The thing about mold illness, like so many of our chronic health concerns, is that it often takes a long time to be detected, and it rarely exists alone.
Symptoms of mold exposure, including fatigue, brain fog, headaches, and digestive issues, can mirror the symptoms of other health conditions.
And not everybody who is exposed to mold experiences symptoms – there are often other underlying issues that either make a person more sensitive to mold, exacerbate the problem, or both.
One connection I wish more practitioners were making?
The link between mold and oxalates.
What are Oxalates?
Oxalates are compounds found in several different kinds of plants, including certain fruits, vegetables, and legumes. Plants use oxalates for protection against viruses and bacteria, and to deter animals and insects.
When we eat oxalate-containing plants, we’re also consuming oxalates. Most of us expel the majority of the oxalates we consume through our urine and stool, so we don’t really need to worry about them.
However, some people may have an impaired ability to expel oxalates, or may experience a buildup or overload of oxalates.
This is a problem because if not eliminated, oxalates bind to minerals including magnesium, calcium, and iron in the body, blocking their absorption. (1, 2) Once they’ve bound to minerals, they also create oxalic acids, which can lead to or contribute to various health concerns.
The Mold and Oxalate Connection
Mold and oxalates are connected in several ways.
First, in addition to those found in plants, certain kinds of molds (including Aspergillus), fungi, and yeasts (including candida) can also produce oxalates. Especially if you’re already dealing with a buildup or a sensitivity, this may be contributing to your overall load.
The biggest issue with mold and oxalates is that they both make it harder for the body to deal with the other.
When oxalates build up in the body, they can impair immune system function and disrupt gut health, making us more susceptible to harm from mycotoxins (toxins created by certain kinds of mold) and to yeast overgrowth.
Then, yeast and mold, as mentioned above, can produce more oxalates, creating a vicious cycle.
Similarly, if you’re dealing with mold illness or mold sensitivity, your body’s natural detoxification system is already in overdrive, making it harder to clear oxalates. Candida also feeds on oxalates, as may certain fungal species.
Both mold toxins and oxalates (particularly for those who are sensitive to them or who have existing imbalances or health conditions) can also trigger inflammation, immune system dysfunction, and gut issues.
All of this is important to understand if you’re dealing with mold sensitivity OR oxalate sensitivity (or if you suspect you’re dealing with one or both of these). Why? Because it helps us untangle the root cause and triggers of your illness.
Signs of Mold Sensitivity vs. Oxalate Sensitivity
The signs of mold sensitivity and oxalate sensitivity (or oxalate buildup) may overlap – and some people may be experiencing both. A functional medicine practitioner can help you understand your symptom patterns and identify the likely triggers of your symptoms (and what to do next).
Here are a few signs and symptoms of both.
Symptoms of oxalate intolerance, sensitivity, or overload may include:
Joint and/or muscle pain
Fatigue
Muscle twitching
Mineral deficiencies even when eating a healthy diet
Digestive issues including nausea or diarrhea; IBS
Frequent headaches
Burning sensation in the eyes, ears, mouth, or throat
Brain fog; difficulty focusing
Brittle bones
Irregular heartbeat
Kidney stones
Fibromyalgia
Symptoms of mold sensitivity or illness may include:
Fatigue
Weakness
Brain fog; difficulty concentrating
Digestive concerns including nausea, abdominal pain, and/or diarrhea
Dizziness or vertigo
Skin issues including rashes or itchiness
Chronic headaches
Respiratory issues including coughing, wheezing, shortness of breath, or sinus congestion
Anxiety
Depression, low mood, or mood swings
How to Find Out If You’re Oxalate Sensitive
With so many different factors that may contribute to symptoms like fatigue, headaches, brain fog, and joint pain, how do you know if excess oxalate levels are behind yours?
I would definitely recommend working with a knowledgeable functional medicine practitioner who can take a closer look at your symptoms, risk factors, and health history.
There are some specialized testing options, like an organic acid test (OAT), that look at markers of high oxalates as well as things like gut microbiome health, nutritional deficiencies, genetic markers that may predispose someone to oxalate issues or mold sensitivity, signs of mold illness, heavy metals, and more.
A low oxalate diet trial can also help you to determine whether oxalates are causing problems for you.
However, unlike many other elimination diets, moving straight into a very low oxalate diet can actually trigger a worsening of symptoms for those who do have a buildup (this is called oxalate dumping and is similar to a die-off reaction). This is another reason why working with a practitioner who can guide you through the process step-by-step may be helpful.
