Oxalates and chronic disease – is yeast or candida the underlying answer?      

Oxalate sensitivity could be linked to underlying yeast or candida overgrowth.  Oxalate, also known as oxalic acid, is an organic compound found in many plant foods. For most of us, oxalates cause few to no issues but for some people with sensitivities, when the level of oxalates is high, it can lead to an abundance of health issues.

Yeast and fungal infections are linked to high levels of oxalates in the body. It is unknown which is the catalyst, and which is the result but usually, if you address high levels of yeast and candida, you can bring down levels of oxalates.

What are oxalates?

Oxalates are organic compounds found in many plants. Under a microscope, oxalates are jagged in structure and look crystalline.

Foods high in oxalate include:

• Beans
• Beer
• Beetroot
• Berries
• Chocolate
• Coffee
• Cranberries
• Dark green vegetables, such as spinach
• Nuts
• Oranges
• Potato
• Rhubarb
• Soybeans
• Soy milk
• Spinach
• Sweet potatoes
• Tea (black)
• Tofu
• Wheat bran ^[1]

The human body can produce oxalate on its own or obtain it from food. Vitamin C can also be converted into oxalate when it’s metabolised.

Once consumed, oxalic acid combines with other minerals like calcium, sodium, magnesium, and potassium to form compounds like calcium oxalate, iron oxalate and sodium oxalate in the kidneys. In a healthy person, around 90% of the oxalate consumed will be excreted through the stool and urine. ^[2]

However, for sensitive individuals, it is not excreted. When there are high levels of oxalates in our cells, it can lead to oxidative damage, depletion of glutathione, the compromise of our immune system and the formation of crystals which cause pain and injury.

Signs and symptoms of hyperoxaluria

Hyperoxaluria is the term used when you have too much oxalate in your urine.

Primary hyperoxaluria refers to a group of genetic disorders resulting in overproduction of oxalate, while secondary hyperoxaluria results from gastrointestinal disorders associated with fat malabsorption and increased absorption of dietary oxalate. ^[3]

Oxalosis happens after the kidneys fail in people who have primary and intestinal causes of hyperoxaluria, and excess oxalate builds up in the blood. This can lead to oxalate deposits in blood vessels, bones and body organs.

Kidney stones

Too much oxalate in the urine can cause calcium oxalate stones, which are the most common type of kidney stone. Kidney stones are solid masses that form in the kidney when there are high levels of calcium, oxalate, cystine, or phosphate and too little liquid. There are different types of kidney stones.

Certain risk factors may cause your body to form calcium oxalate stones. These risk factors include:

• Dehydration from not drinking enough fluid
• A diet too high in protein, oxalate, sodium (salt) and sugar (like high fructose corn syrup)
• Obesity
• Medical conditions like:
• Dent Disease (a rare genetic disorder that affects the kidneys
• Hyperparathyroidism (a very high amount of a type of hormone called parathyroid hormone in the blood that causes a loss of calcium. Calcium is needed to bind with oxalate and leave the body)
• Digestive diseases and surgeries such as Inflammatory Bowel Disease (IBD), Ulcerative Colitis and Crohn’s Disease
• Gastric bypass surgeries [4]

How do you know if your levels of oxalate in too high?

In addition to recurring fungal infections, you may experience some of the following symptoms:

• Pain, muscle aches and fatigue
• Joint pain – if deposition of oxalate crystals is in synovial fluid or connective tissue
• Strange rashes
• Kidney Stones
• Chronic UTIs, interstitial cystitis or kidney infections
• Frequently cloudy or hazy urine
• Vulvar pain in women
• Gastrointestinal problems or irritable bowel syndrome
• Gum problems
• Sore eyes / poor vision
• Excessive histamine signs and symptoms
• Brain fog and fatigue ^[5]

How do yeast infections contribute to oxalate levels?

The composition of your gut microbiota is directly related to the amount of oxalate levels found in your urine.  Oxalate sensitivity and candida overgrowth are commonly linked.  Clinically, we regularly find high oxalate sensitivity in patients we test that have candida overgrowth.

Candida albicans fungus, which is the most common yeast in the human gastrointestinal system, has been found to surround oxalates stones in the kidney, and the presence of yeast infections have been correlated with high amounts of oxalates.

Candida also produces arabinose and all yeast produces erythroascorbic acid. Genetic susceptibility, combined with a lack of enzyme co-factors such as Vitamin A, B1, B6, Magnesium) can result in the misprocessing of amino acids and the liver forming oxalates from safe amino acids like hydroxyproline.

One bacterium in particular, Oxalobacter formigenes, exclusively uses oxalate for food. People who have this bacterium in their gut may have a 70% reduced risk of kidney stones.

