A British doctor in her 40s suffered from a range of problems that all started around the same time:
My legs ached and tingled, I felt tired and my mood was flat. I slept badly — I suffered from restless legs and my muscles kept twitching — and couldn’t concentrate during the day. . . I stopped enjoying going out and couldn’t get enthused about seeing friends. . . . In December 2010, I had great trouble climbing into the loft to get the Christmas tree, having neither the strength nor the enthusiasm for it. . . . I longed to retire early, so I could stay in bed all day.
The muscle pains were worse after eating carrots, potatoes and parsnips. My son’s girlfriend made a delicious parsnip soup for a dinner party last year, and I enjoyed a big bowlful. The following day my legs were aching worse than ever, and I felt terrible. . . . [Using a food diary, I learned] I was also badly affected by potatoes, green beans, carrots, almonds and tomatoes. I searched the internet and found that, among many different theories, some suggested a link between fibromyalgia and dietary oxalate, though this isn’t recognised by the medical profession.
I tried a low oxalate diet, cutting out virtually all ‘healthy’ food — I avoided most fruits and vegetables, salads, beans, nuts, wheatgerm, soya — as well as tea, coffee and chocolate.I could eat meat, fish, dairy, cheese, white rice, white pasta and only low-oxalate fruit and vegetables, such as bananas, peas, mushrooms, onions and cauliflower. Within a few days the symptoms were totally gone; I could walk without pain and sleep normally. My motivation came back — in the eight months since starting the diet I’ve painted the house, landscaped the garden and booked a holiday. Having suffered from the need to pass water frequently, my nocturnal trips to the bathroom have ceased. And, bizarrely, my teeth have felt clean all day long. . . . I’ve found eating any high-oxalate food results in tingling legs and muscle pains within a matter of hours. I’ve become so adept at noticing the signs I can tell what foods and drinks have oxalates in a short time after ingesting them.
Would her discovery help others? She suggested the diet to five women in her practice.
They had all presented with at least four of the following [eight] symptoms: muscle pain, tingly legs, fatigue, irritable mood, bladder irritation, poor concentration, restless legs and poor sleep.
I asked them to score the severity of these symptoms before and after changing to a low oxalate diet. . . . . Out with bran-based cereals, nuts, spinach and smoothies, and in with Rice Krispies, sausages, shortbread and cola! . . . All the patients improved significantly — on average their symptom score halved after three weeks of the ‘unhealthy’ diet.
This surprises me. I would have thought that a condition as vaguely defined as fibromyalgia would have more than one cause.
In any case, this is extraordinary progress — published in The Daily Mail. Surely more important than any of the 7000 peer-reviewed articles on fibromyalgia I found via PubMed. A PubMed search for “fibromyalgia oxalate” turned up nothing.
More about a low oxalate diet. Thanks to Dave Lull.
“Apparently she is the first person to make the connection.” I suppose that rules her out for the Nobel in medicine/physiology, then?
Seth: Since I wrote that I am no longer sure she is the first. A low-oxalate diet is promoted for various disorders, I learned, although apparently never in the PubMed literature. But, yeah, it’s been a long time since anyone resembling an ordinary doctor, which she is, has won a Nobel Prize in medicine/physiology.
Just a little bit of amateur web searching turned up articles about Oxalobacter formigenes, which is a beneficial oxalate-degrading bacterium commonly found in the human gut. However, it can be destroyed by antibiotics, and perhaps indirectly by small intestinal bacterial overgrowth as a result of protein pump inhibitors.
So, quit the antibiotics, quit the PPIs, take some yogurt and other probiotics, and keep eating lots of fruits and veggies that provide fiber for your good gut bacteria,
But I ain’t no doctor. I’m just a cranky old patient. So I don’t give (or take) medical advice.
Some common foods high in Oxalate are “SCRT”:
Spinach
Chocolate
Rhubarb
Tea
I believe Fibromyalgia is more common in women & there is at least an old wives’ tale that women eat more chocolate than men. Maybe I’m grasping at straws here.
Anyway, rather than cutting out ALL vegetables, maybe a 1st approach would be to cut out these big 4 and see if there is improvement? If so, then one might consider further reducing other sources.
Perhaps the important lesson is that wittering about “healthy eating” is pointless if the advisee doesn’t know what is healthy for her.
(It’s easier for men, who know that sausages are healthy for them.)
One of the main antibiotics that destroys Oxalobacter formigenes in the gut is Augmentin – commonly prescribed with a PPI to enable you to ‘tolerate’ it. No wonder you can end up with oxalate overload afterwards.
The Paleo diet is ‘half-way’ to the low-oxalate diet, which probably explains why many people get improvements but not quite full health on the paleo. As a gluten-abstaining coeliac, who still has fibromyalgia, I will definitely try modifying my diet to see if I can remove the fibromyalgia. I would like to get fit without severe pain all the time!
The same doctor mentioned in the article above also said ‘It may also be that certain bacteria in the bowel normally break down the oxalate, but that these bacteria may disappear, perhaps after a course of antibiotics. There must be genetic factors, too, as fibromylagia is more common among families of those affected.’
Yesterday, I came across an article stating that gut bacteria are altered during pregnancy (apparently to increase insulin resistance so that the baby gets more glucose) and this alteration is retained. This might explain why more women end up with fibromyalgia – and why more women can never shed their ‘baby’ weight.