Oxalates: What does antifreeze have to do with Autism?

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We all know antifreeze is deadly when ingested. But what I didn't know, until recently that is, is what makes antifreeze deadly. When the chemicals in antifreeze enter the body they convert to a compound called oxalate. And at mega doses, like you’d find in antifreeze, oxalate is deadly.

It is also what has been clogging up my daughter’s body and has started a cascade of biological and physiological reactions that manifest in the behaviors and symptoms of Autism Spectrum Disorder - or ASD.

Oxalates are found in most plant foods in varying amounts. Foods like rhubarb, spinach and sweet potatoes are very high in oxalates. And in most people oxalates pass through the body and/or they get broken down by their gut microbes and no harm is done. But in some people oxalates build up and cause kidney stones, and in others they build up and cause ASD symptoms including:

  • speech and motor skill delays

  • trouble with linguistic expression

  • lack of social awareness

  • rigidity

  • sleep problems

  • self-abusive behavior

  • pain, especially to do with urination

  • bed wetting

  • problems with cognition

  • fatigue and low energy

  • and many more…

And now to come back to my daughter. Imogen has always been “quirky” but she doesn’t have an official diagnosis — although I now see that much of her quirkiness is really ASD symptoms. She didn’t interact much with other kids as a toddler and wouldn’t go on the playground if there were any other children there. She was slow to learn to speak and didn’t speak clearly for a long time. She didn’t respond to questions from strangers at all and only sometimes responded to our questions. But she did play and interact with us and seemed to be doing fine. By the time she was 8 her teacher noticed that she was falling behind her peers socially — she told the same stories over and over and didn’t seem to be interested in what her peers had to say. Academically she was doing well, but socially it was a growing concern. At home she had tantrums and lashed out at her brother or stormed off during meals or any time she was upset. She didn’t seem to understand how her actions hurt others, instead thinking people were intending to hurt her. She had chronic loose bowels and a rash on her bottom that would not go away.

When she had an Organic Acids Test last fall, the results were very clear — her levels of oxalate were extremely high — 5 times higher than the average ASD child.

After a month of Low Oxalate Diet she had become a different child — the aggression had gone, she was talkative and told many stories about school — including who she was playing with at recess, she was able to be connected and contributing to the family life — following conversations, helping out, noticing if someone was sad or upset. Even her teacher thought this was a different child and said the other students could tell she was able to interact with them differently now. The bowels and the rash cleared up.

However oxalates are complicated, and it’s common for people to go on a Low Oxalate Diet and feel better — for a while. But then when oxalate levels in the blood get low enough the body starts dumping the stored oxalate into the blood stream, and people find the symptoms come back. However, in the long run this is what needs to happen to clear out the oxalates from the body — and when the dumping stops, people typically find that their child is doing even better than before dumping.

For us, after that first “honeymoon” period of one month Imogen’s body started dumping oxalates in massive amounts — she broke out in oxalate rashes, she peed them out constantly, they hurt her eyes and her back — all of which are common signs of the body dumping stored oxalates. And all of her ASD symptoms came back.

Her body is still processing the last 8 years worth of oxalate it has been storing, but with the right supplements now in place she her symptoms are reducing and she is starting to come back to us. She is rarely aggressive, and she is often connected and present with us — though she fades in and out — as does her ability to express herself. Sometimes she is bursting with self awareness and is able to tell us about what is going on for her with amazing clarity. Other times she repeats “Mom, Mom, Mom…what was I going to say…” And drifts away. But we are making progress, getting through all of the oxalates, and helping her body to heal.

And there’s a lot to heal from.

Oxalates also do a lot of damage in the body, which is how they end up producing such a wide range of symptoms. I’m going to get a little technical here, bear with me! I’ll try to make the science as clear as I can.

First up: Oxalates interfere with sulfur chemistry which means that kids with oxalate issues can have problem creating enzymes, proteins, and tissues — pretty basic necessities here. Sulfur chemistry is also responsible for the production of bile to digest fats, for detoxification, and for cellular respiration. So disturbances in all of these processes can occur when there is an oxalate issue. According to Julie Matthews, who wrote the book Nourishing Hope for Autism, the research shows that 73-92% of ASD kids have messed up sulfur chemistry.

Another way Oxalate does damage in the body is by being a mitochondrial toxin. This is important because mitochondria are a little part of a cell and their main job is to produce ATP which is the energy that all of our cells use to do things. It’s the coin of the realm and without it our cells don’t have enough energy and it’s hard to function when your cells don’t make enough energy. Oxalate inhibits mitochondrian enzymes which means that oxalate interferes in the functioning of the mitochondria, and you don’t make enough energy. This leads to kids who are tired, even fatigued, and easily worn out!

Next up: Oxalates like to join up with heavy metals like mercury and lead and then move out of the blood stream and into the body tissues, effectively trapping these toxins in the body. This isn’t the only way oxalate relates to heavy metal toxicity - which is so common in ASD — oxalate also lowers glutathione production — that’s the master antioxidant — it’s also essential for detoxifying heavy metals. Without adequate glutathione heavy metals can build up and cause further neurological problems. And as mentioned above, when glutathione is low it’s not available to fight off free radicals and cells get damaged due to oxidative stress.

And although all of this is tied to oxalates, it’s not just oxalates coming from the what you eat. It turns out that if you don’t have enough B6 (which as Bernard Rimland has shown is often low in ASD kids, and is why they react so well to being supplemented with B6) then your body actually produces oxalates! So some kids can’t process the oxalates they get from food which means they are in the blood stream producing symptoms, and oxalates are also clogging up their tissues sometimes causing pain, and now their bodies are also making more oxalate because they doesn’t have enough B6! It’s quite the cascade and it all turns on oxalates.

Fortunately, by switching to a low oxalate diet you can lower the blood level of oxalates which often decreases ASD symptoms. One family who participated in the initial oxalate and ASD study found that on switching to a low oxalate diet the child made impressive gains in speech, motor skills and cognition - as recognized by this teachers and therapists. He also lost some lingering autistic behaviors, grew 2 inches in 2 months, and his chronic diarrhea disappeared (it turns out that oxalates can be dumped in the stool as well and often results in sandy/fluffy loose stools).

However, as I explained with Imogen, once the oxalate level is low enough the body starts to release the stored oxalate which typically increases the ASD symptoms temporarily, but is, in reality, a good sign because it means oxalates are leaving the body so they won’t be doing any more damage. It’s important to switch to a low oxalate diet gradually, because the body starts to dump the stored oxalate. Cutting oxalates down too low too fast can cause a flood of oxalates in the body which it can’t handle and in very rare cases can be deadly (back to the antifreeze problem here). However, because of all of the other damage that oxalates have done in the body, supplements are often required to help the child heal fully.

It’s not clear if all children with ASD also have oxalate issues — this connection was only discovered in 2007 and more research needs to be done. But Susan Owens, a scientist who worked for DAN! and who is the one who discovered the role of oxalates in ASD believes that oxalates do play a big role for many children with ASD. And this is why: there is a test to check your child’s oxalate levels. It’s the same Organic Acids Test — or OAT test — I mentioned earlier. And it turns out that ASD kids on average have levels that are 7 times higher than their non-ASD siblings. But what Owens has found, is that even for ASD kids who do not have a high concentration of oxalates in their urine, when they go on a low oxalate diet, their symptoms improve. So they do better without oxalates even when the test doesn’t show high levels, which means that a low oxalate diet may help your child.