Poor Oxalate Metabolism, a Cause of Joint Pain, Heart Disease, and More!

Poor Oxalate Metabolism, a Cause of Joint Pain, Heart Disease, and More!

Though the ingestion of plants can have a lot of benefit for our overall health, for some people they do have drawbacks, oxalates being one. Different plants contain types of prebiotic fiber, terpenes, and polyphenols that can benefit our health. Plants also contain some compounds that cause health issues, including histamine, salicylates, and oxalates. Oxalate ingestion for some people that cannot eliminate them properly can cause serious health issues, including joint pain, vagina pain, kidney stones, heart disease, and cognitive problems. So what are oxalates, what foods contain oxalates, and what can one do to improve their oxalate elimination processes?

What are Oxalates?

Oxalates (salts of oxalic acid) are naturally occurring compounds that both our body produces and are in many of the foods that we consume daily. Daily adult oxalate intake is usually 80-120 mg/d; it can range from 44-1000 mg/d in individuals who eat a typical Western diet. Our body produces oxalic acid through the metabolism of vitamin C (cadmium can accelerate this metabolism) and during the Krebs cycle when oxaloacetate is hydrolyzed to oxalate and acetic acid by the enzyme oxaloacetase within our mitochondria. In addition, if you consume ethylene glycol during its metabolism when glycolic acid is dehydrogenated, oxalic acid is also formed. Our kidneys metabolize oxalates and express them into our urine. Oxalates are formed in plants as a defense mechanism to keep other animals, fungi, and insects from wanting to consume the plant. Plants also form oxalates to protect themselves from metal soil toxicity (phytoremediation) by binding some metals including lead, cadmium, and aluminum. Finally, some mold, including Aspergillus, Penicillium, and possibly Candida, can produce oxalic acid. 1 2 3 4 5 6 7

What Do We Eat that Contains Oxalates?8 9

Amaranth – high

Animal liver – medium

Apricots – medium

Artichoke – high

Arrowroot – high

Asparagus – medium

Banana – medium

Beans (most types, lima beans are medium, butter beans are medium, kidney beans are medium) – high

Bean sprouts – medium

Beer – high

Beets – high

Beet greens – high

Blackberries – high

Black pepper – more than one teaspoon is high

Blueberries – medium

Broccoli – low to medium

Brown rice (white rice is low) – medium

Brussel sprouts – low to medium

Buckwheat – high

Butternut squash – medium

Cantaloupe – low to medium

Carrot – low to medium

Cashew – high

Celery – medium

Chia seeds – high

Chicory – medium

Chickpeas – medium

Chives – low to medium

Chocolate – high

Cinnamon – high

Citrus fruit peel – high

Collard greens – low to medium

Corn – medium

Cucumber – low to medium

Currents – high

Dandelion greens – high

Dates – low to medium

Dewberries – high

Edamame – high

Elderberry – high

Eggplant – high

Endive – low to medium

Escarole – high

Figs – high

Flaxseed – medium

Fresh fennel – medium

Ginger – medium

Gooseberry – high

Grapefruit – medium

Grapes – low to medium

Green Beans – high

Kale – high

Kiwi – high

Kombucha – medium to high

Leek – medium

Millet – high

Mushrooms – low to medium

Nut butter – high

Nuts (all of them but chestnuts and macadamia nuts which are medium) – high

Oats – high

Okra – high

Olives – high

Quinoa – high

Papaya – low to medium

Parsley – high

Parsnip – medium

Pear – medium

Peanuts – high

Peppers – high

Persimmon – medium

Pineapple – low to medium

Pistachio – high

Plantain – high

Plum – low to medium

Pomegranate – high

Pumpkin – medium

Raspberries – medium

Rhubarb- high

Rutabaga – high

Sardines – medium

Spinach – high

Snow peas – medium

Soy sauce – high

Star fruit – high

Stevia – medium

Strawberries – low to medium

Sunflower seeds – medium

Sweet potato- high

Swiss chard- high

Tamarillo – high

Tangerine – low to medium

Taro – high

Tea – medium to high

Thyme – medium

Tiger nuts – medium

Tofu – high

Tomato – medium

Wheat – high

White onions – high

White potato – medium (red potato is low)

Yam – high

Zucchini – high

Symptoms of Poor Oxalate Metabolism and Hyperoxaluria (Oxalate Burden)

