A discussion on oxalates, inspired by Toxic Superfoods, by Sally Norton

The effects of oxalate overload on the body was the topic of Red Clover Clinic’s July/August 2021 Newsletter. Now comes a new, comprehensive resource, Toxic Superfoods: How Oxalate Overload is Making you Sick – and How to Get Better by Sally Norton, published at the beginning of the year.  I recommend Norton’s book to anyone who wants to learn more about what oxalates are, what effects they have on health, how to address issues associated with oxalate overload, and how to prevent this issue in the first place.

Briefly, oxalates are a crystalline substance found in plants and matabolically produced by our bodies. They can accumulate in our tissues, causing pain and dysfunction. The list of symptoms caused by oxalate overload is long. Besides pain, a partial list includes inflammation, arthritis, insomnia, chronic fatigue, muscle spasms, urogenital pain, brain fog, diarrhea, constipation, reflux, autoimmune disorders, rashes, eczema, bruising from within, headaches, heart arrhythmias, blood pressure irregularity, cold intolerance, depression, anxiety, inflamed gums, eye/eyelid irritation, and tinnitus. 

Not everyone has an issue with oxalate overload, but I do frequently see evidence of oxalate damage in my clients. At the very least, it is important to educate yourself about the harm you could cause to your health if you drink a spinach smoothie every day, or drink almond milk, snack on almonds, and bake with almond flour. 

I highly recommend that you reread the July/August 2021 Newsletter or take the time to read Sally Norton’s well-researched book. I found the following excerpt particularly interesting, explaining why so few people and practitioners know about oxalate overload:

No field of science is charged with (or even interested in) developing a “whole body” theory of what excessive dietary oxalate does to us, so it is especially difficult to recognize dietary oxalate overload as a unified problem with a common cause. The early signs and symptoms of oxalate poisoning are not well known, can be quite common and diverse, can appear gradually and intermittently, and are dissimilar from person to person. Most important, we don’t notice the gradual erosion of tissues and their lost function until metabolic reserves are depleted and the disease process interrupts our lives. (p. 88)

Urine tests of oxalate excretion levels are the only laboratory tests available. Unfortunately, they aren’t particularly accurate, or as Norton puts it,  “Urine testing is akin to taking a still photo of a moving target.” She describes a study that was done by the VP Foundation, in which nearly 4,000 women with vulvar pain were researched. Each woman’s individual urine void for three consecutive days was analyzed for oxalate content. “The study revealed that oxalate handling occurs in cycles, appearing as two or three brief but very steep peaks of elevated excretion occurring at the same time on each day in each subject, but at different times for each subject. For many subjects, their symptoms also occurred in cycles. Interestingly, despite the toxic elevations in urine oxalate, 24-hour urine level totals were normal in all the subjects.” (p. 99)

I also found Norton’s discussion of why oxalate accumulations start to be interesting. Oxalates, in general, tend to accumulate in tissues that are injured, inflamed, stressed, or undernourished. In other words, they settle into the weakest areas, which don’t have the health to repel them. Non-steroidal anti-inflammatory drugs (Motrin, Advil, for example), she says, can distress the gut lining and kidneys, which in turn can lead to oxalate damage and accumulation. 

I would be happy to discuss the possibility of oxalate issues with you at your next appointment.

Are you suffering from chronic, unexplained pain?

If you are struggling with joint pain, muscle pain, urogenital pain, headaches, burning feet, and/or general, unexplained inflammation, you may be suffering from oxalate toxicity. Oxalates are a crystalline substance found in plants, that can accumulate in our tissues, causing pain and dysfunction. Our bodies also metabolically produce oxalates. If we consume foods that are high in oxalates, and/or we have a compromised digestive system, we may run into problems.

In the latter half of the 19th century, oxalate poisoning was a well known condition, that seemed to worsen during the spring and summer months when high oxalate foods were in abundance. Unfortunately, that knowledge has been forgotten, and the only medical acknowledgement of oxalate issues is in patients with chronic kidney stones. Furthermore, the current health food movement has promoted the use of some extremely high oxalate foods as staples in large quantities, e.g. spinach smoothies and almond flour baked goods.

There are many lists available with information regarding oxalate levels in foods. Unfortunately, there are many discrepancies, which can create confusion. A good place to start is reading through this abbreviated list of exceptionally high and very high oxalate foods, which are mostly agreed upon. 

Exceptionally high oxalate foods: spinach, beet greens, Swiss chard, soy, rhubarb, almonds, plantains, buckwheat, amaranth, sesame seeds, cashews, peanuts, chocolate, and carob. 

Very high oxalate foods: beets, potatoes, sweet potatoes, blackberries, figs, kiwi, adzuki beans, black beans, pinto beans, white beans (cannellini, navy, great northern, etc.), quinoa, teff, most nuts, chia seed, hemp seed, poppy seed, and green and black tea.

Decreasing oxalates in the diet

If you eat foods that are listed above, and you have pain symptoms, you may want to consider decreasing or avoiding consumption of these foods. If you notice a change in your symptoms, then you have your first answer.

It is important to exercise caution when reducing oxalates, however. If reduced too abruptly, after a few days of feeling better, you may start to experience oxalate dumping side effects. These symptoms are very similar to over consumption of high oxalate foods, i.e. pain, inflammation, headache, etc. 

Compromising factors

There are many factors that can set someone up for struggling with oxalates more than others. These include:

• Antibiotic use: antibiotics can kill off the natural gut flora that help to break down oxalates.

• Yeast overgrowth: Yeast produces oxalates and converts collagen (the main structural protein in connective tissue) to oxalates.

• B vitamin deficiency: Certain deficiencies can cause the body to produce more oxalates.

• Magnesium and calcium deficiency: These minerals bind to oxalates and carry them out through the stool.

• Fat malabsorption: If fat isn’t being fully digested, it binds with calcium, leaving the oxalates unbound, and free to be reabsorbed.

• Hyper-permeable gut (Leaky Gut): This allows the oxalates to get into the blood stream, and increase their absorption.

Beyond the diet

A low oxalate diet is the primary and most complicated part of treating oxalate toxicity. That said, it is also important to reduce the body’s production and absorption of oxalates. This is accomplished with strategic use of supplements.

The long haul

There is nothing fast about the oxalate detoxification process. It can take 2-3 years to fully get on top of the condition. It also requires strict diet management.

As with everything, each person is unique. Some may experience extreme symptoms, while others only mild symptoms, and some, none at all. You may be a person who only needs to avoid spinach, almonds, and cashews, while others have to be extremely strict. No matter what, it is helpful to better understand what your body tolerates and what it doesn’t, and adjust your diet the best you can.

If you suspect that you may be struggling with oxalate overload, and want to explore your options further, I would be happy to work with you. I have a special interest in this topic, as it has proven to be the key to the majority of my health complaints. It is an ongoing process, but I am happy to say that I continue to see improvement over time.