Episode 90: What are Toxic Superfoods? A Deep Dive into Oxalates with Sally K. Norton, MPH

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Sally K. Norton, MPH 

That’s really important that people that are young children, elderly and sick people, anyone with got inflamed inflammation needs to be extra cautious about oxalate and the rest of us just deserve to know when reading high oxalate foods so we can choose to minimize what is essentially a toxin in our lifestyle. I think anybody it’s a good idea to know what when you’re exposed to toxins and how to cut back.

Dr. Andrew Wong 

Welcome to the Capitol Integrative Health podcast. I’m your host, Dr. Andrew Huang. We are excited to bring you this episode today with Sally K. Norton, a leading expert on dietary oxalates which are compounds that are found in plants and how they can affect our health. Sally’s personal experience inspired years of research and led to her book toxic superfoods how oxalate overload is making you sick and how to get better. This was released in January 2023 and is available anywhere books are sold. In this conversation, we explore hidden sources of oxalates potential health conditions that are associated with intakes of high oxalate and practical strategies for reducing oxalate intake, while still maintaining a balanced and healthy diet. So stay tuned for an eye opening conversation and it might have you scratching your head and wondering if what you’re eating is really healthy or not for your body. This will empower you to make informed decisions about your own health. And we really hope you enjoy this conversation today. Welcome Sally to our podcast. Thanks so much for coming on today.

Sally K. Norton, MPH 

Thanks for having me. It’s gonna be fun.

Dr. Andrew Wong 

Yes, you’re you’re so welcome. And before we dive into oxalates, and how they affect your health, and you know, oxalates are really an area that are under explored even in in the functional medicine field. Could you tell us a little bit about your listeners about your story and why you decided to write your recent book which we see the background there of that of that book cover? Toxic superfoods how oxalate overload is making you sick and how to get better.

Sally K. Norton, MPH 

Right, this is a place I would never have imagined I’d land. When back in the 1970s. I decided I would get my degree in nutrition when I was in seventh grade. Because I just thought it was magical. The idea that my science teacher said if you know how to eat basically, you can avoid cancer and heart disease and like who doesn’t want to go through life with as few doctors as possible? Forgive me.

Dr. Andrew Wong 

 No, it’s true. We all I think we’d rather be vacationing somewhere on the beach.

Sally K. Norton, MPH 

And yeah, running up and running around building gardens, having kids having parties having a good time not being in unfortunately, too many of us land in polypharmacy and fatigue and pain of all kinds and surgeries and things that really, we need to wonder why we’re struggling. So so I’ve been interested in this prevention idea through nutrition a long time, and decided to get my degree from Cornell University and went on and got my master’s in public health and worked after that, where the program and integrative medicine running a big NIH grant. I had been, you know, interested in nutrition and following all the trends. So by the time I before I was 20, I was a vegetarian did that for eight years. I was vegan for eight more years, and I didn’t have good health. During this time, I had been striving for health, I actually started talking health and nutrition as a kindergartener. And I didn’t, I really missed the mark on how to be healthy because I had developed arthritis and fatigue and problems focusing and back pain. And that was really pretty disabling. I never really connected that with my diet, because of course, I was doing everything worried.

Sally K. Norton, MPH 

But fast forward years later, I’m in my late 40s. And I’m in big trouble with various pain syndromes, and the brain fatigue is severe. I ended up having to leave my faculty position at VCU writing, research grants and so on administrating research, because my back was so bad that I was kneeling half the time and I was bleeding with fibroids and they were like, well, they’re little fibroids, but it was a mess and they I needed a total hysterectomy and I couldn’t focus so I ended up leaving my career had a hysterectomy. And after that I was completely unable to do anything exercise workout. So of course, I lost my ovaries and they found endometriosis in their scarring in the colon and company wide open. They had, you know, they found loose blood I was I’m this healthy eater. And I was a mess. And I had to go to an endocrinologist because hey, I like don’t have ovaries and he couldn’t figure out what was wrong with me sent me to the sleep doctor. And so I did the full sleep lab study with all the sensors and probes on your brain and arms and legs. And that study showed that my brain was waking up 29 times an hour

Sally K. Norton, MPH 

Oh, wow. Yeah, that could explain why I couldn’t read. It didn’t have any energy. That explained a lot. But the research literature suggests that endotoxemia is a major cause of, you know, a toxic brain that can’t sleep. So I thought it was my years of bloating and balancing and constipation and IBS, I thought it had to be dysbiosis. I got it. Methane tests which I failed, I did not have SIBO. But I treated it anyway, because I was so convinced like I needed to sleep. And it turns out that all along it, the poisoning that was racking my brain and causing arthritis, and probably the back pain and the fatigue and the need for hysterectomy, probably all goes back to my fairly high oxalate diet, which was completely off my radar, completely, and it took it took having to live through this and experiencing getting oxalates out of my diet, and then helping others and doing research in the medical literature to convince me what ended up becoming this book toxic superfoods, I felt like the least I could do if oxalates were going to kill me as leave behind a book.

Dr. Andrew Wong 

It’s such a powerful story, Sally, thanks so much for sharing that. And I think a lot of times, as you know, a lot of our listeners know, it’s the personal stories that really touch home and get us to dig deep into kind of what’s going on. Because a lot of times, you know, like you said, doctors don’t know, people don’t always know what’s going on, and you’re the CEO of your own body, you’re going to be able to really often figure that out, sometimes with the health of the health help of a health professional, but but certainly let’s talk about oxalates and they intro question kind of set that up perfectly for, you know, providing an overview of what oxalates are, you know, why should we care about them? And how do they affect our bodies? And how could they be, you know, potentially, I guess damaging to our bodies?

