Jay: [00:00:00] Do you need to avoid all oxalate containing foods, including spinach, potatoes, and chocolate, and what are the best supplements to resolve oxalate issues? We'll be answering these questions in today's episode of the Energy Balance Podcast, the podcast where we explore health from the bioenergetic view and teach you how to maximize your cellular energy to maximize your health.

Today's episode is part four, the final episode of our oxalate series, where we'll be going over the impact of sugar consumption on oxalate production. We'll discuss whether you really need to avoid all high oxalate foods. We'll go over different cooking and preparation methods to reduce oxalate exposure.

We'll also talk about which supplements can make oxalate issues worse, and the best supplements to help fix your oxalate issues. As always, to check out the show notes where I'll link to the studies articles, and anything else that we reference throughout today's episode, head over to jay feldman wellness.com/podcast.

And with that, let's jump right in. Alright, let's talk about oxalates and sugar and fructose consumption, and. Obviously there's, a couple [00:01:00] reasons why we wanted to discuss this. For one, I would say, sugar and especially fructose is probably the most maligned nutrient in the alternative health world.

And with that it's often pointed to as the driver of all sorts of different issues. Pretty much any issue you can think of. And, I actually have not seen it often pointed to when it comes to oxalate production, but there is a little bit of that. I've seen it a little bit here and there. And so I did want to touch on that just slightly.

A couple of aspects here. One is just looking at the consumption of sugar and fructose and whether that increases oxalate, but also some factors going on metabolically inside the cells when there's adequate sugar available. Mike, do you wanna start us off on this first study discussing sugar and specifically fructose intake and the relationship or lack of relationship with oxalate production or excretion?

Mike: Sure. So the paper, subtle contribution of dietary oxalate and oxalate precursors. Urinary oxalate excretion, and they start off here and they say, epidemiologic evidence of the association [00:02:00] between fructose intake and kidney stone formation supports the hypothesis that fructose consumption could lead to oxalate synthesis directly or indirectly through Syria metabolism.

However, a controlled diet study in healthy and volunteers fed with increasing fructose between four to 21% of calories failed to demonstrate a change in urinary oxalate excretion. Furthermore, in vitro experiments in liver cells did not show any conversion of 13 C labeled sugars, fructose, and glucose to oxalate.

The reported association of fructose intake and kidney stone disease may be explained by confounding factors such as obesity and insular resistance. The penals pathway and xylose have been proposed as a source of oxalate synthesis via glyco, aldehyde and glycol synthesis. So basically what they're showing here is that there's associations epidemiologically with fructose intake and kidney stone formation.

And they, the researchers were thinking that maybe the fructose was being converted to oxalate or driving oxalate synthesis through the Syrian pathway. However, when they tested out in healthy [00:03:00] volunteers and they got their fructose intake, between four to 21% of calories, they didn't see any change in urinary oxalate excretion and then also in liver cells when they fed labeled fructose.

So basically the glucose and fructose had a carbon group on it labeled so that they can track how it was, how it moved through the metabolic pathways in the body. They also didn't see an increase amount of oxalate being produced from adding glucose and fructose into the medium. And so basically they're saying it, even though there's associations epidemiologically with fructose and kidney stone formation, it's probably not directly through fructose driving oxalate production.

And what I would guess, based on the things that we've discussed is that if you have people who have insulin resistance. Diabetes, metabolic dysfunction, obesity, which is what they're saying here, is that it may be explained by confounding factors such as obesity and insulin resistance, that the problem is probably more glyoxal in these states, which we talked about as being one of the major drivers of oxalate production and [00:04:00] less fructose itself.

So again and this is actually a really important point and maybe slightly tangential, but I think something to keep in mind is that you can see associations in epidemiologic studies with certain components with certain disease processes, but a lot of times there's so many confounding factors.

So in these studies you have people who are obese and insulin resistance, they have insulin resistant or diabetic. They have an increased risk of kidney stones and then maybe they're out not really eating that well. Maybe they're having a bunch of, processed foods that are higher in, fructose consumption.

So they're doing a food frequency questionnaire and seeing how many 32 ounce slurpees are you having per week. And the people have the most 32 ounce Slurpees, which are high in fructose, are having the most incidents of, or a higher incidence of the kidney stones. And the question is it the fructose or are they not eating well?

They have metabolic dysfunction and they just happen to be having more fructose based on some of their fruit choices on top of a whole bunch of other things besides fructose that [00:05:00] are then driving their increased risk of kidney stones. Because the metabolic dysfunction that they develop is leading to an increased amount of glyoxal production, which is a precursor to oxalate inside the body.

So essentially, I think, and that they're saying this in the paper directly here, I think that is more likely the explanation is the metabolic dysfunction. Not necessarily just directly fructose. And as we've talked about, significant, like many times in this podcast, a Slurpee and the waters typically considered sugar sources is not the same as having a banana or berries or whatever else.

Despite what Glucose Goddess and Dr. Dr. Richard Johnson and Dr. Lustig wanna say the research is pretty clear. They're very different. So when you have confounding factors like that, you really wanna be clear on what the specific problem is and not just say, oh yeah, it's probably just the fructose.

It's yeah, maybe not. And we're seeing that here as well,

Jay: right? Yeah, absolutely. Classic healthy user bias where the people consuming the most sugar are generally the least healthy, but [00:06:00] as you said, it's not because they're eating tons of fruit and fruit juice, which have been shown to be universally beneficial when it comes to things like insulin sensitivity and metabolic syndrome.

And not to mention of course, that those people who are not healthy, it doesn't even mean that it's even the sugar consumption, even in the form of, high fructose corn syrup, sweetened beverages and all that. But obviously those are people on high pofa diets, not moving, not getting good sleep all of the rest.

And and that's been shown, right? We did go through those studies looking at the relationship between, elevated glyoxal, methyl glyoxal levels and insulin resistance, diabetes, obesity, all, pointing in that direction. And obviously you also have increased endotoxin in those situ, in those disease processes you have elevated polyunsaturated fats and all of their downstream lipid peroxide products.

So yeah we've seen that time and time again that oftentimes the sugar and fructose are the scapegoat, but are unfairly blamed. And we see that supported in this study as well as is a study titled Metabolism of Fructose to Oxalate and Glyco, where they're looking more directly at the impacts of these, [00:07:00] and on oxalate production. And first they state when the sugar concentration was one millimolar in the growth medium, all the sugar was completely metabolized. Within 12 hours, an increased synthesis of total oxalate was observed in cells incubated with one millimolar of sugars in comparison to the incubations with 25 millimolar sugars suggesting that sugar deprivation promoted oxalate synthesis in these cells.

So the exact opposite of what's being suggested, and in this case, what they're saying is it's not about the sugar being a potential substrate, a potential precursor to oxalate, but rather more so the relationship metabolically, with what's going on in the cell, right? What is going on in terms of the metabolic state there, that's going to determine whether there's oxalate production.

They supported this as they go on further, they state the formation of glyoxal. A product of cellular peroxidation may be accelerated in these cells when they're deprived of glucose, as increased peroxidation is observed under these conditions. The increase in oxalate synthesis and cells incubated with one millimolar sugar may in part be due to increase glyoxal formation.

And again, more [00:08:00] sugar led to less glyoxal formation. Again, supporting that. It's not actually the sugar, glucose or fructose that are implicated here, but rather the state of chronic stress and impaired mitochondrial function in states like insulin resistance. And then they touch on this a bit more with some of those kind of real wor real world studies.

And there's some good quotes here. First one where they state no increase in urinary oxalate was observed in one study with an oral load of 75 grams of fructose, which is the amount of fructose that's normally contained in two sodas. Two sugar sweetened beverages at once. And also not even touching on the fact that we don't absorb glucose fructose very well without glucose.

So there's probably an increase in endotoxin and other issues with that. But even there was no increase in urinary oxalate observed. But they do say, however, a short intravenous infusion of 35 grams of fructose did increase oxalate excretion. And again, this is a good example. We went through this with the uric acid episodes talking about, Richard Johnson and, and in episodes talking about Robert Lustig as well, where there's these [00:09:00] studies used that are insane relative to any physiological state that you could attain even, compared to 75 grams of oral fructose, which is a crazy amount that you would never that's also never an amount that you would get, on its own without glucose. Normally it would be coming with glucose and that would be, again, a really large dose.

