Sally K. Norton

Vitality Coach, Speaker & Health Consultant

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A Chronic Illness: What Recovery Looks Like

Five+ Years of Low Oxalate — Reflections, Lessons, & Progress.

Back in November of 2018, I had a big anniversary: Five years since my (re)beginning and consistently sticking with the low oxalate diet (LOD)! Those of you who are considering or starting on this path of self-care might like some sort of note from your possible future. What will things be like after years of staying the course? I hope my experience will help to encourage you when things aren’t going as well as you are wanting. First let me offer some context.

A Quick Flash Back

I was in Graduate School at the University of North Carolina (UNC-CH), a patient at the medical clinic for student health. I dared to confess (to the grey-haired doctor) not only my weird symptoms but my observation that my symptoms would follow eating a variety of foods. I knew I was risking his skepticism or criticism, but I really needed help.

After eating whole wheat bread, I would feel both mentally and physically exhausted; soy seemed to cause my face to break out; and some days I would wake up with puffy eyes and a lot of fine wrinkles on my face, other days, not. He ran no tests, asked few questions, and quickly told me that my symptoms were all imaginary. He said, “you need psych-services”—three times. Belittled and soundly dismissed and by “my” doctor, I did sort of feel like I could use a shoulder to cry on. But there was no time for that with a statistics final exam the very next day!

In the meantime, my gynecologist at the UNC student clinic was taking repeat biopsies of my cervix because the tissues there looked so very cancerous. Fortunately, the results kept coming back as “chronic inflammation”. Neither of my doctors could imagine that my body was reacting to toxins, or that my immune system was in hyperdrive, agitated by irritants.

Medical “Care”

Medical practitioners (and other “experts”) have a long history of dismissing problems they don’t understand by accusing the victims of being hysterical or mental cases who need counseling. If you don’t fit their preexisting menu of “legitimate” problems, if you have too many complaints or otherwise feel sort of crummy a lot of the time, then the general attitude is: Well, you can’t be suffering from an organic illness with real causes.

They, the experts, don’t approve of conditions that don’t fit their lists or don’t conform to their assumptions or respond to symptom-hiding remedies. Their inability to help makes us malingerers, cry-babies, or one of the “worried well” (a new blanket term replacing previous labels like “female hysteria”). Likewise, family and friends can also be dismissive, or at best, at a loss as to how to be supportive of us when we struggle with a chronic mystery illness. And, few are tolerant of the idea that dietary changes might have merit.

Sharing to Teach

Given this cultural context, it must be either an act of bravery or recklessness to share publicly the depth and breadth of a multi-focal and wholly ignored illness like dietary oxalosis (oxalate toxicity). Am I foolish, brave, or reckless to admit that I had a lot of stuff bothering me that nobody could figure out? Yes, Yes, Yes. Accuse me of all three. I’m willing to stick my neck out in sharing my story for those who also suffer from a bunch of nasty problems hamstringing their lives.

How Weird is This?

Invariably, the characterization used in the medical literature for this oxalosis problem is “heterogeneous.” The symptoms of excess oxalate in the human body are indeed variable: different for the same individual at different times and different from person to person. Medical writers also use the term “asymptomatic” a lot—but that is yet another issue. The silent start of this disease might mean that things appear normal and healthy until symptoms show up later in the more problematic stages.

The bottom line, confusing as it can be, is this: The same disease looks very different in different people (and is often “silent” in the early stages). All the systems and all the tissues of the body can be affected by oxalate. All of them, every last one. On the other hand, in some people only a few body parts protest. There are no rules of toxic biology that comply with medical expectations or the handbook of medical diagnosis.

A Look at Oxalate Illness

The visible signs that oxalates are interfering with the maintenance and smooth running of our bodies don’t present specific universal patterns unique to this disease. In general, we can divide the likely factors behind this into two general categories. For one, the differing effects and severity in each person most likely reflect a person’s unique history of exposure. Here are some examples of what I mean:

  • timing of intake of high oxalate foods with age and related developmental stages,
  • states of wellness or infection at the time (or pseudo-infections that comes with vaccination),
  • a status of injury or overuse in some area(s) of the body,
  • personal nutritional and sleep habits,
  • levels of physical or emotional stress,
  • microbiome status, gut health,
  • kidney function.

Another source of the varied individual expressions of this disease are each person’s unique vulnerabilities that come from constitutional or metabolic tendencies and factors influencing genetic expression.

Remember too that the various body parts entangled with oxalate are unlikely to hold meetings to decide who among them can be harmed by oxalate, who may be spared (or appear to be spared for now), and who can cope with their level of oxalate exposure without subpar performance.

Reflections After 5 Years on the Low Oxalate Diet

Trite as it sounds, this diet has brought me back to life. Now, life-long health mysteries are not so mysterious. After years of suffering with pain, fatigue, sinus problems and bad feet, there was the possibility of a cure—discovering the cause, putting an end to it, and reversing my chronic symptoms.

It’s Not Just My Joints that Are Happier

The crazy-long list of my health problems (involving sleep, joints, feet, chemical sensitivity, skin, etc.) has shrunk considerably! The payoff from this diet is many-fold. It has allowed me to work and live a full life again, where once that was far from the case. I feel like I’ve grown 30 years younger. My spine moves, my brain works, I can sleep, run, and play in ways that were not possible five years ago. Back then, I was debilitated—too tired to work, to think, to read, and unable to tolerate exercise without extreme fatigue for days after.

I had an explanation and I had undeniable results. But the explanation, which initially seemed more than perplexing to me, also felt like an outrageous double cross. “Healthy” foods can make you very sick?  Oh yes they can!

About the Cause

The toxicity caused by too much oxalate in my diet was the result of eating real, whole foods. It was the result of abiding by the best health advice I knew: “Eat vegetables, emphasize leafy greens, eat beans in place of meat, eat walnuts for omega-3 fats and low-carb snacking”, I did all these things for years. I was very fond of vegetables even as a little kid. I loved real food, and still do.

Discovery, Frustration, and So Much to Learn

When I started oxalate-aware eating, I knew nothing about the chemistry or biology of oxalate and oxalic acid or its tendency to leave deposits in the body that needed to come out. (Neither do most doctors and nutritionists.) Knowing so little, I was shocked by all the benefits and funny reactions I was getting. I did not fully understand why this dietary change improves both new and old health problems, yet triggers rashes, eye sties, cold sores, peeling skin, or a variety of other oddities.

My scientific understanding needed a big boost, so I headed to the medical library. Information on chronic oxalate illness wasn’t simple to dig up there, either. After a lot of effort and time, I learned that oxalate is a known toxin with wide-ranging effects on the body. It has a long history of causing illness and the low oxalate diet is known to reverse illness.

Oxalate is known to collect in tissues. This phenomenon lacked much explanation except in cases when the disease is the genetic form, or the oxalate poisoning is acute. The chronic effects of either acute or chronic exposure on the body are still not well understood. Sadly, even the possibility of long-term effects is ignored by the establishment. In its entirety, the science is still waiting to be valued, explored, and understood.

Tragically, the many fascinating scientific findings about oxalate over the last 200 years are not adequately followed-up (if they are not soon forgotten) and the repeated warnings about the risks of routinely eating high oxalate foods are ignored. Of all the many problems with our understanding and recognition of oxalate-related diseases the most frustrating problem is this: Even receptive scientists or clinical workers do not demand accurate information about oxalate in foods. Without this, we cannot implement or study the effects of oxalate-aware eating. Thus, the diet cannot really be successful as a clinical tool. (Not that doctors are receptive to using an elimination diet, as they don’t wish to practice nutrition.)

A Quick Recap of Science Lessons Learned: A List

Here is a short list of some of the science about oxalate’s effects in our bodies. For more about this, please check back with my science page.

Oxalate:

  • creates crystals anywhere in the body, including in the arteries, joints, bones, and thyroid gland.
  • gets stuck in our tissues in idiosyncratic ways (different in each individual).
  • disturbs digestive health and the function of other organs, connective tissues, and cells.
  • causes muscles to lose potassium (and creates other electrolyte imbalances too), which can cause muscle knots, weakness, and heart palpitations.
  • triggers immune reactions that promote inflammation, pain, and autoimmune disease.
  • are toxic to nerves and the brain.
  • can destroy your sleep. (This is a repeated and widespread finding from real people, I have not seen mention of oxalate specifically in the sleep literature.)

The Beginning is Just the Beginning

As is true with most illness, the condition of oxalate toxicity does not immediately end when the diet begins. Internal residues of oxalate persist. The gradual process of dismantling them can generate difficult symptoms. These symptoms are often inflammatory and typically have some consequences for the nervous system, affecting mood, attention, sleep, physical coordination. This is true for me even after five years of faithful conformity to the diet. The diet allows the healing process to continue in its own mysterious ways.

Still Not on Easy Street

But the five years of recovery have been challenging. There’s much more to it than just “eating less and getting better”, even though that’s a great place for almost anyone to start.

The healing process can be brutal in the first few years. For me, there have been days, way too many days, where the pain and despair caused me to question the extent of the benefits of avoiding oxalate. My own doubt, skepticism, or uncertainty would, at times, compound the miserable physical and mental symptoms. Despite near perfect execution of the diet, pain and ill feelings would reappear in an on-again, off-again fashion. Sometimes they rise up in the middle of a really good week and abruptly stop me in my tracks. Sometimes symptoms would linger. Those days the abyss was wide: The gulf between the struggle I was living and my hope of fully restored health framed a dismally disappointing picture. And yet, it was also fascinating, because it is undeniable that I was continuing to get better. Something powerful is going on here.

Ongoing Recovery Means Still Improving and this Means Some Suffering

The often unpleasant, recovery process is far from over. My body is still blasting away at the oxalate within. Thick, cloudy, crystal-loaded urine both coincide with and follow days of back pain, fatigue, and mental fog. Then, finally a really great day appears: mental clarity and strong supple body enjoying abundant sustained energy. Then a day of symptoms again. So it goes, up and down. The down days get more bearable and the good days more common. Still healing.

So many melodramatic symptoms! They are likely a sign of a strong vital force whipping up a storm intended to blow up and move the mess—out! After one episode passes, the healing force moves on to another junk pile to blow away. And so the process continues on and on. Up and down. Up and down. One good day is followed by 5 hard days. One good week is followed by six hard days. The trend is upward, but the line is jagged!

Is this continuing drama because of some other metabolic problem? Or is this just oxalate deposit removal work? A number of things make it hard to recognize that oxalate is the key to so much suffering. The variable symptom patterns are one factor. The lack of recognition of the implications of persistent high oxalate levels inside the body (due to the sequestering self-defense strategy used when intake is high) is another. Until we have intensive clinical research, the only good way to test this is to eat this way and learn from personal experience. You might be surprised by the benefits that will win you over.

As the body works hard undoing the mess, let’s work with the ways and rhythms of biology. Make your lifestyle supportive. Think: yoga, meditation, rest, limiting sugar and over all carbs, avoiding toxins and junk food. Other modalities (targeted supplements and sauna, for example) can round out a path to vibrant health. All of these self-care practices require constancy to yield the results that unfold gradually over time. Remember that the tortoise won the race. (Rabbits, on the other hand, push too hard, jump around, and either get lost, distracted or burnt out.)

