FAQ about Oxalates

[this document is a work in progress]

First, I recommend the following blog introduction here, which is a nice, readable intro without so much detail to be overwhelming: http://lovingourguts.blogspot.com/2011/12/what-are-oxalates.html

How can I tell if I or my loved one would benefit from the Low Oxalate diet? These are conditions that may be helped by the the Low Oxalate Diet: Autism Spectrum Disorders and other developmental disorders genital, rectal, urinary symptoms as per http://www.thevpfoundation.org/vpfabout.htm Frequent urination, bedwetting, urgency, urinary pain Cloudy pee or white powdery pee Grainy texture, crystals, white dots and/or black specks in stool Loose green, yellow or orange stool Burning stool Constipation Irritable Bowel Vulvodynia (genital pain) low energy/fatigue poor sleep, insomnia, night-waking various kinds of pain symptoms, including joints and arthritis symptoms brought on by recent rounds of antibiotics Fat malabsorption and gut problems of all sorts Eye pain Depression , anxiety, foggy brain Bloating, children with large bellies Salicylate sensitivity Skin issues: Acne-like rashes Eczema flare-ups Asthma, Chronic Obstructive Pulmonary Disease (COPD) seasonal, chemical & environmental allergies Kidney Stones Hypothyroid or other thyroid issues Fibromyalgia, Chronic Fatigue interstitial cystitis Cystic Fibrosis

 Hormone Imbalances Chronic Candida If you want a scientific verification that the LOD can help, you can get a doctor to prescribe the Organic Acid Test (cheaper), or you can order one yourself. [where is a specific document or resource that will help interpret the results for the purposes of this diet?] What should I expect once we begin the diet? Most people get worse before they get better on this diet, because, as the dietary oxalate decreases, the sudden decrease of blood levels causes the tissue-stored-oxalate to be released, thereby causing the same symptoms as if oxalates were being consumed. This is referred to as oxalate-dumping, or usually just dumping. There may, however, be a temporary honeymoon period between the time when low oxalates are being consumed and the initial oxalate-dumping begins, which is usually a few days. Oxalate dumping symptoms include urinary issues, strange rashes, loosening teeth, regressions in behavior or speech, sandy stools or black specs in stool, strept infections, ravenous eating, craving high-oxalate foods, or any increase of symptoms that brought you here. How do I know whether it's working? Possible signs of improvement include being satisfied with less food than before, less picky eating, sudden growth spurt of child that has not been growing, and general symptoms that brought you here start to go away. The OAT test can show you in a more scientific way that the oxalate picture is improving. See the signs of dumping below. How do I do this diet? Most people can eliminate oxalates by eliminating VH foods for the first week, then H foods the next week, then M foods the next week. Then you would stay on L or VL foods for a period of weeks or months until you go through whatever stages of dumping that your body needs, and once you start to feel better more often than not. If you have been eating VERY high oxalates in your diet, then the plan above will cause you to detox too fast (that is, you will get very strong oxalate-dumping symptoms). If this happens, you should slow down and eliminate only one or two VH items per week, working toward lower oxalate foods more gradually in this fashion. In general, if you lower oxalates in your diet and get a very strong negative response, you can adjust your diet by adding in more oxalates so that the overall level is lower than it WAS previously, but higher than the level that gave you the bad reaction. There are various sources from which you can learn about the oxalate levels in your foods. The most recent, reliable, and comprehensive spreadsheet is in the Files section, Information About Foods, Oxalate Spreadsheets.