But even then, that doesn't cause any issues. But if you infuse directly that amount, a massive amount of fructose, then you can start to see issues. And that's the kind of research that you have to do to show increased uric acid production or de novo lipogenesis. It's massive fructose loading oftentimes in rats, er, rodents as opposed to humans, which is a huge difference as well, or intravenous infusions.

And the reason why that's especially important with fructose is because fructose is cleared very quickly from the blood. So there's never really significant levels in the blood. There are normally 10 times or less that, of glucose, normally far less than that actually. And so I. To be intravenously infusing.

That amount of fructose obviously has very little to do with any, anything physiologically, but it's a good a good example here [00:10:00] of the way that a lot of this research is done, and I'm just gonna finish up with this last quote here, where they state, our study was designed to test whether fructose consumption over a 4.9 fold range would affect urinary stone risk parameters.

The upper limit 21% of calories would be equivalent to consuming nearly six cans of a sweetened soda. If the soda provided all of the fructose. Our re our results clearly showed that oxalate excretion was not affected by fructose consumption in the individual's tested token. I think a very clear conclusion there.

Mike: Yeah, I think one, a couple things to point out, because this is, it's funny actually, but even I guess you would say that both you and I probably have a high sugar intake in our diets. But I still am not having 75 grams of fructose in one bolus. That would be the equivalent of 150 grams of sugar.

So I'm not doing, I'm not doing even close to that at, in, in one sitting, which is what they're doing here. So even on people in a high sugar diet you're not seeing that much fructose given in one sitting. And then also, we've talked about this previously in [00:11:00] the uric acid studies provision of glucose with fructose for a variety of reasons that Jay, you already touched on massively changes how these things are metabolized and then what's the absorption and all this type of stuff.

So again, like changing the context, not to mention vitamins, minerals, polyphenols from the fruit, or having that in the context of a meal that has fiber, that has protein, that has fat, which is what you would typically see if you were like in, with the meal construction that we're talking about. So you're adding a variety of other variables here that are extremely important to consider with this type of stuff.

The next thing is and this one's always funny to me, 'cause it, what's the, there's the. The, truism that goes around that. It's like the blood only has one teaspoon of sugar in it at any point in time, and so therefore we don't need that much sugar. And it's so then you wanna quote research papers, like you see this in the low carb C meat, let's quote research papers where we give 35 grams of pure fructose not glucose.

Which is what's that? So a teaspoon is like four grams? Yeah. Five to, so you're looking at [00:12:00] nine times, not almost nine times more amount of sugar given intravenously in one time, in a form of sugar for, in terms of fructose that you would never see that level in the blood. And then saying, see, look, we have problems.

So it's like that's, it's a very interesting way to try, like obviously the researchers that are doing this for a particular reason to see what happens at the extremes, at the ends of the spectrums. But at the same time, like this is not even close to physiologically relevant, and it's like a weird, like inconsistency to cite research like this, which I'm not even saying that everybody's citing these papers, at least it, although in the fructose studies for uric acid, they are citing papers like this.

So it's it's weird to see that and then have this like conversation about the four, four grams of glucose inside the blood. It's just a, it's a weird dynamic. But overall, essentially what you're seeing is, and again they're talking about this in terms of like just pure fructose, not having it with fruit or these other components that are gonna shift a variety, your oxidative [00:13:00] stress status, your glutathione status, et cetera.

And also, potentially adjusting gluconeogenesis, how much hydroxyproline is present, et cetera. Having citrate present you're not seeing this change in oxalate production, so you're not even seeing an increased production from the carbohydrates. So I think this is like a. Pretty decent nail in the coffin for the idea that the carbohydrate would be driving oxalate synthesis.

Unless you were, unless there is starting to be like a fructose injection crisis going on where people are like, I need to get 30 grams of fructose into the bloodstream right now.

Jay: I think that's next after ozempic.

Yeah. I did just want to clarify something I mentioned before, which was that after a 75 gram fructose load, normally you might get around 10 times less of the amount of like a fasting glucose level in the blood.

So you're still talking very small amounts, but like fasting levels of fructose are like 200 times less that of glucose. So yeah, two, we're, when we're talking about intravenously infusing 35 grams and we're talking thousands of times more fructose than is ever in the blood, so totally irrelevant, of course when it comes to any [00:14:00] physiological context.

But as you said, very much nail in the coffin there. And so let's move on and talk about. Action steps people can take to prevent reverse or deal with oxalate issues? Or to prevent, yeah, to prevent them from developing or just to be aware of them and kinda where to draw that line. And I will say before we start here, this is an area that does have it, it's very difficult to have concrete recommendations here for a number of reasons.

For one, the amount that is harmful overall is not clear, right? There's no clear data to show that after this amount of oxalate exposure, there's, you're going to start to see an issue. And that's because there can be so many factors affecting, kidney function and ability to clear it. And again, how much citrate are you having and what's the pH of your blood?

And on. Not to mention it's, very hard to quantify. How much endogenous production might change at a time. There's very few studies looking at oxalate deposition and tissues outside of the kidneys 'cause that would require biopsies and things like that. So it's not an [00:15:00] area that has really clear research in terms of things that would make it easy to create, a clear line

Mike: in terms of oxalate amount.

You're saying it's hard to say what's the like absolute threshold where it's like this amount of oxalate iss a problem. It's you hard to say that 'cause there's so many confounding factors on it.

Jay: Yeah, absolutely. And not to mention all of the other things that we've talked about that will affect absorption.

How much calcium are you having? How much magnesium? How's your fatty acid digestion? How is your bile digest like bile flow? I mean there's, are you dealing with intestinal permeability? So many different things that'll affect your absorption, percentage of oxalates, and then so many things that can affect your liver function, which can affect how much you're clearing or producing, and then things that can affect your kidney function, which would affect how much you're clearing.

So it does become a little bit tricky. And when it comes to navigating that, on one hand you can use symptoms, right? And if you notice symptoms with certain high oxalate foods, it's something to be aware of as a possible driver of those symptoms. It's also worth mentioning that joint pain can be driven by endotoxin [00:16:00] and might have nothing to do with oxalates as can kidney issues, right?

Can kidney disease and endotoxin have a relationship as well? And there's so many other possibilities when it comes to reasons why you might have symptoms from moderate or high oxalate foods. If we're talking about starches like potatoes and sweet potatoes, if you don't respond well to those, it might be a starch digestion issue that, you know, your, that starch is feeding bacteria, might have nothing to do with oxalate content.

So it does become a little tricky, but. What I would, say is oxalate is an anti nutrient of course, and does interfere with the absorption of other of things like calcium and magnesium. So we wanna be aware of that. And there are certain foods that are astronomically high in oxalate, and so we'll talk about which of those are, but it does generally make sense to minimize those.

It doesn't mean avoid them at all costs and if they're, if you're if you don't really have clear oxide issues, having those occasionally might not be an issue for you at all. But it is something to be aware of like we would with other antinutrients. So I'll pause there and let you go ahead, [00:17:00] Mike.

Mike: Yeah. I think ultimately at the end of the day with all the dietary stuff, if you have a bad reaction to something, then the number one, don't keep doing it at the beginning and then you could try to figure out what the deal is. Instead of just oh, it's all oxalates, or it's all fructose or it's all the alkaloids or nightshades, whatever the deal is.

'cause just as an example of this, I don't di like for personally, right? And I've seen this with clients as well. I don't digest I don't digest starches very well for me, right? That's why I do better, I do much better with sugars. But so I could try potatoes and I could say, Hey, I have a bad response to potatoes.

They make me a little sluggish. They change, they slow down my bowels, things like this. Again, maybe I'm a little bit my, my thinking isn't as clear if I have to have them too much consecutively. It's oh yeah, that's just oxalates. But then the next question is like, why can you eat a hundred grams of dark chocolate today without any problems?

So then the question is is it really oxalates? Because the dark chocolate oxalate content's gonna be significantly higher [00:18:00] than a potato. So you wanna be clear. On what the actual issue is. And the way you can do that is just by empirically testing things with like how you respond to different foods in your diet.

