Who Should Consider a Low Oxalate Diet? – Part 1

Mainstream medicine maintains that if you have not had a calcium oxalate kidney stone, there is no need to concern yourself with the amount of oxalates in your diet. As hundreds of listmates on the Trying Low Oxalates (TLO) group have learned, however, there are many conditions which can improve when you lower your oxalate intake. Given that oxalate crystal deposition can occur in almost any tissue of the body, this makes perfect sense. Read on to see who is most in need of the low oxalate diet, and why it can help.

If you don’t have any particular illness, and are just curious about whether or not a low oxalate diet (LOD) might do you some good, go ahead and skip to here to find out.

Kidney Stone Formers

The single largest group currently in search of information about the low oxalate diet is kidney stone formers. Bar none. In fact, some think of this as the “kidney stone diet.” Of course, kidney stones may be comprised of a number of substances, but calcium oxalate is far and away the most common type (roughly 80% of all stones tested). Once a stone former has had their stones tested, and determined that they are indeed calcium oxalate stones, dietary changes are often one of the first (and easiest) interventions recommended for preventing further stone formation.

Autistic Individuals

Parents of autistic children who are fortunate enough to have a doctor that thinks beyond standard pharmacotherapy are no strangers to specialty diets. There are many such approaches, from the straight gluten free diet to more involved approaches such as GAPS (Gut and Psychology Syndrome) and SCD (Specific Carbohydrate Diet). Unfortunately, what we often see when moving from a Standard American Diet (SAD) to something such as SCD, is that items like nuts and nut flours suddenly become a large part of the diet. Because nuts are very high in oxalate, if a child has a hidden sensitivity to oxalates, they may well improve briefly, then suddenly take a turn for the worse. If parents and doctors are unaware of the potential for oxalate issues, this can be disastrous. The great news is that both of these diets, as well as many others, can be combined with a low oxalate diet for maximum effectiveness.

The good news/bad news is that these children often show no increased risk for kidney stones (reference here). This is good news for obvious reasons – these kids already have a tough enough time without the added pain of kidney stones! The bad news is that it means a low oxalate diet may never even be considered by doctors who are so firmly entrenched in the idea that kidney stones are the only valid sign of an oxalate issue.

While a low oxalate diet isn’t generally the sole key to healing autism, it is often a huge piece of the puzzle. Many a parent of an autistic child has seen large leaps in verbal, social and other skills when beginning the LOD. A low ox diet can also help address issues with urinary urgency and frequency that can sometimes lead to children wetting themselves. Improvements of long-standing bowel issues (such as constipation and diarrhea) are often reported as well. Following the low oxalate diet under the guidance of a DAN! (Defeat Autism Now!) physician can prove to be an invaluable step in the overall healing process.

Vulvodynia and Vaginodynia Sufferers

While many folks may never have even heard of these ailments, these gals pretty much blazed the path the rest of us low oxalate dieters follow. It was the Vulvar Pain Foundation that released the Low Oxalate Cookbook, which included paying to have the first rounds of testing completed on common foods. Of course, it didn’t stop there; just like the TLO group, they still release new food testing numbers every few months via their newsletters. Dr. Clive Solomons was the groundbreaking researcher who introduced the concept of a low oxalate diet and helped over 3,000 women overcome their symptoms via this method.

Even today, however, the low oxalate diet is still considered only one treatment option for this devastating pain syndrome, and many women never even hear about it because their doctors do not believe in it. Yet the ladies on the TLO group who have been faithfully following a low oxalate diet have found relief. While I am a great believer in finding proof in the literature, this is one instance where the literature is still sorely lacking. I am hopeful that there will someday be a well-designed study which does not rely on either urine tests (which are poor indicators of an individual’s ability to deal with oxalate) or self-reported dietary intake (which have also been shown to be highly inaccurate)

Dialysis Patients

Unlike the clever human kidney, which either stores oxalate away as stones, or excretes it in urine, the membranes of dialysis machines do a very poor job of removing oxalates from the blood of the dialyzed patient. This results in the body being forced to store oxalates in other tissues, from internal organs right on out to the epidermis (skin). I well remember my own father, who was a dialysis patient for the last few years of his life, developing scaly patches on his forearms that he would worry at incessantly. They didn’t respond to antibiotics or antifungals, and the doctors could provide him with no explanation for their development. Ironically, the cause was already known to be oxalates, even then. But because because doctors don’t have the time to be well-read on the latest literature, the simple solution of changing his diet was never even considered, much less the more expensive solution of switching him to a different type of dialyzer.

