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Ep. 287 Toxic Superfoods: Impact of Oxalates in Human Health with Sally Norton


Join me today in stepping into the world of nutrition science and exploring the fascinating realm of dietary oxalates alongside renowned expert Sally Norton!

Armed with a nutrition degree from Cornell and a Master's degree in Public Health, Sally has dedicated her life to unraveling the mysteries of plant-based oxalic compounds. In her groundbreaking new book, Toxic Superfoods, she untangles the intricate web of oxalic acid, oxalate salts, and oxalate crystals, shedding light on their affinity for binding to essential minerals and disrupting the delicate balance of glutathione and oxidation.


In today's conversation, Sally and I explore the prevalence of oxalates in modern lifestyles. We dive into the alarming deficiency of essential vitamins and minerals in the American diet and the impact of consumer demand for so-called superfoods. We also uncover the fascinating connections between genetics, lifestyle, and symptoms and get into how to address the consequences of consuming oxalate-laden foods. 

Prepare yourself for an enlightening discussion that will give you a fresh perspective on health and well-being! You will be captivated by the depth of knowledge and insights Sally reveals about the pressing health issues surrounding dietary oxalates!


IN THIS EPISODE YOU WILL LEARN:

  • How Sally's health journey led to her passion for sharing information about oxalates.

  • The difficulty of questioning basic cultural assumptions.

  • What are oxalates, and how do they impact the body?

  • Why do we feel the symptoms of high oxalate exposure systemically?

  • How our modern-day lifestyles are contributing to oxalate symptoms.

  • Many clinicians are unaware of how superfoods are contributing to the poor health of their patients.

  • Sally dives into the problem of hyper-nutrition.

  • The hidden pathology of eating disorders.

  • Sally explains how primary hyperoxaluria plays out.

  • Foods that seem benign. 

  • Dealing with constipation and kidney stones

  • How to get enough minerals in the body.


About Sally:

Sally K. Norton, MPH, holds a nutrition degree from Cornell University and a Master’s degree in Public Health. Her path to becoming a leading expert on dietary oxalate includes a prior career working at major medical schools in medical education and public health research. Her personal healing experience inspired years of research that led to her book, Toxic Superfoods: How Oxalate Overload is Making You Sick-and How to Get Better, which was released in January 2023 from Rodale Press and is available everywhere books are sold. 

 

“In the oxalate story, dairy-free is a big problem. So is gluten-free.

Dairy-free means less calcium.”

- Sally Norton

 

Connect with Cynthia Thurlow


Connect with Sally Norton

Order a copy of Sally’s book, Toxic Superfoods


Transcript:

Cynthia Thurlow: Welcome to Everyday Wellness podcast. I'm your host, Nurse Practitioner Cynthia Thurlow. This podcast is designed to educate, empower, and inspire you to achieve your health and wellness goals. My goal and intent, is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives. 

Today, I had the honor of connecting with Sally Norton. She holds a nutrition degree from Cornell and a Master's degree in Public Health. Her path has led her to becoming a leading expert on dietary oxalates. She has a new book called Toxic Superfoods. Today, I spoke at great length with her about her background, and what led her to being so passionate about these plant-based compounds, the role of oxalic acid, oxalate salts, and oxalate crystals, how they bind to and chelate minerals, how they lead to oxidation, disruption in glutathione as well as minerals, why they're more commonly found now in our modern day lifestyles, how over 80% of Americans consume a diet deficient in vitamins and minerals, and how these can contribute to this, statistics from the US Agricultural Society, the impact of consumer demand for "superfoods," what role genetics and lifestyle play in our symptoms, what happens when we consume oxalate-laden foods, and ways to address this. I hope you will enjoy this conversation as much as I did recording it.

I want to take a moment to express appreciation for a recent iTunes customer review from Billion Dollar Matt, "Cynthia is beyond knowledgeable and I'd be doing a disservice by calling her an expert. She not only is at the top of her realm, but she brings a personalized touch that's like no other. I've appreciated listening to her show, reading her tweets, and having conversations with her. This is something you should tap into." Thank you so much, Matt. And please know that my team and I read your reviews on a regular basis. We're so appreciative. Every review is important to us. We really take these seriously. As I've told everyone, doing podcasts with Everyday Wellness is one of my favorite things I do in my business. Thank you so much and I hope you will enjoy this conversation with Sally Norton as much as I did recording it. 

I would love to start the conversation with you sharing a bit about your own health journey and how you got so interested and passionate about sharing information about oxalates because as a licensed healthcare provider, it was not until I had my own health issues that I realized these can really be an instrumental component to why people are suffering needlessly. 


Sally Norton: Well, please share that with your audience. 


Cynthia Thurlow: I will. [laughs] 


Sally Norton: It takes lots of voices. There's a whole potential conversation to be had about all the mental barriers that we have. In fact, last night at bedtime anticipating talking to you, I just wrote this whole page of notes on my date book. I'm like, "If we could just explore this barrier to understanding this in our own heads and our allegiance to what is being said all around us and the difficulty of questioning basic cultural assumptions, it's just emotionally safer to pretend what we know is true."


