The connection between your stomach & high oxalates

The relationship between a damaged stomach lining, low stomach acid (hydrochloric acid or HCl), and high oxalates involves several inter-connected physiological processes.

In short, by addressing both low stomach acid and (an often consequent) damaged stomach lining, it’s possible to reduce oxalate issues, and support overall digestive and systemic health.

Low Stomach Acid (Hypochlorhydria) & Oxalate Absorption

• Adequate stomach acid is crucial for the absorption of minerals like calcium and magnesium. These minerals can bind to oxalates in the gut, forming insoluble compounds that are excreted rather than absorbed. Low stomach acid reduces this binding, increasing the free oxalates available for absorption

  • Minerals like zinc, magnesium, sodium chloride, and vitamins B6, B3 and B1 are needed to make stomach acid

• A damaged stomach lining often coincides with increased intestinal permeability, commonly referred to as ‘leaky gut’. This condition allows larger molecules, including oxalates, to pass through the gut lining into the bloodstream more easily, increasing systemic oxalate levels

• Low stomach acid can lead to bacterial overgrowth in the stomach and small intestine. This dysbiosis can disrupt the balance of gut microbiota, including oxalate-degrading bacteria like Oxalobacter formigenes. A decrease in these beneficial bacteria can reduce the breakdown of dietary oxalates, leading to higher oxalate absorption

the Effects of a damaged stomach lining

• A healthy stomach lining secretes mucus that protects the stomach wall from the acidic environment

• Low stomach acid, where food fails to reach the right acidity or PH to be released into the small intestine meaning it sits there too long fermenting and going rancid, can damage this lining

• Other causes of stomach lining damage are

  • Chronic inflammation

  • Infections like H. pylori

  • Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs)

• A damaged stomach lining can lead to chronic inflammation, which can extend to the intestines. Inflammatory conditions can further impair nutrient absorption and alter gut permeability, creating a cycle that perpetuates oxalate issues

Mechanisms Increasing your body’s production of Oxalates

• Poorly digested proteins from low stomach acid result in higher levels of amino acids such as glycine and hydroxyproline. These amino acids can be converted into oxalate. Glycine and hydroxyproline can be metabolised into glyoxylate, which is then converted into oxalate, increasing endogenous oxalate production

• It can also lead to the impaired breakdown and absorption of key nutrients

  • Vitamin B6 is essential for the enzyme alanine-glyoxylate aminotransferase (AGT), which converts glyoxylate into glycine rather than oxalate. But low stomach acid impairs vitamin B6 absorption, leading to a higher conversion of glyoxylate to oxalate

  • Magnesium binds with oxalates in the gut to form insoluble compounds that are excreted. Without sufficient magnesium, more oxalates are absorbed into the bloodstream. Low stomach acid reduces magnesium absorption, contributing to higher oxalate levels in the body

the causes of low stomach acid

• Low stomach acid itself is caused by

  • Ageing

  • A high sugar or refined carbohydrate diet

  • Chronic stress

  • Medications like PPIs

  • H2 receptor blockers, antacids

  • Nutrients deficiencies like vitamin B12 and B1, zinc, other minerals (possibly caused by low stomach acid failing to break nutrients down adequately, leading to reduce nutrient availability and absorption)

  • Alcohol

  • Low protein diet

  • Inadequate chewing

  • Stomach infections like HPylori

Combined Effects Leading to Oxalate Problems

• Increased Oxalate Absorption – With low stomach acid and a damaged stomach lining, the absorption of dietary oxalates in the intestines increases. The lack of sufficient calcium and magnesium binding, combined with increased gut permeability, allows more oxalates to enter the bloodstream

• Kidney Stress and Stone Formation – Higher systemic oxalate levels mean more oxalates are filtered through the kidneys. This can lead to the formation of calcium oxalate crystals in the urine, increasing the risk of kidney stones, particularly in individuals predisposed to stone formation

• Systemic Oxalate Load – Elevated oxalate levels in the bloodstream can deposit in various tissues, potentially leading to pain, inflammation, and other systemic symptoms associated with hyperoxaluria (high oxalate levels)

• Endogenous Production – Impaired digestion and absorption of proteins and nutrients can lead to deficiencies in nutrients like vitamin B6 and magnesium, which are crucial for metabolic pathways that reduce oxalate production. The result can be an increased conversion of amino acids to oxalates, reduced binding of oxalates in the gut leading to higher absorption and systemic levels, and chronic inflammation along with metabolic shifts favouring oxalate production

how to resolve stomach & oxalate issues

• Increase stomach acid by having apple cider vinegar with meals (sufficient for small increases), supplementing (for lower HCl), avoiding sugar and refined carbs, avoiding over the counter drugs,

• If you react to this, you need to heal your stomach first using compounds like slippery elm and licorice root and aloe vera. Then you can reconsider vinegar and supplementation

• Reduce high-oxalate foods like spinach, beets, nuts, and certain grains

• Increase your calcium intake using foods and/or calcium citrate supplementation to help bind oxalates in the gut and reduce their absorption