Sally K. Norton, MPH 

Yeah, there’s there’s a lot there. And I tried to get into a bunch of it in the book. And just to follow on what you’re saying about doctors don’t know and I was embedded in a medical world I live I worked in two medical schools, and my friends and colleagues for either conventional or alternative holistic functional acupuncture, homeopathy, the whole works, and none of us. None of us knew what was wrong with me, me included. So what I didn’t know about was oxalic acid is this little, tiny molecule it’s a key later is two carbons and four oxygens. It’s an end product of oxidation. So it’s easily formed in nature, soil funguses make it plants make it they needed for their metabolism, safety, diff, self defense, longevity, reproduction, all kinds of physiology, even capturing sunlight is one of the theories and plants build crystals with it, because it’s a key later it grabs minerals, especially calcium, because it has these two hydroxyl groups, these two O H groups drops the proton and has an ionic charge either one or drops both protons and you have a double ionic net negative charge that gives it the power to meet up with positively charged things like calcium and magnesium and iron and so on. And so it forms these, what we call salts. So oxalic acid is the parent compound and when it’s, you know, dabbling around and hanging around with minerals in it’s in a fairly dry scenario, it can salt right out, or, you know, a concentrated scenario salts out into these salt crystals that then line up and form bigger crystals and plants and use that power to build crystals. They’d have to put down an architecture of amino acids sort of scaffolding and then this calcium oxalate can be built in very specific shapes. So we eat oxalic acid and we eat calcium oxalate crystals. And when we eat oxalic acid, it gets into not just our justice system, but flows through the digestive tract into the bloodstream. It’s a paracellular, meaning it flows between the cells of the digestive tract in the water. So the more dilute and dissolve it is, the more it’s in this free ionic form and the watery substance of your tea of your smoothies of your juicing and so on. The more water is your almond milk that gets into the bloodstream, and apparently, right away it starts interacting with and affecting the cells in the bloodstream and the cells of the vascular system. That includes your monocytes. One study down at Burlington Birmingham showed that within 40 minutes of one spinach smoothie that had about 720 milligrams of oxalate in it, the circulating monocytes were in big trouble with inflammatory problems and damage and they were no longer in a position to fight infection. They were actually increasing general inflammation the body because they’re putting out pro inflammatory cytokines, they’re wounded and they’re letting everybody know. And so those that blog light that comes from your digestive tract goes straight to the liver. And those open sinusoidal cells a liver bathed in everything we’re absorbing from our, our food, including oxalate, and that uses a glutathione. And so you use up some of your protective and innate antioxidant power of cells and particularly in the liver right there, because it’s getting a full dose is being consumed by the cells need to protect themselves from the pro oxidative effects of the oxalic acid. It’s, it’s being a charged ion and a key later, it has electromagnetic effects on membranes. It is acidifying, which affects the shape of the proteins, it can get into cells that can cause cells to become leaky to calcium. Calcium can flow into the cells in ways that should not and it can get into the cells in ways it starts chelating calcium within cells, and that really messes up cellular regulation because the endoplasmic reticulum and mitochondria are affected their attempt to tell the cell what it’s supposed to be doing is being interrupted by the loss of these, these informative secondary messenger ions, calcium, so it’s down there at the inner workings of cells. And already you’re hitting your liver which is this major metabolic organ that’s helping to manage a whole body and it flows right on because the liver doesn’t detox oxalate, it doesn’t have any enzymes to break it down, none of our cells can break down oxalate. What the liver does is make oxalate. So after you’ve had a high oxalate meal, like a green smoothie or something, you affect your liver and your blood right away and then the what’s the blood that’s leaving your liver is higher and oxalate than it was coming in, and that blood goes straight to your heart and your lungs because the flow is up the Varian gave toward the heart than for oxygen in the lungs back in the heart, a lot of people don’t know that basic circulation. And even in clinical medicine, we forget that whole path of exposure. So you’re hitting some seriously major organs before you even get into the general circulation. And of course, capillary beds are high pressure where these nutrients and toxin like oxalate gets pushed into the tissues. And some of it will get picked up through circulation again, on the other side of the capillary bed or the length. But basically, you can cause a sort of oxalate bath and tissues in the interest, special intercellular spaces, which is stressful for tissues.

Dr. Andrew Wong 

That may not be a bath that we want to want to take, but it sounds like, oh, yeah, so so there was so much there. And I was taking some notes as you were talking. And, you know, it sounds like it sounds like oxalates are a a root cause really of a lot of inflammatory issues. You know, I would like to kind of go through if you would, some symptoms or you know, conditions, diagnoses that we might label people with, or maybe they experienced themselves. That might be from oxalates. If you could just give us like a high level a bed of some of the some of the big things that you know, maybe people don’t know why they have it, or they’re on some meds or they’re doing some supplements even that, you know, they’re trying to kind of push into their system to try to Bandy the system,

Sally K. Norton, MPH 

Right, but could be caused by oxalates. Yeah, there’s so there’s also vitamin C, and we didn’t get into the foods. But yeah, it’s really important to know, that basically, Oxley could affect any system in the body. So it can show up very differently in each person. And we know that from the medical literature, because there’s a genetic form of this where the liver starts mismanaging amino acids and more of the hydroxyproline becomes oxalate then as normal and you can get very sick and die as a young baby from the genetic form. And we know from that, that the symptom patterns and the sort of clinical presentation varies a lot and some of those patients show up with just neck pain. There’s a lot of weakening of connective tissue and that can cause pain. There’s a neurotoxicity which can cause pain. So when it kind of musculoskeletal pain, even Fibromyalgia arthritis, that sort of bursitis is all of those can be oxalate that’s pretty well documented in the rheumatology literature, and the textbooks and so on talking about oxalate crystals and oxalate exposure, affecting all the itis is of the joints and so on. So, the urinary tract is another area that’s well known in medicine that you can get kidney stones, kidney colic retention, you can get nephrocalcinosis which is a problem of diffuse miniscule bits of calcium oxalate collecting in around the tissues of the kidney. But if you’re waking up at night to pee, that’s probably an irritated bladder that’s got too much oscillate in it. Especially if it’s more than once you really shouldn’t have to get up at night you should be able to sleep through the night and hold your urine.