Of course, annoying scaly patches of skin are far from the worst effects oxalate can have on dialysis patients; merely one of the most obvious. By contrast, the more deadly effects are far less apparent. For example, did you know that a dialysys patient’s risk of renal cell carcinoma increases the longer they are on dialysis? And as this study observes, many of the cancerous cysts contain oxalate deposits. Does oxalate cause this cancer? We don’t yet know for certain, but knowing that answer could save the lives of many dialysis patients.

Because of the shortcoming in dialysis which allows oxalate to remain in the body, I’d be willing to wager that almost every long-term dialysis patient could benefit from a low oxalate diet. Even if these individuals have an unimpaired ability to excrete oxalate via the intestines (an unlikely event in itself), it is probable that the intestines are not capable of carrying that burden alone over the long haul. Thus, implementing a low oxalate diet will greatly reduce the burden on the intestines, and hopefully help prevent many of the “inexplicable” issues which come along with being a dialysis patient.

Chronic Fatigue Syndrome, Fibromyalgia and Other Patients with Autoimmune Disorders

While the research is not yet looking at a low oxalate diet as a treatment for these disorders, there have been many reports on the TLO group of these patients successfully using the LOD to lessen their pain and fatigue. When I was eating a very high oxalate diet, I was seriously considering pursuing a diagnosis of fibro or CFS myself, because of my constant need for naps and my tendency toward disproportionately severe muscle pain. I’ve now been following the LOD for over a year and a half, and I only have to deal with mild muscle and joint pain on rare occasions (during dumping or infractions), and my fatigue is all but gone. I may never hike 10 miles with a 40-pound pack again (as I often did before poisoning myself with oxalates), but at least I can function and be pain free a large percentage of the time!

Anyone with a Known Leaky Gut

One of the known issues in autism which seems to be at the root of so many symptoms is a “leaky” gut. Leaky gut, while once considered the figment of a quack’s imagination, is slowly gaining acceptance as a valid issue (an excellent description, including illustration, is available here). Many parents of autistic kids will be all too familiar with this concept. Unfortunately, kids with an autistic diagnosis aren’t even close to being the only ones suffering from this problem.

For example, people battling intestinal candida or another fungal challenge are often dealing with a leaky gut at the same time. And when you consider that as much as 80% of our immune system resides within our gut (reference here), you begin to realize just how important gut health is to overall health. And because oxalates are a known irritant to the lining of the intestinal tract, we also face the chicken-and-egg problem – did a leaky gut cause the oxalate problem, or did a diet heavy in oxalates (like the SAD, or any “healthy” variant thereof) cause a leaky gut? Despite these uncertainties, I have seen time and time again on the TLO group that the low oxalate diet has helped people repair their leaky gut and keep it healthy.

People with None of the Above

Perhaps most surprising to me have been all of the folks on the TLO group who started the diet to support others, and found themselves dumping as well. This is most common with moms of autistic kids – parents who do the diet to show their kids that there is nothing wrong with eating a ‘special way.’ Suddenly they find that the random aches and pains that they just chalked up to “getting older” disappear. Others have had much more severe ailments like carpal tunnel vanish like magic (I’m one of them). And of course there are those who tried the diet for one ailment (such as vulvoodynia) and found their complaints from other ailments improving as well. While I won’t bother claiming that oxalate is the root cause of all of these issues, it has proven time and time again to at least be an important aggravating factor.

Basically, anyone who eats processed food, grains, or “healthy food,” probably needs to give their body a chance to dump oxalates. A combination of modern agriculture and ideas about the nutritional value of food has made it all but impossible to detox “by accident” as we once did naturally. On the contrary, there are those who are managing to cram amazing quantities of oxalate into their system by following purportedly healthful habits like juicing or raw veganism. Don’t get me wrong; I’m not knocking eating healthfully! But if you’ve read my story, you know that healthful eating can be a bit of a double-edged sword, since we no longer have to forage for food, or wait for it to come into season.

But Wait, There’s More!

As the “Part 1″ in the title hints, there are still many more issues which may be helped by following a low oxalate diet. I have a whole ‘nother long page worth up my sleeve, so stay tuned. I’ll link to it here when it’s done!