So like you can get as detailed as you want and all the mechanisms and all the components. But at the end of the day, if you eat a bunch of spinach and you feel like crap, then just don't eat the spinach. That's what it, that's what it's gonna come down to with the food selection. And then on top of that, the other thing that we'll get into here is there's so many factors that you can bring on board that will adjust how much oxalate you, you can tolerate, right?

So if I getting, if I'm doing a hundred grams of dark chocolate a day and I'm getting 250 milligrams of oxalate, but every meal that I have, dark chocolate, I'm having fruit juice that has citrate and I'm also having calcium and magnesium and stuff like this, that 250 milligrams of dark of oxalate from the dark chocolate is probably not gonna be that big of a deal.

And then, if I'm doing that, I'm not really getting these symptoms from it, then it's okay. Probably not that [00:19:00] much of a concern here. I'd be more concerned about, maybe, for example, if I wasn't getting that much calcium and I decided that I wanted to go on a juice cleanse and just drink raw spinach juice every single day.

And I, and then, and I'm also on a low carb diet or whatever the deal is. So I think that under the contextual factors become really important. And then within your context you can just, test out the different foods and different components. And there could be a variety of reasons that they're not an issue.

So in all circumstances, I think we wanna get clarity on what the problem is. 'cause if you if you start to just say it's all oxalates and you start cutting things out, and that's not the actual problem, you can actually create new problems and more constraints on yourself and think long term. What I see with quite a few clients is that they actually get to a point where it's I don't even know what to eat anymore.

I can't have fructose 'cause of this. I can't have all these foods 'cause of lectins. I can't have these foods 'cause of oxalates. I can't have these foods because. They have pofa and it's I what do I even eat? It's like you just eat chicken or I can't have beef because [00:20:00] iron causes colon cancer.

So they're just like, I'm, all I have is chicken and now I can't even have that. 'cause the amino acids, there's tryptophan and whatever else. And I think that's why you want to be very clear on what are the specific problems in your circumstances and what are the priorities that you need to focus on when you are setting up your diet and you're trying to get your health under control instead of broadly swathing out.

Like all of these things, just like ad hoc. So I think clarity, testing things out systematically, going through things and figuring out what works for your context is absolutely essential. And again, like there's, as you can see, even with the oxalate question there was, it's more than just yeah, I just don't eat spinach.

There's a lot of factors to consider in this, which I obviously why we're making this podcast, but that will even modulate spinach. So if you're having spinach plus calcium and the spinach is boiled, is that really gonna create as much of an oxalate problem as it would if you didn't have like calcium, magnesium and it wasn't boiled, it was juiced.

Like those are gonna massively change things as well. And maybe the spinach was juiced and it was mixed with oranges and apples, like granny smith [00:21:00] apples or something like this. Now you have maleic acid, citric acid, and then you add calcium, magnesium to it. That will massively change the dynamic as well.

So that's why I think it's hard to say yeah, just like after, after 50 milligrams of oxalate a day, like you're done, you're toast. I think that's that's a very that's statement is pretty tenuous in my mind given all of this context.

Jay: Yeah, for sure. And I think again there's this kind of balance we're talking about, which is, on one hand you could be sensitive and have oxalate issues.

If that is the case, let's figure out why that is, which of the many mechanisms that we discussed could be involved in your case. And we'll talk a little bit about that today and what some strategies might be to help you there. And in that time period while you're working on sorting that out, if you have confirmed it with careful testing and looking at patterns and all of that, then yeah, be careful with oxalate containing foods.

Absolutely. But if instead this is not something that you notice any significant symptoms from, that doesn't hypothetically mean it can't cause an issue for you. And so with that in mind, it is something to be aware of. It is important to be aware of the worst offenders here and to, [00:22:00] know that we shouldn't be juicing spinach or consuming raw spinach in any significant amounts.

Like I do think that's important too. But the extent to which we need to avoid any oxalate containing foods, obviously is very different. And there is much more tolerance in the state where we don't have. Particular sensitivity or issues with oxalate containing foods, and especially considering that ideally we're implementing things properly, we have really good thyroid function and liver function and kidney function and everything else.

So that this is generally much less of a concern for us. And obviously we have good calcium intake, all of those things. Now I do wanna mention, when it comes to experimenting properly and understanding all of the different factors that can affect our health whether we're talking what can affect our general metabolic state digestion, sleep blood sugar hormones.

There's a program that I offer called the Energy Balance Solution. In that program, I do help you sort all of those things out. There's clear action steps and strategies in there, as well as personalized guidance from me in that program. There's customized health coaching. There's a video [00:23:00] library with videos on tons of these different topics as well as resources, like a sample meal plan, recipes, a calorie and macro calculator, supplement guide private community, and tons more.

So you can head over to Jay Feldman wellness.com/solution to check out all the details for the Energy Balance Solution Program. So let's dig into some of the specifics in terms of oxalate containing foods, which ones are the worst defenders, and what we might want to do to help reduce our exposure reduce the availability of those oxalates.

And the first thing that is important to mention here, much there's a lot of difficulty in coming to concrete recommendations for how much oxalate is okay and all of that. There's also the issue of looking at oxalate content and food because there's huge variations in terms of reported amounts of oxalates in foods.

Sometimes differences of, several hundred milligrams of oxalate per a hundred milligrams of the food since that's normally how it's how it's noted. And there are so many details that are missed as well, that affect oxalate content of [00:24:00] food. So for example, when we're looking at fruits or vegetables as well, ripeness makes a big difference in terms of the, or a difference in terms of the amount of oxalate in there.

Then there's also the way that we consume those. For example, a lot of times oxalate being an anti nutrient exists in the skins, like the outer parts of the fruits and vegetables, the pulp, the fibrous parts. And so there's not always it's not always effectively quantified that amount. And there's not a lot of studies looking at peeled or actually, I don't know of any looking at, peeled potatoes versus unpeeled potatoes and their oxalate content.

I've seen it a little bit with sweet potatoes, but, there's a number of different scenarios here. Same would be, with carrots, right? If you peel that outer layer, how much oxalate is getting cleared out there. So there's huge gaps in knowledge in the research and also huge variation in the research.

When it comes to the oxalate content of food, which makes it even more challenging to have concrete recommendations here. And just to touch on it really briefly, there's a study where they have a good quote explaining this and to study titled Oxalate Content of Food, a [00:25:00] Tangled Web. And they state oxalate content was extremely variable between various sources.

Fruits with the widest observed range of oxalate included oranges at between two and 10 milligrams per hundred grams. Bananas between zero and 9.9 milligrams per hundred grams among vegetables. Oxalate contents of spinach range between 364 and 1,145 milligrams per hundred grams. Rhubarb between 511 and 984 milligrams per hundred grams.

And beats. Between 37 and 794 milligrams per hundred grams. Those were the most variable among nuts. The oxalate content of peanuts ranged from 65 to 349 milligrams per hundred grams, and pecans ranged from four to 404 point one milligrams per hundred grams. So again, just speaks a little bit to the state of knowledge, currently when it comes to ate content of foods, which also makes concrete recommendations here a bit challenging.

Mike: I think it's clear to see [00:26:00] which are the most bioenergetic foods there. It's clearly the spinach rhubarb and the peanuts and potentially the pecans. Yeah. All things that like that. I think in jokes aside, like inherently I don't think we really recommend those as major options inside the diet.

I think, the, a lot of these components, something you keep in mind, just a general heuristic, maybe not. Extreme, like the most precise thing. But when you're thinking about the foods for consumption, the fruits are generally meant to be, and in the sense that they're being produced so that other organisms will come by, eat the fruit and scatter the seeds somewhere else.

Whereas the leaves, the roots the nuts, the seeds, these types of things on average are meant more so to help, to either provide energy for the plant or to have the plant pass this progeny on somewhere else. So they're generally have components present in them that make them more difficult to digest, make, create, have ob noxious effects so that you don't digest 'em on a [00:27:00] consistent basis, which I think potentially why you're seeing a higher oxalate content in some of these other tissues.

'cause basically if you have an organism that was going to eat large amounts of spinach or rhubarb, they could actually develop an issue, especially if it was raw, where they would get sick from the amount of oxalates that are present. So that, that could be a potential reason or strategy that the plan incorporates to try to deter predation on the vital organs of the plan.

