Sally is a nutrition counselor and oxalate specialist helping people reverse pain with diet. She holds a degree in Nutrition from Cornell University, (where T. Colin Campbell was her nutritional biochemistry professor) and a Public Health Master’s degree from the University of North Carolina at Chapel Hill. In 2013, almost 4 years after her long career in public health was ended by health problems, she discovered the concept of oxalate toxicity. Since then she has been getting younger and younger while doing intensive research specifically on oxalates and health, and she is not done!
She leads a low-oxalate diet nutritional support group in Richmond VA and is working on her book about dietary oxalates. Her book will explain oxalate toxicity, how modern medical and dietary practices can increase the prevalence of oxalate-related health problems, and ask us to reconsider our notions of plant foods as the superheroes of nutrition, and show us the way forward.

Transcription

Carole Freeman:              Welcome, welcome, everyone to another episode of Keto Chat. I am your host, Carole Freeman, certified nutritionist and creator of the Fast-Track to Keto Success Program. I am so excited today to be here with Sally Norton or are we supposed to say Sally K. Norton?

Sally K Norton:                  It helps us remember the website.

Carole Freeman:              Yeah, Sally K. Norton. Sally’s a nutrition counselor and oxalates specialist helping people reverse pain with diet, a topic very near and dear to my heart. She holds a degree in nutrition from Cornell University and this is where T. Colin Campbell was her nutritional biochem professor and we could talk more about the irony of that. She’s also has a public health master’s degree from the University of North Carolina at Chapel Hill. Welcome, welcome, Sally.

Sally K Norton:                  Thank you, Carole. How fun.

Carole Freeman:              Yeah. I met Sally at Ancestral Health Symposium in Seattle, 2017 and I was so excited to hear about your talk and remind me the title of it. I know what the topic was but what was the title of your talk?

Sally K Norton:                  Lost Seasonality and Overconsumption of Plants Increasing Risk for Oxalate Toxicity.

Carole Freeman:              Yeah. I was so excited to hear about this because it’s a … I don’t know what you call a side interest or an area of interest for me is in how we’ve kind of been brainwashed to think that like plants are so healthful and the more plant foods we get, the better and you should try to eat tons of them and juice them and eat giant salads. I really already know that there’s a lot of hidden toxins in plants and there’s antinutrients and things like that, so I’m super excited to hear your talk because it’s not a message that’s really getting out there that plants maybe, especially some of them, aren’t the health fountain of youth and health superfoods that we’re being told that they are and so I was really excited to hear your talk. How did you get on this path to getting this message out and this really powerful important message about that maybe plants aren’t all they’re cracked up to be or all they’re reported to be?

Sally K Norton:                  Yeah. Well, my comfort zone has been in academia, writing grants and doing things on the population level, thinking about interventions and how to test them and evaluate them and all that kind of distant safe stuff. I’ve never thought I’d be out there on the street advocating for a rare and unusual topic in nutrition but I spent my whole life really since I was 12 suffering from a whole variety of different pain syndromes and odd health things and they just keep getting worse and yet, I’ve been the health geek since I was four years old.

I was 12 when I decided I want to study nutrition because, of course, I knew since I was a little kid that if you’re going to really have fun in life and have a good time, do what you want, you’re going to feel good and you got to be healthy. You go to reach for what’s healthy. Then, you can have healthy babies and healthy families and do fun stuff and have a good career. Health is the launch pad for life. I’ve always felt that way and yet, I tried to be healthy and I always had pain and problems and fatigue and this and that, unbelievable stuff, thyroid stuff. I ended up having to lose my job because I had to quit because I was feeling so sick and I basically was disabled. My whole life sort of stopped. When I finally did recognize that oxalate toxicity was my problem, I was floored.

Carole Freeman:              How did you even figure that out?

Sally K Norton:                  Oh, my gosh. It started in 2009 when I had an attack of vulva pain that was so bad that I had this outburst. I was like, “Oh, God. Somebody cut them off because I can’t stand this,” kind of thing and my husband in the other room heard this and he got on Google and found the VP Foundation which is the Vulva Pain Foundation, which is really just up the street from where I worked at UNC in Chapel Hill, that is teaching people in pain, especially genital pain, to get off oxalates. For 25 years, they’ve been carefully testing foods which no one else has been doing. I had this illusion from school that the FDA and handbook aid was collecting data on foods and that there was a centralized database in the government charts where you could look up things in food. You’re just going to be able to look up amino acids and all kinds of stuff in food in the tables but the USDA data is old and inaccurate and amass and tiny and wrong.

I was shocked. Okay, wait a minute. I’m a dietitian or … I never did do the RD but I’m a nutritionist, been doing this my whole life, gave myself a nutrition illness. No one in my circles knew anything about it that could help me. I have tons of friends who are chiropractors and acupuncturists and naturopaths and all this stuff because I worked in integrated medicine, functional medicine folks. I’ve seen everybody. No one could help me and I had to figure it out myself. Now, I didn’t really figure it out in 2009. I was still working, quite ill and doing the best I could. I quit growing sweet potatoes and stopped eating Swiss chard and got rid of some things and didn’t know enough to recognize that I was having healing reactions and I was actually needing the diet, so I was like, “Oh, I have so many other problems. I’ve got to do this other stuff.”