Cynthia Thurlow: Yeah. It's interesting, I probably haven't shared as much about this on my podcast. But in 2019, I spent 13 days in the hospital with a ruptured appendix and every complication you can imagine. As you can well imagine, six weeks of antifungals, antibiotics, the stress of being in a hospital, losing 15 pounds, sick as stink. A good friend of mine who was also a colleague said, "I think everything you're sharing with me in terms of your digestive issues is related to oxalates." 


Sally Norton: Wow. 


Cynthia Thurlow: When we started to look at my diet, I realized I'm gluten free, I'm dairy free. What do I eat? A lot of almonds. And not so much almond flour preparations, but sweet potatoes because that tends to be my higher carbohydrate food. It just uncovered a constellation of symptoms that were exacerbated by my oxalate consumption, which was way higher than I would have anticipated. The unfortunate thing is, I think many of us assume, because these are unprocessed considered to be healthy, even superfoods, I'll put that in air quote, we may find out that these don't serve us at all. And so, when I stumbled upon your work a few years ago, I kept thinking, "This is really powerful." And for me, part of what was my healing journey back from being so sick was going on a low-oxalate diet. 

Even to this day, four years later, if I overdo it with, let's say, for example, it's a holiday, a celebration, I have too much almond flour, like, I have a cake or I have cookies or something like that, my digestive symptoms start all over again. It's almost instantaneous. It's really a barometer for allowing me to recognize my body's trying to communicate that this is not something you should be doing with reckless abandon. It doesn't mean I don't celebrate, it doesn't mean I don't enjoy things, but it means my life has a lot of, I would say, lower oxalate foods in it than it ever did before. 


Sally Norton: It's a great story that needs to be heard. 


Cynthia Thurlow: Yeah, I would agree. And your story, when I read it in its entirety in your book, I was amazed. It sounds like you suffered for years. At one point, you were vegetarian, and you were having all these musculoskeletal pain symptoms, and you were tired and fatigued, and no one was making the connection that it was the oxalates in your diet that were precipitating a lot of these symptoms. Did you stumble upon research or how did you put those pieces together for yourself to come to an understanding that these plant defenses might very likely have been contributing to the symptoms you were experiencing? 


Sally Norton: Yeah. So, I've been exploring all the right ways to eat ever since I was five years old, and decided as a 12-year-old, I wanted to study nutrition to help people not get sick. And yet, already at that age, I was having arthritic like pains, I would sometimes wake up in the morning slightly paralyzed for a nanosecond, I literally couldn't move when I'd wake up, back pain was starting at that age. And then by the time I'm 19, I've got foot problems. It just cascaded. In fact, in high school, I really struggled with concentrating and focusing on studies. I would set myself in front of my books and have a hard time with the brain focus thing. That continued to be a problem with mental fatigue, physical fatigue, aches and pains, arthritis, eventually fibromyalgia, definitely IBS, which I blame the IBS onset from my vegan days of being a busy young career person. I would set up my vegan breakfast as cooked beans in a slow cooker at night. So, I just [unintelligible [00:07:08] beans with a little bit of peanut butter and garlic and delicious flavors, and let them slow cook overnight, and then eat that for breakfast. And then of course, I'd have a whole pot, so then it would be available all week, so I could have a busy life and not cook a lot and have bagels and beans and think I was eating well. 


Cynthia Thurlow: [laughs] 


Sally Norton: So, that was a big problem, because the IBS onset in 1990 really carried on forever. It didn't ever fully resolve. I had, what's called, postinfectious IBS. But the oxalate insight, whoa, that was very long and coming. And even understanding, why was I having mental fatigue in the high school, why was I susceptible to this irritable bowel syndrome, and why was I having all these other problems that turned out to be oxalate, including osteoporosis in my 40s? Excuse me, osteopenia technically. Right down there though, real close to osteoporosis on the numbers. What is going on with me, Miss Healthy, who does everything right? I had this one time when I had on and off, I'd had like crotch itching and things like that, and discomfort and issues, but nothing really big deal. But then I had about three days of really bad vulvodynia kind of pain. My crotch was really bothering the heck out of me to the point of like it was really grabbing me by the throat, so to speak. Like, "Oh, my God, somebody deal with this." 

My husband looked it up on the internet, this is 2009, and he finds that there's a place, a thing in North Carolina an hour from where I used to live and work called The Vulvar Pain Foundation that claims that if you quit eating high-oxalate foods, you can deal with your vulvar pain and pelvic pain. And by the way, there's this thing called connective tissue issues or syndrome, of which I knew very little, but I was a good fit for that. I had aches and pains, I had weak skin, I would really get issues around my fingers, like, if I used soap cleaning dishes without gloves, my skin would get all tender, I would get hangnails that would be really painful and bleedy. Yeah, I was wimpy in the connective tissue department and had issues, but none of that made sense, because I know stuff. [giggles] I'm in the world of public health and integrated medicine, prevention, nutrition, and nothing in my background suggested that connection. Because in school, we know that you need a low-oxalate diet as a therapeutic diet if you have repeated kidney stones. Because, of course, oxalate is in plant foods. 

