Preventing Kidney Stones with Functional Medicine: Root Causes, Oxalates, Citrate & Integrative Nephrology with Dr. M Isreb
Host & Guest Details
Host: Dr. Yousef Elyaman, Functional Medicine Primary Care Physician
Guest: Dr. M Isreb, Nephrologist & Functional Medicine Specialist, Founder of Integrative Kidney
Episode Overview
Kidney stones are becoming dramatically more common, yet many patients leave the emergency room with little guidance beyond drinking more water and hoping they never experience another painful episode.
In this episode of FMP Essentials, Dr. Yousef Elyaman welcomes back nephrologist and functional medicine physician Dr. M Isreb, whose previous episode on chronic kidney disease became the most-viewed episode on the channel.
Together they explore why kidney stones develop, why recurrence rates remain so high, and how functional medicine provides a much deeper understanding than conventional treatment alone. Rather than focusing only on removing stones, they explain how metabolism, nutrition, gut health, genetics, urine chemistry, inflammation, and lifestyle all influence stone formation.
The discussion covers the different types of kidney stones—including calcium oxalate, calcium phosphate, uric acid, struvite, and cystine stones—and explains why identifying the specific stone type dramatically changes treatment strategies.
Dr. M Isreb also shares why every recurrent stone former should receive a comprehensive 24-hour urine evaluation, why restricting calcium is often the wrong recommendation, how oxalates interact with calcium inside the digestive tract, and why the gut microbiome plays a surprisingly important role in kidney stone prevention.
The conversation also explores vitamin C supplementation, collagen, probiotics, citrate therapy, hydration strategies, genetics, vitamin D receptor variants, and practical clinical pearls practitioners can immediately apply in practice.
Whether you're a healthcare professional looking to improve patient outcomes or someone who has experienced kidney stones firsthand, this episode offers evidence-based, root-cause strategies for preventing future stone formation while supporting overall kidney health.
Key Questions We're Answering
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Why do kidney stones continue coming back?
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What causes calcium oxalate kidney stones?
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Is avoiding calcium actually making kidney stones worse?
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How does gut health influence kidney stone formation?
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Which laboratory tests uncover the true cause of kidney stones?
Why You Can't Miss This Episode
Kidney stones affect nearly 1 in 10 people, and nearly half of those individuals will experience another episode during their lifetime.
Most treatment focuses on removing stones after they occur. This episode explores how functional medicine helps identify why stones develop in the first place—giving practitioners and patients practical tools to reduce recurrence while improving metabolic and kidney health.
What You'll Learn
Key Insight
"Kidney stones are rarely an isolated problem—they're often a window into deeper metabolic dysfunction."
Top Takeaways
• Why a 24-hour urine collection is one of the most valuable tools for recurrent kidney stone patients.
• The surprising reason reducing calcium intake may actually increase calcium oxalate stones.
• How citrate protects against kidney stone formation.
• Why hydration alone isn't enough for many patients.
• The connection between gut bacteria, oxalate metabolism, and kidney stone risk.
• Which supplements may increase stone risk in susceptible individuals.
• How genetics can influence vitamin D metabolism and kidney stone formation.
• Why functional medicine focuses on prevention instead of simply treating stones after they occur.
Bonus Clinical Pearl
Low urinary citrate may become abnormal before traditional kidney function tests begin to change, making it a potentially valuable early marker for kidney dysfunction.
Shareable Quotes
"Removing the stone doesn't remove the reason the stone formed."
"Kidney stones are often a symptom—not the root cause."
"The goal isn't just to pass a stone. The goal is preventing the next one."
Unanswered Questions
These questions could be explored in future episodes:
• Should everyone with recurrent kidney stones receive genetic testing?
• What is the ideal diet for patients with different stone types?
• Which probiotics have the strongest evidence for reducing oxalate absorption?
• Can continuous glucose monitoring help identify metabolic contributors to kidney stones?
• What role does mitochondrial dysfunction play in recurrent nephrolithiasis?
This Episode's Sponsors
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Connect with Us
Dr. M Isreb
Instagram: @integrativekidney
Website: www.inkidney.com
Book: A Systems-Based Approach to Modern Kidney Care is now available for preorder: https://www.barnesandnoble.com/w/integrative-nephrology-majd-isreb/1149707762
FMP Essentials
Instagram: @fmpessentialshq
Website: www.fmpessentials.com
Dr. Yousef Elyaman
Instagram: @drelyaman
Music Credit: "Heroes Approaching - Extended" by tunes2go
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Disclaimers
Educational Purpose Only – This podcast is for informational purposes only and does not constitute medical advice.
No Doctor-Patient Relationship – Listening does not establish a doctor-patient relationship.
Supplement Use Disclaimer – Any supplement recommendations are not intended to diagnose, treat, cure, or prevent disease. Consult your provider.
Professional Responsibility – Practitioners should use their professional judgment before applying strategies discussed.
Liability Disclaimer – The host, guest, and affiliated organizations assume no liability for the use or misuse of the information shared.
