Episode 15: Oxalates in the diet – should you be concerned?

00:00:33 Glenn:       Welcome back to Natural Health for People on Pets. I'm co-host of the show, Glen Cooke, and I'm gonna introduce the host of the show, Narelle Cooke, to tell you what the subject matter is about.  

00:00:42 Narelle:       Hello everyone.  

00:00:42 Glenn:        Hello, it's been a while, hasn't it?  

00:00:44 Narelle:        It has, and I do apologize to everyone. 

00:06:18 Narelle:       So today I thought I would talk about oxalates in our diet and in our dog's diet. You're gonna learn all about what they are, but as a clinician it's really hard when it comes to all of these natural compounds that are in our food and the potential negative health consequences they can have. Because if someone presents, or a dog presents in my clinic and they've got all of these chronic health problems and the symptoms are quite broad or vague, I can't tell them, hey, just go on a gluten-free, dairy free, low histamine, low oxalate, low salicylate, low carb diet and everything will be fine.  

00:06:55 Narelle:       Because seriously. What is there left to eat? 

00:06:59 Glenn:       Ice chips?  

00:07:01 Narelle:       It gets really challenging. So the whole point of today is we're gonna talk about oxalates, but the point is to highlight this as one possibility that people may want to consider if they feel like they've tried everything. If you hear some of the symptoms about what I'm gonna talk about and you're like, you know, maybe that could be part of my picture. You know, this is something you can try. It's not for everyone. It's not that everyone has to go a low oxalate, but there is a time and a place for when it might be helpful.  

00:07:28 Glenn:        Well this is good subject matter for me because I don't know what oxalates are, so I'm gonna learn something myself.  

00:07:33 Narelle:       And I think a lot of people will, because when I was back at uni, we were really only taught to move someone onto a low oxalate diet if they had a lot of joint pain. So, you know, chronic arthritic conditions or kidney stones or kidney disease. But there are lots of other symptoms of excessive oxalates in the body. And to give everyone a really powerful example, and this is part of what triggered me to talk about it today as well. There's a nutritionist and a health researcher in the US who's probably now one of the leading experts on the topic of oxalates and their impact on health. So her name is Sally Norton and her website is sallyknorton.com. So if any of what you hear today resonates with you, absolutely jump onto her website, and a lot of the information I'll be talking about comes from her site.  

00:08:20 Narelle:       And the reason she started specialising in this area is that despite her absolute love of healthy food and healthy living from when she was a child, she suffered through decades of pain and health challenges. So things like chronic foot pain, joint pain, muscle pain, back pain, sinus infections, irritable bowel syndrome, thyroid problems, reproductive problems. She had bleeding problems, which led to iron deficiency. She became highly allergic just generally and was super sensitive to chemicals. A sleep study showed that her brain was waking up 29 times every hour of every night.  

00:08:58 Glenn:       Oh my god.  

00:08:59 Narelle:       So that's crazy. And then over the years, her fatigue had become so bad that she couldn't concentrate, and all of these health challenges eventually forced her to quit her job. She was a research officer at a university medical school department, she just couldn't work. And you know, across all of this time, the doctors just couldn't find anything really wrong with her, and out of everything they tried, nothing helped. So it wasn't until she stumbled across oxalates and experimented with a low oxalate diet that she started to feel better. So her energy improved, her pain resolved, a lot of her other symptoms resolved. And I just found it super fascinating. I got into Sally Norton, she presented a four hour webinar for health practitioners on oxalates, which I listened to as part of my continuing education.  

00:09:48 Narelle:        And it was so fascinating to listen to her story and just the stories of her patients that she's now treating for high oxalates and the associated symptoms. So that's the background of why we're talking about oxalates today. But as Glenn said, he knows nothing about what oxalates are. So let's dig in as usual. I really do like to include a little bit of technical information at the beginning because it's important that people understand the how and the why of things, rather than me just saying do this or do that. And people just blindly following my advice. So that's something I'm really passionate about is helping people understand what's the reason for everything. So for those who are technically minded and savvy, you are gonna love this. For the others you are gonna learn something so bear with us. So oxalates, they're these tiny organic salts and they form when a compound called Oxalic Acid binds to minerals. So potassium, magnesium, calcium. So Oxalic Acid itself, have you heard of Oxalic Acid?  