Turn Off the Healing?

How do you moderate or turn-off the body’s impulse to clean out the mess? (We want to do this because it can be brutal.) Hopes of having some say in this requires us to understand the triggers of the clearance process. Down here in the trenches, we can only guess. The triggers seem to be low oxalate intake and being well nourished (with minerals, energy and protein). Does this mean we have to add back some oxalate in the diet? Or fast, or stop taking minerals? Perhaps a diet of 40 mg of oxalate in every meal would hold back the healing reactions? The answers may not be simple, but it would be nice if someone could study this formally. No one individual can do this and prove it a better approach. Careful testing and monitoring of many people over several years would be needed. (I have not done a statistical power calculation.) Such research would take resources and expertise that is out of reach, for now.

Challenge Testing

Some of us don’t notice the benefits or for other reasons. They are more likely to drift off the diet – especially in the early years. This drifting tends to create unintended, private (n=1) “oxalate challenge tests”. This can wake up an oxalate sufferer to the reality of it and pulls them back on course. Just a bowl of freshly picked figs, a baked potato, or a few nut bars and, wow, significant feedback from their body usually pops up—an agitated, sleepless night; too many trips to the bathroom; fatigue; achy wrists; something. It’s as if one’s previous apparent tolerance has been unmasked by the period of avoiding oxalate.

Still, by going back to shunning high oxalate foods and making smart selections among the many other food options, one can relax back into a healing path.

Where I am Today

Now, I am living a full life doing more than most people manage to do. So far, the low oxalate diet has given me a lot. See this table for a before and after comparison:

NowBefore Low Oxalate Diet
Sleep is restorative (after about 10 days on the diet I started waking up feeling good). Restless legs: 95% gone and milder when it does happen. Brain waking up 29 times every hour. Extreme fatigue, even during mornings. Restless legs (Diagnosis based on sleep lab was “Periodic limb movement disorder” and involved arm movements too).
I can read and think and write.Had lost my reading comprehension and mental energy (likely due to sleep problem).
Fully functional feet (not seen in 30 years!), My feet did not tolerate jumping, darting side to side, the wearing of heels, or going barefoot without aching.
More flexible and strong joints with very little pain. Stiffness of joints and connective tissues; occasional random swelling and weakness of fingers, wrists, knees.
Quick recovery from exercise Post exercise fatigue would last 3 -4 days
A seemingly better vascular system and improved lung capacity. No more hiccups. Cold hands and feet. Mildly restricted ability to breathe deeply. Hiccups at night (often severe and painful).
Immune system is calmer with less inflammation overall.   Several “autoimmune” problems like indigestion, IBS, rheumatoid arthritis; “fibro” symptoms, many allergies, and allergic fatigue, puffy eye bags.
Bloating and belching is rare. Unstoppable belching fits at bedtime.
A more youthful and regenerating body (I’m reclaiming my physical abilities.) Felt worn out, aged, physical vitality slipping away.
Skin is stronger and less wrinkled.
Few to no hangnails. Much tougher skin on the bottoms of my feet. 		Bagging neck skin and eye area wrinkle. Frail skin especially noticeable around my nails where hangnails were constant. Tender skin on feet.
Less tartar; no more cavities; less tooth sensitivity (despite some significant flare-ups in the first 2 years on the diet). Constant tartar and frequent cavities in rear molars, sensitive to sweet and cold. Chewing could be uncomfortable.
Few muscle knots. (Potassium supplements were required to achieve this.) Abundant painful muscle knots in shoulders and back.
Increased bone density (increase of 4% at hip; 10% in back, according to DEXA scans) (Potassium may be helping with this too.) Osteopenia.
Improved tolerance to chemicals and fragrances. (No long tail of fatique.) Headaches and persistent fatigue easily triggered by breathing chemicals and exhaust.
Thyroid lumps and enlargement are gone. Reduced thyroid medication by half. Lumpy thyroid and below normal thyroid levels.

Changing Perspective

At the five-year point, I can see how far I have come. Yes, I want even more days of awesome. But being alive in this very honest way is good. After all, it is the amazing progress that emboldens me to dare hope for more. New possibilities expand across my horizons, even if some days those possibilities seem teasingly out of reach!

From this high peak of five years of recovery I can enjoy the view. I remember how far I have come. I can do so much more than before. I see so much progress. Part of “getting there” is a matter of remembering just how good you have it now. Not fighting this moment is part of making our next moments better.

Letting the process be what it is (vs demanding different results)

For those of us who are especially loaded with oxalate, the recovery process is a hard endurance challenge. The body needs to and wants to clean out and recover from decades of excessive oxalate consumption. As the body works to heal, it necessarily uses some rough techniques for blasting out oxalate calcifications. It unearths, attacks, dismantles, disintegrates, disperses and expels toxic crystals from cells and tissues. This work involves disruption of the status quo with inflammation and destruction. This can be painful, nerves don’t like it, muscles don’t like it, kidneys don’t like it. Your brain, your mood, your whole self, they all take a hit. It can be truly awful. (This is one major reason why both researchers and individuals overlook the benefits of the diet — the amount of oxalate in the blood and urine doesn’t necessarily drop consistently and the related symptoms persist.)

Don’t fight the waves, let the tide carry you forward.

Well, the bumpy healing process is what it needs to be. I may want joy, bliss, energy, and strength all the time; after all, I’ve been so good! What I get instead is occasional, unpredictable pain, wavering hope, and feelings of defeat. When these conditions prevail, it is our own expectations and impatience that erodes our confidence and threatens our resolve. Don’t give in to the downward pull of the bleak moments. Just know that it is temporary and will pass. Be willing to wait.

In the not-too-distant future, you’ll be feeling better and taking advantage of that. The bigger issue will be the tendency to take the better health for granted while neglecting the memories of just how bad things once were. Even when getting better, it is possible to focus too much on what is still not better. That is a sure path to misery.

Being Complete vs Not

Without acknowledging successful progress, the striving and wishing for physical perfection can generate a kind of illness of its own. It is an illness of discontent, defeat, and feeling incomplete. Instead, I resolve to be complete inside this day. As a personal hero of mine, Geneen Roth (a prolific author and guide for people struggling with food addiction and body image)[i], likes to teach: “ I am enough”. Likewise, this experience of today can be enough. I don’t need all that I desire to make it a good day. I need only my willingness to persist in a spirit of gratitude.

Today and tomorrow I am sticking with this. Joyfully I celebrate the miracles of being alive in an amazing body able to heal itself. I invite you to stick with it too. Look for and enjoy the miracle of healing.

Some Take-Aways:

  1. You are not crazy. You don’t need a doctor to validate you.
  2. It is not always obvious at the beginning that you are benefiting.
  3. The healing process for some of us carries on for years and years.
  4. There will be times when symptoms are in play making the benefits seem subtle, meager, or inadequate. These are not times to give up, but to resolve to stay the course.
  5. Not everyone has dramatic problems or healing symptoms. Still, it is common to overlook the connection between the oxalate clean-out your body is undertaking and the pain, skin issues, headaches, clumsy days, and tired days that arise in the process (even years after you started the diet).
  6. The pain of healing is part of the process. Six months of tooth pain, three weeks of sinus pain, periodic joint pain, a month of emotional fatigue—each will resolve on its own. You don’t need to intervene medically when your body is already taking care of you. 
  7. Stick with it despite it all; and find ways to enjoy the ride.
  8. Recovery is real. This diet is a gift that has saved me and many others from a downward spiral that was undoing our lives and our sense of who we are.

My future is about living life fully in ways that were for so long compromised by pain and fatigue. Today, my bad days are so much better than my good days were before taking the oxalate out of my diet. I am convinced that my body will perform best with as little oxalate on board as it can manage.

A Brief Note of Gratitude and Thanks

This is a good time to take stock and express gratitude to everyone who made this possible. Thank you, Susan Owens[ii] and your devoted moderators, list mates, and loyal followers for sharing your stories of oxalate mobilization (“dumping”) reactions. Your recognition of this process is not only a brilliant insight, it has helped thousands.

Our current recognition of the connection between food oxalate and pain starts with Joanne Yount, founder and director the VP Foundation[iii]. For over 25 years, she has bravely, fiercely, and loyally attended her mission to test foods for their oxalate content on behalf of people with chronic unexplained pelvic and genital pain.

Let me start and end each day with a grateful heart.

Footnotes

[i] Geneen Roth https://geneenroth.com/books/

[ii] Autism Oxalate Project / Trying Low Oxalate Group: http://lowoxalate.info/

[iii] The VP Foundation: http://www.thevpfoundation.org/


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We’re on a Leading Edge

Oxalate Awareness is missing from the menu of options for healthy living. That is because other people have decided what matters and what doesn’t. What if they based their decisions on wrong and very incomplete information? Can you find peace and confidence despite the experts’ ignorance?

Painful Searching for Missing Answers

My clients and followers care about their health. They’ve read, they’ve done research, they’ve made admirable efforts to do the right thing when it comes to their food, their fitness, and so on. Despite all this intention, attention, willingness and effort, they still don’t feel good. Something is bothering their organs and cells. In one form or another, irritating problems don’t seem to get better no matter what they do. Worse still is that the continuing slide in their well-being can be downright scary or demoralizing.

Increasing desperation keeps them hunting for options and answers. They suffer, they try, they seek, they apply the given remedies, they still suffer. They seek, they try—again and again. People around them question their sanity. Friends start to wonder if these people are malingering, or fanatical, or just plain weak in the face of normal aches, pains, and fatigue. Some loved ones watch them suffer in utter helplessness and confusion.

But like me, my tenacious seekers know they are not meant to suffer so. This conviction keeps them searching for real relief, for that obscured path to a more livable existence. By grace, thousands of us have found the oh-so-elusive solution. We’ve learned how to avoid oxalate. We have started down the long path of supporting our bodies’ efforts to lower our oxalate burden and rebuild our health.

In the wake of some simple diet changes, miracles commence. We’re dumbfounded. So many of the foods we now know to avoid are still being heralded as good for you, and not acknowledged as what we know them to be: the source of pain, bad sleep, bad skin, fatigue, digestive problems, and urinary tract and kidney problems.

Missing Option

Why was this healthy eating option missing for us despite all our reading and research? Why is oxalate awareness absent from the marketplace of ideas and from the curiosity of researchers? Why are doctors, nutritionists, and health coaches ignoring this very real problem? “Why” may be a futile question to attempt to answer. There are many forces that keep the oxalate problem hidden. Exploring them all could fill a book (and might someday).

The fact is that these “experts” (for example: text book authors, university professors, and clinicians) are comfortable with their own ignorance of the science on this subject and happy to discount the experience of those who suffer from very real (and serious) oxalate-induced health problems. They are sure of themselves based on their own social position and cultural forces that valorize their attitudes. Their opinions glitter with a disingenuous veneer of rationality. Shrouded by social prestige, their dismissals of real-world observations and lived experience hold sway. They expect us all to agree with what they believe, because, well, they are the experts. Too often we cooperate.

They are willing to “think” for us and decree what is possible without checking their facts, and with a tenacious resistance to considering phenomena that suggest that some of what they think they know might be wrong. Experts who know nothing about oxalate (and its effects on the body) are the norm, not the exception. That means we’re on our own.