Oxalates can combine with other minerals and heavy metals within our body and cause major health issues. Oxalates that are ingested are either bonded to minerals that we ingest including calcium, zinc, and magnesium. When the oxalates are mineral bonded in the digestive tract they are eliminated through our stool. Oxalates that we consume can also become ingested by Bifidobacteria, Lactobacillus, and Oxalobacter formigenes occupying our digestive tract. If oxalates are not eliminated through our stool or consumed by bacteria they are absorbed into our bloodstream. Some of the oxalates deposit themselves throughout our body. Hopefully, most that enter the bloodstream are filtered by our kidneys, and eliminated in our urine. During metabolism by our kidneys oxalates may bind with other metals and minerals to form crystals that are expressed in our urine. If large enough amounts of oxalates combine with the minerals calcium or iron, for example, within our kidneys, kidney stones may form. Kidney stones if large enough, can obstruct the urinary tract and cause great pain, bleeding, inflammation, and distress. Iron oxalate crystals can cause significant oxidative stress within the body and inflammation and can diminish iron stores which can lead to anemia. Finally, though oxalates bind to heavy metals if the oxalates are not eliminated from the body, they can collect in tissues and cause further differing amounts of oxidative stress depending on the bonded heavy metal.10 11 12 13

Oxalates can also form crystals anywhere within your body, including joints, bones, blood vessels, lungs, and even the brain. Oxalate crystals that form in our joints cause joint pain and inflammation similar to uric acid crystals in gout. Oxalate crystals that form in our blood vessels could increase the risk of blockages and cerebrovascular and cardiovascular events. Oxalate crystals that form within our bones may replace bone marrow and reduce its formation and lead to anemia and immune suppression. Oxalate crystals that deposit in our lungs may worsen conditions including sarcoidosis, especially iron oxalate crystals. The medication condition vulvodynia might also be caused or worsens by oxalic acid formation within the vagina, which would cause painful sex. Finally, increased levels of urinary oxalate excretion have been found in autistic children.14 15 16 17 18 19 20

What May Lead to Hyperoxaluria?21 22 23 24 25

  • A lack of Bifidobacteria, Lactobacillus, and Oxalobacter formigenes occupying your gastrointestinal microbiome.
  • Fat digestion issues, non-absorbed fatty acids can bind to calcium, interfering with its binding to oxalates.
  • Ingesting a diet heavy in oxalates while having oxalate metabolism issues.
  • Lack of dietary ingestion or supplementation of the minerals calcium, zinc, and magnesium, which have all been found to bind to oxalates.
  • Leaky gut can lead to more oxalates entering into the bloodstream from the digestive tract before they are bonded by minerals and eliminated or digested by Bifidobacteria, Lactobacillus, and Oxalobacter formigenes.
  • Inherited oxalate metabolism disorders.
  • Oxaloacetate supplementation when having oxalate metabolism issues.
  • Yeast dysbiosis
  • Vitamin B6 deficiency leads to the enzyme amino alanine glyoxylate transferase (AGT) being produced less. AGT metabolizes glyoxylic acid, and when less of it is metabolized by AGT, it can be metabolized into oxalic acid by the enzyme lactic acid dehydrogenase.
  • Vitamin C ingestion or supplementation when having oxalate metabolism issues.

So, What Can Be Done If You React Negatively to Oxalates?

If you want to increase your microbiome’s oxalate metabolism taking a probiotic like Gutpro and supplementing with the prebiotics 2-FL (Holigos) and pastured collagen may help increase colony forming units of Bifidobacteria and Lactobacillus within your digestive tract. If you suffer from some of the symptoms above of hyperoxaluria, for example, kidney stones and/or joint pain and test low for oxalate metabolism, then ask your healthcare professional about doing the following protocol to find some relief hopefully. Finally, companies are working on marketing a supplemental strain of Oxalobacter formigenes that should hopefully be out in a few years.

If you have many of the symptoms of hyperoxaluria and/or you test high for oxalates in a urine test, going on a diet that is low in oxalates for a period might be crucial for your recovery. You might be able to stop the low oxalate diet once your body’s total oxalate load is lowered, treating yeast dysbiosis if you are suffering from it, or if you are able to metabolize oxalates better.26

