Did you know that eating too many almonds could trigger joint pain, headaches, and IBS? Your green smoothie with 3 handfuls of raw spinach and soy milk can cause the same problem. It’s all because of oxalates.
High-oxalate Symptoms
Eating a high-oxalate diet can be a cause of systemic inflammation. The following symptoms can be caused by high-oxalates in the blood:
- joint pain
- aching muscles
- headaches
- irritable bladder (frequent urination, nocturia, bladder pressure)
- irritable bowel (constipation, diarrhea, cramping, gas, urgency)
- kidney stones
- and vulvodynia
Oxalates are abundant in many plant foods. In high amounts, they lead to oxidative damage and glutathione (antioxidant) depletion. Our bodies also synthesize oxalates from excess Vitamin C, yeast, and fructose. Meaning, high intake of Vitamin C or fructose, as well as fungal overgrowth can all worsen symptoms. These factors may also cause you to be more sensitive to high-oxalate foods.
Deficiencies of magnesium, B-6, and thiamine lead to increased oxalate synthesis. It is important to address these deficiencies if you are experiencing oxalate sensitivity.
Foods highest in oxalates are spinach, nuts, beets, soy, lentils, coffee, and chocolate. You can reduce the oxalate content of dark leafy greens by cooking them. Beans and lentils can be soaked, rinsed, and sprouted before cooking to reduce these compounds.
Oxalate Dumping
When you first reduce these compounds from your diet you may experience “oxalate dumping”. Your body forms crystals from oxalates that bind to calcium and these are excreted in the bowel. Oxalate-dumping can feel like a strong detox reaction. You may experience worse digestive upset, headaches, increased fatigue, aching, and flu-like symptoms.
If you’re eating spinach, nuts, beets, soy, or lentils daily and dealing with symptoms of autoimmune disease or inflammation, consider slowly reducing your oxalate intake. Calcium citrate supplementation can aid in preventing oxalates from binding to calcium to form crystals.
This is a great example of why there is no one-size-fits-all diet. Vegan diets high in soy, spinach, beets, and soy can be hugely inflammatory due to high-oxalate content. Green smoothies and nut-based keto/paleo snacks could be the cause of your IBS.
Are you interested in testing for oxalates in your urine to see if this is a factor in your health challenges? Schedule a functional medicine consult! I offer distance consulting and I can ship test kits to you anywhere in the US (except NY) if you aren’t local.
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Hi Dr Gordon, I already know I have hyperoxaluria and severe oxalosis, and have been dumping for about a year since I’ve gone off oxalates. I’m taking a lot of salt, potassium citrate, a couple of calciums, reduced glutathione, benfotiamine, sulbutiamine, and am aiming for 2:1 keto/carnivore (based on Zsofia Clemens research). I’m definitely noticing improvements, but feel like it’s going to be a long difficult ride. Do you have any recommendations beyond what I’m already doing?
I’m not interested in confirming or proving that I have it, but would like to manage the symptoms. I may be into testing to determine if I actually have some form of primary hyperoxaluria, and other tests: thyroid, testosterone, intestinal permeability.
Do you have experience treating this?
Thank you!
Hi Bill,
I highly recommend testing. The Organic Acids Test (OAT) by Great Plains Labs measures oxalates in the urine among a number of other markers to help determine what is out of balance in the microbiome that is causing excess oxalate production. It’s commonly due to fungal and bacterial overgrowth in the small intestine. It’s rare that I see hyperoxaluria due to diet alone unless someone is consuming green smoothies with kale/berries several times a day. The only type of calcium I recommend with oxalates is calcium citrate; other types can make things worse. I have experience treating many of the underlying causes of elevated oxalates and can recommend additional treatment options. I can’t give personalized medical advice without you being a patient, but feel free to book a telemedicine consult if you’d like to work with me.
Thank you Dr. Gordon!
I was diagnosed with hyperoxaluria many years ago. I passed my first kidney stone at 19 & still have them per my last imaging study. I’ve undergone lithotripsy & surgery to remove a stones with stent placement, no fun. I also have IBS-C & diverticulosis & on thyroid replacement s/p thyroidectomy in 2010. I’m a vegetarian/ pescatarian. Needless to say, trying to navigate a diet is quite challenging & I’m always hungry. Breakfast is most difficult for me & I really wish to find a protein supplement in a drink or bar since many of the low oxalate & IBS diets eliminate foods that are high in this. Any suggestions?
Hi Cindy,
I’m sorry to hear you’ve had ongoing issues with oxalates. I recommend collagen peptides as a low-oxalate source of protein that ought to be well-tolerated. You can get it from marine sources.
How sure are you about the Nocturia aspect of Oxalate dumping? I ask this because I have been off Oxaltes for a year and six months, after eating them heavily for a year at age 45, and my nightly urination has pretty much stayed the same at between 3-6 times a night for 18 months now. I am in China and cannot easily get confirmation of Oxalates, so I thought I would ask an experienced practitioner. Thanks
Hi Christopher,
There are many other more common causes of nocturia such as mouth-breathing or snoring, prostate inflammation, high stress, etc. I recommend looking into these.