On a Leading Edge

We oxalate sufferers have to become leaders in our own healing journey. Out here on the oxalate-aware path we’re on a new frontier. We are pioneers, willing or not. That is disturbing for many of us because it is a life and death matter. We expect to get some validation or some form of help and understanding from health professionals. All that is in short supply. And that is the reason I became an oxalate researcher and educator.

What we have discovered out here on the frontier is that a toxic substance, when consumed on a regular basis, has toxic effects on the body. Insidious, long-lasting toxic effects. Accumulation of the toxin and the resulting cumulative damage causes a huge variety of real and debilitating problems. Why would anyone deny this reality? Why do experts show no interest in the thousands of people who have benefited by lowering their oxalate intake?

Alas, the experts in white coats, the authors, the sellers of nutbars and smoothies, and the plant-based diet demagogues don’t care if you are right. They will deny your reality, despite its logic and simplicity (and scientific backing), because they have concluded that what you are experiencing simply can’t be true.

An Inconvenient Truth

Oxalate (the toxin) is made by plants and occurs in familiar, profitable, and tasty foods. These “advantages” are enough to cancel simple logic and close down the discussion, end exploration, and stifle understanding. The implications (for our diets and our culture) are too painful to face.

Another issue is that oxalate is tricky to study. Although pathologists have repeatedly called out oxalate as trouble, it manages to evade condemnation by researchers and academics. The science is incomplete; our understanding of biology is extremely limited. Current science still tends to treat the biological systems that manage whole-body health too much like a simple machine, rather than a complex actor making use of many interacting systems to maintain its well-being. Our simplistic thinking has made it convenient to dismiss concerns about oxalate before we ever developed the tools to identify its subtle and sneaky effects so we can catch it in the act of ruining our health.

Know What you Know

If you are benefiting from avoiding oxalate, let what is true be true. Celebrate that! Your ultimate success depends on you staying the course. Be glad that you found the missing answer and that your path to health is finally clear.

Please know in your heart that what you have discovered about oxalates’ effects on your health is real and really serious. The most precious thing you can possess is your health and a peaceful heart. You can have both, even in a world that does not yet “get it” when it comes to oxalate.

Remember

You deserve to be informed, even when your doctor is not. Although it has its appeal, you don’t need your doctor to think for you or to validate your experience.

May you move forward in 2019 with hope and transformative healing. May you share the good news with others! May you ring in the New Year with confidence and a peace-filled heart!

Happy New Year!

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Warning: Oxalate Disinformation Doesn’t Make Spinach Safer to Eat

PleaseOne of my fellow oxalate-toxicity sufferers alerted me to The Paleo View podcast episode 286 that attempts to “debunk” reports of the health dangers of lectins and oxalates (the oxalate section starts at minute 30). Unfortunately, the episode contains significant errors that serve only to confuse and misinform listeners by perpetuating myths and misunderstandings about oxalate.

The Paleo View’s Spin

The podcast offers this limited perspective: “Listen to us. Don’t bother to learn about oxalate and its connection to health problems. Don’t moderate your intake of oxalate (unless you have major problems with gut health and kidney health).” The cavalier, dismissive attitude leads to a reckless attempt to justify telling you what they think you want to hear: eat all the spinach you want.

Sadly, the opinions and “facts” aired by the Paleo View podcast are based on inadequate contact with (1) medical literature, and (2) real people who are solving and healing mysterious health problems by avoiding spinach and other high oxalate foods.

The cherry-picked views they present ignore the many medically documented harmful effects of oxalate in the body and how these effects play a role in common illnesses. Instead, they prefer to focus inaccurately on the minor issue of oxalates preventing absorption of certain minerals, and on wishful thinking about colon bacteria consuming enough oxalate to save you from oxalate damage. Let me address these two claims.

Minerals Lost to Oxalate

From the very limited perspective of the podcast, the problem with oxalates is that they bind to important nutrient minerals like calcium and prevent them from being absorbed in the gastrointestinal tract from your food. That’s certainly true, and the consequence is that you’re eating less calcium than you think you are when you consume high-oxalate vegetables, for two reasons.

For one, nutritional tables that count up calcium in high-oxalate foods don’t account for the lack of availability of the calcium that is bound up as calcium oxalate. In other words, nutritional analysis of foods does not distinguish calcium oxalate (a toxin) from calcium (the nutrient). They are not interchangeable as far as your body is concerned, yet nutrition claims for calcium in foods treats them as one in the same.

The second problem is that free calcium, magnesium, and iron can all become bound to the oxalic acid (or soluble oxalates) and be lost as nutrients. (The podcast also makes the entirely fanciful claim that gut bacteria break up calcium oxalate, rendering the unavailable calcium available as a nutrient. There is simply no published evidence for that claim.)

Additional Anti-Nutrient Effects Occur After Oxalates are Absorbed

More importantly, the anti-nutrient effects of oxalate go beyond the loss of minerals from foods. There are anti-nutrient effects from the oxalate we do absorb. This happens because the most reactive forms (ions, nanocrystals, and soluble types) get into the body. There they eagerly bind to calcium, iron, and other minerals that are already present in our bodies. This “mineral-stealing” by oxalate is very real concern and does have important “anti-nutrient” consequences. Still, the podcast claims that oxalates “don’t leach minerals from our bodies.”

In the hours after we’ve overloaded on foods with soluble oxalates, oxalate ions will attach to minerals from our foods or from our blood. As a result, these minerals won’t be available for other purposes (like building bone or maintaining proper cellular metabolism). Depending on the amount we eat over time, repeated meal-after-meal intake of oxalate can add up to deficiencies.

Potassium Problems Too

More insidious (and less well known) is the loss of potassium from muscle cells where oxalate crystals are causing inflammation1–3. This sapping of potassium from cells is a third effect, occurring in addition to the oxalate molecules’ first acts of stealing important minerals from both our food and blood4. Our bones, muscles, and other tissues are the ultimate losers as a result of this mineral high-jacking caused by oxalate, which may contribute to systemic problems such as cardiovascular disease, osteoporosis5, and pain syndromes like fibromyalgia.

Which Oxalates Cross the Gut Lining and How Much?

Oxalates absorbed from food clearly present a major challenge to our health.  But how much do we absorb from food? The podcast wrongly asserts that we don’t absorb much oxalate from foods like spinach. We absorb plenty.

Estimates of the amount that gets into our bloodstream vary a lot. The classic estimate of typical absorption of oxalate from food is 4—10%. When we absorb more than 10% of what is in our foods, it is called hyper-absorption. Some recent studies suggest that absorbing over 10% may be common. Current estimates suggest that a 50% absorption rate is typical when oxalate intake is very low7. And many studies show that when you eat more, the total amount you absorb goes up. The podcast rightly points out that people with gut absorption problems due to Crohn’s disease, bariatric surgery, IBS, leaky gut, and so on are at higher risk for oxalate hyper-absorption problems8–12.

Spinach Leaf

The question of “soluble” and “insoluble” oxalates is also very important with respect to absorption. The podcast falsely claims that spinach contains mostly insoluble crystals of calcium oxalate that stay inside the digestive tract. In fact, only 28-44% of the oxalates in spinach are insoluble.

Most of the of the oxalates in spinach are soluble (56—72%)15–18 (they are not bound to calcium). Instead the oxalate is oxalic acid or is loosely bound to sodium or potassium. Like the nanocrystals of calcium oxalate, the soluble oxalates easily move though membranes (harming cells in the process). Unlike insoluble calcium oxalate, they easily dissociate into reactive ions. These are the principal forms in which oxalates get into the blood stream, cause metabolic problems, and crystallize in body tissues.

What really matters is this: In absolute terms, the amount of oxalate you ingest is the most important factor influencing how much damage oxalates will cause. Truly, you have no way to know exactly how much oxalate you absorb from your foods. The precautionary approach of limiting how much oxalate you eat is simple and has no intrinsic nutritional risks.

Oxalate Crystals Harm Gut Function

The podcasters do not point out that the insoluble oxalate crystals in plants are a gut irritant13,14. These pointed, sharp microcrystals abrade tissues with a variety of shapes possessing the destructive power of microscopic glassy shards, sand paper, and needles. Chronic abrasions to the gut wall can lead to inflammation and absorption problems. This can set up a vicious cycle making you more susceptible to hyper-absorption and oxalate-realated health problems.

Regardless of the size and shape of crystals, eating less oxalate reduces stress on your gut. Eating less mean fewer nanocrystals and ions are available to damage cells when these ultra-small particles penetrate into and through your gastrointestinal cells. Minimizing inflammation and damage to gut cells (from oxalate AND lectins) may improve your body’s ability to resist the passive movement of the larger oxalate crystals into your blood. Lowering your intake may also help with gut function in general. Many people on the low oxalate diet do better on a gluten free diet as well (less lectins is good for the gut too).

Gut Bacteria Won’t Save You

The Podcast claims that your gut bacteria will protect you from a high oxalate diet. This claim also does not withstand scrutiny. Multiple studies have shown that most people (70% or more) do not have viable gut colonies of oxalobacter formigenes19, a colon-dwelling bacteria which eats oxalate as its primary food.

Oxalate is absorbed throughout the digestive tract, including in the stomach and (primarily) the small intestine20. O. formigenes resides in the colon and only encounters oxalate that has not already been absorbed earlier in the digestive system, or that is released by the body back into the colon. The small proportion of oxalate released back into the colon has already traveled in the blood around the digestive tract and liver. Only a small fraction of this tourist oxalate is sent back into the colon from the blood stream. Given that oxalate ions and nano crystals are so toxic and caustic, this circulation of oxalate can lead to a lot of wear and tear on the digestive tract of people who love spinach, almonds, peanuts, potatoes and other high oxalate foods.

Finally, the podcast also falsely states that eating a high-oxalate diet will encourage the growth of oxalate-eating gut bacteria. There is not much evidence for that claim and no proof that this effect could make oxalate safe to eat. But there is plenty of evidence that if you eat more oxalates (even if you are lucky enough to host a colony of o. formigenes) you will absorb more oxalate (as measured by increased levels in your urine after a meal).  People who host o. formigenes will absorb relatively less than people who do not, but they will still absorb more than if they ate lower-oxalate foods. Efforts to re-establish colonies of o. formigenes have to date been unsuccessful.

The lesson is simple: if you want to avoid or recover from possible problems with oxalates, you should eat foods that contain less of them. It’s not hard, it won’t cut you off from essential foods, and it won’t compromise your nutrition. It could change your attitude about which foods you believe are health-giving, however. This may be the tragedy the Paleo View wants to protect you from.

Choosing Low Oxalate Foods Is Healthy and Nourishing

The podcast vigorously promotes the myth that low-oxalate eating means you have to give up “good” vegetables and therefore you can’t get proper nutrition. Nothing could be more wrong. That view (also promulgated by some kidney specialists who haven’t bothered to find out what foods have oxalates) goes back to the days when people presumed that all greens were high in oxalate. There are plenty of greens and other vegetables that are low oxalate when eaten in reasonable portions (1 C raw or ½ C cooked are typical serving sizes.)

There is no dietary reason that low-oxalate eaters risk being more malnourished than those eating a high-oxalate diet. I suspect that the opposite is a more likely scenario. Of course, no one has offered sound evidence that any vegetables or nuts or potatoes are essential to being well-nourished and healthy. The urgency to defend a plant-based diet, especially one based on high-oxalate foods, originates primarily from science that is increasingly being revealed as flawed (e.g. that animal fats are intrinsically bad for you) and from cultural prejudices that have essentially no basis in science (e.g. that farming animals is more unsustainable or environmentally destructive than farming plants).

But you don’t have to give up plants (or even a mostly plant-based diet) to successfully control your oxalate consumption. Anyone who says otherwise is just trying to scare you into staying ignorant of the danger.

Wishes vs. Facts

Being accurately informed is a necessary step before you can take deliberate, sensible actions to lower the risks that may be present in your own situation and dietary practices. Accurate information is not something the Paleo View wants you to have. They’d rather you trust their preferences, biases, and instincts.

Clearly, they do not want your faith in spinach to be shaken. Heaven forbid! And they don’t want you to consider that a life without spinach may lead to less pain, stronger bones, and many other happy outcomes—as it has for (at least) tens of thousands of actual people.

My Conclusion about Their Conclusions

The Paleo View podcast encourages listeners to ignore the evidence of serious health problems caused by excessive oxalate consumption. Their logic is this: since there is no proof that everyone is harmed by oxalate in foods like spinach, you should eat as much as you like and ignore the possibility that it could be harmful. How tragic indeed if the misinformation in this podcast discourages people from considering, let alone trying, an oxalate-aware eating strategy.

No need to fall victim to myths and misunderstandings about oxalate.

More details here, here, here, and here.

Key Points

Minerals are lost from foods and the body due to high oxalate content of our diets.

Oxalate causes gut damage, and damage to other organs too.

Spinach has a lot of soluble oxalate in it.

Bacteria that degrade oxalate are in short supply, cannot be replaced with probiotics and can only do so much to protect us from high oxalate foods.

A low oxalate diet can be perfectly nourishing and safe. We have no nutritional requirement to eat any high oxalate food.

Defending the frequent consumption of spinach is a disservice to listeners.

References

  1. Mulay SR, Anders H-J. Crystallopathies. N Engl J Med. 2016;374(25):2465-2476.
  2. Mulay SR, Kulkarni OP, Rupanagudi KV, Migliorini A, Darisipudi MN, Vilaysane A, Muruve D, Shi Y, Munro F, Liapis H, Anders H-J. Calcium oxalate crystals induce renal inflammation by NLRP3-mediated IL-1β secretion. J Clin Invest. 2013;123(1):236-246. doi:10.1172/JCI63679.
  3. Franklin BS, Mangan MS, Latz E. Crystal Formation in Inflammation. Annu Rev Immunol. 2016;34(1):173-202. doi:10.1146/annurev-immunol-041015-055539.
  4. Muñoz-Planillo R, Kuffa P, Martínez-Colón G, Smith BL, Rajendiran TM, Núñez G. K+ efflux is the common trigger of NLRP3 inflammasome activation by bacterial toxins and particulate matter. Immunity. 2013;38(6):1142-1153. doi:10.1016/j.immuni.2013.05.016.
  5. Shavit L, Girfoglio D, Vijay V, Goldsmith D, Ferraro PM, Moochhala SH, Unwin R. Vascular calcification and bone mineral density in recurrent kidney stone formers. Clin J Am Soc Nephrol CJASN. 2015;10(2):278-285. doi:10.2215/CJN.06030614.
  6. Holmes RP, Goodman HO, Assimos DG. Contribution of dietary oxalate to urinary oxalate excretion. Kidney Int. 2001;59(1):270-276. doi:10.1046/j.1523-1755.2001.00488.x.
  7. Holmes RP, Knight J, Assimos DG. Lowering urinary oxalate excretion to decrease calcium oxalate stone disease. Urolithiasis. 2016;44(1):27-32. doi:10.1007/s00240-015-0839-4.
  8. Canos HJ, Hogg GA, Jeffery JR. Oxalate nephropathy due to gastrointestinal disorders. Can Med Assoc J. 1981;124(6):729-733.
  9. Cartery C, Faguer S, Karras A, Cointault O, Buscail L, Modesto A, Ribes D, Rostaing L, Chauveau D, Giraud P. Oxalate Nephropathy Associated with Chronic Pancreatitis. Clin J Am Soc Nephrol CJASN. 2011;6(8):1895-1902. doi:10.2215/CJN.00010111.
  10. Froeder L, Arasaki CH, Malheiros CA, Baxmann AC, Heilberg IP. Response to Dietary Oxalate after Bariatric Surgery. Clin J Am Soc Nephrol CJASN. 2012;7(12):2033-2040. doi:10.2215/CJN.02560312.
  11. Hueppelshaeuser R, von Unruh GE, Habbig S, Beck BB, Buderus S, Hesse A, Hoppe B. Enteric hyperoxaluria, recurrent urolithiasis, and systemic oxalosis in patients with Crohn’s disease. Pediatr Nephrol Berl Ger. 2012;27(7):1103-1109. doi:10.1007/s00467-012-2126-8.
  12. Kumar R, Lieske JC, Collazo-Clavell ML, Sarr MG, Olson ER, Vrtiska TJ, Bergstralh EJ, Li X. Fat Malabsorption and Increased Intestinal Oxalate Absorption are Common after Rouxen-Y Gastric Bypass Surgery. Surgery. 2011;149(5):654-661. doi:10.1016/j.surg.2010.11.015.
  13. Altin G, Sanli A, Erdogan BA, Paksoy M, Aydin S, Altintoprak N. Severe destruction of the upper respiratory structures after brief exposure to a dieffenbachia plant. J Craniofac Surg. 2013;24(3):e245-247. doi:10.1097/SCS.0b013e318286068b.
  14. Konno K, Inoue TA, Nakamura M. Synergistic defensive function of raphides and protease through the needle effect. PloS One. 2014;9(3):e91341. doi:10.1371/journal.pone.0091341.
  15. Bong W-C, Vanhanen LP, Savage GP. Addition of calcium compounds to reduce soluble oxalate in a high oxalate food system. Food Chem. 2017;221:54-57. doi:10.1016/j.foodchem.2016.10.031.
  16. Brogren M, Savage GP. Bioavailability of soluble oxalate from spinach eaten with and without milk products. Asia Pac J Clin Nutr. 2003;12(2):219-224.
  17. The Low Oxalate Diet Addendum Winter 2010 – Numerical Values Table. VP Found Newsl. 2010;(33):18-23.
  18. The Low Oxalate Diet Addendum Summer 2012 – Numerical Values Table. VP Found Newsl. 2012;(37):6-9, 19-25.
  19. Barnett C, Nazzal L, Goldfarb DS, Blaser MJ. The Presence of Oxalobacter formigenes in the Microbiome of Healthy Young Adults. J Urol. 2016;195(2):499-506. doi:10.1016/j.juro.2015.08.070.
  20. Hautmann RE. The stomach: a new and powerful oxalate absorption site in man. J Urol. 1993;149(6):1401-1404.

 

 

 

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What’s a Dangerous Oxalate Level?

Easy to Over-Do It, Easy to Fix It

Your go-to foods could pave the way for a dangerous oxalate level in your body and lead to very real health problems. Consider these common examples of popular foods that make it way too easy to overdo oxalate:

Are you into peanut butter, chia seeds, seeded wheat bread, sesame crackers, or nuts? If so, you could be eating a dangerous level of oxalate.

Do you reach for spinach for your salads, as a quick-cook side dish, or the tastiest way to green up your smoothies?

Do you like potatoes? Chips, fries, baked, or mashed? Perhaps you like the “healthier” sweet potato chips and fries?

Do you love black beans in your burritos?

Do you like second helpings or “super” serving sizes?

These days, we have at least three factors working against us:

  1. the ubiquity of high oxalate foods,
  2. the frequency with which we eat them (it’s easier than ever to make potato chips or french fries daily fare), and also
  3. restaurant portion sizes that get us in trouble.

Eating quick-and-easy means reaching for nuts, peanut butter, or chips. Eating out, well . . .

Hard-to-Resist Super-Sized French Fries

Many restaurants jumbo size their standard french fry order as cheap advertising. You see, it costs them only pennies to wow the customer and offer a memorable experience that they’ll tell others about. Take Five Guys, for example*. Famous for giant piles of fries, their regular fry order weighs a gargantuan 411 grams—almost a pound! About 5 years ago, Five Guys expanded their menu with a “Little” order of fries. Weighing in at 227 grams (½ lb.) a “Little” Fries order is still too big: it’s easily enough for two people.

Unfortunately, your body takes a hit with the 100 mg of oxalate that comes with the “Little” fry order. If they were made with sweet potatoes: a “Little” fry order would deliver 164mg of oxalate.* For perspective, consider this: 150mg is the amount that medical researchers claim is our typical all-day consumption of oxalate in food. Does that ring true to you? On the days you have the “Little” fry order, is that the only plant food you eat all day? (Hint: add at least an additional 12mg oxalate from the white hamburger bun with sesame seeds on it, and another 3 – 5mg for toppings such as tomatoes.)

The ubiquity of “would you like fries or chips with that?” encourages us all to make potatoes a too-frequent, regular thing. But, you don’t need to eat out frequently to get into a high oxalate food habit, it can happen to anyone. Just fall in love with the wrong food. It’s sort of arbitrary. Few people seem to understand that the danger of regular excessive oxalate consumption is not just theoretical. Check out Sam’s story.

Unlucky in Love: Sam

Sam was an author, naturopath, amateur tennis player, and successful business man. He loved the flavor of buckwheat. He ate it every single day, for many decades. He also liked spinach omelets, and frequently ate almonds as snacks. On Sam’s typical day, these three foods alone could have contributed at least 775 mg of oxalate to his total intake (1 cup cooked buckwheat 180mgª & 3/4 cup raw baby spinach 480mg § & 1 oz. almonds 115mg §). Despite his expertise in health, Sam was unaware of the damaging effects of eating high oxalate foods, nor did he know that his go-to foods have so much oxalate.

Let’s fill in the rest of his daily diet. In addition to these favored anchor foods, it’s possible that he also ate:

(at least) one slice of multi-grain wheat bread (16mg) with his omelet,
at least ¼ tsp black pepper (4mg) over the course of the day;
a cup of black or green tea (25mg)
a few carrot or celery sticks (15mg);
a peanut butter snack (50mg / 2 T);
½ c of brown rice with dinner (10mg);
green beans (18mg/ ½ c boiled)
a tiny bite of milk chocolate for a treat or dessert (20mg/½ oz.).

A day that included all these foods would bring Sam to a total intake of 920 mg of oxalate. That is a potentially dangerous oxalate level in only a modest amount of food.

The Trouble with Healthy Food

I learned about Sam’s love of buckwheat, almonds, and spinach omelets on Dec. 29, 2015. Sam called me after reading my article: “When Heathy Isn’t”. He told me that he had been struggling with a set of problems he called “chronic break down”—including attacks of severe muscle soreness in his upper back, neck, and his upper buttock muscles. The debilitating pain would come and then disappear without rhyme or reason. Sometimes it involved severe muscle weakness that would make movement nearly impossible. This was distressing and embarrassing to an accomplished tennis player and health expert.