It's don't really want my arm eaten, I prefer that I eat my arm intact and, maybe my leg as well. And I also don't want anybody eating my children, like you see with the nuts and the seeds. So I think that's why you're potentially seeing a higher content of these things and these other options.

And I think if you're already incorporating bioenergetic principles into your diet, with the exception of something like dark chocolate, you're probably not gonna have a super high oxalate load. And one thing I do wanna mention here, just briefly, and this is something I guess maybe slightly contentious in the sphere, but the idea of drinking the broth from the cooked [00:28:00] green vegetables, that had been something discussed I think on the forum in previous times.

At least from my perspective because you will leach things like oxalates and some of the glucosinolates and other components into the water from the green vegetables. I typically don't recommend like drinking the broth from green vegetables or things like this. And I usually don't even recommend a lot of these green vegetables because again, in order to get the MI vitamins and minerals outta spinach, you've, number one, it's gonna be hard because you're gonna have, a lot of 'em are bound up with oxalates, but so you're gonna have to boil the spinach and then in boiling the spinach, you're gonna leach the components anyway.

So the paper values for nutrients, for things like peanuts or pecans or spinach or rhubarb or these different components on paper they look good. But when you think about the things that you're absorbing, 'cause you are what you absorb, not necessarily what you eat, then you may find that these things actually don't look that good in the long run.

And that's something to those, just a couple interesting points I think to consider with some of the food [00:29:00] selection. 'cause again, like a lot of these things where we wouldn't typically even recommend. Although they are big things in low carb spheres or vegetarian or vegan spheres, or even in like your Mediterranean diet or traditionally what, or what's traditionally understood as a healthy diet with high amounts of, spinach and green vegetables and salads and stuff like this.

Jay: Yeah, absolutely. And just to touch on that with the greens real quick, there's also massive difference between different types of greens, right? When we're talking spinach charred bee greens, could definitely pose some major oxalate issues. If instead we're trying to get minerals from collared greens, bok choy, kale that, those would be much better sources that are far lower in oxalate.

So it can vary quite a bit between different types of greens. And with those we would wanna cook them due to, genic concerns and all of that. But yeah. Let's talk a little bit about in general, how to prepare food. In a way that minimizes oxalates while we're talking about cooking or just how much of an impact that has.

You touched on it where, raw spinach and cooked spinach can be different beefs. [00:30:00] Even cooked spinach is still very high in oxalates, but it's still a massive difference between them. And same with some other foods too. So we'll touch on that and then we'll go through some examples of, high oxalate foods and some examples of of, constructing bioenergetic style diet and different oxalate content there.

So in this study titled effect of different cookie methods on vegetable oxalate content, they looked at a number of different vegetables, spinach, charred beets, broccoli potatoes carrots, and looked at different cooking methods, steaming and boiling and things like that. Again, as I mentioned, unfortunately they didn't do peel, like they didn't look at the amount of the peel or try peeling them and see what kind of a difference it made.

But they did touch on the impact, especially of boiling on oxalate content. So they state boiling markedly reduced soluble oxalate content by 30 to 87% and was more effective than steaming, which reduced it by five to 53% and baking, which they only used for potatoes and didn't cause any oxalate loss.

Now, I do wanna mention the soluble oxalates [00:31:00] is the primary concern because those are the ones that are absorbable, as we talked about before. Insoluble ones are much less of a concern. They're not really concerned at all since they don't get absorbed now, which they state here. They state because soluble sources of oxalate appear to be better absorbed than insoluble sources.

Employing cooking methods that significantly reduce soluble oxalate may be an effective strategy for decreasing UR in individuals predisposed to the development of kidney stones. So as they touch on there, much less absorption with insoluble oxalate. And when it comes to, and you could, take a look at this study and there's some good charts and figures in there.

But when it comes to spinach, which is generally pointed to as one of the worst when it comes to oxalate issues boiling led to a 60% loss of total oxalate. And from soluble oxalate, there's an 85% loss. So that's a pretty massive difference. As we mentioned, when we're talking about the amounts here, it's still, there's still it would still fall into category of a high oxalate food, but the difference between boiled spinach and raw spinach is massive.

Mike: Yeah, the thing is, it'd still be higher than what you'd see with some of the fruits that are [00:32:00] even considered at a higher point in general. So overall here's the thing with some of the green vegetables that we're looking at, or some of the leafy greens, I think one, they're not as nutrient dense because of these components.

And then and then they also aren't really providing any macronutrients overall. So like the major benefit that I think they'll show is that there may be some shifts in the microbiome and they could be a good fiber source, but as far as like nutritious foods, when I'm thinking about setting up the diet, I'm not really thinking about spinach or shard or beet greens or things like this.

I'm thinking that ideally, like if you look at animal foods, you look at meat, you look at seafood, if you tolerate dairy, you look at dairy and you incorporate fruits. Like you can have an exceptionally nutrient dense diet from both a macronutrient and a micronutrient perspective that are highly absorbable.

Without, again, like the other benefit is you don't have to do as much preparation. You don't have to, boil the crap out of all the stuff because it's, there's like much less toxic load altogether, and a lot of [00:33:00] things are much more absorbable. So I tend to look at, I had to look at these foods as a primary setup.

But again, like if somebody was to have a bit of boiled spinach and they didn't have oxalate issues and they wanted to incorporate in their diet, sure. That's like I don't e especially again, if they didn't have oxalate issues, I think it's not as big of a deal. The only sad one on here for me, which we'll get to in a second, is just dark chocolate because, dark chocolate is a exceptionally exceptionally delicious and I think a lot of people enjoy chocolate and it does have a relatively decent oxalate content.

Overall though, I think dark chocolate versus just pure cacao powder is, has a significant decrease because they do ferment the dark chocolate, which is another method to actually minimize the oxalate formation. They ferment the beans to get the dark chocolate and then they dry them. So I think that, there's a part, these are par potentially part of the reasons why you have a.

Treatment of some of these things like chocolate to get to minimize some of these components Also, enhance the flavor profile and things like this.

Jay: Yeah, and we'll talk about it a bit with cassava as [00:34:00] well, a lot of these foods that have been eaten for a very long time that do have potential concerns here, they tend to involve processes that help to lower the oxalate content.

As you mentioned with cacao, it's it is fermented, which helps to reduce the oxalate content to some extent. Obviously, there's a number of different things that go on when it comes to cassava, which we'll talk about that lower oxalate levels. But yeah, as you mentioned, fermentation is another factor that can lower oxalate content to some extent.

So when it comes to the kind of worst offenders here, the things that are highest in oxalates, we've already touched on most of them, but just to be clear, we have spinach, charred beet greens. Those are probably, those are the three greens that are really highest and most concerning, and they have oxalate levels between 600 and a thousand milligrams.

Per a hundred grams. So these are, really the worst offenders other than rhubarb, which is also right up there at about 800 milligrams per a hundred grams. So these are all ones to be careful with. Again, boiling can reduce de oxalate content by, 50% or more. More. We're looking at the soluble levels by more than 80%.

As you [00:35:00] said, cooked or boiled beet greens or spinach, they don't have to be a hundred percent off the menu. But y we definitely wanna be careful with raw or juice, spinach. I, those would probably be on my avoid list as far as cooked goes occasional here or there. Fine. See how you do with it.

And obviously for a lot of people, oxalates are not an issue. Just something to be aware of with those kinds of things. Not a reason to a hundred percent. Always avoid them

Mike: before you go to the top worst defenders. Just another piece to add is if somebody's asking me if what I think about a salad, I typically recommend using something like lettuce instead of spinach or even like a rugal or stuff like this.

'cause you have. Lettuce, you have a nitrate concern to some extent, whereas with spinach and arugula, you have the oxalate and then the genic components. So in the lettuce, the salads are typically obviously consumed raw. So again, this is in the context of somebody who wants to have a greens for their, wants to have greens for their salad.

Obviously you could do the carrot salad. I'm not saying not to do that, but if some, I have quite a few clients like, look, I like having a [00:36:00] little bit of a side salad with my meal. It's yeah, I would probably use like a lettuce instead of doing like a spinach or a, some type of cruciferous vegetable, like an arugula.

