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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

Food interactions with oxalates:

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Cellini, Barbara, et al. “The Chaperone Role of the Pyridoxal 5’-Phosphate and Its Implications for Rare Diseases Involving B6-Dependent Enzymes.” Clinical Biochemistry, vol. 47, no. 3, Feb. 2014, pp. 158–65. PubMed,

Chen, Lan X., and H. Ralph Schumacher. “192 – Other Crystal-Related Arthropathies.” Rheumatology (Sixth Edition), edited by Marc C. Hochberg et al., Mosby, 2015, pp. 1604–08. ScienceDirect,

Coe, Fredric L., et al. “Kidney Stone Disease.” Journal of Clinical Investigation, vol. 115, no. 10, Oct. 2005, pp. 2598–608. PubMed Central,

Fargue, Sonia, et al. “Four of the Most Common Mutations in Primary Hyperoxaluria Type 1 Unmask the Cryptic Mitochondrial Targeting Sequence of Alanine:Glyoxylate Aminotransferase Encoded by the Polymorphic Minor Allele.” The Journal of Biological Chemistry, vol. 288, no. 4, Jan. 2013, pp. 2475–84. PubMed,

Garrelfs, Sander F., et al. “Patients with Primary Hyperoxaluria Type 2 Have Significant Morbidity and Require Careful Follow-Up.” Kidney International, vol. 96, no. 6, Dec. 2019, pp. 1389–99. ScienceDirect,

Grieff, Marvin, and David A. Bushinsky. “Chapter 42 – Nutritional Prevention and Treatment of Kidney Stones.” Nutritional Management of Renal Disease (Third Edition), edited by Joel D. Kopple et al., Academic Press, 2013, pp. 699–709. ScienceDirect,

Gudbjartsson, Daniel F., et al. “Association of Variants at UMOD with Chronic Kidney Disease and Kidney Stones-Role of Age and Comorbid Diseases.” PLoS Genetics, vol. 6, no. 7, July 2010, p. e1001039. PubMed,

“Home.” Journal of Osteopathic Medicine, Accessed 26 Aug. 2022.

How To Eat A Low Oxalate Diet | Kidney Stone Evaluation And Treatment Program. Accessed 26 Aug. 2022.

Hoyer-Kuhn, Heike, et al. “Vitamin B6 in Primary Hyperoxaluria I: First Prospective Trial after 40 Years of Practice.” Clinical Journal of the American Society of Nephrology: CJASN, vol. 9, no. 3, Mar. 2014, pp. 468–77. PubMed,

Kaufman, David W., et al. “Oxalobacter Formigenes May Reduce the Risk of Calcium Oxalate Kidney Stones.” Journal of the American Society of Nephrology : JASN, vol. 19, no. 6, June 2008, pp. 1197–203. PubMed Central,

Köttgen, Anna, et al. “Uromodulin Levels Associate with a Common UMOD Variant and Risk for Incident CKD.” Journal of the American Society of Nephrology : JASN, vol. 21, no. 2, Feb. 2010, pp. 337–44. PubMed Central,

Kumar, Vinod, et al. “Uromodulin Rs4293393 T>C Variation Is Associated with Kidney Disease in Patients with Type 2 Diabetes.” The Indian Journal of Medical Research, vol. 146, no. Suppl 2, Nov. 2017, pp. S15–21. PubMed Central,

Liebman, Michael, and Ismail A. Al-Wahsh. “Probiotics and Other Key Determinants of Dietary Oxalate Absorption1.” Advances in Nutrition, vol. 2, no. 3, Apr. 2011, pp. 254–60. PubMed Central,

Lorenz, Elizabeth C., et al. “Update on Oxalate Crystal Disease.” Current Rheumatology Reports, vol. 15, no. 7, July 2013, p. 340. PubMed,

Mitchell, Tanecia, et al. “Dietary Oxalate and Kidney Stone Formation.” American Journal of Physiology – Renal Physiology, vol. 316, no. 3, Mar. 2019, pp. F409–13. PubMed Central,

NM_012203.1(GRHPR):C.404+3_404+6delAAGT AND Primary Hyperoxaluria, Type II – ClinVar – NCBI. Accessed 26 Aug. 2022.

Piedra, María, et al. “Rs219780 SNP of Claudin 14 Gene Is Not Related to Clinical Expression in Primary Hyperparathyroidism.” Clinical Laboratory, vol. 61, no. 9, 2015, pp. 1197–203. PubMed,

“Primary Hyperoxaluria.” Wikipedia, 3 Aug. 2022. Wikipedia,

Santana, A., et al. “Primary Hyperoxaluria Type 1 in the Canary Islands: A Conformational Disease Due to I244T Mutation in the P11L-Containing Alanine:Glyoxylate Aminotransferase.” Proceedings of the National Academy of Sciences of the United States of America, vol. 100, no. 12, June 2003, pp. 7277–82. PubMed Central,

Takayama, T., et al. “Ethnic Differences in GRHPR Mutations in Patients with Primary Hyperoxaluria Type 2: Ethnic Differences in GRHPR Mutations.” Clinical Genetics, vol. 86, no. 4, Oct. 2014, pp. 342–48. (Crossref),

Thorleifsson, Gudmar, et al. “Sequence Variants in the CLDN14 Gene Associate with Kidney Stones and Bone Mineral Density.” Nature Genetics, vol. 41, no. 8, Aug. 2009, pp. 926–30. PubMed,

Vezzoli, Giuseppe, Annalisa Terranegra, et al. “Calcium Kidney Stones Are Associated with a Haplotype of the Calcium-Sensing Receptor Gene Regulatory Region.” Nephrology, Dialysis, Transplantation: Official Publication of the European Dialysis and Transplant Association – European Renal Association, vol. 25, no. 7, July 2010, pp. 2245–52. PubMed,

Vezzoli, Giuseppe, Alfredo Scillitani, et al. “Polymorphisms at the Regulatory Regions of the CASR Gene Influence Stone Risk in Primary Hyperparathyroidism.” European Journal of Endocrinology, vol. 164, no. 3, Mar. 2011, pp. 421–27. PubMed,

Zimmermann, Diana J., et al. “Importance of Magnesium in Absorption and Excretion of Oxalate.” Urologia Internationalis, vol. 74, no. 3, 2005, pp. 262–67. PubMed,

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.