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Oxalates, Kidney Stones, Joint Pain: Green Smoothies and Your Genes

Green smoothies have been a health fad for quite a while now, but these health drinks can be a double-edged sword for some people due to their high oxalate content.

Oxalates, Kidney Stones, Joint Pain

Not all people benefit from large amounts of spinach due to its high oxalate content. Oxalates are chemical compounds found in foods. They can bind with calcium and be excreted through your intestines, or they can enter the bloodstream and eventually be excreted through the kidneys. It is where the problems can arise with oxalates causing kidney stones or other joint problems for some people.

As it turns out, genetics – along with the gut microbiome – play a role in your body’s ability to handle oxalates. Approximately 80% of kidney stones are composed of oxalates bound to calcium. A study from 2005 states that “5% of American women and 12% of men will develop a kidney stone at some time in their life, and prevalence has been rising in both sexes.”[ref]

Oxalates are found in fruits and vegetables – some fruits and vegetables contain high oxalate levels, and others just a tiny amount. When we eat plants high in oxalates, first, our gut microbiome takes care of breaking down part of the oxalates, and then our intestines will absorb some of the oxalates we have eaten.

Our body also creates different forms of oxalates when metabolizing various substances. The AGXT gene creates the enzyme responsible for breaking down glyoxylate into glycine.

When any of these pieces go awry — gut microbiome issues, too much absorption in the intestines, genetic variants — you can end up with kidney stones.[ref]

In addition to forming kidney stones, oxalate crystals can sometimes be deposited in joints, skin, and retina.[ref][ref] This can cause joint pain and inflammation.

Foods high in oxalates include:

  • spinach
  • Swiss chard
  • certain varieties of kale
  • arugula
  • blackberries
  • blueberries
  • raspberries
  • rhubarb
  • buckwheat

Here is a list: Foods that contain oxalates


Oxalates Genotype Report

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Low Oxalate Diet:

If you carry one of the pathogenic hyperoxaluria genetic variants, you should talk with your doctor and consider adopting a low oxalate diet. At the least, be aware of high oxalate foods and how much you consume.

Here is a simplified overview (adapted from the American Journal of Renal Physiology):[ref]

Avoid Limit Ingest
Spinach Potato (<100 g) Calcium with each meal (300–400 mg)
Chard Chocolate
Rhubarb Nuts
Star fruit Beets
Bran

Food interactions with oxalates:

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Originally published Oct. 2015. Updated 3/2019.


About the Author:
Debbie Moon is the founder of Genetic Lifehacks. Fascinated by the connections between genes, diet, and health, her goal is to help you understand how to apply genetics to your diet and lifestyle decisions. Debbie has a BS in engineering from Colorado School of Mines and an MSc in biological sciences from Clemson University. Debbie combines an engineering mindset with a biological systems approach to help you understand how genetic differences impact your optimal health.