In practice, we are seeing more and more kids with high levels of oxalates in the body and the need to be put on a low oxalate diet. This presents often with kids on the spectrum, and is caused by a number of different factors. At Koru Nutrition , we want to help educate you on the basic principles of what oxalates are, and how they can impact our kids with autism.
What are Oxalates?
Oxalate (also called oxalic acid) is a naturally occurring substance found in abundance in plants and humans. The role of oxalates in plants is protective and it’s believed that it acts primarily as an insecticide. Oxalate is not a required nutrient for humans, in fact it is often labeled as an “anti-nutrient”, and too much can lead to kidney stones.
In the gut of a healthy person, oxalate binds with calcium and other minerals and is excreted in the stool before being absorbed. It follows that one of the problems with having too many oxalates is that you run the risk of poor absorption of minerals, in particular, calcium. This can be an issue for growing kids as it can impact quantity and quality of bone growth and density.
High Oxalate Foods Include:
It may be surprising that most high oxalate foods are foods that most of us consider to be healthy and good for us! And really, these are healthy foods for the average person. But, if someone has problems with processing oxalates and a build-up occurs in the body, then they can be faced with numerous challenges.
Some foods high in oxalates include:
- Nuts, especially almonds and peanuts
- Most beans
- Rhubarb, Swiss chard, field greens and spinach
- Amaranth and buckwheat
- Sweet potatoes
- Raspberries and blackberries
- Cocoa and dark chocolate
This is by no means an exhaustive list, but can provide an idea that basic, everyday, healthy foods may be a problem for our kids with autism.
How can you tell if you, or your child, have high oxalates?
First, you need to determine if you or your child presents with signs of symptoms of high oxalates, which we’ve listed below. Look at the big picture. Does there appear to be consistency within the symptom list below? If so, then you may wish to consider having an organic acid test (OAT) run by a Naturopathic Doctor or other health professional that specializes in autism.
Symptoms of high oxalates in the body include:
- Headaches, depression, anxiety, brain fog
- Restlessness, moodiness
- Pain (anywhere) – genital, joints, muscles, intestine, eyes
- Cracking in joints
- Low energy and fatigue
- Sleeping challenges
- Burning feet
- Respiratory infections and symptoms
- Gas and bloating
- Bedwetting and incontinence
- Frequent urination
- Urinary pain
- Cloudy urine
- Crystals in urine
- Sandy stools
- Black specs in stools
- Burning in stool
- Yeast overgrowth
- Consuming or craving a high oxalate diet
- Fine or gross motor challenges
- Poor growth in children
- Blood sugar imbalances
Why Does My Child Have High Oxalates?
There are a number of reasons why certain kids (or adults) may have a build-up of oxalates in the body.
One reason is genetics: Some people are predisposed to high oxalates based on their DNA. So, a diet high in oxalates can contribute to a problem with high oxalates in the body for these individuals.
Another reason is Vitamin B6 deficiency: B6 is a cofactor for one of the enzymes in the body that helps reduce oxalates (and kidney stones). Additionally, the human body can produce its own oxalate during metabolism, and B6 helps decrease oxalate production.
The last reason we’ll discuss in this post is low levels of beneficial bacteria in the gut: The good bacteria in our gut can help break down oxalates, making it easier to excrete from the body. When the levels of good bacteria in the gut are low (which is frequently the case in kids with autism), higher amounts of oxalate can be absorbed from the digestive system into the body. If your child has been on multiple courses of antibiotics, this can also contribute to high oxalates, as antibiotics are indiscriminate and will not only kill the target bad bacteria, but also the good bacteria present in the gut. Antibiotics are known to disrupt the gut microbiome, but a specific bacteria called oxalobacter formigenes, which is a bacteria that specifically helps breakdown and get rid of excess oxalates, is particularly susceptible to antibiotics.
What Does Oxalates Have To Do With Autism?
Because oxalates in high amounts interfere with certain nutrients and metabolic pathways, it can cause:
- leaky gut and yeast overgrowth (candida)
- contribute to nutrient deficiencies with minerals, biotin and glutathione
- can increase histamine (triggering allergic symptoms)
- can contribute to mitochondrial damage (mitochondria are the batteries of our cell so mitochondrial damage contributes to fatigue and weakness)
- faulty sulfation (sulfation is an important mode of detoxification in humans)
- oxidative stress and high amounts of free radical damage (oxidative stress is a phenomenon where there is an imbalance in potentially damaging compounds in the body as compared to the protective compounds in the body or the body’s ability to detoxify)
All of the above are potential issues that children on the spectrum may experience.
So, implementing a low oxalate diet may address many underlying health issues that can be contributing to an autistic child’s symptoms and affecting their quality of life.
How The Low Oxalate Diet Works?
The low oxalate diet works by reducing oxalates coming into the body from an individual’s diet in order to reduce the total oxalate burden. Further, by reducing the oxalates consumed in the diet, it gives the body more time to release and excrete the stored oxalates in the body as well.
Additionally, implementing a low oxalate diet and incorporating a specific supplement program can help reduce oxalates being generated in the body, balance biochemistry which has been thrown out of whack by the high oxalate levels, and help manage overall symptoms.
How To Implement A Low Oxalate Diet
Warning: It is important to implement the low oxalate diet slowly.
Oxalates are often stored up in body tissues. So when you reduce the dietary intake of oxalates, allowing the body a chance to get rid of the stored oxalates, a process called “dumping” can occur. Dumping is when the body’s cells release stored oxalates, which can cause symptoms to get worse, usually occurring in cycles while a person is on a low oxalate diet. To avoid heavy dumping and manage symptom flare ups, it is important to go slow. In fact, done properly, it can take several weeks or months to fully implement the diet.
How Do I Avoid Heavy Oxalate Dumping?
To undertake a low oxalate diet in a way that avoids heavy dumping of stored oxalate, it is recommended to focus on consuming 40-60mg of oxalates in a 2000 calorie diet. In more practical terms, this will mean consuming mostly low oxalate foods with a few medium oxalate foods.
Specific food preparation techniques can help reduce oxalate content in foods. Specifically, boiling reduces oxalates in beans and vegetables by about 50% (not enough for high oxalate foods) and soaking grains, beans, nuts and seeds will reduce oxalates, but be sure to drain and rinse after soaking.
We’re here to help!
It can be overwhelming and stressful to undertake a specialized, therapeutic diet; especially if your child is a picky eater and already has a limited repertoire of foods that they will consume.
If you or your child would benefit from more support understanding the connection between oxalates and autism, or how to safely implement a low oxalate diet, our clinicians that specialize in autism are ready to help!