Such you can minimize some of those toxic components while still getting the general feel of having a salad. And you can also put carrots in there, whatever the deal is, things like this. So it's the cruciferous TROs and then spinach, shard, bee green, stuff like this. Hot, much higher in much higher obviously in the oxalate.

So it's like from the problem with lettuce, you just have nitrates. Which, high amounts of nitrates also aren't great. But I'd say comparatively of the three, probably not as bad as the other two overall, at least in my perspective. Again, 'cause like you're not really having that much lettuce typically for a salad.

Jay: Yeah, definitely. And I, I don't have a strong objection to throw a bit of arugula in there. I do think the concentration of gins is less than most of the crucifer, but definitely still a consideration for sure. Especially 'cause it is eaten raw, whereas with the crucifers, you can cook them and it helps to break down the TROs.

And then if you were to [00:37:00] add, almonds, cashews to the salad, then we have some concerns. Obviously these are foods we don't encourage the consumption of anyway, because they're very high in pufa and they're high in various antinutrients and that includes oxalates. So almonds, normally it's quoted around four 50 milligrams per hundred grams and cashews are around 250 milligrams per hundred gram.

So also very high oxalate foods. And that brings us to cacao, which, when we're talking about raw cacao or raw cocoa powder it's a very high oxalate food at around 600 milligrams per hundred grams. And so if you're adding that to your, spinach smoothies or something like that, you could really easily have, a thousand milligrams of oxalates at a time.

It could be a pretty high oxalate load. Definitely something to be aware of. But when we compare cacao to chocolate, there is a number of differences because the cacao itself we're talking about just the non-fat portion of the original cacao bean. It's just the, mostly just the protein.

And so that's the part that has most of oxalates in there. But when we're talking about even a hundred percent [00:38:00] dark chocolate, that has the fat in there as well, the cocoa butter, it's going to reduce the amount of oxalate in terms of concentration. And then the less dark, the chocolate, meaning the more other ingredients, whether it's sugar or fruits or whatever it is, will also decrease the concentration of oxalate.

So you could still be getting, a couple hundred milligrams per a hundred grams of chocolate. So it can still be a decent amount, but it would depend. And, the less dark, the chocolate, the less there will be. And along with that milk chocolate is another great way to reduce the concentration of oxalates in the chocolate, assuming you do well with milk, where that again is going to dilute the amount of cocoa in there further.

And so with that, you could get as low as around 70 milligrams of oxalate per a hundred grams, where it becomes, moderate oxalate containing food. So still one to be aware of, but there's going to be far less with milk chocolate. And if you wanted to even go a step further and do something like white chocolate, which has the cocoa part totally removed, you just have the cocoa butter and sugar and milk typically.

And there you'd presumably be getting nearly zero milligrams of oxalate per [00:39:00] hundred grams.

Mike: Yeah. So basically you have. At the top cacao powder. Then you have cocoa powder, which is basically fermented cacao powder. Then you have dark chocolate. And then within dark chocolate you have a hundred percent as the most.

And as you go down, like even the 50% dark chocolate, you basically have less cocoa powder 'cause you have more chocolate. Or you have more sugar with the chocolate and less cocoa powder altogether. And then from there you have milk chocolate and then you have, white chocolate, which is basically doesn't have any any cocoa powder at all.

So there'll be the tiers from an oxalate perspective. And you could also, you could probably do like a mixture of cocoa butter plus some other components that aren't the cocoa powder. If you still wanted to get the fat and you didn't want to get the dairy components as well. And that would still be pretty low.

I've made something like that with clients previously 'cause they weren't doing well dairy, but they were worried about the oxalates from cocoa and stuff like this. So they weren't doing so well with the cocoa now, but they still wanted to get the cocoa butter, which is obviously a really great fat source altogether.

So yeah, that's a. I think those are all pretty good options. And again, like if you're having your [00:40:00] chocolate with calcium and maybe you're having it with like fruit juice. So your meal is, you have, some orange juice, maybe you have cheese, maybe a little chocolate, or maybe you have orange juice, you have some Greek yogurt, then you have a little chocolate, maybe some fruit.

The absorption of that oxalate from that chocolate is probably gonna be exceptionally low because of the amount of calcium that you're adding plus the citrate that you're getting from the juice that you're having with the meal. So even then, if you were doing, 'cause as an example, like I do pretty well with dark chocolate.

Altogether I haven't really ever had oxalate issues with it. And it does have a decent amount of oxalate, but it's just, I'm always having it with fruit juice and I'm having it with calcium and components like this and also magnesium. That would arguably drastically, I think we said my current calcium intake, I think is about 1.7 grams per day.

Which would put me at the absorption, I think we talked about in a previous episode, only 1.6% absorption or something like this, of the actual oxalate when you hit roughly 1800 milligrams per day. So you're seeing a [00:41:00] pretty significant decrease. Even if I had the 250 milligrams of dark chocolate, I would only be getting about three milligrams of the oxalate from that absorbed, assuming the 1.6 absorption.

So because I'm having calcium with it. So basically that, even though you have a higher food, you could drastically decrease absorption with adequate calcium intake. And then even the amount that gets absorbed, because I have the citrate intake coming in from the juice that I'm having, and essentially it's not, it's unlikely that it's gonna form as a stone because a citrate's gonna inhibit that stone formation altogether.

Plus there's also high amounts of potassium and other minerals present with the fruit and juice that I'm having with the meal. Or if you're to have a dairy product, same type of deal.

Jay: Yeah, absolutely. And again, just to clarify, 'cause I know you were touching on the calcium intake, but it is worth mentioning you don't need to have the calcium at the same time as the oxalate.

As long as you're getting enough throughout the day, it has that effect. Whereas, as we were talking about, the magnesium is a little bit more time dependent, but if, there is some magnesium and chocolate too, which, which can help there. And if you are doing the milk [00:42:00] chocolate, you do get some of that calcium right there with the chocolate.

So maybe that can be the perfect food, of course, for people who tolerate for people who tolerate the milk well. So one other high oxalate food dimension here is soy, which the soy protein itself, if you're using soy protein powder, something like that is pretty high, as high as 500 milligrams of oxalate per a hundred grams.

If you're eating the plain soybeans quite a bit less, about 60 milligrams per a hundred grams. Although again, not something we would recommend due to estrogenic content, phytoestrogens, all of that. And pufa, if you're getting a decent amount of the fat from soy, of course. So of course that one wouldn't be one we would consider anyway, but.

When it comes to the kind of moderate oxalate foods or moderately high ones, there are a handful of foods in there that are often recommended in the context of a bioenergetic diet. This includes potatoes, sweet potatoes potentially cassava as a, grain alternative. Normally used as a flour beets, carrots.

So with these types of foods, generally, when we're looking at potatoes, we're looking at about 30 milligrams per a hundred gram [00:43:00] for a hundred grams of raw. If it's boiled, that drops a little bit to 25 milligrams With sweet potatoes, it looks it's around 60 milligrams per hundred grams, at least in the flesh, and that's raw.

Again, some studies show higher amounts, but I would it has been shown that the concentration of the skin is much higher, so that can be the reason for that. Cassava is a very high oxalate food when it's raw as, as high as 1,250 milligrams per a hundred gram. But with all the processing that's done.

By the time it's a flower, it's much lower at 150 milligrams per hundred gram. It still is moderate of course. Beets are about 60 milligrams raw and that can drop down to about 50 milligrams. Boiled and carrots. We're looking at typically in the low and, 40 milligrams or so per a hundred grams for raw carrots.

Mike: Yeah, and I think this is another reason too, to number one, peel your potatoes and your sweet potatoes, because essentially a lot of people are, oh, I'm gonna eat the skin. It has all these nutrients, all these components, but the vast majority of the defensive compounds in tubers are in in the skins, in the [00:44:00] first few millimeters of flesh.

So basically we, I would say we wanna minimize, you wanna peel your potatoes and then with sea potatoes and also boil them. And also with the cassava too. The cassava has to be processed not only because of the oxalates, but also 'cause of the genic compounds in it as well. So it has, you, the cassava really needs to be prepared well.

And the other thing to mention is that the amounts of these things are probably gonna vary based on the growing conditions in the soil. So I think as the, if the plant stress, depending on the nutrient availability the plant may produce more oxalates versus, or less oxalates. And that's the same thing with other nutrients as well.

