Substantial improvement with (strange) dietary adjustments

[pattismith]

I once read a testimonial by a man who tried literally every kind of diet conceivable to try to improve his CFS. He (of course) at one point tried an all raw diet, and eschewed cooked foods entirely. To his bewilderment, his condition slowly worsened.

He then went the opposite direction (based on Chinese yin/yang principles), and ate only cooked foods, eschewing raw foods entirely. To his utter amazement, he completely recovered his health. I suspect this would almost sound like heresy for some of the people who do well on all raw food diets.

Lot's of Crohn disease people feel bad with raw vegetables, so we can guess that some people with subclinical gut inflammation cannot tolerate them well either.
I once try to eat a raw fruit and vegetables juices diet for a month, and my gut couldn't handle it

 

[Wonkmonk]

Oxalate overload really seem to be capable of causing symptoms. It's seems even stopping oxalate intake abruptly can cause symptoms.

https://www.healthline.com/nutrition/oxalate-dumping

It also seems to be the case that about half of dietary Vitamin C is converted into oxalates:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946963/

That seems to be negligible though. 60mg of Vitamin C result in oxalate formation of 30mg. 3 oz. of spinach contain 500-900mg of oxalates depending on the source/study.

I am not sure though how much of these spinach oxalate is actually being absorbed where as the oxalate resulting from Vitamin C break down is direktly in the system. So maybe not going too high with Vitamin C would be advisable.

 

[pattismith]

@Wonkmonk ,

I do have oxalate problems . It comes from too much citrate reabsorption by the kidney.
citrate is reabsorbed to keep your blood pH in a neutral range when there is too Much acidity in the blood. Tissular hypoxia may trigger this respiratory acidity with metabolic compensation.

the answer isn’t taking more citrate or more bicarbonate (your stomach will lack acidity and vitamins and minerals won’t be absorbed any longer)..

the answer is to drink water + lemon juice (citric acid)

 

[cheeseater]

One thing I found that dramatically changed the intensity of my GI problems was the elimination al all corn products. Corn products are hard to nail down as the culprit because it can take up to three days from ingestion until the long list of possible GI problems show up. Since it can take so long for the symptoms to show up, people tend to blame other foods they have eaten more recently. Just a thought..

If I eat green beans or mushrooms I will have problems within an hour. Corn is also very tricky because it is in so many other food products. Corn intolerance may or may not be the same as Fructose intolerance.

 

[Aidan]

Hi Aidan, that's so interesting, thanks for sharing your experiences. I also get symptoms both ways, i.e., too low calcium intake and too high intake. My sweet spot appears to be in the neighborhood for 800-900mg a day, and I mean total calcium intake from all sources including all foods, drinking water etc.

My main symptoms are:
*Muscle weakness
*Heart palpitations
*Dry and red eyes
*Brain fog and inability to concentrate
*Disturbed sleep including waking up too early
*Restlessness/general feeling of uneasiness
*Upset stomach (mild and not really sure about this, but definitely not constipation)

The symptoms are generally similar if I don't have enough calcium though red and dry eyes are usually absent and heart palpitations are stronger.

I am not sure yet if vitamin D really causes symptoms and if so, if they are caused by the vitamin or just by the higher calcium absorption. This summer, I had the impression that I can tolerate vitamin D from the sun much better than supplements. I tend to feel bad after high-dose supplements (20,000 iE capsule), but can't really say what the symptoms are. I think I get an upset stomach, so I think it may be connected to the oral route of administration. I can sunbathe which creates 10,000+ iE without having stomach problems, so I think the oral administration is a problem.

I am looking forward to hearing your thoughts. Please continue to share your ideas and experiences!

Very interesting, I haven't actually encountered anyone else talking about this problem before so I'm glad to have found someone. For me, the symptoms of too little calcium sort of feel like the inverse of the symptoms of too much calcium, rather than being similar. With too little calcium my muscles feel so weak to the point that I can hardly tolerate any extended walking, and all my muscles and brain have this sort of empty feeling, like they are lacking some really important source of vitality that results in their function being crippled. With too much calcium, my muscles feel like they have too much of the thing they're lacking when I don't consume enough calcium, and I get the urge to be physically active and often actually do go for a vigorous walk as this helps relieve the symptoms.

