6

votes

Recommended a Vegan Diet Because of High Oxalate Levels

Answered on August 19, 2014
Created July 28, 2012 at 7:07 AM

My son (1.5yo) was just diagnosed with a very, very rare genetic disorder (Primary Hyperoxaluria Type III). The specialist who actually described this disease hypothesises that the genetic mutation causes the pathway for the proper breakdown of animal protein to be blocked. Instead, it takes another pathway which causes the excess production of oxalates and has therefore, recommended a vegan diet for my son (milk and butter ok). I am a bit stumped on what to feed him.

C00e493393828df34be65ddc25456c7c

(610)

on July 31, 2012
at 02:27 AM

Pass a stone at 12 months - so the stones happen quite fast.

D01e44fabc04e69a92e65e3179d81e06

(72)

on July 31, 2012
at 01:51 AM

@sue, yes - that seems to be the case.

D01e44fabc04e69a92e65e3179d81e06

(72)

on July 31, 2012
at 01:48 AM

he tried to pass a stone at 12mos. ultrasound showed 2 more stones in 1 of his kidneys. next ultrasound is at the end of next month. hopefully, he hasn't produced anymore stones...

C00e493393828df34be65ddc25456c7c

(610)

on July 30, 2012
at 11:49 PM

The outcome is kidney stones, kidney disease so I don't think there is any symptoms - its the end game which they are concerned with. Does he have symptoms Gayle?

C00e493393828df34be65ddc25456c7c

(610)

on July 30, 2012
at 11:47 PM

I don't understand it fully myself. The problem is the 4th step in hydroxyproline pathway which would be an issue with animal protein consumption. I find it interesting.

2a00b9a42e4cb6e489a0e69d20714576

(3043)

on July 30, 2012
at 01:09 PM

What are his symptoms?

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on July 30, 2012
at 11:37 AM

@Sue, what's the source of problematic oxalates then?

E36cb992cf0a5eba8b97a359c15f38b3

(4347)

on July 30, 2012
at 11:17 AM

I'm not a nephrologist, so I don't understand which conditions warrant low carb/protein/fat, but if they're recommending low protein and fat is OK I imagine that maybe rendered animal fats (ghee, lard) that don't have protein might work? If those aren't, and vegetable fats are OK, you could probably do avocado, coconut, and olive oil. I use those liberally with my kids. (Actually, my son preferred only to eat homemade guac and very little else when he started eating food.) Gayle- Would you please let us know what you end up doing and what you find out from the doc or another doc?

C00e493393828df34be65ddc25456c7c

(610)

on July 30, 2012
at 08:42 AM

but if certain pathways involved in animal protein conversion doesn't work you have to avoid it. So paleo is not healthy for your son.

C00e493393828df34be65ddc25456c7c

(610)

on July 30, 2012
at 08:39 AM

Don't be scared just educate yourself on the best vegan protein sources to give him. People can be health on vegan/vegetarian if done correctly.

C00e493393828df34be65ddc25456c7c

(610)

on July 30, 2012
at 08:38 AM

he doesn't have issue with oxalates from plant food.

A2c38be4c54c91a15071f82f14cac0b3

(12682)

on July 30, 2012
at 07:16 AM

Also, I'm no expert but I agree that dietary oxalates are likely of lesser concern than HP, but I would still seek to minimize them.

A2c38be4c54c91a15071f82f14cac0b3

(12682)

on July 30, 2012
at 07:15 AM

You're welcome, hope I could help since I'm sure this is an issue of significant importance to you.

D01e44fabc04e69a92e65e3179d81e06

(72)

on July 30, 2012
at 07:02 AM

he's healthy at the moment, but as of sunday, 28 july, i stopped giving him all animal products (except milk and butter). so scared. time will tell. genetic mutation seems to only affect one biochemical pathway and nothing else. although, not much is known about it. my son is the guinea pig.

