Why are oxalates a problem?
Oxalates serve no purpose in the body. Some researchers (such as Catherine Tamaro) have proposed that the liver manufactures oxalates as a last-ditch attempt to bind up excess calcium and, while there is emerging evidence to support this idea (and the use of Vitamin K to manage calcium movement), it is clear that the oxalates serve no direct benefit to the body whatsoever.
Oxalates tend to cause problems in four ways:
- This can result in irritation at the brain, dry skin, joint pain, bladder issues, etc. There appears to be no limit on where the oxalates can manifest symptoms
- depletion of vitamins and minerals. In forming crystals, oxalates are also robbing your body of these minerals. Individuals with oxalate issues often have unexplained anaemia or may struggle to increase mineral levels, regardless of how much they supplement. Equally, oxalates are notorious for affecting B1, B6 and Biotin status.
- crowding out’ of competitive molecules, such as sulphur, bicarbonate and chloride. This can compromise a huge array of metabolic reactions.
- depleting glutathione. Oxalates are one of the most efficient agents when it comes to depleting your body’s antioxidant stores. Given how important glutathione is for regulating methylation, immune function, liver detoxification and controlling inflammation in the central nervous system, this can have devastating effects on your well-being.
What symptoms do oxalates cause?
Here’s the interesting part. There are no symptoms specific to oxalates. The symptoms will always depend on where the oxalate crystals are deposited. One of the many mysteries of oxalate is why some individuals store high concentrations of crystals beneath the skin (and therefore suffer from ‘mystery’ eczema) and others may store them in the joints (and therefore suffer from ‘mystery’ pain in the knees, hips, etc). Other may store them in the central nervous system, which is where they can cause all sort of symptoms (poor balance if they should cluster around the cerebellum, anxiety should they gather at the amygdala, and poor memory should they be located on the hippocampus).
In any cases, we will see signs of physical inflammation and neural agitation, which guarantees that energy will never optimal and sleep will never be as refreshing as it should be.
As you might imagine, all of these symptoms are attributable to other causes. And this is indeed how they end up being treated (doctors tend to prescribe ever-increasing amounts of steroids to control the inflammation or use psychotropic drugs to compensate for anxiety, while complementary therapists reach for an arsenal of fish oils, anti-microbials and ever-more-violent detox procedures).
Why do some people have problems with dietary oxalates and not others?
Healthy volunteers have been measured to absorb between 0.75 and 1.9% of oxalates they consume. Research shows that this increases to 50% in some individuals. This all comes down to digestive function. Under ideal circumstances, the body is well-protected from oxalates through three mechanisms:
- oxalate degrading bacteria, such as oxalobacter formigenes. This is a bacterial species that is easily wiped out by antibiotics.
- mineral chelation. 80% of the calcium you eat will not be absorbed. It is deliberated left in the gut to bind with free oxalic acid, and it does so easily (forming a calcium oxalate crystal). Calcium oxalate is not very soluble, thus leaves the body in the stool. Problems occur when fat absorption is compromised. as this sees the undigested fats form complexes with the minerals; this means there is no more minerals left to chelate the oxalic acids.
- If the oxalic acid has not been degraded by bacteria or chelated by minerals, it can have a run at the intestinal lining. If the digestive lining is in a good state, minimal absorption of oxalates will occur. If it is inflamed and more permeable (‘leaky gut’), oxalates will cross the intestinal barrier easily, leading to a massive build-up inside the body.
Most individuals with oxalate issues have no oxalate-degrading bacteria, do not digest fats properly and have inflamed/leaky gut lining. This is why oxalates cause havoc in them and not others.
How are oxalates dealt with?
The first priority is determining why the oxalates are an issue. As mentioned above, these can be absorbed in the gut from dietary sources, converted from arabinose or manufactured within the body should metabolic pathways become deranged.
In most cases, we will avoid oxalates in the diet, while also adding Vitamin B6 to block the conversion of arabinose into oxalates. We will also consider steps required to repair the metabolic pathways involved in oxalate production. Biotin, Vitamin B1, Vitamin K and antioxidants feature heavily in this work.
Will I always have an issue with oxalates?
No. Only as long as your digestive tract is vulnerable or your metabolic pathways are deranged. Both are fixable, although it normally takes several months.
How long does Oxalate dumping last for?
When we stop the input of oxalates into the system, the body will always respond by ejecting these oxalates from the cells. This sees both oxalate crystals and free oxalic acid released into the system. The irritation that it causes is known as ‘oxalate dumping’. Each dump tends to last for 3-6 days, although there are many occasions where multiple dumps occur back to back, which can see ongoing dumping symptoms occur daily for a fortnight. In any case, it is always likely to be an up-and-down journey with both sustained spells of inflammation and glimpses of improved wellbeing. This tends to get slightly easier each week before it settles. We normally see things settle at some point between 8-20 weeks. Although oxalates will continue to be released after things settle, they will no longer disturb your wellbeing to the point that it will affect your day-to-day wellbeing or affect other therapeutic avenues we wish to explore.
What can be done to ameliorate oxalate dumping?
During phases of oxalate dumping, symptoms tend to flare both at the cellular level (where the crystals are being released from) and also systemically (where both oxalates and free oxalic acid can now cause irritation).
There are two basic approaches used to lessen the symptoms during these dumping phases:
- eat oxalate-rich food. This puts the body back into ‘storage mode’, stopping any further release of more oxalate crystals. This obviously means that we are storing up the problem for a later day, although sometimes this is necessary to reduce painful crystal formation.
- consume lots of ‘oxalate competitors’ such as sulphur, bicarbonate, chloride and Biotin. Due to a similar molecular shape, these agents occupy the pathways that oxalic acid would normally use to enter cells, crowding out the oxalate and stopping it from having such an impact at cellular level. The easiest ways to get the first three is through baths (Epsom salts, Bicarbonate of Soda and Magnesium Chloride, respectively) and Biotin is available in supplement form.
- Take Arginine, which is recommended to help deal with pain. I have seen inconsistent responses to this, but it is definitely worth consideration.
(additionally, should the stool turn grey or yellow during the oxalate dumping process, we should consider the use of Taurine).
In practise, both of these techniques tend to only ‘take the edge off’ the symptoms rather than truly deal with them. For this reason, I try to avoid the first option as the small amount of relief rarely justifies extending the timescale required.
Where can I find more information on Oxalates?
There is a Trying Low Oxalates group on Yahoo, which is maintained by Susan Owens. She is a biomedical researcher who has spent years studying the effects of oxalates in the body. There is also the work of Catherine Tamaro which tends to conflict with that of Owens, although my clients regularly notice significant benefits from using the approach promoted by Tamaro (which focuses on the use of Vitamin K2). For an accurate, up-to-date oxalate calculator that measures both soluble and insoluble oxalates, try my Sensible Oxalate Calculator here.