I didn’t realize that it was the central thing that was causing all the problems. I thought it was just one more thing. That’s the thing, so I kind of drifted away from it but in the meantime, I think I have SIBO which I didn’t really have. I have a sleep disorder where my brain is waking up 29 times every hour all night long which is why I couldn’t think anymore and writing grants became just too much. I’m trying everything I can to try to fix this toxicity because when your brain can’t wake up, that’s a sign of neurotoxicity or can’t sleep. You got neurological issues with poor sleep or whatever, dropping things. This is neurotoxicity, so the going theory is that most of the neurotoxicity coming with sleep problems is dysbiosis so I’m convinced I have that because I was bloating. I’ve been bloated for years and comes with belching, those kind of stuff.

I’m trying to figure this thing out and I have tried everything over the years. I’ve done every diet you can think of. It’s specific carbs, gaps and five months and … I’ve done all 600 diets and nothing worked, so I was on a last ditch attempt at something and was doing some juicing that had celery in it and eating kiwi. During that time, I was going gangbusters on it at Ancestral Health in 2013 and by the time October, November rolled around, my joints were stiff. My arthritis was back. My back was worse than ever and I’m realizing that this kiwi … Now because of, thanks to the VP foundation, I understood kiwi was high in oxalate, celery’s kind of high and oxalate but I had sort of disregarded that and was trying this as a therapy to heal the gut. It dawned on me … It’s just one of these flashes of insight like, “Oh my goodness, you mean I’ve had arthritic pains for 40 years, 50 years almost, 40 years and all along, it’s because I’ve been eating beet greens and Swiss chard and sweet potatoes?”

I was just like floored that that this connects to my whole life story of struggles and I realized soon that if this is true for me, it’s got to be true for some other women and other people who don’t have the privilege of a degree in nutrition, a career in science, a whole network of people who do healing. If I couldn’t figure it out, how is anyone else going to figure it out? It’s like my responsibility to take a life lesson. This must be why I’m here, is to suffer for decades and then suddenly, have that give me the strength and the sort of determination to spend the rest of my days getting this message out.

Carole Freeman:              Yeah. Well, yeah, thanks for sharing your story. So many of us that are now so passionate about helping others heal, we have that same common thread of something really bad happened to us and then out of that, we learned a very important message to take to others too. It’s terrible that we had to go through that and you had to go through all that pain but I’m so glad that you’re now taking that and sharing that lesson with everyone. Let’s set the stage of like, well, who needs to know about this oxalate toxicity and then we’ll get into like what it actually is but who do you think is important … like maybe type of person, kind of symptoms they’re having.

Sally K Norton:                  Yeah. Well, anyone who’s had some issues that just don’t seem to line up very well with what the doctors are telling them, they’d go to the doctor and they’d come home really unsatisfied like they’re sure the doctor isn’t quite getting it. They’ve tried lots of different things and they’re not responding to these different treatments, so that’s a good sign right there that there’s a toxicity issue going on and specifically with oxalates, you’re going to see neurological issues, digestive issues and pain issues and things related to connective tissue.

The thing is oxalates get involved in tissues that are having trouble so where you’ve got wear and tear, inflammation, damage, where you’ve had surgery, where you’ve had injuries, where you’ve just got vulnerability for whatever reasons, that’s your individual kind of terrain. Where the terrain is in trouble or struggling is where oxalates cause the most problems. It’s the old things that didn’t heal, you’re going to see some chronic thing that just seems to be getting a little worse every year, those are signs that you’re already to the point where the symptoms are there. Without recognizing the symptoms, we usually think of this as sort of a silent disease because you don’t recognize the connection. You can have no symptoms and you can even have a problem, use the diet and still not notice improvement and still have the problem. Just going on symptoms alone is only one piece.

Carole Freeman:              Should we look at like is it going to be people that have eaten a certain way or like people who’ve always loved spinach and tried to eat as much as they can or like eat lots of greens or-

Sally K Norton:                  Yeah. Exposure is the number one risk factor because with any poison, it’s the dose that gets you. Repeated use of high oxalate foods over time in high concentrations that we’re doing now in blenders and smoothies, we’re growing in these high oxalate foods and consuming them more and more. Many of the foods that are high in oxalate are considered superfoods and considered fantastic in a vegetarian diet or a healing diet, even trying to help who are quite, we’ll encourage them to eat some of these foods and the more ill you are, the least ability you have to cope with the toxin like oxalate.

Carole Freeman:              Okay. What are kind of the top five or 10 foods that people are … the most common ones people are eating right now that are the highest in oxalates?

Sally K Norton:                  I would say spinach and almonds are the top two and then you got your Swiss chard, beet greens, your cashews, your chia seeds. Any kind of seed and nut is pretty much a problem but right now, we think the almond and the spinach are just angelic and without suspicion and so there’s no discussion in your own head. Your [inaudible 00:12:30] is flying around. Exposure is a big thing but unfortunately, there’s so little awareness. Oxalate, it’s like a word no one’s ever heard of on the street.

Carole Freeman:              Yeah. We’re at a time especially when the message is out there is that we need to eat a plant-based diet and we need to do more, the better and it’s going to save the planet, it’s going to save our health and so this is definitely not a topic that’s talked about at all. What is oxalate? Let’s talk about that so people can kind of understand what this is and what it’s doing in our body.

Sally K Norton:                  Yeah. Well, plants make all kinds of chemicals. Plants are chemical factories, thousands of chemicals. I’ve been reading toxicology textbooks quite a bit as I’ve been doing my research and it’s pretty interesting to see how toxicologists say, “It will be really good if we could just create the purified diet of what we really need because these foods are so toxic.” The people who really do the science on toxicology recognize that plants are loaded with chemicals, a lot of them for self-defense and some of them, it’s just way their metabolism works and oxalate is one of those chemicals that plants make. It’s pretty easy to make because it’s this tiny compound. It’s just two carbons, very small, super uber small compound.