Dr. Andrew Wong 

Also for people over the age of 40, as well, or

Sally K. Norton, MPH 

 I think at any age we really are built to I really don’t believe in decay of time. I think that what happens with time, the older we get, we’ve had more years of making the same mistakes over and over again and stressing our body out. I think the most popular way of eating too much oxalate is to have a french fry or potato chip habit. Because potatoes are very high in oxalate and when you deep fry potato, you still indissoluble oxalic acid, and it’s very bioavailable. It’s like 89%, soluble the oxalate and potatoes and that kind of thing where it’s nowadays since the about the 1970s, you get offered potatoes of certain some form it most meals, three times a day dashboard hashbrowns and McDonald’s and then your fries and chips and you’re never looked at potatoes again sealing the destiny of inflammation there it sounds like when you’re eating that. So let’s say you got dried seed oils. Now because they’ve changed from tallow long ago back vegan, we were so happy to see Talgo Dolmabahce have this seed oil. So you know basically soy and canola and other nasty oil, super inflammatory oil sealing in toxic oxalate, it’s a great formula for getting sick. So there’s the urinary tract, if you’ve got painful bladder, even even a bit of incontinence could be this neurotoxicity that’s affecting the function of the sphincter muscles. Often we don’t realize that tremors and twitches and things like this where your muscles seem to be acting up, it’s really a neurotoxicity problem actually makes nerves hyper excitable. So they’re unpredictable and they start getting making muscles do random things just because they can’t control their calcium ions. And they’re under this oxidative stress you mentioned. Sorry. That Thank you, you mentioned quite a few organs that really obviously the circulation is hitting all the organs, but just going from, you know, the the liver to then the heart and the lungs and, you know, gets back to the gut, you know, gets to the brain are those big organs also potentially affected by by oxalic acid and I guess an overload of oxalates. The nervous system and the eyes are very much affected by the oxalates nerves really require control over their calcium right to function. Yeah, yeah, it’s very neurotoxic. And the eyes tend to one of the most common places where oxalates accumulate. So this is the problem with coming along and visiting all your tissues. It’s not just there’s this acute inflammatory stress with the cells can recover from they can produce more glutathione and try to correct this oxidative stress. If it’s, you know, a temporary scenario but the oxalic acid and the crystals, it forms sticks to cells that aren’t healthy or cells that are just regenerating. So we’re always regenerating cells, but they’re in a different metabolic state that makes them stickier at oxalate. And so this the oxalate starts sticking to places where you’re healing. You’ve been injured where you’ve used it all day. And also the vitamin C, which is another dietary factor, you don’t make Vitamin C is not in your body normally, but you eat things to take supplements. Vitamin C gets into cells, and in cells, vitamin C degenerates into oxalate in that adds, you get oxygen coming along directly into the eyeballs or whatever, and the retina and so on. But also the vitamin C that’s being absorbed by the tissues, degenerates into oxalates. Can we can we stop on that for a second? Well, there’s two questions I have. One is are there specific eye conditions that have been linked in the literature to oxalates. And then let’s talk more about vitamin C and all that too. I dug up a lot of the eye studies on it because I had a weird response to the diet as I started getting ice dyes for the first time in my life, and more grit in the eyes. And we see this among those of us who adopted the diet after having a history of high oxalate and or some leaky gut or whatever. And we would get, like, more stuff coming out of our eyes and then get these ice dyes and like, like a detox reaction, like the oxalates are coming out of the eyes. Exactly. Okay. Exactly. Some people weren’t whole crystals coming out of those eye tissues. So the literature there’s several places it’s very preliminary mentioning how you get the hazing of the cornea, from oxalate exposure from the oxidative stress. So, I’ve had about four clients say they’ve reversed their cataracts

Dr. Andrew Wong 

Wow, it’s gonna say because everyone like everyone that we see that a certain age of like up time for cataract surgery, I was gonna ask you about that.

Sally K. Norton, MPH 

Yeah, retinal detachments, all kinds of directions where your eyes start to generating and get into what eventually could lead to blindness. If you live long enough, it pretty much played a role in that.

Dr. Andrew Wong 

Okay, well, that kind of makes sense. You’re increasing oxidative stress. Ox oxalates are oxidative, it sounds like that’s that’s one way to look at it. Let’s talk about vitamin C, should we take supplements? Should we avoid them? What what’s going on with vitamin C and oxalates?

Sally K. Norton, MPH 

Well, it looks like in the literature, the literature suggests that more than 400 milligrams of vitamin C is useless unless you’re in SubSys. Anyway, but we like to use the standard of taking a half or full gram of vitamin C at least once a day, which is really overdoing our exposure. And at that level, it’s really clear that you’re producing oxalate from vitamin C supplementation. And you know, you need some vitamin C, as far as we can tell, it seems to help the immune cells work better and help lower oxidative stress if you get what enough. But it’s easy to get enough we keep thinking Vitamin C is so great. So we keep raising the RDA from 16, and whatever up to like 90 now. But even you know, my feeling is if you get the RDA vitamin C, and you’re not infected and not sick, that’s plenty of vitamin C, and more than that is risking high oxalate and tissues like your eyes.

Dr. Andrew Wong 

 Got it. So we do use in our clinic and I do have to ask you this just as sub question. If someone has a time limited condition like COVID, or an infection, or even cancer or something like that, you know, we’ll give people either high dose oral, or even intravenous IV vitamin C for a time limited, you know, manner, what do you kind of think about those situations?

Sally K. Norton, MPH 

Yeah, it’s interesting, because there were like 1000s of articles suggesting that, you know, IV Vitamin C is great for killing cancer and all that stuff. And I leave that my friend Clark Wong when he had cancer, I said, Clark, you got to go get vitamin C IV. And I got vitamin C IVs. When I didn’t know what was wrong with me. And my functional medicine doctor friend said, you know, that looks like mercury poisoning. I actually had high aluminum with mild Mercury problems. And I got the vitamin C IV. And it didn’t really helped me much. And I also had some glutathione, and so on. But what what was interesting that happened to me is my veins became harder and harder to stab, they became ropey Rowley, and tough and fibrotic, which is one of the effects of the vitamin C. And one point near the end, where we realized we need to stop doing this. And I didn’t have that many. The needle broke the IV needle, is the same gal name was Mary. So she had her favorite spots on each arm. And she obviously put the needle in just about where she had before, hit a crystal. So embedded in fibrosis, it didn’t move, and it was stronger than the needle and snap the needle off.

Dr. Andrew Wong 

Oh, wow.

Sally K. Norton, MPH 

So I think IVs is that we don’t really know, because we can’t get into the cells of the eyeballs and look at the lining of the vascular system. So we don’t know, the side effects. You know, even if it’s helpful for the cancer, we don’t know those other side effects. And oxalate itself is a pro carcinogen. So it’s, it can be Vitamin C is an oxidative, you know, cell killing thing at that dose. And so there’s not just to cancer, it’s just almost like any chemo, there’s going to be some kind of side effect.

