Oxalate Crystals: An Often-Overlooked Pain and Detox Mystery
Like many people during the first year of Covid, my diet and activity level changed dramatically. Considerable Covid stress plus the uncertainties of opening a new medical practice during those crazy times threw my regular routine into a tailspin. I feel compelled to share my personal story about pain, oxalates and how I overcame this pain condition.
Stress eating meant eating handfuls of nuts and bags of Five Guys French fries, daily cravings of chocolate and of course sugar. I also ordered extra spinach and kale on my gluten free pizza and regularly ordered beet salad thinking that would be a better choice.
It wasn’t long before I couldn’t walk without excruciating pain in my feet – my right foot was worse than left foot – and the arthritis pain in my right hip made it hard to stand while wearing my 25 lb. lead apron in the procedure room. Life was not good.
Before realizing that my pain was stemming from an oxalate issue, I tried regular massage therapy, physical therapy, aquatic exercise, cold laser, CBD, supplements to reduce inflammation and NSAIDS, all to no avail.
Then it occurred to me that with every step I felt as though I was walking on ‘shards of glass’. Limping and discouraged, I did some research into the cause and learned that Oxalates could be the cause. My research revealed that there is a little-known link between oxalates and pain. One of the articles I read help connect the dots between pain and oxalates making it easier to solve one of my own medical mysteries. I’ll share what I have learned from this painful lesson and what I put into practice to heal myself. Hopefully this information is helpful to you or any loved one who hurts.
The oxalates topic is important because high oxalates in the body (hyperoxaluria) can be a factor in many chronic conditions, including digestive and urologic issues, autoimmune disorders, and neurological conditions. Oxalates affect mitochondrial function causing fatigue and muscle soreness as well as create inflammation and unnecessary oxidative stress and free radicals, potentially influencing every system in the body.
This article explores the repercussions of the oxalate cascade in a variety of chronic diseases. The following is an overview of oxalates and is a deep dive into the condition called oxalate crystal disease and the association between oxalates and other potentially related conditions to include kidney stones, interstitial cystitis, prostatitis, vulvodynia, autism, and atherosclerosis.
Basically, there are at least three reasons why people have oxalate issues, and some people have all three.
- High oxalate diet- think ‘healthy’ green smoothies, Spinach, nuts etc.
- Candida (yeast) overgrowth in the gut resulting in high oxalates
- Hereditary hyperoxaluria- kidney stones…
Why are Oxalates Important?
“Oxalates present in our body as sharp crystals or crystalline structures with jagged edges that cause pain, irritation, and distress. Oxalates can bind with certain minerals, particularly calcium and magnesium, as well as iron and copper. Calcium oxalates often precipitate in our tendons, fascia, ligaments and joints as well as in arteries and in the urinary tract in the form of kidney stones. Julie Matthews, shares this in her blog,” Oxalates: Their Influence on Chronic Disease
Where to Start Your Oxalate journey? Food.
Diets high in oxalate could create a wide variety of problems for some people. Modifying your diet to reduce oxalates can make a dramatic difference in lowering the oxalate load. It is important to reduce oxalates in the diet very slowly to avoid oxalate dumping.
Some people seem to tolerate high-oxalate diets while others do not.
For those with oxalate issues, oxalate rich foods become a problem – if you eat too many. You might be surprised to learn that high oxalate foods are often considered healthy and include foods like spinach, kale, green smoothies, beets, almonds, sweet potatoes, potatoes, chocolate, kiwi etc. You’ll find several different lists of low, medium, and high oxalate foods online. Note, there is some variability in these lists. If you are an Apple user there is a free easy to use App you can download called Oxalator which is a helpful color coded tool to learn about which foods are high in oxalates.
High Oxalate Foods
- Swiss chard
- Almonds and almond flour
- All nuts, especially Almonds
- Chia seeds
- Sesame seeds
- Most legumes (beans, peanuts, etc.)
- Sweet potatoes
- Kiwi and star fruit
The best way to quickly reduce the negative effects of oxalates is to limit medium and high oxalate foods and to take a combination of 500 mg of activated B6 (P5P) plus calcium citrate and L- Lysine 30 minutes before you eat. This oxalate binding protocol helps to bind the oxalates that you eat and prevent them from precipitating in your tissues.
Cases of “oxalate poisoning “are all unique. This complicates the diagnosis and is likely one reason this is not a well understood condition. Additionally, it is possible to develop symptoms even when you do not eat high oxalate foods as this could be a time of “oxalate dumping”. If you are not sure about your oxalate status, we can order a Urine Organics acid test to assess whether you have high oxalic acid levels. This test can also help determine if you have Candida overgrowth which is commonly associated with high oxalates as the candida produce oxalates as a byproduct of metabolism. Once we get the test results back, if appropriate we can get you started on our oxalate and/or candida protocols.
