When Oxalates Cause Pain: How a Low-Oxalate Diet Can Help
Functional medicine often begins where conventional testing leaves off. Many patients come in with years of symptoms that don’t add up neatly to a single diagnosis. Instead, they’re left searching for answers to ongoing pain, fatigue, or discomfort that has no clear cause. One such case led us directly to an often-overlooked culprit: oxalates.
A Case of Hidden Pain
A 43-year-old woman came to my practice, Sunrise Functional Medicine, with a long history of health struggles. For years, she had dealt with pressure headaches, brain fog, body aches, tendon pain, and cycles of sharp urinary pain. She also had frequent digestive discomfort and painful bowel movements. Despite repeated testing, her bladder pain was never linked to an infection. She had a history of Raynaud’s phenomenon, irritable bowel issues, and past parasitic infections, but nothing explained the extreme muscle pain she experienced after eating certain foods—especially nuts and vegetables.
That detail raised suspicion. We ran an Organic Acid Test, which confirmed our hunch: her oxalic acid level was over 350, an extremely high value. In other words, her body was struggling with oxalates.
What Are Oxalates?
Oxalates, or oxalic acid, are naturally occurring molecules found in many plant foods. In plants, oxalates serve a purpose—helping bind and remove excess calcium. In the human body, however, oxalates can create problems. Normally, oxalates bind to calcium during digestion and pass harmlessly out of the body. But when oxalate levels are too high—or when gut health is compromised—oxalates can build up. This may contribute to kidney stones, bladder pain, joint stiffness, and even widespread body aches.
Most people eating a varied diet don’t need to worry. On average, they’ll consume 200–300 mg of oxalates daily without issue. But for certain individuals, oxalates can become a hidden driver of chronic symptoms.
Who Needs to Watch Their Oxalate Levels?
There are two main groups of people who may struggle with oxalates: Those who eat restricted or plant-heavy diets (such as vegan, raw food, paleo, or keto), which may inadvertently be very high in oxalates. Those with gut health issues or other conditions that impair the body’s ability to process oxalates.
If you’ve struggled with fibromyalgia, migraines, brain fog, urinary discomfort, digestive issues, or kidney stones, oxalates could be worth exploring.
Oxalates, Gut Health, and Kidney Stones
The gut plays a key role in how the body handles oxalates. When the microbiome is balanced, beneficial bacteria help break oxalates down. But with gut dysbiosis, leaky gut, or SIBO, oxalate absorption can skyrocket—from a typical 1–2% up to 40–50%. This is why patients with IBS or inflammatory bowel disease often have higher risks of kidney stones. In fact, research shows that people with kidney stones are more than twice as likely to later be diagnosed with IBS.
Kidney stones themselves are often calcium oxalate stones—formed when unbound oxalates in the urine crystallize. Over time, repeated stone formation can even damage kidney tissue and function.
Back to the Case Study
For our patient, the treatment plan focused on both diet and supportive therapies:
- Dietary adjustments: She avoided high-oxalate foods such as nuts, soy, berries, and spinach.
- Mineral support: Calcium citrate and magnesium citrate with each meal to bind oxalates in the gut.
- Probiotics: High-dose lactic acid probiotics to help degrade oxalates in the digestive tract.
- Targeted supplementation: L-Arginine to ease tissue and bladder pain, plus regular Epsom salt baths for additional support.
Within three months, her symptoms improved dramatically. The urinary pain disappeared completely, muscle and tendon discomfort eased by about 80%, and her fatigue was cut in half. Her bowels normalized, and she even noticed her Raynaud’s phenomenon no longer flared when exposed to cold.
Why a Low-Oxalate Diet Works
The point of a low-oxalate diet isn’t to eliminate all oxalates—after all, many high-oxalate foods are otherwise healthy. The goal is to lower the overall load while supporting the body’s ability to process them.
Some of the most effective strategies include:
- Pairing oxalates with calcium-rich foods. Calcium binds to oxalates in the gut, reducing the chance they’ll be absorbed.
- Limiting excess vitamin C. High doses of vitamin C (over 1,000 mg daily) can convert into oxalates in the body.
- Balancing protein and salt intake. Too much protein or sodium can contribute to kidney stone formation.
- Supporting gut health. Probiotics, particularly species that degrade oxalates, can make a significant difference.
- Drinking plenty of water—ideally with a squeeze of lemon—also helps reduce the risk of calcium oxalate stone formation, thanks to the citrate content of lemon juice.
The Bigger Picture
The case above highlights how oxalates can quietly affect the body in surprising ways—from bladder discomfort to joint pain and fatigue. For many people, especially those with digestive concerns or kidney stone history, investigating oxalate levels can provide long-sought answers. At Sunrise Functional Medicine, we often run Organic Acid Tests, which not only measure oxalates but also give us a broader picture of metabolic health. With this information, we can design individualized treatment plans that address root causes, not just symptoms.
Oxalates may not be a household word, but for some, they can be the missing piece in a complex health puzzle. The good news is that with the right testing, dietary changes, and supportive therapies, oxalate-related conditions are highly manageable—and in many cases, reversible.
For anyone dealing with unexplained body pain, urinary discomfort, or recurrent kidney stones, it’s worth considering whether oxalates are playing a role. As this case shows, identifying and addressing the problem can lead not just to symptom relief, but to a renewed sense of health and vitality. Schedule a consultation today >>>