The main source of oxalate in our body is our diet. We eat oxalic acid in foods like spinach, and that's 50% of the oxalate that gets in your body. Another huge chunk, at least another quarter is coming from vitamin C, and vitamin C degenerates into oxalate, which is not something I was that aware of until I started doing the research. So, thanks to The Vulvar Pain Foundation. The oxalate concept needed to be revisited. So, I'm like, "All right, I'm busy. I can hardly function, and I have a very big deal grant writing job." Writing big grants for NIH funding are massive brain projects. You got to do budgets, and you got to do specific games, and you got to put together a 25-page proposal. Perfect. Get it all fit, follow the rules. I was doing that, helping my colleagues in my department write research grants and administer that whole process. It takes a tremendous amount of [unintelligible [00:10:48] from your brain and ability to focus. I just needed to keep my job in work. So, I wasn't adopting oxalate as the miracle cure, but I was willing to stop eating sweet potatoes and skip the spinach, which I hardly ate, and maybe skip the chard and things like that. 

I didn't eat a lot of nuts, because I already knew they bothered me. So, I quit eating walnuts. But I couldn't tell that it helped that much, because when I went back to my beloved sweet potato, I didn't feel worse. I couldn't tell and there's a reason for that. [giggles] This ugly thing is really tricky, because if you don't know what you're doing when you start the diet even with the advice of The Vulvar Pain Foundation, they've specialized in trying to help people with my kind of issues, but I still didn't get it. Partially, because I knew too much and partially, because it's very tricky to interpret the body's reaction to the change in the diet. So, I still had some issues. I had to quit my job eventually because I wasn't able to function anymore. My back was hurting me so badly. I was kneeling to do all this typing and writing for at least a third of the day. I would kneel for half an hour or an hour and then I'd sit for half an hour and back and forth to try to cope with the back pain. But I was also really struggling with focus. It took everything I had to focus. I used 101% of my capacity to get my work done, but I had to eventually give up and quit because I was also bleeding to death with fibroids. 

I needed a total hysterectomy. They cut me open and they found out I had endometriosis, I didn't know I had, scarring on the colon, pelvis full of blood. And after the surgery, now I have no ovaries and I have a need for some support from an endocrinologist. He can't figure out what's wrong with me. So, he sends me to the sleep doctor. Okay, that's probably a good idea since I'm tired. It turns out my brain was waking up 29 times an hour according to the probes all over my body. That's not sleep. No wonder, I was struggling with this brain fatigue. No wonder, I'm surprised I didn't commit murder with that little-- [laughs], right? 


Cynthia Thurlow: Poor thing.


Sally Norton: It really can ruin your life. And so, now I went on this quest, what's causing the sleep disorder? And the research says it's toxins. It's endotoxemia coming from SIBO, bacterial overgrowth. That's the magic answer to why you don't sleep. So, yeah, I'm bloated all the time, I definitely have belching. I have all the symptoms of SIBO. I get tested for SIBO. No SIBO. Who cares what the test says? I'm going to treat for SIBO. Oh, my God, treat her for SIBO. No help whatsoever. And eventually now, I'm aware of when I'm eating oxalates, but I have this chronic constipation. And the literature says, you can't sleep and you can't work and you can't do anything because of some kind of endotoxemia. So, I'm convinced it's the constipation. So, I start eating kiwi for constipation, so I could fix the sleep problem, so I have a life. After, let's see, August, September, late October, three months of kiwis every day. My arthritis starts coming back, which I had really badly in my early life. 

From age 18, all through my 20s, I had really bad arthritis and it was coming back. I was getting stiffer and stiffer with arthritis, and I'm like, "Oh, are you kidding? The kiwi, the oxalates? This is like arthritis?" I didn't know that, even though I should have known it. It's in the literature a little bit. And that's part of what The Vulvar Pain Foundation was getting at. You have connective tissue inflammation and connective tissue weakness. So, I'm like, "Oh crap, I actually have to do this oxalate thing for real and get serious about it." And so, I did. I finally knuckled down because now I'm not working. You see, when you're sick and working, you don't have the brain space to really learn this, so you're stuck. But now that I clearly can't work and I'm basically just my full-time patient, I can figure this out and do it right. 

Within under two weeks of doing the low-oxalate diet correctly, my brain starts coming back like, "Wait a minute. The sleep thing was not the endotoxemia. It was the food toxemia from a few kiwi and a little bit of celery." I think what [unintelligible [00:15:09]. This was mind blowing. And then it turned out over time, my very long list of health problems are all connected to oxalate. So, my osteopenia reversed itself, my lifetime of foot pain reversed itself, and on and on and on. 


Cynthia Thurlow: It's really an incredible story, because I think for so many listeners, we've all had experiences during our lifetime that maybe aren't easily explained, but when we really start leaning into what our body is trying to communicate to us, it can be really powerful. I think it would be helpful to talk about what oxalates are, so that people that are listening understand. As I was doing preparation for our conversation today, it really stood out to me that there are many different types of components to oxalates. Your oxalic acid and oxalic salts and crystals. And certainly, for most of us that are traditional allopathic trained, we certainly have seen many patients with kidney stones. I was a former ER nurse in Baltimore, and I knew who my kidney stone patients were before they even came into the triage area, because they all had the same appearance. 