The plants make it often from vitamin C. They make vitamin C and they turn it into oxalate. Then, it chelates with minerals and becomes a crystal and so it can form in crystals or it can stay in what we call ionic form. It’s an acid that strips off a proton and has a strong negative charge on it and so that’s called the oxalate ion. That tiny little chemical is very reactive but it’s being so small, it can move anywhere, so you eat it when you eat plants, not animal foods. Plants are the only … If you’re going to divide the world into two big categories, plants versus animal, the animal foods don’t have oxalate in them but a huge number of plant foods do.

Carole Freeman:              Okay, yeah. It’s a little crystal and then, so its job in the plant as I understand it then is to kind of help the plant hold on to its own minerals. Is that-

Sally K Norton:                  Yes. That’s one of the things it does, is it’s a pantry for calcium and seeds particularly like to form calcium oxalate, that’s oxalate plus the calcium together that forms crystals. The plant uses that as the pantry for calcium and for seeds, apparently, it’ll spin off the calcium and use that to generate amino acids during germination. You see it in bran and wheat and beans and anything that’s technically a seed in nature which is an awful lot of things we eat in the Neolithic.

Carole Freeman:              Yeah, and so what happens when we eat those?

Sally K Norton:                  Some of the oxalate is ionic and that means it’s just one little molecule and that just floats right into your system pretty easily unless it’s grabbed by a calcium molecule and forms a crystal. The very smallest crystals, the nanocrystals are still so small, they can just float right in but if they grow into bigger crystals, they become harder to absorb so if they’re tied up with calcium. Now, some of the oxalate in the plant already comes as these mega crystals and those are just big, scratchy, sharp rocks and needles and sand that can be quite mechanically abrasive to cells. If there’s not a real thick mucus layer or some form of protection, you’re going to see this abrasive … Well, we don’t actually notice it much but there’s this likelihood of this abrasive damage that is both mechanical and electromagnetic where you don’t have to get it into your bloodstream for it to start irritating your digestive tract and causing issues.

Carole Freeman:              it’s indigestible by us, right? These oxalate crystals, like our body can’t do anything to break them down, right?

Sally K Norton:                  Well, there is. Liposome can break them into smaller bits and move them around if the cell is healthy and if there’s not too much oxalate in the system but we can’t metabolically like convert it to something else, so we don’t we don’t metabolize it. We just kind of move it around and [crosstalk 00:17:14] it around and try to get rid of it primarily through urine. Of course, the big thing that oxalate is famous for is kidney stones. Most your average kidney stone is made of calcium oxalates, so oxalate is a critical substrate. You can’t really build a kidney stone if you don’t have oxalate hanging around.

Carole Freeman:              One of the most obvious things if somebody’s got a history of kidney stones, they should probably follow a low oxalate diet, right?

Sally K Norton:                  Yeah, absolutely. Then for some people, the kidney stone is the late stage evidence that they’ve had an oxalate problem and you can be troubled for decades and finally, you get to the point where you’re getting kidney stones. For others, the kidney stone is the first sign that they have an oxalate problem.

Carole Freeman:              Is it then … If people have a really healthy digestive tract and a nice thick mucus layer in there like we’re supposed to have, are they more tolerant to oxalates? Do they need to have some kind of a weakness and unhealthy constitution to be susceptible to this or is everyone susceptible to it?

Sally K Norton:                  Well, there’s … Yes, yes and yes. Anybody who’s got issues with the gut is going to be more susceptible to harm from the oxalate crystals and more susceptible to higher levels of absorption into the bloodstream. Now, there’s a … Science likes to think we’re supposed to only be taking in 10% or less of the oxalate that we eat and of course, it’s a very rough number because depending on the ratio of soluble or ionic versus big crystals, it’s kind of loose but for no apparent reason, some people absorb as much as 60% of the oxalates they eat. Now, the ones who are prone to that though are people who have had bariatric surgery or taking drugs for weight loss or had any other kind of gut-altering surgeries seemed to set you up for hyper absorption of toxins, especially oxalate and yet, you’re trying to give you malabsorption syndrome. Now, you can’t absorb your nutrients but you’re much better at absorbing toxins. Those who had bariatric surgery, it’s critical that you learn about oxalates because you don’t want to get in trouble.

Carole Freeman:              Okay. There’s another category of people that need this information. Would the same be true of people taking like acid blockers as well?

Sally K Norton:                  Probably, yeah. Some of this were just isn’t … There isn’t enough research on it because the general oxalate toxicity for the whole body, not just the kidneys, hasn’t been adequately studied yet. It got regulated. They relegated … The whole topic of oxalates’ damage to the body got taken over by the kidney research because the kidney stone has long bothered mankind for hundreds and hundreds of years. Really, ever since wheat became a staple which is a high oxalate food, human beings have been having trouble with kidney stones. It’s such an obvious pain and misery, the kidney stone, that that seems to be where we put all our eggs in terms of our research.

Now, things are opening up more. There’s been some premature conclusions in the science that assume that you have to harm the kidneys so extensively that oxalate starts backing up in the body before you collect it and yet, we know that’s not true because most women have it in their breasts. Most people have it in their thyroid. You get it in your skin, your bones, your bone marrow. It’s there backing up in your system even if you have healthy kidneys and even if you’re just sort of eating what looks like a normal diet to our modern eyes.

Carole Freeman:              Yeah. That was one of the things in your talk that really struck me, was when you talked about how radiologists looking at breast scans are trained to ignore the oxalate crystals in the breasts and so it’s a known thing that accumulates in the body but why aren’t people talking about this?