Dr. Andrew Wong 

Everything has a biological effect, you know, that from from for the whole body? I do have a question about are some people more effective than others? You mentioned some, you know, less common genetic things. But are there is there a spectrum of people that are affected by oxalates? are 100% of us just affected? And we should all go on a low oxalate diet and everything?

Sally K. Norton, MPH 

Well, I think we should all have a chance to know how much oxalate we’re eating and try to live within our biological capacity. And the literature suggests that our capacity is maybe 200 milligrams a day as a human race. And there’s variability on that to based on what’s going on in your life stage. If you’re, you know, a small young child, your kidneys can handle this well. But if you have any kind of inflammatory guts going on, you get any degree of leaky gut, you’re going to be a hyper absorber of oxalate and you can’t handle the 200 a day, just because the gut is so porous, basically. Yes. Right. It’s gonna get more in Okay. Yep. And so, you know, bariatric surgery is another one where you’ve built into the system for absorption of nutrients and easy absorption of toxins kind of permanently, so that’s really important that people that are young children, elderly and sick people, anyone with got inflamed inflammation needs to be extra cautious about oxalate and the rest of us just deserve to know when reading high oxalate foods so we can choose to minimize what is essentially a toxin in our lifestyle. I think anybody it’s a good idea to know what when you’re exposed to toxins and how to cut back.

Dr. Andrew Wong 

So let’s dive into one of our favorite topics on this podcast. I’m sure when

Dr. Andrew Wong 

yours to just nutrition. And what are some of the common foods that are high in oxalates? And why are they considered toxic superfoods? Yeah, so the easy ones to avoid are spinach chard and beet greens. Those are the dark leafy greens. Darn it. Darn it. Darn it. Sorry grower most of my life. I was still eating chart a couple times a week when I finally figured out this thing. How many how many milligrams sorry, how many milligrams let’s just to give people a contest Yale right after Yeah, like 200 milligrams, how much suspended? Yeah, so if you’re eating a spinach salad, the average spinach salad is somewhere between four and 500 milligrams of oxalate. It’s about five leaves, spinach gets you to 50 which would be about your meal limits. So you can handle up to five leaves per meal of spinach, but most people are buying it in giant packs and boiling it down or making smoothies or juices with it in a spinach smoothie. If it has a little scoop a little tiny bit of peanut butter, which is another one with oxalates and a little bit of almond milk, which is very good oxalate delivery mechanism. You can be at a whole gram or 1000 milligrams of oxalate with a spinach smoothie, which is five times what you’re built to handle for an entire day, let alone in one meal. And the lethal dose of oxalate where you get an acute effect it’s so severe that it gives you a heart attack and you die from it is somewhere between five spinach smoothies or maybe eight Smid. Smoothies and when he for

Dr. Andrew Wong 

Okay, so don’t eat don’t don’t drink five to 24 consecutive spinach smoothies. That sounds like a good good idea. You were mentioning before interview on that spinach chard beet and then you’re saying sweet potato Potentially

Sally K. Norton, MPH 

yes, sweet potato for sure. That was my favorite way of ruining my health was when I got off my vegan diet it was because I was no longer tolerating wheat and beans. And I needed a starch. And I was living on sweet potatoes is like my daily bread and having it every day. It’s gluten free. So you know, it’s gluten free. It’s got beta carotene, which is debatable whether that’s any good. It’s supposedly my feeling at the time this is years ago, is that it was the lowest allergy food going up my system was had become so reactive clearly, like I couldn’t eat all the stuff. This is craziness, my system needed like this low allergy diet. So I was trusting the sweet potato to be this low allergy safe, benign food that would keep me going. And you know, that’s what’s so wrong with the situation and why my book is so needed is that even people with degrees from Cornell, who have been in the field of holistic health and nutrition and public health, nutrition, my whole career had no idea that this supposedly innocent sweet potato was ruining my health. And if I look back at it, it’s obvious because when I adopted a sweet potato instead of, you know, I liked whole wheat bread, I was a bread addict time. Instead of bread, I made sweet potatoes, I developed these crow’s feet, wrinkles, and start developing knots in the back of my shoulder blades in sort of the rhomboid area that were really bothering me at bedtime, which is a significant symptom, by the way. Because if it’s coming from your diet, there’s at least a four hour lag from when you eat it to when the peak of levels in your bloodstream. That peak of levels affecting your nerves causing muscle knots is about four hours after you eat it. So four hours after dinner is better. But you have cycles that happened at breakfast lunch and dinner if you were me woke up and had sweet potatoes for breakfast. And then you had a little bit of that maybe in your salad or something for lunch. And then dinner was like Swiss chard, it got constant exposure basically constant exposure that with these overlapping ways because the breakfast load, which might have been whole wheat toast and peanut butter for somebody is at its peak when you eat lunch.

Sally K. Norton, MPH 

And so it’s bedtime is when your dietary exposure is at the highest. And then the reversal of this oxalate that you’ve been eating for years building up making you look old and act old and get old things like wrinkles and pain. The same thing happens at night when you’re releasing the tissues that because nighttime is when the body’s doing its maintenance work. I call it new the time when the janitors come out clean things up and feel you is overnight and so you also will get symptoms at night. So this is why the nighttime waking is a significant

Dr. Andrew Wong 

symptoms. Yeah, yeah, so urinary waking up at night you mentioned the rhomboid specifically, is that one area you said that that is

Sally K. Norton, MPH 

really anything in the neck, frozen shoulder neck pain, upper back pain, lower back pain? Yeah, hand and feet issues can be a thing. So there’s, you know, the development the basic departments of symptoms are your connective tissues, your nervous system, your urinary tract. and your immune system because these crystals start collecting in these areas of the body and continue to be a headache for the immune system. So it’s bad enough that you heard the monocytes when you were eating it. But now that it’s bothering your tissues, immune cells have to come protect the tissues, either try to remove them right away or wall them off, they actually encapsulate crystals by forming little granulomas that die off and it wraps the little crystals and dead white cells. Or the other technique that immune cells have as they extrude their DNA, which is a wrapper for the crystal and that insulates it, it’s like the vinyl around your wire of your, you know, your, your cords, your electrical cords have to be insulated. And so the body does that this sort of electromagnetic nasty crystal by wrapping it in this these materials. So that’s work but then when you gotta dig it back out of your thyroid gland, which is another very popular place for oxalates. To accumulate is glands generally your breasts, your gonads, your thyroid gland, and so on. Probably the pancreas. You got to go in there with jackhammers, you basically have to form giant cells, which are these cell binding together trying to eat the crystal that often fails because the crystals difficult and large. And so they start shooting collagen ace to break down those dead proteins and acid at the crystal to break it down. And so that causes collateral damage, just like a little bit of warfare on the crystals. So when you stop eating isolate, if you start breaking down deposits in your body, often your symptoms from that as well. So you can go on the diet and sometimes feel just as bad as ever.

Dr. Andrew Wong 

And then and then you stop the diet because you don’t think it’s working. But it’s actually you’re detoxing and you will get better if you stick to that.

Sally K. Norton, MPH 

Precisely. And that was my mistake. I tried to start in 2009 when I had an attack of vulvar pain, and I learned about through my husband’s Google search, there’s a vulvar pain foundation in North Carolina, not far from where I used to work, claiming that this valvular pain and connective tissue problems could be oxalates and low oxalate diet will fix this. And you know, that didn’t add up to me and I tried it I stopped my grow my own organic sweet potatoes and chard and everything. So I brought it for a while. And I like yeah, okay, but I was just thought it was the vulgar pain, I had no idea it was sleep and arthritis, none of that it took more now that I knew to think about oxalates and pay attention when I’m eating them. Later on. I was able four years later to suddenly have this light bulb moment going, oh my god, this arthritis, I had so much suffering. This has been my healthy food. This is not anything I would have ever imagined to be true until I lived it.

Dr. Andrew Wong 

And that’s where functional medicine can be helpful in connecting the dots of the biology if we’re our eyes are open, we’re talking my eyes today, in our eyes are open to oxalates. They can affect different systems, which we might not think of in terms of, you know, eating a plant. We all think that plants are healthy, right? And even a lot of us are vegetarian or vegan. So I guess I have a couple questions about that. If you go on a low oxalate diet, let’s talk about some foods that are low in oxalates that are plant based because we have a lot of listeners potentially that are vegan or vegetarian. So is it possible to eat plant based or plant forward without eating a high oxalate diet? And then if you go on that low oxalate diet, how long does it take and your experience with clients and patients in addition to your own experience, to get better and to detox as oxalates right, so

Sally K. Norton, MPH 

absolutely even the vegan can stay vegan and get relief from their gout and their pain aches and pains. You can switch from black beans and white beans to black eyed peas, chickpeas and green beans green peas rather you as long as you properly prepare them and make sure the lectins are disarmed with three days of soaking and high heat cooking to disarm lectins which is going to keep you having leaky gut problems and keep you going. It’s going to limit how much of these plant toxins you can handle if you’re not properly preparing them. Same goes with the grains they need to be soaked and properly prepared to lower phytates and so on. So you can definitely switch from it’s pretty easy to to me not having needs swiss chard is not a difficult thing. Just to get romaine lettuce, leaf lettuce, almost any other green even most of the kales are fine and

Dr. Andrew Wong 

I can give it up you know, I do like the way it looks especially ones like rainbow chard. It’s pretty nice.

Sally K. Norton, MPH 

It’s rainbow chard is beautiful. And he’s you know,

Dr. Andrew Wong 

yeah, yeah, yeah. Or maybe maybe maybe a couple of leaves only but

Sally K. Norton, MPH 

when you know, from what I now know, I

Dr. Andrew Wong 

would just wouldn’t touch it. So if someone’s eating like, Hey, I gotta have some charter. I gotta have like one spinach smoothie. Are there foods that you would take in conjunction with that to detox it or, you know, to mitigate the effect of the oxalate or is it just like avoid it, try to avoid it.

Sally K. Norton, MPH 

Well, it’s very Pretty hard to really mitigate it. The calcium in research studies seems to lower absorption by 20 to 40%, which is, you know, these are really vague barndoors of estimates because every situation every meal is a unique scenario. And each person’s diet is a unique thing. And isn’t it things like the moon phase, or your own hormonal phases can affect all of these functions that affect how much you absorb? Yeah, it’s really interesting. We’re seeing like, Susan Nolan’s name, this time, when you get excessive release from tissues, she calls it oxalate dumping, where the whole body is like, oh, like there’s some big I don’t know, it’s immune signaling or what it is, we’re more and more the tissues are engaged or something are releasing oxalate, and we see a huge surge and those of us are on this diet during right before the solstice.

Dr. Andrew Wong 

Right. But for the solstice, is it related to menstrual cycles at all, as well? Yes,

Sally K. Norton, MPH 

a lot of my clients like they definitely get their clearing symptoms at a certain phase or two phases during the month where they can see it go on and off. And it’s always tied to their menstrual cycle. And we said there was one guy in literature who took his urine 24 hour urine tests every day for 30 days. And when they graphed out the amount of oxalate in the urine, it was a perfect bell curve. So they’re the circadian patterns. So all these like general ideas about how much we absorb or don’t or what is going on with your physiology changes on a daily circadian pattern. You’re doing something different at night when you’re sleeping versus you know what based on what cortisol is going on. And all these other things are constantly in flux. So we try to nail things down to like rules, like how much you absorb how much calcium helps and all that. But it’s in a context, it’s dynamic. So I just mentioned that because you get over hooked on these like, oh, research says this or that, you’re kind of missing the point that we can’t really understand biology at the level you wish you knew.

Dr. Andrew Wong 

I loved I love that point where the illusion is that we’re, we’re human beings and we have we can just check lab work and stuff. But then we’re connected to the earth and the earth has these moon cycles and day night and all this stuff that is probably beyond our comprehension in some way.

Sally K. Norton, MPH 

It is beyond our comprehension. Just the whole physiology of a single cell was beyond our comprehension, let alone the whole wisdom of how a body keeps going day and night and day night and puts up with all the environmental changes that biology is all living things to do. We need to humble ourselves in the face of biology, we think we know stuff. We put out ideas because fancy people with PhDs get good salaries, writing papers, but that doesn’t mean we really know what we’re talking about.

