Sally K. Norton

Vitality Coach, Speaker & Health Consultant

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Painful Gout, Joint Pain, and Oxalates

Do you have painful gout, arthritis, bursitis, or stiff and swollen joints?

Hands and feet showing gout inflammation

Pain is too Popular

Together, painful arthritis, gout, lupus, or fibromyalgia afflict over 53 million adults in the United States. As of 2014, twenty-seven percent of U.S. adults have chronic joint symptoms.[1] An earlier 2006 study revealed that even young people—over 8% of patients under the age of 20—complain of pain, typically in the feet, knees, or back.[2] Joint pain—arthritis and rheumatism—is the most common cause of disability in the U.S., affecting 9.1 million adults in 2010[3].

Chronic pain of one kind or another has become an expensive public health problem in the U.S., costing $635 billion in medical treatments and lost productivity in 2011 alone.[4]  In 2016, Americans spent over $4 billion on pain-killing drugs that did nothing to address the cause of the pain[5]. And monetary cost estimates alone cannot begin to capture the losses associated with pain.

What if we could cheaply get out of pain? What if gout, arthritis, rheumatism, and back pain are a product of our diets—something very much under our individual control. Let’s take a closer look at gout.

What is Gout?

Gout is a form of inflammatory arthritis that can affect anyone. Sufferers experience sudden, severe attacks of pain, swelling, redness, and extreme tenderness in one or more joints, often the big toe, ankle, or fingers. The pain can have a burning quality as if the joints are on fire. Even after the acute gout pain subsides, joint discomfort may linger for days or weeks. With time, repeated attacks tend to last longer and affect more joints.

Gout and Diet

If you have gout, your doctor may be blaming your diet, and in particular the protein and salt you eat. The advice you’re likely to get? “Eat less meat and more low-fat vegetables.” Chances are such advice is tragically wrong.

Oxalate gout, a crystal-induced arthritis, as well as bursitis and tendinitis, can be caused by an oxalate-overloaded diet. Meats, fats, and salt don’t have oxalate, but dark chocolate, spinach, chard, almonds, buckwheat, peanuts, potatoes, and sweet potatoes do. Routine use of high oxalate foods can be the culprit in gout. When I had gout in college, I was a low-salt vegetarian. Thirty-some years later, I discovered that my gout was oxalate gout, caused by my vegetable-heavy diet, overloaded with oxalate.

Oxalate gout can appear, as it did for me, as a symptom of oxalate overload from my high-oxalate diet. But gout episodes can also occur during oxalate clearing as a transient symptom against the backdrop of improved health overall.

Crystals, Inflammation and Gout

Oxalate crystals forming and collecting in joints are known to trigger gouty inflammation and pain. The inflammation can be destructive to joint tissues. The accumulation of calcium crystals in cartilage (a.k.a. “calcification”) affects the elastic qualities of joints as well as their strength and stability. A lack of joint stability can cause pain. When I cut back on oxalate foods at age 49, my arthritis and long-standing foot problems (arising from weak connective tissues) finally disappeared.

Showing the opening paragraph of Dr. Simpkin's 1988 editorial about naming schemes for the sub-types of gout. Here he states that an article written by Rosenthal et. al. uses nine different terms to indicate oxalate gout.
Opening paragraph from Peter Simpkin’s 1988 Editorial from JAMA about types of gout.

Being a toxic irritant, crystals within joints lead to acute or chronic inflammation including gouty arthritis. Oxalate is one of several crystal types associated with arthritis. In 1988, Rheumatologist and editor of the Journal of the American Medical Association (JAMA) Dr. Peter Simkin, pointed out that the medical field uses too many difficult terms including “articular oxalosis” and “calcium oxalate micro-crystalline-associated arthritis” when referring to oxalate gout. The lack of simple, clear, and consistent terms for the various types of gout, especially oxalate gout, interferes with the clinical recognition of oxalate gout.

Oxalate is Hard to See

Diagnosis distinguishing one type of gout from another is problematic and depends on elusive analysis of joint fluid. Several authors, including rheumatologist and medical textbook author Antonio Reginato, call out the difficulty of identifying calcium oxalate crystals in synovial fluid of joints because they can easily be confused with other crystals.[6] Reginato’s work helped to establish the connection between crystals in joint spaces and arthritis and other bone and joint symptoms.

Invisible oxalate nanocrystals and oxalate ions are reactive and mobile, and thus are more toxic than the “prominent” crystals that are typically discovered by pathologists.[7] Slow to notice even the visible crystals, researchers, doctors, and pathologists are even slower to imagine the possibility of toxic trace deposits of nanocrystals and other chemical forms of oxalate in tissues. Although we can’t see them, nanocrystals do the most damage because of their ability to enter cells. And collectively, they have a larger surface area that interacts with living tissues.[8] Consequently, they are simultaneously stealthy, undetectable, and harmful.

Oxalates can also collect in tissues in other difficult to detect forms. In 1967, researchers Zarembski & Hodgkinson noted the presence of a non-crystalline complex of calcium and lipid in the liver and intestine: the oxalate lipids. [9] Similarly Reginato reported findings of lipid crystals and inflammation in joint fluids from patients with gout, rheumatoid arthritis, and traumatic bursitis.[10] He explains that analysis of joint fluids is rarely performed in cases of oxalosis, although joint pain is a known problem for these patients.