Sally K Norton:                  That’s been my big question, like what? Once you get in there and look and you live it and then you start helping people and it seems like everybody who gives this a real go had something wonderful happen. It’s so weird that it hasn’t been out there already. I’m still annoyed at that but I think part of it is the whole idea of toxicology isn’t really … and these are fundamental foundational principles of health. Toxicity is somehow, there’s no real field. You don’t grow up saying, “Mommy, I’m going to be a food toxicologist.” It isn’t done yet.

Carole Freeman:              In the nutrition and health circles, the only toxicology that’s talked about with plant foods is just from pesticides and herbicides and stuff we put on the plants, not what’s in the plants themselves. When I was in school too, I was taught to minimize oxalates, you need to cook really well or sprout, soak and sprout things and so what happens to how does that change the content of oxalates when we do those things?

Sally K Norton:                  Well, the crystals stay crystal form. They’re harder than your teeth and no amount of heating, even probably a pressure cooker can break down crystals. They’re just there, so the heat doesn’t help. Now, sprouting, the things, the nuts that have been tested like pecans and things like that, there’s been four or five that have been tested by these two nonprofits who are doing good research and getting proper analysis done on these foods, suggests that the sprouting process at least in that short run increases the soluble or absorbable oxalates.

Carole Freeman:              Wow.

Sally K Norton:                  [crosstalk 00:23:26] crystals because see, the seed needed that calcium for germinating, so the whole of soaking is to start that germination process and take that out of dormancy because we want to get rid of those enzyme inhibitors and all that stuff, so we’re moving from a dormant seed over to something that’s green and alive like going to a vegetative state away from the dormant state. That’s changing the oxalates and making them more bioavailable. The soaked nut is probably higher in bioavailable oxalate than in dormant nut.

Carole Freeman:              Wow. Well then, once it sprouts, I mean technically a sprout is that little bit on the end but I can imagine that hasn’t done that much to really change-

Sally K Norton:                  Right. I’m sure that by the time it’s a three-inch sprout, we’re fine but by then, the biotransformation in the plant is such that … depending on the variety of plant. If it’s inherently an oxalate plant like beet greens, Swiss chard and spinach, then it’s never going to be low. There are people who’ve been genetically wanting to create low versions because the oxalate is absorbed for a long time, so quite a bit of botany research trying to figure out what can we do to make spinach lower in oxalate and they can’t. Not yet. I’m not sure we’re going to live long enough to see that.

Carole Freeman:              It might be a very limp plant, right?

Sally K Norton:                  You know, that’s exactly right. They’ve known for 200 years, maybe 400 years that the crystals in plants help them to stand up straight. It gives them kind of a skeleton. Even though they’re really tiny compared to us, it helps provide some sturdiness and toughness. Of course, if you’re a bug coming along, you don’t want to chew on one of these oxalate crystals. It’ll kill you.

Carole Freeman:              Okay. The bugs know about that. Let’s talk about like your early work. How did you start getting this message out to people and what kind of ways did you support people in the beginning of moving away from a higher oxalate diet to a lower one?

Sally K Norton:                  Yeah. Well, I started at home and got us both on board at home with the diet and I later on realized that by feeding my husband things he hadn’t eaten before he married me … I was into beets, Swiss chard, sweet potatoes and this kind of thing, which he never ate before. He used to eat low oxalate foods like cabbage and things. I had given him carpal tunnel because he’s been typing his whole life for decades before I met him. He typed and typed and typed and typed, did word processing to get through graduate school and he’s a great computer jockey. He’s a computer software guy. He’s always on the keyboard but he never had any problems with carpal tunnel until about three years after we got married and he had it for almost eight years and was heading for surgery. I never knew there was a connection. It turns out there is reports in the literature of healing carpal tunnel with low oxalate diet but I hadn’t found them yet.

It didn’t took me months to put together the reversal of his pain and problem to the diet but anyway, so I’m doing my research and studying and I’m realizing, “Okay, we got to come up with a shopping list for people. We’ve got to come up with basics and explain this,” and I started doing talks locally and developed a support group in town and have a … We have a monthly support group nos. I just tried it out on people and started learning from clients and started specializing and seeing individual clients who felt that they could benefit from learning more about oxalates and they have taught me an immense amount.

Carole Freeman:              What are some of the transformations that you’ve seen?

Sally K Norton:                  Oh, my gosh. Some of them are just really simple like pain in the hands now gone. Now, you can play the piano or make your pots at the studio without pain. Sleep problems. Almost everyone says their sleep is much more restorative and they just feel like they can sleep now where before, it was a touch-and-go thing. One surprise was a three-day turnaround after 13 years of fecal incontinence.         Horrible, just devastating problem, 10 times a day, unaware, unable to control this fecal leaking that was destroying clothes and relationships and making being out of the house difficult. Invites to dinner or lunch were like touchy, in only three days.

What that tells me with the three-day turnaround is that she was having acute neurotoxicity in the nerves in the rectum that were both sensory nerves and motor nerves that were controlling the function of the rectal area of her digestive system. Because only three days later, she’s texting me going, “Oh, my God. I haven’t been in the bathroom all day,” yeah, so it’s all over the map. One woman had a broken arm. She had severely broken through her arm and it was still lingering and not healing. These old injuries will suddenly start clearing up and cleaning out and that happened to me as well.

Let’s see. Chemical sensitivity. One woman was so sensitive. She was sleeping in her car because she was a house sitter and she couldn’t stay in these nice, beautiful homes, splendid homes with built-in pools and the whole regalia and she’s sleeping in her car because the house is too toxic for her. Now, she is much more functional with that and a lot of other pain, so digestion … Irritable bladder. You probably run into people who get this urgency that comes and goes and then it just starts to bother them at night and they have to get up at night and then they have to like plan out their rest stops when they’re driving around because the bladder just can’t take it and that’s another one that’s kind of common.

