Oxalic acid or
oxalates are very tiny molecules that bind minerals like calcium and
form crystals. It is found in a variety of seeds, nuts and many
vegetables. It’s only two carbons and four oxygen molecules. It’s a
highly reactive compound that is attracted to positively charged
minerals
Oxalates not
only can cause kidney stones (calcium oxalate kidney stones) but also
may be responsible for a wide variety of other health problems related
to inflammation, auto-immunity, mitochondrial dysfunction, mineral
balance, connective tissue integrity, urinary tract issues and poor gut
function
Oxalic acid can
harm glandular function, connective tissue function, neurological
function and the function of the tissues of excretion, particularly the
kidneys and bladder
Having a
damaged gut lining will increase your absorption of oxalates. An
inflamed or damaged gut lining is a very common problem, thanks to
frequent antibiotic use and the presence of a number of chemicals in our
food supply, including glyphosate. Other plant compounds such as
phytates and lectins (such as gluten) can worsen gut health and
exacerbate the impact of oxalates
Tissue
destruction, fibromyalgia and autoimmune diseases such as rheumatoid
arthritis and lupus are all issues that can be related to oxalates
Sally Norton,1
who has studied nutrition and has a graduate degree in public health,
is one of the leading experts on oxalate poisoning — a topic you don’t
hear much about. Chances are you may never have heard about oxalates,
or have any idea why they might matter.
As is often the case with experts in any health field, her expertise
is an outgrowth of her personal struggles with health problems that
didn’t respond to more conventional treatments, including healthy
living (Norton was a vegetarian for 16 years).
“Like so many other people who are now discovering this, I was
the kind of person who, no matter what I did, I could not create the
vibrant robust health that I felt that I wanted, that I felt was
intended for me to have.
It was just perpetual frustration, which is kind of amazing
because the more you try to be healthy, the less it works — even when
you’ve got a degree in nutrition from Cornell University and a degree
in public health.
I worked in integrative medicine and knew all the holistic and
complementary healing modalities … Here I was, the health expert who
was not healthy …
The Vulvar Pain (VP) Foundation started educating people 25
years ago and making a big effort to get foods properly tested to know
about oxalates in food because the story here is that we’re eating
foods that are full of a toxin called oxalate …
We’re not paying attention to how this chemical’s affecting our
physiology … [Oxalate] is a natural chemical that plants make, and we
even make oxalate in our own metabolism.”
Chances are, if you have heard of oxalates, you’ve heard of them in
relation to calcium oxalate kidney stones. A vast majority of the
scientific information available on oxalate refers to this. However,
while it certainly contributes to kidney stones, it can also have other
detrimental health effects.
Interestingly, from the 1850s through the early 1900s, oxalate
poisoning was well-recognized. Back then, it was referred to as oxalic
acid diathesis. It was known to be a seasonal problem that got worse in
the spring and summer, when fresh greens were available, when people’s
oxalate consumption would go up.
Unfortunately, it has since gotten lost and left out of clinical
science. As noted by Norton, there’s scientific evidence showing oxalic
acid can harm glandular function, connective tissue function,
neurological function and the function of excretion routes,
particularly the kidneys.
Oxalate 101
Oxalic acid or oxalates are tiny molecules found in a variety of
seeds, nuts and vegetables. It’s only two carbons and four oxygen
molecules. It’s a highly reactive compound that is attracted to
positively charged minerals. Norton explains:
“Calcium has a particular love of oxalate, and vice versa. The
two of them seek each other out quite easily. We often see very
abundantly the calcium oxalate form of oxalate. We see it in the
plants. The plants form crystals and have the smaller individual ions
and nanocrystals.
But they do form these bigger constructions, these kinds of
plant pyramids, rocks and sticks and diamonds and things that the
plants make, probably deliberately for many … plants are making use of
oxalate for self-defense.
In the body, you’re going to see these other forms … A molecule
that has less strong a bond — potassium oxalate, sodium oxalate and so
on — those are the soluble forms. When you see oxalate in nature, you
see the big calcium oxalate crystals — that’s the same thing that the
kidney stone is made of. The major ingredient of the classic kidney
stone is oxalate.
Unfortunately, in our parlance in medicine, we think of it as
calcium … We just generalize to calcium because there are multiple
types of calcium stones. But in the case of oxalate stones and oxalates
causing calcification in the body, the oxalate part gets sort of
dropped.
Medicine is not taught that you need the substrate to make a
kidney stone. You need to provide enough oxalic acid or oxalate,
soluble oxalate, the potassium oxalate, the sodium oxalates and so on.
You can provide enough of that to perform this calcification in the
kidneys and elsewhere in the body.
The plants that we’re eating have these oxalate crystals. The
big ones just cause abrasion … They’re very small, but at the cellular
level they’re quite big and abrasive. They just cause mechanical damage
…
These soluble oxalates are the ones that easily — because
they’re so tiny — pass through in between cells. Just with passive
transport, we end up absorbing oxalates. The amount we absorb depends
on a lot of factors, especially the health of our digestive tract.
Those of us with any inflammation in the digestive tract are
more prone ... to absorbing more of that soluble oxalate and even
nanocrystals of calcium oxalate. At least 1% of calcium oxalate from
food is also absorbed, in addition to the soluble oxalate.
But you see, soluble oxalate is not content being potassium
oxalate. It would much rather be calcium oxalate, iron oxalate or
magnesium oxalate. Right away, it starts grabbing minerals. It starts
messing with mineral metabolism. It even can create bouts of acidosis.”
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Conditions That Can Worsen Oxalates’ Impact
As mentioned, having a damaged gut lining will increase your
absorption of oxalates. Most people, in fact, have damaged gut lining,
thanks to a number of assaulting compounds and chemicals.
The presence of glyphosate in our food supply
is one of these problematic compounds. If you’re not eating mostly
organic food, you’re bound to be consuming glyphosate, which can wreak
havoc on your gut function, as described in “Glyphosate: Pathways to Modern Diseases.”
Other gut-destroying exposures include frequent antibiotic use,
which can lead to various forms of microbiome imbalance, including
small intestinal bacterial overgrowth.
Some processed foods contain mucus-destroying emulsifiers. Even a
number of naturally occurring plant compounds such as phytates and
lectins (such as gluten) as well as the sharp oxalate microcrystals are
trouble for gut health. These and other compounds found in foods can
worsen gut inflammation and exacerbate the impact of oxalates by
allowing oxalates easy entry into the blood stream.
Many of the foods that have become popularized in the modern diet
are also high-oxalate foods, which means exposure is higher in general.
High-Oxalate Foods
Examples of high-oxalate foods include potatoes, peanuts, nuts, spinach, beets, beet greens, chocolate, blackberries, kiwi, figs,
black beans, buckwheat, quinoa and whole grains. Norton ate a lot of
beans, soy, Swiss chard, and sweet potatoes when she was a vegetarian;
these are all high oxalate foods. When she cut wheat and soy from her
diet, sweet potatoes became a daily staple in her diet.
Eventually, she discovered the healing value of animal foods such as
bone broth, but it took many years of painful disease before she made
the connection between her arthritis and her favorite plant foods.
Nuts and seeds tend to contain high amounts of oxalates, so any seed is suspect if you’re sensitive. Pumpkin seeds,
watermelon seeds, sunflower and flax are among the safest, as they
contain lower amounts. Oils and fats, even when extracted from plants,
are all low in oxalates.
“When you extract an oil or fat, you do not take with you the
oxalates. It could have been from a peanut. The oil’s still low. Olives
are pretty high, but olive oil’s low. It’s really simple. It’s not in
the animal foods, and it’s not in the oils and fats. But it’s in most
things that are seeds,” Norton says.
“It’s also in several green vegetables, mainly spinach, Swiss
chard and beet greens. Those are really the bad ones. There are a
couple of kales that are not so good.
Collards are kind of medium bad. The mixed greens that people
like now … those baby mixes are loaded with little beet green leaves,
little Swiss chard leaves, which are high [in] oxalates …
Certain fruits are really high: kiwi … clementine … Anjou pears,
guava, figs, elderberries, apricots, blackberries, unripe avocados …
Starfruit is so high it’s really dangerous.”
Signs and Symptoms of Oxalate Poisoning
Tissue destruction, fibromyalgia and autoimmune diseases such as rheumatoid arthritis
and lupus are all issues that can be related to oxalates because
oxalate in tissues trigger the inflammasome reactions of the body’s
innate immune system.
“This reactive compound kind of trashes your basic building blocks
of connective tissue,” Norton says. Oxalates also cause inflammation and
interfere with your body’s natural healing and repair mechanisms that
usually happen overnight while you sleep.
Needless to say, this can worsen a wide variety of ailments, and
trigger just as many. Norton tells the story of her own health
problems, and how she finally identified oxalates as the culprit
causing them all.
“Glycoproteins are where the oxalates get stuck on cells. We
tend to see oxalates keeping old injuries in place where you don’t
fully recover all the way. That’s one symptom. You’ve got things that
don’t completely clear up. For me, it was my feet … I was forced to
leave school and go get these feet dealt with. I just could not
function anymore.