So you can see, in some studies you'll see that broccoli sprouts or broccoli is gonna be really high in selenium and in others maybe not as much. And again, like there's gonna be variations in a lot of these things because you have the food being grown in different areas where the act, the nutrient contents of these different areas are gonna be variable.

I think that's another thing that's important to keep in mind is that you could even, you could probably get lower amounts, but I think you were providing us averages here, Jay, as far as what [00:45:00] you can typically expect from these serum foods.

Jay: Yeah. And again, considering the tangled web, some of these numbers could be off considerably, but we're limited in our actual, in, in which studies you wanna go based off of and the variability between those studies.

But. But yeah, as you were saying, ripeness, soil conditions can all make a big difference. Not just oxalates, but for different defensive compounds produced from the fruits or vegetables or whatever it is. So yeah, all good considerations there. And as we mentioned, a really important consideration will be consuming enough calcium, so we'll talk about that.

But first I went through and created a few different examples of bioenergetic diets with some different tweaks that you could make to really lower the oxalate content if it is something you're concerned about. And these are all based on 400 grams of carbohydrate intake a day. So we're, it's probably gonna be on the higher end for most people.

Some people could be, much higher, five or 600 grams a day, but I think a lot are probably below that 500 gram mark, depending on body size and general caloric needs and everything. But so this would just be looking at general [00:46:00] estimations, of course, 'cause. We don't have, concrete values based on all the factors, but just some general estimations that would be worth considering.

And so this first example would be like someone who's not at all thinking about oxalates. Maybe they're consuming a bit more sweet potatoes, bit more dark chocolate bit more whole fruit, and especially pick some of the fruits that are known to be highest in oxalates, which are oranges and raspberries.

But it's worth noting when it comes to oranges, for example, a lot of that, or actually the vast majority of that oxalate is in the fibers parts of the orange. So when you instead look at orange juice, the amount of oxalate is pretty negligible. It's nearly none, but oranges instead, the whole fruit has a bit more we've touched on this before.

When you look at animals in the wild, eating things like oranges or figs or other fibers, fruits, they tend to spit out the fibers. And so I, there could be an argument that because of the anti nutrient content, the difficulty to digest them, the. That could be a factor here. So just throwing that out here.

But raspberries are another one that are known to be pretty much highest as far as fruits go in terms of oxalate content. Whereas the vast majority of [00:47:00] fruits, grapes, papaya, mango, pineapple, melons, berries, bananas that are ripe apples generally are very low in oxalates. And then the juices too tend to be very low in oxalates.

But let's say we were trying to pick some of the highest oxalate fruits here. Decent amount of sweet potato, dark chocolate, baked potatoes instead of boiled. Same with the sweet potatoes. So we're not really doing anything to try to lower those oxalates. And then we get some other carbs from mango, watermelon, rice.

We have a carrot as well, of course, which can add to that oxalate load. So again, this is aiming for 400 grams of carbs. And if we do that from these sources with this sort of breakdown, we could end up consuming about 500 milligrams of oxalate a day. And with the. Absorption estimate, assuming we're just getting around, a thousand, 1200 milligrams of calcium and not more, which of course more would help to lower this even further.

But let's say we're assuming about a thousand to 1200 milligrams, we're assuming about 5% absorption, which we don't. When we were looking at some of those studies before, they did one diet example that had 250 milligrams of oxalates, which [00:48:00] was a little bit higher. It was like 5.8% absorption or something like that.

Here we're assuming 5%. I think it could be even a bit lower, especially if you consider some extra calcium. But even we'd be getting about 25 milligrams of absorbed oxalate from this diet. If you're really sensitive to oxalates, of course that could be an issue for you, maybe due to increased absorption in your case, if you're not digesting fats well, if you've got intestinal permeability or various other issues.

Or due to excessive endogenous production ordered issues with clearance to the kidneys. So this could be, too high for some people, but for others this might be totally fine and not actually an issue. But if you were concerned about this being an issue, there's a couple of small tweaks we could make that could cut that oxalated in half and then even lower pretty easily.

We'll look at this other day on chronometer where there are just a couple of small tweaks. So we cut down the sweet potato a little bit and replaced some of that with regular potato. That's still baked, right? We're not going the boiled route. But we've traded the whole oranges and the raspberries for orange juice, which you know, would also significantly [00:49:00] lower the amount of oxalate.

And so with that, that'll dramatically lower the total amount of oxalate to about 350, 360 milligrams per day. And and again, this will vary. I know, as we were saying, like chronometer won't have the exact. Estimates that we're going off of and all that, but it's all pretty similar.

And if we're assuming a slightly higher absorption here of about five point half, 5.6%, then we'd be getting 20 milligrams of oxalate per day. And again, I, what I want to touch on too is, and we alluded to this, but there's a pretty large difference in oxalate intake from 500 to 360, but only a difference of five milligrams of actually absorbed oxalate.

So just to get an idea of how cons, when we consider absorption and we're not even considering getting extra calcium or anything like that, it really diminishes how much of a difference oxalate intake can make. Again, big caveat here being that if you deal with oxalate issues, there's probably a good chance that you have excessive oxalate absorption.

And so you might need to be more careful while you work on sorting that out. And so in this last diet, we're looking at again, a slightly more oxalate conscious approach. [00:50:00] We've traded out the sweet potato for potato and a little bit of extra orange juice. Still getting some whole fruit in there as well and some rice.

And we've also traded out the dark chocolate for milk chocolate. And in this diet we've dropped our total oxalate intake to about 180 milligrams a day. And assuming with a slightly increased absorption, maybe around 6.6% again, estimated we might be down to about 12 milligrams have absorbed oxalate and this is still getting, 400 grams of carbohydrates from great sources.

And obviously there's tons of other options. Tons of other fruits and juices we can mix in here. And yeah other root vegetables and things like that you could bring in here to keep the oxalate intake particularly low if it was something that you were concerned about, and again, that's not even touching about other factors that would also affect the absorption and clearance of oxalate.

Mike: Alright, so outside of adjusting the food source of oxalates, we can actually adjust components that number one affect our endogenous production of oxalates. As well as affect our absorption and absorption of oxalates as well as the ability of the [00:51:00] ox deform crystals. So we obviously talked about this already, but calcium, magnesium can directly affect the absorption of oxalates.

So we discussed this in our previous episode and also we mentioned it here multiple times. Another component we talked about is citrate can help to inhibit the formation of of oxalate stones. So again, citrus fruits, other fruits like pineapples, berries, cherries, et cetera, can be quite helpful for actually minimizing the formation of the calcium oxalate stones.

We've talked about in a previous episode that high vitamin C intake may potentially spontaneously convert into oxalate. So being careful of like supplementing or super dosing vitamin CI think if you're getting it from food, it's likely gonna be okay with all these other factors. 'cause most places that you're gonna get this vitamin C intake from are gonna be things like fruits, which are also gonna, they're gonna come.

With the citrate, present with the vitamin C as well as polyphenol compounds and help adjust oxidative stress. So those things might be helpful. So I think those are some of [00:52:00] the, some like very simple things from the diet or from supplement supplementing components. We also talked about collagen and we talked about gelatin.

Gelatin being a source of hydroxyproline and high amounts that may increase oxalate production through the pathways that we've discussed as well. And in converting to gly oxalate and then eventually converting to oxalate. So if you're having issues with your with oxalate issues, maybe being careful with your gelatin intake or your collagen intake and then maybe using something like glycine instead.

I think all of these are very basic strategies that you can make shifts with based on your symptoms and based on what's going on to help minimize endogenous oxalate production as well as minimize absorption on top of adjusting which foods you're incorporating in your diet that actually have a high content of oxalates.

Jay: Yeah, absolutely. And so just to touch on a couple of those things, again, generally not going to be particularly concerned about vitamin C intake in foods. Again, maybe if you're very sensitive, it's something to be aware of. Same with hydroxyproline, right? Most people are totally [00:53:00] fine with significant amounts of collagen, gelatin, bone broth.