Carole Freeman:              Okay. Wow, must be just really rewarding work to be able to see … I imagine the most people you’re working with are, they’ve been struggling with this for a really long time, whatever it is the issue they’re having.

Sally K Norton:                  Absolutely, including kidney stone patients. I had one kidney stone patient who told me it was after the 14th kidney stone that his doctor finally said, “Well, maybe we ought to do an oxalate workup on you. Really, 80% of kidney stones are made of oxalates. Why do we need to wait to 14 kidney stones?

Carole Freeman:              Yeah, right. Oh, God.

Sally K Norton:                  This gentleman, he was a meat and potatoes guy, so he’d have a kidney stone every so … maybe every five years and when his wife decided they were going to get healthy and started serving spinach on a regular basis, the kidney stones started coming rapid fire and because they had just mentioned the oxalate workup, they saw my flyer to come here about oxalates and it’s turned it around.

Carole Freeman:              No, wow. What’s the process of cleaning this up? Is it just like follow low oxalate diet or is there more work that people need to do?

Sally K Norton:                  Yeah. Well, there’s definitely more work to do to support the process because … and it’s really individual. The woman with the fecal leaking, she seems to … that’s all she needed to do, was quit eating her almonds and her spinach salads and her peanut butter and she’s hunky-dory. She says all her function is fine and that’s good enough for her. She doesn’t feel a need to optimize her health and get keto or anything. She was happy but not everybody is that lucky.

Sometimes, the longer … Well, I don’t know. I mean there’s just not enough research but if this was allowed to go on, this constant exposure to oxalate and the accumulation, you continuously are doing things like irritating the immune system and you get this inflammation process going and you really get into organic diseases that some of it’s not completely reversible if it goes too long. It’s really quite dangerous to just say, “Well, you probably don’t have that so just eat all you want.”

That’s not a good answer because this stuff is fundamentally toxic to everyone and we should all get aware of overdosing on oxalates on a routine basis is just a bad idea from a whole public health standpoint. You want to take a little bit of precaution and not be assuming that you’re Teflon and you’re fine because in the long run, you’re going to end up being human too and that’s real shame to learn too late if you’ve created problems that are hard to rehearse but some of us who’ve been doing it, like I’ve been growing Swiss chard and eating beets and beet greens since I was nine so I’m loaded with oxalate. I’ve seen an awful lot of these reactions that start occurring where the body’s trying to clean out and those reactions can be all kinds of things.

They can be skin related. You can have a rash which could be a sign that the inflammasome or that you’re getting histamine degranulation of mast cells. Oxalate will trigger these histamine reactions, so you feel like you’re having allergies or get these funky rashes or sort of allergy symptoms and it’s really the oxalates irritating the immune system that’s giving you allergy-like symptoms. You’re not allergic to the oxalate, so forget the idea of sensitivity. If anyone uses the term oxalate sensitivity, just run away. They don’t know what they’re talking about. It’s oxalate irritating the immune system giving you allergy-like symptoms but it’s not an allergy to oxalate. Hopefully, that makes sense to people.

These cleaning up reactions, so your body ends up with accumulations of oxalate. I had it in my thyroid gland and had big, lumpy thyroid and that all cleared up. I didn’t notice symptoms from that clearing up. Now, I have unbelievably perfect thyroid health but before, I was having scans and biopsies and all this stuff but I had symptoms and so does several other people that were energy related. When you get fatigued, you feel just a lot of malaise. You might feel almost demoralized or depressed even because this is a neuro symptom and you have to be able to support the body in this toxic detox kind of shedding of oxalate accumulation so that means probably taking some antioxidants. That means taking some time to rest, staying hydrated, using citrate in lemons. They help the body to keep the crystals from growing and can help dissolve crystals, so taking lemons every day is very good support so that if the body tries to move the stuff out, it doesn’t just create a new chunk of oxalate in some other damaged tissue.

Then calcium, calcium citrate, we use that to prevent any additional absorption of oxalate and maybe even be a magnet to help the body dump some oxalate into the colon. It’s confusing to people but the calcium becomes a magnet for oxalate and you want to keep it in the digestive tract. You don’t want it to be absorbed. You’re taking it to keep it in the digestive tract so you don’t take it with vitamin D, just calcium citrate without vitamin D and then it sits there is kind of a tricky sort of, “Come over here, oxalate,” and it helps the body hold onto it and then take it away in the fecal matter. I call it a bouncer. Calcium citrate is the bouncer that helps us kick this stuff out of the body. That’s really helpful.

Citrate’s in general, magnesium citrate, really helpful because a lot of people, they’ll get constipated and just most people need magnesium anyway. Then, potassium citrate because there tends to be electrolyte issues and for anybody who’s dipping down into the low carb eating and keto and kind of in and out of that, apparently, every time you initiate a low carb diet, there’s a possibility of some wasting of potassium through the urine. Have you read that in the in keto literature?

Carole Freeman:              Well, if people aren’t getting enough salt and so that’s one of the ones that a lot of people don’t get that message, is that you have to actually supplement with salt and quite a bit of it and then it will actually … it maintains your potassium balance and your other electrolytes pretty well without-

Sally K Norton:                  Better. Yeah, and so but a lot of people, they’ve gotten used to eating kind of low salt and aren’t accustomed to dumping some on their food and so you get depleted.

