Overcoming High Oxalates: Why It’s More Than Just A Low Oxalate Diet
If you've been following a low oxalate diet and still feel terrible, there’s more to the story.
Oxalates (aka oxalic acids) are notorious for causing chronic health issues including kidney stones, but the problem isn’t just what you eat.
Oxalates are natural compounds that are found in many foods and can contribute to chronic health issues in high amounts of oxalates.
If you're experiencing recurring kidney stones or other symptoms, high levels of oxalates may be wreaking havoc on your body — but don’t worry, it’s fixable.
This article explores why higher levels of oxalates affect you so intensely, their connection to gut health, how they contribute to your symptoms, and how you can start to regain control of your health.
Key Takeaways
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Oxalates in high amounts can lead to chronic symptoms.
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Oxalate comes from more than just your food!
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Just changing your diet isn’t enough.
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You can heal from high oxalate sensitivity.
Understanding Oxalates
Oxalates can impact your health. Knowing a little more about them can help you protect yourself.
What Are Oxalates?
Oxalates are natural compounds found in many plants like vegetables, fruits, grains, and nuts where they act as a defense mechanism. (Causing irritation if consumed in large amounts.)
You have several sources of oxalate:
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Endogenous production occurs when your liver produces oxalates. (1, 13).
2. Exogenous oxalates come from the foods you eat.
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Microorganisms: Many strains of harmful gut bacteria also produce oxalates that damage your body (6, 10, 27).
Some consider oxalates to be an “anti-nutrient” because there is no known function in the body, and because it can have so many adverse effects (18). It’s actually considered to be a waste product!
Oxalate Metabolism
Unlike other metabolites, endogenous oxalates aren’t eliminated by your liver. Instead, they’re exported into systemic circulation and eventually excreted by your kidneys (13).
Your body produces more oxalates when you’re deficient in B6 and when you’re megadosing vitamin C (41).
Exogenous oxalates (from food) are handled differently.
After you ingest oxalates, they enter your gut and are broken down by gut bacteria such as Oxalobacter formigenes or Lactobacillus who use oxalates as an energy source (9, 13, 22).
When your gut bacteria snack on oxalates, that’s good for you because there are fewer oxalates for your body to deal with.
In a healthy person, any ingested oxalates not degraded by gut bacteria bind with calcium and are eliminated with other intestinal waste material (9, 13).
If your gut is unable to function properly – as is the case if you have gut inflammation, mucosal damage, dysbiosis, intestinal permeability, fat digestion problems, enzyme insufficiency, or other gut issues – your body will not metabolize oxalates well (13).
Allowing them to cause widespread damage and dysfunction. (More on this in a bit!)
When your cells have to “touch” oxalate, they’re managing it, not metabolizing it (41). This is very dangerous for a cell. Think of it like your cells are handling “kryptonite!”
High-Oxalate Foods
There are several foods that are the highest in oxalates you might consume regularly (13). These include:
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Leafy greens like spinach, chard, and sorrel
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Root veggies like beets, carrots, rutabagas, turnips, and parsnips
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Rhubarb
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Eggplant
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Summer squash
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Green and wax beans
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Okra
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Potatoes
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Navy beans
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Soybeans (edamame) and tofu
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Nuts like almonds, peanuts, and sesame seeds
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Chocolate (This is so not fair!)
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Starfruit
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Parsley
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Turmeric
While many foods that are highest in oxalate are healthy, the issue is your ability to metabolize and get rid of oxalate.
Health Implications of High Oxalates
Having high oxalate found in your body can cause several health issues. These include painful kidney stones, conditions like hyperoxaluria, and complications such as interstitial cystitis.
Symptoms of High Oxalates and Associated Conditions
If you have high oxalates, you might experience pain in various parts of your body.
For instance, pain could arise in your abdomen or low back when kidney stones form.
Since oxalate can irritate the urinary tract, it might also lead to interstitial cystitis, inflammation which causes bladder discomfort, and the annoying sensation that you have to go even if you just went.
Watch for these symptoms:
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Frequent or urgent urination
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Pain during urination
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Lower back or side (“flank”) pain
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Incontinence
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Joint pain
While these can be signs of other conditions too, they may point toward oxalate-related issues.
