The Melanie Avalon Biohacking Podcast Episode #104 - Sally Norton (Oxalates)

TRANSCRIPT

Melanie Avalon: Hi, friends. Welcome back to the show. I am so excited about the conversation that I am about to have. I'm really excited for what I think I personally am going to learn in this conversation, and I think it will help a lot of listeners out there. A little bit of a backstory and context for this interview. As you guys know, I've been floating around in the low carb paleo world for quite a while, and I've had a suspicion of [giggles] a lot of the potential compounds and plants for probably about a decade now. One of the first huge dietary changes I made, which I'm no longer doing, but it was basically I went on to basically an all-meat diet for quite a while, this was way before carnivore was a thing. That was because I just realized I tended to react to plants, things just tended to be going on. As the years progressed, and the more I learned, I became more out there in the popular world with the low carb diet, things like carnivore, and I’ve even created an app called Food Sense Guide on iTunes, and it looks at 11 potentially problematic compounds and food. That includes things like gluten, lectins, amines, histamines, and something called oxalates.

Now, I am really, really fascinated by oxalates. We're going to be diving deep into oxalates in this show. I personally don't think I have an oxalate toxicity issue, but I'm very excited to see what I learn in this conversation. When I was making that app, when I was researching oxalates, I kept coming back to this one resource, a fabulous Miss Sally Norton. She's truly one of the go-to sources on oxalate toxicity, how to deal with that, the symptoms, the signs, all of that stuff. I am so honored, so excited to be sitting here today with that lady, Sally Norton. So, Sally, thank you so much for being here.

Sally Norton: Thank you. I appreciate getting to know you and your listeners. This will be fun.

Melanie Avalon: I know. I'm really excited. Actually, my assistant introduced us, and I remember I think I was saying in my Facebook group that I wanted to do a show on oxalates, and she was like, “Oh, I think I can connect you to Sally Norton.” I was like, “Oh, yes, please,” because you're just so well known and so respected in this world.

For listeners who are not familiar with your work, I will tell them a little bit about you. Sally holds a Nutrition degree from Cornell University and a Master of Public Health degree from the University of North Carolina at Chapel Hill. She's worked in the field of integrative medicine at UNC medical school. She was project manager of an NIH-funded project for expanding medical education to include more awareness of holistic and alternative healing arts, which I just love, that is fantastic. Sally has published many articles, and academic and popular journals. She's been in a lot of interviews. Like I said, she's very, very well known for the work that she does on the role of the potential harmful effects of oxalates in our food. So, Sally, I have so many questions for you, but to start things off, would you like to tell listeners just a little bit about your personal history and what brought you to this oxalate fixation, obsession, whatever you want to call it?

Sally Norton: It is a fixation and a life's work. There's so much to learn about oxalate. Like everyone else, despite my education in nutrition, a degree from a great school, a couple great schools, and working in the field of health promotion, I decided as a seventh grader that I wanted to get into health promotion. I didn't think of it as that term, but I knew I needed a nutrition degree to help people avoid disease and realize if you knew how to take care of your body, you wouldn't necessarily have to get sick and it gets something like cancer or heart disease. I thought, “Wow, isn't that a fun thing to be doing?” So, I've been wanting to be in that space for a long, long time. [giggles] Well, it was when I was in seventh grade and it was a very long time ago.

I was always a bit of a goody two shoes about my lifestyle, and my food choices, and was a gardener, as a young person, I had my own community garden club when I was nine or 10 years old or so, and continue to garden to this day. I've got a great interest in plants, food, nutrition, delicious food, I love to cook, and health promotion. I didn't know really anything about oxalate. In my textbooks in school, they were like one inch of text in a single column in a textbook saying, “Oh, well, these 10 foods over here are high in oxalate, and that's bad for kidney stones. By the way, oxalate is bad for calcium nutrition, because it binds it.” That's really all I knew. I didn't really have a high awareness of oxalate that I was eating. It's not something like you look at a plate of food and you can't say, “Oh, that's a high oxalate plate or not.” We're just so unaware of it. Those of us in health professions may not only be unaware, but miseducated.

So, if I was a nurse or a dietitian, and I went to look up information about oxalate, I would find very short, incomplete list loaded with mistakes, and the list wouldn't have amounts or wouldn't tell them what the goal of a low oxalate diet would be, or an oxalate-aware diet. What are our goals? What are we trying to do with it? Not information like that. Not numbers, how much oxalate is in food? Just a list of maybe 40 items that are said to be high-oxalate food. Many of these lists published in professional textbooks have 10 to 20% errors in them. So, you can't even turn to a dietician or your doctor if you think you have an oxalate problem. I was one of those dumb people [laughs] who knows a lot about health, and meditation, and whatever, who really didn't know what she was eating.

A lot of us who like food, who like health, or who like gardening and cooking can get into a thing with certain foods that happened to be accidentally high in oxalate, and if you've ever had-- anyone out there who's had a struggle with their health and is trying to eat well, and then keeps trying harder to eat well, they're likely to turn to more and more of these foods, because so many of the foods that we now promote as being uber good, healthy, full of whatever to make us awesome, are loaded with oxalate. The ironic part is that if you're very health oriented, there's a chance you could be eating a lot of high oxalate foods. Now, there's also the other side of that because oxalate happens to be into just basic foods that we consider normal American things to eat like peanuts, peanut butter, potatoes, and chocolate. So, you could be a Hershey's whatever junkie, potato chip junkie, that sort of thing, and also be consuming a huge amount of oxalate.

Melanie Avalon: Did you have a health condition that [unintelligible [00:07:21] you into this?

Sally Norton: If you go all the way back, which is what I do with my clients, when I work with people one on one, I take a deep history and think deeply about their origins and beginnings, because a lot of us who got so much oxalate into our system that we were quite sick and broken, can really break yourself, and break your health and it's a long road back. When oxalate starts accumulating a new tissue, when you start overloading your body with oxalate, it can turn and become very serious illness. Even to the point of being the unidentified cause of people's early death, believe it or not and I was already having trouble as a 12-year-old. Around the same year I was deciding what to do with health, be a health professional, I was having back pain, I was waking up in the morning sometimes with almost like a paralysis that would last a second. In college, I developed pain in my one foot which developed into two feet. I had to drop out of college for foot surgery. I tried to take tennis in college, and I didn't have the elbow strength to really manage the racket. I've had tendinitis and weak elbows, and weak connective tissue, foot problems, and I developed a tremendous amount of arthritis that lasted all through the years I was vegetarian and vegan. I did those diets each for about eight years apiece, and boy, was I big swollen, arthritic weakling, who did yoga and ate perfectly, and so on.

I've had so many health problems that eventually it ended my career. As a grant writer at the local university here I had a faculty position, designing, and writing, and submitting, and administrating public health research grants, and I got to the point where I could no longer sit. I had to kneel on my knees at least half of the day, because my back wasn't really able to tolerate sitting all day. I needed a hysterectomy. I was really having trouble there and had to quit, and have a hysterectomy. I didn't recover well from that. My doctor sent me to a sleep doctor who discovered that my brain was waking up 29 times an hour. I had all this intense fatigue. I could barely read, I could barely function. I had no exercise tolerance, basically laying on the couch wondering why I can't sleep.

I spent three years researching what were the causes of brain problems to the point where you're not sleeping well, and was directed towards this autotoxicity that can come from bacterial overgrowth in the intestines, which is often called SIBO, where the bacteria are backing up and living in your higher up in the gut than they're supposed to be. But that's not what my problem was. I was toxic, but it wasn't the bacteria doing it. It was my sweet potatoes and Swiss chard.

Melanie Avalon: Speaking to the SIBO thing, I think so, so many people fall into that rabbit hole. I was definitely in that rabbit hole. To this day, I do think a lot of people have that, but I do wonder oftentimes, how often is it actually other things going on? Probably, now, that I think about it, because I remember I was in a really large SIBO Facebook group. I think that might have been the first time that I started seeing things about oxalates. Just because people in in that world are so discussing like all of these potential things that might be involved. Backing up a little bit and just looking at what are oxalates. It's always such a simple question that I start with, but what are oxalates, and what defense mechanism do they serve in the plant and why is that a problem for us?

Sally Norton: Yes, oxalate is a chemical that's all through nature, but plants make a lot of it. When we eat food, it's the plant foods that we're getting it from. Some plants are of so much oxalate, they're known to be poisonous. There's several house plants or plants you see in the mall, like the dieffenbachia plant that are so loaded with oxalates that even one drop of sap from that plant can put you in the hospital literally. We don't eat those plants but plants that have less and less oxalate. On the high end of the ones, we think are edible, something like rhubarb. Rhubarb, beet greens, Swiss chard, sorrel, purslane, and spinach. Those are examples of leafy plants that are really, really high in oxalate make a lot of it. Now, all kinds of plants make oxalate. Some families of oxalate are use oxalate for more reasons metabolically and really needed for their health in their basic function and survival. Plants that are thought to have about half dozen reasons for making oxalate.

What the plant does is, oftentimes, the plant will create vitamin C and convert that into oxalic acid. Now, oxalic acid is a two-carbon acid that has four oxygen molecules on it. That is a very small compound. But what it does is because it has these two OH groups. It drops in H and always has a negative charge, and then when it has an opportunity, if there's a strong reason to do it, it'll let go of that other H, which are the acid molecules and becomes a chelator very quickly. It grabs something that has a positive charge like a lot of the minerals, sodium, potassium, magnesium, calcium, iron. In nature, we see oxalic acid being turned into crystals. The plants will deliberately turn oxalic acid into crystals and use those for lots of different purposes. In trees, for example, the trees put these blocks of crystals into their bark, which makes a lot of sense because the bark is self-defense from insects. If you're an insect and trying to drill a hole in a tree, and you hit this solid block of diamond basically, you're going to give it a chill. [laughs] You can’t be a really desperate insect to try to drill through that, because if you also hit soluble oxalate, you could not only be damaged physically by the crystal, but then chemically damaged by the soluble oxalate.

Now, the plants, the way they design these crystals which come in all these shapes, including a raphide which is a toothpick shape, double-ended spear, designed to be self-defense spear made in bundles like quivers have 200 apiece in these plant vacuoles. The plant can literally shoot them out. When the plant gets damaged, it will shoot these spears out which can penetrate cells, like two cells deep in a soft mucosal membrane like our mouth. I don't know how the insects handle that, but we don't handle that very well. That's part of why dieffenbachia sends you to the hospital, because the raphide crystals are defense weapons on the part of plants. I like to think of plants actually having invented war. [laughs] They knew how to build the spear before we did. The way they do that is so cool, because they lay out this scaffolding of peptides and proteins, and you see the calcium oxalate sticks to proteins and amino acid. By laying out these amino acids in a certain way, you can shape how the crystals come together and form a crystal shape. As a plant, you can create different kinds of tips, grooves in your barbs, and all kinds of shapes and cool things. It's amazing.

Now, the plants will also use oxalate to do things like make peroxide, because it can turn oxalic acid into peroxide. It also uses oxalic acid to store calcium. Those crystals are not only weapons or self-defense, they are a way to pantry calcium. If you're a seed, you need that calcium to germinate. It helps to activate enzymes that drive that germination process. So, it's a great way to store calcium. It's also a way to control calcium, because too much calcium for some plants is quite toxic. It's another way to manage calcium, like bones. We use bones as a place to store calcium and then we'll steal the calcium and other minerals out of our bones if we need it. Plants do that same thing. In fact, desert plants need oxalate especially so because plants have to breathe CO2, and then they produce oxygen during photosynthesis. To breathe CO2, you have to have your little lungs open, and the lungs on a plant are the stoma under the leaves. But if you're a desert plant and you have your stoma open during a hot dry day, you'll dry up and you'll just become crepe paper. You can't hold on to your moisture with your stoma open. So, during the day, the plant can break down the oxalate, which is carbon, and oxygen, turn it into CO2, and continue photosynthesis during the day when the sun is out. But there's no moisture.

Melanie Avalon: They breathe oxalates sort of.

Sally Norton: Yeah, right. Exactly. They produce their own air by storing carbon. They're not only storing calcium as a nutrient, they're storing carbon as a nutrient.

Melanie Avalon: Some follow-up questions about all of that. There are two forms of oxalates like a soluble version that's not attached yet to things and then the crystals where it is attached?

Sally Norton: Right. We talk about them plural, because not only are there two forms, okay? There's oxalic acid, which is basically an ion when it's a molecule that has either one or two negative charges. So, there's already two kinds of ions. The one that has both ages gone and two negative charges, or still hanging on to an agent has one negative charge. Then, it can form a soluble bond with sodium and potassium. Those are single, charged minerals, and they easily disassociate from oxalate in fluid, in liquid versus when oxalic acid and calcium or magnesium get together, calcium and magnesium have the double positive charge and that creates a much stronger bond with the oxalic acid. And those do not easily dissolve again in fluids at body temperature at normal pH is.

We call that insoluble, and that's one of the reasons why that calcium oxalate is so prominent in nutrition in nature rather, because once it's bounded together, you need some kind of enzyme or other superpower to take it back apart again, pretty well. So, if use enzymes and you have to use acids and so on to break it down, so the insoluble oxalates are molecules that can form into nanocrystals, which is another form is the crystalline form, which then grow into these microcrystals, which eventually can get big enough that you can see them under a microscope, provided that how to prepare your sample, stain it, use polarized light, and there's a lot of skill involved and even noticing crystals in tissues of plants or in people who are ending up with this crystal formation occurring in the body. That's where we get into the pathology side. Like in plants, oxalate, whether soluble, whether it's the molecules, or the crystals, and whether it's the big ones or the invisible ones, the plants, they need those things. That's a sign of good health, happy biology for a plant but when we start collecting oxalate and having crystals forming in our body, that is a serious pathology that can lead to a lot of problems for us.

Melanie Avalon: It's pretty cool that the plants have these compounds that are both weapons, and they have nutrient source purposes. Pretty nifty for them. When we eat, because you’ve mentioned foods that are higher in oxalates, some questions about the amounts in foods. You touched on this in the textbooks, you know a lot of the information is just wrong. What is the range of the amount of oxalates in different foods? If a food is considered “high oxalate,” is it typically weigh more oxalates than a “moderate” or “low oxalate food”? Also, within the food, do the oxalates tend to be a certain form more than another form, or is it all the forms? What's going on with all of that?

Sally Norton: Yeah, certain plants are much higher in oxalate than others. A standard portion size, you have to think about how much oxalate is in a food you're thinking about, well, how much of that food I'm eating as well? The more of any food that has oxalate in it you eat, the more oxalate you get. It's not like it's by itself and inherit property high or low depending on how you're consuming it, what quantities and how you're preparing. It will influence this a little bit. But the really high ones are like we mentioned before, rhubarb and beet greens and so on. They’re to the point where a single serving would be dependent-- If you're eating uncooked, which would be appropriate for all plants, you really need to cook plants to make them semi-safe to eat, and even that isn't necessarily going to fix you. Especially, in oxalate by the way, there's many, many myths around oxalate and people think, “Oh, you just cook it. It's gone. You're fine. We're just soak it and it's better,” Actually, it might be the opposite. Anyway, that's just an aside. But something like a bowl of raw spinach is at least 300, but if you put it into a smoothie, you usually use twice as much and you're getting into the 700 or 800, these are milligrams of oxalate. Now, 700 or 800 milligrams of oxalate is actually quite stratospherically high. The way we define foods as either low, medium, or high, a high-oxalate food, one single portion of any food, if it has 10 milligrams or more that's considered a high-oxalate food.

Melanie Avalon: You said a cup of raw spinach could have 300?

Sally Norton: Yeah, 300 to 400. Basically, I think it's something when you-- let me think about this for a minute. I think it's four or five milligrams per leaf of spinach of oxalate. You get a couple leaves and you've already reached high oxalate foods. So, spinach and Swiss chard, and beet greens are examples of like-- Yeah, you really can't get around them in terms of their oxalate content. Chocolate and cocoa is another one. It's so high, it's very bioavailable, it's very easy to get into high doses. So, a tablespoon of cocoa is something like 55 milligrams of oxalate. You're very much in a high-oxalate range. And that level of intake, if you have a meal that's about 50 and above, your potential-- if it's highly absorbed, which there's a whole another conversation about that, but as long as it absorbs which it just floats in your body. It doesn't need a special permission to get in. It just gets in there passively. That's enough to raise blood oxalate levels high enough and raise oxalate levels in the urine where it ultimately has to come out of the body. That's considered really a dangerous dose already just a tablespoon of cocoa.

Melanie Avalon: Wow. You said it was on the side, but I actually am curious about it. Cooking and soaking, does cooking break it down at all? You said soaking might actually make it worse.

Sally Norton: Right. With cooking, we get all different methods of cooking or heating foods. The one way you might be able to use a cooking technique to sometimes lower the amount of soluble oxalate is boiling. If you boil something long enough like broccoli, a lot of greens is one of them. If you boil them long enough, which is basically meaning you turn them almost mush. If you throw out the water, it leaches out some of that soluble oxalate. Remember I said, soluble oxalate will break apart in water. As you break down the cell walls in plants, that can come out of the plant and into the water. You can reduce in broccoli, about a third to a half of the oxalate and bring broccoli from medium down into pretty reasonable amount of oxalate. A reasonable portion of broccoli is quite low if you've boiled it. But if you're sautéing or flash roasting it in the oven or something like that, you're not changing the oxalate content, because you're not using water to leach it out. Now, steaming will sometimes leach out a tiny amount because of the hydration effects where you're leaching. So, that's the one way you can use cooking.

But otherwise, you can't cook food hot enough to destroy oxalate crystals, which is a big portion of the insoluble oxalate or these crystals, which you don't really absorb in your gut, but they just tumble along in there and irritate your gut with physical, mechanical damage, but also an electromagnetic damage, too. The crystals, you can't really get rid of them very well, unless sometimes juicing makes it worse. There's not always an easy answer because there's so many little details in terms of the specific plant material, what kind of oxalates they have, which we don't have a thorough cataloguing of what kind of crystals, how much of it is crystals, how much is nanocrystals, how much of it is this or that? Because that would take a tremendous amount of research because each food is coming from a natural source, which varies from variety to variety, soil to soil, year to year. Just like every human being is unique snowflake, every harvest of blackberries is somewhat unique. You're going to see a level of variability where we take a tremendous amount of testing and a lot of money, and a lot of interest from science and somebody willing to fund it to really have a thorough and detailed understanding of all of those current levels of [unintelligible [00:25:11] details. But we don't really need that much to benefit from what we do know about the science and to recognize that oxalate can be causing us trouble.

It's something you're activating. You're turning on the germination process with soaking. You're trying to undo the phytic acid and make the indigestible seed more digestible. Because seeds are designed to not be digested. They're designed to be tolerating consumption, but surviving the digestive tract, so that the seed comes out the other end, all fertilized and happy and ready to go. We activate-- we take away that dormancy stage and make things a young tender sprout wannabe, and that is now turning on the need for that calcium for the germination process. So, the plant may be starting to break down the crystals and turning it into soluble oxalate. So, you're releasing insoluble oxalate that you may not have absorbed from seeds by soaking, potentially converting some of it to soluble oxalate, which is now the ion forum which more easily floats into your bloodstream and starts chelating calcium and things in your blood. So, activating or soaking, if the food is already high in oxalate, could make it more bioavailable and make it therefore, technically-- In practice, it's like raising the oxalate level by doing that.

Melanie Avalon: Clarification about that. If you took in the unactivated form that wasn't broken down by the germination, by the soaking, would it be in a crystal form, and then it gets broken down? If you take in the broken-down form and accumulates with your minerals, does it then take your minerals, and then on top of that it's formed into a new crystal form?

Sally Norton: Well over 90% of all the oxide you're absorbing is the soluble ions. The little ions are the individual molecules that are with the negative charge, that's a reactive molecule and it gets into your bloodstream very easily, and there, if there's calcium, and iron, and magnesium hanging around, the two of them will get together at some point. Whether it happens in the blood or happens after it gets into a cell somewhere else is a whole bunch of terrain issues and whole bunch of situational issues, and it ends up being very idiosyncratic in different people and how much binding and stealing of the calcium from the blood is going on. But you see it in chronic or, excuse me, acute poisonings, especially when it's something that's a precursor of oxalate. People try to commit suicide with ethylene glycol, ethylene glycol is turned into oxalate in the liver of the body. The liver starts releasing oxalate into the tissues, and people often get a lot of neurological symptoms. They start getting Bell's palsy, and crazy spasms and tremors, and sometimes they just have a stroke or something and die, or have a heart attack Those kinds of things with oxalic acid poisoning or from a precursor like ethylene glycol, it's often the heart attack that takes them out. That's because a quick lowering of the calcium in the blood is disturbing the electrolyte balance that is required for the pacemaker to work, for the heartbeat to be maintained.

Melanie Avalon: Yeah, that was one of my questions from the beginning when you said, it's often the cause of unexplained early deaths. When that does happen, is it normally things like that, the calcium and pacemakers, or are there a lot of just conditions and nobody's realizing that it's oxalate?

Sally Norton: Yeah, nobody's really recognizing it. Oxalate is the ultimate bad guy. Somebody should be writing Nancy Drew novels and really cool mystery novels, because it is this mystery. It has tricked us. It is happening under the radar of our awareness and science. In the recent half century or so, science has really only been paying attention to the crystal forming in the kidneys, because we are peeing out oxalates all the time every day you are peeing in on oxalate. For some people, oxalate crystals can start getting stuck in the tubules, start sticking to each other, sticking in the kidney, and becomes a kidney stone. That is an obvious event that you can't deny. They go in there, and they cut it out, or they blast it out, and usually when that happens, that person ends up getting more kidney stones, because the oxalate will stick on cells that are injured. If you blow up a diamond crystal in the kidneys with lithotripsy or something, you actually create some shrapnel there that's going to continue and cause additional damage which is already getting started from the oxalate itself.

Oxalate ions and the little nanocrystals that form are already creating tissue damage in the kidneys and that tissue damage brings in inflammation, and that situation of damaged tissue creates tissues that are more prone for oxalate sticking to them, because every cell has proteins in the membrane. Proteins are made of amino acids. Amino acids are sticky to calcium and calcium oxalate. So, if a cell isn't healthy, it can be the proteins on a cell, or a cell fragment, a dead or dying cell that can stick there. The oxy crystal can stick on those membrane fragments, and there's no cell there to defend itself. You have to wait for the immune system to come in and address it. That is a trigger event that starts a new deposit. Whenever an oxalate molecule gets stuck somewhere in the body, that starts a new deposit. We call that trigger. And that's what I was saying about that cocoa dose, that tablespoon of cocoa is enough oxalate to trigger new deposits in the body. Then, when you go down eating just, say, meals of 40 milligrams instead of 60 or less, you've got enough oxalate continually flowing in, it doesn't sound much. But that's enough to maintain that deposit and make it hard for the body to clear it.

Now, other tissues that tend to get these sticky to oxalate is not just the damaged tissue or inflamed tissue, but also regenerating tissue. Well, usually, damaged tissue is regenerating. It's trying to heal itself. That's the other thing that's sticky about these cells to oxalate is that regenerating tissue has a lot of glycoproteins and that's the carbohydrate molecules sticking to the protein molecules that are part of the cell’s recognition process, part of the cell communication process with that, like sugar hair, cells have cotton candy on them, that's the way they know each other, and they actually use those sugar molecules to climb along acting fibers and move around. When you build a new cell, sometimes you're building a sell, say over here, and you've got to put it into place when as it's maturing in that movement of a new regenerating cell requires those glycoproteins So, anyway, that sticky sugar is sticky to oxalate too. Both an injured tissue and inflamed tissue as well as the regenerating tissue, they're all prone and vulnerable to oxalate that you are absorbing from your food getting hung up in those tissues. A high-oxalate diet can lead to poor recovery from injury, poor recovery from surgery, very slow recovery or old injuries that just linger in small ways for a long, long time.

Melanie Avalon: This is a super naive question, but just to clarify for kidney stones. Are all kidney stones from oxalate? Is there anything else that can cause kidney stones?

Sally Norton: Yeah, there's infectious stones, stylobate stones, there's potentially urate stones, but kidney stones are primarily calcium oxalate. But 80% of all kidney stones are made mostly of oxalate.