Carole Freeman:              Yeah. My clients, I have them actually measure it out and take it like a shot and-

Sally K Norton:                  Yeah. Well, you can’t throw it in your lemon juice. Do a lemon shot in the morning and throw some salt in there but also, the potassium citrate is helpful to help sort of rehydrate your tissues because if you’re really low in potassium, you’re going to dry out. Your blood might not show up in a blood test but your [inaudible 00:37:50] dry up and so all those citrates, really helpful support. Then, some other supplements that are antioxidants are a good help and then, other forms of nutritional supports can be really good.

Carole Freeman:              Would other forms of calcium not be a good idea like would that just encourage more of the depositing the crystals or am I not understanding it right?

Sally K Norton:                  For a long time, science tried to blame the calcium. They call these deposits calcifications, right? We don’t want calcification of the circulatory system or anywhere else but a lot of it is calcium plus some other problem chemical. It’s not really the calcium so much and so the citrate is helpful because it keeps crystals from growing so we like the citrate form and it’s a pretty absorbable form but not that we really want to absorb it but it does disassociate in the gut pretty readily from what I understand, so it is a great form for this particular issue and the one you would want to stick with if you can.

There’s a limit in how many supplement companies are making the simple straight up calcium citrate without the vitamin D. NOW brand has a powder and a 1,000-milligram capsule and I think Allergy Research or somebody does one that’s a mix of magnesium and calcium citrate but there’s room to develop at sort of oxalate specific one I think where you could take it before meals, which is a good time to take it like a half an hour before meals so that if you do have oxalate in that meal, you can reduce the amount that’s absorbed somewhat. We can’t 100% eliminate that absorbable form, so it’s not a perfect like you can’t just take it and then, oh, you can have your spinach smoothie. It doesn’t work like that. You’re still going to have those crystals causing trouble anyway. It’s not like, “Oh, this is how I can still have my spinach by taking the calcium.” It’s not at all as much as someone might wish that’s the case. That’s not.

Carole Freeman:              Okay. Yeah, those are great bits of information and I had actually stumbled on potassium citrate supporting people starting out with the keto diet that have a history of kidney issues or whatever but I didn’t … the research didn’t explain why that was and now, it makes total sense of why that was helpful for people, for some people that I’ve worked with and so that’s really cool to put all that stuff together. I wonder … People are probably wondering at this point like, “Okay, so I can’t eat all these foods that I thought were really healthy for me like what’s left? Should I just not eat anything, any plants at all?” I mean that’s one approach which we’re not going to cover but-

Sally K Norton:                  That’s the [crosstalk 00:40:46].

Carole Freeman:              What are some of the top five or 10 like replacements for those things that people-

Sally K Norton:                  Arugula is low, okay? Arugula is low. Anyone who said it’s not, it’s another person to run away from because they haven’t done their homework because there’s many people out there saying arugula’s high. It’s not. Arugula, cabbage, asparagus, all kinds of cabbage, Lacinato kale is low but the curly kale is not so low.

Carole Freeman:              Really? Okay.

Sally K Norton:                  [crosstalk 00:41:15] low. Yeah. One kind of kale is much better than the others. The ugly dark green one that sort of looks like dinosaur skin, that’s the one that’s low and mustard greens aren’t too bad. Your cresses, watercress and upland cress, mache is a lovely little green if you can get it. It used to be in the stores for a while and then, the spinach has just pushed it off. It seems like-

Carole Freeman:              Is it spelled like … I thought it was pronounced mache but it’s M-A-C-H-E?

Sally K Norton:                  Yeah. Yes, that’s it. Corn salad. It has a couple of nicknames. Corn salad and that’s really low. Lettuces, of course. The romaine lettuce is a beautiful green. It’s got a lot of nutrients in it. It keeps really well in the fridge, not hard to grow. It’s available in most markets and it tastes good and it’s really versatile. You can use it like bread and you use it as a dipper and it’s just … Go for some romaine. [inaudible 00:42:14] and … Let’s see.

Carole Freeman:              How about endive?

Sally K Norton:                  Endive, let’s see. Yes. Endive is okay.

Carole Freeman:              Okay. That’s an underappreciated leafy thing, I think.

Sally K Norton:                  It is. Absolutely, right. Then, for people who do root vegetables, turnips, rutabaga, celeriac, those are all nice replacements for potato if someone’s a potato fan.

Carole Freeman:              Potatoes have oxalate.

Sally K Norton:                  Yeah. White and sweet potato and white potato, both pretty high but cauliflower is really low so anybody in the keto world is using cauliflower where they used to use potatoes.

Carole Freeman:              Yeah, okay.

Sally K Norton:                  Let’s see. That’s pretty much … Cucumber, cilantro, zucchini, those are all nice and low.

Carole Freeman:              Nice, okay.

Sally K Norton:                  There’s definitely vegetables to eat. One of the myths is, “Oh, don’t eat greens. Can’t eat greens. Eliminate the vegetables,” because it’s hard to get good data and people don’t know where to get good data, so they make these sweeping comments especially as the urology office will say, “Well, you can’t eat anything green and leafy anymore.” That’s not true.

Carole Freeman:              Well, yeah. Lots of variability. My son was disappointed because his favorite green was spinach and so I came home and told him about that. He’s like, “Oh, man.” It’s interesting though like why that was his favorite. I’m curious about that but I know his father has a history of kidney stones and so … but he’s never had an issue with that thankfully but I don’t know. I’m always curious about the things that we’re attracted to and we like sometimes are the worst things for our own body.

Sally K Norton:                  Yeah, I know. It’s really true and the thing you’re most allergic to is the thing you’re eating all the time.

Carole Freeman:              Right. Yeah.