In my practice and in the research, I’ve seen high oxalates be associated with So. Many. Conditions. I’m sure there are a few that might surprise you:
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Arthritis (29), stenosis, tendonitis, and joint pain
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Diverticulosis, IBS, and gastroenteritis (keep reading to learn why)
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Asthma and pulmonary fibrosis (9)
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Cataracts, retinopathy, and vision loss (37)
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Cardiovascular disease – high blood pressure, atherosclerosis, coronary heart disease and stroke (15, 36)
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Autism
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Osteoporosis, osteopenia, broken bones, and cracked teeth (9)
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PCOS, hair loss, uterine fibroids, vulvodynia, endometriosis, and breast cancer (35)
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Rashes, white spots on skin, and skin problems (9)
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Thyroid dysfunction
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Vitamin and mineral deficiencies
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Fatigue, autoimmune issues, and fibromyalgia
If oxalates build up, it leads to conditions known as hyperoxaluria and oxalosis.
Hyperoxaluria and Oxalosis
Hyperoxaluria happens when your urine contains too much oxalate.
This can be problematic and lead to calcium oxalate crystals forming. There are several types of hyperoxaluria:
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Primary Hyperoxaluria: A rare genetic condition.
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Secondary Hyperoxaluria: Often comes from high oxalate diets.
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Enteric Hyperoxaluria: A type of secondary hyperoxaluria linked to digestive disorders where oxalate absorption increases. This includes inflammatory bowel diseases, fat malabsorption, “leaky gut syndrome,” and pretty much anything that causes changes in the microbiome or mucosa (9, 13, 18).
Oxalosis, on the other hand, is when oxalate builds up around your body, possibly causing bone disease over time.
Role in Kidney Stone Formation
Kidney stones are a well-known issue caused by high oxalate levels.
Specifically, calcium oxalate kidney stones commonly form when oxalate combines with calcium in your urine, leading to painful crystal deposits (4, 5, 7).
Staying hydrated with distilled water helps reduce the concentration of oxalate in your urine, helping you avoid kidney stones.
Why Do Oxalates Bother YOU So Much?
I get it.
It sucks.
Having to deal with oxalates when they don’t bother any of your friends.
Why do oxalates only seem to bother you?
You Are Unique
You are totally unique.
Think about it! In the entire history of the planet, there has never been another you.
No one else with your identical genetics, experiences, exposures, education, biochemistry, psychology, emotions, anatomy, and functionality has ever existed, even if you’re an identical twin.
Therefore, every person will have varying impacts from, well, everything.
Conventional medicine seeks to generalize to the masses and suppress your symptoms.
Bio-regulatory medicine celebrates your uniqueness and the amazing ability of your body to self-heal and self-regulate (38).
We don’t treat clients according to a specific model or pattern. Instead, we support your unique healing processes. (That’s why our clients experience so much success!)
Healing is an internal journey on more than one level.
Your Unique Exposures
Your unique cumulative exposures to things like mycotoxins, industrial chemicals, or heavy metals can make your body struggle with oxalates.
Parasites can also add to the issue.
All these exposures impair your immune system, damage your gut, and lead to chronic symptoms.
They overload your system and make it harder for your body to function normally.
But the good news is, they’re fixable!
Remove the exposures and interferences and let your body do it’s healing thing!
Immune and Gut Dysfunction
Your unique exposures can cause immune and gut dysfunction.
If your immune and digestive systems aren’t operating smoothly, oxalates become a bigger problem.
Immune dysregulation – and the exposures themselves – lead to gut inflammation and microbiome changes.
These gut-related issues can increase mucosal damage and intestinal permeability.
When your gut is off-balance, functional problems like fat malabsorption can occur.
Wait…couldn’t that be a good thing?
Doesn’t it sound like fat malabsorption would lead to less fat accumulation in your body? (I wish!)
Unfortunately, no. It just continues a cascade of dysfunction leading to chronic symptoms.
When you can’t metabolize fats properly (due to IBD, bile abnormalities, enzyme insufficiency, leaky gut, or even surgical procedures), it leads to an increase in fatty acids in the colon.
The fatty acids bind to calcium, leaving the non-bound oxalates to get absorbed into your bloodstream instead of being eliminated in your solid waste (9, 11, 12, 13, 19, 20).
The absorbed oxalates make their way to the kidneys, where they now bind with calcium, forming painful crystals. (Oxalates should bind to calcium in the colon, not in the kidneys!)
These crystals can be deposited in many tissues, causing dysfunction and pain.
In addition, oxalates reduce the amount and activity of gut bacteria that produce short chain fatty acids like butyrate, which protect your gut (6, 11, 14). One study found a “trilateral relationship” between SCFAs, immune cells, and the kidneys during stone formation (31).
