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HEALING Polycystic kidney disease one bite at a time.

CITRATE DECREASES CYST GROWTH

So, recently our new member and prolific researcher Thomas Weimbs made me aware of his 2019 paper on microscopic kidney stones that increase cyst growth in PKD. Where do they come from? You guessed it… Oxalates in your food. There is a reason I recommend the bulletproof diet for you guys! ๐Ÿ™‚ By doing bulletproof, you naturally avoid these nasty plant defense molecules. But lets talk about what happens when you eat them first: So, you make yourself a nice raw kale smoothie or enjoy some baby spinach in your salad. You dont think much of it, if you are sensitive, you might notice your teeth getting a little rough on the outside.

Thats oxalic acid sticking to the calcium in your teeth- and it does exactly the same thing once it is inside your body. It sticks to the calcium in your blood, your urine, your organs,… and forms tiny, very hard and jagged crystals. These then deposit in many places, causing kidney stones or even painful sex in women (yes, they deposit in the vagina for some women and their doctors have no idea whats wrong.) However, even if you dont have kidney stones, you will still have microscopic tiny calcium-oxalate crystals floating around in your kidney, and every time they cut a tiny bit of kidney tissue when they slosh around, your kidney is injured, which in turn leads to a cyst growing in that place on many occasions. So, you ask, what if you have been consuming leafy greens uncooked for pretty much all your life now and you probably have a lot of these crystals in your kidney? Well, normally your body produces something called citrate. You can think of it just like descaling your water boiler. Add some citric acid, give it some time and all the calcium deposits dissolve and it becomes shiny and like new again! Your body uses its own citrate to dissolve these crystals, and it does it better when you are younger.

As PKD progresses and you age, your production of citrate may go down. This is a reason why the bulletproof diet is a very alkaline diet. For example my recent urine pH was 7, which is on the alkaline side of optimal. As Thomas Weimbs showed in his paper, when citrate levels are low (measured in urine) people tend to have more cysts in PKD. Less citrate means more tiny crystals which means more injury which means more cysts. What can you do? There are two options: You can supplement citrate or you can supplement malate. If you are still in early stages and want to keep your citric acid cycle going strong, you can increase your own citric acid production by supplementing with something like magnesium malate or another mineral form of malate. This is a softer approach that keeps you metabolic machinery working. The second option is supplementing citrate – in the form of sodium, potassium or magnesium citrate. For reference in one study 30% of patients dissolved all their kidney stones when they supplemented 3g of potassium/sodium citrate 3 times per day for 8 weeks.

Keeping that dosage for longer would probably work even better. You could do this indefinitely as long as your kidney function is good enough to stomach the large amounts of sodium and potassium. I personally have supplemented with similar amounts of potassium and find it to be unproblematic. I tend towards the first option for supporting your own citric acid cycle when its still in good shape, and the latter for more dramatic cases of later stage PKD. If you can handle the mineral load that comes with it, this seems like a very good and inexpensive idea. At the very least, we should get annual urine citrate tests done and start supplementing when the levels are low. Sources: https://labs.mcdb.ucsb.edu/weimbs/thomas/publications/1536 https://kidneystones.uchicago.edu/citrate-to-prevent-stones/