In general, eating Low Oxalate is akin to counting calories. You want to keep your overall oxalate level low, so if you are going to eat some of the higher oxalate foods, be sure to eat only small amounts. The spreadsheets mentioned above give enough details that you will be able to count oxalates using them. Aim for the overall daily intake to be between 40-60 mg for adults (based on a 2000 calorie diet) and 20-40 mg for kids. If you plan to reduce oxalates loosely by staying away from VH, H, or M foods, just be aware that the spreadsheets list the oxalate foods based on serving sizes, not based on oxalate density. This will explain why some foods may be listed as both L and M for examplethe difference is the serving size. You might want to start the diet a few days before a work or school vacation so that the worst dumping symptoms happen in the peace of your own home. Please give me a quick low-down on the supplements used with this diet protocol. There are several supplements that are necessary or useful in either helping to reduce the effects of oxalate in the body, or helping to undo the cellular damage that has been done by the oxalates. Specifics can be found in the files section (in much detail!), but the most important are VSL#3 probiotic, calcium citrate, magnesium citrate, biotin, and the antioxidants Vitamin A & E. (Vitamin C is not used as an antioxidant because it's gradually converted into oxalate.) When you begin supplements, start with only one supplement at a time (with the exception of Cal/Mag), and start with miniscule amounts, increasing them slowly over time. Expect that your body may have reactions to the supplements especially if you were very low in that nutrientthere may be a sort of overreaction as your body has been desperately looking for it (hyperactive receptors.) Starting Cal/Mag: Cal/Mag can be given in such a way that it will bind the oxalates in your food. Youll have to take the calcium alone just before meals (20 minutes if tablets/pills, and 5-10 minutes if powder form).The magnesium should be taken after or between meals. The idea is that you want the calcium to be alone in your system long enough to bind the oxalate so it can be carried away (preventing it from entering or re-entering the cells), and not together with other supplements that enhance absorption into the body (like magnesium, vitamin D, etc). If you want to ALSO use Cal/Mag as a dietary supplement, youll need to take them together away from meals so they are not binding with dietary oxalates. For binding oxalates, many here are using 1000 mg calcium and 500 mg magnesium daily, divided over the meals of the day. Remember to start low and work up. Starting Biotin: biotin is important because it competes with oxalate for access into the active site of carboxylase enzymes (that are inhibited by oxalate). Start with 300mcg once or twice a day, double every couple days. Work up to.....It depends Some are between 5-10 mg, some higher like 40-50 mg. Biotin can deplete magnesium, so you may need to increase the mag as you increase the biotin. This can be seen in the stool, as biotin can be constipating and magnesium can soften the stool. Biotin competes with B5, so give the two separately. How long does it take to get better using this diet?

It all depends on how long you have been eating high oxalate foods and other health issues that may be in place (whether caused by the oxalate damage or not). It also depends on whether your body endogenously produces oxalates. The majority of people see decent results within xxxxx. Can I ever resume eating my favorite high-oxalate foods? [thanks to Karla] That depends. Many find that after a period of time on the diet, they're able to tolerate "higher" oxalate foods, and gradually increase their overall oxalate intake, so they're eating more of a medium oxalate diet. However, there are some foods that are SOOO high in oxalate (spinach, chard, rhubarb, and almonds are a few examples), that its best to keep them off the menu permanently. What are oxalates and why are they bad for us? Oxalates are naturally irritating substances found in many plants, seeds, and nuts, which nature has in place to protect the plants. Most humans have mechanisms for eliminating oxalates so that they will not build up in the body and/or cause health issues, but those with Leaky Gut do not have adequate defense in place, making them vulnerable to oxalate damage. For those with oxalate issues, how is it affecting our bodies? Oxalates bind with minerals, depleting them from our bodies. They also interfere with mitochondrial action, impairing the body's metabolism and ability to detoxify. Also, the crystals can lodge in the tissues, causing pain, discomfort, and/or inflammation. There is an excellent more detailed summary of what happens with oxalates in the body here: http://f1.grp.yahoofs.com/v1/YO3bTsbF8vON0U4zUrkFDFx3m6Gkfc0afwPB3kPkT9uGSAs1O6eAYIreeHiL56WSibMw6OXzmae_TrzQfEDU_ozhMhtlAxUPJEdvDc/Autism%20Issues/An%20Intro %20to%20Low%20Oxalate%20Diet%20for%20Autism%20by%20Susan%20Owens How will I recognize cycles of dumping?
[thanks to Monica] Dumping is the cyclical process whereby oxalate is first liberated from wherever stored. (If it is stored in your nervous system, you could get brain fog. If it's stored in glands like the thyroid, you could feel cold or be tired. For those who have it stored in the digestive tract, there can be poor digestion). Initial symptoms will depend on where the oxalate is stored in your body. Once liberated, it then circulates in your body for a bit (and likely causes some more symptoms - generally reminiscent of the symptoms that brought you to the diet in the first place) before you'll excrete it. During this period - while it's circulating in the blood stream - many people report a peculiar kind of insomnia where you wake in the middle of the night, and are awake for a time, before falling asleep again. This kind of insomnia is very characteristic of oxalate. You may also get other symptoms that will make you think that your health is taking a step backwards. It isn't! Dumping is a good sign, and it means that you are reducing the toxic load in your system. When you excrete the oxalate and finally get it out of your system, you can also get symptoms, like diarrhea, constipation, cloudy urine, skin irritation, etc. This is oxalate's "last kick at the can", as it leaves the body.