Oxidative Stress
Your unique biochemistry, genetics, and exposures influence the oxidative stress in your body.
Oxidative stress happens when you have an imbalance between free radicals and antioxidants (19).
It's like your cells are under attack.
Calcium oxalate crystals increase oxidative stress and promote widespread cellular damage (24).
More on Your Unique Exposures
Exploring how high oxalates interact with parasites, heavy metals, and hormones can shed light on health issues you might face. Each element plays a significant role in how your body deals with oxalates and overall health.
Parasites & Other Invaders
Parasites, such as liver flukes, can impact how your body’s ability to deal with oxalates.
Not only do parasites suppress your immune system, but when your body is busy fighting them off, it may not have enough resources to manage oxalate buildup.
Parasites cause inflammation and damage tissue, making it easier for oxalate crystals to form.
One recent study even found calcium oxalate crystals around the eggs of liver flukes – gross (32)!
As if that all weren’t bad enough, the bacteria IN your body can be a huge source of oxalates. Check out some of this research:
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Many microorganisms such as Aspergillus, Klebsiella, Staphylococcus, Pseudomonas, E. Coli, and Mycoplasma can promote stone formation (6, 8, 12, 27, 40).
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The Aspergillus species produces oxalic acid – when it interacts with calcium in the blood or in the tissues, it will “precipitate” calcium oxalate crystals (10, 39).
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Your liver increases its oxalate production when infected with cryptosporidiosis (16).
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Mosaic DX Labs (an advanced functional testing laboratory) state that candida (you know – everyone’s best friend, yeast) uses glyoxylate as an energy source (43). When they break it down, oxalate remains.
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One case report found Aspergillosis, candida, and calcium oxalate crystals found together on autopsy (42). (To be clear, this doesn’t prove that candida produces oxalate, but it’s a first step to additional research!)
Heavy Metals
Heavy metals such as lead and copper have significant implications for oxalate levels in your body.
Heavy metals can form the nidus, or core, of a stone (17).
High levels of heavy metals cause inflammation and gut damage and stress your liver and kidneys. This makes them less effective at filtering oxalates.
This can lead to more sharp oxalate crystals or stones forming in your body (25).
Hormones
Even your hormones contribute to the oxalate situation. (Because of course they do!)
Androgens like testosterone increase the excretion of oxalates and the deposition of those “stabby” calcium oxalate crystals (6). (I know that’s not a real word, but I like it!)
Estrogens have the opposite effect.
If these hormones are out of balance (as we see in mold toxicity, parasitic infection, industrial chemical and heavy metal exposure and more), they can disrupt your oxalate metabolism.
Still not convinced that oxalates should be avoided? Keep reading to learn more about the science!
Deeper Dive: Oxalate Damage in Your Body
High oxalate levels can cause various health issues by triggering oxidative stress, affecting immune cell function, and causing kidney and epithelial damage. Understanding these impacts can help guide better health choices.
Impact of Increased Oxidative Stress
When oxalates accumulate, they disrupt the balance between free radicals and antioxidants.
Your body becomes more toxic.
This increased oxidative stress damages your cells and tissues, contributing to inflammation, aging and various diseases.
Calcium Oxalate and Monocytes
Several studies have focused on the damage calcium oxalate does to kidney cells, monocytes, and macrophages (6, 15, 24, 28).
Monocytes are a type of white blood cell.
When an invader enters your body and trigger your immune system, the monocytes go on the hunt!
At this point, we call them macrophages, and their job is to find and destroy the invader to protect your body.
Oxalates have been shown to decrease the telomere length of kidney cells and monocytes, leading to an increase in “premature cell senescence” or death (24, 28).
Having your kidney and immune system cells die early is not a good thing.
Oxalates also impair the mitochondria of kidney cells and macrophages (6, 15, 28).
Mitochondria are the “power houses” of our cells. They make “ATP” which is the cellular form of energy.
Cells with shorter telomeres and less ATP face impaired cellular bioenergetics and struggle with normal functions (28).
Additionally, oxalate can compromise how monocytes transform into macrophages. “Activated” macrophages further increase crystal deposition (6).
This disruption can weaken your immune response, leaving you more vulnerable to infections and impairing recovery from diseases.
Kidney Damage
Excess oxalate in your system can be particularly harmful to your kidneys, causing acute injury, decreased function, and even kidney cell death (4, 6, 7).