D01e44fabc04e69a92e65e3179d81e06

(72)

on July 30, 2012
at 06:58 AM

Diagnosis is correct as all of our DNA has been sequenced and the mutated gene found.

Medium avatar

(3213)

on July 30, 2012
at 06:58 AM

And, how is his health right now?

Medium avatar

(3213)

on July 30, 2012
at 06:56 AM

Ok, does he have trouble digesting any other type of protein?

D01e44fabc04e69a92e65e3179d81e06

(72)

on July 30, 2012
at 06:53 AM

also was informed that oxalates from food will not affect his oxalate levels as much as animal protein.

D01e44fabc04e69a92e65e3179d81e06

(72)

on July 30, 2012
at 06:51 AM

Yes, am in Perth. They have been giving me journal articles from the past year. And, yes, their hypothesis is that something's gone wrong with the pathway of the breakdown of animal protein causing elevated levels of oxalate. My son's diagnosis is correct as they sequenced his DNA as well as my own and my husband's and he definitely has the genetic mutation leading to the disorder.

D01e44fabc04e69a92e65e3179d81e06

(72)

on July 30, 2012
at 06:46 AM

thank you so much for that! i was just told by the nutritionist assigned to my son that we're allowed to occasionally give him egg yolk. i will query the oysters and beef liver. i agree with a vegan diet being a bad idea...

Medium avatar

(3213)

on July 30, 2012
at 06:32 AM

How do you know if he has been diagnosed correctly?

C00e493393828df34be65ddc25456c7c

(610)

on July 30, 2012
at 02:45 AM

Thats interesting. They are saying despite a block in the conversion of hydroxyproline to glyoxylate - the immediate precursor of oxalate - there still seems to be an increase in oxalates. This is a contradiction to them. So if hydroxyproline cannot be converted to glyoxylate then how does oxalates increase if glyoxylate is not formed to then be converted to oxalates. Must be occuring another way.

C00e493393828df34be65ddc25456c7c

(610)

on July 30, 2012
at 02:35 AM

In type 1 and 2 can't do the required conversions of oxalates from plant foods but in type 3 this is okay, just can't do the conversions from animal protein foods?

C00e493393828df34be65ddc25456c7c

(610)

on July 30, 2012
at 02:34 AM

In type 1 and 2 can't do the required conversions of oxalates from plant foods but in type 3 this is okay, just can't do the conversions from protein foods?

C00e493393828df34be65ddc25456c7c

(610)

on July 30, 2012
at 02:30 AM

Ask them for papers etc, anything to understand it more fully and how protein plays into it.

C00e493393828df34be65ddc25456c7c

(610)

on July 30, 2012
at 02:29 AM

Yeh, you have no control unfortunately. Are you in Perth?

D01e44fabc04e69a92e65e3179d81e06

(72)

on July 30, 2012
at 02:24 AM

this is a link to the latest journal article written about the disease: http://www.springerlink.com/content/0345114gv5v10228/

C00e493393828df34be65ddc25456c7c

(610)

on July 30, 2012
at 02:20 AM

Protein may be issue for type III http://www.sciencedirect.com/science/article/pii/S0002929710003800

C00e493393828df34be65ddc25456c7c

(610)

on July 30, 2012
at 02:10 AM

Fat seems to be an issue for type II, not type I. Not sure about type III. Most have I or II.

D01e44fabc04e69a92e65e3179d81e06

(72)

on July 30, 2012
at 02:09 AM

And definitely not kidding...but you're right. Seems like a giant joke having a 2 paleo parents and a vegan child...

D01e44fabc04e69a92e65e3179d81e06

(72)

on July 30, 2012
at 02:07 AM

thank you. it's hard not to be overly concerned about your child's health...especially when he's still practically a baby...

D01e44fabc04e69a92e65e3179d81e06

(72)

on July 30, 2012
at 02:05 AM

yeah, it's just really hard for me to wrap my head around this. vegan just seems like the opposite of paleo...