Please note that while this test is a useful tool to point to oxalates as an explanation for symptoms, they are not necessarily definitive. Thus, if you have symptoms that are otherwise poorly understood and believe that you do not tolerate high oxalate foods, please listen to your intuition, and take the simple steps to improve your overall health.
For more information on oxalate testing and our oxalate protocol please consult with our medical staff at www.BarrCenter.com.
Oxalate Crystal Disease
How do we know where oxalate crystals will form in the body? Some in the nutrition world believe that oxalates can cause issues where you have a ‘weakness, referring to this as our “Achilles heel” or our unique weak spot.
For example, I injured my right hip while rock-climbing 15 years ago, so I suspect this is why my right hip is painful when I eat high oxalate foods. You, however, might experience symptoms in your feet, knees, shoulders, elbows, eyes etc. Because there is no single target organ, oxalate related issues can be challenging to diagnose. A good analogy is that solving the oxalate puzzle is like peeling back the layers of the onion.
The condition “oxalate crystal disease” is often associated with kidney stones. But not everyone with an oxalate issue has kidney stones and most people have normal kidney function. One hint that oxalates could be the root of your pain- a positive family history of kidney stones.
Oxalates and Joint Pain
Oxalate arthropathy is a rare cause of arthritis characterized by deposition of calcium oxalate crystals within synovial fluid. This condition typically occurs in patients with underlying primary or secondary hyperoxaluria. Primary hyperoxaluria constitutes a group of genetic disorders resulting in endogenous overproduction of oxalate, whereas secondary hyperoxaluria results from gastrointestinal disorders associated with fat malabsorption or candida overgrowth resulting in an increased absorption of dietary oxalate. In severe cases oxalate crystals can deposit in the kidney leading to renal failure. Calcific tendonitis and fasciitis are also very common.
Since oxalates are primarily eliminated in the kidney when the kidneys fail oxalates can accumulate throughout the body- a state referred to as oxalosis. Affected organs can include bones, joints, tendons, ligaments, fascia, heart, genitourinary system, eyes, and skin. Since patients can present with renal failure and oxalosis before the underlying diagnosis of hyperoxaluria has been made, it is important to consider hyperoxaluria in patients who present with unexplained pintor soft tissue crystal deposition. The best treatment of oxalosis is prevention. If patients present with advanced disease, treatment of oxalate arthritis consists of symptom management and control of the underlying disease process. Excerpted from: Update on Oxalate Crystal Disease.
Calcium Oxalates and Other Symptoms:
Although most commonly identified with the formation of calcium oxalate kidney stones (oxalate bound to calcium), when unbound, free oxalate can interfere with cellular functions, affecting health on a broader level. It has been shown that oxalates interfere with cellular function and cellular nutrition resulting in increased oxidative stress, mitochondrial disruption and damage, and nutrient depletions. The impact of this triggers widely varied symptoms including fatigue and inflammatory cascades, joint pain, or pain anywhere in the body. Chronic low energy is very common because of a reduction in ATP (energy) in the mitochondria. Oxalates could be a hidden source of headaches, urinary pain, genital irritation, joint, muscle, intestinal or eye pain.
Other common oxalate-caused symptoms can also include mood conditions, anxiety, sleep problems, weakness, atherosclerosis, prostatitis and burning feet.
As Julie Mathews points out- “It’s important to note that oxalates can inhibit the absorption of calcium, magnesium, and other minerals, which actually makes oxalates an “anti-nutrient.” Minerals in food become bound by oxalate – for instance calcium (thereby forming insoluble calcium oxalate) – which cannot then be absorbed properly by the intestinal tract. This can lead to mineral deficiencies, such as calcium and/or magnesium deficiency and potentially explain osteopenia/osteoporosis. This is one reason we recommend the addition of trace minerals in our oxalate treatment protocol.
In the gut of a healthy person, oxalates typically bind together with these minerals and then they are eliminated in the stool. While this inhibits absorption of nutrients, beneficially this ensures they are excreted rather than crossing the gut into the bloodstream and causing cellular distress and damage.”
