What are oxalates?
Oxalates (or oxalic acid) are a naturally occurring compound found in foods like spinach, legumes and grains. The role of oxalates in plants is to provide protection against predators, such as harmful bacteria, insects, and animals. Oxalates are also anti-nutrients. Which means that they inhibit the absorption of calcium, magnesium, and other minerals in the body. They do this by binding to them and passing them through the digestive tract and out through the stool.
In addition to oxalates that originate in food, called exogenous oxalates, the human body also produces them (endegenous) mainly in the liver from excess vitamin C, fructose, and yeast. In susceptible people oxalates can form painful crystals in various places such as the kidneys, bladder, vulva, gut wall, and other mucosal membranes.
If the gut microbiome has been compromised by antibiotic use, even just once, it may not be able to break down oxalates properly. This is because the exact species of healthy bacteria (OXALOBACTER FORMIGENES) that breaks down oxalates is often wiped out by antibiotic use.
If oxalate is not able to be excreted effectively, it can be transported across the gut wall and into cells where it can cause major damage.
Oxalates and Autism
oxalate sensitivity can be extremely common in those with autism due to underlying health issues that cause excess oxalate in the body...
In children with autism, yeast overgrowth (a common problem for these kids due to over use of antibiotics, poor diet, immune dysfunction, toxicity) can lead to increases in oxalate production. In fact as we can see below most of the causal factors implicated in oxalate excess are common issues we see in children with autism. Such as; leaky gut/ poor fat digestion, mould exposure, nutrient deficiencies, antibiotic overuse, yeast and candida overgrowth.
In her book 'Outsmarting Autism' Patricia Lemer points out that in the presence of mercury high levels of oxalates slow mercury elimination. So oxalates are extremely important from a detox standpoint too!
If you are trying to eliminate mercury or candida - a low oxalate diet could be useful if the body isn't able to excrete them effectively right now.
From the below list you can also see that common symptoms/ imbalances we see in autism can also be challenges caused by oxalate;
- Induce oxidative stress
- Lower glutathione levels
- Adversely impact sulphation by pulling sulphate out of cells
- Cause histamine release (histamine issues are common in children with autism) click HERE for information on histamines
- Impair growth and sugar regulation
- Bind with calcium and iron impacting absorption
- Impair growth
- Activate the immune system to trigger inflammatory cascades
- Interfere with and damage mitochondrial function
- Damage cells and tissues
- Cause seizures during toxic exposure to oxalate
oxalate levels in controls and those with autism
Researcher Susan Owens found that those with autism have five to six times the normal amount of oxalates in their urine.
high oxalate foods
- Spinach
- Swiss chard
- All nuts
- Chia seeds
- Sesame seeds
- Buckwheat
- Quinoa
- Most legumes - yellow split peas, mung beans are okay
- Potatoes
- Sweet potatoes
- Chocolate
- Beetroot
- Carrots
- Some kale varieties
symptoms of oxalate sensitivity
- joint inflammation
- fibromyalgia
- digestive problems
- skin rashes
- behavioural issues (including anxiety/depression and bed wetting)
- red, burning, painful eyes - eye poking in some children
- chronic candida/sibo
- There is not much improvement on the gluten/casein free diet
- Your child becomes worse on the gluten/casein free diet - this can be because substitute flours are used such as nut/almond flours
- Various urinary issues such as genital pain, painful urination, urgent urination, frequent urination, difficult toilet training
- Unresponsive bowel problems
- Kidney stones
- Digestive pain after eating
- Bad behaviour after eating
- Craving high oxalate foods such as nuts, soy, chocolate, potatoes
- Sandy and grainy stools
POSSIBLE CAUSES OF OXALATE SENSITIVITY
Antiobiotics that wipe out oxalate degrading bacteria - Oxalobacter Formigenes
Antibiotics such as Azithromycin, Ciprofloxacin, Clarithromycin, Clindamycin, Doxycycline, Gentamicin, Levofloxacin, Metronidazole, and Tetracycline all have the ability to wipe out Oxalobacter formigenes.
