In Reply Dr Hoffer reasons that the investigation of nonspecific abdominal or flank pain may result in the diagnosis of nonsymptomatic kidney stones and that such diagnoses are more likely among ascorbic acid supplement users, leading to an overestimation of the risk. We believe it is highly improbable that those presenting with such symptoms would be more likely to be examined with respect to stone disease if they have a history of ascorbic acid supplement use. First, for this to be the case, the patient would have to provide information on their supplement use either after being asked by their physician or without having been prompted to do so. Second, the physician would have to consider use of ascorbic acid supplements, by the patient, sufficient to warrant the prioritization of diagnostic tests for kidney stones over those of other potential causes.
Tiselius H, Åkesson A, Thomas LDK. Ascorbic Acid Supplements and Kidney Stone Risk—Reply. JAMA Intern Med. 2013;173(14):1384a-1384. doi:10.1001/jamainternmed.2013.7699