By Tracy Tranchitella, N.D.
Oxalates, aka. oxalic acid testing has definite clinical usefulness in any functional medicine practice. People often present with a myriad of seemingly unrelated symptoms. This is a particular case of an individual who presented with significant body aches, tendon pain, and bladder discomfort.
A 43 year old female presents to our practice with a history of the following:
• pressure headaches
• fatigue, brain fog
• body aches and tendon pain
• cyclical urinary pain (sharp)
• digestive discomfort (bloating, painful bowel movements)
The majority of these complaints had been going on for 7-8 years, but the urinary discomfort and body aches more so over the past 1 to 2 years. She had been tested on many occasions for bladder infections, all coming back normal.
Past medical history is significant for Blastocystis hominis and Cryptosporidium parvum infection (treated successfully), Raynaud’s phenomenon (excessively reduced blood flow in response to cold or emotional stress causing discoloration of fingers and toes), and irritable bowel. She currently takes periodic Ibuprofen and Atarax (for suspected interstitial cystitis).
One interesting fact about her clinical history is her “extreme muscle pain” when she eats nuts and vegetables. No other doctor has given much thought to this symptom.
Our suspicion, based on the following complaints, was that she had elevated oxalic acid which was confirmed by testing with an Organic Acid Test revealing oxalic acid over 350 (which is significantly high). Patient was given the following instructions:
1. Avoid all soy, nuts (including nut butters), berries (including jam and juice), and spinach. Also, she was to evaluate her own diet for other high oxalate foods at www.lowoxalate.info.
2. Placed on approximately 250mg of calcium citrate and 100mg of magnesium citrate with each meal – breakfast, lunch, and dinner. The citrated form of these minerals help to bind oxalates in the digestive system and prevents them from being absorbed.
3. High dose lactic acid probiotic upwards of 225 billion organisms per dose – given twice daily. This helps to degrade oxalates in the digestive tract.
4. L-Arginine at 1000 mg daily (need to watch for history of herpes lesions as L-Arginine is known to activate herpes in some people). The benefit of L-Arginine in high oxalate problems is to decrease tissue pain, particularly bladder discomfort.
5. Epsom Salt Baths at least 4 times weekly – 1 to 2 cups as tolerated in bathwater. Epsom salt helps to soothe the skin and aids in the bodies processing of oxalates.
This patient’s response was impressive. Over the next 3 months, she reported complete elimination of bladder/urinary pain, and approximately an 80% improvement in muscle and tendon discomfort. Bowels become more regular and without pain. Fatigue had improved by about 50%. In addition, patient no longer experienced Raynaud’s phenomenon when exposed to cold temperatures.
The test performed on this individual to evaluate for oxalic acid and other metabolic markers was the Organic Acids Test from Great Plains Laboratory. This is a urine test that evaluates numerous markers useful for toxicity, certain vitamin levels, bacteria, yeast biotoxins and much more.