In our world today a lot of people are facing chronic health issues. Unfortunately many people do not understand the cause or causes of their underlying dis-ease. As a doctor or naturopathic and a functional medicine lab consultant, I have the opportunity to interpret many lab results from various people with a wide range of medical diagnoses. In my experience one common underlying cause of dis-ease is oxalates.
What are oxalates?
Oxalates. Say what? Some of you that read this may have heard of or read about oxalates but others may have no clue what they are. Oxalates are a naturally occurring compound found in plants and humans. These are not needed for human health but we all have them or come into contact with them. The structure of an oxalate is a crystalline formation. These crystals can deposit in every system in the human body. In overabundance they can cause the affected individual to experience a wide range of symptoms. The body rids us of these via the urine as oxalate metabolites. There are three different types of oxalate metabolite one could be affected by. These metabolites include oxalic acid, glycolic acid, and glyceric acid. Traditionally when oxalates are mentioned people automatically think of kidney stones. This is accurate as the oxalates bind with calcium to form the stones that can be lodged in the kidneys. But there are other effects these crystals can precipitate
Symptoms and common conditions associated with oxalates
When a person is affected by oxalate overload the most common symptoms experienced are pain and anxiety. The crystalline structure of the oxalates irritate the tissues that they are deposited into. This is what leads to the pain experience. If they deposit in the brain anxiety can be the outcome. Many times I have seen individuals with chronic pain take many medications/supplements without true relief. Upon testing we realized that they actually have oxalate overload at the root of their issue, or at least a contributing factor.
Oxalates have been shown to be a contributor to the following conditions: headaches, fibromyalgia, vulvodynia, arthritis, low back pain, kidney stones, neurotoxicity (sleep and brain dysfunction) . Other conditions not associated with pain but associated with oxalates includes chronic fatigue syndrome. As these crystals irritate the soft tissues of the nervous system this can lead to fatigue. In children there have be major connections to oxalate irritants and autism spectrum disorder and ADHD. These conditions have a wide range of causes and contributing factors, and oxalates are another that should be considered in the lives of these children
Causes of Oxalate Overload
So with all of this talk about what can happen with too many oxalates, how do we get them in the first place? Well there are a few ways everyone will normally come into contact with oxalates. In the body we produce oxalates in our liver. Our body normally houses a fungal microorganism called Candida, which is a normal part of our microbiome. This organism produces a compound that our liver then takes and makes oxalate metabolites. Under normal circumstances we will all produce some amount of oxalates from general function. In cases of overgrowth of candida, more of the compound it produces is formed thus more oxalate is being produced by our liver. This will subsequently increase our load.
In some people, there is a genetic predisposition to make more oxalates. This set of conditions are known as hyperoxaluria. These people will produce a combination of oxalic, glycolic, and glyceric acid in higher amounts than someone who isn’t genetically predisposed. There are 3 types: type 1, type 2, and type 3. Each type consists of the development of kidneys associated with oxalates but the time of life they are experienced varies for each type. One thing about the genetic condition of oxalate overload is that it is very rare and most people will not have the genetics to support it.
Another way that we can get oxalates is through our diets and certain supplements. So currently and for the last few years, the green smoothie has been touted by many as the face of health. Everyone at one point was loading their blenders with cups and cups of spinach and other leafy greens, berries, and nuts. On the surface this is an excellent practice as these are wonderfully healthy foods. The issue for someone struggling with a chronic condition is that these are the HIGHEST oxalate foods. Other very high foods include soy products and chocolate. As described before, all plants will have some oxlates, but with the addition of these on a regular basis can easily shift someone struggling into hyperoxalosis stimulating their symptoms even more.
Testing for oxalates
Oxalate metabolites are tested via urine sampling. The Organic acid test (OAT) offered by The Great Plains Laboratory test for all 3 oxlates, italic acid, glycolic acid and generic acid. When these are elevated we can understand how many oxlates are depositing in the soft tissues and causing issues. This profile also looks at the intestinal overgrowth of candida and can determine if candida overgrowth is apart of the cause as well. If you are curious if your pain or condition may be affected by oxalates, try a week trial of a low oxalate diet and reassess your symptoms. This is an at home way of seeing how much affect they’re having or not.
How do we get rid of them?
If it is determined by testing that oxalates are an issue along with a candida overgrowth then treatment would require the use of antifungal agents to treat the fungal overgrowth. Your practitioner can suggest prescription medications like Nystatin or an apple drug, natural agents like oregano or garlic, and probiotics to correct the imbalance. Vitamin B6 is another available treatment option. Often time B6 is deficient in elevated oxalate situations. This is important as in the presence of this vitamin the liver will make less oxalates. It down regulates oxalate production in the body. Diet wise try reducing or eliminating the highest oxalate foods: spinach, soy, nuts, and berries for 4 to 6 weeks. Also calcium and magnesium citrate when taken with meals act to bind to the dietary oxalates in your meal so they can pass in the urine rather than depositing in the body.
So all in all, oxalates are a part of chronic conditions that are rather unassuming. They are apart of our lives and can be managed if needed. If you suffered from chronic unrelenting pain or fatigue then oxalates may be a factor in your dis-ease.