I have been researching oxalates since receiving Jaxon’s OAT test results from Great Plains Laboratory. I am blown away that more people are not speaking out about oxalates and their effect on our health.
Are you following the keto diet or consume a heavily plant based diet? Do you eat a lot of spinach, almonds/almond flour, cashews, soy, or potatoes? Do you consume high levels of fructose, have a vitamin b6 or thiamine deficiency, or don’t get enough calcium?
Do you know someone with chronic inflammation, UTIs, leaky gut, kidney stones, renal failure, vulvar pain, cystic fibrosis, crohn’s disease, pancreatitis, kidney disease, chronic diarrhea, or autism? Do you have chronic yeast/candida infections, specifically ones that aren’t resolved with antifungals? This is important information for everyone but especially for those mentioned above.
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What are oxalates?
Oxalic is an organic acid that is ubiquitous in plant foods, low in animal foods, and is made endogenously through metabolic production by the liver in low levels*. It binds tightly to various minerals, mainly calcium, magnesium, potassium, and sodium.
There are two different types of oxalates:
Soluble & free oxalic acid is water soluble, mainly absorbed in the small intestine (another puzzle piece to the SIBO epidemic), travels through the blood into kidneys, and is excreted through urine.
Insoluble oxalate is bound with a mineral (mainly calcium) and forms a crystal that can’t travel through the blood or be absorbed into the gut, and is excreted through feces.
When oxalic acid binds with calcium, it forms insoluble salt crystals that are extremely spiky, rectangular, or diamond shaped [pictured]. When these come in contact with tissue, they can cause physical damage and even lodge themselves into the tissue, joints, lymph nodes, etc.
*liver production rate increases if vit b6 deficiency, thiamine deficiency, or oxidative stress
Why do most plants contain oxalates?
Plants can’t fight off herbivores with teeth or arms, so this is their built-in defense mechanism. Since mammals lack the enzymes necessary for its utilization, oxalate is a toxic waste product that must be excreted, primarily through urine. An imbalance in oxalate production/absorption and excretion can lead to hyperoxaluria, a major risk factor for calcium oxalate kidney stone formation (80% of all kidney stones) which affects ~ 1 in 11 of the US population.
Ever chew on spinach and think there’s dirt that didn’t wash off? There’s a very high chance that grit is actually oxalate crystals.
What are factors that increase oxalate absorption?
- Antibiotics: Kills off oxalate-degrading bacteria, the main one being Oxalobacter formigenes, an anaerobic bacterium that lives in the colon and depends solely on oxalate as a source of metabolic energy. Some other bacterial species that help with this are Eubacterium lentum, Enterococcus faecalis, and Lactobacillus acidophilus.
- Fat malabsorption: “If you have anything hindering ability to digest fats (SIBO, poor bile flow from liver, pancreatic insufficiency), what this is going to do is cause fat to get into the intestines and free fatty acids are going to exist in the intestine and bind with dietary calcium leaving less calcium to bind with oxalate and leaving more oxalate to get into the bloodstream.”- Elliot Overton
- Intestinal permeability: Often referred to as “leaky gut”, meaning the tight junctions which decide what goes in and out of the bloodstream are damaged increasing oxalate absorption.
What is the Organic Acids Test?
“The Organic Acids Test (OAT) offers a comprehensive metabolic snapshot of a patient’s overall health with 75 markers. It provides an accurate evaluation of intestinal yeast and bacteria. Abnormally high levels of these microorganisms can cause or worsen behavior disorders, hyperactivity, movement disorders, fatigue and immune function. Many people with chronic illnesses and neurological disorders often excrete several abnormal organic acids in their urine. The cause of these high levels could include oral antibiotic use, high sugar diets, immune deficiencies, acquired infections, as well as genetic factors. Our Organic Acids Test also includes markers for vitamin and mineral levels, oxidative stress, neurotransmitter levels, and is the only OAT to include markers for oxalates, which are highly correlated with many chronic illnesses.“
Jaxon’s oxalic levels were through the roof! Luckily, his endogenous levels were low which means majority were because of his diet and environment, not from his liver.
Testing numbers: Low end is 35, high end is 185
Jaxon’s number: 350!
This is called hyperoxaluria. There are two types of hyperoxaluria:
- Genetic/Endogenous (test markers Glyceric & Glycolic): Comes from the liver. Absent activity of vit b6 (80% of the cases). 10% of cases are from a mutation in the GRHPR gene located on chromosome 10 or mutation in the HOGAI
- Environmental/Diet/Enteric (test marker Oxalic): Excessive intake of precursors like vit c, glycine, hydroxyproline. Also SIBO, celiac, and a high oxalate diet. Glyphosate and low levels of sulfur also play a role
What are the consequences of too much oxalate in the body?