Often, periods of "dumping" alternate with periods of feeling improved over your previous level of health. This is very common. However, some people can "dump" for prolonged periods before getting a break. This is also normal. The good news is that, once a dump is done, you should see health gains." So basically, it is (1) symptoms of oxalate liberation, (2) symptoms of circulating oxalates, and (3) symptoms of excretion, followed by possible feelings of improved health. If you see cycles like this over time, then you will be able to recognize the dumping cycles for your own body.

How do I manage the Dumping periods? One thing that may help is to manipulate urinary or salivary pH when there are big swings (which often happens during regressive periods) by eating the appropriate foods. Epsom salt baths help detox the oxalates quicker. (If you or your child seem to get worse from these baths, then see the section above about starting supplementsstart low and gradually increase. Also, you could start by having the baths farther away from bedtime until the body adjusts and begins to relax with the baths) The VSL#3 probiotic helps to shift the oxalate excretion from the urine to the stool, which can help symptoms. Sodium Bicarbonate can help with behaviors. Keep up with the appropriate supplementation to minimize oxalate production and help undo the damage that oxalates have created. What is Soluble Oxalate all about? Generally, soluble oxalate is more easily absorbed (like in the stomach) during digestion. The insoluble oxalate stays in the digestive system longer, allowing the calcium and/or magnesium (that you took before your meal) to bind it. Both forms will cause problems in the body (for those of us with Leaky Gut), so you should pay attention to the Total Oxalate column. When you are choosing the medium or lower high oxalate foods, it may benefit you to steer clear of foods that have higher percentage of soluble oxalates, and stick with those that have a greater percentage of insoluble oxalates, since the soluble ones will be absorbed. When cooking, it is possible to eliminate some of the soluble oxalate by boiling (and possibly soaking) the food and pouring off the water. What's the meaning of the yellow and green sections of the Oxalate Spreadsheet? Yellow indicates the item is gluten and/or casein free. If the item isnt casein free, it is specified. Green indicates a newly added or updated item. Common acronyms used on the loop: LOD-Low Oxalate Diet

DD/DS/DH/DW- dear daughter, dear son, dear husband, dear wife PANDAS- Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus ASD-Autism Spectrum Disorder Keep reading! The files section is rich with detailed information. Read, read, read to understand better all the nuances of oxalate issues. Here are some of the more basic sources of information that would be helpful for beginners: http://www.lowoxalate.info/faqs.html http://www.lowoxalate.info/index.html http://www.thevpfoundation.org/vpfoxalate.htm http://www.thevpfoundation.org/effective_treatment.htm Here are the links that Karla has compiled for beginners to get a handle on the Oxalate Diet: 1. A resource for beginners Look for the file "Advice for Beginners on the Low Oxalate Diet". There's a file specifically for those dealing with Autism and a similar file for those dealing with other conditions. http://health.groups.yahoo.com/group/Trying_Low_Oxalates/files/A%20resource%20fo\ r%20beginners/ 2. Dumping some posts to give an idea of what dumping is like http://health.groups.yahoo.com/group/Trying_Low_Oxalates/files/Dumping/ 3. Oxalate Spreadsheet in xls and pdf formats our food list. http://health.groups.yahoo.com/group/Trying_Low_Oxalates/files/Information%20abo\ ut%20foods/Oxalate%20Spreadsheets/ 4. Status of Foods on other diets list -A list of food status regarding other diets like SCD, GFCF, Low Salicylate http://health.groups.yahoo.com/group/Trying_Low_Oxalates/database?method=reportR\ ows&tbl=1 5. Information about useful supplements and ones to avoid http://health.groups.yahoo.com/group/Trying_Low_Oxalates/files/supplements/ 6. Low and Medium Oxalate Recipes Includes Gluten/Casein Free, Specific Carbohydrate and some vegetarian/vegan recipes. http://health.groups.yahoo.com/group/Trying_Low_Oxalates/files/Recipes/ 7. Recipe Database A lot of the recipes that are in the Recipes Folder, but the database has a search

function, so recipes may be easier to find http://groups.yahoo.com/group/Trying_Low_Oxalates/app/recipes/view/list 8. Online Supplement Sites http://health.groups.yahoo.com/group/Trying_Low_Oxalates/links/Online_Supplement\ _sites_001307760072/ http://lowoxalate.shutterfly.com/pictures