D01e44fabc04e69a92e65e3179d81e06

(72)

on July 30, 2012
at 02:02 AM

definitely oxalate

D01e44fabc04e69a92e65e3179d81e06

(72)

on July 30, 2012
at 02:01 AM

It was actually a bit of a fluke that he was even diagnosed correctly. Our renal specialist is Dr Francis Willis (Department of Nephrology, Princess Margaret Hospital for Children), the biochemist is Dr James Jonathon Pitt (Laboratory Head, Murdoch Childrens Research Institute), and the person who described this disease is Prof Yaacov Frishberg (Director of Division of Pediatric Nephrology, Shaare Zedek Medical Center).

D01e44fabc04e69a92e65e3179d81e06

(72)

on July 30, 2012
at 01:07 AM

the specialist (who actually described this disease) my doctor is consulting about my son's treatment is: Prof Yaacov Frishberg, MD Director, Division of Pediatric Nephrology Shaare Zedek Medical Center

0bc6cbb653cdc5e82400f6da920f11eb

(19245)

on July 28, 2012
at 10:48 PM

Hello Gayle, I am sorry for the rather unhelpful reactionary responses to your question here, this tends to happen whenever a vegan diet is mentioned. It sounds like quite a rare issue that your son has. I am interested in the problem however I do not have time right now to look for a good answer but would be interested if you could post a comment with the name of your specialist who has come up with this hypothesis and give any more details that you have about the disease.

E36cb992cf0a5eba8b97a359c15f38b3

(4347)

on July 28, 2012
at 10:35 PM

I agree. When I ate a vegan diet the oxalate content of my food was much higher than it is now. The issue might be that he can't eat too much animal protein? If that's the case, I'm guessing he could probably do a low-protein diet that's not vegan. At any rate, I agree with Matt: Get him a second opinion.

4886d3390cb1de913ecc198e72cc072c

on July 28, 2012
at 10:26 PM

Some good low oxalates resources: http://www.lowoxalate.info; Yahoo Group to join: http://health.groups.yahoo.com/group/Trying_Low_Oxalates/

8109fc078d6ff5ff05743d448c2d3849

(90)

on July 28, 2012
at 05:16 PM

Sounds like your doctor is lost in the 60's and early 70's with that kind of nutritional recommendation. There is absolutely no benefit for your son to go on a vegan diet rather than a paleo diet.

0a9ad4e577fe24a6b8aafa1dd7a50c79

(5150)

on July 28, 2012
at 03:12 PM

A vegan diet actually has the potential to increase oxalates, depending on what you eat.

0a9ad4e577fe24a6b8aafa1dd7a50c79

(5150)

on July 28, 2012
at 03:12 PM

If "animal protein" is not being absorbed well, plant protein definitely won't be getting absorbed any better. I see possible protein deficiency in your child's future.

4303a65967884e68bfae59817c227351

(1881)

on July 28, 2012
at 10:15 AM

I read a little about it just now as I've never heard of it. Something something calcium something in kidney. . . I dunno. Veganism never cured anything that I know of. Other than getting people off SAD which anything is an upgrade from. Hopefully someone out there can help though. The best I can do is suggest another physician for a second approval. Especially one who generally promotes healthy eating (paleo, not vegan) and see what they have to say.

Medium avatar

(3213)

on July 28, 2012
at 07:52 AM

Sorry, you're full of shit

Medium avatar

(3213)

on July 28, 2012
at 07:51 AM

Bullshit, that's what they're feeding you

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7 Answers

8
32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on July 28, 2012
at 12:24 PM

Not sure I understand how a vegan diet minimizes oxalates... which is the problem with hyperoxaluria. Oxalates are absent in animal products, and present in many plant foods. I'm guessing it stresses the kidneys so they're just trying to minimize urea production, which seems like treating the symptom more than the underlying disorder.

Get additional doctors' opinion, particularly one who's actually worked with this disorder.

