I'll be honest; while I have heard much about oxalates and even counseled clients with oxalate overload issues, I never really felt like it was something I needed to worry about. I recently completed a continuing education course on oxalates and was floored at how they can impact health on many levels.
If you have ever heard the term "oxalate," it was likely in the context of either kidney stones or avoiding this anti-nutrient in some plant foods,, which can bind to calcium. If you have never heard of them, please keep reading because oxalate overload is a big issue for many people. Most of us "health-conscious" folks might be struggling with oxalate toxicity and not even know it!
What are oxalates?
I think of them as armor for plants. Since plants can't move or talk, they need some way to defend themselves. Plants use oxalates and other anti-nutrients, like lectins and phytates, which make whoever is eating them sick in various ways. Anti-nutrients interfere with the absorption of nutrients. Oxalates, in particular, bind with the absorption of minerals like calcium, magnesium, zinc, and iron- leaving you no chance of absorbing these minerals when there are oxalates in the foods you are eating with them. Once oxalates bind to the minerals, they create these sharp, knife-like crystals. These nasty nunchucks, if unbound, can get into cells, joints, organs, and pretty much anywhere and wreak havoc. These oxalate crystals literally shred you! Oxalates can also bind to heavy metals like mercury and trap them in your body's tissues, contributing to heavy metal toxicity.
Even more surprising is that we can create oxalates ourselves! 80-90% of oxalates found in urine excretion are from endogenous production (from our own bodies). When we suffer from certain nutrient deficiencies or even genetic predispositions, the chances of having an overload of oxalate production increase. And if you struggle with yeast or mold exposure, your body goes into overdrive making oxalates!
We can eliminate oxalates and prevent them from shredding our insides in 3 ways:
We bind oxalates with calcium and eliminate them in the stool.
We can also process them in the kidneys and pee them out.
Or, the good bacteria in our gut can nibble them up.
However, this requires us to have a very healthy gut microbiome (not the case for almost everyone I know), to be eating and absorbing plenty of minerals like calcium, and to be pooping every day! But what happens when you move into a house with some dank closets? And what about when your buddy talks you into doing a juice fast? Oh, and don't forget those antibiotics you were taking for your last sinus infection- yep, they wiped out all the good bacteria in your gut! The point is that it is a rare individual who doesn't need to pay a little attention to oxalate overload.
Do You Need to Worry about Oxalates?
I'm not saying you should stop eating your veggies and go full-on carnivore... But! If you are dealing with any of the below symptoms, oxalate overload might be a problem.
PAIN!- especially in the urinary tract, genitals, muscles, intestines, head, and eyes
Inflamed joints and muscles
Frequent UTIs or Yeast infections
Inflammatory bowel disease
Rashes or hives
And honestly, this isn't an exhaustive list. These darn things can shred you pretty much anywhere, and if you are suffering from pain in your body, please, keep reading! If you suspect that oxalates could be a problem for you, it could be for a few reasons:
Overconsuming high oxalate foods like spinach, Swiss chard, chia seeds, rhubarb, plantains, etc.. (see complete list below👇)
Antibiotic use decreases the good bacteria needed to break down oxalates.
Having dysbiosis, which means not having enough good bacteria to break down oxalates.
Having a yeast or fungal overgrowth. These add to the oxalate burden by actually producing more oxalates.
Being deficient in B vitamins, calcium, or magnesium which are needed to bind to oxalates for excretion.
Not digesting fats. Undigested fats will bind to calcium and leave it unavailable to bind to oxalates.
Having a leaky or inflamed gut. This will cause oxalates (and other things) to get into the bloodstream and migrate to various tissues causing pain.
Being genetically predisposed. Some people can't handle oxalates. If your family has a history of kidney or gallstones, this might be you.
As I said at the outset, I didn't think I needed to worry about this. Heck, I don't have much pain! But once I dug into the science, I realized that my osteoporosis might be partly caused by major oxalate consumption; something just clicked. I've always been the chick who loved a good salad, played with being vegetarian, and loves an almond milk latte. But maybe all those years of juices and soy protein substitutes were robbing my bones of calcium! Ugh- you know, you try to eat healthily...
Testing to Consider
If all the above sounds a little too close to home, it might be a good idea to consider some testing. While there are various ways you can look into your oxalate toxicity, the most comprehensive and helpful test is the Great Plains Organic Acids Test. I wrote a lengthy blog about this test and all you can learn from it here. But when it comes to oxalates, you actually will see three very helpful markers on this test to give you clues on how you should be managing your strategy for treatment:
Oxalic Acid: This organic acid is only elevated in people who get too many oxalates in their diet. It will also be elevated in those with Candida overgrowth. Candida itself produces oxalates.
Glycolic Acid: Mild elevations in this marker indicate that your body is making oxalates. But if it is incredibly high, you likely have a genetic disease of oxalate metabolism (Hyperoxaluria type I).
Glyceric Acid: Mild elevations in this organic acid also mean that your endogenous production is high. But very high levels indicate Hyperoxaluria type II.
You might also consider running a GI pathogen stool analysis. This test will give you many helpful insights, such as:
Yeast or fungal overgrowths: many of these can produce oxalates themselves.
