sweat from your body and that promotes evaporation.
• Avoid strenuous exercise at the peak heat of the day—early morning or late afternoon are preferred times.
• The young and the elderly are at higher risk, so this population should hydrate to an even greater extent.
• Be particularly careful about dehydration if you take a diuretic or drink a lot of caffeine or alcohol, since you will be particularly prone from the dehydrating effect of these substances.

Bottom Line: Always be cognizant of weather conditions when undertaking any type of outdoor activity. Remember, Mother Nature rules supreme and is not something to take lightly…serious, or even deadly, consequences can be the result.

Andrew Siegel, M.D.
Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food:
Available on Amazon in paperback or Kindle edition
Blog subscription: A new blog is posted every week. On the lower right margin you can enter your email address to subscribe to the blog and receive notifications of new posts in your inbox. Please avail yourself of these educational materials and share them with your friends and family.

Liquid Gold

February 23, 2013

Liquid Gold

Andrew Siegel, MD  Blog # 95


Urine is as valuable as gold is—at least when it comes to its potential for revealing our underlying health or infirmity.  Our kidneys work 24/7/365 filtering and removing from our bloodstream toxic wastes.  These include nitrogen-rich soluble products generated from cellular metabolism, numerous other organic and inorganic chemicals, salts and metabolites, as well as excessive water.  Urine—the end product appearing in our bladders—can provide amazing insight into our overall health.

With every pulsation of our heart, arterial blood flows into the kidney via the renal arteries; after the blood is filtered, the cleansed blood is returned via the renal veins.  In essence, the artery brings “dirty” blood to the kidneys for filtering, with the renal veins providing transport back of cleansed blood. Urine is a sterile by-product of this filtering process.  For this reason, when operating on the urinary tract (for example when the bladder is opened and urine enters the abdominal cavity), it is of no concern from an infectious point of view.

Using a simple and inexpensive dipstick, in a matter of moments, diabetes, kidney disease, urinary tract infection and the presence of blood in the urine can be diagnosed.  Although there are many benign causes of blood in the urine, the worrisome possibilities are kidney and bladder cancer.  The dipstick also reveals specific gravity, a test that can indicate dehydration, over-hydration, and other potential health issues. Not only can the dipstick disclose the presence of diabetes mellitus (sugar diabetes), but it can also reveal a condition known as diabetes insipidus, in which the kidneys lose their ability to concentrate urine. As a result, massive amounts of dilute urine are produced, which can have dire consequences.  Urine testing can also reveal substance and performance-enhancing drug abuse. Who knew that a waste product could be so revealing?  Of all the waste products that humans produce, urine uniquely provides the best “tell” regarding our health.

Urine odor can provide information as well. A sweet smell is consistent with diabetes mellitus; a foul odor may indicate a urinary infection or the intake of certain foods such as asparagus.  Vitamin intake can also cause the urine to have an unpleasant odor. Vitamins B and C are water soluble and therefore not stored in the body.  Any excess above what is necessary for the body’s use is immediately excreted in the urine.  Malodorous urine that has a feculent scent may indicate an abnormal connection between the colon and the bladder that is known as a colo-vesical fistula. This happens most commonly on the basis of diverticular disease of the colon.  When it occurs, there is often air in the urine, designated by the term pneumaturia.

Color is a “tell” with respect to hydration status.  When well hydrated, our urine will look clear or very pale yellow, like a light American beer.  When dehydrated, our urine becomes very concentrated, appearing dark amber, like a strong German beer.  Excessive B vitamins can result in light orange urine. Red urine is most often blood in the urine, which may indicate a potentially serious underlying condition, although overconsumption of beets, blackberries, and rhubarb may sometimes impart a red color to urine.  “Iced tea” or “cola” colored urine is often indicative of old blood, as opposed to the bright red color of urine indicative of fresh and active bleeding. Dark brown urine may indicate jaundice.  Pyridium, prescribed for the discomfort of urinary infections, turns the urine a neon orange color.  Other urinary analgesics that contain methylene blue can turn the urine blue or green.  Cloudy urine may be indicative of a urinary tract infection, but can also occur when phosphate salts crystallize in the urine on the basis of dietary intake of foods high in phophates.

When our urine is occasionally foamy or sudsy, it is considered to be normal. When it occurs consistently, it can be a sign of protein in the urine, indicative of kidney disease.

