I hope I have it right this time . . .

[notnowdad]

Friends, I have continued to keep a diary of my eating and my reactions to various foods. I think I have come up with a deeper insight into our affliction. Allow me to share my latest conclusions and a brief account of how I connected the dots.

1-My previous post on this website that certain goitrogenic foods were causing my RLS was helpful to me but it was slightly off the mark.
2-I now believe my “trigger foods” such as spinach and Swiss chard are a problem not because they are goitrogenic, but because they are high in oxalic acid (also known as oxalate).
3-It seems possible to conclude that a diet which is consistently high in foods rich in oxalic acid can cause certain people to manifest RLS.

After my initial breakthrough with avoiding goitorgenic foods generally, I started loosening up my quite restricted diet, allowing back in some tame things like coffee, tea and some 85% cacao chocolate. In the early days I found that I could tolerate some occasional spinach. I started putting ground flax seeds on my oatmeal. While I was still avoiding wheat for other reasons, I enjoyed having lunchtime tacos on corn tortillas.

As my overall well being declined over several months, I didn’t associate it with RLS. Because I wasn’t manifesting the bedtime squirming, I chalked up my daily discomfort, low energy and increasingly bad attitude to “old age”. I decided that it was normal for me to be unable to tolerate sitting for more than an hour or two. Let me say that, as someone who suffered from increasing RLS for two decades and then became free of it and then had it creep back in, even if you aren’t squirming at bedtime, low grade RLS does exist and it can make you miserable all day long. Imagine it as a 3 on a 0 to 10 scale. The only acceptable goal is to be completely free of it.

What finally happened was I made some soup with a selection of my favorite non-goitrogenic vegetables. Within 24 hours I was up to a 6 or 7 on my RLS scale. I was wiggling my legs in bed and wondering how a soup with no significantly goitrogenic vegetables had triggered my misery. I happened to remember some healthy eating advice about always boiling spinach because it is high in oxalic acid. On a whim I searched on foods that are high in oxalic acid. Not only were my old friends spinach (H-high in oxalic acid) and Swiss chard (H) near the top of the list, but not far down the list were my soup ingredients leeks (H), bell pepper (H), okra (H), green beans (H), carrots (MH-moderately high) and tomatoes (MH). By trying to make a really healthy soup and retain vital nutrients, I had brought together some great sources of oxalic acid and, by not throwing away the cooking water, I had retained all of the acid in my soup pot.

I read that during digestion oxalic acid bonds with iron, zinc, copper, calcium, magnesium and manganese forming chemical compounds which make these vital minerals unavailable for absorption by the body. I remembered that some people associate deficiencies in these minerals with RLS. I realized that my daily spring time diet, while avoiding the highest sources of oxalic acid, was giving me a dose of mineral absorption blockers at every meal.

Breakfast: blackberries (H), blueberries (H), strawberries (H), flax seed (H), coffee (MH).
Lunch: iced black tea (H), corn tortillas (MH), one or more high or moderately high vegetables
Supper: one or more high or moderately high vegetables, chocolate (H)

All I had to do was realize what was happening and break the cycle. I still have coffee and tea, but I’m cutting back on OA generally and consciously designing some meals with a minimal oxalic acid load. That seems to be all that is necessary. My chronic low level discomfort has completely gone away. I can sit at my desk all day with no problem. And my family members have been remarking about how much less crabby I am.

Be warned that the information out there about OA levels in food is a bit inconsistent. On the other hand you don’t have to get it 100% correct to get the benefits. I believe you just have to know what is happening and keep working at it. Fortunately there is quite a bit of available advice on how to eat a low oxalate diet because it has been disseminated for people who tend to form kidney stones. The best I have found is a pdf put out by The Children’s Medical Center of Dayton Nephrology Department. After several pages of mind numbing statistics they offer some simple guidelines for meal structuring. Here is a link to their resource:

http://www.childrensdayton.org/cms/reso ... d_diet.pdf

As always, I wish you all the best. For all of our sakes, I hope I have it right this time.