Oxalobacter Formigenes is an oxalate-degrading beneficial bacteria that lives in the large intestines.
Lower levels of of Oxalobacter formigenes correlates with higher oxalate sensitivity. Oxalobacter levels are inversely related to kidney stones.
Chronic diarrhea also flushes out and depletes O. formingenes
- Azithromycin is used to treat ear infections
- Ciprofloxacin and Levofloxacin were widely used to treat ear, respiratory and urinary tract infections. These antibiotics are no longer used routinely because of the risk of serious side effects
- Clarithromycin is used to treat ear and chest infections
- Clindamycin is used for tooth, chest and skin bacteria infections
- Doxycycline used to treat chest and skin infections
- Gentamicin tends to only be used in hospital to treat very serious illnesses such as septicaemia, as it can cause serious side effects, including hearing loss and kidney damage; they're usually given by injection, but may be given as drops for some ear or eye infections
- Tetracycline is usually used to treat skin infections, but can be used for other bacterial infections such as chest - it is not recommended for children under 8. However it has been used with children younger when the proposed benefit outweighs the risk
Low levels of lactobacillus (a beneficial bacteria that lives in the gut)
Lactobacillus acidophilus is a type of good bacteria found in the gut. And is an oxalate-eating species, but when oxalates are in excess, lactobacillus can be killed off. Some children also have have great difficulty colonising lactobacillus in the first place. This can be due to antibiotic use, stress, poor diet.
Leaky Gut
When the gut is leaky caused by antibiotics, stress, poor diet, food intolerances etc - oxalates are absorbed, instead of consumed by good bacteria in the gut. High levels can end up in the blood, urine and tissues. Resulting in sensitivity.
Mycotoxin (from mould) exposure
Some moulds produce mycotoxins which then produce oxalates. Aspergillus and Penicillium, moulds that are indicative of water damage when found in indoor spaces, produce ochratoxin. Ochratoxin produce oxalates.
Candida and Yeast Overgrowth
Oxalates are produced by fungus and mold spore. Chronic Candida issues and oxalates tend to go hand in hand. It is common to find that those who are diagnosed with a fungal Candida infection also have high levels of oxalates in their bodies. If a Candida sufferer is eating a diet rich in oxalates, it can cause those who are attempting to heal their Candida overgrowth with a diet free of grains and sugar and using anti fungal supplements to see little or even no results.
Deficiencies in some nutrients can cause the body to produce excess oxalates - most of these are common deficiencies in children with autism
- Sulphur - When sulphur is deficient, the body creates excess oxalate. Sulphur and oxalate share transport into the cells of the body. When sulphur is low, oxalate can cross into cells (this can cause mitochondrial dysfunction). See why sulphur is important for sulphation here.
- B6 - B6 is invloved in the degradation (break down) of oxalates. When B6 is low - oxalate levels increase.
- B1 - Low Thiamin (B1) levels will increase your body’s oxalate production. Thiamin is an important for carbohydrate metabolism. Excessive consumption of carbohydrates can lead to Vitamin B1 deficiency
- B5 - B5 helps break down dietary oxalate but if it gets too high and depletes B2 then the body will make endogenous oxalate. B5 and B2 must be balanced.
- Magnesium - Magnesium binds oxalates and is depleted by excess oxalate - When there is not enough magnesium, the body uses calcium instead which makes the person prone to forming kidney stones
- Vitamin K - Vitamin K manages calcium and controls endogenous oxalate production
- Calcium - Calcium binds to oxalates to then excrete them in the stool. If fat digestion is impaired (common with leaky gut) the undigested fat can tie up calcium in the body. Calcium is also important in preventing leaky gut as it assists the system of nutrient absorption in the gut.