00:10:44 Glenn:       I have not. I've heard of lactic acid, but I have not heard of Oxalic Acid

00:10:48 Narelle:       Oxalic Acid. So it's super corrosive. And the reason I thought you might've heard of it, and you know this is very sexist, I was gonna say some men might be more familiar with it, is that it's often used as an industrial cleaner to remove things like rust and fuel stains and blood stains, it's used in textile bleaching and as a heavy duty timber cleaner. So you can buy it from Bunnings. I think I Googled it. You can, it's just nasty, it's corrosive. But when it binds to a mineral such as calcium and it becomes an oxalate, it's less corrosive. And because of all the minerals, calcium has the strongest affinity for Oxalic Acid. So calcium oxalate is generally the main oxalate compound that we hear about and talk about when it comes to health.   

00:11:32 Narelle:        People may not realise this either. Oxalates are found all throughout nature and they're produced in most plants. They're also produced as a normal part of human metabolism, but it's considered an anti nutrient in humans so there's really no health benefit to having oxalates in our body, which is quite different to plants. So in plants, oxalates have a really awesome purpose. They protect the plant from excessive calcium in the soils. If you ever look at oxalates under a microscope. If you google them and look at the images, they're nasty, they're really sharp crystalline structures with these razor sharp pointy edges and spikes coming out of them. So when insects eat a plant that's got a lot of oxalates, it actually is harmful and damaging to the insects. It's a protective mechanism and because of their structure, they can also provide structural support to the plant itself. This is really interesting. So people who love organic food, because organic food and plants are more prone to insect attack compared to say conventionally sprayed crops, they actually have higher levels of these natural compounds that are detrimental to us for the most part, such as oxalates because they need to ramp up their defense mechanisms because they don't have the chemicals.  

00:12:46 Glenn:       So it's a natural deterrent.  

00:12:48 Narelle:       Yeah, it's a natural defense mechanism of plants to keep pests away. I find that really interesting. 

00:12:57 Narelle:        But when it comes to the human body, as I mentioned, we make some naturally ourselves. Between 50 and 80% of the oxalates in our bodies is coming in through the diet, the diet's gonna be the main focus today as it applies to us and our dogs. But just before we get into what foods are high in oxalates, in terms of how the body makes it, there's a compound called hydroxyproline, which is an amino acid that comes from protein and it's a precursor to oxalate formation. Which means it gets converted into oxalate in the body, which increases the body's overall levels of oxalates. But hydroxyproline is found in things like gelatin, bone broth and collagen supplements. So they're all really popular these days. I know I've jumped on the collagen bandwagon as I've started to see all my crow's feet and my wrinkles getting worse and worse.  

00:13:47 Narelle:        But if you are prone to kidney disease or kidney stones, collagen, bone broth and gelatin, you know, may just be making matters worse for you. And the other interesting compound is vitamin C. So vitamin C is a precursor to oxalate in the body. So even two grams of vitamin C, which is nothing, I mean most people over winter would easily take a thousand milligrams a couple of times a day. But that can increase the oxalate level in the body by anywhere from 20% to 50% depending on the person. So again, vitamin C is considered really benign and safe, but not necessarily everyone's friend depending on oxalate levels. So there is also a genetic disorder called primary hyperoxaluria, which causes the body to produce more oxalates as well. How are you going? Are you still with me?  

00:14:37 Glenn:       I don't know anything about it, but I'm learning.  