Another experiment led by a Belgian hematologist exposed human serum and dishes of living human cells that line blood and lymphatic vessels to oxalate crystals. They confirmed that oxalate crystals collect in blood vessel walls and trigger the immune cell reactions associated with the pain of gout and vasculitis[11].

Accepted clinical standards seem to miss the connection between oxalate and joint pain. Gout is strongly associated with kidney stones and chronic kidney disease. Despite this association, gout patients are typically excluded from studies on oxalate kidney stones. That is unfortunate given that high levels of oxalate (promoting stones anywhere in the body) seem to encourage uric acid gout and oxalate gout.

the formation and accumulation of crystals in tissues is a hallmark of many metabolic and inflammatory conditions, not just kidney and bladder problems.

Other Reasons High Oxalates Create Pain

Based on existing science, let me explain why minimizing oxalate exposure can get at the root cause of inflammatory problems and solve chronic pain problems. Science now recognizes that crystals forming in tissues are part of the development of gout and atherosclerosis[12]. Many studies have demonstrated that calcium oxalate crystals cause renal inflammation and damage renal immune cells[13]. In fact, the formation and accumulation of crystals in tissues is a hallmark of many metabolic and inflammatory conditions, not just kidney and bladder problems.

In addition to oxalate collecting in joint spaces, tendons, cartilage, and bones, oxalate causes nerve damage that creates pain, and increases uric acid, which is also associated with joint pain and gout. Most doctors blame uric acid for gout symptoms, which is elevated in people with oxalate kidney stones.

Inflammation

When oxalic acid grabs calcium and changes into crystals, calcium oxalate nanoparticles activate human monocyte cells and enhance local tissue inflammation[14]. That process and the related cell damage stirs up defensive innate immune system actions. These actions include “foreign body” alerts and “inflammasome” reactions, which call in platelets, causing tissue damage and promoting the development of auto-immune symptoms and fibrosis.

The immune engagement caused by exposure to high levels of either oxalate ions or oxalate crystals can lead to inflammatory conditions such as intermittent and chronic pain[15]. Oxalic acid ions and crystals create free radicals in cells that stimulate immune cells to secrete an immune signaling protein called MCP-1 (Monocyte chemoattractant protein-1). MCP-1 is implicated in the development of many diseases, including cancers, neuroinflammatory diseases, rheumatoid arthritis, and cardiovascular disease.

Aside from mechanical damage to the tissues, oxalate can also have a dramatic effect on cell physiology, including inhibiting the immune response to infection and shifting immune system toward uncontrolled inflammation.

Long before oxalates become crystals in tissues, oxalic acid damages immune cells (macrophages) and puts them in a pro-inflammatory state (with reduced cellular energy, increased oxidative stress, and damaged mitochondria)[16]. Dr. T. Mitchell’s team at the University of Alabama found damage to circulating immune cells in their human volunteers just 40 minutes after giving them a spinach smoothie with 720mg of oxalate[17].

Famous Gout Sufferers

Queen Anne (b. 1665, d. 1714)

Image of Queen Anne from Wikimedia Commons.
Queen Anne from the Workshop of John Closterman, Public domain, via Wikimedia Commons.

The famously gouty monarch of Great Britain and Ireland, Queen Anne, experienced bouts of pain in her limbs, stomach, and head. Today’s doctors may have said she had systemic lupus and pelvic inflammatory disease.

Anne Stuart suffered from other illnesses too—diseases associated with modern foods like tea, chocolate, and way too much refined carbohydrate: diabetes, nutrient deficiency, and probably oxalate overload.

Not only was she morbidly obese and diabetic at age 30, but pain also tormented her. By age 33, Queen Anne’s gout was a migratory arthritis affecting many of her joints, especially her feet, knees, and hands. The debilitating joint pain prevented walking: in 1702 she was carried to her coronation in a sedan chair. She was 35. She also had other forms of chronic inflammation: headaches, stomach pain, skin problems (red and spotted face eruptions that coincided with her bouts of joint pain).

Her issues suggest that her high oxalate diet was likely a factor behind her suffering.

In childhood, sickly Anne was sent to France for treatment of a serious eye condition with excessive discharge known as “defluxion.”[18] (Some of my clients report copious fluid draining from their eyes with fine grit in it.) While she lived with her French relations as a child, she was introduced to using chocolate, sweets, and tea to help her cope. Anne loved all things sweet.

She adopted a habit of a nightly cup of sweetened hot chocolate. Anne also enjoyed tea every day. Even more so than chocolate, tea was a great exotic novelty of her age, initially popular with the Dutch and French (she had Dutch family and married a Dutchman).

Irish Anglian cleric and author of Gulliver’s Travels, Jonathan Swift (1667 – 1745) was a contemporary of Queen Anne. Swift, who frequented taverns serving hot chocolate, or “chocolate houses,” wisely blamed gout on the over-consumption of chocolate. (According to Wikipedia, Swift hoped for a church appointment in England, but the Queen disliked Swift, finding his first book, A Tale of a Tub (1704), blasphemous.)