After reading my article Sam had a “eureka” moment. At last, in his late 60s, he learned of a critical missing piece in his understanding of the health effects of foods. Sadly, Sam died less than 2 years later, despite his devotion to healthy living, a happy marriage, and a thriving business. Based on our conversations, I know he believed that a lifetime of high-oxalate eating contributed to his early passing.

Counting a Daze-Worth of Oxalate

Take a look at the table below. It imagines a diet based on Sam’s favorite meals and snacks and compares it with another menu that some other man might have selected. Neither person selected his foods with oxalate in mind, but the difference is astounding – Sam’s diet is 14 times higher in oxalate. A full gram of oxalate in a day is a toxic level of oxalate exposure!
MealSam (mg Oxalate)Low-Ox (mg Oxalate)
Breakfast ½ C buckwheat (180)
¼ C Raspberries (18)
½ C whole Milk (0.5)
1 C black tea (24)		1 C Rice Chex™ (8)
½ C Blueberries (4)
½ C whole Milk (0.5)
Unflavored Coffee (2)
Breakfast Total22215
LunchSpinach Omelet with Salsa
3 eggs (0)
¾ C baby spinach leaves (480)
1/8 tsp. black pepper (2)
¼ C Picante salsa (10)
1 slice multi-grain toast (16)
Butter (0)
1 med. Anjou pear (20)
1 C Whole Milk (1)		Cheese & Shrimp Quesadilla
Cheese (0) Mushrooms, canned (¼ C) (0.3)
Baby Shrimp (0)
White Flour Tortilla (10).
Corn salsa:
½ C corn (2)
2 T red onion (0.5)
2 T red bell pepper (0.25)
½ clove garlic (0.1)
2 tsp. lime juice (0.2)
2 tsp. olive oil (0)
¼ tsp. chili powder (2)
¼ tsp. cayenne (1.5)
Apple and Banana Fruit Bar (3)
Lunch Total53020
Snack1 oz. almonds (115)Cheddar cheese (0)
6 saltines (6)
Snack Total1156
DinnerHomemade chicken soup made with: chicken (0)
½ carrot (5)
½ stalk of celery (5)
¼ C ckd. brown rice (5)
¼ C boiled green beans (10)
½ C raw curly kale (10)
1/8 tsp. black pepper (2)
1/8 tsp. celery seed (4)
½ tsp. dried oregano (4)
1 Tbs. fresh basil (3)
½ oz milk chocolate (20 +)		Baked Chicken seasoned with Shake 'N Bake™ (4)
1½ C Caesar Salad: romaine (1.5), croutons (3.5), dressing (1.5)
½ C cooked mustard greens (6)
½ C buttered white rice (3)
5 oz. red wine (0)
½ C red grapes (2)
Dinner Total7022
Evening Snack1 Clementine (19)
1½ T peanut butter (36)
5 Keebler Toasteds® Sesame crackers (21) 		6 oz. vanilla yogurt (6)
Evening Snack Total756
Daily Total1,01270

Who’s Looking Out for Us?

Health authorities have dropped the ball. As a result, no one is paying attention to the oxalates in our food and how the amount we’re eating has been creeping up and up and up. We’re paying a price for our ignorance about what we’re eating.

Don’t wait for some official warning. Oxalate is a toxin. Unlike most environmental poisons, this is one toxin that is within your control to avoid. Don’t let your health depend on a roll of the dice. Get started.

Note: You may have good reasons for avoiding Rice Chex™, Shake ’N Bake™, or other packaged foods (check out my recipes!). The point here is that commonly eaten foods can be very high or very low in oxalate, and nobody is aware of the difference.

*reference http://www.fiveguys.com/-/media/Public-Site/Files/FiveGuysNutrition_Aug2014_CAN_E.ashx (Oxalate estimates are based on tests of Russet / Idaho potatoes and frozen fries performed at the University of Wyoming 2011, and 2015)

ªcalculation based on 86g uncooked weight and average of known tests of buckwheat and buckwheat flour which equal 133 + 270/ 2= 202mg/100g

§based on VP Foundation data published in their Newsletter

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Which spices are high in oxalate?

Spice of Life: about Spices and Oxalate content

Eventually, you’ll get around to wondering: which spices are high in oxalate? You wouldn’t imagine they could make a big difference, those light sprinklings of everyday seasonings. But they do.

A quarter teaspoon of regular old black pepper has as much oxalate as 1.5 cups of sliced onions and 22 times as much as the same amount of white pepper. In fact, if you’re sticking to an intake of 50 mg of oxalate every day, that ¼ teaspoon of pepper would occupy 6% of your days’ total oxalate allowance.

Granted, we need to take care of the heavy hitters first. After all, the 3 mg of oxalate in a ¼ tsp. of black pepper pales in comparison to the 33 mg provided by a 3-ounce portion of french fries or the 150 mg in one fluffy, half-ounce cup of raw spinach. Given the heavy hit made by these modern lunch foods, we’re tempted to discard any concern over how our food is seasoned.

But that would be a mistake.

Helen’s Breakthrough

My friend Helen is a case in point.  She was still in chronic pain due to an auto accident 13 years ago. And she was also trying to drop stubborn pounds after decades of frustration at not losing weight while enduring a constant nagging hunger. For years she had struggled to get control of her tendency to reach for chips, soda pop, and a quick sandwich. Thus, she was pleased with her recent success in sticking with a strict no-sugar, no-gluten diet, but feeling discouraged that the excess pounds didn’t drop, not in the least.

Her best efforts to follow the combined advice of her nutritionist and counselor led to other frustrations too. Some of their advice conflicted with what her body was telling her—that many vegetables didn’t agree with her. “Healthy” foods often gave her stomach pains. Her nutritionist and counselor both insisted that she just needed to comply and eat her vegetables. She was caught in a tussle and needing some new ideas.  I ran into Helen in a local café and she begged for my input. She needed more options, desperate for a breakthrough.

Trying Low-Oxalate

As we chatted, I told her that my physical energy and mental focus was much better on the low-oxalate diet—simply by avoiding certain vegetables, nuts, and fruits. In no way was I suggesting that this was a fit for her situation. But Helen insisted that I look at her diet and suggest changes. She wanted to know what not to eat. On a napkin, I wrote a list of low-oxalate vegetables she could have and told her to eat more butter and olive oil. I never mentioned spices. Later she set an appointment to get more details and suggestions, so she could try this approach and still comply with her counselor’s advice to eat “healthy foods”.

A few weeks passed, it was mid-July, and a much happier Helen called me. “I feel like I got my life back. I know this sounds like a trite exaggeration, but this approach has worked miracles” she said. “I feel better and I am not getting headaches. I’ve stopped taking Advil at night. My stomach aches are better, and my digestion is finally working. For once, I feel as if I am digesting and absorbing my food and I don’t feel hungry. I am eating much less, and it is easy. I am feeling a level of peace and simplicity about it like never before.”

Many Spices are High in Oxalate!

Helen got a second breakthrough when she studied my table of oxalate in foods. She was amazed to learn how much oxalate was packed into black pepper, cumin, turmeric, and other spices.

She had always gravitated to spicy foods. Her favorite snack, specially ordered and shipped in, was black pepper potato chips. Her favorite local hot-bar was stocked with heavily seasoned foods loaded with exotic aromas and strong, pungent spices, including: Indian curries, Ethiopian cuisine, and Mexican-style dishes.

Photo by: T. Maari

After seeing the actual numbers, the amount of oxalate conveyed to her diet by seasonings, she made a big, surprising shift. She started cooking most all her meals at home… cooking for one and eating alone, just she and her cats. She does NOT like to cook, and keeps it all as simple as she can. She tells me: This produced another breakthrough. Her back and knee pain were so much better! She could walk, exercise, and take stairs like she hasn’t for years.

Refine Your Diet

Paying more attention to spices might be a good way to refine your oxalate-aware eating plan. If you are really already avoiding potato chips, fries, nuts, snacks with nuts and seeds, spinach, and so on – the spice cabinet might be your next step. After all, most spices are potent seeds.

If you love spice too or love to cook with spices like I do, you might be daunted or otherwise resist this step. (It took me years to discard several spices languishing in my cabinet.) Please, don’t be afraid of cleaning out your spice cabinet. You can still enjoy great food, even with a simplified approach to seasoning. Undoubtedly, the best flavors come from the quality of the ingredients. When handled with care and skill in the kitchen, fresh ingredients shine without excessive embellishment.  But, you don’t have to give up spices entirely – just be aware of what you’re eating, and use spices that are consistent with your low-oxalate goals.

Alternatives to High Oxalate Seasoning

Easy Substitutions and Approaches to Bringing out the Flavor of Foods

1. White pepper in place of black pepper

2. Lower the amounts of spices in your cooking by half

3. Use more white pepper, ground mustard seed, pinches of cayenne pepper, and mineral-type salts like pink Himalayan or Real Salt brand salt (ancient sea salt mined in Utah).

4. Use more salt. If you’re not eating processed food, you’re getting half of what most people are.  And salt has an undeservedly bad nutritional reputation in any case: you might even need more salt to be healthy!

5. Add a hint of lemon juice, lime juice, or vinegar just before serving to give all the flavors in your dish a subtle lift.

6. Use enough fat when cooking and serving. An extra dash of olive oil or butter when garnishing and serving extends and enhances flavors.

7. Try prepared horseradish more often. It is great with beef and seafood. Good stirred into sour cream or yogurt, too (along with Frank’s Hot Sauce).

Essential oils and extracts can make good substitutes in the kitchen. Begin with these easy substitutions:

1. To replace (whole root) turmeric use a turmeric extract sold as a dietary supplement. (Start with 1 -3 caps per recipe, opened and the capsule discarded.) (Oxalate tends to stick to fibers and other elements removed when an extract is made.)

2. To replace lemon peel: use oil of lemon (1 small drop per tsp. of zest) or lemon extract (1/4 tsp./ lemon). (Oxalate is filtered out during extraction, and does not hang around in the oil fraction of any given food.)

Extracts typically don’t have exactly the same taste as the whole spice, but for certain recipes they can still provide a safe and pleasant flavor enhancement.

An adventurous cook will want to try using other essential oils too…

. . . such as the essential oils of clove, ginger, cardamon, and cumin seed oil (not black cumin seed -nigella- oil – which has very little flavor) (Cumin seed oil is hard to find.)

  1. Purchase high-quality edible grade essential oils and a brown glass dropper bottle.
  2. Dilute the essential oil 10:1 (5 teaspoons macadamia or almond oil to 1/2 teaspoon essential oil).
  3. Label the brown glass dropper bottle with the names of the two oils used and the ratio of your mixture. (invest in a quality label machine). Store the mixture in a dark cabinet.
  4. When cooking, add the oil at the last step of preparation.
  5. Use only one drop of the diluted oil per recipe, taste and adjust up from there.
  6. Make notes about what worked or didn’t.

For Curry Style Foods . . .