00:14:39 Narelle:       Okay, good. The most commonly accepted symptoms of excessive oxalates in the diet tend to be those related to what's called the genitourinary system. So you know, organs like the kidneys, the bladder, the genitals, and you know, what you might see is urinary urgency, high urinary frequency, and cloudy urine is a good indicator that oxalates might be causing a problem. Bladder pain, incontinence, kidney pain, kidney stones, pelvic floor pain, prostatitis and vulvodynia in women. So vulvodynia, it's just this chronic inflammatory state which causes a lot of pain for women throughout the whole genitalia area. They're the most common symptoms that doctors will tend to know about, but there's this whole body of evidence that's increasing for all of these other symptoms that may be as a result of high oxalates in the diet. And a lot of doctors don't recognise them, mainly because the symptoms are so vague that it could be attributed to pretty much anything. And that's the challenge. So this is why when you listen to the show today, if you think some of this is relevant to you, you've just gotta give it a go basically.  

00:15:48 Glenn:       Right, to at least consider that that might be a contributing factor to your ailment.  

00:15:52 Narelle:       That's right. Because just because something's not a hundred percent documented…  

00:15:57 Glenn:       You’d go rule it out.  

00:15:58 Narelle:       Yeah, and it's so safe to do so. So there's gonna be no harm if you do wanna try a low oxalate diet. But I'll talk about the few important bits if you do wanna go down that path. But some of the other non atypical symptoms that you might present with include feeling unstable, or weak, or easily injured, being slow to heal. Because like I said, oxalates are these sharp little crystals that can get into the bloodstream and move around the body and lodge in joints and things. I mean just think gout, uric acid crystals, it's the same sort of concept. So they really do interfere with connective tissues particularly and the maintenance and the repair, so they can lead to joint and muscle weakness in that regard. Because they're so sharp and damaging tissues that are affected by them take longer to heal.  

00:16:42 Narelle:       So yeah, all your joint problems, joint pain, stiffness, soreness, swelling, osteoporosis or weak or brittle bones or cracked teeth. Because remember calcium is an oxalate magnet. So the calcium gets bound up by the oxalate, which means it's no longer available to support our bone health and our teeth and things like that. There's evidence that it may be connected with poor sleep, nerve pain, all of the mental health presentations, whether it's poor concentration, emotional fatigue, depression, anxiety, poor memory, brain fog, headaches. Even hiccups because, and I thought this was really interesting, the nerve irritation that can be caused by oxalates may actually be a trigger for some people to hiccup. There you go, I didn't know that. Fatigue, because oxalates damage our cells and our enzymes and our mitochondria. Autoimmune problems like, your rheumatoid arthritis, inflammatory bowel disease, thyroid problems. Digestive problems are huge because like I said, they can damage the mucous membrane lining of the gut.  

00:17:47 Narelle:        So even if they're not the actual cause, they can certainly make symptoms worse. If you've got any gut issues, mineral deficiencies, as I mentioned, you know, they bind to minerals and it can also compromise our detoxification pathways because the oxalates damage our cells. They can also deplete glutathione levels. So glutathione is one of our master antioxidants in the body. When glutathione levels are compromised then you get an increase in free radicals in the body, which can just increase overall cellular stress and cause early cell death. That's a lot of symptoms and you can see why it's so hard to pinpoint because there's a million different possible causes for all of those symptoms that I've just mentioned. And the big problem is that a lot of super healthy foods are actually high in oxalates. And for this reason, a lot of the fad diets out there can potentially cause a lot of problems for people, because technically you can die from oxalate toxicity.  

00:18:42 Narelle:        It's not common, but the body's burden of oxalates can get to the point where it can kill you. So keep that in mind. And to put it in perspective, a healthy level of oxalate in the diet is said to be around a hundred to 200 milligrams of oxalates a day. And a low oxalate diet, so if you've got kidney stones, your doctor might say go on a low oxalate diet that's about 50 milligrams a day. But get this, a typical smoothie, let's say you're having a smoothie for breakfast 'cause you wanna get healthy and you put a couple of handfuls of spinach in there and you put some almond milk, you might put a spoonful of nut butter of some description that could easily and likely will contain over a thousand milligrams of oxalate. So that's one meal. So we should be having around a hundred to 200 at the most.  

