The Low Oxalate Diet and www.lowoxalate.info

[Guest guest]

Hi, everyone,

I just subscribed and would like to introduce myself. About three years

ago, I started a new research project looking at the benefits of a low

oxalate diet to those with autism. I'm a member of the DAN! thinktank

which was put together about twelve years ago by the Autism Research

Institute. As part of the oxalate project, I set up a general list for

those trying to reduce dietary oxalates in a group called

" Trying_Low_Oxalates " and I also started a website that is

still under construction called www.lowoxalate.info.

I thought this diet was worthy of exploring because our thinktank has been

determining for many years now that most people who have autism are

afflicted with terrible gastrointestinal problems...inflammation of the

sort that is clearly associated in the literature with risks of absorbing

high quantities of oxalate from the diet because of increased permeability.

I confirmed that a pilot group had high urinary oxalate and then I began

our project, not knowing what might change for those who tried the

diet. Happily, we quickly learned that core features of autism were going

away in children and more slowly in adults with autism on this diet. That

research continues.

But why am I here?

It is my usual style to be purposefully multidisciplinary, so I set up

these sites to be useful to anyone who wants to reduce oxalates in the

diet. There are many types of patients and conditions that are explicitly

discussed in the literature where oxalates are a problem, including

bariatric surgery, and our site has already attracted conditions like

cystic fibrosis, celiac disease, fibromyalgia, vulvodynia and other

disorders....even those with calcium oxalate kidney stones.

Three years ago, after spending about four months studying every study and

abstract I could get my hands on about oxalates, I attended the FASEB

oxalate conference in the summer of 1995. I found the attendees at this

basic science conference (besides myself) included only two categories of

people: botanists and kidney doctors. Since I had read about all the many

conditions that are made worse by oxalates, the lack of diversity in the

attendees was a bit shocking to me, but I had noticed before that that

almost all the research on oxalates has been done by busy kidney doctors

who don't have much time to look at issues outside the kidneys, even when

those issues are glaringly obvious and serious.

When oxalates get into other tissues and cause damage, it is called

oxalosis. The oxalate can come from endogenous production because of gene

defects or cofactor deficiencies for the relevant enzymes, or it can come

from what is called enteric hyperoxaluria. This second category includes

any condition where excess oxalate is absorbed from the gut, and that

absorption happens mainly in the colon. The percent of the oxalate in the

diet that is absorbed is made much worse any time the function of the small

intestine is reduced. That is actually what happens with bariatric

surgery....changes in small intestine function leave more oxalate to be

absorbed in the colon. Also, antibiotics kill back the most important

microbe for degrading oxalate in the gut: oxalobacter formigenes.

Almost every article that has been written on the association to bariatric

surgery (and there are MANY) talks about the only risk being kidney stones,

so it leaves the impression for professionals that this is the only sign to

look for regarding oxalate damage. This false impression can be extremely

unfortunate, for oxalates can cause LOTS of peripheral damage to many organ

systems. In fact, the damage in other places may happen long before there

is any sign of involvement by the kidneys. Unfortunately, kidney doctors

don't realize that other systems may be affected first!

By linking people with any condition doing the low oxalate diet, our

internet list has been experiencing a continuous dialogue about unexpected

things that are improving on this diet that may have nothing to do with the

presenting condition. Because of that, we have been moving quickly into

new territory. Even though some of the changes our listmates have

experienced were unexpected, it has not been hard to find literature that

is able to explain why those improvements occured.

I thought to look for your group this week because someone I know who is

almost forty had bariatric surgery about a year ago, and she has developed

problems that very well may be oxalate-related. I did give her literature

about the association of the surgery with oxalates even before they did the

surgery, but it was not something the doctor talked about, or apparently

anyone associated with her care talked to her about, and that's why she did

not watch this part of her diet. Enough time has passed (she has halved

her weight) that some very serious things have happened.