The severity of Queen Anne’s symptoms was both cyclical and progressively worsening until her death in 1714 at age 49. Some scholars speculate that the ultimate cause of death was kidney failure.

Ben Franklin

Quotes about Ben Franklin's gout from Walter Isaacson's biography of Franklin.
Ben Franklin and Gout, photos from: A Benjamin Franklin Reader, Edited by Walter Isaacson. Simon & Schuster, 2003.

Decades later, in 1780, American founding father Ben Franklin was bedridden with gout. Pen in hand, he asked, “What have I done merit to these cruel sufferings?” ‘Madam Gout’ had an answer. She told him his gout was due, in addition to his sedentary amusements, to his “inordinate breakfast, four dishes of tea with cream, and one or two buttered toasts . . .” People had been drinking tea from china bowls (without handles) since Queen Anne’s day. When she ruled England, tea had been around for just a few decades; by Franklin’s time, tea was standard daily fare in Great Britain and its territories.

Science Explains the Connection Between Tea, Chocolate and Pain

In the early 1940’s, researchers produced dramatically stunted growth in rats by adding 16% cocoa to their normal diet. They concluded that “indiscriminate and excessive use of chocolate flavored foods, especially in a diet already low in calcium, is not to be recommended”[19]. Today it’s easy to consume a diet consisting of 16% high oxalate foods like chocolate (and lots of sugar too). Yet, chocolate is now heralded as a health food. Previous generations knew better: two of our long-favored stimulants, chocolate and tea were not to be trusted.

Healing story of Joint Pain Relief with Diet

I have heard and have witnessed many remarkable cases of relief from joint pain after the removal of high oxalate foods from our diets.

My husband who developed debilitating carpal tune syndrome in the wake of the high-oxalate diet he adopted after we met reversed it with a low-oxalate diet.

My friend Ron mentioned in Chapter 13 of Toxic Superfoods also reversed pain in his thumb joints.

Many others have shared their stories online or written me directly, as did this woman from Australia. She is over-joyed to have relief from 8-years of gout. Here is her story:

Dear Sally,

I came across your work through Dr. Bill Schindler who was being interviewed on Episode 108 of the WildFed Podcast. My ears perked up as he was describing his health issues with gout and he explained how he had discovered your work with oxalates. My eyes widened and jaw dropped! I have been suffering from gout for the last 8 years. My mind was completely blown! I felt like a 1000-piece puzzle just fell completely into place at once.

Chard (silverbeet greens), tahini, dark chocolate, almonds, and sweet potatoes were all a part of my “healthy” diet. I expected they would get my gout pain to subside.

I have now been on a low-oxalate diet for three months and my gout has entirely disappeared. My receding, brittle fingernails are looking the best that they ever have and the eczema around my mouth (which I have always had and thought was a dairy related issue) is completely gone.

Since hearing that interview, I have immersed myself in your work. I’ve read and listened to everything that I can find!

From the bottom of my heart, thank you so much for the work that you are doing. The gratitude that I feel is beyond words. Thank you for your passion, your love, your genuine care for people, and your integrity. You are changing lives!

Reversing Oxalate Crystal Deposits in Joints: It’s not over until it’s over

Though low-oxalate eating can lead to remarkable improvement from gout and other joint and connective tissue conditions, gout can also be a symptom of oxalate clearing. When recovering from oxalate overload and enjoying overall improvements in health, the immune system’s efforts to remove oxalate from joint tissues can provoke occasional gout attacks in some people as they recover. The process can take years, but these painful episodes become less frequent and eventually end, seemingly for good.

Footnotes

[1] CDC, “Age-Adjusted Percentages of Selected Diseases and Conditions Among Adults Ages 18 and over, by Selected Characteristics: United States, 2014 Summary Health Statistics: National Health Survey, 2014 Table A-4a” (U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, 2014), http://ftp.cdc.gov/pub/Health_Statistics/NCHS/NHIS/SHS/2014_SHS_Table_A-4.pdf.

[2] Albert Tan et al., “Epidemiology of Pediatric Presentations with Musculoskeletal Problems in Primary Care,” BMC Musculoskeletal Disorders 19, no. 1 (06 2018): 40, https://doi.org/10.1186/s12891-018-1952-7.

[3] Theis, K. A., Steinweg, A., Helmick, C. G., Courtney-Long, E., Bolen, J. A., & Lee, R. (2019). Which one? What kind? How many? Types, causes, and prevalence of disability among U.S. adults. Disability and Health Journal, 12(3), 411–421. https://doi.org/10.1016/j.dhjo.2019.03.001

[4] Institute of Medicine (US) Committee on Advancing Pain Research.

[5] “OTC Sales by Category,” accessed December 12, 2017, https://www.chpa.org/OTCsCategory.aspx.

[6] A. J. Reginato and B. Kurnik, “Calcium Oxalate and Other Crystals Associated with Kidney Diseases and Arthritis,” Seminars in Arthritis and Rheumatism 18, no. 3 (February 1989): 198–224.