00:19:32 Narelle:       One smoothie can blow you out over a thousand. And then if you had meat for dinner with some Swiss chard and some sweet potato on the side, that might be like another thousand milligrams. So people can really rack up like thousands of milligrams of oxalate in their diet and not realise it. But the burden on the body and the potential for symptoms to manifest with that load is huge. And just to give some examples of foods that are high in oxalate, so I mentioned Swiss chard, that's one of the worst. You've got spinach, your beet greens. So usually it's the leafy parts of the plants, your beet greens rather than the beet itself, things like that. But sweet potato, white potato, rhubarb, they're all really high. But things like chocolate, beans, greens, seeds, nuts, kiwi fruit, you know, a lot of the berries, and this is something I didn't know until I listened to this webinar is black pepper and turmeric.  

00:20:27 Narelle:       So you think about it, you know, if you've got joint pain or if your dog's got joint pain, one of the go-to supplements is Turmeric. And for people who make their own golden paste at home, you know they're using a turmeric powder and they're usually adding black pepper to it to help with the absorption. But turmeric powder is actually really high in oxalate, so if people wanna work around that, what I always use and recommend for my human and dog clients is the curcumin extract. So there's two curcumin extracts that I know are low in oxalate and one is called the curcumin C3 complex and the other one is called the curcumin BCM95 complex. So they're my go-to’s because I know they're not gonna aggravate anything, but that's a really interesting point that people generally don't know about or consider.  

00:21:15 Glenn:       I would never have even known any of that.  

00:21:17 Narelle:       Well that's why I do what I do. Yeah, I love what I do. And people who suddenly go on a juice diet or they wanna get healthy so they go on a predominantly plant-based diet that contains a lot of spinach and sweet potato berries, green tea, black coffee, dark chocolate.  

00:21:33 Glenn:       So it's basically just liquid oxalates. You're ruining everything for me now. I heard chocolate in there, I heard rhubarb. These are some of my favorite things.  

00:21:42 Narelle:       There was no red wine, so we're all good.  

00:21:44 Glenn:       Oh yeah. So grapes don't contain oxalates.  

00:21:47 Narelle:       Some berries do. I don't know if grapes are high up on the list. I'd have to double check. There's lots of lists out there, but we'll talk about that as well. So people wanna get healthy, they go on a juice cleanse or they start just eating a lot of plant matter and they feel worse and this is usually put down to a detox reaction. It's so common, you feel crap and everyone's like, oh you're just detoxing. You know, all the rubbish is coming out 'cause you're eating healthy. But in many cases it could actually be that they've just exceeded their body's oxalate threshold with all of these healthy foods and they're experiencing acute hyperoxaluria or oxalate toxicity. So you know, our bodies don't detoxify oxalate. Detoxification happens in the liver and essentially involves changing the identity of the substance being detoxified by certain chemical modifications.  

00:22:37 Narelle:        So when people say, oh you're just detoxifying the oxalates, it's just not possible. Our liver cannot detoxify oxalates. There's absolutely no way for our bodies to make them less toxic. They're either filtered out of the body through urine or the stools and they can be broken down by gut bacteria. But how's this? There was a paper in 2018, a pretty current paper, the title of which was Green Smoothie Cleanse, Causing Acute Oxalate Nephropathy. So nephropathy, just think kidney disease. So I've got the abstract here in front of me. I'm just gonna read a couple of snippets from it because it really just drives home how severe a reaction these healthy foods can cause in some people. So just reading from the abstract, ‘oxalate nephropathy is an uncommon condition that causes acute kidney injury with the potential for progression to end stage renal disease’. So they report a case of acute oxalate nephropathy in a 65 year old woman temporarily associated with the consumption of an oxalate rich green smoothie juice cleanse prepared from juicing oxalate rich green leafy vegetables and fruits. So she's just going on a health kick. She had normal kidney function before using the cleanse and then developed acute kidney injury that progressed to end stage renal disease because of the cleanse. So that's pretty full on.  

00:24:01 Glenn:       I have a question. Hearing you go through the explanation, is anybody genetically predisposed to this more than other people? You mentioned this lady before that got you onto this, or that you studied her work through her symptoms. So did she have more of a genetic predisposition to it? Is this something that some people suffer acutely with as opposed to other people? That's where my interest is being peaked now.  