Bacterial overgrowth: too much of the wrong bacteria can crowd out the good bacteria needed for breaking down oxalates in the gut.
Fecal fat: Undigested fats will bind with calcium when you don't have enough lipase (fat enzymes), leaving calcium unavailable to bind with oxalates, leaving them free to get into the bloodstream and run amok.
Parasites: Certain parasitic infections have been shown to produce oxalates.
Lastly, learning about micronutrient deficiencies is critical in the process. If you lack B vitamins, particularly B1 and B6, you are more likely to produce more oxalates. If you are deficient in minerals like calcium, magnesium, zinc, and copper, you will be unable to bind excess oxalates, allowing them to run free through your system. If you are a vegetarian, and/or eat a low-fat diet, this may be a concern for you.
Please note: if you have had your gallbladder removed, you are highly likely to have fat malabsorption. The inability to store bile (needed to emulsify fats) means that fatty foods are no longer being adequetly absorbed. Without sufficient fat digestion, minerals and fat-soluble vitamins (A, D, E, and K) will be depleted.
It's not enough to just assume you are having issues with oxalates. You need to know how! Once you run an OAT, GI-Map stool test, or micronutrient profile, you can strategize ways to alleviate the burden on your system.
How to Lower Oxalates
So, if you find that getting your oxalate burden down is a priority, how should we go about this? In a word: SLOWLY!!
I was surprised to learn that if you decide to drop your oxalates to zero too quickly, you can get sick. We want to be careful not to "dump" oxalates out of the system all at once. Remember, oxalates have likely been stored in your body's tissues, which means that if you suddenly rip those spiny little jerks out, you will only cause more pain! The key is to slowly work on several strategies to bring your oxalate load down:
Reduce exogenous oxalates (those coming from outside your body). This includes getting rid of mold exposures and using a Low Oxalate Diet (LOD).
Decrease endogenous production (those coming from inside your body). You'll want to maximize your B vitamins and correct any yeast issues.
Minimize absorption of oxalates. If you support fat digestion, make sure you have lots of good gut bacteria (and decrease the bad ones), and correct mineral deficiencies, your body can eradicate any excess oxalates on its own.
Reducing Exogenous Oxalates
If you feel that you are being exposed to molds either in your home or work environment, please make efforts to change that. Chronic long-term exposure to mold can really wreck your health in a myriad of ways, oxalate overload being one of them.
Following a Low Oxalate Diet (LOD) is the other way you can decrease your exposure to oxalates. Again, you'll want to go at this slowly, with the goal of decreasing dietary oxalates by only 5-10% per week to avoid "dumping" symptoms and increased pain. The ultimate goal would be to bring total daily oxalate consumption down to about 40-60 mg/day. Note, that the average American consumes between 80-120 mg/day. And those of us who are more health conscious and eat regular salads, juices, smoothies, and nut milks, are easily getting upwards of 1000 mg of oxalates per day!
While you can easily find lists of high and low oxalate foods online, there is some debate about the validity of these charts. I'll give you some basics below, but I recommend checking out the website lowoxalate.info for the most up-to-date and accurate information.
A typical LOD will be comprised of mostly low oxalate foods with a few medium and even higher oxalate foods. It's not an all-or-nothing situation, but if oxalates are an issue for you, learning to make trade-offs is a good place to start. Here is a good example of trading high oxalate foods for lower oxalate alternatives.
Start with just one or two swaps for a week or so. Then, incorporate a couple more. It's easier to just focus on looking for lower oxalate alternatives that it is to sit there adding up oxalate grams every day. That said, here are some really high oxalate foods you should start with avoiding:
The foods below can have their oxalate levels decreased if you cook them in water. Throw out the water instead of consuming it, and the overall oxalate load will decrease.
And here are some very low oxalate foods to work on incorporating into your diet as much as possible:
Additionally, you'll want to pay attention to sugar consumption. Fructose, and even sugar replacements like Xylitol and Sorbitol, can get converted to oxalates in the body. Be especially wary of corn syrup, high fructose corn syrup, and agave nectar. These fructose hits will increase your risk of developing kidney stones in two ways: increasing oxalate burden and uric acids levels! Not only that, but sugar consumption causes calcium and magnesium to be excreted in the urine. This means these minerals become deficient, and are unavailable to bind to oxalates. Sugar is NOT your friend when it comes to oxalates!
This all might seem a bit daunting, but if you've made it this far in the blog, I know you are concerned about oxalates and how they are affecting your health. Please work with your health practitioner on an oxalate lowering plan. If you don't have one, I'm happy to help you myself. You'll want your plan to include the following:
An assessment of your symptoms and health history
Testing to evaluate the reasons behind your symptoms (it might not only be oxalates at issue)
Assistance with lowering your oxalate burden with a low oxalate diet plan
Strategic supplementation that should address:
-Binding oxalates in the gut
-Breaking down oxalates in the gut
-Correcting nutritional deficiencies
-Addressing yeast/fungal overgrowth
-Reducing pain and dumping symptoms
Feel free to reach out if you need help in your health journey. Please share this with family or friends who might be struggling with oxalates.
Yours in Health
All information adopted from: "An Advanced Guide to Oxalates" presented by Lisa Pomeroy, ND, FDN-P.
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