[7] Xin-Yuan Sun et al., “Mechanism of Cytotoxicity of Micron/Nano Calcium Oxalate Monohydrate and Dihydrate Crystals on Renal Epithelial Cells,” RSC Advances 5, no. 56 (May 18, 2015): 45393–406, https://doi.org/10.1039/C5RA02313K.

[8] Xin-Yuan Sun et al., “Size-Dependent Toxicity and Interactions of Calcium Oxalate Dihydrate Crystals on Vero Renal Epithelial Cells,” Journal of Materials Chemistry B 3, no. 9 (February 18, 2015): 1864–78, https://doi.org/10.1039/C4TB01626B.

[9] P. M. Zarembski and A. Hodgkinson, “Plasma Oxalic Acid and Calcium Levels in Oxalate Poisoning,” Journal of Clinical Pathology 20, no. 3 (May 1967): 283–85.

[10] Reginato, A.J., and Kurnik, B. (1989). Calcium oxalate and other crystals associated with kidney diseases and arthritis. Semin. Arthritis Rheum. 18, 198–224.

[11] M. A. Boogaerts et al., “Mechanisms of Vascular Damage in Gout and Oxalosis: Crystal Induced, Granulocyte Mediated, Endothelial Injury,” Thrombosis and Haemostasis 50, no. 2 (August 30, 1983): 576–80.

[12] Franklin, B.S., Mangan, M.S., and Latz, E. (2016). Crystal Formation in Inflammation. Annual Review of Immunology 34, 173–202. 10.1146/annurev-immunol-041015-055539.

[13] Mulay, S.R., Kulkarni, O.P., Rupanagudi, K.V., Migliorini, A., Darisipudi, M.N., Vilaysane, A., Muruve, D., Shi, Y., Munro, F., Liapis, H., et al. (2013). Calcium oxalate crystals induce renal inflammation by NLRP3-mediated IL-1β secretion. J Clin Invest 123, 236–246. 10.1172/JCI63679.

[14] Mulay, S.R., Herrmann, M., Bilyy, R., Gabibov, A., and Anders, H.-J. (2019). Editorial: Nano- and Microparticle-Induced Cell Death, Inflammation and Immune Responses. Front Immunol 10, 844. 10.3389/fimmu.2019.00844

[15] Umekawa, T., Chegini, N., and Khan, S.R. (2002). Oxalate ions and calcium oxalate crystals stimulate MCP-1 expression by renal epithelial cells. Kidney Int 61, 105–112. 10.1046/j.1523-1755.2002.00106.x.

[16] Kumar, et al 2021 Oxalate Alters Cellular Bioenergetics, Redox Homeostasis, Antibacterial Response, and Immune Response in Macrophages.

[17] Kumar, et al 2021. Dietary Oxalate Loading Impacts Monocyte Metabolism and Inflammatory Signaling in Humans.

[18] https://www.willowandthatch.com/history-queen-anne-britain-favourite/; https://www.historyofroyalwomen.com/anne-queen-of-great-britain/queen-anne-an-unhealthy-life-part-three/

[19] W. S. Mueller and M. R. Cooney, “The Effect of Cocoa upon the Utilization of the Calcium and Phosphorus of Milk.,” Journal of Dairy Science 26 (1943): 951–58, https://doi.org/0.3168/jds.S0022-0302(43)92791-2.

See Also:

Hoffman, G.S., Schumacher, H.R., Paul, H., Cherian, V., Reed, R., Ramsay, A.G., and Franck, W.A. (1982). Calcium oxalate microcrystalline-associated arthritis in end-stage renal disease. Ann. Intern. Med. 97, 36–42.

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Fact or Fiction: Dates Are A Low Oxalate Food?

Dates in My Low-Ox Diet Plan: What Does the Data Say? 

Following a low-oxalate diet is much easier when you have the right oxalate data. Unfortunately, there’s a lot of misinformation, limited science, and conflicting results on the internet, which leads to confusion when deciding which low oxalate foods to put on your plate. 

The debate around the oxalate content of dates perfectly illustrates this conundrum. Rumors suggest they’re high in oxalate, while other sources claim the opposite.

As you’re wading through this conflicting information, what should you believe? Let’s look at the data together to find out how much oxalate dates contain, and whether they have a place in a low-oxalate diet. 

Are dates a high or low oxalate food? Photo by VD Photography on Unsplash

Before We Begin: Learning to Read Oxalate Data

Let me provide some orientation on interpreting oxalate data.

The universal way to report the oxalate content of foods is oxalate per 100 grams. However, serving sizes vary from one food to the next.

Most people want to know how much oxalate is in one date. However, a single piece of fruit naturally comes in different sizes, which means oxalate content could vary from one date to another.

Depending on the variety, a date might weigh 7 mg or 24 grams. So, keep in mind that there is not one right number for oxalate in dates—especially by the piece. Understanding oxalate in natural foods takes some thought about several variables involved, especially the weight (amount) of the item you eat.

Now, with that reminder, here I’ll refer to the oxalate content in typical (modest) servings. Let’s get back to the oxalate content of dates.

Dates in My Low-Oxalate Diet Plan: What Does the Data Say? 