00:24:27 Narelle:       It's a super awesome question. So as I mentioned earlier, there is an actual genetic condition called primary hyperoxaluria and those people absolutely are more predisposed to high levels of oxalates in the body naturally. So their body burden, you know what their body is creating itself and then what's coming in, they just don't deal with it well. So that's them, they're their own little box. But there's so many factors that can make people become what's called hyper absorbers of oxalates. So remember oxalates, if they're just sort of bound up and excreted, generally that's fine if they go out through the urine, as long as people are drinking enough fluids that the urine doesn't become concentrated and the body can flush it out that way. Or if it gets bound up with compounds and then excreted in the stools, that's fine.  

00:25:13 Narelle:        But what happens, factors that can really increase the risk of symptoms, you know in that article, acute kidney disease and renal failure include things like, people who have had a gastric bypass, which automatically compromises the integrity of the gut lining so it's making it more porous, so it's easier for oxalates to get into the body. So basically, people with diets that are pro-inflammatory, so you know, highly processed diets or lots of alcohol, which again are compromising the integrity of the gut barrier and allowing more oxalates to come in through the diet. People with malabsorption issues, particularly fat malabsorption. Because what happens in this instance is that the fat binds to the calcium in the gastrointestinal tract, which means that the calcium isn't available anymore to bind to the oxalates that are coming in from the diet and being removed that way. Does that make sense? 

00:26:06 Glenn:       So to you it does.  

00:26:09 Narelle:       So normally when oxalates come into the body, one of the best things that can happen is that it binds to calcium and gets excreted. Okay, but when there's a lot of fat in the gut the fat binds to the calcium instead.  

00:26:22 Glenn:       Right, so it inhibits the connection of the oxalate connecting with the calcium.  

00:26:27 Narelle:        Yeah, so now you've got this free oxalate that can be absorbed into the bloodstream. So that's more likely to happen with people who had their gallbladder out. So anyone with gallbladder disease or lack of gallbladder, they're gonna have fat malabsorption issues. So that puts 'em up at a higher risk as well. And you know, this is super common for us and our dogs, a history of antibiotic use or current antibiotic use because one the dysbiosis created, you know, with antibiotic use is known to contribute to leaky gut or increase permeability of the gut lining. But there are certain bacteria that help to break down oxalates. And so if we're sort of wiping out everything with antibiotics, then we lose that as a sort of a safety factor for reducing the burden of oxalates. And another thing is diets deficient in B6, so vitamin B6. And most people are like, oh you know, surely I'm not gonna be deficient in vitamin B6. But vitamin B6 is really important just for the body's handling of oxalates. And our bodies produce more oxalates naturally when we are lowing vitamin B6. But people with again, a poor diet and 50% of us on average are eating ultra processed crappy nutrient lacking diets.  

00:27:37 Glenn:       So what are some immediate good ways that people could build up their B6 intake?  

00:27:42 Narelle:        Just eating less processed food, and just more whole foods. A lot of the grains and legumes and nuts and seeds contain high levels of B vitamins across the board. But it's just about eating a better diet. Generally alcohol leeches so many nutrients from the body. So make sure that your alcohol consumption is moderated. And the oral contraceptive pill for women really depletes a lot of key nutrients, including the B vitamins. So they're naturally at a greater risk of nutrient deficiencies. But I just wanna give one more example from the literature of when people just go on a health kick and it goes terribly wrong. So there was another example of a man this time that went on a weight loss diet and he was eating six meals a day.  

00:28:32 Narelle:        So I'm like, oh, that's awesome. He's being sensible about it. His day was full of spinach and berries and nuts, but as a result of his diet, he actually developed acute onset kidney disease. So that's just another example of when you know you're trying to get healthy, it doesn't have to be extreme. It's one of my little soapbox topics I think where people just feel that to make progress in any area, it's gotta be all or nothing. It's gotta be extreme, otherwise they don't see the value or the point in it. And it's generally the worst thing you can do, whether it's for weight loss or any sort of other area of your life. It's the little choices we make every day that are gonna add up and make the biggest difference. You don't have to just go on a juice cleanse for a week for your weight loss.  