Kidney infections | Chronic kidney disease |
Chronic UTIs | Interstitial Cystitis |
Autism | Vulvodynia |
Arthritis | Glaucoma |
Cystic Fibrosis | Chronic diarrhea |
Crystalline nephropathy through deposition of calcium oxalate crystals in the renal parenchyma that cause tubular damage | and more |
What are some common symptoms of too much oxalate in the body?
Bladder irritation/ Frequent urination* | Joint + muscle pain |
Migraine | Itchy eyes |
Skin rashes | Fatigue |
Chronic yeast/ candida infections | Gout |
Anxiety, depression, brain fog | Intestinal pain |
Slow wound healing | Thyroid issues |
Carpal tunnel | Low vit b6 levels |
*Some patients have microscopic blood in urine but no signs of UTI. After oxalates are excreted through the kidneys, they go into the bladder. This is where the crystals can actually lodge into the lining of the bladder and urinary tract causing irritation and inflammation.
Where can you find oxalate crystals in the body?
Kidneys | Urinary tract |
Coronary arteries | Myocardium |
Thyroid gland | Spleen |
Lymph nodes | Testis |
Intestines | Bones |
Eyes | Skin |
Liver | Brain |
BUT that’s not everywhere.
Oxalates also operate on a biochemical level as intracellular micron and nano crystals.
These inhibit key enzymes, including biotin-dependent carboxylates and pyruvate kinase. Oxalate actually inserts itself where biotin should be and stops them from making energy.
Not only do they inhibit key enzymes, they also cause intracellular destruction. Since oxalate is a toxin, when they get into the cell, they cause apoptotic and necrotic cell death, rupture cell membranes that lead to lysosomal rupture. This means they break open and leak hydrolytic enzymes that degrade healthy components of the cell.
Do oxalate effect mitochondria?
First, let’s review. Mitochondria are very important. They are the cells energy factory where ATP happens. Mitochondria play a critical role in the generation of metabolic energy in eukaryotic cells. They are responsible for most of the useful energy derived from the breakdown of carbohydrates and fatty acids, which is converted to ATP by the process of oxidative phosphorylation.
And, YES, oxalate causes mitochondrial dysfunction by depleting antioxidants, like glutathione and superoxide dismutase. This sets the stage for many, many chronic illnesses. “It is well known that oxidative stress and inflammation can trigger mitochondrial damage and cell death. It is critical for mitochondrial function to be intact in monocytes/macrophages in order to regulate inflammation. Our findings suggest that the interaction of monocytes with oxalate both in the soluble and insoluble form injures mitochondria and disturbs redox homeostasis. It is likely that once these cells enter a pro-inflammatory environment within the kidney, the cells are exposed to a secondary insult of CaOx crystals and/or the pro-inflammatory environment. As a result this may alter monocyte/macrophage cellular integrity and metabolic activity. These findings suggest that oxalate may be a major contributor to mitochondrial dysfunction observed in our patient population.”
What about sulfate?
In addition to gut issues, sulfate/sulfation can be underlying factors in oxalate issues.
When sulfate is low, and sulfation biochemistry is poor, oxalate problems can arise. Sulfate is very important in the body; it is needed for processing phenolic foods, and dozens of processes in the body including digestion, gut integrity, and neurodevelopment. Sulfate also allows the body to create structured water. “Oxalate and sulfate have a bidirectional exchange of ions in and out of the cell; When there is high levels of oxalate on one side and low levels of sulfate on the other, for every oxalate that goes in, one sulfate will go out of the cell.”– Elliot Overton
Oxalate competitively inhibits uptake of sulfate into cells.
“Another way that low sulfate can cause problems with oxalates, involves the role of the kidneys. Susan Owens, who heads the Autism Oxalate Project, said that insufficient sulfate inside the kidney tubule cells would interfere with the ability of the kidneys to remove oxalate from the blood and to deliver the oxalate to the urine. Therefore, inadequate sulfate could cause higher levels of oxalate in the system. It’s a double-edged sword if you’ve got low sulfate. If there isn’t enough sulfate, you might not be regulating your oxalate very well. Depleted sulfate can allow for higher oxalate absorption, and the more oxalate you absorb, the less sulfate your body is likely to have. Because there are so many conditions that have poor sulfation underlying them, it’s sensible to consider a low oxalate diet and other support for a variety of chronic health matters. We need to step well outside the mainstream thinking of just kidney stones.”- Julie Matthews
Those with low sulfate, can also potentially have histamine and salicylate intolerances as well.
Faulty sulfation can be of influence to thesechronic health conditions:
- Autism
- Parkinson’s disease
- Migraines
- Rheumatoid arthritis
- IBD
- Depression
- Food sensitivities
- Alzheimer’s disease
- Chronic fatigue syndrome
- Lupus
- Asthma
- Hyperactivity
Do oxalates play a role in breast tumors?
