, super informative, thanks. What sorts of things apart from VSL3 have you found useful for the oxalate issue? It's interesting that acidophilus is recommended. Out of all probiotics, it's the one I can least tolerate. It has always given me what @adreno
and I tend to refer to as lactate hell. It's the same reaction I get from glycine/DMG supplements so perhaps this indicates that oxalates were being mobilised from tissue. It sure felt like being stabbed with shards of glass lol.
In the post above http://forums.phoenixrising.me/inde...icum-a-game-changer.37324/page-22#post-601132
I attached info on probiotics from the trying low oxalate group. Unfortunately the testing for oxalate digestion has been very limited, so the only known strains which are good at it are two L. acidophilus and one B.lactis (BL-07). There have been no recent updates on the Ox-thera product (Oxalobacter formigenes) which has been given orphan drug status by the FDA. One day soon it will hopefully be available.
The importance of the probiotics is that signalling from the gut that appropriate flora are present seems to be necessary before oxalate dumping will happen. Daily probiotic use is recommended by the trying low oxalate group for this reason. VSL 3, which has been tested and found to be one of the good ones, is the usual recommendation (even though we don't know what actual strains are in it). I have never looked for a preparation containing B. lactis BL-07 without any acidophilus but one probably exists. Adding this could be very important in persuading your body to start dumping its oxalate stores. It will probably be necessary to start low and increase slowly.
As I also noted in that post I stopped taking the VSL 3 at the end of March before the uBiome test and decided not to start again and see what happened. I have been thinking about this for a while and making the post prompted me to add it back. I have definitely deteriorated over the past month or so. Of course many things could be responsible for this (including just the after effects of getting rid of so much Proteobacteria) but oxalate accumulation could be part of it - certainly I have some of the symptoms. I added it back two days ago and will see what happens.
I first became aware of my oxalate problems in late 2013 and had an OAT test from GPL which Susan Owen's analysed (she is not longer doing this due to ill-health). This showed that I was becoming an endogenous oxalate producer. Glyceric and glycolic were elevated (showing that AGT was no longer taking them down that benign path) as well as oxalate, plus there were many indicators of deranged metabolism in pathways know to be adversely affected by oxalate. The most important of these are B6, B1 and biotin dependant, as well as sulphur and glutathione related.
Susan recommended boosting all of those pathways with the appropriate B vitamins, topical magnesium sulphate, plus various antioxidants - as well as the probiotics. Plus there are various other strategies that help, such as calcium or magnesium salts with meals to bind dietary oxalate, arginine for pain, etc. Antioxidants are very important since it is oxidative stress which causes the original problem with AGT (by causing conformational change in the enzyme so it no longer binds its B6 cofactor) but they and the B vitamins often precipitate uncomfortable oxalate dumping. Start low and go slow, one at a time, is the recommendation.
I have attached a document from the trying low oxalate group where a moderator replied to a question about supplements for endogenous oxalate production in a succinct way with recommendations almost all in one place (the problem with the site is that most of the info is scattered and hard to find) . She didn't canvas biotin, which is also very important. Susan recommends 20 - 40 mg daily (but start with maybe 1 mg or less if very sensitive).
I am not as sensitive to supplements as you seem to be though there are certainly plenty that cause me problems. I have been able to get my B6 up to 50 mg P5P plus 75 mg pyridoxine. This is not nearly as high as the upper recommended target but more causes too many problems for me. I do revisit from time to time but have so many others things that I am trying that it is some time since I have tried to up the dose.
Magnesium is also necessary to support B6 dependant enzymes and the recommendation is twice as much as B6, plus topical magnesium sulfate (or epsom salts baths) but I have always taken a lot of that.
I also take 20 mg biotin and 50 mg allithiamine daily.
Regarding antioxidants, I won't have a bar of the recommendations for NAC and glutathione (apart from causing me problems I don't think it is a good recommendation) and I take moderate-high doses of vit A, gamma E, tocotrienols, ubiquinol, silymarin extract, r-lipoic acid. I used to take high doses of vit C but stopped this on Susan's advice. Ascorbate is converted to oxalate. I went to 500 mg/day and have just upped it to 1 g/day (more than recommended) because on a recent OAT I am showing quite low vit C markers.
I don't think the particular antioxidants taken are so important as taking a tolerated mix to help counter the on-going oxidative stress.
I have had two OATs since and all of the B6, B1 and biotin markers have normalised and on the most recent one, glyceric and glycolic were low normal. Oxalate is high normal but that is a good thing I think since it means I am getting rid of it. Glutathione-related markers were also fine. On a recent Genova test I did have an elevated marker for lipid peroxidation, but not too dramatically bad. Antioxidants are among the group of supplements I do have problems with and so far I have not been able to find anything else to deal with this.
In general I am hoping that ultimately the gut strategy will deal with a lot of these issues in a more permanent way but in the meantime I keep taking the relatively high doses of the various supplements.
Have to go now (more acupuncture) but if I think of anything else will post later.