– From Julie Matthews Oxalates: Their Influence on Chronic Disease,
Broad Impact of High Oxalates:
- Disrupt mineral absorption and usage especially calcium and magnesium
- Impair cellular energy resulting in fatigue
- Deplete nutrients like glutathione and interferes with biotin
- Create oxidative stress
- Activate the immune system to trigger inflammatory cascades
- Interfere with and damage’s mitochondrial function
- Damage cells and tissues
- Cause seizures during toxic exposure to oxalate
- Cause faulty sulfation- leading to weakness in detoxification
- Cause histamine release- leading to mast cell issues and allergies
When the Gut is Unhealthy- Endogenous Oxalate Production
Leaky gut syndrome, the health of the gut microbiome and fat malabsorption can influence whether or not a person has an issue with oxalates. Mineral deficiencies can also cause high oxalates as there are insufficient minerals in the gut to bind the oxalates. A history of antibiotic use, dysbiosis or other conditions that negatively affect the microbiome can contribute. Oxalobacter formigenes, a strain of beneficial bacteria that degrade oxalate can be wiped out by a few courses of antibiotics and impact health for months, if not years.
With optimal health, good digestion, and mineral intake, calcium would be available for binding to that oxalate; however, when there is excess fat the calcium binds to the fat, allowing the oxalate to be free to get into the bloodstream and into the cells.
A stool analysis can help you determine if dysbiosis and/or fat malabsorption is at play. Symptoms of fat digestion issues such as floating or greasy stools. Working with digestive enzymes, supporting gallbladder and bile production can be helpful as well as detoxification support.
Nutritional Deficiencies and Endogenous Oxalates
Genetic differences and nutritional deficiencies can impact one’s ability to process oxalates. B vitamin deficiencies, including vitamin B6 and B1 deficiency can result in endogenously high oxalates. Vitamin B6 is the most critical B vitamin in energy production, and it is also the most common B vitamin deficiency. Thus, B6 is a critical part of our oxalate protocol. Additionally, vitamin A deficiency can cause the body to absorb excess oxalate through the gut resulting in worsening oxalate related symptoms.
Under certain conditions our body chemistry can convert a substance into an oxalate; Vitamin C and the amino acid glycine (a key component in bone broth) can cause problems. Fructose, xylitol, and other sugar alcohols can also convert to oxalates. Diets too high in meat can also be a problem for some people.
Oxidative Stress, Inflammation, and Glutathione
There are many pieces to this puzzle. High oxalates can lead to oxidative stress, and subsequently inflammation and injury which can cause oxalate stone formation in the kidney, and damage to joint or soft tissue or area of the body where they interfere with cellular function.
High oxalates increase free radicals and deplete glutathione thus throwing a monkey wrench in our ability to detoxify medications and environmental toxins. Conversely, antioxidants and free radical scavengers can decrease oxalate stone formation in the kidney, as well as reducing the inflammation caused by oxalate. We do have a detox trip protocol at Hang 10 Drips called the Bodhi and this IV therapy protocol can help bring your body back into a healthier state faster through nutrient and glutathione repletion, hydration and free radical reduction.
Oxidative stress, inflammation, and low glutathione status are common manifestations in many chronic diseases. Understanding this relationship and the potential sources of chronic inflammation and stress helps us know where to turn to start feeling better. This allows us to address the triggers that can be causing the problems and not just focus on symptoms. Oxalates could be an important factor to consider.
Chronic Conditions Associated with High Oxalate:
- Autoimmune thyroid or other autoimmunity
- Chronic fatigue syndrome
- Cystic Fibrosis
- IBD (inflammatory bowel disease)
- Interstitial Cystitis
- Kidney Stones in family
- Low muscle tone
- Migraine and Headaches
- Depression and Anxiety
- Mitochondrial damage and dysfunction
- Rett Syndrome
- Obesity, heart disease, and diabetes
Schedule a Consultation
If you think that you may have an oxalate related issue and want more information, feel free to reach out to our medical staff to schedule a consultation at www.BarrCenter.com, www.Hang10Drips.com or call us at 757-578-2260 .
Online Resources to Learn More
Good websites offering information about oxalates include:
SallyKNorton.com– Sally’s site has a downloadable low oxalate e-cookbook and she has basic information about things to know including oxalate dumping syndrome, which can happen if you withdraw oxalates too quickly. Other sources include Trudy Scott and Susan Owen. https://lowoxalate.info.
Great Plains Laboratory Oxalate Control brochure – https://greatplainslaboratory.com. The Vulvar Pain (VP) Foundation – https://thevpfoundation.org. Nourishing Hope (Julie Matthews, CNC.) – https://nourishinghope.com. These sites are easy to understand and very helpful. There is also a Trying Low Oxalates Facebook group for support and feedback.