The first thing that happened was gall bladder problems that prompted

another surgery. She then managed in the next months on two different

occasions to break major bones. She has been on so much pain medication

for these injuries that she got addicted to pain medication and had to go

into a detox center. Her parents are concerned that she may no longer be

able to take care of herself. Today I printed for her mother a listing of

about seventy articles talking about how oxalates can get into bone and

weaken them making them easy to fracture. Oxalate can also get into the

bone marrow and harm hematopoeisis and can even cause pancytopenia. This

may be relevant because this woman had an earlier history of a rare blood

disorder.

Oxalate causes pain! It likes to bind phosphatidyl serine which is usually

on the inside leaflet of the cell membrane, but moves to the exposed side

of the membrane when there has been damage or injury to the cell. That's

why oxalate tends to seek out injured tissues and than makes them feel

worse. Once inside cells, it can tie up glutathione. further turning on

inflammataory cascades while wreaking associated damage.

Oxalate can also damage the teeth, causing so much bone resorption in the

roots of the teeth that the teeth can get loose and even fall out. Oxalate

can cause terrible damage to the gums. The most vulnerable organ to oxalate

outside the kidneys is the thyroid, and oxalates may be involved with a

patient becoming hypothyroid or developing thyroid-related autoimmune

disease. The heart can be damaged by oxalate. Because of our autism

project, I am also convinced now that oxalate can get into the brain (and

our thinktank has been doing animal studies to help confirm that). It

seems that one of the biggest things to be affected is executive function,

like planning and keeping up with goals. I am also quite suspicious about

fibromyalgia due to a precedent of the diet being successfully used in that

condition to reduce pain. Perhaps that involves a possible upset in the

pituitary or hypothalamus that also may affect sleep.

At any rate, today I put together for this lady's doctor a listing of

articles on associations of bariatric surgery with oxalates and there were

nineteen articles. I would be glad to post those here if anyone is

interested, but please understand that that they talk about kidney issues,

but I want you to think much more broadly about this area. In fact, I hope

I can open your eyes to other things that may get disrupted if oxalates are

allowed to remain high in circulation. I also found about seventy articles

on oxalates damaging bone.

It is certainly possible to get urinary oxalate tested. One of the labs

that caters to the autism population does an organic acid test that

includes oxalic acid and it might be a useful test to see if there are

other disruptions in the chemistry that may be happening in patients. Is

that test used much in your field? I'm in the process of doing statistics

on more than 200 of these tests for children with autism.

Anyway, please let me know if this is of interest to you, and take a look

at my site www.lowoxalate.info. You might particularly be interested in

the research pages, in the FAQ's, or in the media pages where you will find

presentations I've done on the connection to autism.

By the way, I am not a nutritionist, but had six years of work in a health

food store before going to graduate school in biology and neuroscience. My

knowledge base is very similar to what nutritionists know. I have been

pushing hard for more involvement of nutritionists with the care of

children with autism because dietary intervention is THE most effective

intervention for autism hands down. We have many of hundreds of children

who through the efforts of our thinktank and associated physicians have

lost their diagnosis of autism. This kind of success is very important

since there is now an autism epidemic. Doubtless you have heard autism

more in the media lately.

I've gotten the impression that the low oxalate diet is not often in the

everyday world of most nutritionists and for that reason not many

nutritionists are comfortable with it. One of the obstacles to acceptance

of this diet in autism crcles has been the problem that a lot of vegetables

that are generally thought to be among the most healthy foods are very high

oxalate.

At any rate, I'm here because I just want to be a resource and to talk to

you about " peripheral " issues that you may have seen in patients that may

tie into this area. I am VERY into cross-pollination and would love for

you to be able to benefit from my years of study in this very specific area

and from the experience of our almost 2000 listmates who have explored

using this diet. I also started a list for professionals called

Advising_On_Oxalates , but there is practically no traffic

as we haven't reached critical mass!

With best wishes,

Owens

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