I would have women telling me that kidney stone pain was worse than labor. So, it gives you a sense, when these men come in and we as women sometimes weren't giving them as much sympathy as they deserve to have, I was like, "Wait a minute." From what I understand, these are incredibly painful, but that was the most exposure I had to this concept. But let's explain what they are, how that you mentioned they come into us through our diet, but what they do in the body that starts to create so much inflammation and symptoms? 


Sally Norton: Yeah. So, oxalic acid is the parent compound of a set of things we call oxalates. We call it oxalates. The lates mean salt, because it's a chelating acid. Meaning, it grabs minerals. So, this has single or double negative charge that's attractive to anything, any other ion. That means it's an ion with a charge. An ion with a positive charge like calcium, magnesium, and other minerals love each other and they connect. So, this oxalic acid is a great chelater. It can take the rust out of your patio. It's been used as a cleaner. It has a lot of oxygens on it. It's the end product of oxidation. So, certain compounds can oxidize into oxalic acid. So, it easily forms in nature. Plants make it easily. Many of them in order to make it, first, make vitamin C. Vitamin C is a precursor that can oxidize into oxalate. Polluted clouds make oxalate. The acid rain that comes down on us contains oxalic acid. In fact, that's one of the dominant acids in that polluted acid rain. 

This stuff is pretty toxic, it's a prooxidative. Because of it's reactivity, it messes with charges in the body. Everything in the body that's living and moving and doing things is doing it because there's electricity there. There's charge gradient across cell membranes, and that's your mitochondria, and that's your proteins, that's all the stuff that's happening at the life level, like all of this. It's a lot of orchestrated enzymatic reactions that is life. And that stuff requires control over ions. Calcium ions and where your sodium is, and where your potassium is in the cell and outside the cell, this stuff really matters to life. Oxalate muddles that up. It is a pro-oxidative disruptive toxin. It's considered highly toxic in the right concentrations. Now, all toxins require a certain dose to be at their full toxic potential.

The problem is, you can drip in a dose slowly or you can drip it in fast. So, there's potential for acute problems, especially if you've already had subacute problems over time with oxalate exposure by itself, because oxalate by itself has enough power to come along and injure cell membranes and turn on oxidative stress in a way that injures tissues and injures individual cells to the point of cells literally dying or not. They have some compensatory mechanisms, if they're healthy and so on. But honestly, the oxalates consuming the glutathione, increasing this stress in cells, and that decreases its own inherent self-protection. The antioxidant capacity that the body has is inherent and that gets used up. 

So, you get more free radicals in cells. This is turning on inflammation, hampering the structure and function of proteins, membranes, lipids, carbohydrates, DNA, mitochondrial DNA. You get the mitochondria unhappy, you get the subcellular organelles unhappy, especially the endoplasmic reticulum, which makes your steroids, your cholesterols, your lipids. It folds the proteins. It assembles things. It's really important center worker in the cell. It controls calcium ions. It's a storage place for calcium. Well, calcium is a really important, what we call, signaler or messaging molecule that helps the cell. It tells the cell what to do when and where. Once you have mitochondrial stress and you have endoplasmic reticular stress in cells, you're on your way to being highly vulnerable to any kind of neurodegenerative disorder that could be brain aging, it can be neuropathy, it can be vision, hearing loss, diabetes, and metabolic problems, blood flow problems, and the downstream effects of that, oxygen and nutrient starvation and tissues, cancer, atherosclerosis, inflammation, infections, more vulnerability to other toxins like mold and heavy metals, and psychiatric problems, anxiety, and all kinds of disorders like that. 

So, you're messing with the most fundamental function with this little tiny chemical. That's because it's so little and it's an ion, it floats in the water of your foods and just floats between the cells of your gut and goes straight into your blood cells, into the blood. The blood cells can pick it up, actually. It can roll around in the plasma. It doesn't tend to stay in the plasma though. It can stick to the linings of the capillaries and veins and arteries and that blood is immediately affected. In fact, set of researchers looked at and are still looking at that one spinach smoothie 40 minutes later, you have damaged circulating monocytes. Those are your immune cells. One spinach smoothie is enough to put them in oxidative stress. We know that oxalate causes this prooxidative stress in the system. It goes straight from your stomach to your bloodstream to your liver, because everything you absorb from your digestive tract goes to your liver. The liver has open cells, the sinusoidal design, so that all the contents of the blood can be examined, flushed, processed by liver cells. That includes the oxalic acid.

The thing is, the liver can't metabolize, or change oxalic acid or oxalate salts. All it can do is add more oxalate, because the liver itself, in the processing of amino acids, creates a little bit of oxalate. So, when your blood leaves your stomach and goes to your liver and then it leaves the liver, it has even more oxalate than when it started. So, now you've got blood leaving the liver from your spinach smoothie, your chia bowl, your almond bread, your almond flour, this or that, your dark chocolate, this or that, your sweet potato fudgy brownie, your turmeric laced, whatever, all of those foods are increasing oxalate in your gut, your blood, your liver. And then that circulation that leaves the liver, goes straight up to the heart, passes through the diaphragm. You need the diaphragm to breathe, by the way, and that can be affected as well. The nerves that innervate the diaphragm can be affected. But then that's just passing through, what is it, the superior vena cava or something straight to the heart. Now, the heart pumps that blood into the lungs to pick up oxygen. 