Try the curry styles of Thailand. Instead of cumin and turmeric (Indian style curry ingredients), Thai food are seasoned with various combinations of the following: cayenne, chili peppers, garlic, lime, lemongrass, mint, coconut milk, fish sauce, onion, and cilantro. To make the switch, keep these four ingredients on hand: 1) Thai chili paste (red or green), 2) fish sauce, 3) limes, and 4) coconut milk or coconut milk powder.  Use the first 3 in ~1 tablespoon amounts… you can make nearly any dish interesting. These four ingredients can easily transform bone broth into something really nice.

Oxalate in Spices

High Oxalate Spices

Milligrams (mg) of oxalate (culinary portions)
SpicePer 1/2 teaspoon
(2.5 ml)		Per 10 grams
Turmeric24219
Clove21200
Cinnamon20168
Celery Seed16128
Fennel seed11129
Curry Powder12120
Cumin Seed, ground10100
Allspice10105
Lemon Peel, dried10 73
Onion Powder10 73
Coriander Seed9103
Ginger, Dried8 96

Moderate Oxalate Spices

Milligrams (mg) of oxalate (culinary portions)
SpicePer 1/2 teaspoon
(2.5 ml)		Per 10 grams
Garlic Powder0.10.7
Almond Extract0.20.6
Mustard, ground powder0.21.7
White Pepper0.43.0
Red Pepper Flakes112
Thyme, Dried118
Mrs. Dash Seasoning Blend119
Ginger, Fresh217.5
Paprika328
Cardamom, ground331
Cayenne Pepper333
Chili Powder431
Oregano, dried445

Oh, Spice Road: Spices in Verse

Pepper black, pepper red,

pepper, pepper

excite me, entertain me,

soothe me.

Conceal, mask, camouflage.

Spice, satisfy me, soothe me.

What longings, what emptiness shall I fill?

What hunger, what boredom, what lack can you displace?

Hunger, hunger what do you want?

 

Let me run away, travel, find jungle, beach, tropical paradise.

Oh, spice road, take me away from here.

What can you show me? What can you mask?

What fears can you quell? Sadness, aloneness, weakness, death?

Oh, spice entertain me! Oh, spice connect me, me oh spice, warm me, rev me, jolt me alive.

Oh, spice don’t flog me, punish me, or make me fat.

Hunger, hunger what do you want?

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Our Oxalate-Loaded Environment: No Seasons, No Awareness

I’m very excited to announce a new article in the Journal of Evolution and Health: “Lost Seasonality and Overconsumption of Plants: Risking Oxalate Toxicity” by me: Sally K. Norton. Link http://jevohealth.com/cgi/viewcontent.cgi?article=1085&context=journal (or you can download it from my site)

Please read and share this heavily referenced, peer-reviewed article. Perhaps it will help us all see how we’re eating today in a new light. The article offers an up-to-date synopsis of what we know about oxalates, based on my extensive review of the scientific literature.

The rest of this blog post revisits and expands on the key points from the article.

Oxalate Toxicity Illness

Once you realize that oxalate in foods is at the root of your suffering, you can’t help but wonder: Why am I in trouble with oxalate? Why is this happening? Hasn’t oxalate been around forever? Is there something wrong with me that made me especially vulnerable to the oxalate problem? Why me? – this is the classic victim question. Yes, you are a victim, but of what? I say you are a victim of modern progress, affluence, cultural trends, and generalized ignorance of oxalate science; hear me out. . .

Oxalate-related illness is, in general, a problem of: 1) oxalate exposure and 2) bioaccumulation inside of our bodies. This is so, regardless if the effects of this exposure and accumulation surface as arthritis, digestive problems, headaches, pain issues, skin trouble, bad sleep, or kidney stones.

The One-Two Punch

Let’s consider that modern eating patterns douse us in oxalate far too routinely. (Missed any meals recently?) When the continuous oxalate marinade (daily low to moderate doses) includes occasional pulses of extreme doses (as in a spinach smoothie or a bag of almonds), accumulation is bound to occur. This combination – constant eating of plant foods (like bread and spices) interspersed with the occasional dark chocolate bar or spinach salad – is especially good at promoting the build-up of minute oxalate deposits in the body. The speed and extent of this process may be what separates the seemingly unaffected from those of us with joint, digestive, brain and neurological issues. Beyond just the level of oxalate intake, these factors seem to be key determinants of how fast and how extensively oxalate toxicity develops:

  • oxalate absorption
    • (many dietary factors and other changing conditions will affect the amount that gets inside the body),
    • it is generally much higher then scientists used to think
  • gut health, and
  • internal inflammation.

Never a Break

Never before has it been so easy to obtain oxalate-heavy foods. At the same time, we’ve become nibblers (or grazers) who believe that six small meals daily make for a healthy and acceptable meal pattern. We never take off from eating plant foods. We used to have those breaks: things called winter, or drought, or crop failure, or high-holy fasting days. And, of course when we’re eating oxalate, we have no idea that we are doing it; no one has bothered to tell us. Hardly anyone is aware of the presence of oxalate in our beloved foods and its potential dangers. Never have we been so at risk for slow, low-grade health damage thanks to our modern food choices, constant eating, and unawareness.

Global Food System Has Erased the Seasons

Winter is gone. No longer do we subsist on ham, onions, pickles, and white biscuits from January to March. Now, fresh green spinach, fruits, and nuts of all kinds can be had any day of the year. Our modern food scene is slick and sexy (packaged with grand promises), tasty and super-convenient, affordable, and . . . risky.

You can get nearly anything you could want, seven days a week, 365 days a year. Refrigerated trucks, the interstate highway system, inter-continental shipping, and the 24-hour grocery store all work to meet the demand for affordable, constant access to any and all foods. We usually see this as a great victory of modern commerce, but the downside… well, it has made it possible to bypass and disarm the body’s own defenses against what was historically only periodic over-dosing on high oxalate plant foods. That’s my guess, anyway. There is not any good research on the amount of oxalate in our diets and how this has changed.

Getting Plenty of Neo Foods

Envision some modern basics: tea, chips, fries, and almond milk. . . Finding our way to a daily cup of tea was never this easy! No longer do you have to haul water from the river, or fire up a wood stove. Potato chips? They were mass-produced for home consumption only recently. And french fries? Routine access to fries came with the invention of cheap (and addictive) fast food in the 1950s. That helped to launch the new and steadily expanding practice of eating meals away from home,  not just on special occasions but as part normal daily life. Restaurants eagerly offer hash browns, potato chips, fries, and mashed (or baked) potatoes as the classic side. (Too cheap, popular, and profitable to resist.)

Almond and rice beverages? These new-fangled products became commercially available and widely distributed only about 10 years ago (and have been growing in popularity). And please note: These faux “milks” are marketed as a fitting substitute for calcium-rich dairy milk. They are not. Not only do they contain oxalate (which real milk does not), but they lack milk’s ability to protect against oxalate absorption offered by dairy calcium.

Normal variability in what and when we eat, and restrictions that once came with the seasons and periodic food scarcity, are all gone in modern affluent societies. Easy, routine access to tasty oxalate-ridden foods has created a new situation for our bodies. The constant bombardment of our bodies by oxalate is an escalating, and uniquely problematic source of toxic stress in 21st Century life. It’s as if it were Thanksgiving Day, every day. The harvest is in and abundance is the theme of the moment. Have whatever you like; if its “healthy”—have a lot of it, frequently.

Modern Concepts of Health Foods

Modern dietary approaches have placed great emphasis on the health benefits of vegetables, nuts, chocolate, and spices, despite their being high in oxalate. There is a great deal of encouragement, pressure even, to eat greens, nuts, fruits, and other “whole” plant foods. We constantly hear that the sure path to complete health is the “plant based” diet. If it doesn’t work, you are just not trying hard enough… so just keep selecting antioxidant-rich “health foods”.

In this culture, how would anyone ever begin to suspect something amiss with this moral and fail-safe approach to eating? They don’t, not until they have exhausted every other possible explanation for why they hurt or can’t think well or get restless sleep… but I digress.

Accumulation of Oxalate

Any tissue of the body can end up with oxalate deposits, not just the kidneys and other parts of the urinary system. But how and why? This question has been posed, but rarely studied, at least since 1940 when a London coroner found oxalate crystals at the site of a brain aneurysm in a 61-year old woman.1 The prevailing theory in medical science is that the entire drainage system had to be broken down (persistent kidney failure) for oxalate to collect in non-renal tissues. Yet the exceptions to this rule are many—littered across the various fields of research.

Pathologists report finding oxalate deposits in eyes, arteries, hearts, skin, wherever—despite functional, healthy kidneys. We find this in cases of acute oxalate poisoning among patients who have tried to commit suicide with oxalic acid washing powders or ethylene glycol anti-freeze (ethylene glycol is a metabolic precursor that becomes oxalate in the body), and in cases of genetic disorders that cause excessive internal production of oxalate. But we also find these deposits in the chronically ill, in previously injured tissues, and in perfectly healthy people.

Stuck in Catch Mode

The scientific evidence suggests that the body is good at a game of “catch and release”. This is a process in which healthy cells take on minute oxalate crystals with the intention of this being a temporary accommodation. When the coast is clear and conditions right, cells recruit immune cells to help them dismantle and release the sequestered oxalate and send it off for excretion. Our diets, however, are pitching oxalate steadily (and at quite a clip). The effect is that the catch and release cycle gets stuck in “catch” mode. Cells holding oxalate attract more oxalate crystals which then become ever-present because oxalate is ever-present in so many of our favored foods. Injured cells or cell fragments passively get saddled with crystals that not only persist but grow, for years and decades.

We don’t see the inevitable but invisible nano-deposits and non-crystalline traces in cells throughout the body. The trained pathologist can see the much larger micro-crystals (when the tissue are fresh and properly handled, and when using the appropriate stain and polarized light). But the hunt for these troublesome contaminants isn’t done in typical tissue biopsy and tissues are usually not fresh. (The central concern being the detection of cancerous cells.) The body, however, is aware of oxalate. It is designed to unload these toxic traces, if it can only get the opportunity.

Let the Toxin Go

The cells await the conditions necessary for dismantling and releasing crystals. It would seem that tissues may need several days of very low-level oxalate intake to start the slow process of dismantling, dissolving, and unloading these nano-deposits. (In one study, looking at rat kidneys, this process was underway in just a matter of days. In another study, complete dissolution of a crystal took five or more weeks to complete).

The way we eat, the “release” conditions don’t come very often or for very long. The next time someone tells you “you’re full of it” they might be right!  And they might be full of it themselves!

References

1. Glynn, L.E. (1940). Crystalline bodies in the tunica media of a middle cerebral artery. J. Pathol. Bacteriol. 51, 445–446.

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Keto Getaway: Eat Less Plants and Feel Better!

In January I spoke at a wonderful nutrition and health conference, the Keto Getaway Conference, in West Palm Beach held by LowCarbUSA. Even though I was sick and the weather in Florida was cold, I had a wonderful time. Way to go Pam and Doug Reynolds, the founders and organizers who pulled together a wonderful program and a terrific line-up of speakers for the 2018 Keto Getaway!

