Diet Protocol General Health & Specific Conditions
This is a basic ‘foundation’ diet that I discovered, created by Dr Wilson, an American GP with over 1,400 articles for free on his website, geared towards better health. I have played around with many diets over the years, and this very simple program seems to agree with me the most. It helps to ‘normalize’ gut function, and increase energy, thus creating a fantastic foundation to build health and reverse many diseases. In many cases, further steps are required. In this article I mention further modifications, especially for vulvodynia, as I see a lot of this in my clinic.
Diet Protocol For Vulvodynia, Fibromyalgia & Interstitial Cystitis
Oxalate. What is it and why is it relevant to my pain?
Oxalate (a naturally occurring compound) is present in a lot of plants and fruit that we eat, especially high in almost all seeds and nuts. Ordinarily, the gut won’t absorb much of the oxalate from the diet because most of the oxalate will be metabolized by the gut flora or just leave the body with the stool. When we have certain situations like gut inflammation (from dysbiosis or abnormal gut bacterial balance, commonly caused by gut surgery and antibiotics), a lot of dietary oxalate is absorbed. The difference can be as great as going from 1-2% of the dietary oxalate absorbed to as high as 50%. The oxalate combines with calcium to create crystals that have very sharp and jagged edges. These crystals deposit in certain areas of the body. For some they cause kidney stones, others joint pain, and for many women, deposit in the outer walls of the vagina causing stinging pain and irritation.
This means that there is a high level of oxalate in the urine. This can sometimes be observed in vulvodynia, however the oxalate isn’t always excreted in the urine in large amounts. It binds to other compounds and stores in bone and tissue, especially tissue that is already damaged or sensitive. Thus, a urine test may not reveal accurate results.
Can our bodies also make oxalate?
Yes. By just restricting high oxalate foods, doesn’t mean that you will eliminate all oxalate from your body. Oxalate can increase in the presence of Vitamin C, and low levels of Vitamin B6, magnesium and thianine. As oxalate is broken down in the gut lining by bacteria, if there are certain over growth and certain undergrowth of particular strains, the oxalate will be stored in tissue or excreted in the urine.
What protects us from oxalate and do we have our own defense mechanism?
Yes, we have our own natural defense mechanism against oxalates, it is called gut bacteria. Unfortunately, these bacteria, particularly ‘oxalobacter formigines’, and to a lesser extent Bifido and Lactobacillus strains, which are subject to being killed by antibiotics.
Are there other bacteria that can make oxalate worse?
Yes, it seems so. From a recent study, “…intact viable E. coli, K. pneumoniae, S. aureus, and S. pneumoniae had significant promoting effects on CaOx crystal growth and aggregation”. Therefore, in many cases, I recommend a stool sample to analyze the levels of good and unwanted bacteria in the gut, to give us a good idea what might be potentiating the increase in oxalate crystal deposits.
So a green smoothie probably wouldn’t help?
No way! Well, you’d think it would be the best thing for your health. And it probably would be beneficial if your intestinal bacterial flora was in perfect balance. But, it’s probably not, and that green smoothie will probably contain: spinach leaves, kale, tumeric, chard, raw carrots, maybe almond/soy milk, sometimes cocoa powder/nibs, broccoli powder, dates – all, which are VERY HIGH in oxalate. Dr. Shaw from Great Plains Laboratory calculated the average intake of oxalate in the average American diet to be about 100 mg, whereas those eating just one green smoothie (prepared with 2 cups of spinach or the equivalent) were netting 15,000 mg of oxalate. That is going to have a very negative effect on your pain.
So all I need to do is avoid oxalate and take Vitamin B6, Calcium Citrate and may pain will go away?
No, unfortunately. It may work for some people, but I doubt it will be enough for most. There is a reason the oxalate is being stored in tissue and not broken down properly and there is a reason vitamin B6 is low. No one, really knows for sure, but as mentioned previously it appears that it all started with an imbalance of intestinal bacteria, probably from antibiotics, which removed the bacteria that break down oxalate (bifido, lactobacillus and O. formigines) this then put a many number of biological functions out of balance, which is potentiating pain in certain individuals. It may then be affecting certain individuals because of a genetic predisposition and unhealed tissue, complicated with sensitization of nerve receptors in the vagina, in the case of vulodynia, Genetic predispositions are very hard to prove and the world of genetics is still in its infancy, so it is hard for us to point the finger confidently at any gene. Having said that, even if we do know, will it change our treatment? Possibly not.
So what should you do? I recommend seeing someone qualified to take you through the steps. Don’t start on a strict ‘Oxalate Free Diet’ however do observe it and start slowly. Starting too fast can lead to ‘dumping’ of oxalate into your system, causing temporary worsening of symptoms. Slower is better. The main idea is to heal, repair and normalize your intestinal lining and bacteria. You can take B6 if you’re deficient and Calcium Citrate will help reduce the oxalate. The best way to find out if there is an overgrowth of ‘E. coli, K. pneumoniae, S. aureus, and S. pneumoniae’ and an undergrowth of ‘oxalobacter formigines’, and to a lesser extent Bifido and Lactobacillus strains, is to get a specified stool test. A standard stool test from your GP will not cover these bacteria. You will need a company like Doctors Data. This can be done through our clinic or your local professional Functional Doctor etc.
Other reading for self care of vulvodynia. Link.
Diet Protocol For IBS
Combined Diet Protocol For IBS with Vulvodynia
For more information regarding vulvodynia and how we treat it please contact our clinic on 8676 0599 or email us on the ‘contact us’ page. Diet is a very small part of the treatment, however is an important element to full recovery. We also use acupuncture (no points go any where near the genitals), herbal medicine and external herbal wash. The combination of these, sometimes combined with probiotics works very well when tailored to the individual.
Acupuncture combined with lifestyle and diet changes can offer treatment for various conditions including Cystitis/UTI, Resltess Leg Syndrome, Trigeminal Neuralgia, Male Infertility, Prostadynia, asthma, acne, hay fever, sinusitis, weight loss, pelvic pain, rectal pain, female infertility, morning sickness, period pain, general pain and many more.
Chris Eddy is a registered doctor of Chinese medicine and university lecturer. He has been treating for the last 13 years in his city practice in Melbourne Australia.