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If you’re navigating the challenging journey of Interstitial Cystitis (IC) or Bladder Pain Syndrome (BPS), you’re well aware of the search for relief from its persistent and often debilitating symptoms. A key player in the discomfort you’re experiencing could be oxalates—a substance that, when at high levels in the body, is linked to increased bladder irritation and pain. Through our specialized lab investigation, we dive deep into identifying the sources of oxalates affecting your health. Whether the culprits lie in your diet, nutritional gaps, oxidative stress, lipid peroxidation processes, or even your genetic makeup, we’re here to pinpoint the root causes and guide you towards a tailored solution.

Understanding the impact of oxalates on your condition is the first step toward better management of IC and BPS.

Let’s uncover the answers together and move closer to the relief you deserve.

The Impact of Oxalates

Oxalates are natural compounds found in many foods and produced by our bodies. While they play various roles in plant metabolism and human physiology, high levels can lead to health challenges. In some individuals, especially those with certain health conditions like Interstitial Cystitis (IC) and Bladder Pain Syndrome (BPS), oxalates can contribute to symptoms by forming crystals in the bladder, leading to discomfort and pain. I discuss the link to oxalate and IC/BPS in this video.

Mitochondrial Toxin

Oxalates can disrupt important energy-producing cycles in your cells, potentially reducing their efficiency by nearly half. This disruption might be why you’re feeling off.  I describe the role they play in the REDOX system and how they destroy the mitochondria in this video.

Oxidative stress

Oxidative stress occurs when there’s an imbalance between free radicals (unstable molecules that can damage cells) and antioxidants (molecules that neutralize free radicals) in your body. This imbalance can lead to cell and tissue damage, contributing to aging and various diseases, including heart disease, cancer, and diabetes. Essentially, oxidative stress reflects the strain on the body from the continuous effort to counteract the harmful effects of free radicals with its antioxidant defenses.

I discuss the role this plays in oxalate synthesis and your antioxidant system in this video.

This image shows how an infection can trigger a cytokine storm, which generates free radicals. The free radicals can create an imbalance of antioxidants and free radicals, causing oxidative stress. This can be a major trigger of endogenous production of oxalate in the body.

Diet’s Role

Some people are consuming too much oxalate in the diet. If you notice an improvement on a low-oxalate diet, your diet may be too rich in oxalates. But if there’s no change, your body might be producing them internally, with one key culprit being glyoxylate, a byproduct of certain oils in your body breaking down.

Endogenous production

In this video, I discuss how your body can be making oxalate. There are many ways this happens. Some may be overabsorbing oxalate, as I discuss here about enteric hyperoxaluria. Some people may be endogenous producers genetics, which I discuss in this blog.

Others may be low in compounds that solubilize oxalate such as hippuric acid, as I discuss in this blog.

But others may be making oxalates from the glyoxylate pathway due to other reasons such as oxidative stress or lipid peroxidation. Image below

Image credit

Seed Oils and Oxalates

Research suggests that the spoilage of seed oils in the body can lead to the production of harmful substances, which are more potent than sugar in generating certain toxic byproducts. These byproducts can eventually lead to higher oxalate levels.  This is called lipid peroxidation.

Fats, particularly unsaturated fats, can go through a process called lipid peroxidation, a chain reaction that damages cell membranes and other structures containing lipids. Here’s how it unfolds

What is lipid peroxidation?

Lipid peroxidation is a chemical process that occurs when free radicals steal electrons from the lipids in cell membranes, causing cell damage. This process is a crucial aspect of oxidative stress in the body. Lipids, particularly polyunsaturated fatty acids, are sensitive to oxidation because of their molecular structure, which contains multiple double bonds between carbon atoms. These double bonds are vulnerable to attack by free radicals, leading to a chain reaction of lipid destruction.

The process begins when a free radical interacts with a lipid molecule, creating a lipid radical. This radical then reacts with oxygen, forming a lipid peroxide radical, which can in turn attack other lipid molecules, propagating a cycle of damage. The end products of lipid peroxidation, such as malondialdehyde (MDA) and 4-hydroxynonenal (4-HNE), are harmful to cells and can modify DNA, proteins, and other molecules, potentially leading to various diseases and conditions, including inflammation, atherosclerosis, and aging.

Given its impact on cellular integrity and function, controlling lipid peroxidation through antioxidants that neutralize free radicals is vital for maintaining health and preventing disease progression.

Initiation

  • The process begins when a free radical—a highly reactive molecule with an unpaired electron—attacks an unsaturated fat, specifically the double bonds in its fatty acid chains. This results in the removal of a hydrogen atom from the fatty acid, creating a lipid radical.

Propagation

  • The lipid radical is highly unstable and reacts with molecular oxygen (O2), leading to the formation of a lipid peroxyl radical. This radical is capable of attacking neighboring lipid molecules, stealing a hydrogen atom and generating another lipid radical.
  • This creates a domino effect, propagating the chain reaction and producing more lipid radicals and peroxides. The process continues, spreading the damage to more lipids and generating a significant number of lipid peroxides.