Bottom Line:  Urine is an invaluable waste product and offers many clues as to our overall health or presence of illness.


What a dipstick can reveal:

specific gravity…status of our hydration

pH…acidity of urine

leukocytes…urinary infection

blood…many urological disorders including kidney and bladder cancer

nitrite…urinary infection

ketones…in the absence of carbohydrate intake, fat is used as fuel and ketones are by-products of fat metabolism; may also indicate a very serious condition known as diabetic ketoacidosis

bilirubin…a yellow pigment found in bile, a substance made by the liver; its presence may be indicative of jaundice

urobilinogen…a byproduct of bilirubin breakdown formed in the intestines by bacteria—when elevated may indicate: impaired liver function; hepatitis; cirrhosis; excessive breakdown of red blood cells—when low may indicate bile obstruction or failure of bile production

protein…kidney disease



Andrew Siegel, M.D.

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food:

Available on Amazon in paperback or Kindle edition

Blog subscription: A new blog is posted every week.   On the lower right margin you can enter your email address to subscribe to the blog and receive notifications of new posts in your inbox.  Please avail yourself of these educational materials and share them with your friends and family.

Kidney Stones…Ouch!

October 19, 2012

Andrew Siegel, M.D.   Blog # 80


I have chosen kidney stones as a topic since they are a very prevalent problem that I treat on an everyday basis, and a condition often related to our dietary habits, the quantity of fluids that we drink, and our weight status.

If you have ever suffered with a kidney stone, you truly know what excruciating pain is.  Many women who have experienced both passage of a kidney stone and natural childbirth without any anesthesia will report that the childbirth was the less painful of the two!

Stones are a common condition that has occurred in humans since ancient times; kidney stones have even been found in an Egyptian mummy dated 7000 years old.   The good news about stones is that most of them will pass spontaneously without the necessity for surgical intervention. The other welcome news is that if surgery is required, it is minimally invasive—open surgery for kidney stones has virtually gone by the wayside.

Kidney stones form when minerals that are normally dissolved in the urine precipitate out of their dissolved state to form solid crystals. This crystal formation often occurs after meals or during periods of dehydration. The lion’s share of kidney stones manifest themselves during sleep, at a time of maximal dehydration.  Dehydration is also why kidney stones occur much more commonly during hot summer days than during the winter. This past summer—one of the hottest on record—kept urologists very busy in terms of caring for patients with kidney stones.   Anything that promotes dehydration can help bring upon a stone—including exercise, saunas, hot yoga, diarrhea, vomiting, being on bowel prep for colonoscopy, etc.

In addition to dehydration, another factor that can contribute to kidney stone formation is excessive intake of certain vitamins. The biggest culprit is Vitamin C, also known as ascorbic acid.   When metabolized by the body, Vitamin C is converted into oxalate, one of the components of calcium oxalate stones, the most common variety of stone.  The problem is that vitamin C is a water-soluble vitamin, so any excessive intake is not stored in the body but appears in the urine in the form of oxalate. Additionally, excessive dietary protein intake, fat intake, and sodium are all associated with an increased risk for kidney stones. Having inflammatory bowel disease or previous intestinal surgery can also increase the risk for stones.     Urinary infections with certain bacteria can promote stone formation. Having a parathyroid issue and high circulating calcium levels is another cause of kidney stones.  Obesity is also a risk factor for kidney stones. Some stones have a genetic basis, with a tendency to affect many family members.  My uncle is currently plagued with a stone lodged in his ureter and is scheduled for stone surgery on Monday, and both my father and brother have passed stones.  What does that bode for me?  So far I have been lucky.

A kidney stone starts out as a tiny sand particle that grows as the “grain” is bathed in urine that contains minerals.   These minerals are deposited and coalesce around the grain.  They can grow to a very variable extent so that when they start causing symptoms they may range from being only a few millimeters in diameter to filling the entire kidney.

Some stones are “silent” because they cause no symptoms and are discovered when imaging studies are done for other reasons.  However, most stones cause severe pain known as colic. Colicky pain is often intermittent, originating in the flank area and radiating down towards the groin.  It often causes an inability to get comfortable in any position, and is associated with sweating, nausea, and vomiting. Kidney stones can also cause blood in the urine, sometimes visible and, at other times, only on a microscopic basis. When a stone moves into the ureter (the tube running from the kidney to the bladder), it can become impacted and block the flow of urine. Stones can sometimes cause lower urinary tract symptoms such as urgency and frequency, particularly when the stone approaches the very terminal part of the ureter that is actually tunneled through the wall of the bladder.