I also tolerate vitamin d from the sun perfectly fine. In fact, I feel quite a bit better when I can get sunlight. Vitamin d supplements cause the whole array of symptoms that too much calcium does for me, but significantly more extreme and the effects last significantly longer. Even just 200-400 iu will set it off. I only started being this sensitive after a period of taking vitamin dexcessively (50-70000 ius per week). I think I have a post on my profile that goes more in depth on these symptoms in case you're interested.

Do you have any theories about what mechanisms are occurring that cause these symptoms following high calcium intake? Unfortunately I have none. But I'm also interested to hear any more details or interesting things you've noticed regarding this issue

 

[Aidan]

I have the hypothesis that oxalates are either harmful on their own or exacerbate the negative effects of too much calcium. @Aidan

Depending on the source, oxalate contents of foods appear to vary a lot. Like carrots are ranging from less than 50mg for half a cup cooked vs. 500mg for 100g fresh. Preparation methods also seem to matter, though I can't imagine it makes that much of a difference for carrots.

https://oxalate.org/

https://en.wikipedia.org/wiki/Oxalate#Occurrence_in_nature

I suspect that the main culprit in my case is spinach. I don't really eat much of the other high-oxalate foods. I'll cut out spinach from my diet for a while and see what happens. Normally, oxalate absorption can be greatly reduced by adding high-calcium foods to the meal, but this is obviously not an option.

I might have to re-check other foods again that were previously ruled out as they might be less of a problem if the diet isn't high in oxalates. There appear to be interaction effects between the foods, some only harmful if consumed either together in the same meal or when the diet in general includes certain other foods.

It's very complicated.

Hi, do you have any updates since you've cut out the spinach? I haven't looked into oxalates content of food much so I'm not sure yet if I have the same issue, but I definitely have slightly differing symptoms depending on calcium source. I'll try and figure out if oxalates are playing a role there. I don't consume any spinach or Swiss chard, but I find kale to cause quite negative symptoms, even if I just have 75g or so. Interestingly, I seem to have become more sensitive to kale over the course of the last year.

Also, I saw that you mentioned that you are vegan. I am too, so I wonder if that somehow has a direct or indirect connection to this problem we are having, as it doesn't seem to be a very common problem.

 

[cheeseater]

If you eat high oxalalic acid food like spinach or greens, supposidly you can cancel out or neutralize a lot of the oxalates by adding some lemon juice.

 

[xploit316]

@Wonkmonk I second Pattismith, lemon water was really helpful with oxalate issues. The other is to avoid high oxalate foods and cook vegetables thoroughly and discard the water.

the answer is to drink water + lemon juice (citric acid)

 

[Wonkmonk]

I do have oxalate problems . It comes from too much citrate reabsorption by the kidney.
citrate is reabsorbed to keep your blood pH in a neutral range when there is too Much acidity in the blood.

Interesting, so this comes "from the inside" basically in your case. Then a low oxalate diet won't make your symptoms disappear, at least not entirely. But as you say, you can flush it out with water.

Unfortunately, I do not improve when I drink more water.

 

[Wonkmonk]

One thing I found that dramatically changed the intensity of my GI problems was the elimination al all corn products. Corn products are hard to nail down as the culprit because it can take up to three days from ingestion until the long list of possible GI problems show up.

That's what I found, too. The symptoms often start with a significant delay and then it's hard to tell which foods caused them and the wrong foods are suspected.

I don't eat any corn products at all (it's much less popular here in Europe than in the US), and when I did occasionally, I did not find that it's worse than other grains. But maybe I didn't take the delay into account.

 

[Wonkmonk]

Very interesting, I haven't actually encountered anyone else talking about this problem before so I'm glad to have found someone.

Same here, haha.