Again, if you're sensitive here, then yeah, that amount of hydroxyproline could be an issue. And so especially if you're eating massive amounts of protein and you're getting massive amounts from those sources it might be something to be aware of if you're dealing with oxide issues and if that is the case, if you seem to have issues with those foods, you could try just pure glycine.

But yeah, those are some, broad spectrum things to consider. Another important one, of course, as we talked about in the last episode, is making sure we're getting enough carbohydrates, considering all the different mechanisms through which a lack of carbs can contribute to oxalate production.

Increases in oxalate production, decreases in clearance. A couple other things we might want to pay attention to, and I should mention as well. We're just trying to get into some details here that are specific between diet and oxalate concerns. One, if you're wondering, about our broader perception, thoughts and suggestions when it comes to diet.

We did a couple of episodes talking about the kind of bioenergetic diet basics, so I'll link back to those. But carbohydrates being incredibly important, being careful [00:54:00] with excess protein due to the increased gluconeogenesis, the effects on pH levels in the blood, and how that affects the kidneys.

So that's something to be aware of when it comes to fat intake. We want to be very aware of how we're digesting it. Again, when it comes to people who tend to have these oxalate issues, there tend to be tends to be increased oxalate absorption, and that coincides in many cases with issues with fat digestion.

And we talked about the mechanisms for that, issues with bile flow. So you might need to moderate the amount of fat you're consuming. You might need to decrease the amount of saturated fat you're consuming if you seem to have symptoms with those kinds of foods. So that's something to certainly be aware of.

And then one that of course we've talked about many times is the polyunsaturated fats. And, it's just worth noting here that a, the oxalates tend to induce damage by causing oxidative stress and that contributing to damage of the fats and the membranes of the cells, the structure of the cells.

And the more poof that we have there, the more susceptible we'll be to that damage. And so we [00:55:00] definitely wanna make sure we're minimizing the consumption of the polyunsaturated fats. And so that's one consideration. And the other is that in general, when we have higher oxidative stress and those fats are getting damaged, which honestly it just happens, if you have a lot of pofa just being in our, in, the human body with a lot of oxidative things going on, you're going to have lipid peroxidation.

And that will be a direct precursor to Glyoxal, which is a direct precursor to oxalate. Another reason to make sure we're minimizing proof of consumption to reduce endogenous oxalate production.

Mike: And something I want to, I wanna point out here as well, is that. It's, I think a combination of these things, especially with the protein and carbs, like being on a high protein and low carbohydrate diet, I think is probably a great recipe to, to drive some of these endogenous oxalate problems.

Which again is what we talked about inside the low carb episode and talking about people on a carnivore diet with oxalate dumping is that if they're on a low carb diet, plus they have quite high protein intake, plus they have the high hydroxyproline intake from collagen and gelatin and things [00:56:00] like this and they don't have the citrate coming in they may be in a circum and maybe calcium magnesium intakes are altered as well.

There they may be in a circumstance where they are ripe for the increased endogenous production of the oxalates instead of actually having an issue of a high oxalate intake. 'cause again, on a carnivore diet, you're not really eating much things that have oxalates. So it's, I think the problems that you'll see with a lot of these things is a combination of factors.

That are driving the problem and not necessarily one singular thing by itself. By itself. Maybe if you're somebody who's yeah, I'm gonna dose six grams of vitamin C and then you get oxalate problems, sure. But like just from food, it's probably not an issue. You're somebody like, I'm gonna go on a gelatin only diet, and then it's like lower carb, maybe then you'd start to see issues.

But I think in the vast majority of cases, I think the biggest concern is combinations of factors or people doing things at the extremes will tend to find see, test their limits and see where their system is gonna be susceptible to issues. Obviously these things can cause issues [00:57:00] in other ways as well.

Like for example, just having an all gelatin diet, there's not having enough of the complete amino acid profile that you need. So there's a variety of different components that can happen. But I think it's important to point out that a lot of these are combin combination things. I think a lot of health problems are often combination things and not just one factor by itself.

So the pufa by itself could cause other problems that aren't related to oxalates. But then if you combine the other components and you have an oxalate problem, now you have increased susceptibility to lip it peroxidation. And if you have metabolic dysfunction and you're loaded up on pufa, you may see higher glyoxal, which could then increase oxalate as well.

So I think it's like, again, these combinations of components, these multitude of variables coming together, creating this perfect storm that drives these problems for people. And I think carnivore and low carb can be one of those perfect storms for some people with a predisposition to having issues with oxalates.

Jay: Yeah. Yeah, I agree. And again, I think another thing you're pointing to is that if you get your foundations in place, if you're doing general things to eat [00:58:00] digestible food and support your digestion and support your metabolic state, lower stress hormones, support function at the liver, you're eating a nutrient dense diet, again, all things we've talked about before, then you can get to a place where none of these things are an issue for you if they were before.

And if you're concerned about them becoming an issue, just having general good diet and lifestyle in place makes the biggest difference. And and yeah, it involves things like not eating excessive amounts or not eating excessive amounts of protein, minimizing pufa, getting enough carbs, all of that.

And then when it does come to, some of the more advanced things for someone who already has those things in place and they've addressed. To the extent that they can, their gut health and all of that. Maybe there's some other things to consider too. When it comes to supplementary support.

Obviously we've touched on calcium would take a bunch and if you're not able to get enough calcium from your diet, if you don't tolerate dairy or things like that, then a calcium supplement could be a good idea. And we've talked a bit about recommendations for calcium supplementation and intake [00:59:00] before, and the relationship with parathyroid hormone and all that.

So I'll link back to that episode. But supplementing with calcium, just making sure you're getting enough throughout the day can make a huge difference from the absorption side. Magnesium can also make a big difference from the absorption side. And again, as we talked about, dosing that maybe with the meals, especially with the higher oxalate meals could help specifically.

And then there's a couple of other things. For one, we've talked a lot about liver function here and we did a huge series, an eight part series talking about the things that drive dysfunction at the liver and fatty liver disease. And so if you're dealing with issues at the liver, recommend going back through that series again, all linked to it in the show notes here, because liver dys dysfunction is going to lead to.

Issues with pH balance and also especially concerns with excessive oxalate production. So that's going to be central here, and there's a number of things that we can provide as far as support goes to help with some of the enzymatic pathways that will help to lower oxalate production. Mike, I'll let you go ahead and touch on a few of those.

We, we talked about these pathways before in the relationship with these nutrients, but they might be worth [01:00:00] considering in terms of supplementation if this is an issue for you.

Mike: Yeah, I think that the first one we'll start with, I think it's just B vitamins in general, and then we'll talk about specific ones.

Because there's specific ones that are directly involved in oxalate metabolism, but there's other ones that if you don't have enough of them, you can cause oxidative stress, which we talked about deplete glutathione and shifts glyoxal towards oxalate production. So having adequate, all of all the B vitamins would be important.

Which I think would also include the methylated B vitamins, which are essential for liver's processing of different components, and the detox processes and things like this. So you wanna make sure the liver's functioning just in general, and b vitamins are essential for that process. But with the oxalate pathway specifically, we talked about how gly oxalate can be metabolized in multiple ways and with steps that involve vitamin B one, which is thymine.

So making sure that your thymine status is optimized as a great way to help make sure that the metabolic pathways for clearing gly oxalate are working effectively. So you don't have that gly oxalate convert to oxalate. [01:01:00] Then we talked about one of the major enzymes. Involved in the glyoxal pathway is a GXT one, which basically takes, I think it was glyoxal and converts it into glycine.

And essentially that is vitamin B six dependent. So we wanna make sure that we have adequate vitamin B six so that we can have glyoxal convert into the glycine and basically not have it convert towards oxalate. And again, we talked about with primary hyperoxaluria type one, that you can actually supplement high doses of B six and in some people that may help to rescue the enzyme function.

'cause AG XD one is one of the major enzymes that gets impaired there. The next thing is, besides to be vitamins, which are gonna be helpful I think across the board for a multitude of issues. Is making sure that the liver in general has adequate antioxidant status, and that's via glutathione. Now the major precursors to glutathione are gonna be glycine, cysteine, and also glutamate.

And then you need to have adequate selenium status. So if you want to, if you want to have [01:02:00] adequate glycine intake, you can take in glycine. If collagen, if you're having oxalate issues, maybe you want to, hedge a little bit on collagen or gelatin, then you wanna use maybe a pure form of glycine.