Kidney stones are usually any easy diagnosis to make, based upon their rather classical presentation, although on occasion, a stone causes no symptoms whatsoever and is picked up incidentally on an imaging study such as an ultrasound, a CAT scan, or an MRI.   The imaging study of choice for evaluating a kidney stone is an unenhanced CAT scan (without contrast).   A plain x-ray of the abdomen is very useful for stones that contain calcium, and thus are readily visible on an x-ray.

Most stones will pass spontaneously without intervention given enough time.   Conservative management involves hydration, analgesics and the use of a class of medications known as alpha-blockers that can help facilitate stone passage by relaxing the ureteral smooth muscle.   As long as the pain is manageable and there is progressive movement of the stone seen on imaging studies, conservative management can continue to be an option.  Intervention is mandated under the following circumstances: intolerable pain; refractory nausea and vomiting with dehydration; larger stones that are not likely to pass; failure of a stone to pass after a reasonable amount of time; significant obstruction of the kidney; a high fever from a kidney infection that does not respond to antibiotics; a solitary kidney; and certain occupations that cannot risk impaired functions such as an airline pilot.

There are a number of minimally invasive means of treating kidney stones depending upon the size of the stone, its location, and the degree of obstruction of the urinary tract.  Gone are the days when treating a kidney stone required a painful incision and a prolonged stay in the hospital.  Most kidney stones now are managed on an ambulatory basis. Shockwave lithotripsy is commonly used to treat stones in the kidney or upper ureter.  Typically done under intravenous sedation, shockwave lithotripsy uses shockwaves directed at the kidney stone via x-ray guidance to fragment the stones into pieces that are small enough so that they then can then pass down the ureter, into the bladder and out the urethra with the act of urinating.  Another means of managing stones, particularly amenable to stones in the lower ureter but also applicable to any stone, is ureteroscopy and laser lithotripsy.  This procedure is done under general anesthesia. A narrow lighted instrument known as a ureteroscope is passed up the ureter to visualize the stone under direct vision.  A laser fiber is then utilized to break the stone into tiny particles.  The largest fragments are removed using a special basket. A ureteral stent is often left in place after this procedure to allow the ureter to heal as well as to prevent obstruction of the kidney.

You are at high risk for kidney stones if you:

  • Don’t drink enough fluids
  • Have an occupation that requires working in hot environments, such as a chef
  • Exercise strenuously without maintaining adequate hydration
  • Are a male, since the male to female ratio of kidney stone incidence is 3:1
  • Had a previous kidney stone, since about 50% of people who have a stone will experience a recurrence
  • Have a family history of kidney stones
  • Have a urinary tract obstruction
  • Have an excessive intake of oxalate, calcium, salt, protein and fat
  • Take excessive amounts of vitamin C, A, and D
  • Have an intestinal malabsorption
  • Have gout
  • Have parathyroid disease

The key to preventing kidney stones is to stay well hydrated, particularly when exposed to hot environments or when exercising for prolonged periods of time. It is also important to avoid overdoing it with certain vitamins—particularly vitamin C—a major risk factor for kidney stones.  The two biggest risk factors for kidney stones are, in fact, dehydration and excessive intake of vitamin C. Chances are that if you have a healthy diet, you have more than adequate intake of vitamin C and any extra is potentially dangerous. A good sign of adequate hydration is the color of your urine: the urine of a well-hydrated person will look light in color like lemonade, whereas the urine of a dehydrated person will look like apple juice.

So drink up, particularly on hot days…and eat an orange instead of popping a vitamin C supplement…your kidneys will thank you!

Andrew Siegel, M.D.

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food:

Available on Amazon in paperback or Kindle edition

Blog subscription: A new blog is posted every Saturday morning.   On the lower right margin you can enter your email address to subscribe to the blog and receive notifications of new posts by email. Please avail yourself of these educational materials and share them with your friends and family.

For a nice booklet on kidney stones in PDF, go to and click on patient education and then on ABCs of Kidney Stones