High levels of some nutrients can cause the body to produce excess oxalates
Vitamin C - High dose vitamin C can convert to oxalate in the body
Glycine - Supplementing DMG, TMG, Magnesium Glycinate (all contain glycine) in large amounts can increase oxalate levels
Vitamin B5 - when in excess can deplete vitamin B2 which causes production of oxalate
Poor fat digestion
Normally, oxalates bind to calcium to form calcium oxalate, which we excrete in the stool. With impaired fat digestion, the undigested fat binds with calcium, leaving oxalate adrift and more readily absorbed and accumulated. Less lipase, less fat digestion - more oxalate accumulation.
How do i know if my child has oxalate issues?
A food diary can be a good way to ascertain patterns in behaviours after consumption of certain foods. I would suggest keeping it for a few weeks to get an accurate gauge of responses to a range of different foods.
There are lab tests, which analyse the urine, or blood for oxalic acid level. These can be costly though. So I would always suggest using a food diary first. In which case, if you suspect oxalates are an issue, an elimination diet can be also be useful. As the name suggest, an elimination diet 'eliminates' certain problem foods for a period of time to see if symptoms improve.
What can be done to help my child?
You'll notice as you browse these pages, that inevitably all issues lead back to impaired gut function! Supporting and healing the gut is the most important thing you can do. One of the biggest determining factors in whether or not oxalate gets excreted effectively is the state of the microbiome. Since gut dysbiois, leaky gut and antibiotic use, and nutrient deficiencies are extremely common in ch
Try eliminating high oxalate foods/ try a low oxalate diet. To eliminate all oxalate would be stressful and nigh on impossible. Think of oxalate sensitivity as a bucket (this has helped us not to get too restrictive or overwhelmed when changing diet) It is also important to note that if you remove all high oxalate at once symptoms may worsen due to dumping of excess oxalate. It’s best to switch f
Consider specific SNPs that could cause oxalate to be an issue. Genetic testing can be carried out via www.23andme.com. (Your child will need to fill around a half a test tube with saliva - so will need to be able to spit). This raw data can then be run through a genetic programming software (this sounds complicated but is as simple as an upload) to ascertain if your child has specific SNPs.
There
Incorporate fermented foods into the diet. These are rich in probiotics (good bacteria) that contain lactic acid. This binds with the oxalate's and helps with elimination. Increasing probiotic foods can also help with other gut issues such as bacterial imbalances and leaky gut. With the high number of artificial additives, preservatives and antibiotics etc in our diet, it can make it very hard for
Do your best to ensure adequate intake of B6, B1, B5, magnesium, calcium, vitamin K (many good food sources of vitamin K also contain high oxalate levels, try steaming them first to reduce oxalates and reduce other high oxalate foods first, and sulphur.
Sources;
- B6 - salmon, eggs, chicken liver, beef, carrots, potato, green peas, bananas
- Magnesium - pumpkin seeds and green leafy veg
- B1 - pork, l
Avoid supplementing with vitamin C and glycine if your child has oxalate issues as they can cause the body to produce excess oxalate.
Supplements such as magnesium glycinate contain glycine.
Cooking foods reducing the oxalate content. If you are going for oxalate rich greens in a smoothie - try gently steaming them first to reduce oxalates.
Ensure the child is drinking adequate water. Drinking water can help dilute oxalate in the blood and can make it easier to be flushed out of the body
Remediate any mould in the home. Mould is extremely detrimental to health, and causes the body to produce oxalate.
There is some research to suggest that 'People can obtain Oxalobacter formingenes (the main type of bacteria responsible for breaking down oxalate) through eating animal meats and fats, fats from grass fed pastured animals carry the most nutrient density'.
Avoid glyphosphate as this can interfere with oxalate metabolism
See this presentation by Julie Matthews and Stephanie Seneff. Here they discuss how glyphosphate impairs sulphation and how this impacts oxalate in the body.
Address fat digestion (and digestion in general / gut health)
- Supporting liver and gallbladder health (bile from the liver and gallbladder supports our pancreatic enzymes in digesting and absorbing fats).
- Addressing potential deficiencies in pancreatic enzymes and supporting pancreas health.
- Evaluating other common root causes for fat malabsorption (such as SIBO, low stomach acid, etc.).
- Remove food