Oxalate Intolerance Risk Factors
There are a few conditions and factors that may make you more likely to experience an oxalate sensitivity, intolerance, or buildup.
Gut health issues. This is one of the biggest risk factors for oxalate intolerance. Inflammation, leaky gut, an imbalanced gut microbiome (dysbiosis), SIBO, and other digestive issues can increase the likelihood of oxalate buildup and impaired nutrient absorption.
Chronic or recent antibiotic use. Antibiotics are known to disrupt the gut microbiome, and can kill off certain kinds of bacteria that we rely on in order to degrade oxalates. In particular, antibiotics may kill a bacterial species called Oxalobacter formigenes, which plays a significant role in reducing the buildup of oxalates in the body.
History of kidney problems or kidney stones. The majority of kidney stones are actually made up of oxalates. Those with a history of kidney stones or related kidney issues should likely avoid a high intake of dietary oxalates. (3)
Low vitamin B6 or thiamine (vitamin B1) levels. Low levels of B6 and/or B1, as well as magnesium, can make it harder for the body to eliminate oxalates.
Genetic factors. Certain gene variations may predispose some people to oxalate sensitivity. Keep in mind that these variations don’t guarantee that a person will have a problem with oxalates – our health outcomes are an interaction between our genes and our environment.
Mast cell activation syndrome (MCAS) or histamine intolerance. Oxalate intolerance often overlaps with histamine intolerance and/or mast cell issues. If you already know you’re dealing with histamine overload, but there seems to be more going on, oxalate buildup may also be worth looking into.
High Oxalate Food List
Here is a list of some of the most common foods that are high in oxalates. As you’ll see, most of these are generally healthy and packed with nutrients – remember, they’re all plant foods!
Raw green leafy vegetables including spinach, kale, broccoli, kale, and swiss chard
Beets
Potatoes
Beans
Radishes
Black pepper
Nuts including almonds, peanuts, and cashews
Soy products
Berries
Chocolate and cocoa powder
Buckwheat
Kiwi
Sweet potatoes
Leeks
Not everyone should avoid high oxalate foods, and for those who are dealing with oxalate overload, ideally it’s only short term and these healthy foods can be reintroduced into your diet once the underlying issue has been resolved.
Again, it’s not generally recommended to eliminate all high oxalate foods at once, as this sudden elimination can be hard on the body and cause a worsening of symptoms.
What to Do Next
If you’re experiencing oxalate sensitivity, it’s not enough to just reduce dietary oxalates. We want to know why your body isn’t clearing these compounds the way it should be. The cause may be related to mold in your environment or even in your diet, and/or there may be underlying gut or immune system issues to address.
Here are a few things you can do to help tackle oxalate buildup and mold sensitivity:
Look into specialized testing. Testing doesn’t tell us everything, but it can help to identify concerns around mold toxicity, oxalate overload, gut imbalances, and other related concerns.
Steam your greens. Green leafy vegetables are among the biggest sources of dietary oxalates, but most of them are killed off when you steam, boil, or otherwise cook your vegetables.
Take a probiotic. Probiotics can help to rebuild a balanced microbiome that is better equipped to fight off oxalates and mycotoxins, absorb nutrients, and keep the immune system working properly.
Supplement with calcium and magnesium. This doesn’t necessarily get to the root of the problem, but while you’re working on healing, taking calcium and magnesium with meals may help to neutralize oxalates from the food you’re eating. (4)
Supplement with B6. Vitamin B6 can help to reduce oxalate overload, and low levels of B6 may lead to increased oxalate sensitivity.
Address environmental mold. Consider any sources of mold you may be exposed to on a regular basis, either at home, in your workplace, or even in your food and drinks. If mold exposure is contributing to your symptoms, the first step is to eliminate it or remove yourself from the source if possible.
Cut out sugar. Mold and yeasts feed on sugar. Sugar can also disrupt your gut microbiome and overall health.
Support liver health with herbs. We rely on the liver to detoxify, including from mycotoxins. Milk thistle and dandelion are two of my favorite herbs to support liver health. My supplement blend Protect incorporates milk thistle, B vitamins, and other key nutrients to support the body’s natural detox pathways.
Sweat. Another way that we eliminate toxins and unwanted substances from the body is through sweating. Exercise and sauna sessions are two great choices! (5)
Dr Will Cole
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