What are Oxalate Crystals?
Oxalates are small nanoparticles that may be made in the body or may come from many healthy foods. These small particles are composed of 2 carbons and 4 oxygen molecules creating a supercharged particle. As a result of being “supercharged”, oxalates are known to bind with many other positively charged minerals. These “other” molecules include important minerals like calcium and magnesium.
Calcium oxalate crystals magnified X 100.
Once they bind and create crystals they can cause pain and inflammation in any tissue where they occur. Kidney stones are a common condition known to be caused by oxalate crystals. These microscopic crystals cause damage in the tissues where they are found creating pain and problems with healing. The damage and inflammation in the tissue may also contribute to mitochondrial dysfunction which can cause decreased energy production and chronic fatigue. Fibromyalgia and arthritis are two common conditions that may be worsened by high oxalates. More recently it has been found that even certain neurological conditions are worsened by oxalates including dementia and autism.
Health Conditions Associated with Oxalates:
Many different health conditions may be influenced by accumulation of oxalates. Often these foods are considered healthy. Due to this, many patients may overdo the oxalates in their attempts to eat healthier. The oxalates in higher amounts form crystals which may contribute to inflammatory conditions.
I often see my vegetarian and vegan patients struggling with autoimmunity and pain syndromes due perhaps to accumulation of oxalates or lectin issues. These small crystals can create irritation and immune reactions on the lining of the arteries contributing to heart disease and even neurological issues. In the urinary system they also irritant the delicate lining of the bladder, vaginal tissue and may cause pain. From the photos above you can envision these crystals as sharp and piercing into tissue creating inflammatory responses. Many different disease processes can be linked to high oxalate levels.
- Autoimmunity: Rheumatoid Arthritis, SLE- Systemic Lupus Erythematosus
- Arthritis
- Congestive Heart Failure
- Irritable Bowel Syndrome
- Kidney Stones
- Autism
- Dementia/Alzheimers
- Anxiety/depression
- Insomnia
- Vulvodynia
- Interstitial Cystitis
- Fibromyalgia
- Mitochondrial Dysfunction/Chronic Fatigue Syndrome
- Sensitivity to sound/smell/light/chemicals
Symptoms of High Oxalates:
Due to the fact that these crystals can accumulate in nearly any body tissue, symptoms can be diverse and widespread. Patients may present with different combinations and varying effects due to the many tissues that may be involved. Many autoimmune disease processes may start in this way as well.
- Joint Pain/Arthritis
- Muscle Twitching
- Nerve Irritation
- Muscle Pain
- Fibromyalgia
- Vulvodynia
- Urogenital Pain
- Interstitial Cystitis
- Kidney Stones
- Hiccups
- Loss of Coordination
- Tremor
- Sensitivity to sound, light, smells
- Sleep Issues/ Insomnia
- Difficulty Concentrating
- Word finding difficulty/memory issues
- Anxiety/depression
High Oxalate Foods
Many of the high oxalate containing foods are beneficial in other ways and only cause issues if the oxalate content becomes high enough in your body to form crystals. So, eating oxalate containing foods is alright if done in moderation. Some of these foods contain higher oxalate levels and eating many of these on the same days may cause the concentration in your body to rise to levels that cause the oxalates to crystalize and cause pain.
I often see patients with joint pain using many of these substances in high amounts daily in their smoothies. While the antioxidant and vitamin properties of these foods are beneficial, the oxalates may cause an issue in certain individuals at the right concentrations. High doses of Vitamin C can also contribute to high oxalate formation.
- Unripe Avocados
- Beans
- Beer
- Beets
- Berries/blackberries/gogi berries
- Black Pepper
- Chocolate
- Coffee
- Cranberries
- Dark Green Vegetables
- Elderberry
- Figs
- Guava
- Kiwi Fruit
- Nuts
- Oranges
- Rhubarb
- Soda
- Soy Milk
- Spinach
- Star Fruit- one of the highest content
- Sweet Potatoes
- Tea- black
- Tofu
- Wheat Bran
- Yeast and Molds
Low Oxalate Foods:
- Meats
- Dairy/eggs
- Fats and oils
- Arugula
- Cucumber
- Bok Choy
- Garlic
- Lettuce
- Watercress
Oxalates and the Gut/Microbiome
Gut integrity and the microbiome are both important in both the formation and elimination/absorption of oxalates. https://www.drjenniferkessmann.com/a-healthy-microbiome-and-its-impact-on-your-brain/ Gut lining inflammation from chemicals in our environment and foods and lead to increased absorption of oxalates. Yeast overgrowth can cause high oxalate levels which then contribute to inflammation in many tissues. Antibiotic exposures can contribute to yeast overgrowth in the gut. Muscle twitching is a symptom of yeast overgrowth and oxalate irritation to nerve tissue contributing to twitching.
Certain bacteria may also help break down oxalates and allow our body to remove them more effectively. Research In animal models demonstrates that certain lactobacillus and bifidobacteria species contribute to a lowering of oxalate levels. Oxalobacter is a species that uses oxalate as its sole carbon source. Lactobacillus Gasseri and Acidophillus both have been shown to break down oxalates in the gut removing them before they are absorbed. Decreasing yeast in the gut is also important to decrease formation of extra oxalates.
Decreasing Oxalate Levels
A combination of removing some of the high oxalate containing foods and increasing beneficial bacteria that breakdown oxalates are two potential strategies for decreasing oxalates. Increasing water consumption can help with filtration through the kidneys and excreting these substances before concentrations rise enough to allow for crystallization of oxalates. Certainly decreasing yeast in the gut can help immensely if it is a problem. Certain minerals like calcium citrate can help with removal as well. B 6 is a needed nutrient required in the breaking down of oxalates.
Conclusion:
Paying attention to oxalates in foods is important in relationship to many inflammatory conditions. Since these foods are generally healthy, learning how to decrease oxalates is important to prevent issues. Learning how to optimize your diet and improve and decrease inflammation is important for most all health conditions.
Dr. Jennifer Kessmann is a fully licensed physician who recognizes the importance of nutrition and prevention of disease. She works closely with patients to help understand issues to look for changes that may help improve quality of life. We also are able to work virtually for patients in the state of Texas.
References:
Oxalates and Joint Pain/Arthritis:
https://dx.doi.org/10.1007%2Fs11926-013-0340-4
Oxalates in Foods:
https://apjcn.nhri.org.tw/server/APJCN/8/1/64.pdf
Oxalates and Mitochondrial Dysfunction:
https://dx.doi.org/10.1016%2Fj.redox.2017.12.003
Oxalates and Congestive Heart Failure:
https://doi.org/10.1681/asn.2020121793
Oxalates and Interstitial Cystitis/vulvadynia/urogenital pain:
https://dx.doi.org/10.1038%2Fsrep39227
Crystals and Neurologic Dysfunction:
https://dx.doi.org/10.3233%2FJAD-200535
Oxalates and Kidney Stones:
https://doi.org/10.1152/ajprenal.00373.2018
Microbiome and Oxalate: