Starting the Low Oxalate Diet

(LOD)
Disclaimer
• This presentation does not constitute medical advice. Please consult
with your own health care professional regarding any changes you
would like to make to your own health care plan
What’s covered in this presentation
• Determine your caloric intake and your current oxalate intake before
starting LOD
• The Spreadsheet
• How quickly to reduce your intake
• How to reduce oxalate safely
• Supplements to take before meals
• Dumping
• Supplements that can help manage dumping
Determine your caloric intake
• Low Oxalate is 40-60 mg od oxalate per day based on a 2000 calorie
diet
• If you're consuming 1500 calories a day, your low oxalate range would be 30-
50 mg a day, at 1800 calories a day your low oxalate range would be 35-55 mg
a day
• If you're consuming 3000 calories a day your low oxalate range would be 50-
70 mg a day
• Its not advisable to go lower than the lower end of your range. The goal is to
lower oxalate intake while still meeting your nutritional needs. Going too low
makes getting enough nutrients extremely difficult. That’s not what we want.
Determining your current oxalate intake before
starting LOD
• Take 5 days before starting LOD, logging all meals, drinks and snacks
• See example on slide 4
• Use Spreadsheet to help you determine oxalate levels for each item
• See example on slides 5, 6 and 7
• Will not be 100% perfect, but will give you a good idea of your overall
intake and assist you in determining how much to lower daily
Sample daily menu (before LOD)
• Breakfast: 1 cup grape nuts with ½ cup milk, ½ pink grapefruit, 1 cup
coffee
• Lunch: Spinach salad (2 cups) with chopped roasted almonds, Italian
salad dressing (2 tbsp), Pepsi (8-oz)
• Dinner: Steak, 1 baked potato (no skin), steamed broccoli (1/2 cup),
wine (6 oz)
• Snacks: 1-oz roasted peanuts, ½ cup chocolate ice cream
Spreadsheet example
Calc Level Item Total Oxalate (mg) per 100g Total Soluble Oxalate Serving Size Serving (g) Calc Oxalate per Calc Soluble (mg) Oxalate per serving
(mg) per 100g serving

EH Cereal, Grape Nuts, Post 79.8 40.2 ½ cup 58.00 46.28 23.32

VL Milk, Cows, whole, homogenized 0.40 0.40 1 cup 245.00 0.98 0.98

H Grapefruit, Pink, 3-1/4 in diameter 14.00 2.50 1/2 grapefruit 123.00 17.22 3.08

L Coffee, Black, no brand specified 0.60 0.60 1 cup 236.00 1.42 1.42

EH Greens, Spinach, raw 1145.00 1/2 cup 6.55 75.00 0.00

EH Nuts, Almond, dry roasted, chopped 406.00 1/2 cup 67.00 272.02 0.00

L Salad Dressing, Italian, Wishbone 6.70 3.30 2 tbsp 30.00 2.01 0.99

VL Soda, Pepsi, canned and bottled 0.10 12 oz 370.00 0.37 0.00

VL Meats, Beef, Fresh or Frozen 0.01 0.00

EH Potato, Russet Burbank or Idaho, Baked, flesh 49.40 37.40 1 318.00 157.09 118.93
only

M Broccoli, steamed 10 mins 1/2 cup 6.60 0.00

EH Nuts, Peanuts, roasted 187.00 1 oz 28.40 53.11 0.00

VH Ice Cream, Haagen Dazs Chocolate Ice Cream 20.00 13.40 1/2 cup 102.00 20.40 13.67
Calculate daily total
• Breakfast: 1 cup grape nuts (46.28 x2=92.56)with ½ cup milk
(.98/2=.49, ½ pink grapefruit (17.22), 1 cup coffee, black (1.42)
total=111.69
• Lunch: Spinach salad (2 cups) (75x4=300) with chopped roasted
almonds (1 tbsp) (272/8=34), Italian salad dressing (2 tbsp)(2.01),
Pepsi (8-oz) (0) total=336.01
• Dinner: 8-oz Steak (0), 1 baked russet potato (no skin) (157.09),
steamed broccoli (1/2 cup)(6.6) total=163.69
• Snacks: 1-oz roasted peanuts (53.11), ½ cup chocolate ice cream
(20.4)
• Daily total: 111.69+336.01+163.69+53.11+20.4=684.9
• Add daily totals and divide by 5 to get average overall daily intake
Calculate daily total cont
• Ex: 684.9+570.6+500.8+620.2+430.7=2807.2 (5 daily total)
• 2807.2/5=561.44 (average daily oxalate intake)
• Don’t forget that this calculation is still an estimate
• May not include all ingredients (i.e. herbs and spices and amounts used in
rubs, sauces, etc.) so daily totals may be slightly higher or lower
• Still a very good indicator of your overall intake
• Very helpful in determining how to reduce SAFELY
How to reduce oxalate safely
• If you are eating over 500 mg of oxalate per day, you should reduce by
no more than 5% per week - that means about 20 weeks to get to a
low oxalate diet of 40-60 mg per day based on a 2000 calorie diet.
The goal is to reduce by about 25 mg of oxalate each week.
• If you are eating less than 500 mg of oxalate a day, you may be able to
reduce 10% per week - which still means about 10 weeks to get to
low oxalate. The goal is to reduce by about 50 mg of oxalate per
week.
How to reduce oxalate safely…Cont.
• An easy method
• Reduce and eliminate Extremely High and Very High Oxalate items
one at a time. When that item has been eliminated, move on to next
EH or VH item. Repeat till you’ve reached your desired range
• Example: Week 1: the 1-oz of roasted peanuts (roughly ¼ cup) and Extremely
High Oxalate at 53 mg . Reduce to 2 tbsp over the course of a week and
replace with a lower oxalate substitute like some cheese slices or a handful of
grapes or a lower oxalate nut like pistachios.
• Week 2: Eliminate the remaining two tbsp of peanuts by the end of the week
and replace with a lower oxalate option like ¼ cup of pumpkin seeds
Dumping
• When lowering oxalate, you’re likely to experience a phenomenon
called “dumping” which is the release of stored oxalate
• Oxalate didn’t accumulate overnight and isn’t going to come out
overnight
• Its not a pleasant experience, but should NOT be debilitating
• Why we strongly recommend a SLOW reduction
• A slow reduction helps you manage it
• If at any point dumping starts to become too much to manage
• Add some higher oxalate items to slow down the process
• Utilize supplements that can help you feel more comfortable
• Consider reducing more slowly
Supplements to take before/with meals
• Calcium or Magnesium Citrate
• Calcium and Magnesium bind oxalate
• Citrate form inhibits crystal formation
• If citrate causes irritation or has too much of a laxative effect, taurate is good
alternative for magnesium
• Take Recommended Daily Allowance and divide between the 3 meals
• Any form of calcium or magnesium will bind, but the glycinate form may exacerbate
oxalate issues for some, so Magnesium glycinate should be used cautiously
• 20 minutes before meals if in a capsule or tablet form-takes that long for the capsule
or enteric coating to break down and be available for binding oxalate
• With meals if in a liquid or powdered form added to juice or water
• Without Vitamin D. Vitamin increases calcium/magnesium absorption and in this
case, you want the calcium/magnesium to be available for binding oxalate
• Take Vitamin D (with or without calcium/magnesium) between meals
Dumping…Cont.
• Dumping is cyclical and not a one-time process. Many dump off and
on for a few years
• Some experience a honeymoon period of a few days when starting
the diet before the dumping starts
• Expect to initially experience more bad days than good
• Dumps can last a week or more before you see some good days, then the
process starts again. Gradually you’ll find the dumps are shorter and less
intense with more good days in between
• If the dumping is too intense, add some higher oxalate items too slow it down
and use helpful supplements to reduce your discomfort
• Don’t lose hope. Many have reduced oxalate successfully and are happy to
help you navigate this process. Ask as many questions as you need to.
Supplements and things to help with dumping
• Epsom salt baths or lotion-When your dumping magnesium and calcium are
being depleted and this is one way to get some extra magnesium into your
system.
• Water-stay hydrated
• Electrolytes-another way to get some of those minerals that oxalate depleting
back into your system. Coconut water and mineral water (add a little juice if you
don’t like the taste) are good options
• L-Arginine-very helpful for pain management
• Antioxidants-reduces oxidative stress dumping can cause (CoQ10, glutathione,
NAC)
• B-vitamins-oxidative stress depletes the B’s (Biotin, B1 and B6 deficiencies have
known oxalate implications)
• Start with low doses