Melanie Avalon: Okay. Because the kidneys are responsible for filtering all of this, and you’ve mentioned all of the other places in the body that oxalates can attach to and create a buildup, can a person have kidney stones, and it's just in the kidneys and not anywhere else in the body, or is it if they have kidney stones, does that indicate they probably have build-up everywhere, or is there not really like a relation?

Sally Norton: Yeah, that's a really great, great question. I wish science wanted to answer that question. [giggles] It is my feeling that kidney stones are an example of a way that oxalates cause damage and collect in the body, and not everybody who is collecting oxalate in your body gets kidney stones. That is for sure of a known fact in science. I believe that if you're getting kidney stones, you are definitely having stressed kidneys and you're definitely collecting oxalate. I think there's very few people who are getting kidney stones of the classic calcium stone. They call it calcium. By the way, they don't tell the patient that it's oxalate stone, they don't call it a calcium oxalate stone or not oxalate stone, they call it a calcium stone. Then, everyone's blaming calcium, and calcium is all scary now, and supplements are supposed to kill you, and it's nonsense. Oxalate has stolen a really, really valuable nutrient. It's stolen it from your bones in your blood, and is turned it into hoodlum, and making it dangerous in the body, and the doctors are calling that calcium, but it's actually kidnapped calcium. It's not calcium doing it. Oxalate’s what's empowering calcium to become a toxin.

Melanie Avalon: When that does happen because of the intricate relationship with calcium, how does it affect in general calcium stores or calcium blood levels potentially? For example, I was asking for questions, and Maryann said, this is actually good example of people don't associate oxalates with calcium, but she says, “I don't know about oxalates, but I had kidney stones for years, and my doctor ignored as unimportant that my serum calcium levels were elevated.” Is it usually the opposite, though?

Sally Norton: Yeah, it is usually the opposite, though. But often you're not going to see changes in calcium oxalate with oxalate toxicity normally, because the bones are such a huge store of calcium. What it does is, it turns on the parathyroid glands which tells you to break down your bone tissue. You may have a slow-brewing osteopenia coming along like I did, because you're eating all this Swiss chard and sweet potatoes like I was, and just sucking the minerals from your bones and constantly breaking them down. You don't see many problems in blood. Now, the high calcium in her blood may suggest kidney stress, that her kidneys weren't able to move calcium out, extra calcium or some other metabolic stress going on where the parathyroid gland maybe overdoing it a little bit and releasing too much calcium from the bones. But anyone with high blood calcium should be concerned about their bones.

Melanie Avalon: She found out she had hyperthyroidism.

Sally Norton: That would be why.

Melanie Avalon: Okay.

Sally Norton: But you see the oxalates turn on the parathyroid glands a lot, and it activates the immune system. So, it's quite possible that an overworked parathyroid gland could end up with an immune issue, because it's so overactive and who knows, it could even be a spot for calcium oxalate to start collecting, because the oxalate can get anywhere, anywhere. There's really no place in the body that it doesn't go.

Melanie Avalon: Just to drive home the point you just made about the bones, I can see how this would be-- Like you said, osteopenia, osteoporosis, because I recently had on the Caltons, who wrote Rebuild Your Bones on the show, and we were talking about blood calcium levels. They were saying how it's so, so rare to see blood calcium levels that are not normal, because the body is so good at pulling calcium out of our bones. I could see how, if we're eating a high-oxalate diet, and that's binding to our calcium, you could be doing great damage pulling your cal-- The oxalates would be binding to your calcium, then you'd have to be pulling calcium out of your bones, but you probably wouldn't ever be aware of that because blood calcium is usually, it's not usually normal for most people.

Sally Norton: Yeah, you're not going to find a lot in the blood. The blood in my view is the river of perfection, because the blood is what keeps everybody communicating and alive. Every other body tissue will sacrifice for the sake of healthy blood to keep the heart working. Because no tissue is any good whatsoever if there's no heart, or if the kidneys fail. So, the other tissues will take second fiddle and service the needs of the vital organs as much as they possibly can. The bones take second place and make sure the heart is going to keep beating, sensible.

Melanie Avalon: Wait, what did you call it? The river of perfection?

Sally Norton: Yeah, the river of perfection. We go diving into the bloodstream because it's convenient. We have needles, and we've developed tests for blood, and we say that's the basis of deciding health and disease. To me, that's insane. That's just evidence that science and medicine has moved towards science and away from biology. You know that old story about the drunk guy who lost his keys and he lost him down the block, but he goes looking for it under the streetlamp, because that's where you can see? That's what we do and blood testing, urine testing. We can get to those tissues without invading someone's body. The only way to really know if you've-- Well, not the only way, but technically in science, the gold standard way of finding out if you have oxalate accumulation is to take a chip of bone out of your hip and then examine the bone tissue. Now, that is very invasive. No doctor is going to order that test. Even then, you're prone to false negatives where you've chose the wrong piece of bone and you missed where the crystals are hanging out.

Melanie Avalon: It's the crystals you're looking for in the bone?

Sally Norton: Yes, because oxalate loves calcium and calcium loves oxalate. The bones are a magnet for oxalate and some people will collect oxalate in their bone marrow. Now, what is bone marrow doing for us? Well, it's building blood. It's building white blood cells, red blood cells. It's a really important tissue. What if your immune system is born in oxalate-loaded marrow? You bore immune cells that are already damaged with mitochondrial stress. Then, you eat a spinach smoothie because you don't feel good, and you're trying to get healthy, and you then damage your mitochondria in your white blood cells in your circulation. Then, you have crystals in your kidney and your white blood cells show up to try to help that problem and they've already been dinged twice with oxalate at birth and oxalate during transition time in the circulatory system. So, it really gets you in really basic places.

Melanie Avalon: When I asked for questions about the oxalates, Pasha said, “How to prevent stones, how to minimize the likelihood of them coming back if they're already there.” A lot of questions about getting rid of them, because it seems like there can be problems in the clearing process. So, Alison said, “How do you clear oxalates from your body before they build up and create stones?” Sharon said, “How do you go slowly as to not over dump or purge oxalates?” Is that a problem? She says, is there a way to slow it down if you do start to dump, does it matter how many oxalates you have in your tissues as to how you go about cleaning house? Because there's definitely this idea out there of dumping, and I think a lot of people, especially in the low carb and carnivore world experience this. So, preventing the stones and then when you do have them, can you just stop eating oxalates? Will they go away if you just stop eating them? Do you need to actively try to get rid of them? And then on top of that, if you go too fast, will you suffer issues? It's a lot.

Sally Norton: It's a lot. There's like 15 questions. We'll try to keep circling back, so we make sure we hit all those points. A lot of people don't realize-- Okay, overdoing oxalate in our diets, which is so easy to do, because we all grow up on peanut butter and whole wheat this and that. The brand is really high. So, let's go back real quick, if you're suspecting oxalates, the first risk factor for oxalate accumulating in your body is that you've been eating the heck out of them, either intensely recently or just generally in your life. If you're into lemon poppyseed cake, well, poppy seed’s really high and so is the rind of citrus fruit. Lemon rind is high, and we put that in the lemon desserts. Hemp and tahini from the sesame seeds, almonds, cashews, peanuts, pine nuts, these are all really high foods. So, if you've been pigging out on nut butters and keto bread and stuff, you are probably somebody to really pay attention to this discussion.

We talked about some of the greens, the sweet potatoes, a lot of white potatoes are pretty high, although the red potatoes aren't too bad if you boil them and eat them in modest quantities. But mostly, what we eat are the high russet and Idaho potatoes that we use to make chips and French fries. Baked potatoes and mash potatoes are often made with the really high-oxalate potato. I find when my client base that an awful lot of my kidney stone folks were/are potato chip freaks, they have this addiction of potato chips or into potatoes with every meal. If you have that background, you want to be paying attention. If you happen to like cactus, that's really crazy. One of those desert plants that's high in oxalate.

Melanie Avalon: Have you had that before, by the way, cactus?

Sally Norton: I used to use cactus. You can buy it pickled in a jar, and I used to use it on my salads.

Melanie Avalon: What does it taste like?