E36cb992cf0a5eba8b97a359c15f38b3

(4347)

on July 28, 2012
at 10:35 PM

I agree. When I ate a vegan diet the oxalate content of my food was much higher than it is now. The issue might be that he can't eat too much animal protein? If that's the case, I'm guessing he could probably do a low-protein diet that's not vegan. At any rate, I agree with Matt: Get him a second opinion.

0a9ad4e577fe24a6b8aafa1dd7a50c79

(5150)

on July 28, 2012
at 03:12 PM

A vegan diet actually has the potential to increase oxalates, depending on what you eat.

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on July 30, 2012
at 11:37 AM

@Sue, what's the source of problematic oxalates then?

C00e493393828df34be65ddc25456c7c

(610)

on July 30, 2012
at 08:38 AM

he doesn't have issue with oxalates from plant food.

C00e493393828df34be65ddc25456c7c

(610)

on July 30, 2012
at 11:47 PM

I don't understand it fully myself. The problem is the 4th step in hydroxyproline pathway which would be an issue with animal protein consumption. I find it interesting.

5
E36cb992cf0a5eba8b97a359c15f38b3

on July 29, 2012
at 02:29 AM

I finally had time to look this up. I'm interested in kidney problems, and apologize if my previous comment was unhelpful to you. Anyhow! Kidney stones sort of run in my family, and I just asked my closest relative which type she deals with (answer: oxalates). So, here's what I found:

Obviously you've learned all this by now, but for others who are looking at this thread, here's some info on the condition: http://www.ohf.org/about_disease.html

This is some information I found about a low-oxalate diet. I'm not sure if it'll help you totally, but it might be a good place to start: http://www.upmc.com/patients-visitors/education/nutrition/Pages/low-oxalate-diet.aspx

As an overview of the above, it looks like the following generally-kid-friendly foods are low-oxalate:

  • apple juice and cider
  • butter* (not sure how you feel about dairy)
  • avocados
  • bananas
  • melons
  • cherries
  • mangoes
  • white rice
  • cucumbers
  • cauliflower
  • meats except for sardines**

**You mentioned that your son has problems breaking down animal proteins, so I only mention that because it's on the low-oxalate-foods list. I'm not a doctor, so please don't take my word for anything. If he can't digest those proteins, by no means should you just give them to him because they're part of an ideal diet for MOST people. (Your son is not most people.)

At any rate, it looks like a good number of fruits (except a lot of berries) might be okay? I'm a little confused by looking at the condition information whether animal fats might be a problem in addition to proteins, or whether certain starches might be good or bad. If it turns out your son can eat some animal products in small amounts you'll probably have to be pretty choosy as to which ones he eats.

Additionally, dark leafy greens probably aren't the best as they're pretty high in oxalates.

I do think, though, as per my earlier comment, that you may wish to get a second opinion if only to make YOU feel better about making decisions for your son. As a parent, I do not envy your position. Hang in there! You're an awesome parent for trying to figure all this out for your child.

D01e44fabc04e69a92e65e3179d81e06

(72)

on July 30, 2012
at 02:07 AM

thank you. it's hard not to be overly concerned about your child's health...especially when he's still practically a baby...

C00e493393828df34be65ddc25456c7c

(610)

on July 30, 2012
at 02:20 AM

Protein may be issue for type III http://www.sciencedirect.com/science/article/pii/S0002929710003800

C00e493393828df34be65ddc25456c7c

(610)

on July 30, 2012
at 02:10 AM

Fat seems to be an issue for type II, not type I. Not sure about type III. Most have I or II.

E36cb992cf0a5eba8b97a359c15f38b3

(4347)

on July 30, 2012
at 11:17 AM

I'm not a nephrologist, so I don't understand which conditions warrant low carb/protein/fat, but if they're recommending low protein and fat is OK I imagine that maybe rendered animal fats (ghee, lard) that don't have protein might work? If those aren't, and vegetable fats are OK, you could probably do avocado, coconut, and olive oil. I use those liberally with my kids. (Actually, my son preferred only to eat homemade guac and very little else when he started eating food.) Gayle- Would you please let us know what you end up doing and what you find out from the doc or another doc?

