Should You Follow a Low-Oxalate Diet?

Adopting a low oxalate diet can significantly benefit those susceptible to kidney stones and other conditions linked to oxalates. Although these compounds are typically harmless for the general population, some people struggle to eliminate them effectively. Following a low oxalate diet doesn't require sacrificing all your beloved foods. By making a few simple substitutions and employing effective strategies, you can regulate your oxalate intake while maintaining a satisfied body.

What Are Oxalates?

Oxalates are naturally occurring compounds found in numerous plant-based foods, such as almonds and spinach. Similar to lectins and phytates, they are classified as anti-nutrients because they can hinder the absorption of vital nutrients and disrupt digestion.

These organic acids can bind with calcium and other minerals, leading to crystal formation. While most individuals can effectively break down and eliminate oxalates, they can contribute to kidney stones and chronic pain conditions in some people.

Oxalates can be found in a wide range of foods, particularly leafy greens, legumes, nuts, seeds, root vegetables, and certain grains.

What Symptoms Can Indicate Oxalate Issues?

Most individuals can process and eliminate oxalates through urine without any problems. However, those at risk of kidney stones, particularly calcium oxalate stones, may need to limit their consumption of high-oxalate foods to lower the likelihood of stone formation.

When oxalates bind with calcium in the digestive system, they create insoluble compounds that the body can excrete without being absorbed. However, if oxalates enter the bloodstream, they can be eliminated through urine and form crystals, potentially leading to kidney stones and other related symptoms.

Symptoms that may suggest an issue with oxalates include:

• Joint pain
• Muscle pain or weakness
• Digestive problems (such as bloating, gas, diarrhea, or constipation)
• Frequent urinary tract infections (UTIs)
• Skin rashes or irritation (including small, hard nodules under the skin)
• Fatigue
• Brain fog
• Burning, numbness, or tingling sensations in the hands and feet
• Vision issues (like dry or gritty eyes)

These symptoms may also be associated with diagnosed conditions. If you have been diagnosed with any of the conditions listed below, considering a low oxalate diet could be beneficial.

Conditions Linked to Oxalate Intolerance

Oxalate intolerance can contribute to or worsen various medical conditions, particularly when the body struggles to process or eliminate oxalates. Here’s a brief overview of conditions associated with oxalate intolerance:

• Kidney stones
• Vulvodynia
• Interstitial cystitis (IC)
• Irritable bowel syndrome (IBS) and gut dysbiosis
• Chronic pain (such as fibromyalgia)
• Chronic fatigue
• Autism spectrum disorder

If you suspect you have oxalate intolerance or have been diagnosed with any of these related conditions, it may be beneficial to pursue some testing.

Which Foods Have Oxalates?

Reducing your consumption of high-oxalate foods can help you manage your oxalate levels. You don't need to eliminate these foods entirely; instead, aim to balance them with lower-oxalate options. Here’s a brief overview of foods that are high in oxalates:

• Vegetables: spinach, Swiss chard, beet greens, rhubarb, okra, leeks
• Fruits: beets, figs, raspberries, kiwi, oranges, grapefruit, and dried fruits like prunes
• Nuts and Seeds: almonds, cashews, peanuts, sesame seeds, sunflower seeds
• Cereal Grains and Grain-Like Seeds: wheat bran, wheat germ, brown rice, corn grits, buckwheat, quinoa
• Legumes: peanut butter, soybeans, soy milk, and other soy products
• Tubers/Starches: sweet potatoes, yams, rutabaga, turnips, tapioca, taro
• Other: chocolate (including hot chocolate and chocolate milk), coffee, tea

For lower-oxalate fruit alternatives, consider blueberries, blackberries, cranberries, apricots, plums, nectarines, melons, or mangoes. Lime juice is low in oxalates, but lime peel is not. Instead of spinach, you can try romaine lettuce, Lacinato or "dinosaur" kale (other varieties tend to be high), mustard greens, or cabbage. Broccoli, Brussels sprouts, and zucchini are also good choices as relatively lower-oxalate vegetables.

Our current form of healthcare agrees with the idea that high amounts of oxalates can cause kidney stones. Dietitians specializing in kidney stone prevention generally recommend keeping your oxalate intake to 50 to 100 mg of oxalate daily.

For milligrams of oxalate per serving, check out https://oxalate.org. This website has compiled data from university and government sources for 750+ foods.

How to Enhance Oxalate Tolerance

If you're worried about oxalates, particularly with a history of kidney stones, consider these tips for managing your oxalate levels:

• Pair Oxalates with Calcium-Rich Foods: Consuming calcium-rich foods alongside oxalate-rich ones can prevent the absorption of oxalates. Calcium binds with oxalates in the gut, forming an insoluble compound that the body can excrete. Dairy products from goats and sheep, as well as low-oxalate leafy greens, can be beneficial. Sardines with bones are also a great source of calcium.

• Stay Hydrated: Drinking sufficient water helps flush oxalates from your system, minimizing the risk of buildup in the kidneys.

• Moderate Your Portions of High-Oxalate Foods: It's not essential to eliminate all oxalate-rich foods (many are nutritious), but controlling portion sizes can be helpful. For instance, try to avoid consuming large quantities of spinach in one day.

• Cook Vegetables: Boiling high-oxalate vegetables like spinach can reduce their oxalate content, as some oxalates leach into the water, which you can then discard.

• Limit Vitamin C Supplements: High doses of vitamin C can contribute to oxalate formation in the body. It's advisable to obtain vitamin C from natural food sources and to avoid high-dose supplements if you're susceptible to kidney stones.

By combining these strategies, you can enhance your body's ability to process and eliminate oxalates. Over time, this may improve your tolerance, lowering the risk of kidney stones and other conditions related to oxalates.