Termination

  • Eventually, the chain reaction is halted when two radicals react with each other or when antioxidants neutralize the radicals. Antioxidants, such as Vitamin E, donate hydrogen atoms to lipid radicals without becoming reactive radicals themselves, effectively breaking the chain reaction.
  • The termination phase results in the formation of non-radical end products, which can still be harmful. For instance, lipid peroxides can break down into malondialdehyde (MDA) and 4-hydroxynonenal (4-HNE), toxic compounds that can further damage proteins, DNA, and other cellular components.

Factors Influencing Lipid Peroxidation

  • Presence of Metals: Transition metals like iron and copper can catalyze the decomposition of lipid hydroperoxides into more reactive radicals, accelerating lipid peroxidation.
  • Oxygen Concentration: Increased oxygen concentration can enhance the rate of lipid peroxidation since oxygen is directly involved in the propagation phase.
  • Antioxidant Levels: The availability of antioxidants is crucial for terminating the lipid peroxidation chain reaction. Lower antioxidant levels can lead to increased lipid peroxidation.

Lipid peroxidation is a significant mechanism of cellular injury and is involved in various diseases, highlighting the importance of maintaining a balance between free radicals and antioxidants in the body.

Beware of AGE’s!

Advanced Glycation End Products (AGEs) are harmful compounds formed when proteins or fats combine with sugars in the bloodstream, a process known as glycation. AGEs can also form in foods during cooking, especially through methods that involve high temperatures, such as grilling, frying, and roasting. These compounds are implicated in various health issues, including diabetes, cardiovascular disease, and aging, as they can promote inflammation and oxidative stress.

Foods High in AGEs

  • Processed Foods: Many processed and pre-packaged foods are high in AGEs due to their manufacturing processes.
  • Animal-derived Foods: High-fat meats, especially when cooked at high temperatures, can contain significant levels of AGEs.
  • Fried and Grilled Foods: Cooking methods that involve high temperatures and low moisture, such as frying and grilling, substantially increase the AGE content in foods.

I discuss AGE’s in food in this video.

Cooking and AGE Levels

Cooking methods greatly influence the formation of AGEs in foods. High-temperature cooking, dry heat, and longer cooking times can significantly increase AGE formation. In contrast, cooking methods that involve lower temperatures and higher moisture content, such as boiling, steaming, and poaching, result in lower AGE formation. Marinating meats in acidic solutions like vinegar or lemon juice before cooking can also reduce AGE formation.

Glyoxal, CML, and Lipid Peroxidation

Glyoxal is a highly reactive aldehyde formed during the breakdown of sugars, lipid peroxidation, and as a byproduct of metabolism. It’s one of the precursors of AGEs, including carboxymethyllysine (CML), one of the most common and studied forms of AGEs. The formation of glyoxal from lipid peroxidation illustrates a link between oxidative stress and the generation of AGEs. Since lipid peroxidation can increase the production of glyoxal, it indirectly contributes to the accumulation of AGEs in the body, highlighting the interconnectedness of oxidative stress, dietary habits, and chronic disease risk.

Minimizing AGE Intake

  • Opt for Cooking Methods that Reduce AGE Formation: Favor boiling, steaming, and stewing over frying and grilling.
  • Incorporate Foods Low in AGEs: Increase intake of fruits, vegetables, whole grains, and legumes, which are naturally low in AGEs.
  • Limit Processed and High-Fat Animal Products: These are typically high in AGEs, especially if cooked at high temperatures.
  • Use Antioxidants: Consuming foods high in antioxidants can counteract some of the damaging effects of AGEs and oxidative stress.

Understanding the formation and impact of AGEs offers valuable insights into how dietary choices and cooking methods can influence health outcomes. By making informed food selections and adopting cooking practices that minimize AGE production, individuals can potentially reduce their risk of chronic diseases associated with AGE accumulation.

How do you measure lipid peroxidation?

Lipid peroxidation, indicative of oxidative stress and cellular damage, can be measured through various biomarkers that represent the end products or consequences of the lipid peroxidation process. One of the ways to assess this in individuals is through comprehensive tests like the Nutreval test, which evaluates nutritional status and provides insights into various health parameters, including the extent of lipid peroxidation. Here’s how lipid peroxidation is typically measured

Common Biomarkers for Lipid Peroxidation

  • Malondialdehyde (MDA): MDA is a well-known byproduct of lipid peroxidation. Measuring levels of MDA in the blood can serve as a direct indicator of lipid peroxidation and oxidative stress.
  • 4-Hydroxynonenal (4-HNE): Another product of lipid peroxidation, 4-HNE, is highly reactive and can form adducts with proteins, DNA, and other molecules, further contributing to cellular damage.
  • Isoprostanes: Formed from the peroxidation of arachidonic acid, a type of polyunsaturated fatty acid, isoprostanes are considered one of the most reliable markers of oxidative stress and lipid peroxidation.
  • Thiobarbituric Acid Reactive Substances (TBARS): This assay measures substances in the blood that react with thiobarbituric acid, including MDA, providing an indirect measure of lipid peroxidation.

Nutreval Test and Lipid Peroxidation

The Nutreval test, a comprehensive nutritional evaluation, includes measures of oxidative stress by assessing biomarkers like those mentioned above. By doing so, it offers a glimpse into the body’s antioxidant capacity and the potential damage caused by free radicals, including those resulting from lipid peroxidation. The test can be particularly useful for identifying individuals at risk of conditions associated with oxidative stress and guiding interventions to mitigate these risks through dietary changes, supplementation, or lifestyle modifications.

Measuring lipid peroxidation provides valuable information on the body’s oxidative state and can help tailor specific antioxidant strategies to combat the damaging effects of free radicals, thereby supporting overall health and well-being.

Nutritional Strategies

Reducing lipid peroxidation is crucial for maintaining cellular integrity and overall health, as it plays a significant role in preventing oxidative stress-related damage. Various strategies, including dietary and lifestyle modifications, can help minimize lipid peroxidation. Here are some effective methods:

  • Choosing Healthier Fats: Opting for tropical oils, olive oil, and fats from grass-fed animals over common seed oils can help manage oxalate levels. It’s also beneficial to boost your antioxidant intake, particularly if you’ve been consuming seed oils for a long time.
  • Supporting Your Antioxidant System: Protecting your body requires a strong antioxidant defense. If you’ve consumed seed oils historically, your body might need extra support for years. Adding foods rich in alpha-tocopherol, a form of Vitamin E, can be beneficial.

Increase Antioxidant Intake

  • Vitamin E: Vitamin E is a powerful lipid-soluble antioxidant that plays a critical role in protecting cell membranes from oxidative damage by neutralizing lipid radicals. Incorporating vitamin E-rich foods like nuts, seeds, spinach, and broccoli, or considering supplements, can help bolster your body’s defense against lipid peroxidation.
  • Tocotrienols: Part of the vitamin E family, tocotrienols are compounds with potent antioxidant properties, offering superior protection against lipid peroxidation compared to other forms of vitamin E. They’re found in wheat germ, barley, oats, and certain oils like palm and rice bran oil. I discuss Vitamin E and tocotrienols here in this blog.
  • Antioxidants: A diet rich in antioxidants can counteract the effects of oxidative stress. Foods high in vitamins C and A, selenium, and other antioxidants can help prevent lipid peroxidation. Fruits, vegetables, whole grains, and green tea are excellent sources of these nutrients.

Healthy Fats

  • Omega-3 Fatty Acids: Omega-3 fatty acids, found in fish oil, flaxseeds, and walnuts, can help reduce inflammation and oxidative stress, thereby decreasing the risk of lipid peroxidation.
  • Reduce Polyunsaturated Fat Intake: Lowering the intake of polyunsaturated fats, which are more prone to peroxidation, from sources like certain vegetable oils, and replacing them with monounsaturated fats, such as olive oil, can also help.

Lifestyle Changes

  • Minimize Exposure to Environmental Toxins: Exposure to pollutants, cigarette smoke, and other toxins can increase oxidative stress and lipid peroxidation. Reducing exposure to these factors can help minimize risks.
  • Exercise: Regular physical activity enhances the body’s antioxidant defenses. However, it’s important to balance exercise intensity, as excessive physical stress can increase oxidative stress.

Nutritional Supplements

  • Curcumin: The active ingredient in turmeric, curcumin, has strong antioxidant properties that can reduce lipid peroxidation.
  • Selenium: This mineral enhances the activity of glutathione peroxidase, an enzyme that plays a key role in protecting against oxidative damage.
  • Membrane lipid replacement: Membrane Lipid Replacement (MLR) uses natural membrane lipid supplements to safely replace damaged, oxidized lipids in membranes in order to restore membrane function, decrease symptoms and improve health. Oral MLR supplements contain mixtures of cell membrane glycerolphospholipids, fatty acids, and other lipids, and can be used to replace and remove damaged cellular and intracellular membrane lipids.

Addressing lipid peroxidation involves a holistic approach that includes diet, lifestyle adjustments, and possibly supplementation. By focusing on antioxidant-rich foods, healthy dietary fats, reducing exposure to environmental stressors, and maintaining an active lifestyle, you can effectively reduce lipid peroxidation and promote overall health. Remember, it’s always a good idea to consult with a healthcare professional before starting any new supplement regimen

Comprehensive Nutritional Approach

  • Nutrient Support: Nutrients like biotin, B12, folate, and vitamin B6 are crucial in managing oxalate levels and supporting your body’s detoxification processes.
  • Personalized Health Strategies: For a tailored approach, comprehensive nutritional screening can identify specific deficiencies and energetic bottlenecks in your metabolism. Whole genome sequencing might also offer insights into genetic factors affecting oxalate metabolism.

In essence, managing oxalate levels involves a combination of dietary adjustments, boosting antioxidant intake, and possibly supplementing specific nutrients to support your body’s natural defenses. Understanding the sources and impacts of oxalates is the first step toward feeling better and ensuring your body functions optimally.

The good news is, our Root Cause investigation can help you get answers. Through our comprehensive lab testing, we can identify where your oxalates are coming from so you can develop strategies to reverse your condition and help you manage your health long term.