Sally K Norton:                  Well, spinach has got its moment in the sun right now. I mean you cannot go in a store and not see a wall that’s ten feet wide and clam shells and different versions of spinach mixed with other high oxalate foods. It’s very quick to cook. It’s very tender. It’s versatile because you can eat it raw and cooked and it throws in the blender and it’s not real stringy, so I think it has these sort of winning qualities that have kept it at this funny place of being popular even though we’ve known for 100 years that because there’s so much oxalate in it, there is zero available calcium. All the calcium in spinach that’s tied up is calcium oxalate.

Carole Freeman:              Well, that’s the thing that most people don’t realize is that our nutrient databases, the trackers that maybe some people are using to look up their food, it shows what … like chemically, if we put that spinach in a lab and break it down chemically 100% percent what’s in there but it has nothing to do with what our body can actually get out of it.

Sally K Norton:                  Exactly. That is-

Carole Freeman:              That’s not reflected on nutrition labels or anything.

Sally K Norton:                  So neglected. It’s really …. It’s wrong. I mean when I was in school, we could just use the tables and add it up and get credit for designing a diet that was adequate according to the RDA regardless of bioavailability, regardless of the fact we’re really just pushing the oxalates in order to get an A on the test. It’s not scientific. There’s a huge need and there are several people who’ve written about that in the science literature, frustrated that we’re not doing more bioavailability nutrition. That just shows you how immature the field is.

Carole Freeman:              Yeah. I can’t wait for that. That is very exciting to me. It will change so many things. I mean it will make nutrition a lot more complicated but it will change so much.

Sally K Norton:                  Well, we’ll just start being able to give advice that actually helps people. It’s quite dangerous to delve out advice based on half-baked, half-truth things. They tell people if you want to not get macular degeneration, eat spinach because of the lutein and this and that. That is not absorbable. It’s not. The beta-carotene and stuff blocks all those other carotenoids. The way to get those nutrients is through egg yolk, not spinach but that message isn’t getting out.

Carole Freeman:              Yeah, and everybody’s been throwing away the egg yolks for far too long.

Sally K Norton:                  Thirty years. Public health down the drain. It’s sad.

Carole Freeman:              Sally, I want to ask you another topic and this is one I’m going to spring on you that I haven’t even … but it’s something I’m curious about too about, okay, so oxalate is what we’ve been talking about, is this antinutrient and toxin. What about the other antinutrients and plants? Do people need to worry about that as well or is this kind of the big elephant in the room that we tackle that first and then maybe the other ones as well, or what do you think about that?

Sally K Norton:                  Yeah. The lectin issue is a real issue and the phytates and so on. Those are all real issues and then there’s thousands of others that we don’t really understand. Even these flavonoids that are supposed to be so great are toxic too and so, I think our whole concept of looking for heroes in the phytonutrient world is really misguided. We need more balance. We need to be recognizing that plants are fundamentally toxic and that is the reason why even though people try so hard with their juicing and they’re really trying … I mean these folks are spending time, energy and money buying special blenders and working hard to eat well and giving it to their children and their babies without knowing about these toxins.

I think it’s much more important to study and educate about the negative side. Then, maybe this stuff will be good for us that we’re hearing about. I say it’s sort of an infinite pool of toxins in the plant world but oxalate is very unique in its ability to poison and its ability to crystallize and if you catch it early enough, and your ability to reverse a lot of the damage that it causes but if it goes on too many decades, you will create some deranged immune system and we’ll get stuck in tissues that are too alkaline to clean themselves out and cause a real disease.

Carole Freeman:              What have you found personally as you’re eating templates? Right now, what would you describe or the way that you eat that works for your body right now?

Sally K Norton:                  Well, I’m an interesting case because I’ve been on oxalate so long that my immune system thinks it’s allergic to the entire plant kingdom, so I’m still experimenting with what am I allergic to and I’m starting to try the five-day modified fasting, fasting-mimicking diet. I’m still playing around. I’ve been a pretty heavy grass-fed, local nose-to-tail eater. I’m big on feet and bones and marrow and sinew and stew and soup and broth and things like that. I do still love my lemons every day and do like some vegetables every day but it’s getting simpler and simpler. I’m very culinarily oriented. I like to put on a big plate of food with like three vegetables and a gorgeous entree and all of this and I’m continuing to simplify and think more like Inuit because I honestly feel best. One time, I prepared an entire pig head.

Carole Freeman:              Oh, yeah. You were sharing this story with us a week ago.

Sally K Norton:                  I ate the whole thing for a week because I had a big like Thanksgiving type party. It was in February in a weekend. We had a big snowstorm and everyone’s snowed in and I was having this party with just a few friends and we shared the purchase of the pig. I just ate it the whole week because we were sort of snowed in and living simple and I never felt better in my life. As much as I … I’m an ex-vegetarian. I’m a good cook. I like the flavor, the texture, the color that vegetables bring to the plate but my body is quite content if I stick with many fewer vegetables.

Carole Freeman:              Yeah. Thanks for sharing that. In kind of wrapping this up, if we just give people your top tips of like, okay, this might be the first time they’re hearing this like what do you recommend that they do just to kind of get started with figuring out whether this is an issue for them or not?

Sally K Norton:                  Yeah. Well, first of all, try to just take a deep breath and just sort of relax about it because people are right now emotionally worked up about food and their diet, and attached, so just take a step back and then, see about living on salads made of romaine instead of spinach. See if you can figure out if you can use low oxalate foods. If you insist on having smoothies, go there. Try some pumpkin seeds sprouted like the Go Raw brand pumpkin seeds. They’re low and oxalate, a few sunflower seeds, watermelon seeds. Those are some of the very few seeds that are low in oxalate. Try those instead of almonds, almond butter, peanut butter, cashews. Try that and see if you can get yourself some organic white pepper. Start using white pepper instead of black pepper. You’ll never miss the black pepper.