Sally Norton: It's a little bit slimy. I don't know. Don't try it. [laughs] Don’t try but it's so crazy. You could get into some little weird thing like that, and just pile on oxalates, because you're just don't know these things, and this isn't easy knowledge to get. There are good lists out there. People don't know that that's what's happening. I had no idea like, “Oh, my little cactus thing, I thought it was unique and interesting.” But no, that's not a good idea either. Then, there's plantain chips. They're all the rage right now. Who knows why? But it's a little bit novel, and people love chips. Now, we've basically moved to a snacking culture. When I was a kid a million years ago, we sat down to meals. My mother would say, “Don't eat that. We're going to have dinner in half an hour. Just wait.” There was this definite eating times and not eating times. It was like, “Hey, the kitchen’s closed. Quit making a mess. We're done eating.” [giggles] But now, everything's in a convenience store, in a little bag for us packaged and we're really quite comfortable now with eating say sweet potato chips, root chips, plantain chips, banana chips, all that stuff is really high in oxalate. Then, there's anything made with beans and soy is high, and then, there's pseudo-grains, buckwheat. I have a friend who died pretty young. He was eating buckwheat every day for years for breakfast. He liked it. I don't know why but he liked it.

Then, there's quinoa which not only has oxalate but has saponins and other gut destroying chemicals in it. I used to love teff, and sometimes make teff for breakfast with just a little bit of cocoa in it, and it was like-- do you remember cocoa wheats and that was a cooked breakfast cereal? Teff made I thought the healthy version of that. No, not good. Then, there's dark tea, black tea, and green teas, and chocolates, and then certain spices. If you are a person who did those things or do, then you definitely have been putting yourself in harm's way with pretty high-oxalate foods.

That's just the background to these questions of, “All right, if I've had a kidney stone, what do I do about that? How do I knock it the next one? How do I clear the ones I have now? What about the rest of my body? How do I clear that?” If crystals of oxalate have been forming in your tissues, they're probably in places where you've had inflammation, where you've had injury, something you use a lot, so, if you type all day, and then you-- The thing is one other point about, oh, there's a million points. [laughs] We eat oxalate during the day. Now, when we're sleeping, it takes a while for them to be absorbed. There's this eight-hour period after high-oxalate meal. The spinach smoothie for breakfast, the fries at lunchtime, and then the sweet potato whatever at dinner, each of those meals introduce at least a 6-, 8-, 10-hour period of oxalate being absorbed from the digestive tract. They're overlapping. Lunch piles on to whatever breakfast had, and then if you have a little Kit Kat bar or something in the afternoon, there's a little more chocolate or worse, something like the peanut butter cup, and then you have dinner, and so they keep adding on top of each other. By the time you're going to bed, your oxalate levels in your blood, in your kidneys and so on are at their highest. But bedtime is when you're supposed to be healing from your day's activities. Sleeping is the centerpiece of good health, because sleep is when tissue repair happens. But if there's oxalates running around those tissues during the night, then that tissue recovery is not very effective in that. So, you can end up with carpal tunnel syndrome and various supposed overuse problems. It's not about the overuse. It's about the fact that during the night, your body didn't have whatever it needed, which would be low toxicity and high nutrients to recover and heal the day's activities. If you've got anything like that, any aches and pains, arthritis, backaches, memory problems, brain fog, fatigue, that kind of thing, then that's a sign that you have symptoms that could be related to too much oxalate in the diet.

Then, there's the kidney stone. Now, kidney stone is the obvious oxalate illness, and even that your doctor tells you, it's a calcium stone, sadly. The body and healthy kidneys put out a ton of these proteins that-- remember proteins, stick to calcium oxalate and vice versa. The body puts out these proteins to prevent the crystals from clumping, and people who get kidney stones are people who don't really make enough of those proteins, and who also aren't putting in enough citric acid or citrate. Citrate also is a calcium chelator and binds to those crystals, and creates a little coat that prevents them from getting clumpy. You can increase your citrates in your urine by having basically more alkaline urine. One easy way to do that is to eat citrate. Citric acid from lemon and citric acid supplements, calcium citrate, potassium citrate, magnesium citrate, that citrate turns into bicarb in the liver, and that bicarb then helps the pH go up a little bit, and a better pH like that will allow the kidneys to put out more citrate. Eat citrate to put citrate in your urine, and that citrate is very good at breaking down crystals, and also is very protective of the kidneys in the same way that those proteins are. If you're a kidney stone type person, you can't rely on those proteins that you should be making to prevent the stones, you have to rely on citrate. It's really important that you use lemons, or citric acid, or other ways of alkalizing to increase citrate in the urine.

Often that works great in the context of a low-oxalate diet. That won't work if you're still eating a lot of oxalates right. When we are eating oxalates, we can be eating in what I call the danger zone level where it's way overwhelming day in and day out. Where most of your meals are really high, you're doing keto bread, or chocolate, or something. There's enough of these foods. Even though, it's a fairly small subset of foods that are high oxalate, they're common, and praised, and beloved enough and it's easy to get hung up on the same foods like the potato chips, that you could be really in that danger zone. Doing more than about 1000 milligrams a day is definitely in this really dangerous place where it's causing a lot of inflammation and stress in the body, and you're on your way to having an autoimmune disease. Now, if you come out of danger zone, you can come down into just trigger zone, I'm just having 50 milligrams with a meal with a chocolate here and there. That's still a fairly-- you have to be really aware of your food to be able to bring it down into trigger zone. Then, you can bring it down in what we call maintenance zone where you're eating just a little bit all the time and that prevents the clearing. It's when you go really zero, when you go on a carnivore diet, you're cutting out all plants, so you're totally going to almost a zero-oxalate diet. That is a dramatic shift in your metabolism from one that is sequestering and defending and trying to deal and cope, which is a whole different set of metabolic talents, to one that now is like, “Woo, oh, my gosh, we're finally getting a break. Ooh, we can clean up this mess.” It takes you know at least five days for a lot of cells to develop new superpowers to start attracting this process of elimination.

But you really don't want a whole lifetime of spinach, and almonds, and potatoes, and peanuts to suddenly shake loose and come out all at once. You will overwhelm your kidneys, your bloodstream, and feel sicker, and potentially provoke kidney stones during the clearing process. So, this is the weird part about this. You may be making yourself sick on high-oxalate food and have no symptoms of it at all. You start avoiding oxalate and suddenly you get symptoms, and you feel worse, because now, you're autointoxicating from inside.

Melanie Avalon: Yeah, like Stephanie said, if you go carnivore, they blame almost every symptom of just about anything on oxalate dumping. Some say it can go on for years.

Sally Norton: Yes, it can. I have a back right now that looks bruised. It started with tenderness couple weeks ago and these small and red pads that looked on rashy, almost a rug burn on the surface that turned into this deep. I really looked like I've been beaten up, and then they turn dark brown, and now that skin that turned dark brown is now peeling. Underneath, there's more of these coming up. I believe that this is my back healing and maybe if we have time, we can get into why this is happening now.

But I am seven years on this diet, and I have a spine that’s quite deteriorated. It's got Schmorl's nodes, which are holes and pits in the vertebral bodies, and lots of bulging discs, and probably calcified ligaments, and ligament stiffness. Ligament that is too big, I can't really backbend very well without a lot of pain. I had back pain for freaking ever. I believe I'm at a stage where I'm starting to get some healing in the vertebral bones and that's what this bruising is coming from.

Melanie Avalon: Do you know if degenerative discs ever relate to this?

Sally Norton: Yes, yes. There's a handful, just a few articles in the medical literature showing that they find crystals in degenerating discs and the authors believe it's a major cause of disc degeneration. Yep.

Melanie Avalon: Wow, my mom really struggles with that. So, I'm really thinking of her right now. Mom, listen to this.

Sally Norton: Oh, yeah, mom. It's sad for us old gals to be trying to fix our backs at this stage. It would have been nice if I'd known this as a 10-year-old. [laughs] Young moms, what we eat in pregnancy and what we feed our children, they really have long-term ramifications. The cool part though is that I do work with old gals. A lot of us who finally fall apart and are figuring this out, we're in our late 40s, 50s, 60s, 70s and beyond. I truly believe that life doesn't quit. Life is reaching for itself no matter how old you are, and healing is possible. We just have to whisper into biology and listen to it, and let it take the lead, and learn how to support it, not overwhelm it, and not try to provoke it to do things we want to make it do. But learn how to work with it to turn back on stem cells, turn back on that healing ability, and somehow make it gentle and kind. This is not a race. You cannot race your way out of toxicity. You have to drip your way out of it and take the 10 years that it takes to recover from this.

