By now most of you have likely heard of a condition called leaky gut. I’m fact many of you are likely suffering from it and aren’t really aware that this is the issue. So how does this relate to the oxalate conversation, the main reason is because oxalates leak in through a dysfunctional gut… a leaky gut. Leaky gut, also known as intestinal permeability means just that – your intestines are permeable by things that should be kept out (or in).

With the rise of leaky gut, comes the rise of oxalate issues. I mean sure there are some who also have genetic factors making them at higher risk for oxalate issues but that’s a much smaller section of the population. That is unless you have  a MTHFR gene mutation…. say what?! 

Ok let me back it up a bit –  The MTHFR gene contains instructions for making an enzyme that’s important for metabolizing folate (folic acid or vitamin B9). It also helps our cells recycle homocysteine, a chemical in the blood, into methionine, a building block for proteins. So it’s kind of a big deal. Having elevated levels of homocysteine put you at risk of heart disease. I’m constantly asked if I’m worried about folate levels on a carnivore diet – since I’m consuming less and it’s needed to keep those levels low. Yet when I look at lab values from vegans they actually tend to have HIGHER levels of homocysteine than I ever did. My levels are great btw so no worries here. Yes I check my folate status and if it was low my homocysteine would be elevated.

ok back to the gene aspect, there are two common variants in the MTHFR gene,  C677T and A1298C plus of course MTR and MTRR which we also look at when assessing a patient’s DNA. About 50% of the population is thought to have this or some sort of similar variant in the pathway which is cause for concern when it comes to oxalates. You see oxalates make methylation issues worse. Oxalate problems cause sulfate problems. The genes most effected are the SULT (and other phase II related pathways). Just in case you aren’t familiar with your phase II pathway it has to do with how our liver helps us detoxify daily so it’s kind of a big deal.

We need sulfate in order for our SULT pathway to properly detoxify, when those levels drop we are going to run into issues that cause this cascade effect, sort of like dominos. It’s going to in turn slow down other phase II gene SNP’s such as our COMT, NAT2, ALDH, GSH, GSS, UGT, oh and SOUX too. This is going to leave you ultra sensitive to daily toxins, hormones, phenols (like food colouring and chemicals or additives found in processed food), xenobiotics, and heavy metals and OXALATES

When oxalate levels are high, sulfate levels are low which messes with our ability to detox effectively. This leaves us with elevated homocysteine levels, gallbladder issues, inflammation, and hormone imbalances. 

So what’s the gallbladder got to do with all this you ask? It was actually something I noticed by fluke with one of my patients. Their oxalate levels rose (a lot) after bariatric surgery. I decided to look into the literature and sure enough I found that after bypass surgery (which compromises the upper GI tract) patients developed excess oxalates in the blood and urine (we call that hyperoxaluria). It’s really easy to explain – when we put ourselves through such an invasive and intense surgery we damage both the stomach as well as the gallbladder which includes bile flow and production – in turn impacting digestion leaving us open to oxalate damage. I put together a quick video if you decide this article is too long winded, have a peek (or continue reading)

Sorry about the muffled sound for about 10 seconds – it goes away quick I promise!

If we don’t have adequate bile production or it’s sluggish we will have oxalate issues. If we have leaky gut we will have oxalate issues. If we have gut dysbiosis we will have oxalate issues. If we drink those stupid high oxalate spinach and blueberry smoothies everyone says are so healthy, and we are in this compromised state we will have oxalate issues! 

Let me say it again for the folks in the back…When we have bile issues we have oxalate issues –  bile helps us absorb the fats we need and pass the oxalates in the stool so they don’t cause problems. Ever look at the amount of people walking around with gallbladder issues? Or the increase in people having their gallbladder removed (like we don’t need it and it’s not a important organ) we clearly aren’t getting the job done are we.  If we don’t absorb the fats they go rogue in our small intestine binding to the calcium… which means now the oxalate has no calcium to bind to so we absorb it. So we are absorbing jagged glass shark like compounds, what could go wrong here?!


When we have bile issues from digestion issues, liver/gallbladder issues, stomach issues, and even taurine deficiency we all of a sudden start absorbing more oxalates… those crazy shards of glass that are such a pain in the ass. Want to know why you have nutritional deficiencies (like malabsorption of those fat soluble vitamins)? Look at your poop. All that fat and calcium that was pooped out cause you didn’t have adequate bile to absorb it. It also leads to elevated inflammation and issues like osteoporosis. When the gut doesn’t provide enough calcium for the rest of the body our bones get broken down to release calcium into the bloodstream. 

Ever wonder why those who have had their gallbladder removed have a higher propensity for these issues? It’s another reason I have my patients take ox bile if they don’t have a gallbladder (that’s a non negotiable folks!) 

Pro tip? Grab some calcium-citrate, it’s utilized FAST in the gut, helping to bind up the extra oxalates floating around (plus it will help yourself kidneys out). Take it at mealtime to help your body out. Oh and get rid of the oxalates. 

We also have handy bacteria that degrade oxalate in the gut (Oxalobacter formigenes,  Lactobacillus and Bifidobacterium)

Unfortunately if you have had long bouts of antibiotics or excess oxalate exposure (remember those smoothies I mentioned?) then you may need some extra help cause you’ve killed off those bacteria (specifically the Oxalobacter formigenes). 

Want help transitioning to a low oxalate or carnivore lifestyle? Why not grab a session with me and let’s get the ball rolling!