Including a presentation on dietary oxalate in a low-carb nutrition event… this was a first! I am so grateful to have had the opportunity to introduce oxalates to some of the leaders in the keto nutrition movement. The credit goes to Carole Freeman (a.k.a. Keto Carole) who recommended me to Doug Reynolds. Thanks to her I shared and gained a number of important insights about the relationship between low-oxalate eating and a keto diet, some of which I have summarized below.

For those of you who are new to ketogenic diets, the first part of this post explores the whats, whys, and hows of “ketogenic” eating.  If you’re already familiar with keto, you might want skip ahead to My Insights from Hanging in the Keto World.

What is Keto?

Keto is the popular term for eating a diet that is nearly free of carbohydrates, creating a fat-burning body “economy”. The term “keto” comes from the molecules (referred to “ketone bodies”) that your body generates when it burns fat instead of glucose to fuel activity and metabolic functions. Even the brain can switch to burning ketones when carbs are cut from the diet, which is a good thing.  Doctors will sometimes worry about the body creating ketones, because they don’t understand the difference between nutritional ketosis (a normal healthy process that occurs when your body burns fat) and ketoacidosis (which also creates ketones, but which occurs when your metabolism is not working due to diabetes or other metabolic disorders).

Long having held the ecological niche of game hunters, human beings have been eating low-carb for many tens of thousands of years. Today’s carb-centric diet is a recent invention; the idea that processed carbs (eaten in abundance) are safe just came into being about 40 years ago. This is about the same time the 24-hour grocery store was invented. Not long after that, cup holders in our cars became standard equipment by the 1980s as well. By then we were hooked on sugar-on-the-go.

Why Keto?

A low-to-no carb diet is not new but is being explored anew by people seeking to:

  1. cure obesity,
  2. reverse diabetes,
  3. treat brain and neurological disorders (Epilepsy, Parkinson’s, Alzheimer’s Disease, brain injury, mood problems and more),
  4. manage endocrine disorders (Polycystic Ovary Syndrome),
  5. support cancer treatment; and to
  6. improve general health, well-being, and longevity.

Also, fasting has become a big buzz of late. Training your body to be good at burning fat and ketones is the best preparation for fasting. For my own health, I have been a carb-restricting eater for at least eight years, with the last year going lower and lower and relying on my fat-burning capacity more consistently over the last 6 months so I can experiment with fasting (and still stay energetic and fully-functioning).

How Keto?

To “go keto,” people remove sugars and starchy foods from the diet: grains, fruits, potatoes, junk foods, juice, sweet drinks, etc. The only effective way to lower carb intake is to eat something else, specifically fats (not excessive protein). Basically, if you want to burn fat for fuel, you need to eat fat. Simple logic, right?

The best example of this type of diet is The Atkins induction diet. Typically, a low-carb, high-fat (LCHF) diet involves a reduction in the amount of plant foods (no grains, beans, or potatoes), more animal foods (eggs, meats, fish) and many more fat calories from both animal (full-fat meats, bacon, chicken skin, bone marrow, lard, tallow, butter, heavy cream, cheese) and vegetable sources (coconut, avocados, nuts).

Bone Marrow

Shrimp Salad

Is it Safe?

A ketogenic diet means eating more butter, olive oil, heavy cream, coconut, avocados, and fatty meats. This is a shock to most people because we have been wrongly told over-and-over again for four decades that eating fat is bad for our health. It turns out that the only real problems with fats come from:

  1. trans-fats (hydrogenated vegetable oils),
  2. processed vegetable oils (e.g. canola, soy, corn),
  3. poor-quality fats in the context of a sugary, high carb diet, and
  4. the contamination of fats with environmental chemicals and, perhaps, with certain naturally-occurring plant sterols (as in soy oil).

Clean animal fats like lard, egg yolks, beef tallow, cream, and butter are beneficial to health because they contain needed nutrients, help the body assimilate nutrients, help act as a solvent, moisturizer, and clean-burning energy source in the body. Coconut oil, and fats from avocado are also safe and beneficial in the context of a low-junk, low-sugar diet. Despite the many unknowns still surrounding very low-carb, high fat diets (see the next section), lowering carbohydrate intake is safe for most people because a healthy body has no intrinsic need for them. (Some conditions, including heart failure, kidney stones, and gout may need special attention from a keto-aware medical professional who can monitor liver, kidney, and heart function to ensure safety.)

The State of the Art of Ketogenic Living

The science and even the definition of ketosis is still emerging. That is, although there are many scientific papers on the subject, many basic questions are just starting to be explored. For example: what is the most accurate way to measure ketone bodies so that we can monitor the state of ketosis? (Is it by the breath, urine, or blood?) How does a fat-burning metabolism affect our need for micro-nutrients? How do we correctly interpret diagnostic testing that has been standardized based on the modern grain-based, high-carbohydrate diet, when these tests are performed during prolonged ketosis? We may need more salt and electrolytes on a keto diet, but how much and when?

I have my own question too: Is the reduction of plant foods (such as wheat, beans, and potatoes) part of the reason that people on a keto diet feel better and love this way of eating? The keto diet is dramatically different from the standard diet, and there are many moving parts that are very much unaccounted for! (Especially the effects of reducing our intake of plant toxins.)

Does a Keto Diet Work?

Yes—if you do it right and give it enough time! That is, to feel your best while burning fat, your cells need to change the equipment they use for energy production. That takes time. There is a transition period of several months or a year, or even longer for some people. This transition can be a bit of an ordeal or it can be straight-forward: everyone is different.

There are several factors that can make the transition period challenging or even unpleasant. For example, you have to face the addictive nature of carbohydrates–they stimulate insulin and brain chemicals that make us crave sugar, bread, pasta, pizza, fries, chips, potatoes, donuts, desserts, chocolate, etc. Carb withdrawal is ugly. The addictive pull of carbs sets us up to abandon our body’s keto-metabolism training due to “cheats”. When we cheat and eat carbs, the progression to keto is up and down—prolonged and delayed by the internal food fight, personal habits, and the cultural challenges that are waiting around every corner in a carb-centric world. Patience, persistence, and starting again and again eventually pay off for some, but many people give up and prematurely declare themselves “not-a-fit” for this approach.

Key Tips on the Keto Journey

From my experience in being strict about carbs, there a few critically important keys to success:

  1. Eat more salt, a lot more, because your kidneys will “waste” salt and potassium when you switch to low carb. If you keep switching on and off ketosis (like I did for years), you may end up depleted of salt and potassium and electrolytes generally. This can mean dry connective tissues and induce muscle aches and knots.
  2. Get enough food: “strict low-carb” is not “low-calorie”.
  3. Embrace fats: eat much, much more ghee, butter, and other animal fats than you think you should.
  4. Let it take the time it takes (measure in months, not days). You will be reworking daily habits, holidays, ways to celebrate, etc. This involves the psychologly, sociology, and the physiology of eating!
  5. While slowly progressing toward maintaining a consistent keto lifestyle, live and love your life as it is without fretting about the “depth” of your ketosis.

My Insights from Hanging in the Keto World

High-carb foods come from plants, and many (namely: grains, potatoes, beans) are high oxalate.  Switching to ketogenic eating means cutting out grains, potatoes, and beans—completely! Unless you are frequently eating spinach, swiss chard, mixed salad greens, nuts, and chocolate, you will often be eating less oxalate on a keto diet. Some keto dieters even move to an all-meat, or mostly animal foods diet. This is exemplified by Amber O’Hearn (find her here and here) and many other 100% carnivorous eaters (think of this as the “feline diet”). What keto dieters may not realize is that this all-animal diet is also one way to do a zero oxalate diet.

One of the medical leaders in the field of therapeutic ketogenic diets is Dr. Eric Westman of Durham NC. He and other keto-promoters like to mention (okay: brag) that not only can they correct (cure) diabetes and obesity with diet, but that their patients also report less pain and digestive problems. He says that 80% of his patients with reflux get relief on the keto diet. He’s crediting ketosis for these bonus outcomes, without considering the effect of reducing plant toxins. However, pain and digestive problems regularly clear up on a low oxalate diet—even without ketosis.

Could it be that cutting out wheat, potatoes, and beans while eating more meat is a path to a moderate oxalate diet? Surely, reducing or removing oxalates and other plant toxins from the diet adds to the benefits of the low-carb, high-fat, ketogenic diet. Still, the keto world is mostly invested in the idea that ketones in the body are the principal source of the “keto magic”. Ketones are only one of the many reasons that people feel better on a keto diet. (Subtracting plant toxins feel good!)

Eat Less Plants

Who is looking at the changes in exposure to plant toxins? Sadly, not many researchers are exploring this angle in nutrition. But some keto proponents do suggest that a “low plant, high animal food diet” results in better health than a keto diet that includes more plants. Psychiatrist Georgia Ede does a great job explaining this seemingly radical idea.

Here is quote from Dr. Ede:

“There’s no evidence that I could find proving that plant foods are good for us. You see many, many studies showing that plant extracts can be used as medication when someone has a disease, are using [a subset of] their naturally toxic properties to your advantage. But if you are a healthy person, do you need to eat plants? As far as I can tell, you don’t…. When it comes to anti-nutrients, these natural chemicals within plants not only can irritate our systems, but they can interfere with our ability to digest and absorb nutrients, key nutrients …. The part of the plant which is most risky for us… is the seed. Because that’s the most heavily protected, that’s the future of the plant. …grains, beans, nuts and seeds are all seeds and they are very heavily protected. And I think that that is why… many people feel better on that [keto] diet, because they’ve removed legumes, they’ve removed grains… They have [often] not removed nuts and seeds, although I think some people who don’t feel better enough on a [low-carb] diet might want to consider that .”

Other Hints that Keto Sometimes Works Like a Low-Oxalate Diet

Example of the Low Oxalate Diet Rash

  • The “keto rash” sounds just the low-oxalate rash (see the picture nearby)!
  • Reports of “keto gout” sound a lot like oxalate flooding (dumping) reactions that may happen on the first year or two of a low-oxalate diet.

Why Oxalate Awareness is Needed in the Keto World

Oxalate is one more factor that makes ketogenic eating a good idea, SOMETIMES. There are at least 2 ways oxalate could be a problem in a keto diet:

1. Too Much Oxalate.

Some keto dieters may overdo oxalate by making these mistakes:

  • relying too heavily on nuts;
  • routinely eating some of the classic super-high-oxalate greens (spinach, swiss chard, beet greens, micro green salad mixes);
  • spicing up their foods with high oxalate spices like cinnamon, cumin, turmeric, etc.; or
  • treating themselves to keto “fat bombs” and hot drinks made with coco and dark chocolate.

Any combination of these low-carb/high-oxalate ingredients can quickly add up to a dangerously high oxalate diet.

2. Too Few Oxalates, Too Fast.

Another Low Oxalate Skin reaction – on a foot

The mostly-animal food version of keto may mean abruptly (and unawarely) switching to a much lower (near zero) oxalate intake. In some people with a history of eating high oxalate foods: Oops!  They may experience an abrupt outbreak of a whole new set of problems. Why? Because this switch is likely to destabilize oxalate deposits in the body and trigger oxalate flooding / dumping. Boy can that be unpleasant! Flooding your tissues with ionic or nano-oxalate is hard on your body. The deleterious consequence of the body’s desire to be rid of oxalate can be softened with certain supplements and other strategies that are just beginning to be explored (and that need to be figured out for each individual).

