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Does any-one know of any paleo/traditional methods to reduce the oxalate content of foods or of any other methods to offset their effects? Most of my staple vegetables- spinach, but also carrots (and also chocolate!)- are quite high. Would the paleo response to these foods have been some particular treatment, would they just have largely avoided them as staples or would being paleo mean that one doesn't have to worry about these compounds' potential downsides?

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Well, I followed a hint on the Wikipedia page and googled around for Oxalobacter formigenes, a gut bacterium that is said to be able to break down (or "metabolize," whatever) oxalate. The main threat of oxalate is that it binds easily with calcium, and then this compound, calcium oxalate, can form kidney stones. (I guess the majority of kidney stones are made up of calcium oxalate.)

Some studies suggest that having higher levels of Oxalobacter formigenes in the gut can help prevent kidney stones. Here's a newer (2008), observational study, and the mainstream press response to it. And here's an older (2004) study that suggests the same thing.

So can we take supplements? I googled around on that one too, and it looks like you can't take a direct Oxalobacter formigenes supplement, but that you can take a supplement with bacteria that might have similar effects.

I expect that someone out there who has dealt with kidney stones will be able to give some more details.

As for paleo speculation, I would presume that we would have been equipped with this bacterium in the past, and that the modern world has brought conditions that can hinder it. (For example, it seems like we know that Oxalobacter formigenes is killed by some common antibiotics.) But who knows.

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Thanks Paul, it's interesting, though irritating, that good gut flora can help, since I'm almost certainly lacking this (along with most modern populations I assume) and there doesn't seem to be any efficient way of correcting the matter. – David Moss Dec 14 2010 at 12:26
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Not sure if this question is aimed at reducing kidney stones or simply reducing oxalates for some other reason. If the former, I would speculate that 1) paleolithic oxalate consumption was fairly low to begin with, as it's mostly found in plants; and 2) neolithic kidney stone formation derives from an increase in sodium consumption, which inhibits calcium reabsorption in the kidneys. (It is my conjecture that paleolithic humans did not ingest anywhere near the sodium content that we get today and, therefore, did not get kidney stones.)

In my simple world view, sugar and grains are responsible for most diseases of civilization (cancer, diabetes, automimmune). But sodium gets the blame for kidney stones.

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Definitely the latter, WAPF have another article ascribing various bad effects to oxalate consumption too (westonaprice.org/food-features/…). I agree about paleo avoiding excess sodium, though Paul Jamimet suggests that insufficient salt causes kidney stones (perfecthealthdiet.com/?p=1177). – David Moss Dec 14 2010 at 15:32
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Perhaps I misread the Paul Jaminet piece. I read it to say that zero-carbers need to be sure they get adequate salt. The WAP piece has a nice suggestion--supplement with calcium and magnesium, which bind with oxalates and get eliminated through the digestive tract rather than the kidneys. – wjones3044 Dec 14 2010 at 17:14
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Yes, we're saying the same thing in comments surely? (That LCers are often deficient in salt and this- rather than too much salt- contributes to kidney stones). Personally I'm confused by whether we'd want to consume extra calcium/magnesium with oxalate foods- kidney stones are made of oxalate bound to those and other minerals, so would adding more of the binding materials be a good or a bad thing? – David Moss Dec 14 2010 at 19:03
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Yes, the contradictions abound. Take less calcium. Take more calcium. Avoid oxalates altogether; oxalate intake doesn't matter. Makes the head spin. I get the feeling that much of what passes for advice to kidney stone sufferers is much like the CW with respect to diets--unfounded in evidence. – wjones3044 Dec 14 2010 at 20:45
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I've been researching this the last few days and the reason more calcium is recommended for folks with kidney stones is that your parathyroid will start stealing it from your bones if you stop taking it in, in an attempt to stop the kidney stone formation. Apparently, the amount of calcium lost through the kidneys is static, and it is oxalate that causes problems. – Happy Now Jul 20 2011 at 18:56
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Oxalate is a substance found in many plants that causes burning sensations, inflammation, and pain in an organism that eats the plant. It is a self-defense mechanism that keeps many types of insects and herbivores from grazing on the plant. Most people's bodies are able to deal with a moderate amount of oxalate (what would have been found in a Paleolithic diet, although please note that most moderns following a Paleo diet have high oxalate diets because most eat a huge amount of tree nuts and spinach--more so than would ever have been consumed in the Paleolithic era).

