Which dietary supplement would you question in a high school football player with hypercalciuria?

Which dietary supplement would you question in a high school football player with hypercalciuria?

• A. Protein supplements
• B. Salt tablets
• C. Sports drinks
• D. Vitamin C

Answer: (A)

When a high school athlete has hypercalciuria, dietary factors that increase calcium loss in urine are key to examine. Extra protein, especially from supplements, is the most likely culprit. Metabolizing much protein—particularly concentrated protein powders—creates an acid load. The kidneys buffer this acid by releasing calcium (and phosphate), which increases calcium excretion in the urine. This effect is amplified with supplemental protein and can contribute to ongoing or recurrent hypercalciuria and stone risk in a growing adolescent. Sodium-containing products, like salt tablets, can also raise urinary calcium because sodium and calcium reabsorption in the kidneys are linked, but the impact is less direct and typically smaller than the protein effect. Sports drinks and vitamin C don’t drive calcium excretion as a primary concern in this setting; vitamin C can influence stone risk at very high doses through oxalate formation, but that’s a different pathway than the main hypercalciuria mechanism. So, the supplement you’d question first is protein supplements, given their strong potential to elevate urinary calcium.

When a high school athlete has hypercalciuria, dietary factors that increase calcium loss in urine are key to examine. Extra protein, especially from supplements, is the most likely culprit. Metabolizing much protein—particularly concentrated protein powders—creates an acid load. The kidneys buffer this acid by releasing calcium (and phosphate), which increases calcium excretion in the urine. This effect is amplified with supplemental protein and can contribute to ongoing or recurrent hypercalciuria and stone risk in a growing adolescent.

Sodium-containing products, like salt tablets, can also raise urinary calcium because sodium and calcium reabsorption in the kidneys are linked, but the impact is less direct and typically smaller than the protein effect. Sports drinks and vitamin C don’t drive calcium excretion as a primary concern in this setting; vitamin C can influence stone risk at very high doses through oxalate formation, but that’s a different pathway than the main hypercalciuria mechanism.

So, the supplement you’d question first is protein supplements, given their strong potential to elevate urinary calcium.