The peer-reviewed medical literature doesn’t include dates in the oxalate data testing reports. However, the VP Foundation sponsored tests of dates performed in Laramie, WY at the University of Wyoming by Dr. Michael Liebman and his team. They tested Medjool dates three times, California-grown Deglet Noor dates once, and another unspecified variety grown in Pakistan.2

According to their reported results, 24 grams of pitted Medjool dates (around one date) contains approximately 1–2 mgs of total oxalate.  24 grams of Deglet Noor dates (about three and a half dates) contain around 2 mg.1 No published testing found over 2.5 mg of oxalate per 24-gram serving.

If Dr. Liebman’s testing is right, dates are low oxalate foods. Yet mainstream sources like WebMD and Harvard incorrectly claim dates are high in oxalate, without offering any citations showing where they got this idea. They also failed to indicate the varieties, rendering the data useless.

These “reputable” and familiar institutions are seemingly reporting oxalate data, but not really. Verifiable testing shows them to be flat out wrong. This misinformation, coupled with a lack of transparency, is adding to the confusion around oxalates. This undermines the efforts of their readers to make educated decisions and limit oxalate-rich foods. 

Comparing Deglet Noor and Medjool dates

Dates vs. Figs: Oxalate Content of Food

Why would Harvard and WebMD post faulty information about dates? Perhaps the mistake comes from someone confusing dates with their Mediterranean counterpart, figs. Dates and figs are often and easily mixed up, both being small, soft, dark, and intensely sweet.

Despite these superficial similarities, dates and figs are very different fruits, especially in the oxalate department.

I know of only five tests of figs, four of them being fresh (not dried) and of the “unspecified” variety and one of them of the dried Mission fig. Some of the unspecified fresh figs have also tested low in oxalate, even lower per 100g than dates!

However, other tests find figs—especially the dried California mission figs we usually encounter in the stores—have about 12 times the oxalate content of dates with up to 95 milligrams of oxalate per 100 grams.

A typical serving of dried figs is 42 grams (four figs), which has ~34 mg oxalate. That’s 11 times higher than the approximately three mg oxalate in two Medjool dates (weighing 47 grams). Eating four to six figs could deliver a substantial oxalate level and have serious health consequences.

If you’re a fan of Fig Newtons, a test also conducted at University of Wyoming found ~8 mg oxalate per cookie—which definitely won’t kill you. But the standard serving size is three cookies (25 mg oxalate). Most people I know eat at least four at a time (32 mg of oxalate).

A photo of three fig varieties from a recent trip to the grocery store.

Moreover, researchers haven’t taken into account that there are more than 700 named varieties of fig trees. With so much breadth for one fruit, even the most exacting of researchers can’t test the oxalate content of each type of fig that exists.

Finding Oxalate Data You Can Trust

The dates versus figs discussion touches on several data-related problems in the oxalate space. And to make things even more contentious and confusing, the oxalate data listings in textbooks (for nurses and other health professions) and nutrient content tables used by dieticians are short and filled with errors.

As a community, we must look at the information out there through a critical lens, and learn to recognize bad data. New interest in this topic is only likely to increase the confusion and arguments in the short run. All of us becoming more data savvy will pave the way forward for having more clarity about healthful food choices. You definitely don’t need to eliminate oxalate foods from your low-oxalate diet plan that you love, like dates.

While it is impossible to correct every problem that exists with the science around oxalates, you can make good food choices with the information that is available. You just need a good filter to cull out the junk. I’ve been working to curate the most accurate oxalate data available, and help you make the most informed food decisions possible. As you’re trekking along your low-oxalate journey, take my (expanding) resources as a trust map and companion.

Sign up for my email list to get accurate, reliable information about the oxalate content of more foods and tips for sticking to a low-ox diet plan.  

Data Sources

DATES (are Low Oxalate Foods)

“The Low Oxalate Diet Addendum 2011 Fall- Numerical Values Table.” The VP Foundation Newsletter, no. 36 (November 2011): 17–20.

“The Low Oxalate Diet Addendum 2012 Summer- Numerical Values Table.” The VP Foundation Newsletter, no. 37 (June 2012): 6–9, 19–25.

FIGS

The Low Oxalate Diet Addendum 2008 Fall- Numerical Values Table. The VP Foundation Newsletter 7–11.

The Low Oxalate Diet Addendum 2011 Fall- Numerical Values Table. The VP Foundation Newsletter 17–20.

The Low Oxalate Diet Addendum 2011 Spring- Numerical Values Table. The VP Foundation Newsletter 14–17.

Hönow, R., and Hesse, A. (2002). Comparison of extraction methods for the determination of soluble and total oxalate in foods by HPLC-enzyme-reactor. Food Chemistry 78, 511–521. https://doi.org/10.1016/S0308-8146(02)00212-1.

FIG NEWTONS

The Low Oxalate Diet Addendum 2022 Winter- Numerical Values Table. The VP Foundation Newsletter 12. 

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Oxalates in Foods: How To Make Sense of the Data

Starting a low oxalate diet? Going low oxalate can be a huge step into a brand-new world. It’s not only unfamiliar but somewhat disorienting. What to eat? How much to eat? What should your new staples be? How will you learn and remember which foods are high in oxalate? You need practical guidance—and a bit of data on how much oxalate is in your foods.