Dr. Andrew Wong 

And we can we can present that we know potentially, we

Sally K. Norton, MPH 

more were willing to listen to our own bodies and our own biology with a certain amount of humility and servitude I I really believe that you do best if you become the servant of your body. And you listen to your real physical needs over your need to fit in and you know, do shots or only the students stupid things humans like to do to fit in socially, is really like trading in your whole vessel of life, your whole your whole being. So in terms of how to you know, get away with some oxy food, you don’t have to be on a zero oxide diet, it’s not recommended. And in the back of my book, you’re seeing like page 288. I have this this one of my Colin in here, dosing estimates of selected high oxalate foods. So there’s several pages of charts here, that will tell you that if you eat here it says, boiled beet greens. If you need 20 milligrams of oxalate in your diet, which will help you not do all that excessive clearing, you get one teaspoon of oil beet greens.

Dr. Andrew Wong 

So,

Sally K. Norton, MPH 

go ahead, you get two and a half teaspoon. So there’s a whole chart trying to sort of quantify it. Calcium is helpful in both in prevention and recovery. So calcium is really critical and you can supplement counts.

Dr. Andrew Wong 

Okay, well, let’s talk about calcium. And then I have a interesting personal question. So what type of calcium do you recommend and and I guess since we’re on the calcium subject, do you do you think that oxalates are related to bone health and osteopenia and osteoporosis and things like that? Don’t question? Yes,

I love that question. Because I did develop bones at a very very good case of osteopenia right on the edge of osteoporosis. From mine delicious, perfect organic swiss chard laced diet. And within just a few years that reversed completely

Dr. Andrew Wong 

nice okay,

Sally K. Norton, MPH 

there’s no question in my mind that oxalate is probably the number one cause of osteopenia and oxalate I know some people just be horrified that I dare say that, but it makes complete sense. oxalate causes a diminished loss of calcium from the tissues, especially the blood, the heart and pacemaker can’t tolerate that you need to have calcium. So that is very clear that It needs to maintain a perfect pH and perfect calcium levels in the blood. So it, it continues to take withdrawals from the bones after every oxalate meal. So you just did that just replacing the calcium loss, you get bone inflammation, that’s what it’s inflammatory cells that turn on that breakdown of the bone tissue. Yeah, that makes it itself there’s nothing affinity, right, it’s causing a CD. So you get the bones. Even if you’re not losing calcium, you’re getting plenty of calcium, but you have to correct the acidity because that’s the chalk, then you have the deposits of oxalates love calcium. So oxalate deposits tend to occur in the bones in the bone marrow. And that creates this inflammatory crystallin problem, and it is inflammation that’s causing bone loss.

Dr. Andrew Wong 

Wow, you just mentioned three powerful mechanisms there. I feel like it’s crystal clear. Now I can understand. So the opposite, like acid is binding to minerals, including calcium depleting the bloodstream, and then to create the pH balance that we need to survive. The bones are going to release the calcium. And then you mentioned the other things, too. So I think that’s a really great point. I think I don’t know if I’m glad you’re reading this, that you wrote this book, so that we can all learn about the certainly not taught in conventional medicine, or in my functional medicine training, either or nutrition, or nutrition. Yeah. It’s getting a little more popular in Integrative Nutrition. But I always thought it was a little bit more of a side topic. But now that we’re talking, it’s like a main topic, it’s probably something we should all know about. But really, that was

Sally K. Norton, MPH 

the shocking conclusion is like, Oh, my God, this is so central to everything that we want for good health, it is so central to all the processes of disease. This, this is in it makes sense. From my own personal story. I have done everything right. I’ve tried every possible accepted thing. I’ve done every diet and none of them like avoiding all the toxins, even though I’ve chemical sensitivity. And I’ve had history of formaldehyde exposure and all these things, avoiding those chemicals and buying expensive furniture that doesn’t have the nasty foam and the nasty, like I’ve done it all I’ve ordered in special paints, I’ve done everything to be correct and being healthy. And the only thing that really moved the needle was quitting the Swiss chard and sweet potatoes.

Dr. Andrew Wong 

So Sally, let’s talk about why, you know, listeners out there what you know, these are foods that you’re most near universally is like, Oh, they’re healthy, right? They they have, they have you know, carotenoids and phytonutrients. And all these things that are potentially antioxidants. So then, but then there’s this hidden, you know, almost like oxygen in there, I guess oxalates How did our How did a human race, you know, evolve or, you know, get to a point where we’re eating all these tons of high oxalate foods, and I kind of want to zoom out a little bit a little bit further, philosophically, to maybe the Paleolithic era. I’m not trying to push a paleo diet on this podcast or anything, but just like how did we evolve to this point where we’re now eating is really high inflammatory diet, maybe unwittingly,

unwittingly, yes, our clever inventions over time have backed us into this toxic place. And I completely agree, the simplest and the most logical way to make sense of this is to take this ancestral perspective. If anyone’s been to a natural history museum, they see the diorama of sort of the caveman era wearing, you know, leopard skins and leather with their clubs sitting on an iceberg, right? Because a lot of human history was during the Ice Age. Living on big iceberg, like it was cold, where it wasn’t little spinach gardens hanging around for us.

Dr. Andrew Wong 

They didn’t need the air conditioning like we do now.

Sally K. Norton, MPH 

Exactly. Now, we’ve spent a lot of time just out there fishing and hunting. And that was our major food for million years easily. That’s what helped us develop big brains. And those big brains are very clever. And we started being able to control you know, we figured out seeds and plants and how to grow stuff and develop agriculture and developed wheat and grains and Egypt emerge with this sort of brain based culture and parsley, Egyptians all had arthritis and all kinds of health problems especially once the pharaohs they, you know, they prayed

Dr. Andrew Wong 

the most grains Yeah, they were like beer.

