What are Oxalates, and why might they be the cause of your pain?
Image of the surface of a calcium oxalate kidney stone crystal
Have you been diagnosed with Interstitial Cystitis, have chronic urinary tract pain with no diagnosis, vulvodynia, or vulvar or vaginal pain? Do you have chronic mid back, hip, pelvic, or other joint pain that hasn’t responded to chiropractic treatment? Did these problems begin or become significantly worse during a pregnancy? Do you eat a diet high in plant foods, superfoods, or green smoothies and juices, and avoid gluten and dairy products yet continue to feel your health decline and pain increase?
Oxalate is a simple molecule that is common in many plants, and allows plants to protect themselves form pests and infections. Although, essentially all plants contain some amount of oxalate, specific types have extremely high amounts such as spinach, beets, sweet potato, rhubarb, kale, swiss chard, nuts, cacao, black and green tea, turmeric, amaranth, buckwheat, kiwi, and pomegranate. Unfortunately many of the foods have been labeled as “superfoods” and have used in extreme excess in the diets of many well-intentioned health conscious people, myself included. (Read my story about my struggle oxalate toxicity here.)
When you eat an oxalate containing food, the oxalate can either bind with calcium (and to a lesser extent magnesium) in the gut, become unable to pass through the intestinal wall (unless there is significant intestinal permeability or “leaky gut”) to be safely excreted later. If the oxalate is in it’s free form, it will be readily absorbed into the bloodstream.
Once in the bloodstream, the body is able to eliminate oxalate in urine through the kidneys. However, the kidneys can only deal with a limited amount. When blood levels pass this limit, the body begins to deposit oxalate crystals in various organs and tissues. This phenomena is well documented in the study of kidney stones, around 80% of which are formed from calcium oxalate. To make matters worse these sharp, spike, even needle like crystals tend to accumulate in areas of inflammation an injury, increasing pain, and slowing healing. Below are some images of oxalate crystals.
Why are pregnant women more at risk for oxalate poisoning? Many of the factors that place you a greater risk of oxalate absorption and accumulation such as high oxalate diet, poor fat digestion, less calcium available in the gut, nutrient deficiencies (epically vitamin b6), intestinal permeability, increased oxidative stress, and antibiotic use, tend to be more common during pregnancy.
Insufficient production or flow of bile is common issue during pregnancy, and can lead to poor breakdown and absorption of fats. (You can read my article about sluggish bile during pregnancy here to learn more) Large globules of undigested fats can “wash” away the available calcium in the gut, leaving behind insufficient amounts to bind with oxalate. In addition, the body’s need for calcium is higher during pregnancy, leading to more being absorbed in the gut, which also means there is less available to bind with oxalate.
There are three ways to mitigate the damaging effects of oxalates on the body; eating a low oxalate diet, eating more bio-available calcium and magnesium with high oxalate foods, eating only small amounts of high oxalate foods along with large amounts of low oxalate foods. In addition, increasing your intake of sulfur rich foods and vitamin B6 rich foods can help support your body to eliminate oxalates. If you are struggling with kidney pain, joint pain, or have been diagnosed with calcium oxalate kidney stones, you need to keep your oxalate consumption below 150mg a day, preferably 50mg.
It is also critical that you reduce your oxalate consumption slowly, if you have been eating a high oxalate diet, around a 10% reduction per week. If blood levels of oxalate drop too quickly, you body will dump large amounts of stored oxalate into the blood stream, which can cause dangerous levels of tissue damage and can lead to a lot of discomfort. This is more likely to occur the longer the overconsumption and absorption of oxalates has been occurring.
There is hope for your pain. I struggled for two years with severe mid back and pelvic pain that never went away, no matter what I did. I felt like I constantly had a UTI, had pee at least every hour, and often had discomfort with sex. Only a few months into my low-oxalate journey, my symptoms have been almost completely resolved. I can now carry my heavy toddler all day (not that I want to ha!), when I could only carry him for a few minutes at a time before. I regained my energy, sexual vitality, and so much more!
Please see my other articles on oxalates for more guidance on reducing your oxalate consumption, and ways to support you body eliminate oxalates and put end to your pain!
Written by: Alexandra Radway, BS, FNTP
References:
https://jevohealth.com/cgi/viewcontent.cgi?article=1085&context=journal
https://www.eonutrition.co.uk/post/sulfate-v-an-introduction-to-oxalate-toxicity-gut-dysbiosis
https://sallyknorton.com/oxalate-science/oxalate-basics/