Melanie Avalon: Wow. For listeners listening, if they suspect they have oxalate issues or oxalate overload, do doctors do urinary tests? Is that something that you should even do? Should listeners, if they suspect it, just try a low oxalate diet?

Sally Norton: Yeah, the urine is very different than the blood. One of the reasons why the blood stays so even and perfect is because the urine is never the same thing twice. It's so dynamic. There's so many compounds, and chemicals, and so much changing going on in the urine, because the kidneys are a major metabolic control mechanism. They're doing a lot for the whole body and they're constantly cleaning things up, and balancing things, keeping your pH right, keeping your levels of electrolytes right as best as it can with what you're given it to work with. So, the urine is very dynamic and variable place. One of the research studies I looked at was saying that really in order to even guess the mean of oxalate in the urine, you need nine tests to do that. It's very easy to get a false negative, because the kidneys excrete oxalate in peaks. Two or three urines a day might be super off the charts high and the rest of them will be super low. A spot test is especially prone to that variability problem where it's easy to look like there's nothing there when there is. But if you ever see cloudy urine and you see that frequently, then that could be crystals in the urine that are refracting light and giving it that cloudy appearance. People think of it is, oh, it might be bacteria. It could be excess amount of cell shedding. It doesn't always work with kidney stone people because the tubules will strip their cells. When there's too many crystals there, and one way it gets rid of the crystals that are sticking is it just sheds whole layers of cells. So, you can get cloudy urine just because your kidneys are stressed and they're shedding cells. But that's still a sign your kidneys are uber unhappy. You shouldn't have mucky urine.

It's almost better rather than try to get nine tests and convince your doctor that he should look at oxalate, because oxalate is not usually a normal thing to test for. They have only recently started to say, oh, crystallin urine or turbid urine. They'll mention that in the urine analysis. But you have to specifically request an oxalate analysis. That's an additional expense. You're almost better off learning more about oxalate so that you can just gauge it with your diet. You can do your own challenge tests at home although I don't recommend that you quit oxalate and start adding them in randomly, but we’ve got to get back to the question of how do you control the release from the diet, because that's a place where you do want to really finesse how much oxalate you're eating, which is an interesting little process.

Melanie Avalon: Yeah. So, what is that process?

Sally Norton: Okay, so the test. Before we get into that, if you have not gone carnivore and gone on a zero-oxalate diet or even tried to reduce your oxalates yet, you don't want to start by going to carnivore. I happen to agree with the carnivore world that, if you got a lot of problems on carnivore, oxalate is the most likely reason. It can be like being a voodoo doll, somebody has randomly giving you symptoms that come and go then involve your nervous system, your connective tissues, inflammation, histamines, rashes, headaches, a bad day in terms of being grumpy or uncoordinated aches and pains that come and go, tooth pain, you name it sinus pain, migraines, it's all can be oxalates. No question about it. If you go from a high-oxalate diet and move to a low-oxalate diet, usually something a little weird will happen. You might get a funky little rash you've never seen before, or start getting eyes styes, or get achy teeth, or the tartar suddenly goes away because saliva concentrates the oxalate about 10 times higher than the blood level. So, if you've been eating a lot of oxalate, you may be a person who tends to get tooth tartar, and when you start a low-oxalate diet, usually that goes away, and then it'll come and go, depending on how much oxalate is back in the blood, because your tissues start releasing it back into the blood. Tooth tartar, cloudy urine, aches and pains, mood, those are all signs one way or the other, where they’re moving oxalates or not, after you're on a low oxalate diet.

Now, if they get out of control, those kind of clearing illnesses, I call it clearing illness. Susan Owens is a brilliant woman who's been working with families with autistic kids for quite a while now. She is really the first one to say, “Hey, these funny symptoms that we start getting on this diet that these four kids are getting with crazy rashes, sudden behavior things that are weird--” where the autistic kids do really well on low oxalate diet, and great many of them start regaining their ability to communicate their ability to self-direct an activity to be by themselves and be able to be safe. They really do well on it, but they'll have these rashes and just some pretty severe clearing illness. Susan realized that this is the body clearing oxalate and she's the one who dubbed it ‘dumping.’ It's not yet used in medical world, because the medical world believes that this crystal accumulation in the body only occurs when there's kidney failure, that it only occurs when the kidneys stopped working permanently. But the medical literature will tell you that after every high-oxalate meal, that is kidney failure. For a certain period after high-oxalate meal, your kidneys cannot keep up. That's what kidney failure means. It is the kidneys cannot keep up with the load that they're being asked to deal with. High oxalate diet keeps you in quasi permanent kidney failure.

But a lot of us like me, we have super strong kidneys that never get into problems. I can pee out gallons of cloudy urine all the time and pee out crystals like crazy, and I've never had a kidney symptom or kidney stone. I just produce enough of these proteins that protect me from this accumulation. The downside of being good at peeing out oxalate is you've turned on these proteins all the time. Some of these proteins, one in particular, is probably the reason I have fibromyalgia symptoms. That fibrosis process is an oxalate issue, and these proteins encourage that by [unintelligible [01:00:04] problem that gives you all that muscle pain and other problems that go along with fibromyalgia. This is one reason why men who tend to get kidney stones don't get fibromyalgia, but the women who are high in oxalate to don't get kidney stones are probably the ones that are prone to this achiness, and muscle problems, and connective tissue problems.

Melanie Avalon: Maybe it's too simplistic to think about it this way, but fibromyalgia, it just seems something that this would cause. It's a compound literally building up everywhere.

Sally Norton: Yeah, and when that tissue damage or those crystals collecting in the body, and just the ions there all the time, creates cellular damage. It damages membranes. The membranes have a certain structure that gets completely disorganized when oxalate ions and crystals are nearby. But you literally end up killing cells that mitochondria get damaged and die, and then cells start dying. What the body has to do to replace the damage is create connective tissue to hold it together. That's called scar tissue or fibrosis. Any fibrotic disease where scar tissue starts filling in for where you used to have real cells, which is probably part of what's going on in my spine with the ligaments.

Melanie Avalon: Is that a really long process to undo in a way?

Sally Norton: It probably depends on the tissues involved and how far progressed it is because you need to have stem cell, and chondrocytes and osteoblasts, and the right cells available to start rebuilding tissue and breaking down connective tissue. Now to break fibrosis, you have to put out enzymes, which is what the immune system does. The immune system comes along either to eat the crystals and that can be a frustrating problem, and that's actually why oxalate crystals can start an immune condition of the lungs or any other tissue you can get into an immune condition, because the crystals are hard to deal with. They're too big for one monocyte to eat. Then, they get together, and they form giant cells, like 5 or 10 of these cells try to eat it and work on it, and that doesn't work. Then, the cells will start bombing it with enzymes to break down the proteins that are around the crystal which works. You can sometimes break up the crystals that way and then shooting out acid.

But if you're putting out collagenase enzymes, you're not just breaking down crystals, you're breaking down cells. So, there's friendly fire involved in the immune system going in and cleaning out crystals. That's why we get this autoimmune illness that persists for years. Every time we're clearing out crystals, the kidney or elsewhere, you're turning on immune system. Even before you got there, to the point of clearing during the building-up process, this constant presence of crystals causing cell damage turns on the immune system chronically. Oxalate is the most likely-- if you realize your biology is the most likely, most common, most prolifically available chemical that we're exposed to that's turning on the immune system chronically.

Melanie Avalon: That is huge. Yeah, actually, yesterday, I was interviewing Dr. Benjamin Bikman for his book, Why We Get Sick. He was talking about that, about how macrophages and how everything that's an enzyme or breaking down things when there's some infection or injury basically is activation of the immune system. That's really a huge concept, what you just said that oxalates may be the one source that-- or chemical-- well, it’s not a chemical.