Sally K. Norton, MPH 

Yeah, in some doc and so on, but they tend to eat too much wheat so that inventing grains and bread was a human invention itself just like the bicycle and the automobile on the airplane. That was an invention, but we invented things like the carrot. The wild carrot is tough and edible, bitter, not for a second when any human being bite on that thing, let alone swallow it. But we through plant breeding way long ago in the Renaissance era, they started seeing carrots and paintings so they’re trying to figure out where did we come up with domesticated, domesticated carrot, it turns out pretty much everything in the produce department at your local grocery store is a human invention. The tomato used to be the size of a massive pea, in midair in green, and the big red juicy tomatoes you see is all plant breeding. Yeah, that’s it. We’re not human food until after the Civil War. Chocolate didn’t become a food for the masses until about, well, fancy people in the 1880s could buy the first chocolate bar. But you know, dark chocolate didn’t become a thing until about 25 years ago. This is all brand new stuff. Having spinach year round is a luxury that comes from electricity and refrigeration and trains and trucks and planes and grocery stores and electrics everything. You could not have had most of these foods year round, let alone I mean, it doesn’t exist. Yeah, potatoes were brought from like Peru and you know, 400 years ago and were gradually adopted is a poor person’s food. If you put enough butter and salt on it, it started to taste good. And then we figured out how to make them taste good by frying them and deep frying them. But this is all brand new, you think you have the right to eat these human inventions, it’s like you have the right to an airplane. Well, nature didn’t hand it to that was completely human invention is so we’ve, we believe in our little novel inventions. And we like them, and we’re comfortable with them. But that doesn’t mean they’re suited to us.

Dr. Andrew Wong 

Especially in that that, you know, we think about you know, is there a mismatch between our genetics and how we’re kind of built, you know, for millions of years versus our environment, the environment includes the foods that we eat, and how we grow them. It sounds like a lot of its domesticated and not not really quote unquote natural anymore.

Sally K. Norton, MPH 

Not natural, not very, no, it’s not.

Dr. Andrew Wong 

Yeah, what if you take the the heirloom seeds and things would they be more more natural and less toxic and things like that?

Sally K. Norton, MPH 

Heirloom is a bit of a marketing term that says these are the ones that humans developed by hand that weren’t incorporated by industrial agriculture. So now we have industrial scale agriculture that does require basically planes flying over to spray it and giant tractors and it’s very automated. You know, Florida has a big tomato growing region uses a tremendous amount of herbicides and chemicals to do that. And they have a very limited number of varieties. So use. So heritage just really means the older varieties that people developed, that aren’t being used in conventional agriculture.

Dr. Andrew Wong 

Yeah, that’s true. I think there’s so much here. So I wanted to kind of sum it up for listeners in terms of what and I really would recommend everyone check out your book toxic superfoods, because it’s probably going to give us the detail that we need to, to make sure you know, we’re not eating a whole spinach salad and wondering why joints hurt afterwards, although I do like spinach, but I know it’s high in oxalates, I just didn’t know how much you know, what would be what’s kind of your general maybe for you personally, and maybe what you recommend for, for a lot of people, your general dietary pattern, you know, that you would sort of recommend to reduce inflammation and avoid high oxalates and stuff like that?

Sally K. Norton, MPH 

Well, everyone has to start with where they are and what they already know about what they can and can’t tolerate, and work on changing things gradually. Because when you dramatically change your diet, there’s going to be shifts in your microbiome and other things that can make it physically harder. And also, since most of us are grownups who have jobs and families and responsibilities, making a gigantic change in how you shop and how you prepare your foods and when and so on is too disruptive to be practical. So it’s a sort of a slow process of adopting some wisdom and learning your options, which is a great way to get off the high oxalate diet, because if you sneak out of this mess, slowly, it’s probably less likely to trigger this big reaction because the gut is reading just like you can taste things on your tongue, your gut can taste what you’re eating, it knows what you’re up to. And if you abruptly change that it’s looking for this opportunity because in the past, as we said, in our ancestral past, there was always a winter season was pretty devoid of oxalate. So we would annually clean out oxalates but now you might have 30 years of oxalate to get rid of or 40 or worse 50. And so you want to not get that too excited. You want to sneak out I call it sneaking out of the baby’s room, like tiptoe backwards, so it’s okay to just learn how to live without spinach for a while. Then learn how to live without almonds and then cut back on your potatoes and cut back on your peanut butter and start gradually finding different things to do. But I really think people, women especially the older they get, but even in Young’s Young Life, women don’t eat enough protein. I think they should prioritize clean for Eating meat and so on if you can do it if you can’t, you know, it’s tougher to eat enough protein if you’re on a vegan diet. But if you’re a vegetarian, have at least two eggs every day for the choline have some cottage cheese or cheese, you know, get that protein, especially if you can get up to 30 grams and a meal that will trigger the building a muscle and bone. And that’s great protection against old age and just general uselessness you want. You don’t want frail bones, you want good strong muscles and proteins important. So I think depending on who you are, you may be under eating protein. And if you just look at some of these worst offenders that might be in your diet from Oxleas standpoint, learn to live without them get enough protein, eventually your your body will help guide you in a better direction.

Dr. Andrew Wong 

So just thank you, thank you, Sally. And just to kind of break it down into the three basic macronutrient categories of proteins, fats, and carbs sounds like proteins. It’s especially in animal proteins, meat, fish, eggs, but also maybe soaked nuts and things like that, and lagoons would wouldn’t be as high in oxalates, the meats wouldn’t really be high in oxalates at all,

Sally K. Norton, MPH 

there’s isolated the animal foods to take, there’s little traces, technically, but it’s not nutritionally worth thinking about nuts and seeds, I have a real problem with anyone who has leaky gut and allergies, if you’ve got a lot of those things going on, they’re very rough on the gut. The nice thing about the meats is that they don’t have these plant anti nutrients, the phytates and the lectins and the oxalates. And they’re, they’re basically just the same material you’re made of. So they’re very easy to digest, and they’re easy for your system to know what to do with it. There’s not the complexities of Oh no, here comes some tannins, which is these phytonutrients that we think are so great, which is a whole nother discussion, we could do a whole nother conversation about tannins, and all the phytonutrients and the whole theories there. I did a chapter on this because the first question everyone asked when they start hearing me say, look, spinach is not a great health food. You’re like but but but but plants are so great. So I did a whole chapter on Baba plants, I got to have them and so the essential pneus of plants is something to question but there if you do pick the right ones and don’t like think you need to keep endlessly increasing the amount we go from five a day to seven a day to 10 a day to endless amounts of like more is not always better.