Oxalates in Foods:
Hard to Measure and a Bit Confusing.
Photo by Jennifer Burk on Unsplash

When you’re researching the oxalate content of foods, where do you turn first? Probably Google. But most internet sites offer scant information laced with factual errors. As you comb through the search results for that list of oxalate-rich foods, you could easily find different websites that don’t agree with one another. A given food may be listed as high on one site and low on another. The lists are also often short, with just a few foods listed. The “top ten” is far from the whole story!

Obviously, the easy-to-find data isn’t especially good. And this mess can be a big, discouraging curve-ball. Don’t let all this conflicting information and lack of consensus among various data resources get you down! It is still possible to succeed in adopting a healthier, oxalate-aware way of eating.

Still, making sense of the data can overwhelming and confusing. It was for me, despite my nutrition education and professional experience. To get you oriented and make you more fool-proof, let me walk you through the mine-field of oxalate content confusion.

Online Lists Will Keep You Feeling Confused About Oxalates in Foods

How can you tell which information is credible? You won’t know just by looking at the list. Fame and fortune (institutional reputation such as USDA, Harvard, or WebMD, for example) do not assure you that a list is correct.

Misinformation about oxalates is widespread, especially among mainstream sources! For example, there’s one false claim that dates are high in oxalate posted on WebMD and thus elsewhere. (Please see my short post on the error with dates here, coming next week). There is also confusion about oxalate content in coffee because some researchers claim coffee is a high oxalate food. Neither is true. Multiple credible sources prove that in both cases, the sites listing dates and coffee as high oxalate are wrong. But mistaken notions persist. And mistaken data goes uncorrected.

Most list makers fail to mention where they got their information, let alone who did the testing and by which methods. Nor do the list makers bother to explain their rationale for designating foods as “high” or “low” in oxalate. And they rarely (if ever) revisit old information and update it.

Since the online lists aren’t good enough, surely medical journals, health agencies, and academia must have trustworthy numbers, right? But if you put on your thinking cap and take a deep dive into the literature, you might have a hard time finding much. In the end, what you manage to dig up from professional papers is also conflicted and confusing. It’s frustrating and frankly shocking how difficult it is to find credible, consistent resources on oxalates in our foods.

The full value of low-oxalate eating is not yet well-known, and sufficient resources have not been assigned to the necessary work.

Oxalate Data Online is a Mess!
Photo by Magnet.me on Unsplash

Despite the jumble of imperfect science, incomplete data, and untrustworthy conclusions about what amount is safe to consume, we can still find our way to low oxalate eating and heal from oxalate toxicity.

How to Get Better Information

Despite the data muddle, you can transition to this eating strategy successfully. Start with my Beginners’ Guide. This vetted, trustworthy list will get you 90% of the way there.

Read on if you want to understand more about the state of oxalate data and why it can be challenging. Remember that enduring some confusion is part of learning.

In the remainder of this post, I’ll attempt to explain the reasons for the discrepancies in oxalate data.

Better Sources Exist for Oxalates in Foods

I want to reassure you that there is enough credible information to support low-oxalate eating. Today we have more knowledge than ever before on oxalate in foods and how they impact health. The work of The VP Foundation and Susan Owens’ Trying Low Oxalates Facebook group has helped to launch our emerging era of growing awareness of oxalate overload. As more of us discover the healing benefits, our growing oxalate-aware community can continue to improve the data, making it more accessible, understandable, and usable over time. Most importantly, we all need to advocate for more food testing.

For a better understanding of the oxalate content of foods and using oxalate data, keep the following five tips in mind.

Need to Know Tip #1: Oxalate Levels Vary for the Same Kind of Food.

Plants naturally produce oxalates for survival to ward off microorganisms, fungi, and plant eaters. It also helps them to discard excess calcium they pick up from soils.

Oxalate levels can also vary between different types of the same food. Let’s look at apples as an example, which have over 7,500 varieties grown worldwide. I know of only 24 tests of apples. An Egyptian study found an apple of average size (~ 6 oz) had 15 mg of oxalate, but it doesn’t indicate which type of apple. Meanwhile, other tests conducted in the US found that a Pink Lady apple contains 2 mg of oxalate, a Gala has 2 to 5 mg, and a medium Granny Smith contains 5 mg. Based on a set of tests done for the VP Foundation, variations in oxalate content between varieties of tomatoes is far wider.

Situational factors such as soil content, pH, and weather can impact how much oxalate each plant contains. Unless you test every individual fruit, vegetable, or slice of bread you eat, it’s impossible to know exactly how much oxalate it has. Research reports typically don’t indicate variety, maturity, and other factors with their test results.

How much oxalate is in an avocado?
Photo by Towfiqu Barbhuiya on Unsplash

Current research typically does not seriously investigate variability in foods. And we don’t know how much each type varies and what factors influence this variability. Different growing conditions may explain the difference between US-grown apples and those grown in Egypt. Thankfully, the amounts in apples are relatively low. 