Sally Norton: It is. It is a chemical. It is this particulate matter, like nanocrystals are particles and they're also chemicals depending on whether they're ions or not. We're eating it all the time. Our immune system problems are just all over. Everybody seems to have immune system problem now. You asked about, does the fibrosis and scar tissue go away and how fast it can be? I can tell you, one of the great things about the diet is all kinds of superficial scars get flatter and hard to notice. The low-oxalate diet naturally allows your body to go back and fix old scar tissue and so on. The deeper the tissue, the more extensive the damage. Probably that restricts how much, how far the recovery can go. But definitely, if you give it a good five years and you're consistent with it, you'll see scar tissue and scars really reverse-- Those of us who've been really sick with oxalate, we feel much older than we really are. I've been in my 80s since I was 19. But now, I feel I'm in my 30s, and I'm going to be 57 next spring. The low-oxalate diet is my personal fountain of youth. That includes the scar tissue, that includes regaining the ability to exercise to think to function to be happy. It's great to not be poisoned or to unpleasant myself. I'm still in this unpoisoning process, and like I said, my back looks I've been beat up, but my life is working again. I wish that for anybody who doesn't feel well.

Melanie Avalon: This is so incredible. For listeners, you’ve talked about the potentials of if somebody starts to carnivore diet, it cuts out all oxalate, so they might experience that dumping. Is there a pathway or approach that you recommend that most people can safely follow to remove oxalates? You mentioned a test, a tolerance test.

Sally Norton: You want to let your metabolism adjust to any change in diet no matter what's going on. if you're planning a dramatic change in your diet, you want to ease into it as best is as practical as you can do. You're not a machine who can go, “I'll do 15% of this today and 5% tomorrow.” That's not practical, but find a practical way to ease out of these foods. For one thing, regardless of the oxalate issue, your microbiome in your digestive tract is used to a certain set of foods, and you're going to shift which bacteria are happy. You want to create a big die-off by starving off all your current guys that quickly. Just for that practical side, you do that. But also, with the foods that are high in oxalate, you may want to just cut out most of them and leave a couple of them in your diet, kind of the way you've been eating them for at least a little while. I call this the lazy way, and I think of it-- The reason I know it works is because husbands take this route. The wife decides to change their diet. She changes what she buys and prepares for meals, because usually women are still the ones planning food and deciding what we're going to eat, and usually, men are happy if someone fills a plate, they'll help them empty the plate. It's easy to let someone else change most of the foods and then you hang on to your little secret potato chip thing, your little secret chocolate, or your little peanut butter snack at night, because you are not going to be controlled by your lover.

That's a good way to hang on to [giggles] things. Most people are slow to let go of chocolate. Hang on to the chocolate for a little while, hang on to that little bit of peanut butter or whatever it is you do, and get rid of the Swiss chard. I promise you, life is okay without Swiss chard. Somebody who's been growing it for decades, I'm doing just dandy without it. There are certain high-oxalate foods like in buckwheat really, I think you can give up the soba noodles or whatever it is. That's the easy way to start, is get out of the danger zone, stay in maintenance zone, keep a few around so every day, you got oxalate. Now, when you get serious, we want to bring you down into a zone of probably about 20 milligrams per meal which might be a clementine, a cup of tea, a plate of carrots, some more moderate foods that will bring you a little bit of oxalate per meal. That will again-- there's still some coming in, and that is telling the body that we're still eating oxalate. It's not pure winter, like carnivore’s a winter diet, where I think of oxalates in the past, if we ever had high-oxalate food, it was for brief periods like when the blackberries came ripe, or such and such came ripe, or while we had harvested some grains which knock a few into your canoe, and you keep them for a few months, and then you move on back to hunting buffalo or something.

But now, we don't have seasonality. But I think of the carnivore diet as zero, you don't really want to be that low unless you just have some individual situation where you're not nearly as toxic as some people, and it's fine for you to go that low. Everyone is completely different in how this works out. Everyone's a snowflake, there's so many factors that are affecting this. But from a safety point of view, since you really don't know how your body is going to react to this, you're better off taking your time, coming down stepwise, and then realizing when you get down, when you're pretty close to-- we'll call carnivore a version of a very low-oxalate diet. When you're very close to that, that's when you really want to be careful, and start noticing it. You usually will start noticing stuff if you get out of the danger and trigger zone, that's where you start to feel better. When you get down into the super zero is when you start revoking this release of oxalate when you start feeling crappy.

Understanding that, now gives you a chance to test it out on yourself. If you go low oxalate and you suddenly get a rash like, “Oh, something's going on.” If you suddenly get a toothache or sinus pain, or you're starting to get weird migraines are something that could be part of this, you're turning on the clearing, and then if you can add some clementines, or some tea, or some carrots as I was saying before, add in just a few potato chips, or a little tiny bit of chocolate, you might feel a little better, because you're now stopping at clearing illness. This is why some people say “Oh, I’ve tried it for a while. Now, I tolerate it and I'm fine,” because they've put back enough oxalate where they've stopped the clearing. So, they feel better if they're not clearing the oxalates. You can stop the symptoms of recovery, but you're also stopping that recovery. Because people think of this as a sensitivity. This is not an allergy. This is a toxicity. It's a toxicity that creates deficiency, and deficiency and toxicity is a very deadly combination when it comes to your wellbeing.

Melanie Avalon: It seems to have a lot of characteristics very unique to it compared to other things that-- this is mechanically damaging our cells, building up potentially taking years to undo the damage. So, I think this is huge.

Sally Norton: It's a ringleader really, because all these things can work together against us. The more oxalate they have, the more of those other things can be toxic. The more you have those other things, the more oxalate can be toxic. I sincerely believe that I created IBS for myself when I was slow cooking beans. Someone with a degree in nutrition ought to know better, because lectins are preserved with that low heat cooking environment. You really need to soak beans for three days, and pressure cooker, use rapid boiling, or high heat baking to really get the lectins down in beans and make them safe. But I was silly enough to be using a slow cooker, cooking beans overnight and eating delicious mixed beans, a little bit of peanut butter and garlic in them for breakfast, because it was convenient. I was a working single person, and it was a way to have cheap, convenient food and keep moving and have a life. It was a disaster for my GI tract. I'm still paying for that.

Once you've got lectins really creating leaky gut or anything else creating leaky gut, inflammation of the gut occurs when you're obese, diabetic, metabolic syndrome, or eating a lot of plant compounds like the saponins and the lectins, oxalate is so tiny, it's already just floating through anyway with a healthy gut. But once you've got leaky gut, the level of oxalate absorption can be 50% that of the normal 10% to 15%. The amount of food you need in order to get too much oxalate in your body goes down to from a tablespoon of cocoa to a half teaspoon. You're absorbing way too much of it when your gut is inflamed. Plus, oxalates turning on the mast cells and all the rest of the immune system and helping generate a lot of histamine and just chaos, and so all those other compounds start to become harder and harder to cope with. A lot of that poor coping is coming secondarily to the oxalate damage.

Melanie Avalon: I just have one specific food question, because you keep mentioning blackberries as an example. You've been mentioning the different foods and I've been checking to make sure that I have them listed as high in the app and everything has been matching up so far. The fruit I eat a lot of is blueberries.

Sally Norton: Right. That's a good question. That's a really good question. Because it's wrong on a lot of lists. For a long time, people thought blueberries were pretty high. But a half cup of blueberries counts as a low-oxalate food. If you use a moderate portion, blueberries are fine. Of course, they're full of seeds and skin and planty stuff. So, if you do have a damaged gut, you may not really tolerate them that well, but from an oxalate standpoint, blueberries are fine.

Melanie Avalon: Okay, yeah, because I have them, and now I feel I need to have more specific amounts for how I list them in my app. I don't have them as completely zero, like grain. People out there were saying they were high, but it seems they actually were low. Whenever that was the case, I would mark them as just a little bit, just to be on the safe side.

Sally Norton: That's right. You got it right.

Melanie Avalon: Okay. I eat a lot of blueberries. With all the ones that I eat though, I might be actually reaching higher levels.