In humans, the gut lining keeps most of the oxalate from being absorbed by the body, calcium and magnesium bind with it to take it out, and some bacteria in the gut (Oxalobacter formigenes and others!) can break it down. But some people have real trouble with oxalate. They may form kidney stones or they may have A LOT of other chronic health problems because of oxalate. Many of these problems cause burning sensations, inflammation, and pain in ANY region of the body, including the genitals, rectum, mouth, eyes, intestines, bladder, joints, and muscles. It can also cause fatigue, brain fog, irritability, and increased allergies and food sensitivities. Most people with oxalate issues can be greatly helped by a low oxalate (or medium oxalate diet) and careful supplementation.

A number of supplements will bind with oxalate and help take it out of your body. Some are more "natural" than others. Calcium citrate (without Vitamin D) is king! Magnesium citrate is also good. Any pro-biotic with help, but the best on the market for this purpose is VSL#3. Biotin and B6 do not bind with oxalate, but each is super important for people with elevated oxalate levels and can help them achieve greater health.

Some people also use oxabsorb which is marketed as an oxalate binder although there are mixed reviews on how effective it is.

If you would like more information http://www.lowoxalate.info/ is a great website for general oxalate info. I also write a blog that provides many links, recipes and resources for people concerned about oxalates in their diet or possible oxalate-related health issues.

http://lowoxalatefamily.wordpress.com/

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I forgot to add, the yahoo.group called "Trying Low Oxalates" is also a great resource for oxalate information, supplementation advice, testing advice and general support. – Heidi Oct 26 2011 at 18:25
This explains my burning sensation when urinating. The last couple weeks I have been eating a ton of sweet potato (4+ lbs a day) and spinach. Thanks for the info. – ROB Oct 27 2011 at 1:05
You are welcome, Rob! I hope you are feeling better soon. Yes, 4 lbs of sweet potato, plus spinach, seems like too much oxalate for most people's bodies to handle. We've evolved good defense mechanisms in return, but not that good!!! Of course, I'm not one of those people with good defense mechanisms, so I would have been on the bathroom floor in agony, probably for weeks, if I ate that. Hopefully, your body will deal with it in a few days. – Heidi Oct 28 2011 at 21:21
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I've had kidney stones a half year back and I think it was because of the combination of a high fat diet, too much vitamin D and no vitamin K. I was taking 5000 IU a day then. At the moment my diet is pretty much the same, but I take 2000 IU of vitamin D now and most importantly, vitamin K2. I also eat a lot of chocolate and nuts which both have a lot of oxalates in them, but I haven't had any problems again since the last time.

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Thanks Kevin. I've read that a low carb/high fat diet has been blamed for kidney stones by some, but I've equally heard the reverse- that a high fat diet actually causes kidney stones to shrink (to the extent that they might pass). I take 5000IU myself, but I don't think this is an unreasonable amount, so here's hoping, but I also get relatively little calcium and (so long as my butter's good) lots of K2. – David Moss Dec 14 2010 at 12:30
What's the mechanism by which K2 reduces risk of kidney stones? – JJ Dec 14 2010 at 17:39
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I think that one of the things vitamins K1 and K2 do is help put calcium in the bones, and thereby keep it out of the arteries. So supposedly it can help fight both osteoporosis and also cardiovascular disease. But I think this hasn't been proven. Here's something interesting: vitamink2.org/presentation.html (I think it's connected to a company selling supplements.) Anyhow maybe keeping calcium in the bones also keeps it out of the kidneys? I'm really over my head here. – Paul Dec 14 2010 at 19:07
Just by the way, there are lots of Stephan posts on K2 (but I haven't found any having to do with the kidneys). Here's a good one, with links to earlier ones: wholehealthsource.blogspot.com/2009/03/… – Paul Dec 14 2010 at 19:18
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The people over at PerfectHealthDiet did a long post on kidney stones, their causes and how to prevent and get rid of them. Here's a link: http://perfecthealthdiet.com/?p=1177

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