Oxalates and Pain

Oxalates are non-toxic organic compounds naturally occurring in certain foods, mainly vegetables and fruits. An accumulation of oxalic acid crystals in the muscle and connective tissue cells may be a cause of muscle aches and pain in some people. It’s a bit tricky though – a connection between oxalates and pain may be an issue for a relatively small subset of people, not for everyone. If you read through the oxalate foods you will see that there is quite a cross-over between high oxalate foods, and foods that are generally recommended as healthy, which might make it a bit confusing and difficult to know where to draw the line. To help, here are a few hints that can tell you if oxalates might be problem for you:-

Be suspicious of the oxalate connection if (1) you have had long term problems with yeast even prior to antibiotic therapy; (2) you have a history of kidney stones that were oxalate-related; (3) you respond adversely to magnesium supplementation; (4) you experience vulvar pain; or (5) you have high oxalate levels on lab testing. If you fit these criteria you may do a trial of a low oxalate diet and see if it helps your symptoms.

For many years, people with a condition called congenital hyperoxalosis have been prescribed low oxalate diets. These people have an accumulation of oxalates that may result in kidney stones and crystalline arthritis. It is also recognized that vulvodynia and vestibulitis (pain and inflammation in the vulvar area) may be associated with oxalate deposition in the tissues. So the idea of low oxalate diets is not new – its association with fibromyalgia and chronic pain-related syndromes that has received more recent recognition.

There may be an association between calcium, magnesium and oxalates. People with high oxalate levels sometimes do not tolerate magnesium well, leading to irregular heartbeat, nausea, stabbing pains and increased muscular aches (this may also occur with Epsom salts baths which are magnesium sulfate). It is best to take calcium citrate to block the absorption of oxalates and help excrete them from the body.

Another oxalate connection relates to Candida and yeast overgrowth. Good bacteria in the gut help to keep oxalates in check by breaking them down. Bad bacteria in the gut can produce oxalates. Oxalates are said to suppress the immune system and make one more susceptible to Candida overgrowth. Therefore, along with a low oxalate diet, addressing yeast is imperative to reduce the overall oxalate load.

There are even more implications of oxalates in the body. Oxalates deplete glutathione, one of the key antioxidants; oxalates change how zinc works within the body, which can affect immune function; and they also fuel inflammation which can contribute to joint and muscle pain.

An organic acid test can help measure oxalates in the body (it’s a single urine collection, I use a lab called www.thegreatplainslaboratory.com. I also cross-reference oxalate levels with arabinose levels (arabinose is a metabolite of Candida) – as high Candida levels can elevate oxalate levels. Both markers are provided on that one test.

Foods for the Low Oxalate Diet
The following foods are high oxalate foods, therefore they should be avoided.

Starches
- fig cookies
- fruit cake
- graham crackers
- grits, white corn
- kamut
- marmalade
- soybean crackers
- wheat germ

Fruits or juices
- blackberries
- blueberries
- red currants
- dewberries
- figs, dried
- grapes, purple
- gooseberries
- kiwi
- lemon peel
- lime peel
- orange peel
- raspberries
- rhubarb
- strawberries
- tangerines

Dairy
- chocolate milk

Vegetables
- beans, green
- beans, baked in tomato sauce
- beets (tops, roots, greens)
- celery
- chives
- collards
- dandelion
- eggplant
- escarole
- kale
- leeks
- mustard greens
- okra
- parsley
- parsnips
- peppers, green
- pokeweed
- rutabagas
- sorrel
- spinach
- summer squash
- sweet potatoes
- Swiss chard- tomato soup
- vegetable soup
- watercress
- yams

Nuts, Seeds
- almonds
- cashews
- green beans, waxed and dried
- peanut butter
- peanuts
- pecans
- sesame seeds
- sunflower seeds
- soy protein
- tofu (soybean curd)
- walnuts

Herbs, Spices, Condiments
- cinnamon, ground
- parsley (raw)
- black pepper (>1tsp/day)
- ginger
- soy sauce

Miscellaneous
- beer
- cocoa
- chocolate
- coffee, instant
- tea

POINTS TO REMEMBER:

• The low oxalate diet may be helpful to you if you have a long history of yeast overgrowth; have vulvar or vestibular pain; have a history of kidney stones; or are intolerant to magnesium supplementation.
• An organic acid test is useful to check if you have high oxalates in your body.
• Certain high oxalate foods are “healthy” foods as oxalates occur abundantly in fruits and vegetables.
• Remember that Candida can increase oxalate levels, and often adopting an anti-Candida diet and doing antifungal therapy may bring oxalates down naturally, without having to avoid all the high oxalate foods altogether.