So, now oxalates hits your liver, your heart, your lungs, and then it pumps it back into the heart. So, both sides of the heart get it, then back out to peripheral circulation. So, in the meantime, those blood vessels and those tissues are in a position to be exposed to oxalate. Because in the capillaries, where you get this exchange of nutrients and oxygen, there's high pressure pushing oxalic acid into those tissues. There's lymph that might pick it up, there's the vein inside of the capillary beds that might pick it up, there're cells that are being bathed in it. And that is toxic when you're doing it every single meal. 


Cynthia Thurlow: I think you did such a beautiful job painting the picture of why we feel these symptoms systemically, from top to bottom, understanding that it's carried in our blood. So, it means that it's going from our brain all the way to our feet. What is it about our modern-day lifestyles that makes us more exposed to high-oxalate foods? You do a really nice job talking about this in the book, but I think that as we have gotten to a point as a society where we want to have strawberries year-round and we want to have sweet potatoes year-round, the foods that we're choosing to eat that aren't per se seasonal are definitely contributing to this issue of why we are bathed or in this overexposure of high-oxalate foods unknowingly.


Sally Norton: Completely unknowingly. We have no radar for oxalate. I've heard from many of my followers that most doctors don't know what it is. When they mention oxalate, they go, "What's that?" So, any listener who hasn't heard of oxalates, [giggles] you're like everyone else. Modern people have not been hearing the word, oxalate. Even if you get kidney stones, they don't tell you're having an oxalate stone. They tell you having a calcium stone, because it's calcium oxalate that's that salt that's forming. So, yeah, we live in the lap of luxury in modern life. We have grocery stores and convenience stores open 24/7. We can eat the same food any time of year. There's no longer waiting for strawberry season. We don't wait for blackberry season. We don't wait for almond season, which didn't used to exist. Peanut butter season was invented a hundred and something years ago and it's year-round. 

We live higher than kings and queens ever did, because we use all this fossil fuel to produce foods. We have these trains and boats and planes and refrigerating foods anywhere. We can refrigerate foods on a plane, on a train, on a boat, on a truck. We've got 24 hours grocery stores, we've got greenhouses, and we can use wherever the weather is good for growing something at certain time of year, we've got it. We somehow have the capacity to send enough planes back and forth all over that you can have whatever you want. People have this entitlement attitude, you should have whatever you want. If someone thinks it's good for you because it might have this old theory that's 40 years old and dying about antioxidants and foods, you're going to justify that. Who wants to interfere with your luxury life, your modern privileges? 


Cynthia Thurlow: Yeah. No and it's interesting because as I was reading the book and thinking thoughtfully and we've had many guests that talk about killer kale. My mother, who's Italian, is convinced I'm going to die because I don't eat spinach and I don't eat kale. I just say, "Mom, if those work for you, great. They don't work for me. They don't make my body feel good. They remind me of how I felt four years ago when I left the hospital." Same digestive issues. But I think it's the overconsumption of these high-oxalate foods. But you also discuss the concept of meal frequency and how these highly processed hyperpalatable foods, all these things are contributing to why we are increasingly becoming sick. It may not solely be related to oxalates, but the meal frequency piece, the poor metabolic health, the overconsumption of food like substances, all of these things are contributing to the disease that we're seeing today. 

Certainly, for me, I've been in healthcare for over 25 years. What my patients were struggling with in the 1990s is very different than what my patients are struggling with now. And so, we're evolving into an increasingly unhealthy population. It's something that is reversible. But I think that many clinicians are not aware of oxalates. They're not aware of a lot of the ways that, and I'm going to put it in air quotes, these superfoods are contributing to poor health of their patients. They just assume if they keep telling their patients to have celery juice in the morning because it's great, it's going to be hydrating and nourishing, not realizing that that oxalate bomb first thing in the morning is setting you up for problems if you are susceptible to a high-oxalate diet. 


Sally Norton: Yeah, we have a problem of, what we call, hypernutrition or overnutrition, malnutrition where we're eating too many calories and too often. It's all highly processed and it's not in its native form, depending on what kind of foods we're talking about is or isn't a problem. But we have long been saying, really since the 1950s, really since World War II when we stopped allowing for starvation. You can have whatever you want. We think that vegetables matter because they're low calorie. We're trying to solve the don't eat too much, food is everywhere. And food is everywhere and you can eat all the time. We'll just eat a bunch of nothing like celery that has practically no calories in it and you can't hurt yourself. That's the attitude. Because we think it's all about people just being gluttons. But we develop gluttony, because our bodies are starving for actual nutrients and they're toxic. 