I had surgery. I stayed out of school for four years because I
wasn’t getting better … I was getting weird vulvar symptoms, arthritis,
fatigue, difficulty focusing and cognitive problems. There are a lot
of neurological neurotoxicity [effects from oxalate] that interfere
with cognitive function and sleep.
Fast forward years later to 2009 when I learned about the Vulvar
Pain Foundation and connected the bout of vulvar pain that I had to my
diet. But it took me years more of flipping around with complete
disability. I could no longer work … I basically was sofa-bound.
I had to have a hysterectomy … There was endometriosis in there.
The ovaries were trashed … and I didn’t recover well from that. My
endocrinologist sent me off to this sleep lab because he said, ‘You’re
eating great. You look awesome by way of blood tests. But, obviously,
you can’t read, function or exercise.’
I was surprised to see that my nervous system was so toxic that
my brain was waking up 29 times an hour … I developed irritable bowel
syndrome, and then eventually it turned into chronic constipation,
which is very common amongst us oxalate-poisoned people.
Part of what’s going on there is those nerves and muscles are
almost paralyzed. They’ve lost their control. Their sphincters aren’t
working well. The muscle tone in the colon is not functioning well
because of this constant stream of oxalates coming …
It looks like you have SIBO, or you probably do, because of all
the antibiotics. Of course, … emulsifiers in our [processed] foods are
eroding away the mucous layer. The mucous layer is another layer of
protection that we’ve lost and increases our absorption of oxalates.”
Eventually, you may develop signs and symptoms that look very much
like an autoimmune disease, such as rheumatoid arthritis or lupus.
Norton realized she needed to get her gut healthy. The question was
how. She’d already tried everything she could think of.
An experiment with a kiwi diet in 2013 finally made the oxalate
issue hit home. Her arthritis flared up and she couldn’t sleep from the
pain. At that point, it dawned on her that the kiwi — a high-oxalate
fruit — and the arthritis were connected.
In about 10 days on an oxalate-free diet, all of her symptoms
improved. Six months after that, her feet, which had never properly
healed after her surgery, were completely fine.
Lectins and Oxalates Are a Problematic Mix
On a related note, lectins — another plant chemical — can also wreak havoc on your health, and Dr. Steven Gundry, author of “The Plant Paradox:
The Hidden Dangers in ‘Healthy’ Foods That Cause Disease and Weight
Gain,” strongly believes lectins are at play in many autoimmune
diseases. Norton warns that together, lectins and oxalates can “gang up
on you.”
“Plants have many other chemicals too. In my research, it looks
like the main target of plant chemicals that are aggressive and harmful
to us is the gut … Lectins are going to create that leaky damage and
make you vulnerable to infection and absorbing oxalates.
Basically, these [oxalate] nanocrystals and ions are the most
toxic forms. The bigger ones that later on you can see in … kidney
stones, they’re actually less toxic than the little ones.
Nanocrystals are known to interfere with the charge on cells.
They depolarize cell membranes and start disabling the functions of
membranes, which means your mitochondria are not working. The oxalate
slows down the mitochondrial ability to produce energy.
The nanocrystals of asbestos and oxalates have basically the
same level of harm. It’s just that we don’t eat asbestos three times a
day and call it health food.”
How Oxalates Contribute to Heart Failure
Oxalates can also contribute to heart arrhythmia, heart failure,
endothelial disorders or generalized endothelial distress. Endothelial
cells are the cells that line everything, including your vascular
system. Oxalates floating around your vascular system can do
considerable damage, causing irritation and injury to endothelial
cells.
“You set up the conditions for vascular problems,” Norton says.
“Oxalates are grabbing minerals. It’s taking calcium out of the blood …
and probably other minerals as well. It also has the potential to take
the place of the normal chelator that would hold iron in your
transferrin …
What we see in people who are post-keto, where they’ve been
doing the almond bread and spinach smoothies a lot (these are the kind
of people who come to me — ex-vegans and ex-keto dieters), they are
getting attacks of heart rates of 130, 150. They’re getting attacks of
arrhythmia … A few of them get hospitalized and they’re seeing T-wave
inversions … In this case, people have stopped eating the almond bread
and the spinach smoothies …
Now the body is so ready to be done with the oxalate that’s
gotten stuck in all these tissues that it starts removing too much at
one time. Then you get localized acidosis. You get effects in the
blood. You get effects in the heart rate.
