A few years ago a client of mine with fibromyalgia asked what I knew about the connection between joint and muscle pain and eating foods high in oxalate. She had read that eating foods high in oxalic acid can trigger fibromyalgia symptoms. She felt discouraged in that she had been making such an effort to eat healthfully to help improve her condition and her overall health. Ironically, many of the nutritious foods she was consuming may have turned out to exacerbate her pain rather than relieve it.
Oxalates are naturally occurring molecules found in some plants. Normally our bodies are able to excrete oxalates in our urine and feces, but if not, oxalate can bind with minerals – especially calcium- and form oxalate crystals, which are sharp, jagged edged objects that can lodge themselves into joints, muscles and mucus membranes and trigger pain and inflammation.
Most people have no problem metabolizing moderate amounts of oxalate in their diet. For those that do accumulate high levels of oxalates in their joints and soft tissue it can be due to: Hyperoxaluria, a genetic defect which predisposes one to kidney stones; or the lack of good bacteria in the gut – often resulting from the overuse of antibiotics ); or a vitamin b-6 deficiency; or a deficiency of magnesium which binds to soluble oxalate and make it insoluble; or a high consumption of oxalate containing foods.Any or all of these causes can result in the accumulation of oxalate crystals in joints and tissues over time and can lead to problems, such as:
- painful or inflamed joints
- achy muscles or muscle cramping
- burning urine or bowel movements, anal itching
- vulvodynia – external female genital pain or irritation
- eye irritation
- kidney stones i.e. oxalates combine with calcium to form these
- developmental disorders in children, including autism
In researching the answer to my client’s question, I wondered in the back of my mind whether my lingering hamstring and pelvic pain might be due to my own oxalate consumption which had recently escalated.Six months before my fiance moved in with me. We eat a lot of salads and he loves beets (very high in oxalates) so I started including them. In addition, as the weather grew warmer I began a nightly ritual of eating frozen blackberries, raspberries, blueberries and sometimes strawberries (all high oxalate) with my lactose-free milk. Because they’re so naturally sweet and delicious, I would often have two or more cups of mixed berries. Turns out, combining the high-oxalate berries with the calcium-loaded milk further encourages the crystallization of the oxalates. We were also eating more kale since it was becoming so much more available in stores. And while I’ve used turmeric (also high in oxalates) on my cooked veggies and salads for many years, recently I’d been adding more to my diet thinking it would help the joint and muscle pain I was experiencing because it’s an anti-inflammatory without realizing itI was fueling the fire. Furthermore, overconsumption of oxalates (or the inability to excrete them) is often responsible for delayed healing as oxalates more easily bind to injured tissues. This might explain my lingering pain even after pursuing my usual healing modalities, including massage, aquatic therapy, acupuncture and rest.
As I dug deeper into the subject of oxalates I discovered that those with a leaky gut resulting form celiac disease or Crohn’s Disease, Colitis, or Irritable Bowel Syndrome are more susceptible to oxalate buildup and crystalization. A person with a healthy intestinal tract is able to process oxalate and excrete it in their feces. When someone has a penetrable gut, however, oxalate can “leak” into the bloodstream and travel wrecking havoc throughout the body. I think the fact that I had undiagnosed Celiac Disease for so many years has made me susceptible to this condition. So my problem with oxalates is not necessarily a recent development but one that has progressed over time to the point where my recent increase in oxalate consumption finally overloaded my system.
Figuring out which foods are high in oxalates can be confusing as many of the oxalate food lists on the web offer conflicting information. Oxalate levels can also depend on whether a food is raw or cooked. For example, some vegetables such as broccoli, brussels sprouts and especially kale and collard and mustard greens are lower in oxalate the more they are cooked (i.e. boiled verses steamed). Here’s one of the most comprehensive and reliable sources I’ve found.
CAUTION: If you suspect oxalates may be triggering your pain, don’t eliminate all oxalate-containing foods from your meals in an effort to decrease pain. There’s something known as “oxalate dumping” that can occur when a person abruptly ceases consumption of high oxalate foods and consequently their body starts to excrete stored oxalates at a rapid rate. This can cause an increase in symptoms. Instead, cut back gradually starting with foods containing the highest oxalate levels.
Read below for updates I wrote after publishing this initial post on the subject back in 2013.
UPDATE: 7/11/13 Well it’s been exactly 8 weeks since I lowered my oxalate consumption – primarily by eliminating beets, berries and collard greens from my meals and reducing my kale and celery intake. I’ve also been eating apples mostly without the skin and boiling my broccoli and brussels sprouts instead of steaming them. I turned a corner this past week and my pain is noticeably less. In fact this week I’ve been able to run as far as I want to with no negative repercussions. I also went hiking for a couple of hours with my sister this week and for the first time in awhile I didn’t even notice my body on the hills – I was able to focus completely on our conversation. My left hamstring and gluteal muscles are still tight but much better than they were when I began the oxalate reduction I’m also experiencing less pelvic pain in general. I’m still a bit uncomfortable driving or sitting in a car for extended periods, but even that’s improving. Like many people, I did experience a brief honeymoon period when I first reduced my oxalate consumption (perhaps too drastically) and then my pain increased for a few weeks, so I must admit that it was difficult sticking with it when I wasn’t sure if it was helping – and seemed to be making me feel worse. So if you’re reading this and you’re experimenting with lowering your oxalates, be patient, have faith and give it time to see what unfolds. I’m glad I hung in there.
UPDATE #2: 9/28/13 It’s been about 6 weeks since my last update and I’m happy to report that my joint and muscle pain have continued to decrease. I did have a bit of a setback with my Haglund’s deformity in my right foot after I stupidly did a toe stand in yoga class – something I hadn’t done in a long time and was excited I could still do, but I paid for it within 36 hours. My pelvic pain is almost gone and I was even able to sit in the car for a 9 hour car ride to Bend, OR twice in 5 days. The only other strange symptom I’ve had recently is some eye irritation after passing some small granules in the inside corners of my eyes. Apparently you can secrete oxalates through the fluid in your eyes. As a result, my left eye has been bloodshot (something that never happens to me – even after swimming without goggles). I’m guessing it is oxalate-related as my body is probably slowing releasing it through various avenues.
UPDATE #3 4/26/14 I can’t believe that it’s been so long since I’ve updated this post. I’m happy to say that it’s been almost a year since I drastically reduced my oxalate consumption (on 5/10/14). Things are much better than they were a year ago. I still get my “oxalate dump” days, but they’re more manageable and they don’t last as once. One product that has helped me tremendously is Magnesium Malate (I take capsules by Source Naturals). When I feel my symptoms coming on, the magnesium malate really helps reduce or eliminate them. I also still get some oxalate deposits in my eyes in the morning, but not as much as I used to. The best part is my pain level has greatly decreased and I’m back to being able to take long runs and bike rides without pain and without having to urinate frequently.