  • Begin slowly consuming less oxalates in your diet and eventually transitioning to a low oxalate diet in a few months. You should attempt to reduce the amount of oxalates you are consuming by five to ten percent each week. Reducing oxalate consumption can lead to oxalate dumping as the body tries to detoxify, which can cause or worsen symptoms of hyperoxaluria. The following is a link to a good low oxalate diet.
  • Boiling high oxalate foods and draining/discarding the water can reduce the amount of oxalates in the food from as much as 75%. In people who are really sensitive to oxalates, this probably will not make high oxalate foods non-reactive, but medium oxalate foods might be made tolerable.27
  • Pure Encapsulations calcium/magnesium citrate – two capsules with each meal that contains oxalates.28 29 30
  • Pure Encapsulations P5P – one capsule every other day with breakfast, no longer than two weeks unless under the supervision of a healthcare professional. Long term vitamin B6 supplementation in some people can cause toxicity (mainly neuropathy).31 32
  • Relieve yeast dysbiosis if you are suffering from it.
  • Maintain proper hydration, which can help your kidney’s express oxalates into your urine. If your urine is clear and not pale yellow, you are consuming too much fluid.
  • Supplementation of N-aceytlglucosamine (do not use if you are allergic to shellfish or if you are suffering from yeast dysbiosis, it can feed the yeast) may reduce pain caused by elevated oxalates by increasing hyaluronic acid production, especially in people suffering from vulvodynia.33
  • If you are suffering from a lack of bile production or biliary sludge supplementing with artichoke extract, consuming one cup of organic black coffee in the morning daily, or consuming extra virgin olive oil may help.34 35 36
  • Avoid supplementation of vitamin C (for some people they can tolerate less than four grams daily before symptoms of elevated oxalates occur, only avoid if it triggers symptoms), chitosan, and oxaloacetate.37
  1. https://www.greatplainslaboratory.com/articles-1/2015/11/13/oxalates-control-is-a-major-new-factor-in-autism-therapy
  2. https://www.researchgate.net/publication/317237827_Oxalic_AcidOxalates_in_PlantsFrom_Self-Defence_to_Phytoremediation
  3. Gundry, Steven. The Plant Paradox. Harper Wave, April 25, 2017
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946963/
  5. https://www.bulletproof.com/recipes/eating-healthy/the-kale-shake-is-awesome-so-upgrade-it/
  6. http://www.gplworkshops.com/s/4.pdf
  7. Urry, Lisa, Cain, Michael, Wasserman, Steven, Minorsky, Peter, Reece, Jane. Campbell Biology, Pearson, October 29,2016
  8. https://melanieavalon.com/food-sensitivities/
  9. https://www.upmc.com/-/media/upmc/patients-visitors/education/unique-pdfs/low-oxalate-diet.pdf
  10. http://www.gplworkshops.com/s/4.pdf
  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3090165/
  12. http://www.gplworkshops.com/s/4.pdf
  13. https://www.greatplainslaboratory.com/gpl-blog-source/2016/8/8/oxalates
  14. http://www.gplworkshops.com/s/4.pdf
  15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3090165/
  16. http://www.gplworkshops.com/s/4.pdf
  17. https://www.greatplainslaboratory.com/gpl-blog-source/2016/8/8/oxalates
  18. https://www.ncbi.nlm.nih.gov/pubmed/15909602
  19. https://www.ncbi.nlm.nih.gov/pubmed/10957762
  20. https://www.ncbi.nlm.nih.gov/pubmed/9322615
  21. https://www.greatplainslaboratory.com/articles-1/2015/11/13/oxalates-control-is-a-major-new-factor-in-autism-therapy
  22. http://www.gplworkshops.com/s/4.pdf
  23. https://www.ncbi.nlm.nih.gov/pubmed/10203369
  24. https://www.greatplainslaboratory.com/gpl-blog-source/2016/8/8/oxalates
  25. Gundry, Steven. The Plant Paradox. Harper Wave, April 25, 2017
  26. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3090165/
  27. https://www.ncbi.nlm.nih.gov/pubmed/15826055
  28. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4708574/
  29. https://www.ncbi.nlm.nih.gov/pubmed/6764473
  30. https://www.ncbi.nlm.nih.gov/pubmed/30412704
  31. https://www.ncbi.nlm.nih.gov/pubmed/30412704
  32. https://lpi.oregonstate.edu/mic/vitamins/vitamin-B6
  33. http://www.pkdiet.com/pdf/oxalatevestibulitis.pdf
  34. https://www.ncbi.nlm.nih.gov/pubmed/12587687
  35. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5622710/
  36. https://www.ncbi.nlm.nih.gov/pubmed/12952432
  37. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306929/
  1. Such an amazingly well written article, and I am impressed with your knowledge! I had to research this a few years back due to spinach hurting me so much, and I was wondering if it is a double whammy with me – I am sensitive to oxalates and gluten/casein, so I am thinking this is why I find spinach to be the most painful food. But It doesn’t make me “feel good” like wheat, and I didn’t crave it. I am getting your book, you seem to be one of the few who really knows their stuff! My gut issues were from a vaccine, and I never had oxalate issues prior. Wondering if this is a common thing.

  2. Thanks for writing such a helpful article, John. Do you know what very high oxalic acid, high glyceric acid and very low glycolic acid might indicate on an Organic Acids Test?

  3. What about oatmeal? I eat it every morning. Natural brans.

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