[ViewsAskew]

Keep us informed about how it keeps working. We just know so little about so many things (in terms of true research - double blind, etc) that we're often just guessing and trying anything, aren't we? This at least seems to make some sense - especially in relation to the people who find that taking magnesium and other minerals helps them.

[Polar Bear]

This is very interesting, I've saved the linked document to my favourites for information

[notnowdad]

Today I read most of the posts on this website concerning the Wahl’s Diet thread. I also listened to Dr. Wahl’s TED talk. I am in awe of what she has achieved. And the dedication that some of you have displayed to this promising prospect. It also made realize that I must sound like an idiot. Here I am saying I didn’t need to go grain free, or dairy free, or alcohol free, I just needed to cut back on a bunch of foods that everybody knows are "Super Foods". But, all I can do is tell you what works for me. And, I hope it may help somebody else.

Since I last posted I have had an up and down few days. I set out to further explore the advantages of a diet low in oxalic acid. I found another website with another good summary of current dietary recommendations for a low oxalate diet:

http://printfriendly.upmc.com/printPati ... -diet.aspx

I felt good all day Saturday. Sunday I felt so good I couldn’t stop grinning all day. I had a new level of energy I hadn’t experienced in years. I did household chores that I normally hate doing. I wrote emails to friends telling about my breakthrough in wellness. Yesterday was a great day too, except in the late afternoon I became very aware of discomfort in my legs. I was able to get to sleep by 9:30 despite increasing discomfort. When I woke up at midnight, it was really bad. I have been up ever since.

What happened? I had a strong reminder that what I’m trying to share here is simple but it isn’t easy. Sunday supper, in addition to a nice grilled steak, I had three foods reported to be very low (L) in oxalate: cucumbers, mushrooms and endive, as recommended by the upmc.com website above. I also had small quantities of moderately high (M) vegetables: asparagus and onions. As I reported over a year ago, when I eat a trigger food or, as I now see it, a complementary group of trigger foods, my RLS kicks in within about 24 hours. Well, I can’t be completely sure about the cause, but at least one website, the website I referenced in the my post identifies endive as a high (H) oxalate food, you might even say very high with 273 mg per serving. If I had noticed that data, I wouldn’t have put it together with several portions of M foods.

As I go deeper into the research, I find more and more inconsistency about oxalate levels in various foods. But the good news is, that even though I inadvertently slipped over the line on Sunday, with my careful food selections on Monday, I’m already back to being fine. The RLS faded away around noon today and I’m perfectly comfortable as I sit and type this.

Even with this experience I’m not entirely sure if it was the endive. I just don’t make a conclusion that fast. I’m “pretty sure” because I have many recorded instances of having asparagus and onions without a reaction. But, you should know, 90% of the websites that mention endive, even the ones focused on raising rabbits and gerbils, seem to be sure that it is a low oxalate food. I suspect they pretty much all copy the same incorrect internet source. In the last post I said the information is a "bit" inconsistent. "Wildly" would have been a better word.

Even though I had a really bad night, I’m glad I had this experience to share because it is an excellent example of how tricky this stuff can be. For now I strongly recommend cauliflower or broccoli or cabbage plus green peas and mushrooms as “go to” foods to eat along with meats, fish, eggs, white rice. I’m eating a lot of mango and cantaloupe also. If you respond the way I do, you will be a lot better within 48 hours. I haven't been eating cabbage but it is consistently identified as low oxalate.

BTW, when I started all this diet analysis 5 years ago I had very significant improvement when I gave up wheat, corn, potatoes and various beans. I now believe they were not out right “trigger foods” for me like the (H) foods I have identified. Rather they were “complementary trigger foods” by virtue of being (M) - moderately high oxalate foods. I am back to enjoying all of them, but I do use them carefully.

Until next time . . .

[badnights]

The oxalate connection is an interesting theory.