We've got only so many ways to cope and food is an acceptable addiction. It's okay to cope with your feelings of being unloved or whatever is the hidden pathology under eating disorders or whatever. We have total permission. That's how you go and have fun. Now everything in social event is food. Go out and meet the girls for some food event. It's food plus alcohol often. There's all this symbolism around cake for birthdays. It's important to give your one-year-old a chunk of chocolate cake. Why? [laughs] We are an eating disorder as a culture. We have way too much food all around us. We use food for all the nonnutritive purposes we can imagine. We use it as a symbol for love. We think that as long as we throw in enough broccoli and vegetables, you can get away with that. That mixture of giving ourselves permission to eat garbage and eat too much and throw in the healthy vegetables to fix it all is really clashing in a big, toxic, ugly mess. 


Cynthia Thurlow: It's interesting because I reflect back on-- Obviously, now I have teenagers, but I know that when my kids were younger-- When they're younger, they're [unintelligible [00:30:38] whatever their parents feed them. I recognized very early on, I have a child with life-threatening food allergies to peanuts and tree nuts. And so, our world was small for a few years till I felt comfortable knowing that we could actually eat outside the house without his allergies being triggered. But when they would go to parties, and my younger son in particular, the artificial colored frostings on cakes, he would become a different child, because it would trigger all this hyperactivity. This child who could normally focus and had no issues was, all of a sudden, you couldn't get him to focus, and he almost couldn't help himself. He was just running around like a crazy person. But I think it has very much become a normal part of all culture that we eat junk and that those of us that choose to eat less often, I'll just put it that way [unintelligible [00:31:25] you choose to intermittent fast or not, but eat less often, choose not to drink alcohol as an example, maybe choosing not to, maybe you don't eat dairy, maybe you don't eat gluten.

When you go to places, people are oftentimes very triggered by our own choices. I always say, if someone's triggered by how I choose to eat, it's really more a reflection of them than it is of me. And so, the acknowledgment that as I've been able to navigate, raising children in a culture that is very food focused, celebrations are wings and pizza and an overconsumption of processed carbohydrates and all of these different things, it forces me to reflect on the fact that we probably don't eat like the average person. I've just come to realize that for each one of us that's listening, if there's something that doesn't make you feel good, I give you permission to not eat it. You don't have to love foods that don't love you back. 

I think that's an important distinction, because in many ways, sometimes people will say, "Oh, well, I suspect something bothers me." But it's too inconveniencing when I go to someone's house to pass on whatever is this being served. And I said, "No, it's actually okay. It's a way of honoring yourself," just like you did navigating the oxalate issue and saying, "I'm having all these symptoms, but as soon as they're removed from my diet, I feel completely differently." I think we need to give ourselves the opportunity to acknowledge that for each one of us that might look very different. Now, when we're talking about the oxalate levels of particular types of foods, in the book, you talk about these US agricultural stats. And two, seemingly benign foods, sweet potatoes and spinach, which are both very high in oxalates. In terms of crops, they had the biggest increases in acreage from 2012 to 2017. Sweet potato had a 38% increase. Spinach had a 51% increase. 

When you were reading those statistics, how did that make you feel? I can imagine as someone who's trying to help people become more aware of the potentiality of having issues related to oxalate consumption, but knowing that this is now a huge focus of the agricultural industry to increase the availability of these foods in particular.


Sally Norton: Well, they're responding to consumer demand. It was clear to me during all my years in the program in integrated medicine that juicing books and all this was coming out massively. The push for juicing is 30 years long. It really happened back in the late 1960s and early 1970s. With the 1970s, we had almost like an emergence of cancer becoming really common and carrot juice was like the answer to cancer treatment way back in the 1970s and 1980s and so on. And so, there's been this trend in the field of holistic health anything, you name us some subset of that has been pushing the vegetables thing as the ultimate answer. It's coming from lots of places that are hundreds of years long, but still we have this movement where consumers are using it more. 

I have a good friend and neighbor who's been working at a grocery store since she was senior in high school, delivering groceries to the car. During this COVID era, the grocery stores all needed people to do your shopping for you in the store. She's like, "People are buying massive amounts of spinach." And people tell me all the time, they go to the big box like the Costco's, and they buy spinach, three-pound clamshells, and they'll use that every four days. They'll use it up. So, people have been told to concentrate these [unintelligible [00:35:00] [laughs] using them. So, it's reflected in the agricultural statistics. I think that produce is one of these almost a lost leader in grocery stores. Produce only lasts so long. Honestly, spinach is old by the time you brought it home. In terms of its nutrient quality, it's already diminished. All the things we think are good about it are already faded away by the time you get it home, because it needs to stay very cold and be eaten pretty close to when it's picked. That's not what's happening. 

But you have to go back to the grocery store pretty often to maintain fresh produce in your house. That's important for the grocery industry to get you back in the door and remind you why you're here. Right there you walk in the door and the first thing you see is the beauty of fresh produce. It gives you this brain-- It's almost like a little endorphin hit to see a beautiful laid out display of produce. There's something inherently effective about that. We're being manipulated on lots of levels to eat vegetables and fruits and value them. It's reflected in the fact that we're growing a lot more of them. I think, honestly, the push to eat produce comes from its profit motive. The push to produce a railroad system that took everything all the way to California and back was to help make California economically viable. Major piece of the economy of California is produce and food. And that's how we justify the railroad. Our whole economic system is built on agriculture and our nutrition system is built on top of that. So, our nutrition information comes from the agricultural folks who says, "Eat these foods."


