Everything you need to know about oxalate intolerance

What are oxalates and how do they make us sick?

Calcium oxalate is a calcium salt of oxalic acid. Oxalates are microscopic calcium crystals in the plant foods we eat, though some oxalates are found in animal products we normally don’t consume, such as crab shell, for example, but can be a problem due to cross-contamination or lazy food preparation practices. Oxalates are the most acidic organic acid found in bodily fluids and, commercially, are used to remove rust from car radiators. Some foods are higher in oxalates than others — cacao, nuts, rhubarb, tea, chard, tea, soy, buckwheat, quinoa, curly kale, and spinach are all considered extremely high oxalate — while animal fats and proteins contain virtually no oxalates. Other plant foods fall elsewhere on the range — from negligible to low to medium to extremely high.

In a healthy person, oxalate-degrading bacteria in the gut are supposed to consume oxalates and digest them so that they do not end up in human tissues. While most people eat oxalates without noticing specific symptoms, oxalate poisoning is a very real occurrence and can cause immediate symptoms like burning and closing of the throat, swelling, digestive upset, coma, and even death. These cases are rare, however, and slow oxalate “poisoning” is a much more common occurrence. 

There are several bacteria responsible for breaking down oxalates in our guts: oxalobacter formigenes, lactobacillus acidophilus and bifidus. Researchers aren’t quite sure how the bacteria, oxalobacter formigenes, gets passed onto a person’s gut — is it via the birth canal, touching/hugging/kissing from family members, or a exposure to dirt and soil-based organisms? The mystery remains, but we do know that people who have oxalate intolerance often have low or non-existent levels of oxalobacter formigenes in their gut. Strangely enough, a person can also have very high levels of oxalobacter formigenes in the gut but still not tolerate oxalates. Why? Genes definitely play a role. If a person has a family history of oxalate problems, it’s likely they share a gene with their relative that would cause them to not properly digest and eliminate calcium oxalate. Urea cycle disorders, heavy metal toxicity, leaky gut syndrome, and mineral deposition issues can also play a big role. 

A person with normal gut microbiota and a person who lacks the gene mutations that cause oxalate intolerance may be able to eat high oxalate foods their entire life and never suffer ill effects. A round (or more) of antibiotics that kills oxalobacter formigenes and other healthy bacteria like Lactobacillus or Oxalobacter formigenes, however, or a stressful life event that alters hormone levels, or exposure to an environmental pollutant, or a nutrient deficiency, may suddenly switch on oxalate-associated genes and start causing problems. However, because again, oxalates are technically classified as a poison, even a healthy person with no Leaky Gut Syndrome, and no genetic mutations, and who has healthy levels of oxalobacter formigenes has a chance of being intolerant of oxalates.

Oxalates work differently than your typical “allergen” or food “sensitivity” or “intolerance”. Because oxalates have been classified as a poison, oxalate symptoms occur when you have been exposed to too much at once — just like other food chemicals. When a person is habitually eating a very high oxalate diet, they not experience symptoms but because their body is storing oxalates in the human tissues instead. True oxalate symptoms may not show up for years and years and even then may act like a “bucket effect” — where a person needs to consume a certain number of oxalates in a given meal, or day, or week, for a spillover of symptoms to occur.

Because of oxalate deposition, a person with oxalate build-up must learn how to eliminate the stored oxalates safely. Here, I use the term “oxalate intolerance” or “oxalate sensitivity” loosely. Oxalates function much differently than another kind of intolerance, like gluten or dairy, for example. However, “intolerance” and “sensitivity” are easy-to-understand ways to describe a food that causes chronic health problems but that does not always elicit immune-mediated allergic responses. Some people are intolerant to gluten but do not experience an immune reaction the way a person with celiac disease does. It is similar with oxalates — the spectrum of noticeable reactions varies, and just because a person doesn’t experience an immediate responses does not mean they are not oxalate intolerant or sensitive because so much of oxalate intolerance is “silent”, latent or not very obvious (until a person knows better).