00:29:17 Glenn:       Recently Pat and I just did a podcast episode on frustration on The Canine Paradigm and that topic tended to come up a lot about extremities. People just being extreme in their thinking and their actions and so forth. And I think that extreme always is the catalyst for problems. Anytime I find that people are being extreme in their behavioral patterns, or dogs are being extreme in their behavioral patterns, it usually leads to a negative outcome.  

00:29:45 Narelle:        That's right. It's not sustainable. I mean, yes, people might get results in the first few weeks and feel good, but then you can't keep that level of extremism up and then everything always tends to come crashing down and the situation is often worse than beforehand. So any of my patients will know I'm all about slow and steady wins the race. And if you think about it, even a lot of the low carb ketogenic and gluten-free diets that are out there at the moment, they rely heavily on a lot of high oxalate foods. You know, almonds, particularly almond flour, almond bread, almond butter, almond milk. They're a staple when you're doing gluten-free or low carb and then all your leafy greens and berries because you know they're low carb as well. But even if that sounds really depressing for everyone, there's a lot of foods that you can eat that are low in oxalates. So for all of those carnivals out there, meat pretty much contains no oxalates, dairy, eggs, your fats and oil. So most of the non plant foods are good to go. But even within the leafy greens and the vegetables, your rocket, bok choy, cabbage, cauliflower, zucchini, coriander, cucumber, lettuce, mushrooms, green peas, there's a lot that you can put on a plate that's low in oxalates.  

00:31:00 Glenn:       So this would be something that vegans would have to be painfully aware of, right?  

00:31:04 Narelle:      Well you'd think so, but I get a lot of vegetarians, well I don't get a lot, I get some vegetarians and vegans in my clinic and a lot of people are doing it badly. So you know, they're not even considering the obvious things like iron and B12. So sometimes I think they're not gonna be thinking about these more out there compounds, like oxalates.  

00:31:22 Glenn:        Yeah. Well this is not a topic that I've really come across in my life before, even when you brought up this topic as a subject matter for the podcast, I was thinking, I don't even know what that is. I'm completely ignorant of it. So this is all new information to me right now. And there might be people out there who've heard it and you know, it might be a subject matter that they're very familiar with and they're thinking, oh, how could you not have heard about this? We did this in science at secondary school. But it might not be either.  

00:31:47 Narelle:        But I guess that's the challenge. As a clinical naturopath and nutritionist, a lot of people come to me because they've tried everything else. They've been to the doctors, the doctors have got to the point where we don't know, or there's nothing else we can do for you. So you know, we are forced to just think outside the box and look for any possible sort of contributing factors that may be impacting someone's health and contributing to their symptoms. So that's why we come up with these sort of things.  

00:32:11 Glenn:       Absolutely.  

00:32:12 Narelle:        But I guess when it comes to our dogs. Eating grains, things like wheat, soy and corn, they're extremely high in oxalates, as are as I've already mentioned potatoes, but so is beet pulp. So if people don't realise the bulk of many dog kibbles these days are bordering on vegetarian and they're just filled out with potato and beet pulp and grains and legumes. So our dogs are getting pretty decent amounts of oxalates in their diet. And the other way that kibble diets contribute to problems for some dogs is that because they lack moisture. So a typical kibble might have about 10% moisture, whereas things like muscle meats and organ meats and even bone like bone, might have about 30% moisture, but your muscle meats and your organ meats are sitting up around the 70% moisture.  

00:33:02 Narelle:       So if dogs aren't consuming enough fluid throughout their day and they're eating a kibble based diet, that's gonna result in a really concentrated urine, which increases their risk of kidney stones forming, that's something people need to be aware of. I never used to pay attention until we had Ladybug with her spinal injury and that's increased her risk for UTI’s. I never really paid attention to how much water our dogs were drinking in a day, but now I'm acutely aware. I know if Ladybug hasn't been drinking enough, I'm straight on it because I don't wanna have to go down antibiotic paths with UTI’s and things like that. 

00:33:36 Glenn:       And one of your ways to encourage her to drink is bone broth.  