With too little calcium my muscles feel so weak to the point that I can hardly tolerate any extended walking, and all my muscles and brain have this sort of empty feeling, like they are lacking some really important source of vitality that results in their function being crippled. With too much calcium, my muscles feel like they have too much of the thing they're lacking when I don't consume enough calcium, and I get the urge to be physically active and often actually do go for a vigorous walk as this helps relieve the symptoms.

...

Do you have any theories about what mechanisms are occurring that cause these symptoms following high calcium intake?

I think what you are describing makes complete sense. Calcium is important for muscle activation and contraction. Too much calcium could result in overcontractibility and muscle cramps, not enough might cause muscle weakness.

But normally, blood calcium should be tightly controlled by parathyroid hormone. Every checked if something might be wrong there? It's a simple blood test. Mine returned normal or slightly elevated though nothing that would explain my symptoms.

Another thing that might play a role is magnesium, which plays the opposite role in the muscle. It may be worthwhile to experiment with a magnesium supplement and see if anything changes.

I also tolerate vitamin d from the sun perfectly fine. In fact, I feel quite a bit better when I can get sunlight. Vitamin d supplements cause the whole array of symptoms that too much calcium does for me, but significantly more extreme and the effects last significantly longer. Even just 200-400 iu will set it off.

That those symptoms are the same as for calcium intake and last longer also makes sense. Vitamin D3 has a half life of about 3 months in the body. It stays there for quite a while and while it is there, it raises calcium levels permanently, suppressing parathyroid hormone. This is actually a desired function of Vitamin D. Parathyroid hormone should be low. Vitamin D should do the job.

What's very strange is that you are that sensitive. 200-400 IU is a very low dose, even if taken daily. It shouldn't affect your plasma calcium that much.

What is also very strange is that you (like me) can tolerate Vitamin D from the sun, which even with a low amount of exposure, produces much more than 200-400 IU. Maybe the vitamin D does something else, too in the GI tract or the microbiome.

Hi, do you have any updates since you've cut out the spinach? I haven't looked into oxalates content of food much so I'm not sure yet if I have the same issue, but I definitely have slightly differing symptoms depending on calcium source. I'll try and figure out if oxalates are playing a role there. I don't consume any spinach or Swiss chard, but I find kale to cause quite negative symptoms, even if I just have 75g or so. Interestingly, I seem to have become more sensitive to kale over the course of the last year.

Also, I saw that you mentioned that you are vegan. I am too, so I wonder if that somehow has a direct or indirect connection to this problem we are having, as it doesn't seem to be a very common problem.

I am doing much better since I cut out the spinach, and also the tahin and almond milk. I found that there are many hidden sources of oxalates that aren't well known, like almond or soy milk. (and almonds or soy in general). Especially for vegans like you and I that seems important.

I have improved systemically, like most symptoms. Gum inflammation has disappeared, brain fog much lower, more strength and ability to concentrate, less upset stomach, less pain in the back and kidney area. I can also tolerate calcium better. I think there is an interaction of some sort. The oxalate detox took about 2 weeks for effects to become noticable and I think it's still improving.

It's interesting that you are reacting to kale. I think that's not the oxalate, because kale is very low in oxalates. But it may the calcium in the kale. Kale can have up to 250mg per 100g according to the USDA and bioavailability is excellent (comparable to cow's milk according to some studies).

https://fdc.nal.usda.gov/fdc-app.html#/food-details/168421/nutrients

I have also noticed that I was sensitive to kale, too while I had a high oxalate intake. I think there is an interaction, maybe with the calcium. Too much calcium may be worse with the oxalates.

Regarding the veganism, I am doing it mainly because most animal products are high in lysine and many are at the same time high in fat, especially monounsaturated fatty acid, and that's a combination I really feel I have to avoid. Paradoxically though, the higher oxalate content in plant foods may be counter productive. I'm currently trying to figure that out.

Please continue to share your experience, it's very interesting to discuss these.

 

[Wonkmonk]

If you eat high oxalalic acid food like spinach or greens, supposidly you can cancel out or neutralize a lot of the oxalates by adding some lemon juice.