There are three “medically acknowledged” oxalate diseases that doctors diagnose and treat: Primary hyperoxaluria which is considered a rare genetic disorder of liver metabolism that can results in life-threatening damage to the kidneys. The liver doesn’t create enough of a certain enzyme that prevents overproduction of oxalate, or the enzyme doesn’t work properly. Enteric hyperoxaluria is the second type which includes several intestinal diseases like Crohn’s disease and short bowel syndrome. Also certain surgical procedures like Bariatric surgery may increase the absorption of oxalate from foods. Dietary hyperoxaluria is the third type which is caused by eating a diet of high oxalate content foods. This can cause high levels of oxalates in the urine and can increase the risk of hyperoxaluria or kidney stones. Generally diet changes will decrease the level of oxalates in one’s urine but it takes longer to eradicate oxalates that have been stored in the tissues, which is why urine testing (such as an Organic Acids test) can be flawed. 

However, modern medicine has yet to acknowledge just how common oxalate intolerance and storage may be — and it’s connection to many common illnesses. Many people have anecdotally demonstrated that the reach of oxalates goes far beyond these seemingly rare inherited diseases. Studies prove that oxalates are known to deposit themselves in human tissues — including but not limited to: the thyroid, inner ears, skin, myofascial system, eyes, kidneys, liver, digestive tract, jaw, parathyroid, arteries.

Common oxalate intolerance symptoms and conditions:

  • Vulvodynia
  • chronic yeast/fungal infections
  • urinary tract infections
  • B vitamin deficiencies
  • muscle pain
  • joint pain
  • myofascial pain
  • calcification
  • headaches
  • Fibromyalgia
  • chronic fatigue
  • hormonal imbalances
  • leaky gut syndrome
  • autoimmunity
  • thyroid cysts
  • cloudy urine
  • kidney stones
  • kidney infections
  • cysts
  • iron deficiency
  • mineral deficiency
  • irregular blood pressure
  • Interstitial Cystitis
  • Cystic fibrosis
  • Autism

Common oxalate “dumping” symptoms:

  • Cloudy urine/crystals in the urine
  • Grainy or sandy stools (or changes in color of stools)
  • Skin rashes
  • Incontinence or frequent urination/urgency
  • Painful urination
  • Vaginal pain
  • Eye pain
  • Insomnia
  • Pain from previous surgery or injury sites
  • Irritability, anxiety, anger, depression
  • Lower back or abdominal pain
  • Kidney stones
  • Fatigue
  • Cravings for high oxalate foods

Again, there are tests one can order to determine if they are in fact dealing with an oxalate intolerance (an OAT). However, these tests can be flawed because oxalates go through phases of storage and elimination. One may be in a storage phase at the time of testing and therefore will not be eliminating large quantities in their urine sample, which would lead to a false negative. Great Plains Laboratory offers testing and lab values for oxalate intolerance.

Starting a low oxalate diet

It’s very easy to eat an extremely high oxalate diet of over 1,000 milligrams of oxalate per day if you are eating supposedly healthy foods like sweet potatoes, spinach, concentrated tomato sauces, whole wheat, cacao or chocolate, dates, nuts and seeds, cinnamon or curry powders, black tea, beets, and gluten-free or grain-free and dairy-free alternatives that are made with nuts and nut butters, teff, quinoa, hemp and soy. Eating extremely high oxalate is not a rare phenomenon and in fact encouraged by many popular diets such as vegan and Paleo. 

It is essential to reduce your oxalate intake very slowly. I cannot stress this enough. If you have been eating a very high oxalate diet for most of your life or you have significant health issues, this is especially important. A low oxalate diet is considered to be under about 50 mg of oxalates per day. Sometimes between 30 and 50 mg is recommended when eating “low oxalate”. Because oxalates build-up (store themselves) in human tissues, start the low oxalate diet very slowly and gradually increase the strictness to avoid a sudden “dumping” (as it’s called) of oxalates being liberated from your tissues.

For example, an average oxalate intake may average over 300 mg daily for someone who is not monitoring their intake. So decreasing very suddenly from 300+ mg of oxalates to under 50 could cause a sudden exit of oxalates that have been stored in tissues. This could result in painful symptoms for a person, including kidney stones, infection, pain, or whatever the original oxalate symptom was. You could end up feeling very sick before you start to feel better.