3
A2c38be4c54c91a15071f82f14cac0b3

(12682)

on July 30, 2012
at 05:45 AM

Primary hyperoxaluria is more than just avoiding oxalates, though that's important too. Yaacov Firshberg, the specialist your doctor is consulting with, believes (and his evidence is convincing) that people with PH3 have an issue with hydroxyproline due to a mutation of the gene involved with the pathway by which hydroxyproline can be converted into oxalate.

Since animal protein is the really the main significant dietary source of hydroxyproline it makes sense that he would advocate a vegan diet. But I still think it's a bad idea.

I don't have an issue with a diet low in animal protein in this case, but eliminating animal products completely comes with risks of deficiencies. My recommendation is to keep animal protein low except for the occasional nutrient dense animal food, for example oysters, pastured egg yolk, and grass fed beef liver. Beyond that, look for food with low oxalate content, there are lots.

And hey, pastured animal fats are low oxalate and hydroxyproline too!

D01e44fabc04e69a92e65e3179d81e06

(72)

on July 30, 2012
at 06:53 AM

also was informed that oxalates from food will not affect his oxalate levels as much as animal protein.

A2c38be4c54c91a15071f82f14cac0b3

(12682)

on July 30, 2012
at 07:15 AM

You're welcome, hope I could help since I'm sure this is an issue of significant importance to you.

D01e44fabc04e69a92e65e3179d81e06

(72)

on July 30, 2012
at 06:46 AM

thank you so much for that! i was just told by the nutritionist assigned to my son that we're allowed to occasionally give him egg yolk. i will query the oysters and beef liver. i agree with a vegan diet being a bad idea...

A2c38be4c54c91a15071f82f14cac0b3

(12682)

on July 30, 2012
at 07:16 AM

Also, I'm no expert but I agree that dietary oxalates are likely of lesser concern than HP, but I would still seek to minimize them.

3
E95216c62a14d21c371fcbf2fed8469b

(1867)

on July 28, 2012
at 11:52 AM

Get a second and third opinion. Do what's best for your family. If you find that all your additional consults advise a vegan diet then do it. It's so different now and you know it's really all first world problems all this diet debate stuff. My mother had a rare disease so be prepared for a lot of ignorance. There's an Internet group for everything. Go find allies :)

D01e44fabc04e69a92e65e3179d81e06

(72)

on July 30, 2012
at 02:05 AM

yeah, it's just really hard for me to wrap my head around this. vegan just seems like the opposite of paleo...

D01e44fabc04e69a92e65e3179d81e06

(72)

on July 31, 2012
at 01:51 AM

@sue, yes - that seems to be the case.

C00e493393828df34be65ddc25456c7c

(610)

on July 30, 2012
at 08:42 AM

but if certain pathways involved in animal protein conversion doesn't work you have to avoid it. So paleo is not healthy for your son.

1
1d0497f8781845ab371b479455bfee8e

(11157)

on July 28, 2012
at 11:14 PM

How bizarre. Vegan & vegetarian diets are often very high in oxalic acid due to the amount of soy, legumes, grains and leafy greens they eat. Are you sure he wasn't talking about uric acid?

D01e44fabc04e69a92e65e3179d81e06

(72)

on July 30, 2012
at 02:02 AM

definitely oxalate

0
9a5e2da94ad63ea3186dfa494e16a8d1

on July 30, 2012
at 04:16 AM

A friend of mine's kid had a lot of digestive issues for his first 5 years, he was at times diagnosed with various food allergies (dairy, protein, wheat, sugar, etc), later with "leaky gut", and some other things mixed in. She went through at least a half dozen doctors as the kid would get better and then worse again with slightly different symptoms, and it was a long and agonizing road.