00:33:40 Narelle:       Yes, Ladybug's mental for bone broth. So you know with our dogs, raw food diets are much better for them from a moisture content perspective. But a lot of raw fed dogs, particularly people who are making homemade raw food diets for the dogs, they can contain a lot of high oxalate plant matter, things like spinach and sweet potato and berries are really common for raw fed dogs. But you know, your dog would have to eat a lot of spinach to cause damage. So dogs that have healthy kidneys and are drinking an adequate amount of water can easily process the amounts of oxalates that most people are gonna be putting in their dog's diet if they're just making it themselves from home. But if you are feeding your dog a lot of spinach and sweet potato every day long term, that can cause kidney stress and you might get symptoms such as muscle weakness, heart arrhythmias and a lot of other things.  

00:34:31 Narelle:        So you do need to sort of be mindful of it, but not stress out and be paranoid about it. Look, it is complicated. You can google lists of high oxalate and low oxalate foods. But you've gotta be mindful, one, there's a lot of discrepancies between different lists, but they are a good place to start. Two, the type of foods within a meal affects how much oxalate is absorbed and three, there are what's called soluble and insoluble oxalate. So we are not gonna go into any of that today, but if you are eating a meal that's got calcium in it, like we've said, calcium binds to oxalates and can help pull it out of the body. So adding milk to black tea is gonna reduce the oxalate burden. If you're having spinach and you have ricotta in spinach, that's gonna reduce the oxalate burden. So the tricky thing is, again, just to touch on it so people can have it in the back of their minds. There is less oxalates in kale than there is in spinach, but spinach has more calcium in it than kale. So technically you might get more oxalates from kale because there's less calcium to bind it up.  

00:35:34 Glenn:        How dare these plants just confuse the matter even further?  

00:35:38 Narelle:        I know, and for people who are really prone to oxalate issues, the recommendation by Sally Norton is to take a calcium supplement, particularly calcium citrate before you eat a meal that's rich in oxalates. And that's just gonna bind up the oxalates that are coming in through the diet if you're not having dairy rich foods with that meal as well. The great thing is for people who are raw feeding their dogs, if you are giving your dog a raw bone meaty bone every day or every few days, they're gonna get that calcium that they need to bind up any of the oxalates from maybe the spinach or the sweet potato that you might also be feeding. So that's good. If you're buying commercial patties such as the Big Dog patties, they've got all that bone already in them ground up. So again, hugely beneficial. 

00:36:18 Glenn:       As long as they don't have gallbladder issues.  

00:36:19 Narelle:        Well that's where things get complicated. I mean, I give general advice, but if someone or their dog has unique health needs, you really do need to speak to someone to nut out the detail of what's appropriate in that situation. So just to wrap things up a little bit, how can people know if oxalates are an issue for them? I mean, we've been through the symptoms, we've been through the foods, we've given some examples of the juice cleanse or the healthy eating can be a trigger for some people. But there's actually no super easy way to determine if oxalates are causing an issue or the extent of the issue. And you know, a lot of doctors beyond the sort of the kidney symptoms, it won't even come to their mind to suggest and consider it.  

00:37:05 Narelle:       But the accepted medical tests for oxalate accumulation involve taking biopsies from the kidneys or the bones or the skin. But who's gonna pop into the doctor and say, hey I want a biopsy just to rule out oxalates. So, you know, that's not really practical. Urine tests are not super reliable because you get natural variations in the oxalates in the urine. And the thing is, often symptoms don't directly correlate with intake because oxalates are considered a toxic compound. And you know, I guess a poison to the body, the body in all its beauty has defense systems in place. It's why when we ingest or inhale toxic chemicals or heavy metals into the body, the body will sequester those toxic compounds away and they'll store them in the fat because fat's inert.  

00:37:54 Narelle:       So that's a super safe place to store toxic stuff, or in the bones. So a lot of heavy metals will get stored in the bones. And you know, research is starting to show now that potentially a lot of symptoms that post-menopausal women experience could actually be due to, because they lose their estrogen and their bones start to break down could be due to the release of heavy metals from their bones. Things like lead that are causing a lot of symptoms. So that's fascinating and a whole other conversation in itself. So if you do wanna try a low oxalate diet, the strong recommendation from people who know what they're doing is you don't go cold turkey. You don't go from a super high oxalate diet to a 50 milligram oxalate diet.  