In my health coaching practice, I have had success with immediately reducing oxalate intake for clients dealing with chronic pain conditions like Fibromyalgia and muscle and joint pains from extremely high to high, then medium, to low over the course of several weeks or months. But in working with clients with a history of kidney stones, osteoporosis, irritable bowel syndromes, or who are in seriously poor health, I always make sure they very gradually reduce their oxalate intake.

You will need to monitor how a lowered oxalate diet is affecting you. If your oxalate “dumping” is coming on too quickly or strong (you are having a sudden flare of symptoms), you should increase your oxalate intake to stop the “dumping”. In the case of clients with a history of kidney stones, I know that causing them to “dump” too quickly could result in large or painful kidney stones, which is very important to avoid because no one wants an unplanned trip to the E.R. 

Also consider that oxalates naturally bind with minerals. So if a client comes to me with a low iron count, low magnesium, potassium, or calcium, I immediately think of oxalates. It may sound strange for low calcium to be a symptom of oxalate intolerance (because oxalate is calcium after all), but keep in mind there are different forms of calcium your body utilizes to keep blood levels in check — and calcium oxalate is not one of them.  

In addition to a lowered oxalate diet, there are also other tricks you can use to absorb fewer oxalates that you are eating, including, supplementation with calcium citrate or other minerals in the citrate form. When taken slightly prior to meals (about 5-20 minutes before), oxalic acid in the intestine combines with the citrate mineral to form insoluble calcium oxalate crystals. These crystals are then eliminated in the stools, commonly, and do not end up in the human tissues. When a person’s diet is low in calcium, soluble oxalic acid can be absorbed from the intestine into the bloodstream. In this way, it is helpful to eat dairy-rich foods if you can tolerate them, and if you have an oxalate problem — it means fewer oxalates will be absorbed by your body. The tricky part for people who have to eat dairy-free is finding non-dairy sources of plant calcium that are not high oxalate (because they almost always are) — this is why supplementation before meals can be helpful.

A common misconception is that cooking denatures or destroys oxalates. The reality is, it does not destroy oxalates and fermenting reduces oxalate content only in very few cases, but in some ways we can manipulate how we prepare foods to reduce the oxalate content. Boiling, for example, reduces the overall oxalate content of food because some will be drawn into the water.

Oxalates are also formed in the human liver. Some people experience what is called “endogenous oxalate production” which compounds an oxalate intolerance. This is where your body converts common substances like synthetic vitamin C, amino acids (like glycine), calcium or vitamin D supplements into calcium oxalate. So even if you are not eating a high oxalate food, you may be predisposed to converting non-oxalate substances into oxalate. This is purported to be caused by a vitamin deficiency like vitamin B6 as well as an interruption in the glycolate pathways caused by genetic mutations/inborn metabolism errors. If you have had your genes tested, you can look to see if you have ACAT, AGT, AGXT, SLC26A, MTRR, and ACE mutations which can contribute in various ways.

Avoiding foods rich in protein like meats and bone broths, gelatin, or synthetic vitamin C may be necessary to work around one’s oxalate intolerance/storage problem. Some species of mold or fungus like Aspergillus and Penicillium produce oxalates as well so there is reason to believe that infection by a certain pathogen can also cause oxalate production and intolerance. Supplementation with specific forms of B vitamins, such as biotin, P5P, and adenosyl or hydroxy B12 may also help.

Supplements that may help oxalate intolerance:

  • Minerals in the “citrate” form: These are generally taken 5-20 minutes before a meal to bind with the oxalates in the foods being eaten. Magnesium citrate, calcium citrate or potassium citrate are the most commonly used. Some people should not take calcium supplements, however, so magnesium may be the safest source.
    Also note that because oxalates bind with minerals, a person may be mineral deficient and need additional mineral supplementation regardless. Taking a multi-mineral supplement or using dermal magnesium chloride oil can help to reduce pain and symptoms of mineral deficiency
  • Anti-inflammatories: natural pain medications like Arnica (for muscle/joint pain caused by oxalates)
  • MSM: for muscle/joint pain.
  • Curcumin: as an anti-inflammatory. Note that turmeric is high oxalate but its active ingredients called curcumin is low oxalate. 
  • Essential oils: essential oils are used for many purposes, including everything from anxiety and depression to skin problems, sleep disturbances, infections, hormonal balance, and more. Oils generally have zero to a negligible level of oxalates so they are permitted on this diet. 
  • Vitamin B6: generally the active form called P5P is recommended over the synthetic B6 form.
  • Methylated B vitamin: your needs for this will vary depending on your gene mutations, so be sure to work with a practitioner before starting a B vitamin supplement. Low B6, B7 and B12 can contribute to oxalate intolerance. 
  • Homeopathics: homeopathics are used for various ailments and are generally considered low oxalate. Beware that homeopathic pellets often contain lactose so they are not appropriate for those with dairy allergies, or homeopathic tinctures contain alcohol so they are not appropriate for those with histamine intolerance.  
  • Humaworm for kids: this is an antiparasitic but also great for killing yeast that is associated with oxalate intolerance.
  • Oxalobacter formigenes probiotic supplement (this is not yet available on the market but projections show it should be available soon).
  • Biotin: to kill the yeast infections that oxalates can cause, or to rebuild Biotin stores as oxalate intolerance commonly causes Biotin deficiency
  • epsom salt baths to raise magnesium levels or act as a pain reliver for muscle/joint pain
  • Lactobacillus acidophilus and bifidobacterium lactis: they consumes 86-100 percent of oxalates in the gut even if you do not have adequate levels of Oxaloacter formigenes.
  • High-quality molecularly distilled fish oils: for the vitamins A, D, E, and K content, which aide in oxalate elimination in the bowels
  • Chondroitin sulfate: may help prevent the formation of calcium oxalate crystals
  • Digestive enzymes and supports: including betaine, protease, lipase, amylase, and possibly ox bile to stimulate digestion and bile production to stop oxalate absorption in the gut
  • Taurine: (if low in the plasma upon testing, which is common) to stimulate bile salt production to reduce oxalate absorption
  • Vitamin E and selenium: they have been shown to reduce oxalate damage
  • Arginine: to prevent oxalate deposition in the tissues

As with any diet or supplement changes, you must speak with your healthcare provider before making any changes. You do not want to guess as to which supplements you need or how much oxalate to reduce in your diet upon starting a lowered oxalate diet. It is truly that serious. 

Ready to reclaim your health and self? Click here to learn more about Nutrition Consultations, Energy Readings, and Body Readings. 

Advertisements

Thyroid nodules and Graves’ Disease are histamine intolerance symptoms

We’re told no one really knows why illnesses happen or where they begin. We’re told we need more research, more money invested into studies and pharmaceuticals. We’re told there are no cures for diseases. None of this is true. I know because I healed my Hashimoto’s disease and scoliosis with natural remedies. And I have given my clients information to help them do the same for themselves. There is a true monopoly on your health and care and unless you’re willing to seek new information that your doctor may not be familiar with, you’ll stay sick.

Over the years, I’ve primarily worked with clients with various forms of thyroid disease. And no matter which form of thyroid malfunction you have, there’s a good chance you could be suffering from thyroid nodules.

Thyroid nodules, that is, lumps that form in or around the thyroid gland, are a fairly common occurrence, affecting somewhere around 25-75% of Americans. Nodules affect both those who have been diagnosed with thyroid disease and those who are not hormonally affected.

In some cases, thyroid nodules are caused by nutrient deficiencies (such as iodine). In other cases, nodules are benign pockets filled with fluid. Still others are “hot spots” emitting too much thyroid hormone.

Or perhaps you have been diagnosed with Graves’ Disease, a serious form of autoimmune hyperthyroidism. If you do have nodules or Graves’, here’s what no one had likely told you before: while there can be many causes for both of these conditions, thyroid nodules and Graves’ Disease are commonly histamine intolerance symptoms.

Histamine is a neurotransmitter that is both formed intrinsically in your body as well as found in large amounts in certain foods. Histamine intolerance food lists have flooded the internet, but please know, many are flawed and contain not so great information.

Foods like mushrooms, spinach, legumes, pork, tomatoes, strawberries, bananas, and fermented or cured foods are classically high in histamine. Other foods known as “histamine liberators” (such as tea or other caffeine sources and egg whites) are exactly what they sound like and tell your body to release more.

Common symptoms of H.I. can include everything from seasonal allergies to hives, G.I. distress, mood disorders, flushing, trouble breathing, throat or thyroid swelling, and more. 