Now you could use an N-Acetyl cysteine if you'd like, but you could also just use a whey protein or eat adequate amounts of if you tolerate dairy, or animal protein in general, we'll provide the cystine that you need. And then glutamate is gonna be in both those pro in, in any of the animal protein sources.

So that plus the. The selenium will allow you to produce adequate amounts of glutathione so that you can convert the, again, the gly oxalate to glyco 'cause it's gonna be glutathione dependent. And then also having adequate carbohydrate in conjunction with that is important so that you can recycle glutathione through the pento phosphate pathway.

With N-A-D-P-N-A-D-P-H production, in conjunction with the glutathione, you can help to increase the recycling of glutathione by actually providing adequate amounts of vitamin E, which will, you know, number one, vitamins, antioxidants, that can help recycle glutathione. Plus, it can help to minimize lipid [01:03:00] peroxidation which is, as we talked about, involved in glyoxal formation.

And that glyoxal formation can be converted into oxalates through multiple steps. So essentially, adequate Vitamin E can help to protect against that while recycling the glutathione. And I think another one here would be something like using an or managing your iron status could be a really important one.

'cause the iron plus the pufa can drive that oxidative stress, the pufa being polyunsaturated fatty acids. So that's another really important component that I would look at here. I dunno, Jay, if you wanna touch on some of the other elements in terms of supplements to be careful with and then potentially some of the, some things related to guts and the gut and probiotics.

Jay: Yeah, absolutely. And just a couple things to, I just wanna come back to. When it comes to B one, we did talk about a couple of obscure pathways that thymine specifically helps with and some less obscured pathways. And then also that vitamin B one is necessary for activating B six, which is important for that AG XT one enzyme.

So while all the [01:04:00] B vitamins can be really helpful here, thymine in particular can be one that's B one that's particularly important. Another thing I wanna mention you mentioned the methylated B vitamins and when there's stress at the liver, inflammation, oxidative stress, that can certainly impair the methylation pathways.

And they can certainly be helpful in a case like that if you don't need them. We don't necessarily need extra amounts, so might be something to evaluate individually, but it's worth mentioning too, if we're having methylation issues that can lead to lack of NAC. And so that might be a case where we wanna provide some extra NAC to produce glutathione, especially if we're getting enough glycine as well.

So yeah, a number of kind of integral or intricate factors, things that have relationships with each other, but all things to potentially consider if we feel like the liver especially is one of the central issues in our endogenous production is our major concern. Yeah you had mentioned gut health and probiotics and so there are a number of bacterial species that have been shown to help with the degradation of oxalate. There's oxo backer and certain lactobacillus [01:05:00] species, and so they've done studies with probiotics to, providing those types of bacteria.

To try to reduce oxalate loads, but in general, they've not been found to be particularly effective. And I'll just share one quote here from a study. And there's a couple others that I'll include in the show notes, but here they state diet, but not oral Probiotics effectively reduces urinary oxalate excretion and calcium oxalate super saturation, where they state patients randomized to a placebo probiotic or a symbiotic preparation.

Neither study preparation reduced urinary oxalate excretion nor calcium oxalate supers saturation. Fecal lactobacilli colony counts increased on both preparations, whereas enterococcal and yeast colony counts were increased on the symbiotic. And the symbiotic was a combination prebiotic probiotic with a couple other components in there.

But now the short of it being that even though there's a bacterial relationship here, like in many cases, the probiotics themselves are not particularly effective for sorting that out. And instead, we need to work on the things that all influence the state of the gut and can support the [01:06:00] growth of the more beneficial bacteria.

We've talked about all these before and concerns with probiotics as well, and the fact that they can actually contribute to SIBO and things like that. So I'll link back to those episodes where we discuss that in more detail. But the short of it being that I would be very wary about probiotics being a good solution here.

And then yeah, a couple of other supplements we wanna be careful with. You mentioned collagen as one where extremely high doses can be with the hydroxyproline content especially can increase oxalate production. We then have vitamin C, which, and the large doses that some people use can increase oxalate again, doesn't mean it's necessarily an issue for you.

And definitely these doses are far higher than we would ever get. Typically in a diet, but something to be aware of, especially if if you're somebody who is susceptible to oxalate or kidney related issues. And in this study, they it's titled Effective Vitamin C supplements on urinary oxalate and pH in calcium star calcium stone forming patients.

And they state a significant increase [01:07:00] in mean urinary oxalate was observed in calcium stone forming patients receiving either one gram or two grams of vitamin C where the increase was 50 and 48 milligrams of oxalate per 24 hours. And then in healthy subjects by 25 milligrams. Just something to be aware of if you're doing really high doses of vitamin C, again, might be worth it for something else you're working on.

There's certainly a place for it, but it's just something to be aware of as a possible driver of increased oxalate production. And then the last that we have mentioned innu, a number of different contexts. We did talk about it in the Fatty Liver Series. But this is iron. And if we have excess iron that can drive oxidative stress, which can increase susceptibility to lipid, peroxidation can increase liver dysfunction.

Tons of different issues that all could contribute to oxalate production. And so that's one to be aware of if you've been supplementing iron or if you're on a very, if you're coming from a high protein, low carb diet, like a carnivore diet as we've mentioned, when we see clients who are coming to us from those diets, high iron iron [01:08:00] overload is really common.

Something we're dealing with all the time. So it's something to be aware of that could be contributing to some oxalate issues when you know if that if that's you, if if that's something that, that you've been doing diet wise or if you've just been consuming exorbitant amounts of iron or iron supplements for some reason.

Mike: Yeah. Just to add to the carnivore piece here too, I've seen people, I. Coming with high iron, so they're like iron overloaded, plus their PTH values are bumped, which we talked about can actually adjust oxalate metabolism and increase oxalate absorption or, and potentially stone formation. So you have that.

And then also I've seen quite a few carnivores long-term developed changes in their liver function where you can actually see bumped liver enzymes. I likely through running gluconeogenesis. So I think there's a variety of factors that we see there in conjunction with the iron. The, and again I'm gauging like for PTH, you're drawing blood levels and you're seeing okay, it's we're way past the target that we wanna be at, plus ferritin values are bummed and an A-L-T-A-S-T-G-G-G-T values for liver [01:09:00] function are not looking good.

It's oh, there's a lot of things we have to correct here. Not to mention if have people coming off carnivore and they're having digestive issues, so having maybe bile acid diarrhea or fat mal absorption from the amount of fat that they're trying to eat. These types of things also could further create issues that we would see leading towards some of the oxalate problems as well.

So just something to put out there. 'cause I've seen these three, especially the iron overload liver stuff, and then the PTH from the carnivore diet, like pretty consistently with clients that I've worked with trying to, come out of a carnivore diet after being in it for a little while.

Jay: Yeah, likewise. I've definitely seen that too. And in some people dealing with those, with the fat digestion issues and that yes. Obviously being something that can cause tons of issues, not just oxalate issues, but tons of, yeah. Of other issues. Yeah. I think that's a good place to wrap it up as far as some specific dietary supplement considerations for, people who are concerned about oxalate issues for one reason or another.

With that in mind Mike, why don't you go ahead and tell the listeners where they can find more of your work? I.

Mike: Sure thing, [01:10:00] they can find me at my YouTube channel, Mike Fave YouTube, and they can also find me at my website, mike fave.com.

Jay: Perfect. Alright, if you guys enjoyed this oxalate series, please leave a like or comment if you're watching on YouTube, but if you're listening elsewhere, please leave a five star reading and review.

All those things. Really do a lot to help support the podcast and are very much appreciated. As always, to check out the show notes, we'll link to the studies, articles and anything else that we've referenced. Throughout this series and specifically today's episode, you can head over to jay feldman wellness.com/podcast.

And if after listening through this podcast, you're not sure where to get started, if you're looking for maybe some extra guidance or help with resolving your oxalate issues or any other health issues might be working on, head over to jay feldman wellness.com/call where you can sign up for a free call with a member of the j Feldman Wellness team who can provide you insights and next steps to take on your health journey.

So again, head over to j feldman wellness.com/call to sign up for a free call. And with that, we'll see you in the [01:11:00] next episode.