I’ve seen almost every supplement imaginable recommended on the TLO group (though not always as a help for dealing with oxalates). However, these are the ones recommended by the official documentation in the group (in fact, I should mention that I copied some of these verbatim from that documentation; it’s not my intention to make it sound as if this comes from my own research) and most directly related to oxalates and dumping.
Arginine: Important for replenishing nitrous oxide that helps to reduce oxidative damage from oxalates.
Taurine: Important for making the bile acid taurocholate, which limits absorption of oxalate; take if stools turn yellow.
Vitamin A: Important for helping to close the leaky gut and important as antioxidant.
Vitamin E: Important as an antioxidant.
There is much talk of probiotics on the TLO board. They are generally regarded as necessary for restoring proper gut function, particularly if there is a past history of antibiotic use. There are two probiotics which are recommended time and again among the folks on the board. They are as follows:
VSL #3: This is a very potent probiotic. It is important to note that the sachet version is four times stronger (has four times as many active organisms) than the capsule version. Note that this is a pretty spendy probiotic. You can sometimes snag a deal on VSL #3 via Amazon (check prices here), but make sure that you communicate with the seller to be sure that they ship it packaged with coolant, especially in the summer – this probiotic needs to be kept cool (refrigeration is recommended). If you just want the most trustworthy source (which is often also the best-priced), go straight to the manufacturer’s site. Some have been able to find this probiotic locally, or have their local CVS keep it in stock for them as well, which may save on shipping.
Another note: Some children with PANDAS have difficulty with this probiotic, as it contains a strep strain. For those who have difficulty with this strep strain, many recommend this probiotic:
Custom Probiotics 11-Strain: This is another strong probiotic. It comes in powder form, so the amount taken is easily adjusted to any quantity, though it also includes adult & child size scoops for accurate measurement of doses. While it is recommended as an alternative to VSL#3, they are not entirely similar in their strains, so please compare carefully before making a purchase decision. Here is a link to the manufacturer’s website, where the probiotic may be purchased.
A Word of Caution About Probiotics
One caution I would extend, based on my own personal experience, is to watch very carefully for negative effects from probiotics, particularly the high-dose ones. Reason being, it is possible to cause an overgrowth of probiotic bacteria in the gut, and this will cause many more problems than it helps. I made the grave mistake of doing this not once but twice, and had a very long and expensive path back to health both times.
The worst part of this is that most people don’t have immediate negative reactions to probiotics. I know in my case it was something that developed over the course of a couple of months, and the process of identifying probiotics as the culprit was made more difficult by dumping symptoms as well as other health issues I had going on at the same time. My personal advice: if you are constipated, you might not want to try probiotics. I realize that some folks swear by them for relieving constipation, so in the end you’ll have to make your own decision. But in my case, the combination of constipation and heavy doses of probiotics really set me back.
Other Recommended Supplements and Their Purposes
Alpha Lipoic Acid (ALA): Works for some, not for others; important antioxidant and can prevent some endogenous production of oxalate.
NAC (N-acetyl cysteine): Important for restoring glutathione that gets depleted by oxalate; sometimes there are negative reactions (such as leaky gut).
Glutathione: Helps restore glutathione; helps reduce metabolism of glycolate to oxalate; helps behavior on diet (meltdowns) for some children.
Citrate (a form of calcium or magnesium): May prevent crystalization of oxalate and may help break down crystals already formed.
Lipase or ox bile: May help if steatorrhea is leading to excess absorption of oxalate.
Co-Q10: another valuable antioxidant.
Lemon juice: Helps with digestion when given before eating and may help balance pH issues when acidity is a problem.
Antihistamine: Oxalate may cause histamine release so this counters that. Do not use an antihistamine formula that includes a decongestant.
Bicarbonate: sodium bicarbonate (baking soda) or Alka-Seltzer Gold, can reportedly help with behaviors.