Sally Norton: The thing is, you don't really want to be too over reliant in big portions of a lot of these plant foods because blueberries there's little tiny wild ones from Maine. Then, there's the big suckers, and there's like, I don't know, at least 20. There's low bush, high bush. There's easily 20 varieties of blueberries. Depending on where they grow and what variety, there may be some variability there. Who has spent the money to test every variety of blueberry? No, there's only been a couple of random tests, a couple of random years. We really don't know how variable blueberries are, unlike strawberries are crazy variable. Some strawberries are really low, and some strawberries could have 15 milligrams per berry of oxalate and give you from 1 to 15, there’s huge range there which makes sense, because oxalate helps defend plants from infections, and molds, and things like that. Strawberries grow on the ground, on mud, and they're very prone to fungal problems because of that. In a really wet year, maybe there is a lot more oxalate in a strawberry grown in a wet year versus a dry year.

Again, we don't know, but strawberries were a point of confusion for half a century. I still think we don't really have enough testing, and enough expertise to say what are the factors its influencing this. Is it variety, is it soil, is it season, is it weather, is it other stress? Because when you stress the plants, they're more likely to produce more oxalate. Infestation of insects will maybe increase oxalate levels in plants versus if you put a toxic insecticide on the plant, it may have lower oxalate. Not necessarily that you want to eat blueberries that are covered in fungicides.

Melanie Avalon: That’s what I was going to say. I was going to say it sounds organic produce has the potential to be higher because it's creating its own--

Sally Norton: I think a little bit that's possible. But those rules of thumbs break down really quickly in reality. It's really easy to mistake. Even in the data, I've seen some really badly written medical articles and respectable journals by people with highfalutin careers who've put out garbage saying things just like that, that are like, “Ooh, scary.” You’re scaring me with what you're saying versus what your data is saying. [laughs] But in nutrition is especially prone to that. If you actually read nutrition literature, and you read the methods, and you read what they're doing, and then you read their descriptions and conclusions, too much of the time, the two don't match up at all.

Melanie Avalon: Oh, it drives me crazy. [laughs] It's awful. Sometimes, I'll read it, and then I just want to look around and be like, “Is anybody else reading this?” But it's published in the journal.

Sally Norton: It's like the editors didn't read it, the authors didn't read it, and the readers aren't reading it, and they still have a respectable career. Because to get tenure, you just need a thick stack. It doesn't mean anyone's read your stack of papers, it just needs to look impressive from across the conference table.

Melanie Avalon: Listeners, do your own research.

Sally Norton: It's hard to do. I have spent six years digging up information in the library. It has been a tremendous amount of work and effort to get to the level of confidence that I have with my information, and with this whole topic and looking at all the confusion over the years. You have to know so much about a topic to be able to know who's blowing smoke, and who actually is giving you a good science. A lot of people dip in, and they look at five articles, and they proclaim certain things, because they're listening to the wrong people who are repeating stuff that's not true. They're just promoting bad information. You have to step away from career wanting to make money if you really want to know something. That's why we have tenure. And that's why we have academic positions because you're supposed to be able to live a life while being a scholar. But since I was never appointed a scholar at a university to do this, I'm in public health, and grant writer, and educator. In order for to really know a topic as confusing as oxalate, you cannot casually dip and read 40 articles and know what you're talking about.

Melanie Avalon: If you had an unlimited budget and you could design a dream study about oxalates, what would you do?

Sally Norton: I would start first with simple people studies. I would take a list of people with pain syndromes, whether it's tooth pain from a dental school or arthritis, and design diets for them and design ways of measuring their wellbeing, and measuring the reactions to the diet, and start documenting the clearing illness that shows up, and start taking tissue samples, because people will start moving oxalate out, and sometimes in idiosyncratic ways. Some people when they start getting into clearing on this, they'll get severe diarrhea. We would actually need to study what's coming out in that fecal matter and see what's happening there and understand that reaction. Some people get these rashes that blister up and push out whole crystals.

Now, I've never had that happen to me, but I have plenty of clients and followers who've had that happen. I want to test that tissue, what skin is coming off, what's in that skin, what's in those crystals? Then, most of us are peeing it out crazy, and I want to look at that urine and see what's going on, and I just want to observe. Science is really supposed to be about observing and listening to biology and nature, and having it teach us. Unfortunately, a lot of the way we design science now is we have to narrow things down to three specific games based on trying to show that A and B are related in a causative way or not. Nature isn't A to B. Nature is a big cobweb of things going on. Urine has dozens of compounds. You cannot ever narrow down health to calcium is here, and citrate is here, and therefore that explains everything. That's not how it works.

Melanie Avalon: Wow. Well, this has been incredible. I'm sure so many listeners now are wanting to-- well, what you just said, look into this further, but it can be so confusing, but thankfully you've provided so many resources. You have your website, sallyknorton.com. A lot of free resources on that website as well as things for sale, and I'm so grateful. So, listeners can actually use the code, MELANIEGUIDE--

Sally Norton: Yeah, the beginner's guide is only $2.50, and you can get it for free. Then, there's also a PDF cookbook on there. It's not a physical book. They'll get mailed. It's a download PDF. So, we'll send you an email where you can download the cookbook. That's not free. That has got information about the diet and a whole bunch of material on the front and then about 180 recipes. So, if you don't want to go full carnivore, and you're trying to figure out what to do with Thanksgiving or holiday time, you're going to find something in there that might really make your life easier, and you don't have to struggle as hard as I did in the dark trying to create make it a lot easier for folks than it was for those of us who didn't have any [laughs] resources and tried to figure it out.

Melanie Avalon: Oh, my goodness, this is so amazing, so helpful. I'll put for listeners all of this information in the show notes. The show notes will be at melanieavalon.com/oxalates. And again, so the coupon, MELANIEGUIDE, will get you that Beginner's Guide for free, or you can apply it as a $2.50 discount to anything else on the website. Like she says, there is that cookbook which definitely can come in handy. Well, this has been absolutely amazing. The last question that I always ask every single guest on this podcast and it's just because I've come to realize more and more each day, how important mindset is surrounding everything. So, what is something that you're grateful for?

Sally Norton: Oh, my gosh. I'm grateful for you, I'm grateful for people who really want to learn, I'm grateful for my life, I'm grateful for my husband, I'm grateful for this lesson. I paid a big price for this for decades, and somehow, I got set up by factors I have no idea what they are, to be in a position, to be able to share this message. So, at least my own messy suffering with all this pain and so on is turning into something that can really shift our thinking, and really, we're in this cool, profound place right now, rethinking our fundamental assumptions about food, and health, and building community online. The only thing I'm really grateful for is that we have this electronic technology, and we're able to take advantage of it, and get together in this digital way. It's so cool. Thank you.

Melanie Avalon: That's so beautiful. Well, I am so grateful for you and all of this work that you're doing. It's profound. It's incredible. Like we talked about this whole time, there's so few people drawing attention to this, and I think it's so huge. So, thank you so much for everything that you're doing. Any other links that you want to put out there besides the ones that we just mentioned with the website?

Sally Norton: I do have an Instagram page. Right now, I'm working on my book, trying to get my manuscript finished in the next few weeks, which is a pretty, pretty big job. I'm not really posting a lot in social media, but it isn't because I'm not working hard for you guys and trying to bring information and make your lives easier. It's because my devotion to this that I have to stay focused on the book. But do check me out on Instagram, because there's a lot of studies in there and pictures of my bad back, and my improving osteopenia-- now I'm normal, I've recovered that. There's just information about spinach and stuff that you can share around. So, check that out, and feel free to come in and invite others to start learning about oxalate to help us build this awareness.

Melanie Avalon: I did not know that you were in book writing phase. That's a lot. So, I'm grateful for that, for you, for all of your time in doing that because, man, writing books, it's a lot.

Sally Norton: It's thousand times bigger project than you could imagine. It's not like writing a term paper in college. [laughs]

Melanie Avalon: I know. When I published my first book, I was like, “Okay, I'm good. Never again.” [laughs] It's like having a baby or something, but yeah. Well, this has been amazing. Thank you so much for everything, and hopefully we can stay in touch and talk again in the future.

Sally Norton: Yeah, I'm looking forward to that next time, Melanie, thank you.

Melanie Avalon: Perfect, especially for your book when it comes out, that'd be great.

Sally Norton: Yeah, yeah. We'll have a bunch to talk about.

Melanie Avalon: Awesome. All right, well, thank you, Sally.

Sally Norton: Be well.

Melanie Avalon: You too. Bye.

Sally Norton: Bye.