Many foods, herbs, and supplements have only been tested (and reported) once. This means we are unsure of the estimated content for these rarely tested items. Because of natural variation and limited testing, I suggest that you think about the numbers around oxalate levels as somewhat “fuzzy.”

Need to Know Tip #2: Oxalate in Foods Information is Incomplete

What really brings us garbage data are the human factors. It might be the testing method used, sloppy execution of the testing, or inaccurate reporting that explain the 5-times higher oxalate content of the Egyptian apple, and not the apples’ natural variability after all. Without more resources and interest by researchers, we don’t know.

We need to retest many foods to understand the extent of this variability, reveal mistakes, and reduce confusion around the oxalate content of what we eat.

Additionally, plants produce two types of oxalates. The first, oxalic acid, is soluble and is easily absorbed into your bloodstream. The second, oxalate crystals, are insoluble, irritate your digestive tract, but probably don’t enter the bloodstream. Both types of oxalate can impact your body, but in different ways. Many reports don’t make this critical distinction. Only recently has it become common for researchers to distinguish between the two categories of oxalate in their reporting. This can add to the confusion.

What can I eat on a low oxalate diet?
Photo by Thought Catalog on Unsplash

Need to Know Tip #3: Sloppiness is Widespread

Some researchers use unreliable methods in their analysis. (See my coffee post on this problem.) In another case, testing done for the VP Foundation mistakenly used too small a sample in testing oils and got numbers overstating their oxalate content, which is in reality essentially zero. Later, they repeated the testing and reported corrected data. But in both cases the old, wrong data continues to circulate.

Many reports also fail to mention food preparation—such as whether something was tested raw, steamed, boiled, or fried—which can significantly impact oxalate levels and the data’s usefulness for estimating how much oxalate you are eating. All of these factors can create bad data.

There may also be simple data entry mistakes (aka, “typos”) causing confusion. Even our most reliable source of oxalate data, the VP Foundation, has reported several items incorrectly. For example, when they calculated the oxalate in one ounce (28 grams) of sweet potato chips, they mistakenly used “17 grams” instead of 28 grams because one ounce is about 17 chips. Thus, they mis-reported the amount of oxalate per one ounce serving as (37 mg oxalate), which is much lower than it really is (60 mg). 

Two tree fruits compared. Cluster of 3 tamariallo fruits on left, one tamarind pod on right.

Tamarillo and Tamarind are not the same thing

Here’s another example of a reporting error: the experienced German researchers, Hönow and Hesse, said they tested “tamarillo” (a Central and South American tree fruit in the nightshade family) but they described it as “tamarindus indica” (the Indian fruit taramind). Those are entirely different foods, and we don’t know which one they tested. Thus, it’s garbage data, and probably worse than useless.

I’m not bashing anyone with these examples. What you need to realize is this: These mistakes are very easy to make. Even the best data sources contain them. You need to use your head when looking over the data.

Data discrepancies and misunderstandings about oxalates in foods could have critical implications for our health. The scientific community needs to step up to ensure they are not the reason for the confusion. Unfortunately, taking the time to get the facts right is an unusual approach!

Need to Know Tip #4: Older Oxalate Testing Methods Were Less Accurate

Prior to 1980 or so, the usual testing was prone to error. One important source of error affected tests of foods that have very little oxalate but contain abundant vitamin C. For example, the USDA data (published in dietitians’ handbooks) states that radishes are high in oxalate. But they are, in fact, very low. If the vitamin C in the radishes degraded to oxalate during testing it might be a partial explanation for the error. Or, perhaps it’s just bad data management, yet again.

Accurate testing continues to be challenging, but more recent testing tends to offer more reliable information.

Need to Know Tip #5: Oxalate Data Researchers do not Calculate Portion Sizes

To make things more complex for consumers, researchers often don’t translate their numbers into amounts per typical portion size in their reporting. They might, for example, present the results based on the dry weight without calculating the oxalate content of the food as it is normally consumed (including the moisture that was removed before analysis).

How do I know how much oxalate is in the foods I eat?
Photo by Louis Hansel on Unsplash

Let’s go back to the coffee example. One test of instant coffee found 57 mg oxalate per 100 grams of coffee powder. That sounds like a lot! As I explained in my blog post about coffee, you only use one-half to one gram of instant coffee to brew a cup.

Unless you’re choking down an entire cup of undiluted instant coffee powder—or adding high oxalate ingredients like cocoa to make a mocha—coffee is a low-oxalate food. Even if you drink a Venti dark roast from Starbucks every morning (which I don’t recommend because of the caffeine and other chemicals in coffee), you’re not drinking very much oxalate. In addition to how it’s prepared, portion sizes will impact how much oxalate you consume. Researchers need to do a better job at taking portion sizes into account when publishing reports so that consumers can use the data correctly.

We Need More (and Better) Research on Oxalates in Foods

There are significant knowledge gaps in the current literature regarding oxalates in foods and oxalate toxicity. More research is required to understand how much oxalate various foods contain, how much it varies from one variety to another (or for other reasons such as ripeness), and to weed out the technical errors and mistaken conclusions that linger in obsolete publications and in the minds of researchers, doctors, and the unsuspecting public. Unfortunately, “weeding” of medical literature is not something journals have any incentive to bother with, and it is difficult to execute.