Lets Get Together

In my own experience, Low-Oxalate and Low-Carb are a wonderful combination for enhancing mood and energy, and for managing pain. Both are important for optimal brain development and function, limiting the effects of brain aging, and for preventing and perhaps treating dementia. There is a potentially powerful symmetry in the union of know-how in the previously unconnected worlds of low-carb and low-oxalate. Lets keep thinking together about what we need to learn and teach to bring the greatest possible benefits to human health.

 

To view videos of 2018 Geto GetAway speakers go here. (https://www.lowcarbusa.org/videos/video-members-area/2018-wpb-premium-videos/)

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Winter Solstice and Imperceptible Change

Finding Your Own Brighter Days Ahead During the Yuletide

Today, in the Northern Hemisphere, our winter solstice sun appears at its lowest point in the sky. Many traditions and cultures honor these short days and long nights as a sacred and special time.

This time of year is associated with light – electric string lights, the burning yule log, and candles. Hanukkah in the Jewish tradition is the Festival of Lights, which just completed the 8 days of ritual illumination of the menorah. There’s the advent wreath of the Christian faith (weekly lighting of candles) and the all-night bonfire of the Yule log. The lights are reminders of our inner light, an affirmation of our higher and better selves, and hope for brighter days ahead – as we move through our darkest days.

Winter Festivities – Coping with Darkness and Chill

The trimmings, the sweets, the parties and the hoopla of the season are all intended to help carry us through this dark and cold time of the year. Without our social connections and the promise of brighter days ahead, the winter blues might be overwhelming. Parties and holiday gatherings remind us that we’re all in it together. And it can, indeed, be good medicine because we humans long for a sense of belonging, to feel that deep bond of family and community, to be part of a “tribe”.

Of course, we get distracted by all the “wanting”—feelings of lack, and a focus on stuff, or even our longings for perfect health.  And we easily miss the central point:  to love one another, to offer companionship and reinforce our connections through the trimmings and the gifts (the ones we give!). We tell ourselves that it is the cookies, the drinks, the food and the gifts that make the holiday special. Try them out all by yourself, and see if you can honestly say that is the case.

The Way Out of Winter Solstice Darkness

And then there is the pressure to be positive, cheery, merry, and bright. But you may have your pain, grief, or worry—your own reality that seems at odds with all the outward festivity. What if melancholy does have you in its grips? Does all this ‘cheer’ make you feel even more alone with your pain? It could, and you don’t need to apologize for that. Let me offer you permission to feel what is real for you.

I don’t mean to suggest that it is best to wallow in sorrow or become some version of Scrooge.  I’m just saying that you need and deserve some compassion—from yourself. And some loving input—from yourself. So, if you’re not feeling the “be-of-good-cheer” vibe, try this: Claim your right to be supported, by you, first and foremost.  Find 10 minutes of peace and calm to sit with pen and paper. Write a list of “wellness” actions you might take on your own behalf. Choose actions that would give you a solid and level foundation from which things will, at least, not get worse. Look for your own paths to healing, and be willing to take steps in those directions. Touch an inner compass, and find the place within you where purpose lives.

Imperceptible Change

The truth is that things don’t stay the same. Even though our sunken sun appears to be the same for several days before and after the solstice, we are still moving towards spring. So if you feel sad and perhaps even a bit hopeless, just know things won’t stay this way forever—especially because you’ve befriended yourself.

Winter solstice marks the beginning of the return of longer and brighter days, though there are many weeks of winter ahead. While we might be feeling the long darkness of night, the days are indeed growing, though we won’t see the difference at first. Yet by December 25th, where Christmas tucked itself into the calendar in place of a Roman winter festival*, daylight hours are indisputably getting longer. Hooray!

Remember, the dying of the sun and the passing of the year also mark a rebirth of the sun, of the cycles of life, and of hope, faith, and love in our hearts. May you nurture your own heart and soul this season.

Sending you my love!

Three young women in black with their snow person construction

Snow Fun

*December 25 was adopted as the date for Christmas in Europe in order to superimpose on the pre-existing mid-winter festivals. The Romans held a festival on December 25 of Dies Natalis Solis Invicti, “the birthday of the unconquered sun.”  The Romans also had a week-long winter festival called Saturnalia that included public feasting, dancing, singing and gambling. Houses were decorated with evergreens and bunches of holly were given as tokens of friendship. When this festival was absorbed into the Christian calendar, holly, evergreens, and other symbols were adopted as well.

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Choices to lessen suffering and open our hearts to joy and Thanksgiving.

My trip to the farmers market today was beautiful. In a magical perfection, bright yellow and orange leaves fluttered everywhere in the swirling wind, contrasting with the strong, steady, black-bark covered limbs arching over streets and sidewalks. Everyone at the market seemed calm and very content to be there. It put me in a mood to slow down, just be, and reflect about the ways we cope, consume, eat.

South of the James Farmers Market

And, I want to suggest to you that, this Thanksgiving, you eat whatever you want.

But, before you do, be sure you really want it. And that you know why. Do we ever know why we do what we do? We say we want to be out of pain, physically, emotionally, and yet… Too often our actions don’t always fit our true wants. Perhaps, we are so busy wanting that we cling to our cravings and beloved symbols of comfort, especially when we get emotionally triggered.  And our desire to be loved is often being the biggest “want” of all.

Emotionally triggered? Do you think it’s possible at this time of year? Honestly:  do you think it’s not possible? A lot of us go into super-charge mode emotionally, putting ourselves on a hair trigger, easily upset by the smallest of things. It works great for retailers who put all kinds of irresistible comforts, stimulants, and distractions right under our noses. It doesn’t usually play out so well at family gatherings, however.

How will you be in this moment, this time we call Thanksgiving? This is the time we say is the opening of the Season of Joy. Can it be so for you? What would make it so? Is it about the sugar-coated, pecan-topped sweet potatoes, really? Foods like these may serve our past habits and past memories. And so, we tell ourselves that they are security, ground, and comfort—and a pleasure we need and deserve.

Clinging to the Past

The old way of doing things provides a railing that we hold on to as we navigate the steps of relationships, change, and uncertainty. But, truly, life is best lived in a state of uncertainty. That is where discovery lies.  That is where novelty, growth, and the best in life reside.  Perhaps, too, clinging to our old choices, habits, and memories is just an escape from uncertainty. So often we don’t dare be fully present, or embrace our new path. Perhaps because we fear feeling sad. Sad is bad enough at any time, but horrible in the Season of Joy.

This is an ideal time to build our confidence in our ability to drop our old ways and choose wisely. As Pema Chödrön, puts it: “Natural intelligence is always accessible to us. When we’re not caught in the trap of hope and fear, we intuitively know what’s the right thing to do. If we’re not obscuring our intelligence with anger, self-pity, or craving, we know what will help and what will make things worse” [for us emotionally].

Let your own capacity to feel appreciation, gratitude, tenderness, and a sense of humor be your core, your warmth, your comfort, your peace, your celebration. This is great time to nurture our inner warmth, first to ourselves and then to everyone around us. Light a small fire inside, let it glow with your life energy. Let it be reason enough for the season. Let it give you peace, let it free up your intelligence and be a fuel for making wiser choices. De-escalate the meaning and value of former favorites, and look forward to trying new things that are good for you.

Happy Thanksgiving!! And, remember, a low-oxalate holiday begins with your mindset.

Sources:

Pema Chödrön (2009) Taking the Leap. Freeing Ourselves from Old Habits and Fears. p.5

Photo Credit: Copyright: <a href=’https://www.123rf.com/profile_maxsheb’>maxsheb / 123RF Stock Photo</a>

Links:

http://www.freeuniongrassfarm.com/

 

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Will today’s natural foods fix our health problems?

Today’s health crisis. Have you noticed it? Obesity, insulin resistance, diabetes, kidney disease, cancer, infertility, behavioral and mood problems, poor sleep, and PAIN. Do you know anyone with any of these problems? Yes, you do, even if you are not aware of it. And, the suffering is happening at younger and younger ages. Our kids are in trouble, we’re all in trouble.

It is expensive to be sick. Both time and money are sucked out of our lives, not to mention the fun. And what about the bigger picture all around us? Perhaps you’ve noticed that poor health is threatening social and economic stability, world-wide.

Eating Better?

So, what are we doing about it? Eating better? Going “natural”? Yes, we are indeed eating more veggies and less meat, less fat too. We’re swearing off gluten and A bag of cheese-like "healthy food" substance made from almonds.milk, going for alternative low-carb or gluten-free breads, alternative “milk”, and fake cheese. Is this going to save us? I say no. Hear about one reason why this approach is not a great solution: in this video about oxalate toxicity from natural foods.

My Ancestral Health Symposium Presentation

In September, I had an opportunity to offer an address to the Ancestral Health Society. This presentation argues that many of today’s health foods are having the opposite of the intended effect. Rather than making us healthier, the superfood food craze could, like the holy war against saturated fat, be launching another public health calamity, as expensive and unpleasant as the current diabetes and obesity explosion.

Here are some highlights from this talk:

Bags of chocolate covered almonds on a supermarket produce shelf.

Chocolate is now “produce” at Walmart

  • Low-level toxicity and nutrient deficiencies make us sick.
  • One of the most potent toxins that people regularly ingest in the contemporary diet is oxalate.
  • Oxalate causes nutrient depletion AND toxicity in the body.
  • Oxalate, when purified, can rapidly kill a person.
  • It was even the poison of interest in the very first experimental toxicology study published in 1823 in England, because it caused several accidental deaths in the early1800s.
  • Many of the plant foods we like to think are good for us have enough oxalate to harm our health in much more subtle ways.
  • These natural foods might even cause mechanical abrasion to your digestive tract do to the “needle effect”.
  • Oxalate can collect in your tissues.
  • The availability of high oxalate foods we see today is unprecedented.
  • Today we are eating oxalate in amounts that cause us to begin accumulating oxalate in our arteries, bones, thyroid, breasts, and kidneys.
  • When you eat “normal” levels of oxalate, you “maintain” and grow the oxalate deposits that have already started in your body.
  • Medical and nutrition authorities have virtually no awareness of the threat of biological toxicity posed by over-exposure to oxalate and its precursors. They are not paying attention to the increase in our use of high oxalate foods.
  • Going low destabilizes oxalate in the body, and helps it move out.
  • Going low can prevent and even reverse a lot of common complaints, as proven by thousands of reports from real people in the real world (members of the VP Foundation, Participants in the Trying Low Oxalates online groups, my own clients and followers, and many others).

Action Items for You

  • Please watch the video, it is only 39 minutes and is packed with helpful images and information that will make you want to share it and watch it a second time.
  • Please give it a thumbs up.
  • Share with those you love.
  • Let me know what you think.

… and

The fewer toxins in your body the better, even the natural ones!

“From a practical point of view, it would be better to avoid oxalate-rich foods than to take measures to neutralize the effect of oxalic acid, especially when other sources of green vegetables are available.”

—Hoover and Karunairatnam (1945).
Oxalate content of some leafy green vegetables and its relation to oxaluria and calcium utilization.
The Biochemical Journal 39, 237.

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    May 18, 2025 @ 11:00 am - 11:40 am
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