After many years, she finally struck on a diagnosis of a fungus overgrowth in his gut, which was found by a homeopathic doctor, and was treated by a high concentration of garlic in his foods for about 6 weeks. It was uncomfortable at first (the theory is that the fungus fights back before dying off) but he was eventually completely cured and has been fine ever since.

I say this not to suggest that your kid has the exact same condition, but just that digestive disorders are tricky to diagnose and doctors don't always get it right, and tend to have strong biases. For example doctors with a genetic background tend to find genetic disorders, homeopathic doctors tend to find problems with diet and well-being, most doctors try to get you out of their office with a prescription. I would get a 2nd or 3rd opinion for your kid.

I am not a doctor but am very skeptical of a vegan diet as a diagnosis, since I think that a vegan diet just simply doesn't nourish a human sufficiently, and have seen many people improve their health significantly by switching FROM a vegan diet. Going vegan might get your kid through a rough patch but I don't think it is a viable long term alternative.

0
Medium avatar

(3213)

on July 28, 2012
at 07:27 PM

Either, you've been misinformed or you are toying with us. If not, you should go to a different MD or a Nutritionist.

Who diagnosed him?

Medium avatar

(3213)

on July 30, 2012
at 06:56 AM

Ok, does he have trouble digesting any other type of protein?

D01e44fabc04e69a92e65e3179d81e06

(72)

on July 30, 2012
at 02:01 AM

It was actually a bit of a fluke that he was even diagnosed correctly. Our renal specialist is Dr Francis Willis (Department of Nephrology, Princess Margaret Hospital for Children), the biochemist is Dr James Jonathon Pitt (Laboratory Head, Murdoch Childrens Research Institute), and the person who described this disease is Prof Yaacov Frishberg (Director of Division of Pediatric Nephrology, Shaare Zedek Medical Center).

C00e493393828df34be65ddc25456c7c

(610)

on July 30, 2012
at 02:35 AM

In type 1 and 2 can't do the required conversions of oxalates from plant foods but in type 3 this is okay, just can't do the conversions from animal protein foods?

C00e493393828df34be65ddc25456c7c

(610)

on July 30, 2012
at 08:39 AM

Don't be scared just educate yourself on the best vegan protein sources to give him. People can be health on vegan/vegetarian if done correctly.

Medium avatar

(3213)

on July 30, 2012
at 06:32 AM

How do you know if he has been diagnosed correctly?

C00e493393828df34be65ddc25456c7c

(610)

on July 30, 2012
at 02:30 AM

Ask them for papers etc, anything to understand it more fully and how protein plays into it.

Medium avatar

(3213)

on July 30, 2012
at 06:58 AM

And, how is his health right now?

D01e44fabc04e69a92e65e3179d81e06

(72)

on July 30, 2012
at 02:09 AM

And definitely not kidding...but you're right. Seems like a giant joke having a 2 paleo parents and a vegan child...

C00e493393828df34be65ddc25456c7c

(610)

on July 30, 2012
at 02:34 AM

In type 1 and 2 can't do the required conversions of oxalates from plant foods but in type 3 this is okay, just can't do the conversions from protein foods?

C00e493393828df34be65ddc25456c7c

(610)

on July 30, 2012
at 02:29 AM

Yeh, you have no control unfortunately. Are you in Perth?

D01e44fabc04e69a92e65e3179d81e06

(72)

on July 30, 2012
at 07:02 AM

he's healthy at the moment, but as of sunday, 28 july, i stopped giving him all animal products (except milk and butter). so scared. time will tell. genetic mutation seems to only affect one biochemical pathway and nothing else. although, not much is known about it. my son is the guinea pig.

D01e44fabc04e69a92e65e3179d81e06

(72)

on July 30, 2012
at 06:51 AM

Yes, am in Perth. They have been giving me journal articles from the past year. And, yes, their hypothesis is that something's gone wrong with the pathway of the breakdown of animal protein causing elevated levels of oxalate. My son's diagnosis is correct as they sequenced his DNA as well as my own and my husband's and he definitely has the genetic mutation leading to the disorder.

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