When oxalate mixes with calcium, it forms crystal deposits that can lodge in the kidneys and surrounding tissue (3, 5).
These deposits increase the risk of developing kidney stones, which can be incredibly painful.
I’ve had clients tell me the pain is more excruciating than childbirth!
The presence of these crystals can also lead to renal tubule damage, affecting the kidneys' ability to filter waste from the blood.
This damage might cause long-term problems like chronic kidney disease, requiring medical intervention to manage effectively. (Spoiler alert – I know how to make sure it doesn’t get to that point!)
Epithelial Damage
Oxalates also affect epithelial cells, which line the surfaces of your tracts and organs.
Specifically, crystals can deposit in the lining of the lumen (the hollow part of a tube), the interstitial cells (supportive tissue around your organs), and inside the cells themselves (34).
This causes significant inflammation, irritation and dysfunction (7, 10), and promotes
crystal formation, growth, and deposition (6).
Protecting epithelial cells is crucial for maintaining a healthy barrier against infections and ensuring proper nutrient absorption.
Managing Oxalate Intake
Reducing your oxalate intake can help prevent issues like kidney stones. It involves understanding which foods are high in oxalates and using calcium to aid in absorption.
Adopting a Low-Oxalate Diet
Your diet influences oxalate crystal and stone formation at multiple points in the process. That’s great news because you can control your diet!
Start by identifying and reducing oxalate-rich foods, but do not start cutting out all foods!
Start slow and go at your body’s pace.
Switching to low-oxalate options like apples, bananas, and white rice can be helpful.
More importantly, eat to understand the root causes of your health concerns. (Sensitivities are a symptom, not the root cause.)
Nutrients such as quercetin and resveratrol can reduce inflammation and oxidative stress.
Sulforaphane (found in cauliflower, brussels sprouts, kale, etc.) can decrease adhesion of and damage from calcium oxalate crystals (7).
Beneficial bacteria such as lactobacillus degrade oxalates and protect your intestinal barrier (6).
Calcium-rich foods or calcium supplements can reduce the buildup that may cause kidney stones.
Lifestyle Choices for Oxalate Management
Apart from diet, lifestyle changes can aid in managing oxalate levels.
Drink plenty of distilled water throughout the day. High fluid intake dilutes urine, reducing the risk of crystal and stone formation.
Engage in regular physical activity and maintain a balanced diet to manage your weight.
Reduce your salt intake (5, 6, 11).
Figure out your unique exposures and heal the root causes. For example, harmful microorganisms damage your gut and increase crystal formation while beneficial bacteria break down oxalates and protect your gut (11).
Make choices to support beneficial bacteria and health instead of harmful bacteria and dysbiosis.
Conclusion
A low-oxalate diet (addressing only one of the three sources of oxalates) can provide symptomatic relief, but it doesn’t address the underlying imbalances that lead to your high oxalate sensitivity.
Factors like exposures, poor gut health, dysbiosis, or impaired detox pathways drive oxalate intolerance.
To fully heal, it’s essential to explore what’s disrupting your body’s natural balance rather than just managing your diet.
But a great first step is to join our food filters masterclass to learn more about how you can individualize your food choices and help yourself.
I know you can do this, and I’m here to cheer you on!
Frequently Asked Questions
When dealing with high oxalates, certain dietary and lifestyle adjustments can help manage the condition. Below, you'll find insights into diet changes, specific foods to avoid, and ways to potentially lower oxalate levels in your body.
What can you eat to counteract high oxalate foods?
To balance high oxalates, include foods like kale, cabbage, and bananas in your diet. These are low in oxalates and can help replace the high-oxalate foods you might need to cut back on. It's also good to focus on calcium-rich foods, which can help reduce oxalate absorption in the body.
How can you reduce oxalate levels in your body?
Address all three sources of oxalates: Your body, your diet, and the microorganisms that live inside you! Reduce your intake of oxalates and increase your excretion by optimizing gut and immune health. Staying well-hydrated helps flush oxalates through your system.
What foods should you avoid if you're sensitive to oxalates?
If you're sensitive to oxalates, consider avoiding foods high in oxalates like spinach, beets, rhubarb, and nuts such as almonds. These foods can increase oxalate levels and potentially be the cause of kidney stone development or other health issues.
What are the common signs that you might have oxalate buildup?
Common signs of oxalate buildup might include pain in the kidneys or bladder, painful urination, and frequent urinary tract infections. If you notice these symptoms, consult a root cause practitioner to resolve your high oxalates.