Dr. Andrew Wong 

Right. And I remember remember my my one of my first conference I went to was food as medicine conference, James Gordon cnbm, you know, conference and I remember the speaker talking about the the maximum level of ORAC you know, is basically there’s a maximum you hit, you can only eat so many blueberries before you hit that maximum of antioxidant response. So I’m curious on your top three, you know, when you do eat plants and vegetables, what are your kind of your top three, go to yourself that you like to eat? Because I don’t think it would be helpful to eat some of course, yeah,

Sally K. Norton, MPH 

I use winter squash, and papaya. I don’t use a lot of vegetables anymore. The interesting thing, remember I said I think you should be servant of your body. My body has taught me that in allergy tests have confirmed us that I’m basically allergic to the whole cabbage family, which cuts out a third of the produce department. And

Dr. Andrew Wong 

so are you saying sensitivity testing or allergy testing? Yeah, well,

Sally K. Norton, MPH 

I mean, it’s some kind of testing they said yes, cauliflower and cabbage. In my but my body had already been telling me that, you know, I can’t eat them anyway. So yeah, yeah, one of respect that like what so some of us the problem with oxalates is it messes up your immune system so much and your gut so much that you can end up like me and have all this food reactivity. So that’s another sign that you may have an oxide problem. So you have all this sensitivities going on and reactivity, light sensitivity, noise sensitivity, food sensitivity, chemical sensitivity. All of that is the picture of someone poisoned with oxalates. So in my case, my foodless is really limited lemons are really helpful. Citric acid citrate is the preferred form of calcium but any calcium is good. The citric acid helps to break down oxalates it helps to protect your kidneys from kidney stones and so on. And literally lemon in the half morning and night. That gives you about half a cup of lemon juice you need to protect yourself from kidney stones and help your body release oxalate Calcium helps you bind and release oxalate. So lemons are great. Various fruits are good the cubit family which is the watermelon and the other melons, the cucumber and the winter squashes, those are all low oxalate foods and perfectly great if you’re not reacting to them. And you know, it varies the food varies. We don’t have the greatest testing of all you know, on everything to really have a sense for how variable it is like tomatoes vary greatly from one to the next. And yet tomato paste isn’t that high in oxalates so you can make your own homemade ketchup and your powder sauce and your I mean cocktail sauce and these kinds of things and not worry about it too much. not really about developing a lot of fear, just knowledge so that you can get a sense for what to do but honestly believe that most people who are sick should be often nuts and beans, it’s too aggressive on the gut. And you’re better off finding easier things to digest. And sometimes it’s a matter of what that person is tolerating today. So I don’t really believe in like blanket recommendations other than don’t eat this poisonous stuff and limits things that you think you might be sensitive to and just learn from that nothing become like Orthorexic or obsessed with your food. Right? Just because whatever your situation is, your body will, it’s easier actually to get feedback from your body when you quit eating the ox fellated It’s amazing. It’s amazing, where there’s just confusion, you’re probably you’re suspecting food to some degree, but you can’t cannot figure it out. If you get oxalates out of the picture, you can start hearing what is triggering you and what isn’t.

Dr. Andrew Wong 

That might be even one of the first things to do and then see what your gut is, at that point, see where your body is at that point, once you kind of remove that veil. Well, thank you so much, Sally, for coming on to this really enlightening podcast, love to talk to you more. We’re continuing this podcast on next year, we can maybe be great to talk more about tannins or different things like that, but um, love to have you back again, if you if you can. But thank you so much. We do want to ask you a personal question. If you don’t mind, we have this mission here to make integrative health care more accessible. And this could mean things like self empowerment, where people can kind of go out and do things for themselves become CEO of their own health. So we’d love to hear from you personally, what is one thing under $20 That you feel has transformed your health? I guess it could be oxalates avoiding them. But what is kind of one thing you found personally, like that’s helped you.

Sally K. Norton, MPH 

I think the under $20 is such an interesting idea. Because truly, what makes us healthy is pretty cheap. And it doesn’t involve hundreds of dollars on fancy things. So indeed, the low oxalate diet is about the cheapest under $20 hack you can do to be healthy. I like to do a few things that have cost $20 I love my hot yoga class that I do. My gym membership for my sauna is $20 a month. Luckily, we have a team that’s really, really nice. And those are really great. For me, I think just like going outside gardening, being barefoot now and then getting some sunshine, being with friends, having a good time laughing. Those are all part of being a real human being and go a long way to really balance your brain chemistry, seeing our going to the museum when it’s free. Our museum here is free all the time. These are things that really help with endorphins and help you with the balanced brain that allows your system to be in a better place to heal.

Dr. Andrew Wong 

Yeah, yeah, healing doesn’t have to be super expensive. And I love the fact that a lot of those things you mentioned quite a few things. So thank you so much for you know, giving people multiple options there. And thank you so much again, how can listeners learn more about you, Sally and read your book toxic superfoods?

Sally K. Norton, MPH 

Yes. So I have a website that Sally Kane norton.com. So just remember the case so you can get the right Sally and on there. There’s lots of free stuff to read. You can sign up for group class. If you want to get a little lesson and meet some other people. You can go into the shop and get some free downloads, you can download a pay for PDF cookbook that has about 180 recipes, lots of cabbage family recipes, lots of vegetable recipes there in toxic super foods is available in print, also an ebook and an audio book and you can get it anywhere books are sold, you can call your local bookstore called Barnes and Noble go to Amazon and wherever. Because it’s a Random House book and it’s available pretty much anywhere.

Dr. Andrew Wong 

Great. Thank you so much, Sally for coming on today for this enlightening conversation and we’ll talk to you soon.

Sally K. Norton, MPH 

What an honor to connect with you. Thank you for this opportunity.

Dr. Andrew Wong 

Thank you so much for joining us today for this episode of capital Integrative Health podcast. A quick reminder that the information we share on this podcast is meant for educational and informational purposes only. It’s not a substitute for professional medical advice, diagnosis or treatment. We highly recommend that you speak to a qualified health care provider before making any medical or healthcare decisions. If you enjoy this episode, please take a few moments to subscribe and leave us a review. Your reviews help us reach more people and continue to offer innovative insights and information to better optimize your health and wellness.