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HEALTH CONCERN? BioHealth Health Concerns

Oxalates and their role in Fibromyalgia syndrome

Contributing Author: McFadzean, Nicola N.D.

Nicola McFadzeanDr. Nicola McFadzean is a licensed Naturopathic Doctor, trained in both the United States and her native country of Australia. She received her Doctorate in Naturopathic Medicine from Bastyr University in Seattle, Washington. Dr. Nicola works with a wide variety of health conditions, ranging from cognitive issues to digestive problems to hormonal imbalance. She can access a full spectrum of laboratory testing to assess imbalances in the body, while having the freedom to prescribe natural remedies and prescription medications when necessary.

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Oxalates are nontoxic organic compounds naturally occurring in certain foods, mainly vegetables and fruits.  An accumulation of oxalic acid crystals in the muscle and connective tissue cells may be the cause of the muscle aches and pain associated with Fibromyalgia syndrome (FMS).

FMS can be a debilitating condition, involving many systems within the body.  It stands apart from arthritis and autoimmune reactivity in that the muscles are not inflamed on biopsy.  However, the pain can be every bit as intense and FMS is often resistant to treatment.  Associated symptoms of FMS include chronic fatigue, headaches/migraines, brain fog, yeast overgrowth, insomnia and hormone imbalance.

For many years, people with a condition called congenital hyperoxalosis were prescribed low oxalate diets.  These people have an accumulation of oxalates that may result in kidney stones and crystalline arthritis.  Vulvodynia and vestibulitis (pain and inflammation in the vulvar area) may also be associated with oxalate deposition in the tissues.  So the idea of low oxalate diets is not new – it’s the association with Fibromyalgia that has come under more recent investigation.

Dr. St. Amand, author of What Your Doctor May Not Tell You about Fibromyalgia, promotes the use of a medication called guaifenesin to treat FMS.  Guaifenesin was found to increase phosphate excretion by 60%, oxalate excretion by 30% and calcium excretion by 30%.  The medication guaifenesin itself is fairly benign.  The challenge with this protocol is strictly avoiding all salicylates (another organic compound found in foods, personal care products, etc.).  Also, guaifenesin is not a quick fix remedy, may take months to show real benefits and can cause an initial worsening of symptoms as the body dumps phosphates and oxalates.  That said, a number of FMS sufferers have found relief with guaifenesin.  (For those interested in this protocol, I recommend reading the book by Dr. St. Amand as a starting point.)

An interaction between calcium, magnesium and oxalate may be occurring.  People with high oxalate levels sometimes do not tolerate magnesium well, leading to irregular heartbeat, nausea, stabbing pains and increased muscular aches (this may also occur with Epsom salts, which are magnesium sulfate).  Certainly, FMS sufferers should make sure to take calcium and magnesium in the citrate forms, which are best suited to block the absorption of oxalates and help excrete them from the body.

Another oxalate connection relates to Candida and yeast overgrowth.  Good bacteria in the gut help to keep oxalates in check by breaking them down.  Bad bacteria in the gut can produce oxalates.  Oxalates are said to suppress the immune system and make one more susceptible to Candida overgrowth.  Therefore, along with a low oxalate diet, addressing yeast is imperative to reducing the overall oxalate load.

There are even more implications of oxalates in the body.  Oxalates deplete glutathione, one of the body’s key antioxidants; oxalates change how zinc works within the body, which can affect immune function; and oxalates also fuel inflammation, a major issue in FMS.

If you suffer from FMS, a low oxalate diet may be a valuable part of your nutrition goals.