A Low Oxalate Diet in Autism

There's no shortage of dietary options and recommendations when it comes to those diagnosed with Autism and other learning and developmental conditions. Usually patients with these diagnoses have trialed various diets including gluten-free and dairy-free eating, but not many have explored a low oxalate diet. Lately, and with good results, I've been having patients experiment with a careful selection of low oxalate foods if they have Autism and other developmental challenges.

Autism

A developmental disorder that impairs the ability to communicate and interact. Symptoms include difficulty with communication, difficulty with social interactions, obsessive interests, and repetitive behaviors.

Oxalates:

Oxalates are also known as oxalic acid and are natural compounds found in plants. Children with Autism, and other learning, behavioral disorders seem to have a propensity for higher oxalate levels. In fact, one study found children with Autism had 3-fold higher plasma Oxalate levels compared to normal controls.(R) This may be a consequence of genetics, poor excretion, enhanced absorption, Blood Brain Barrier (BBB) permeability, imbalance in gut flora and/or nutritional deficiencies such as B6, which may lower oxalate levels in the body. It's difficult to determine. Repeated use of antibiotics is also known to create gastrointestinal imbalances and interfere with absorption and excretion. Oxalates in these children are theoretically associated with these aforementioned conditions through oxidative stress, increases in histamine, and by inducing intestinal permeability and dysbiosis; a imbalance of gut flora. Oxalates have also been shown to induce mitochondrial dysfunction that lead to improper inflammatory responses. (R)

Symptoms of High Oxalates

It really does depend on this child or individual, but some common symptoms are listed below:

Brain fog

Restlessness

Anxiety

Headaches

Depression

Joint pain

Painful urination

Difficulty concentrating

Fatigue

Skin Rash or Hives

GI disturbances

High Oxalate Foods

Just keep in mind that completely eliminating high oxalate foods is impossible. The best you can do is be mindful of foods with high oxalate content and attempt a reduction protocol. It's fairly simple, and the following is a good start with eating low oxalate.

Spinach

Nuts and seeds (mainly almonds)

Soy

Potatoes (mainly in the skin)

Figs

Beets

Navy Beans

Dates

Berries (raspberries have the highest)

Cocoa and dark chocolate

Tea

Low Oxalate Foods

Most people intake between 200-300mg of oxalates from their diet daily. A diet low in Oxalate content should be around 50-100mg daily. Here's a some substitutions and good food options with low oxalate content:

Kale

Cashews and Walnuts

Pumpkin seeds

Sweet Potatoes

Broccoli

Kidney Beans

Blueberries

*If one sticks to a Autoimmune Paleo (AIP) or the Gut and Psychology Syndrome (GAPS) diet, it will eliminate grains and beans, which potentially contain high oxalates. Careful selection of vegetables and possible elimination of nightshades are suggested, too.

Oxalate Testing:

There's simply no reliable test which is why symptom improvement is the best measure with patients. Great Plains Laboratory does have a urine Organic Acids test that can be done and does show Oxalate levels, however. I suggest this for patients if they want objective testing.

Additional Notes on the Low Oxalate Diet:

Those on a low oxalate diet may have symptoms worsen for the time being since oxalates are clearing from the body. It's a term called "oxalate dumping" and may be associated with rashes, behavioral regression, further GI disturbances, urinary pain, a change in urinary frequency and increased appetite. Basically, an increased intensity of symptoms if there's quick removal from the body. It's suggested to decrease oxalate intake by 5-10% weekly to minimize symptoms. Patients adopting this diet may also benefit from oxalate binders such as calcium or magnesium citrate while staying away from vitamin C, since this vitamin can convert to oxalates. All in all, this dietary plan may help children with Autism, and developmental conditions, but also those with oxidative stress, chronic complaints, auto-immunity and other learning, behavioral conditions. If interested, please contact Trivita Health Center for more information regarding a low oxalate diet and integrative psychiatric care.