I have plateaued on the Wahl's diet. Since last September I have been at 9-12 mg hydromorph contin, after reducing from 18-21 in 6 months. (I am not going to get excited yet, but I may be off the plateau: I have been taking only 9 mg almost every day for the last month or two. It's been a bumpy plateau, though, so maybe this is just a little trough I'm passing through).

I tried the third level of the Wahls diet; I was ketogenic (very low carb, adequate protein, and very high fat) for about 4 months, I'm guessing. High-intensity exercise took hours to recover from, though, and my belly was always swollen with bloat of some kind (though that might have been an effect of the SIBO treatment). So I'm back on level 2.

Perhaps all I needed to do was stop gluten and dairy! I can't help but think, though, that it was more than that; consuming whole foods containing all those vitamins, minerals, & other micronutrients, and going as low as possible on pesticides (not that I get much choice where I live), has to be helping my body repair itself, including whatever has gone haywire in my neurons.

So now I should think about oxalate, and see if I notice any connection. Thank you for this.

Have you thought about phytates? Do you eat lots of nuts and seeds? Grains, especially the bran? Beans, especially pinto, kidney, navy, & soy? Potatoes?!? Phytates bind to metals and prevent their absorption, especially iron, zinc, manganese, and calcium. eg. http://healthyeating.sfgate.com/foods-h ... -3307.html

[ViewsAskew]

Often times I don't have the energy, time and/or knowledge to evaluate claims, particularly related to functional medicine and alternative approaches. While I absolutely believe that are things Western science needs to learn, I also believe that there are many, many, many people just taking advantage of others without any science backing them up. Sometimes we don't have the ability to evaluate, sometimes there hasn't been money to do it... but when people ignore it and advocate things that are proven not to work, that is completely different!

Chris Kresser appears to be one of the more evidence-based people writing about integrative medicine. I listened to a podcast recently about SIBO and gut health - he has his own take on it. Might be worth reading or listening to for anyone following this path.

[notnowdad]

Thank you both for your suggestions. It is interesting that phytic acid poses similar issues as oxalic acid in terms of interfering with mineral absorption. While I have been generally avoiding nuts and whole grains (wheat and rice) I have been having steel cut oats for breakfast most days, and very often corn tortillas at lunch. Both these foods are fairly high in phytic acid which is hard to remove during processing and cooking. Potatoes, which I eat several times a week, are also a potential problem. My first real breakthrough came several years ago by following a "blood type diet" which, for my blood type, happened to be low in these phytic acid rich foods. I will be looking at whether cutting back on those foods could give me a bit more flexibility with the oxalate rich vegetables and fruits.

Concerning the issues of "gut health", I'm very open to all possible explanations and insights. At the moment I'm going to stay focused on trying to put together the last pieces of a method to get to "a really good day" virtually every day. I feel I'm very close.

A last thought: My working hypothesis has become the idea that some component of my diet prevents a daily replenishment of needed minerals which I should be absorbing from a balanced intake of well prepared high quality foods. In suggesting that others attempt a similar approach I have indicated that it is likely to expect an almost instantaneous improvement, within a day or two. I realize that when I first achieved a situation where I could "switch it on and off" within 24 hours, I had been through a period of diminishing the impact of the underlying issue which was acting on my body. In other words you might say I was closer to being "well" and therefore able to achieve more rapid improvement from making a dietary adjustment. All this leads me to suggest, maybe giving the program a little more time before you decide if it might be working for you.

[badnights]

Notice I said the bloating might have been en effect of the SIBO treatment - not of the SIBO. I am not at all sure of the method used to diagnose my SIBO, since it's not accepted in standard medical circles. Nor am I at all sure of the treatment, which scared the hell out of me to contemplate doing, perhaps with good reason - we shall see.

I Will check into Chris Kresser. I have not done any research lately into WED/gut/nutrition issues; I am not really holding my own in my job although I'm doing much better than I was a year ago. So all my time goes to work, gym, food (buy, chopping, cooking, eating, dishes, endless), and some temporarily heavy duties for my hockey league.