We see this electrolyte disturbance, which involves continued
wasting of potassium and other minerals. We have to keep re-adding
these minerals. Also, it’s almost like tissue dehydration. I really
like to push salt, potassium, calcium and magnesium to help manage this
sort of flushing …
Diaphragm hiccups, by the way, are a bad sign … hiccups are a
neurotoxicity symptom; the vagus nerve and the whole diaphragm is
getting flipped up by being poisoned … The literature … shows that one
of the last symptoms before the rats die or the humans die from oxalic
acid poisoning is hiccups …”
Dental tartar and even dental caries are other signs of excessive
oxalates. I struggled with chronic tartar buildup myself, until I
learned it was related to oxalates. When clearing out oxalates you may
also experience sinus pain. Your sinuses, eyes, teeth, jaw and
salivary glands are all prone to oxalate buildup, as are your fingers,
toes, feet and joints in general.
Do You Need to Ditch High-Oxalate Foods From Your Diet?
If you’re eating a lot of high-oxalate foods and are struggling with
any kind of chronic health issue that doesn’t seem to respond to other
sensible lifestyle changes and treatments, you’d be wise to give a
low- or no-oxalate diet a try.
In my own case, I was eating a lot of sweet potatoes because they’re
a good source of “healthy” carbs, but they are also loaded with
oxalates. All potatoes are. There is no potato that’s not high in
oxalates, so get rid of the potatoes. Norton offers the following
advice:
“Turning this around, you have to make a decision that you’re
willing to walk away from group think because everybody around you
thinks that plants are so great and you need the spinach smoothies … If
you’re willing to get some facts that are science-based, then I’ve got
a lot of free information on my website.
The way I understand one of the major mechanisms is this
something called a trigger-maintenance theory of the oxalate
accumulation in the body. The body is really smart. It’s holding onto
oxalates because it’s trying to protect you from that heart arrhythmia
and all that vascular damage.
The nonvascular system … the body is willing to sacrifice in
order to keep the vascular system well … If you’ve got too much oxalate
in your blood, the other cells will deliberately hold on to it as a
temporary deal …
The body’s holding on to oxalate is meant to be temporary. Every
tissue that’s holding oxalate so wants it to be gone. You give it that
opportunity when you stop eating oxalates. But there can be so much
already onboard. If that stuff starts moving at the same time, you
could release oxalate from tissues at a [toxic] level … We’ve got to be
careful about how quickly and how we go about moving [oxalate out] …
There are simple things you can do to start lowering your
oxalate. Pick the foods that you don’t need in your life and then
eventually get down to the chocolate and cut that too …
On my website you can get a beginner’s guide2
that explains the basics and has a graphic that shows that your spinach
smoothie is 20 times what your level of oxalate should be on a whole
day’s intake. It has a list of the safe bet foods and the worst
offender foods that you’ve got to start cutting back on and then
eventually eliminating altogether …
The two main causes of disease are toxicity and nutrient
deficiency. Oxalate is causing both … You’re losing both B-vitamins and
minerals. It’s very toxic. It is a poison. It’s fundamentally messing
with the basics of metabolism that allows tissue recovery, repair,
[that] allows growth and flourishing.”
The Carnivore Elimination Diet
Norton has for several months now been doing the carnivore diet as described in “Health Effects of the Carnivore Diet,” which features my interview with Dr. Paul Saladino. Norton discusses her transition:
“I kept seeing allergy, intolerance and colon intolerance to a
lot of plant foods. I had already worked my way down to eating lemon
juice because citric acid … helps weaken in bonds of the [oxalate]
crystals and make them quite easy to come apart.
Citric acid protects your kidneys and is a great way to dissolve
kidney stones. A half a cup of lemon juice a day and a low-oxalate
diet will help your kidneys release all this oxalate painlessly. You
just start peeing out all your kidney problems without pain.
I was using a lot of lemon juice, four or so lemons a day, and
eating coconut products and coconut water, often from fresh young
coconuts, sometimes bottled or dried coconut, and very little else for
like a year. It really does help the colon repair and recover. It’s
such a nice elimination diet.
April 1, 2019, I dropped the lemons and a few more supplements I
was taking, like vitamin E, and dropped the coconut products … I went
full carnivore.
I, myself, think that the mitochondrial and metabolic damage
that’s happening from the oxalates is also being promoted by PUFAs, the
polyunsaturated fatty acids, which I did not have a lot in my diet.
But some of us still need some sugars in the diet to keep the
mitochondria happy. I’m back to using some maple syrup and some mangoes
and a little bit of carbs to keep my legs from cramping up with low
muscle glycogen.