“We found that the chronic exposure of breast epithelial cells to oxalate promotes the transformation of breast cells from normal to tumor cells, inducing the expression of a proto-oncogen as c-fos and proliferation in breast cancer cells. Furthermore, oxalate has a carcinogenic effect when injected into the mammary fat-pad in mice, generating highly malignant and undifferentiated tumors with the characteristics of fibrosarcomas of the breast. As oxalates seem to promote these differences, it is expected that a significant reduction in the incidence of breast cancer tumors could be reached if it were possible to control oxalate production or its carcinogenic activity. It is supposed that the accumulation of oxalate is toxic to living tissue since it induces some pathological circumstances, as mentioned above. Indeed, exposure of renal epithelial cells to oxalate triggers diverse events that include a plethora of cellular changes on the p38 MAPK pathway activity, induction of immediate early gene expression like c-fos gene and re-initiation of DNA synthesis, among others. Furthermore, oxalate stimulates IL-6 production in human renal proximal tubular epithelial cells. By Affimetrix gene expression it was found 750 up-regulated and 2276 down-regulated genes in renal cells exposed to oxalate.
Despite the importance of mammary microcalcifications for the early detection of breast cancer and their potential prognostic and biological relevance, little research has been carried out to investigate its function and even more, to the best of our knowledge, no one has considered free oxalate as an important inductor of breast pathologies. The fact that oxalate can induce human breast cancer cells to proliferate in vitro is not minor. It is interesting to try to extrapolate the carcinogenic effect of oxalate in mice to a possible effect in human.
The mechanism by which oxalate exerts its action on breast cells is still largely unknown and further research is needed to elucidate it. However, it is expected that a significant reduction in the incidence of breast cancer tumors could be reached if it were possible to control the oxalate production or its carcinogenic activity.”
ncbi.nlm.nih.gov/pmc/articles/PMC4618885
Can oxalate cause candida overgrowth?
We usually only hear bad things about candida. In reality, we all have candida arabinose because, when in proper levels, it aids in nutrient absorption and digestion.
They are only a problem when they are not properly balanced.
Oxalate is toxic to candida and blocks their ability to create energy, which turns our friendly candida into bio-film covered pathogens. If you have chronic yeast/candida infections and antifungals do not work for you, it’s because antifungals do not target oxalates. I would suggest working alongside a trusted practitioner to figure out the root cause and check your oxalic levels.
What about oxalates and autism?
*Words from William Shaw, PH.D
“Oxalates in the urine are much higher in individuals with autism than in normal children [picured]. As a matter of fact, 36% of the children on the autistic spectrum had values higher than 90 mmol/mol creatinine, the value consistent with a diagnosis of genetic hyperoxalurias while none of the normal children had values this high. 84% of the children on the autistic spectrum had oxalate values outside the normal range (mean ± 2 sd). None of the ± 2 sd). None of the children on the autistic spectrum had elevations of the other organic acids associated with genetic diseases of oxalate metabolism, indicating that oxalates are high due to external sources.
As shown in the table below, both mean and median values for urine oxalates are substantially higher in autism compared to the normal population. As a matter of fact the mean oxalate value of 90.1 mmol/mol creatinine is equal to the lower cutoff value for the genetic hyperoxalurias. The median value in autism is six times the normal median value and the mean value in autism is five times the normal mean value.
A brand new diet is being extensively used to treat children with autism and other disorders. Researcher named Susan Owens discovered that the use of a diet low in oxalates markedly reduced symptoms in children with autism and PDD. For example, a mother with a son with autism reported that he became more focused and calm, that he played better, that he walked better, and had a reduction in leg and feet pain after being on a low oxalate diet. Prior to the low oxalate diet, her child could hardly walk up the stairs. After the diet, he walked up the stairs very easily. Many hundreds of children with autism throughout the world are now being placed on this diet with good results.
Benefits Reported By Parents Using Low Oxalate Diet
-IMPROVEMENTS IN GROSS AND FINE MOTOR SKILLS
-IMPROVEMENTS IN EXPRESSIVE SPEECH
-BETTER COUNTING ABILITY
-BETTER RECEPTIVE AND EXPRESSIVE LANGUAGE
-INCREASED IMITATION SKILLS
-INCREASED SOCIABILITY
-SPEAKING IN LONGER SENTENCES
-DECREASED RIGIDITY
-BETTER SLEEP
-REDUCED SELF-ABUSIVE BEHAVIOR
-INCREASED IMAGINARY PLAY
-IMPROVED COGNITION
-LOSS OF BED WETTING
-LOSS OF FREQUENT URINATION
-IMPROVED HANDWRITING
-IMPROVED FINE MOTOR SKILLS
-IMPROVEMENT IN ANEMIA
AND MANY MORE.”
