More than six years ago I found that I could turn my RLS discomforts on and off by controlling the amount of oxalate in my diet. My original breakthrough in understanding came after about 5 years of closely monitoring my diet and my daily discomfort level. Many people who conscientiously follow a low oxalate diet report about a 90% improvement in their RLS symptoms. Because there is some oxalate in virtually every plant based food it can be difficult to fine tune the diet and get to 100% relief.
Before I could consistently get close to my goal of 100% relief I had to have two more breakthroughs. Because virtually every source of information about low oxalate diets says that meats are oxalate free and not a problem, it took me years to realize gelatinous soups and stews trigger an RLS response in me. For years I had been thinking that, even though the vegetables in my soups were low oxalate, the slow cooking process was making their oxalate more bio-available, and they were triggering my reaction. Scientists have recently confirmed my conclusion by finding that eating gelatin raises urinary oxalate. Their explanation for this is that gelatin causes the liver to endogenously produce oxalic acid. Some years ago I had noticed that magnesium supplements with glycine in them triggered my RLS. Apparently it is the glycine in the gelatin that is involved in the inappropriate production of oxalic acid.
The other big breakthrough happened when I came across information on the internet that an oxalic acid solution is typically sprayed on certain vegetables and fruits post harvest because it preserves freshness and nutrients during transport and storage. Although asparagus is a low oxalate food, it seemed to be triggering my RLS. I had wondered if asparagusic acid, which is unique to asparagus, could be acting like oxalic acid. I now eat asparagus again, but only if it is sold as organic. I intend to do more research into how much of our produce is being treated this way, and I buy organic whenever possible.
Now that I have gotten almost complete relief from RLS by following a low oxalate diet, I have been reading some of the scientific studies and trying to come up with a possible explanation for what is happening in my body when I experience an episode of RLS.
Because researchers have established that low levels of iron in the brain and cerebro-spinal fluid may exist in all RLS sufferers, I assume that condition pertains to me. And I assume I have a low ferritin level. However, the fact remains that, without addressing those particular bio-markers in any significant way, I have achieved almost complete relief of symptoms. And, when I do “slip up” and trigger an RLS episode, the discomforts arrive on the day following the dietary mistake and last less than 24 hours.
My theory is that my body’s chronic low iron level makes it critical that my body’s systems do an impeccable job of distributing iron to all the places where it is needed every day. And the oxalate/oxalic acid interferes with that daily distribution.
Iron is typically bound to transferrin (the body’s iron distribution vehicle) with carbonate. However, oxalate can take the place of carbonate as the binding agent. Scientists have found that when oxalate takes the place of carbonate the bound iron is “locked up” so that it doesn’t release from the transferrin and, I assume, distribution is not accomplished.
Because our bodies have a greater iron binding capacity than we use on any given day, mine is able to bring additional resources into service and correct the situation within 24 hours, assuming I eat correctly on that second day. It might even make sense to say that the unpleasant sensations in my legs are a signal from my body to get me to move around and increase circulation in order to expedite the restoration of normal iron distribution.
I think it is critically important that scientists look more closely at the mechanisms which lead to the liver producing inappropriate amounts of oxalic acid. Some people are attempting to raise their ferritin level by taking ferrous bisglycinate and vitamin C. My experience is that glycine stimulates production of oxalic acid. And vitamin C supplements are widely recognized as stimulating its production also. I think we may also find that the augmentation which some people experience while taking Pramipexole and similar drugs is due to stress on the liver and a resulting endogenous production of oxalic acid. There are similar liver bio-markers noted in people who take Pramipexole and those who suffer from secondary hyperoxaluria, a potentially fatal over production of oxalic acid.
Some scientists are dismissive of the idea that oxalate will take the place of carbonate in iron binding function in the “neutral pH of the blood.” It seems logical that the inappropriate production of excess oxalic acid may disturb the pH of the blood. The displacement of carbonate may eventually be seen as a protective mechanism that helps to maintain a proper pH of the blood because it helps to “mop up” the excess oxalic acid.
I wish you all the best in your struggles with this devastating affliction.