It’s enough to make anyone’s head spin, but I have good news: going low oxalate isn’t about bean-counting. It isn’t about strictly accounting for everything you eat or measuring the exact amount of oxalate down to the milligram.

This isn’t Weight Watchers. I dislike tracking everything I eat. It can be distracting, demanding, and impractical. You can successfully lower your oxalate intake without sweating the data details. However, if you love to track things, please do. It will help if you know what you actually ate instead of just what you remember eating.

Practice Tip #1: You Don’t Have to be Perfect

Going low oxalate is about awareness and consistency, not perfection. We have enough information about oxalates in foods that we can make educated decisions about how to structure our diets without getting too hung up on what we’re eating.

Despite the limitations of oxalate data, we know that certain foods are reliably low in oxalate, including meat, poultry, dairy products, fats, true lettuces, white rice, several herbs (dill and thyme, for example) and spices (white pepper, mustard, cayenne pepper), as well as most vegetables in the cabbage family. If you build your diet around these staple foods, you will have no trouble keeping your oxalate levels in a safe range.

Practice Tip #2: Portion Size Matters

Portion size is critically important. Eating one bite of a high-oxalate food, like chocolate cake, is very different from eating an entire slice. Another example would be choosing ONE (normal-sized) chocolate chip cookie instead of a fudge brownie or mug of hot cocoa. While I don’t recommend throwing caution to the wind, you don’t need to sweat occasionally eating a tiny amount of high-oxalate foods (like a few chocolate chips).

We can learn as a community and advocate for better oxalate information.
Photo by Valiant Made on Unsplash

For example, spinach is a high-oxalate food I recommend avoiding. However, if you order a salad at a restaurant, realize some spinach leaves are mixed in, and you accidentally ate one or two of them, don’t worry: you won’t cause more oxalate to collect in your body. Just pick out the rest of the leaves and make sure the remainder of your meal is built around lower-oxalate foods. In fact, by eating small amounts of oxalate, you might avoid or delay heavy oxalate clearing symptoms. That is a good thing.

On the other hand, giving yourself permission to ignore what you’re eating can be a mistake. For example, taking several solid bites of an intense fudge brownie has the potential to bring on symptoms within one to five hours after the indiscretion. It’s not tragic if it happens, but it’s also easy to avoid if you pay attention.

Practice Tip #3: Keep Learning

Going low oxalate is a nuanced process, and there’s always more to learn. As you transition into low-oxalate eating, I’m here to help you make sense of the information that’s out there.

Get the “big rocks” right by using my Beginner’s Guide to trim out the worst offenders and adopt the “safe bets.” The middle ground foods? I’ll help you with that too, but don’t sweat them in the first phase of getting off the dangerously high foods. Tables available via my group meetings and in my book, Toxic Superfoods, will give you further guidance. For lots of specific data, my forthcoming Oxalate Data Resource Manual will provide you with all the particulars currently available for refining your oxalate-aware diet.

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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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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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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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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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When Anger Melts into Gratitude

Radio Interview On Richmond’s WRIR show Lightly on the Ground Radio

Aired: Aug 9th, 2017, 12 PM EST

During this radio interview with Sunny Gardner, Jane Cummings shares the story of her recovery from severe joint and nerve pain (in her wrists and feet) that was accompanied by brain fog. All these problems improved tremendously after following my advice to limit her oxalate intake.

Jane was initially angry at the information, having worked so hard to get to a healthful diet. She, like me, grew her own sweet potatoes and tomatoes. She also carried “pocket food”—nuts and seeds on most days.

Despite her feelings about the idea that her “healthy foods” could harm her, she moderated her food choices. She added more low oxalate foods, including romaine lettuce, and cut way back on the nuts and seeds. Things backed off, the foot stiffness and wrist pain essentially went away. Having been on the diet for almost 2 years, she now understands when she strays. Her body will tell her and symptoms will return. It works for her, every time. Just check the list and remember what foods she needs to move away from eating.

During this interview, I explain how the body can be overwhelmed by too much oxalate coming in and how the body makes a shift when you cut way back on consuming oxalate.

Jane now feels very grateful – she has a way to manage her own health. She could not get this information from doctors or the internet. So, she tells her friends about oxalates in our foods and how avoiding them has helped her.

Jane tuned her anger into a feeling of empowerment.

We both are grateful to have this option for better health. Thank you, Sunny for helping us tell our stories.

Please enjoy this 30 minute interview, and share your thoughts.

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Celebrating Life!

“I Like Feeling Good!”

In this short video, Cathy explains how the low-oxalate diet has improved her life: eliminating back pain, mouth tartar and cavities, brain fog, energy issues, and chemical sensitivity.  Her enthusiasm for what she learned in my previous talks and support group is contagious.  Cathy wants you to feel good too!

Celebrate Low-Oxalate Living: “Happy Birthday, Cathy!”

For her birthday celebration, Cathy organized a low-oxalate talk that I presented at Ellwood Thompson’s Local Grocery in Richmond, Virginia, on January 18, 2017.

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