Nicola McFadzean, N.D.
Oxalates are organic compounds naturally occurring in certain foods, mainly vegetables and fruits. An accumulation of oxalic acid crystals in the muscle and connective tissue cells may be the cause of the muscle aches and pain associated with FMS.
FMS can be a debilitating condition, involving many systems within the body. It stands apart from arthritis and autoimmune reactivity in that the muscles are not inflamed on biopsy. However, the pain can be every bit as bad and it is often resistant to treatment. Associated symptoms of FMS include chronic fatigue, headaches/ migraines, brain fog, yeast overgrowth, insomnia and hormone imbalance.
For many years, people with a condition called congenital hyperoxalosis have been prescribed low oxalate diets. These people have an accumulation of oxalates that may result in kidney stones and crystalline arthritis. It is also recognized that vulvodynia and vestibulitis (pain and inflammation in the vulvar area) may be associated with oxalate deposition in the tissues. So the idea of low oxalate diets is not new – it’s the association with Fibromyalgia that is under more recent investigation.
Dr. St. Amand, author of What Your Doctor May Not Tell You About Fibromyalgia, promotes the use of a medication called guaifenesin to treat FMS. Guaifenesin was found to increase excretion of 60% phosphates, 30% oxalates and 30% calcium. The medication guaifenesin itself is fairly benign. The challenge with this protocol is strictly avoiding all salicylates (another organic compound found in certain foods, personal care products etc). Also, guaifenesin is not a quick fix remedy, may take months to show real benefits, and can cause a worsening of symptoms initially as the body dumps phosphates and oxalates. That being said, a number of FMS sufferers have found relief with guaifenesin. (For those interested in this protocol, I would recommend reading the book by Dr. St. Amand as a starting point).
There may be an interaction between calcium, magnesium and oxalate. People with high oxalate levels sometimes do not tolerate magnesium well, leading to irregular heartbeat, nausea, stabbing pains and increased muscular aches (this may also occur with Epsom Salts baths which are magnesium sulfate). Certainly, FMS sufferers should make sure to take calcium and magnesium in the citrate forms, which are best suited to block the absorption of oxalates and help excrete them from the body.
Another oxalate connection relates to candida and yeast overgrowth. Good bacteria in the gut help to keep oxalates in check by breaking them down. Bad bacteria in the gut can produce oxalates. Oxalates are said to suppress the immune system and make one more susceptible to candida overgrowth. Therefore, along with a low oxalate diet, addressing yeast is imperative to reduce the overall oxalate load.
There are even more implications of oxalates in the body. Oxalates deplete glutathione, one of the key antioxidants; oxalates change how zinc works within the body, which can affect immune function; and they also fuel inflammation which is a major issue in FMS.