Treating yeast infections by reducing your oxalate levels

Consuming a low oxalate diet

If a Candida sufferer is eating a diet rich in oxalates, even if they are avoiding grains and sugar, may have no success in healing their Candida overgrowth. A low oxalate diet means avoiding foods high in oxalates (listed above) and eating foods that are low in oxalates, such as:

• Fruits: bananas, blackberries, blueberries, cherries, strawberries, apples, apricots, lemons, peaches
• Vegetables: mustard greens, broccoli, cabbage, cauliflower, mushrooms, onions, peas, zucchini
• Grains and starches: white rice, corn flour, oat bran
• Proteins: eggs, meat, fish, poultry
• Dairy products: yogurt, cheese, milk, butter
• Beverages: coffee, water, fruit juice
• Herbs and spices: cinnamon, black pepper, turmeric, cilantro, cumin, dill

You can also reduce the oxalates in foods by cooking oxalate-rich foods, such as leafy greens and cruciferous vegetables. Heat can help break down oxalates. Soaking beans, nuts and seeds is the best method to remove oxalates.

Oxalate dumping when oxalate in cells will be “dumped” from your body when you start following a low oxalate diet. If you remove oxalates too quickly you can experience oxalate dumping, so gently reduce by 10-20% weekly maximum.  Symptoms of oxalate dumping can include a yeast flare, painful bowel movements, rashes or hives, grainy stools, pain with urination and irritability or moodiness. ^[6]

Clearing oxalates from your system with supplements – oxalate sensitivity and candida

• Take probiotics. It is vital to optimise your gut bacteria with a good quality probiotic that works well with oxalate issues. It’s also important to do some gut clearing work as there may be yeast or parasites present, as there often are when there are oxalates. These can be checked with a stool test.

Probiotics such as lactobacillus acidophilus, lactobacillus plantarum, bifidobacterium lactis, bacteroides and oxalobacter formigenes are effective in the breakdown of oxalate in the gut.  Re-establishing a healthy balance of good bacteria is critical in restoring beneficial bacteria. Taking a probiotic supplement that contains beneficial bacteria with anywhere from 25 -300 billion units a day, as well as taking a prebiotic (food for the good bacteria) supplement will be beneficial. There are several ways you can clear oxalates from your system:

• Take calcium citrate. Calcium citrate binds with oxalates to make a larger molecule that passes through the digestive tract without absorption. Its best to take calcium citrate with calcium rich foods.
• Consume oxalate competitors. These include sulphur, bicarbonate, chloride and Biotin. They have a similar molecular shape so will occupy the pathways that oxalic acid would normally use to enter cells, crowding out the oxalate and stopping it from having such an impact at cellular level. The easiest ways to get the first three is through baths (Epsom salts, Bicarbonate of Soda and Magnesium Chloride) and Biotin is available in supplement form. ^[7]
• Take vitamin B6 as it helps urinary excretion of oxalate, one of the major determinants of risk for calcium oxalate kidney stones. ^[8] “Methylation nutrients such as vitamin B6 and B12, as well as glutathione, are needed for oxalate metabolism in the Citric Acid Cycle. This shows how poor methylation can be a contributing factor to oxalate build up in the cells, or how oxalates can disrupt methylation. Sometimes nutrients such as B6 do not bind very well to their receptors which can reduce the effectiveness of extra supplementation and will need to be addressed.” ^[9]

• CBS dysregulation, either through genetic expression or environmental upregulation (such as yeast infections), can contribute greatly to oxalate formation due to its need for vitamin B6 and its role in the formation of bile salts and glutathione. The CBS pathway, Cystathionine Beta Synthase, is the sulfuration pathway in the body responsible for detoxification and the production of glutathione.  When this pathway is impaired it can increase oxalates.

• Limit your vitamin C intake. For people with recurrent kidney stones, typically the advice is that you reduce or limit your vitamin C intake because it has been shown to increase the overall risk of developing kidney stones. ^[10]
• Increase your water intake to help eliminate oxalates.
• Take activated charcoal which acts as a binding agent.

How we can help overcome your oxalate sensitivity by treating candida overgrowth

Yeast infections and high levels of oxalates tend to go hand-in-had and although we don’t have all the answers as to which comes first, we can treat both by taking care of the gut microbiome with probiotics, antimicrobial herbs and other supplementation and trialling a short term low oxalate diet to ascertain its effectiveness in combatting symptoms.

At Advanced Functional Medicine, through thorough testing and investigation, we can get to the root cause of your symptoms and overcome oxalate sensitivity. With a holistic approach to diet and supplementation we can start to work towards returning you to better health.

Find out more by contacting us or filling in the form below.