Cynthia Thurlow: Yeah, it's interesting how there's this seemingly lack of connection, lack of transparency. For most people, they're just not recognizing that these things go together. Very interesting about how rapidly spinach loses exactly the nutrients that we are trying to utilize it for. I think about my mother who buys those massive things of spinach and eats spinach with everything, because she's been conditioned to believe that that's helpful. Let's pivot a little bit and talk about what is the impact of genetics, and lifestyle play, and symptoms? Because I think this is really interesting that, obviously, there are some of us that are going to be more susceptible to the exposure to oxalates than perhaps others.

I think there are people who are seemingly completely disconnected from their bodies that even if they were having symptoms, whether it's cognitive dissonance or something else, they're just not willing to believe that food is contributing to their symptoms. But how does this play out in the literature and the research? 


Sally Norton: Well, the most interesting piece in the literature is coming from the literature on primary hyperoxaluria, which is a genetic deficiency problem where the genetics have changed. It's like 150 ways that genetics can be off that affects the cells, the liver cells especially, ability to manage amino acid metabolism. Amino acid metabolism gets skewed and messed up, because you don't have the right enzymes or they're not in the right place. Like, there're 150 ways to get this wrong. What it causes is high production of oxalate in the body. This is a deadly disease. Sometimes, it shows up within the first six weeks of life. Usually, it shows up in childhood at some point, but sometimes it doesn't show up till you're 50. So, right there, you see huge genetic variance on when the kidneys fail or some other thing fails enough to get enough of a workup. 

Unfortunately, in the science we focus only on the kidney damage and the kidney stones, so the assumption is that all the other bodily problems are secondary to the kidney problems, and it's probably quite the opposite of that. So, we wait in these patients till they have complete kidney failure, and other serious problems, growth retardation, and arthritis, and broken bones, and whatever. We wait for that point and then we work them up and we find out they have this genetic disorder that will kill them. And in many cases, there aren't any symptoms. Like I said, you can have this genetic disorder of overproduction of oxalate. And sometimes, the only symptoms these patients show up with is neck pain. Just a little bit of neck pain and it turns out to be a deadly disease that will seriously shorten your life. Infants who are diagnosed with this problem usually don't make it to 18 months old or two years old. It's pretty deadly pretty quickly, because they're going to need a new liver ultimately. They're too young to have a liver, it's just not going to work. 

They're getting better at managing the liver transplants, and antioxidant therapies, and different ways to try to support the body. But these patients, what's so interesting about them, they all have the same disease, primary hyperoxaluria. Some of them, their bones dissolve out from underneath them and they're just this weak, exhausted, painful lump of in a wheelchair. Other people die with this with no bone problems at all. Some people, their teeth fall out completely. Usually, there're lots of kidney stones, but not always. Sometimes, it's just something called nephrocalcinosis is the major form of kidney problems, which is very common. Most of us die with some degree of nephrocalcinosis. Most of us die with oxalate crystals in our thyroid gland, our bone marrow, our eyes, our bones. And sadly, we're eating high-oxalate foods thinking they're protecting our eyes. In fact, with my clients and followers, I reversed all those problems, including osteopenia. But night vision, cataracts, visual acuity, hearing loss, fibrosis, all kinds of problems can disappear when you quit eating oxalate. 


Cynthia Thurlow: That's really fascinating. I would imagine that there's an absorption piece as well.


Sally Norton: Right. 


Cynthia Thurlow: For those who have bariatric surgery, which I saw a lot of that in cardiology because-


Sally Norton: Oh, yeah.


Cynthia Thurlow: -we convinced our patients to gain enough weight to have their gastric bypass, so that they could then qualify for their insurance to cover their surgery instead of talking to them about lifestyle changes. 


Sally Norton: Wow.


Cynthia Thurlow: That happened a lot. 


Sally Norton: Quite a reveal. 


Cynthia Thurlow: Yeah, exactly. So, individuals that have had bariatric surgery, I would imagine, they've got absorptive issues to begin with, especially if they've had removal or rerouting of their digestive system. Has that been something that you've seen clinically as well? 


Sally Norton: I've had a handful of people that are post bariatric surgery. But it's very clear in the medical literature that bariatric surgery, you need to be on a low-oxalate diet if you're going to have bariatric surgery. That's very clear. And yet, it's not at all in a clinical practice. In your consent forms, there should be a whole half page explaining you will not eat spinach, [giggles] you will not eat dark chocolate. That's part of the price you pay for a malabsorption syndrome that's permanent. The point of these surgeries is to prevent you from absorbing nutrients. What it does is it allows you to absorb more toxins like oxalate and makes you more and more deficient in nutrients. It leads to cancer, arthritis, bone problems, you name it, and all kinds of serious health problems. 

Yes, your level of absorption is the key. So, you don't even need a high-oxalate diet to become sick with oxalate if you are, what's called, a hyper absorber, which any kind of leaky gut and gut inflammation will raise, how much you absorb? Supposedly, according to the literature, a healthy gut absorbs about 10%, maybe 15% of the oxalate you eat, which is bad enough. That's enough. But if you also have leaky gut and other kinds of inflammatory issues, your absorptive rate could be 50% or more. That is tremendous. So, there's really three sources. You eat oxalic acid directly and it goes right into your bloodstream, or everything goes in your bloodstream that's toxic because you have inflammation in the gut, or you're overconsuming vitamin C and collagen which are molecules that the liver can convert or just convert into oxalate in the body.