There are several causes of histamine intolerance. Gene mutations (HNMT and DAO) are a common cause, as well as Small Intestinal Bacterial Overgrowth (SIBO). Kidney and adrenal dysfunction are also causes as DAO (the enzyme your body makes to degrade histamine) is produced by the kidneys (as well as other areas of the body), and the stress that causes adrenal dysregulation can induce high histamine. 

I have anecdotally observed in my work with clients over the years is that histamine intolerance can not only cause or contribute to Graves’ disease but also thyroid nodules. 

Here are two case studies:

One client I worked with was diagnosed with Hashimoto’s Disease and had one large nodule on the right lobe of her thyroid gland. She had been eating gluten and dairy-free for quite some time because she knew those foods bothered her. From time to time, the nodule would seem to swell and make it difficult for her to speak and sing (which was a problem as she was a professional singer). Her main symptoms were mood issues that included anxiety and depression, random constipation, and she had serious insomnia problems, sometimes only sleeping two hours per night. 

Though she didn’t have “classic” histamine intolerance symptoms such as flushing or hives, I suspected she did indeed have a histamine intolerance that was contributing to the nodule swelling. We put her on a low histamine diet (which excluded all high histamine foods) for 4 weeks. The swelling stopped and her mood and sleep regulated. 

Then one day, while at a gig, she ended up hungry with no food options other than pizza someone else had ordered. About an hour afterward eating the pizza, the nodule began to feel swollen and her voice was affected. This happened every time she reintroduced a high histamine food. 

In another example, I worked with a Korean woman who was living in the U.S. and had been diagnosed with Graves’ disease. She had been on thyroid medication for well over a year and was already eating a gluten and dairy-free diet when she came to me. Because of her roots, she enjoyed cooking with soy products, fermented vegetables, eggs, pork and broths daily. Her main symptoms were anxiety, seasonal allergies, fatigue, and eye swelling and sinus drainage in the mornings. 

Again, I suspected she had an underlying histamine intolerance. We put her on a low histamine diet for 4 weeks, as well as added in natural anti-histamine remedies. Her symptoms improved during the month, and once we had her add back in high histamine foods, her symptoms returned. Within four months on the low-histamine diet, her doctor was able to take her off of her medication completely. 

I have seen this over and over again in my work. 

If you suspect you have a histamine intolerance, there is plenty you can do to improve your thyroid nodules or Graves’:

  • Get a Lactulose breath test to see if you have SIBO. Ideally you would get a methane and hydrogen test to determine which type of bacteria is affecting you. Some people just get one test or the other but this won’t give you a full picture of the issues. 
  • If you test positive for SIBO (or display the symptoms), use natural remedies to kill the bad bacteria.
  • Reinoculate the gut with soil-based probiotics (not traditional acidophilus-based probiotics because some strains can make histamine intolerance worse).
  • Make sure you are producing enough bile to break down fats. Fat malabsorption is a leading cause of SIBO, which can therefore cause histamine intolerance.
  • Work on your liver and gallbladder health.
  • Use natural anti-histamines to help you degrade histamine (such as DAO, nettles, quercetin and rutin — just be sure these last two aren’t derived from citrus).
  • Add in natural anti-histamine teas, herbs, and fruits and vegetables into your diet.
  • Be sure you’re getting enough cholesterol in your diet as a high plant-based saturated fat diet and low cholesterol diet (as we often see in Paleo or vegan diets) is another contributor to histamine intolerance.
  • Heal your leaky gut. You need healthy gut function to stop immune reactions.
  • Work on your methylation. Again, gene mutations can be at play so make sure you are taking in the correct forms of vitamins (such as methylated B vitamins if you take them, instead of synthetics).
  • Heal your adrenals and find ways to destress.
  • Balance your blood sugar in order to help your adrenal health. 
  • Go on a low histamine diet for at least 4 weeks then reintroduce high histamine foods gradually. I do suggest having DAO (or perhaps Benadryl) on hand if needed in case you get a serious reaction to the reintroduction. And please be under the care of your healthcare provider in case any troubling symptoms should pop up. 

As always, speak with your healthcare provider before making any changes. 