I think what you mean is the negative effect on the kidneys. Lemon juice is acidic and the citric acid can affect the PH of the blood and result in a lower propensity of the oxalates to form insoluble chrystals.

I am not sure lemon juice will cancel out other negative aspects of oxalate intake, especially the building up in tissues which appears to be causing symptoms for many people.

What does "cancel out" oxalates to some degree, interestingly, is dietary calcium because it forms insoluble complexes in the GI tract (just like it does in the kidney) and these then do not get absorbed and are thereby neutralized.

 

[pattismith]

I think what you mean is the negative effect on the kidneys.
Lemon juice is acidic and the citric acid can affect the PH of the blood and result in a lower propensity of the oxalates to form insoluble chrystals.
.

Yes citric acid is acidic, but in the blood it has a basic effect (citrate). More citrate in the blood allows more citrate excretion in the urine and then as you said lower propensity of the oxalates to form insoluble chrystals ;

Lemon juice has two beneficial effects

-improve vitamins and minerals absorption
-lower the oxalate crystals risk in the urine

 

[Wonkmonk]

My latest findings:

(1) One major culprit seems to be fat + protein + some type of carbs + time for fermentation.

It appears to cause or exacerbate the symptoms if I eat foods in which protein (esp. lysine) and fat have been together at room temperature for a while (bacterial fermentation). This affects hummus for example as the chickpeas (which themselves have 5% of fat) are mixed with fatty acids from the Tahin.

It could also explain why I react so badly to soy soghurt and tofu. Dried soy beans are 20-30% protein and 20% fat, much of it monounsaturated. Soy beans are watered at room temp for an extended period during tofu production. In the case of soy yoghurt, it's additionally fermented. I think harmful compounds are produced during fermentation in the presence of protein (esp. lysine), fat (esp. monounsaturated fatty acids) and a fermentable substrate like legume fiber or fructose.

I have repeatedly found that I do not nearly react as badly to cow milk or sheep milk yoghurt as to soy yoghurt, although the macronutrient composition is very similary. That may be because there is a different carb substrate to fuel the fermentation (lactose vs. legume fibers and unheated starches). I also react negatively to undercooked potatos, but not to thoroughly cooked potatos. The carbohydrate substrate seems to matter.

(2) Fructose per se is probably innocuous.

I can eat 2-3 pounds of fruit in the morning on an empty stomach with a 6-hour fasting period to the next meal (to avoid meal mixing) with almost no symptoms. That is probably because there is fructose as a carb substrate, but there isn't much protein (esp. fruit is low in lysine) and also almost no fat at all.

The equation is:

Protein (esp. Lysine) + fat (esp. Omega 3 & 9) + carb substrate + fermentation/time at room temp = BAD

It seems if anything is missing from the equation, that lowers or prevents deterioration of symptoms. (fermentation cannot be eliminated because it happens in the GI tract).

(3) Carrots are bad.

Same meals (a) riced cauliflower, tomatos, onions, garlic, kale, carrots, tomato purree, salt, mustard seed powder, (b) wholegrain spaghetti, tomato puree, kale, carrots, salt.

With carrots: Relatively strong symptoms
Without carrots: Much less (or none at all)

Either there's another compound in carrots that's harmful, or it's oxalates again. I found values for carrots varying a lot from 6mg per 100g to 500mg per cup. Whatever it is, I think I have to cut carrots out.

(4) Oat milk seems to be bad.

I will henceforth avoid all fermented foods whatever they are. It's a bit tough because I'm a vegan, but that means most plant-based milk products are out for now.

 

[Wonkmonk]

It appears I have to stop eating dates and they might be the reason for why I thought fruit in general is bad. I can eat fruit first thing in the morning with 5-6 hours distance to the next meal with, it appears, no symptom flares. But if the fruit contains dates (which I used as a sweetener), it doesn't work.

I suspect it's the oxalate content. There are different sources saying different things about dates, but estimates go as high as 25mg per date, so when I eat 10 dates, that's a lot of oxalate. I also suspect the oxalate in fruit may be better absorbed. E.g., in legumes, much of the oxalate is insoluable. I suspect that's why plain cooked lentils do not cause trouble.