4 Responses to Who Should Consider a Low Oxalate Diet? – Part 1

  1. Rima says:

    I discovered oxalates while trying to find a way to stop the calcium from causing painful ulcers and eruptions on my fingers from the auto immune disorder called Scleroderma.
    Since going on a lower oxalate eating plan about 8 months ago, as well as having been gluten and mostly dairy free for about 12 years, I’ve dumped several times and have not as yet had relief from the calcium leakage. Has there been any research to back up this crazy notion of mine that there is a connection?

    Is there anyone else out there with a similar problem? Help….I’m getting desperate!

    • Michelle Fields says:

      Hi Rima,

      I must admit, before your comment, I had never researched the connection between scleroderma and oxalates. However, when I did, I found very little information about the topic in the literature. In fact, the only paper I could find mentioning the low oxalate diet for scleroderma patients was this one, which was in a case of acute renal (kidney) failure. No comment appears to have been made in that paper about whether or not the diet helped her other symptoms.

      In fact, quite the contrary, I see here that one of the drugs used to treat scleroderma has oxalate as a component (praxilene). This really makes me wonder if the person in the first study was treated with this drug, prior to developing the oxalate nephropathy (kidney damage). Scary stuff!

      On the other hand, the anecdotal evidence, on sites like this one, is that lowering oxalates may help.

      Taken together, this evidence suggests that yes, there is a known connection between oxalates and scleroderma.

      Now, is the low oxalate diet a magic bullet for scleroderma? I’d have to say no, because the low oxalate diet isn’t really a magic bullet for anything. It’s a long, slow process to encourage the body to dump its oxalate stores (I’ve been on it for over three years now, and can still dump if I take enough B6 or P5P). However, given the evidence that oxalates ARE a problem in scleroderma, and can even build up to the point that they cause kidney failure, I’d say you are a wise person to have adopted this eating plan!

      I don’t know if anyone else is out there with a similar problem, or has found any sort of solution, but if they happen upon this comment stream, I certainly invite them to chime in. In the meantime, I will add scleroderma to the list of ailments which may be ameliorated by a low oxalate diet (I really DO intend to add a “Part 2″ to this section someday soon), and I thank you for bringing it to my attention! In the meantime, if there’s any other information you can think of that would be helpful for you in your low oxalate journey, please let me know.

      Take care,

  2. Claire says:

    I’m reading through your site as wondering if part of my problems are caused by oxalates.I took antibiotics for what was thought to be a UTI. After 2 days of antibiotics my bladder symptoms dissapeared (after having them for 2 weeks), so it seemed to help. But once the course finished I have been having similiar type of bladder irritation (usually only after emptying the bladder or if the bladder becomes very full (eg at night). It usually lasts 2 days and then clears up. I do a urine dip stick test but no sign of infection shows up. So I’m confused about what is happening.
    My past history, is that I did have IV Vit C a few months earlier for amalgam removal, and then shortly after I became pregnant and miscarried. Then, I had a UTI a week later. And since then and even more so after the antibiotics course I’ve been having anxiety type symptoms (mainly tight chest). I just can’t figure out what’s going on.
    Is there a way to test if one has a problem excreting oxalates?

    • Michelle Fields says:

      Hi Claire,

      Your tale sounds pretty familiar. Difficulty with oxalates often seems to come on the heels of a course of antibiotics. This is because antibiotics tend to kill everything in their paths, including the bacteria in our guts which degrade oxalates. And IV Vitamin C is a huge offender, since excess Vit C is known to metabolize to oxalate. In addition, you are right on to suspect them in your bladder symptoms. I myself had similar issues (and was repeatedly prescribed antibiotics for nonexistent bladder infections) back in the beginning.

      As to your question, to the best of my knowledge, there is no way to test whether or not you are having difficulty excreting oxalates. There are, however, tests to see how much of them you are excreting. This may be helpful, at least in terms of convincing a medical practitioner that oxalates are one of your issues. It’s a 24-hour urinary collection, so a bit of a pain, but certainly worth it if you need to get your doc on board. If you are the only one who needs convincing, then generally the best way to see if oxalates are a problem is to try the diet for a month or three. Just make sure to heed my cautions about reducing oxalates slowly, so that you avoid the horrors of dumping as much as possible.

      Best of luck,

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