What are some high oxalate foods?
- Spinach
- Almonds
- Cashews
- Buckwheat
- Chia seeds
- Cornmeal
- Quinoa
- Soy
- Oranges
- Rhubarb
- Swiss chard
- Beets
- Raspberries
- Potatoes
- Dates
- Okras
- Lentils
How can you reduce oxalate absorption?
*Do not try any of these on your own. You must work with a trusted practitioner who can order tests and monitor progress as nothing is one-size-fits-all. Some of these suggestions are my own and some come from Dr. Shaw who created the OAT test
- When eaten with calcium, you will absorb much less oxalate. Calcium is what fights off damaging effects of oxalates. Keep in mind, since you are eating oxalates with your calcium, it is going to reduce the bioavailability of the calcium. Spinach is not a source of calcium since it is bound to oxalates
- Vitamin B6 is a cofactor for one of the enzymes that degrade oxalate in the body and has been shown to reduce oxalate production. I recommend LifeBlud Energi+ B vitamin complex and increasing vitamin B rich foods like salmon, grass-finished red meats, organ meats, pasture raised eggs, animal milks, oysters, poultry, kefir, and yogurt
- Up magnesium intake as stress within the body depletes magnesium quickly even though it is needed for 3,000 enzymatic reactions within our body. Recommendations on my Recommendations Page
- Increase water intake to help to eliminate oxalates, but don’t rely on regular ol water. Filtered water with added electrolytes/minerals (sea salt, Cure, Zuma) is what will make sure your cells are actually getting hydrated with proper sodium to potassium balance
- Excessive fats in the diet may cause elevated oxalate if the fatty acids are poorly absorbed because of bile salt deficiency. Non-absorbed free fatty acids bind calcium to form insoluble soaps, reducing calcium’s ability to bind oxalate and reduce oxalate absorption. Before meals, use a bitters spray to help with proper digestion of all foods and ensure you are eating the proper fats and have eliminated vegetable oils and hydrogenated fats from the diet
- Probiotics may be very helpful in degrading oxalates in the intestine. Individuals with low amounts of oxalate-degrading bacteria are much more susceptible to kidney stones. Both Lactobacillus acidophilus and Bifidobacterium lactis have enzymes that degrade oxalates. My recommendations are Smidge and Entegro Flourish, as these were the ones I used with my son. You can find the links and coupon codes on my Recommendations Page
- Increase intake of essential omega-3 fatty acids, commonly found in fish oil and cod liver oil, which reduces oxalate problems. High amounts of the omega-6 fatty acid, arachidonic acid, are associated with increased oxalate problems. My only recommendations is the Rositas Cod Liver oil from Perfect Supplements. You can find that HERE and use my code TAMRA10
10. Take a high quality vitamin E supplement like the one from LifeBlud or Mito Life (both can be found on my Recommendations Page) - Go on a low oxalate diet for at least on month to give the body a break. This may be especially important if the individual has had Candida for long periods of time and there is high tissue oxalate build up
What is oxalate “dumping”?
There may be an initial bad reaction lasting several days to weeks after starting the low oxalate diet since oxalates deposited in the bones may begin to be eliminated as oxalates are reduced. Some things to look out for include skin rashes, itchy eyes, urinary tract infections, brain fog, fatigue, muscular and joint pain. This process varies from person to person. When my son was having his oxalate dumping, I would put him in a bath with magnesium and give him a relaxing facial with bentonite clay to help draw the oxalates out.
Final thoughts on oxalates
I thought that I was doing right by Jaxon for having him on a heavily plant based diet. He ate quinoa, beans, lentils, broccoli, asparagus, avocados, all the veggies, all the fruit. He has been on an amazing probiotic since he was little for his eczema and rarely ever had any sugar that didn’t come from fruit. I made him smoothies all of the time with “super food” spinach and raspberries. I was so taken aback when all of his health problems started to unravel. I didn’t understand why his stomach was in so much pain or why his joints would randomly hurt. I didn’t know why his face was so itchy to the point where he would make himself bleed. I had no idea that these foods being touted has “super healthy” and “needed by everyone” were causing majority of his health problems.
Everything, except for his opportunistic bacteria which we found via his GI MAP test, can be traced back to oxalates; His dysbiosis, SIBO, low vit b6, low biotin, low CoQ10, extremely low vit c, high candida arabinose, high salicylates…Everything!
The supplements we have him on now are focused on healing his leaky gut and building up all of the essential vitamins and minerals his body is lacking because of hyperoxaluria. He does not take them all every single day and I will reevaluate, add some, and take out some with more research that I come upon.
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