My main problem currently is getting enough essential fatty acids. As combinations with fat appear to be bad for almost every food, my best source of fat is chickpeas (which contains a surprisingly high 6% of fat when dried) and quinoa (also about 6% fat). Not sure how much of it can be digested.

I hate to do this (I want to remain vegan), but I will try if I can tolerate oatmeal with low-fat cow's milk. Maybe oatmeal was only problematic because of the oxalates (a large part probably soluble) in almond and soy milk or the fermentation in oat milk. Maybe it might work with cow's milk. The high lysine content might be a problem though. I have to check this.

 

[Wonkmonk]

I am wondering if the symptom flares I get from kale pasta and cauliflower rice is from the tomato paste I use to make it. Some sources say stored tomato products have higher oxalate contents.

This one here lists tomato sauce as "very high" and paste is even more concentrated:

https://ucikidneystonecenter.com/wp-content/uploads/2020/06/Oxalate-Content-of-Foods.pdf

I will try to make it with fresh tomatos (which are said to be low) and see if it makes a difference.

 

[Wonkmonk]

I have deteriorated in the past 1-2 weeks, and I don't know exactly why, but I think it is because of the Omega-3s in greens.

100g of kale has 0.37g of 18:3 fatty acids according to the USDA. When I eat half a pound, that's more than 1g of Omega 3s, and I eat them thoroughly cooked, so bioavailability should be good. Also, leeks (which I'm cautiously optimistic that I can tolerate them) have 0.1g, which sounds like nothing, but it's easy to eat a pound of leeks in a leek and potato soup and that's 0,5g even without any added fat. On top of that, even foods that aren't known to be "rich in Omega 3s" do have 'some' Omega 3s, e.g., 100g of Quinoa has 0.3g.

I think I have to limit Omega 3s to less than 1g a day to maybe about 0.5g a day. That's not ideal, but it's probably still high enough to avoid deficiencies and health problems.

I think the mechanism of action in which Omega 3s make me worse is increased triiodothyronine (T3) conversion (seen studies that Eicosapentaenic acid/EPA does that). supplementing T3 on top of T4 always made me worse, so increased conversion, while probably good for a healthy person, might make me worse.

In the summer, when I started eating greens, walnuts and avocados (they don't have much Omega 3, but high fat in total, so a little of much is still a lot), my TSH got suppressed (near 0.0) and T4 shot over the norm even though my dose didn't change much and I was in a weight range that in the past didn't warrant a dose reduction. T3 remained normal, but note that T3 blood concentrations aren't a very good indicator, because most T3 is produced intracellularly. Reducing the dose didn't help for some reason, maybe because it did nothing to stop the increased T3 conversion in the cells due to the EPA. Things normalized when I cut out walnuts and greens again.

I will probably have to limit myself to 100g of Kale maybe every other day and leek soup only occasionally (and less leek, more potato).

Apart from all of this, I don't feel too bad. All-fruit breakfast (low oxalate) with 5-6 hour distance to lunch works well. I use frozen blueberries, blackberries, tart cherries, pineapple, mangos and fresh apples.

 

[Wonkmonk]

But the above post once again highlights the enormous complexity if the diet selection problem. If just one thing isn't right (this time supposedly to much greens/Omega 3), I worsen again, even if I get everything else right.

 

[Wonkmonk]

It also seems like tomato paste or passata is problematic in spaghetti while fresh tomatos are not. Because it's so concentrated, paste and puree have a higher oxalate content.

I could also imagine that when something is old or sitting on the shelf for a while that there is either fermentation or some sort of chemical reaction that makes foods more problematic. It's apparently best to cook all things fresh.

 

[cheeseater]

Keep in mind that high uric acid (Gout) causes kidney stones but more commonly causes severe arthritic pain. Interestingly enough, some people have the ability to produce uric acid crystals from Niacin (not niacinamide) and can get profound arthritic symptoms that disappear when the niacin stops. I am talking about highish doses of niacin (nicotinic acid).