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  • Writer's pictureTeresa Rodríguez

Do you know the 10 mechanisms behind the risk of hyperoxaluria?

Updated: Oct 11, 2023

Explore the 10 mechanisms behind the risk of hyperoxaluria, from genetic factors to gut health. Understand the varied causes and improve your health.

Hyperoxaluria is a condition caused by too much oxalate in your urine. Oxalate, an organic acid found in plants and synthesized by your body, is a common cause of kidney stones and chronic diseases.

Common causes of hyperoxaluria include genes, intestinal disease, and eating too much of foods high in oxalate. However, several other mechanisms go unacknowledged. Here are 10 you should know:

1. Genetic Predisposition

Primary hyperoxaluria is a genetic condition caused by mutations in the genes responsible for glyoxylate metabolisms. As a result of these mutations, the liver’s ability to break a substance called glyoxylate is impaired – subsequently, it gets converted to oxalate, leading to its increased urinary excretion and other chronic diseases.

2. Mold Exposure: Aspergillus and Penicillium

Exposure to certain molds, especially Aspergillus and Penicillium, can lead to endogenous oxalate production. These fungi produce oxalate as a metabolic byproduct, elevating levels after being ingested or inhaled in significant quantities.

3. Candida Overgrowth

Candida, a type of yeast, also produces oxalic acid as a metabolic waste product. Overgrowth of Candida in the body, therefore, increases the production and accumulation of oxalate, potentially contributing to hyperoxaluria.

4. Gut Dysbiosis

The gut microbiome plays a significant role in oxalate metabolism. Specifically, the bacterium Oxalobacter formigenes breaks down oxalates in the gut – insufficient levels of this species reduce oxalate breakdown, leading to increased uptake and subsequence urinary excretion.

5. Low Citrate

Citrate is a key inhibitor of calcium oxalate crystallization in the urine. That not only increases oxalate presence but also potentiates kidney stone formation as the low levels of citrate allow calcium oxalate to develop in the renal pelvis or ureters.

6. Histamine Problems

Elevated histamine levels in the body are associated with increased gut permeability. A ‘leaky gut’ is more likely to absorb dietary oxalates, resulting in hyperoxaluria and increased kidney stone formation. However, this is only the case if the diet contains a significant quantity of oxalate-containing foods.

7. Fat Malabsorption

When fats aren’t adequately absorbed by the intestines, they bind to minerals like calcium. Calcium commonly binds with oxalates in the gut, preventing their absorption. With less calcium available to bind to oxalates, they’re absorbed at higher levels.

8. Glyphosate Exposure

Glyphosate (or Roundup) is a common herbicide linked to disruption in the body’s metabolic pathways. Some new research indicates that glyphosate exposure may disrupt gut microbiota, increasing oxalate synthesis – however, further research is required to confirm and understand this mechanism.

9. Low Sulfate

Sulfate is a key component in the transport of oxalates into the body. Reducing sulfate levels, therefore, modify the activity of solute carriers responsible for oxalate transport. In some cases, that could increase oxalic acid levels in the body.

10. C. Difficile and COVID

Clostridium difficile infections have been linked to gut microbiome disturbances. Any disruption to the gut’s microbial balance can impact oxalate metabolism, potentially elevating its levels in the body.

This mechanism is hard to predict, as it depends on several secondary factors. That means not all individuals exposed will develop hyperoxaluria.

Hyperoxaluria is a multifactorial condition influenced by a combination of genetic, environmental, and microbial factors. Understanding these mechanisms can offer insights into its prevention and management, emphasizing the importance of holistic approaches in addressing this condition.


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