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TO YOUR GOOD HEALTH #12345_20220525
FOR RELEASE WEEK OF May 23, 2022 (COL. 3)
BY LINE: By Keith Roach, MD
TITLE: Can a low-oxalate diet improve blood pressure?
Dear Dr. Roach: My blood pressure skyrocketed and I started taking medication. I had eaten what I thought was healthy food to control my blood pressure. My nutritionist suggested I remove my handful of almonds daily and check my intake of other oxalate-rich foods. Two weeks later, my blood pressure was normal. I stopped taking blood pressure medication, and after four years my blood pressure remained low to normal. — D.
Answer: Oxalate is a plant-derived chemical found in many foods, such as almonds, but also dark leafy green vegetables such as chard and spinach. A low-oxalate diet is often recommended for people with a history of calcium oxalate stones. I couldn’t find definitive evidence that oxalates raise blood pressure in people without a history of kidney stones.
A large trial looking at oxalate intake in people with chronic kidney disease showed that people who consumed a large amount of oxalate had a higher risk of worsening kidney failure, but it didn’t. There was no difference in blood pressure between the different groups. Individual trials have shown that certain oxalate-rich foods, such as beetroot juice and green tea, lower blood pressure in healthy volunteers.
The DASH diet, which is high in fruits, vegetables, legumes, and nuts, moderate in low-fat dairy products, and low in animal protein, refined grains, and sweets, has been shown to reduce blood pressure. This is not a low-oxalate diet, but it has been compared to a low-oxalate diet in people with a history of kidney stones. In the study, those who followed the DASH diet reduced their risk of kidney stones to a greater extent than those who consumed a low-oxalate diet, suggesting that the dietary effect of oxalate is weak.
I’m glad your diet helped, but since many high-oxalate foods are healthy for other reasons, I wouldn’t recommend a low-oxalate diet without a good reason (like stones) or other evidence. benefits, which I don’t. to find.
Dear Dr. Roach: On my annual physical, my creatinine was 1.11 (normal range 0.6 to 0.88). What do I have to do? Is it safe to use Tylenol? –CC
Answer: The higher the creatinine count, the worse the kidney function. However, if you hadn’t eaten or drunk any liquid for a long time before your lab test, that could also have raised creatinine. The general pattern of your creatinine over time should be considered. A rapid increase is much more worrisome than a stable or slowly increasing level.
Most often, in people with a modest elevation in creatinine, nothing needs to be done except to make sure you don’t injure your kidneys. Anti-inflammatories like ibuprofen and naproxen are much more dangerous for your kidneys than Tylenol, which is safe if taken occasionally. However, even Tylenol taken in large doses for many years can itself cause kidney damage. A kidney specialist is the expert to consult if your creatinine levels continue to rise.
Dr. Roach writes: A recent column on RhD incompatibility and hemolytic disease of the newborn contained an embarrassing typo: it is when the mother is RhD negative and the father is RhD positive that the danger lies, and I wrote it upside down. Most people were relatively nice to point out this error.
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Dr Roach regrets that he cannot respond to individual letters, but will incorporate them into the column whenever possible. Readers can email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
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