I still love a high-fat diet. I eat a lot of beef fat and pork
fat. I really enjoy a meat-centered diet. I think it’s a fabulous
elimination diet that can help us. Then figure out how to bring back
into the diet, as much as you wish to, low-oxalate foods like lettuce,
apples and coconut stuff and some rice, some blueberries … things that
you may want in your diet.
There’s a whole lot of vegetables in the cabbage family that are
low in oxalate, if your digestive tract likes them, [that] … have
resistant starch in them and can be useful … Transitioning from a
high-oxalate diet to a low-oxalate diet, maybe even all the way down to
the carnivore-style elimination diet, needs to be gradual.
Because if you create a big microbiome die-off, you’re just
going to feel sick from that as well. When the oxalates start coming
out, that makes you feel sick. That’s another reason why we need
supplements.”
Recommended Supplements for Oxalate Poisoning
Supplements recommended by Norton for those struggling with oxalate
poisoning include calcium citrate, potassium citrate, magnesium citrate
and potassium bicarbonate. These are all simple mineral salts that you
can easily buy in bulk powders, which I recommend doing as readymade
capsules contain amounts that are so low you’ll have to swallow a whole
handful of pills to get the dosage you need.
If you dislike the taste of potassium bicarbonate (which has a
flavor reminiscent of baking soda), you can purchase large empty
capsules and make your own. Natural unprocessed salt (such as Himalayan
salt) is another important “supplement.”
“Some people go through these waves of feeling ill again as
their body starts pushing out oxalates because, when you stop eating
oxalate, that doesn’t fix your oxalate problem in the short run,
because you’re still full of oxalates ...
It’s just that the acute phases that were occurring post-meal
aren’t there anymore. But you’re going to have some other phases that
are often circadian in nature where you have waves of not feeling good.
We want to be aware that some of what’s going on there is a form
of acidosis … The combination of lemon juice and bicarbs — about a
quarter cup of lemon juice and about one-eighth teaspoon of sodium
bicarb and one-eighth teaspoon of potassium bicarb — makes a lovely
Alka-Seltzer Gold, made with natural citric acid …”
Again, any changes you make, whether removing food items high in
oxalate or adding supplements, make sure you do it slowly and
incrementally. If you have a lot of oxalate in your body, too-rapid a
change can shock your already fragile system, causing you to get worse
rather than better.
Over time, work your way up to 1,200 milligrams of calcium citrate,
about 400 to 500 mg of magnesium and 2,500 – 4,000 mg of potassium per
day. The purpose of the calcium citrate is to help release oxalates
from your tissues, so when looking for calcium citrate, make sure it
does not have vitamin D in it, as the vitamin D encourages absorption
of oxalates.
“The bicarb is wonderful because it’s not citric acid [which,
for some, can irritate the gut]. It is also alkalizing, as is the
citric acid and the minerals. All of this helps with alkalization.
You’re replacing the minerals. You’re also providing it citric acid,
which protects your kidneys and other tissues from oxalate accumulation
and damage.
They’re really helpful. You want to take as much as you can
tolerate, because the more the merrier when it comes to the minerals. I
think general liquid mineral for a broad spectrum is really good,
[and] taking [natural unprocessed] salt to help pull hydration and pull
potassium back into the bones and the muscles.
A lot of us, if you get any muscle numbness, like fibromyalgia
pains, that’s the potassium deficiency showing up in the muscles, where
they end up in chronic rigor and you get hypoxia from the poor
circulation going on there.
Once you’ve got enough potassium that will disappear completely
in about five or six weeks … I have salt and potassium bicarb,
potassium citrate always in my drinking water … I drink it all day
long, all the time ...”
If you don’t want to drink it throughout your day, Norton recommends
taking a third of your daily dose at bedtime, as this is when your
body is repairing and recovering and needs these nutrients most. Take
another dose in the morning, and a third dose with a meal. An
additional dose can be taken if you’re having an episode you think
might be related to oxalate release.
More Information
Norton currently has a book in the works. Until then, the best place to find more information is her website, SallyKNorton.com.
There you can find symptom lists, guidance on oxalate-elimination,
low-oxalate recipes, free articles and additional interviews and talks,3 along with more details on the science behind oxalates’ devastating health effects.
For a quick look at your own intake of high oxalate foods and the
signs of oxalate-related health issues, check out Sally’s Symptom and
Exposure Inventory, HERE.
“If you work your way through the various tabs on my site, you will get a huge education there,” Norton says.
“And then work your way … through my blog … There’s enough reading
there. You’ll be busy for a while. That will really help a lot.”
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