Carole Freeman:              Black pepper is oxalates too. Okay.

Sally K Norton:                  Yeah, black pepper, cumin, turmeric, cinnamon, so not entire whole teaspoons of cinnamon in the blender. No, no, none of that. In fact, you can get allspice extract to use instead of allspice too. Allspice is lower, quite a bit lower than cinnamon but right now, there’s this thing like throw a lot of cinnamon and turmeric in every blender full as well. I found my clients really got the true benefit when they finally got around to the spice part, got all the nuts gone and the beets and the high oxalate vegetables and then they realize eating the Ethiopian spices and the Indian spices and so on was a big problem and that once they switched to cooking at home with just white pepper and simpler seasonings, that really was the breakthrough for them.

Carole Freeman:              Okay, nice. Well, and I’m going to add that they should go over to your website, sallyknorton.com and grab your article that you’ve got there. It’s pretty obvious what tab. We’ll link that in the show notes as well but start there and get a little more information because I’m sure a lot of people listening to this, their head is kind of spinning right now like, “Wait. What? What are you even saying? How come these foods that I thought are so healthy for me be not so great for me?”

Sally K Norton:                  Yeah. One thing you’ve got to know that if you’re going to go for a low oxalate diet, there is a number to shoot for how much oxalate to eat per day which is 50 milligrams per day. That’s explained in the article and explained on my website. I have many tabs of information on the website and I’ve pulled together data that was testing done and published by researchers and some of it done and published by the Vulva Pain Foundation because they’ve really been the lead ship that’s made this possible. Without them, we wouldn’t be here today. They spent 25 years getting food tested and been publishing it in their newsletters. That’s reliable information.

There’s another group that’s done the same so I’ve compiled it in a little simple short list of for what leafy greens, what’s in them. You can really look at the numbers and see for yourself what those are and then, the berries because the raspberries and blackberries are really high, especially blackberries, and several of the sort of modern funky berries like mulberries and things like that are pretty high in oxalate. You can take a look at that data if you want but yeah, just think about it’s just a matter of simple substitution. Once you get going with this, it’s not a big deal but there’s a learning curve like, “Okay, so where are the oxalates and what are the things that are low?” That’s the hardest part of it and there’s … I’m here and there’s two other organizations that can help you too.

Carole Freeman:              Okay. People can get support on your website, so if they want to delve into this more and have some support and hand-holding and coaching that they go through this, then you are there for that as well, right?

Sally K Norton:                  I really look at people where they’re at emotionally, habit wise and where their health picture is and how we need to support their health and how they can do this in a safe way. You don’t really want to dive from a very high oxalate diet to a low oxalate diet in a rapid way. For some people, that can trigger some pretty terrible reactions and it’s not necessarily safe. It would be better to work with somebody … If you think you really have a problem, you really should work with me or someone who knows how this works and do it in a informed way.

Carole Freeman:              Yeah, excellent. Well, was there anything else that you were hoping I would ask you about or that you think is important to share now as we wrap this up?

Sally K Norton:                  There’s a lot of myths out there about oxalates and I just hope people recognize that science is sort of imperfect and so it’s easy to cherry-pick and go find fifteen articles on PubMed that would maybe support a counter point of view but that’s just cherry-picking from scientists who share the same weaknesses and biases that that we all have imagining that plants are so great and that oxalates must not be such a big deal because we’ve been eating them a long time. That’s how people are about gluten and all kinds of other things. Just keep in mind that most people haven’t really looked at the thousands of articles and really dug into the research and seen the problem so it’s easy to find … If you want to disagree with the point of view that oxalates are a problem, easy to do because you can cherry-pick your information and do that but it’s not necessarily a good strategy in terms of protecting and optimizing your health. Caution is better.

Carole Freeman:              Yeah, so very true and you … Definitely, you’re the expert on this and you’ve spent the time to look at all of the information out there. Yeah, I just want to thank you so much for everything you’ve shared. I have one final question for you. If today is your last day on earth, the meteor’s coming. It’s going to wipe us all out. What is going to be your last meal?

Sally K Norton:                  Gosh. Well, it’s probably whatever is already in the crock pot because there’s always something going on in the crock pot, right, or whatever will go on the grill. Of course, if the power’s out and I’ve got a freezer full of local grass-fed meat, so it’ll probably be a giant meat fest on the grill. I’ll invite all my neighbors over and anyone who’s freaking out will just eat meat and die happy.

Carole Freeman:              Okay. That’s awesome. It’s a little bit of a trip for me but I might try to make it depending on how many hours till the meteor is-

Sally K Norton:                  Yeah. It’s delicious. It’s worth it.

Carole Freeman:              Well, Sally, thank you so much for being here and for sharing this message. We’re going to spread this and get the word out to people because it’s going to make a big difference in a lot of people’s health and I know just from talking with you after your talk, there were people coming up to you and sharing their own stories of family members that have had dramatic health transformations with going on a low oxalate diet and how it just was so … it’s just not known and so I’m really glad that you’re out there doing this work. I’m happy to help spread the message and so we can help heal more people and get more people feeling really awesome. Thanks for being here. If you guys enjoyed this, give us a thumbs up and subscribe if you want to see more of these. Please share this information with anybody that you think could benefit from it as well. That’s all for now. Thank you again, Sally, for being here and we’ll see you soon. Bye.

Sally K Norton:                  Thank you [crosstalk 00:59:31] your interest in the topic. Be well.