00:38:35 Glenn:       So what you're saying is don't go through that all or nothing phase. 

00:38:38 Narelle:        Exactly right. Do not do all or nothing with oxalate reduction in your diet because you'll then get a dumping of oxalates and chances are, symptoms will just exacerbate and go through the roof and it's not the way to go about it. So the recommendations are, if you wanna try it, have a look at your diet. Google some lists of high oxalate foods, see what stands out for what you're eating on a regular basis. And initially for the first few weeks, you might just not cut out those foods, but just reduce the portion size of those foods so you're eating less of them. Then once you've done that for a little while, then you might pick one really high oxalate food and eliminate that for a week or two, and just let the body reset, then pick another food. So it's a process over many, many months to bring the oxalate content down of your diet. So do not do anything extreme. All or nothing.  

00:39:27 Glenn:       Good advice.  

00:39:28 Narelle:       And one final thing before we go is that it's a myth that cooking destroys oxalates. So you'll often see online you just cook your spinach and you'll get rid of all the oxalates and it's fine. It's got a caveat. Oxalates cannot be destroyed, they just get moved from one spot to the other. So when you boil spinach, for example, the oxalates will move, not all of them, but a decent percentage will move from the spinach leaves into the water, but then you need to throw that water out. So boiling is a good method to reduce the amount of oxalates in the food, but then don't throw it…  

00:40:04 Glenn:        On the pet food.

00:40:06 Narelle:       Yeah, or give it to the dog, or I'll make a soup out of it, or something like that. That's the worst thing you could do. So boiling is the best, steaming is good, although it's not as good as boiling, because even when I steam my broccoli and zucchini you still see the water go green, so it's still leaching some stuff out of it. Things like baking, they showed with potatoes really didn't reduce the oxalate load because the moisture's coming out, but the oxalates are still stuck in the food. So don't think that just because you cook a high oxalate food that it's better. It really depends how you cook it and what you do with that cooking water.  

00:40:39 Glenn:       So not even thoroughly washing it beforehand or anything will get rid of it.  

00:40:43 Narelle:       Not that I've read. No, I don't think washing it would cut it. That's a lot of information that I've just dumped on everyone.  

00:40:51 Glenn:       I know you're gonna have people dreaming of these horrible, sharp, crystalline oxalates coming to get them in their sleep Now.   

00:40:59 Narelle:        I find it's so fascinating an, there are people who are much more expert on this topic than I am. So if you are interested, I highly recommend Sally Norton's website. So sallyknorton.com and she's got great recipes and just great guides and what to look for and what to do and you know how to approach the whole situation. And there's a really good Facebook group. One of the best Facebook groups on this topic is called Trying Low Oxalates, and then in brackets it's got TLO. So tons of information on both of those resources. So have a look at that. If you've got any questions, you know, you can jump onto my Facebook page, Natural Health for People and Pets, you can go to my website, naturalhealthandnutrition.com.au. If you wanna email me narelle@naturalhealthandnutrition.com.au. But it's a fascinating topic and it may just help someone figure out why they're feeling so bad.  

00:41:52 Glenn:        One question before we wrap up. What happened to Sally K Norton in the end?  

00:41:57 Narelle:        She's doing awesome. Yeah, so that was her whole journey. You know, her journey from miserable to health. I mean, anyone who suffers from chronic health problems, there's always blips in the road. You know, it's never just a linear, perfect journey. And she acknowledges that if she falls off the wagon with her diet, her symptoms will flare up. And that's why it's important to understand why things happen. So when things change, you've got a better understanding of what's going on and what to do to remedy that. So people can read all about Sally on her website.  

00:42:30 Glenn:        Terrific. Well that's a good place to leave it because that's a happy ending.  

00:42:33 Narelle:        Happy ending. Yeah. Bye all. Bye everyone.