Oxalates and autism
Oxalates or in its acid form Oxalic acid comes from three sources: the diet, from fungus such as Aspergillus, Penicillium, and possibly Candida, and also from human metabolism. Foods especially high in oxalates include spinach, beets, chocolate, peanuts, wheat bran, tea, cashews, pecans, almonds, berries, and many others. If oxalate levels are elevated in the blood they can precipitate and lodge in the bones, joints, blood vessels, lungs, and even the brain. In addition, oxalate crystals in the bone may crowd out the bone marrow cells, leading to anemia and immunosuppression.
Oxalate crystals may cause damage to various tissues. The sharp crystals may cause damage due to their physical structure and may also increase inflammation. Iron oxalate crystals may also cause significant oxidative damage and diminish iron stores needed for red blood cell formation.
In my practice I have seen many children with elevated oxalates in their urine and blood. Commonly these children will suffer from inexplicable pains, eye poking or head banging, tantrums, bed wetting, poor growth, constipation and other neurological symptoms. Changing to a low oxalate diet can be prove to be very benenficial along with supplementation to bind the oxalates for excretion from the body.
Benefits from a low Oxalate Diet
Improvements in gross and fine motor skills
Improvements in expressive speech
Better counting ability
Better receptive and expressive language
Increased imitation skills
Speaking in longer sentences
Reduced self-abusive behavior
Increased imaginary play
Loss of bed wetting
Loss of frequent urination
Improved fine motor skills
Improved Iron deficiency anemia
How are high Oxalates treated?
Various methods can be used to treat this common problem in children with autism. Antifungal drugs to reduce yeast and fungi that may be causing high oxalate may be necessary. Children with autism frequently require years of antifungal treatments. Calcium citrate to reduce oxalate absorption from the intestine is always a must. The best way to administer calcium citrate would be to give it with each meal. Children over the age of 2 need about 1000 mg of calcium per day. Of course, calcium supplementation may need to be increased if the child is on a casein-free diet. The most serious error in adopting the gluten-free, casein-free diet is the failure to adequately supplement with calcium.
Excessive fats in the diet may cause elevated oxalate if the fatty acids are poorly absorbed because of bile salt deficiency. Non-absorbed free fatty acids bind calcium to form insoluble soaps, reducing calcium’s ability to bind oxalate and reduce oxalate absorption. If taurine is low in the Amino Acids Test, supplementation with taurine may help stimulate bile salt production (taurocholic acid), leading to better fatty acid absorption and diminished oxalate absorption.
Probiotics may be very helpful in degrading oxalates in the intestine. Both Lactobacillus acidophilus and Bifidobacterium lactis have enzymes that degrade oxalates.