Ready to reclaim your health and self? Click here to learn more about Nutrition Consultations, Energy Readings, and Body Readings. 

 

 

 

 

The healing you seek is right in front of you

Until you understand yourself, you will never understand your health. I have found this to be true time and time again both for myself and my clients over the last seven years. I will tell you the truth: your body is a metaphor for all you have lived, all you have experienced (the good and bad), and all of the trauma you have suppressed or internalized. The answers you seek are right in front of you. 

That ache in your back, the tightness in your throat, the gait with which you walk, the way you carry your shoulders, the food allergies, the stomach bloat, the chronic fatigue, the brain fog — it is all a cue and clue as to the greater analogy of who you are, what you have been through, and how your body handled it all. 

Think of your health as a poem. A left-brained critical thinker (aka: doctor) may take a look at the words (aka: your body) and assume prescriptions are the solution for any and everything that ails you. That is all they have been trained to do and they do not function outside of these boundaries because it feels scary to them. It is a trek into unknown, uncharted waters. To them, you are black and white, cut and cry, no gray area or room for discussion. Anything else would imply they don’t have all the answers.

Modern medicine has relegated health and wellness into the realm of the left-brained scientist: “Only they can be trusted, only they can be believed, only they have the answers I seek.” This just isn’t true. It takes a right-brained creative thinker that knows no bounds, is comfortable with free thought, and understands you are a limitless individual with limitless solutions available to you to find the answers to your pressing, painful health complaints. It takes a poet, an artist, an inventor to say, “there is more to the story. I know this because I can read between the lines.” Yes, we’ve been doing it all wrong. 

What if instead of medicating (which never gets to the root of why you are experiencing the health problem in the first place) we began to “read” you to deconstruct the meaning behind it all? What if we unraveled, line by line, symptom by symptom, the meaning of you? What if we went so deep into you that we solved the mysteries?

Chronic illness does not have one cause. Yet thyroid diseases and autoimmune conditions are diagnosed and treated as though they do come from a singular cause. Medication, testing, adjusting of dosage, more testing, more adjusting. Round and round we go on this hamster wheel. You end up so frustrated or defeated that you give up trying to improve things altogether. Let me tell you this: it is not you, it is them

I think of each client as a unique mystery begging to be solved. How did they get here? What is their potential for healing? What do we need to do to get them there quickly? I know there are always solutions because I healed my Hashimoto’s Thyroiditis and put it into unmedicated remission despite medical professionals telling me it wasn’t possible. They couldn’t read between the lines, but I could. And I did. 

I have worked with clients at the end of their rope with their health. I have seen women with Graves’ disease go medication-free and keep their labs in check with specific, tailored nutrition and deep mind-body work; Graves’ Disease! — an illness that can literally kill someone. They came to me eating a gluten-free and dairy-free diet because that’s what they’d read big-name left-brained doctors and internet stars say they had to do. It wasn’t getting them anywhere. You see, diseases happen for “cluster” reasons. Once we understand the cluster, we deconstruct it to stop it.

This means they didn’t just have a genetic predisposition to autoimmunity or hyperthyroidism — they had 10 or more issues that were compounding to create the Graves’ disease state:

  • histamine intolerance
  • large consumption of thyroid-stimulating foods (coconut, avocado, and brazil nuts, for example)
  • leaky gut syndrome
  • Epstein-Barr infections
  • Small Intestinal Bacterial Overgrowth (SIBO)
  • adrenal fatigue or high/low cortisol
  • erratic blood sugar
  • too little cholesterol in their diet and way too much plant-based saturated fat (thanks to big name doctors promoting a low-cholesterol, high saturated fat Paleo diet)
  • nervous system dysregulation
  • stored chaotic energy
  • abuse or neglect
  • little to no self-care
  • “screaming” to be heard their entire lives 

What happens when you deconstruct and remedy the cluster? You stop the disease state. 

But keep in mind, this is only a template. It’s like the stanzas in a poem. The words will be unique to you, despite the outline of the rhythm being the same. Until you understand your unique cluster, you will never halt the health problems. 

The answers you seek are literally and figuratively right in front of you. You must find someone to help you deconstruct the metaphor that is you.

Ready to reclaim your health and self? Click here to learn more about Nutrition Consultations, Energy Readings, and Body Readings.