Cynthia Thurlow: As we're talking and as I read your book in 2018, again, I probably haven't shared much about this with my listeners, I got the worst food poisoning I ever had in my entire life. I was in Morocco. I told my husband, I was convinced I was going to tear my esophagus. It was just projectile vomiting. It was very unpleasant. But we think that that was probably the starting point. The degree of endotoxin that I was exposed to, and then five months later ending up in the hospital with a ruptured appendix, all these connections. And so, to your point, the average person should only absorb 10% to 15%. I'm sure for a long time, unknowingly, I was absorbing way more than that because I had this leaky gut syndrome. 

We will reflect on the degree of metabolic disease in this country right now. Metabolic syndrome, diabetes, PCOS, etc. We know that those individuals are at higher risk for having issues related to this malabsorption or overabsorption of nutrients. You also mentioned collagen peptides. How many people are taking collagen peptides? I even have to be careful with that. So, when I read this, I was like, "Mm, I probably need to be doing that a whole lot less often." We think of it as being benign, but the recognition that sometimes things that are seemingly benign may not be good for us. What do you think about dairy free vegan diets? Does that make us more susceptible to gut irritants from particular types of "health foods"?


Sally Norton: Certainly, in the oxalate story, dairy free is a big problem. So is gluten free. The dairy free means less calcium. Dairy is the predominant source of calcium in human diets these days. Unless you're eating bones straight up, like you eat sardines all the time and make an extra effort to eat bones, there just isn't that much calcium in foods that we eat. So, dairy, take it out of the diet and now you have oxalate free ring because there's no calcium there to bind it. There're way less bioavailable minerals. The minerals in milk are very bioavailable. They're free to interact and be available as nutrients. They can interact in the food itself. And to some degree, 10% to 25% of the oxalate in food, if the dairy calcium is free to intermingle with, it can reduce absorption of oxalate. So, you take dairy and calcium out of the picture and you've got another wide-open highway for oxalate just to freely get in.

Especially, if you liquefy the oxalate-containing foods in the source of soups and smoothies and juices, because now it's very well dissolved in the water, and water is the conduit that brings it into the body. The juicing is not so good. The dairy free is not good. And then if you go gluten free, because of course, you have gut problems, everyone has to go gluten free for their gut, you're now likely to be told, "Well, now you can have chia seeds, almond flour, buckwheat, teff, quinoa." These gluten free foods are very high in oxalate. So, you go from a normally high-oxalate diet to an exceedingly high-oxalate diet when you do the gluten free. When you do the dairy free, you go from a diet that's bad enough to worse. 


Cynthia Thurlow: I think there's probably a lot of people listening that are thinking, "Hmm, maybe I need to be more conscientious about the foods that I'm choosing to eat." If you already embrace an elimination diet of some sort or another to really make sure that you're being conscientious about avoiding eating solely high-oxalate foods. Let's circle back to some of the things that you've already touched on. You talked about how oxalates can have this neurotoxic effect and impact brain function. Do you see an upregulation in reported symptoms of anxiety, and depression, and mood disorders in relationship with the consumption of high-oxalate foods? 


Sally Norton: It's easier to see it in the reverse where people have had serious lifelong problems with anxiety, depression, and flat affect. We see this a lot also. I want to talk more about the flat affect thing and the changes in the mood that come and go when you're trying to recover from oxalate poisoning. But what's really been amazing to me is people have written to me and clients and so on, followers. "Hey, I've been in therapy for 30 years. I don't need it now because I stopped eating dark chocolate and sweet potatoes." Unbelievable. To me that's real observation. We've been trying to be well for years and tried everything there is to try, and you try this and you do it correctly with the right information, which is not easy because most of the information out there is wrong, even about what foods have oxalate or don't. Some of it is just completely flat out wrong. So, it's really tough to do this well, which is why there's a real need for the book for many reasons. But at least, I made an effort to try to vet the information and get the data right around what foods are high and low, best we have, which is never perfect. 

But the fact that finally something makes such a dramatic difference should get our attention, because that's real-world observation. Some people want to discount that, which is sad, because what you're doing is you're using your abstractions, and your cultural beliefs, and making them more important than observing actual things in reality. It used to be that science was about cataloging what's happening in the real physical world around us. And those of us who've lived this are very clear how real it is. 


Cynthia Thurlow: Absolutely. What I found interesting was for a lot of middle-aged women, especially people that are working with me and my team, they think it's benign to have to get up at night to urinate. So, it's a term we use, nocturia. It should not be happening for a variety of different reasons. But you mentioned that nocturia. So, getting up at night to urinate can lead to cystitis, which is this inflammation of the bladder. But this in and of itself can be a sign of too much oxalate use. 


Sally Norton: No question about it. I would say the most likely explanation for having to pee too much, or pee at night, or having to run to the bathroom urgently because you're leaking, or like having to pee when there's two tablespoons there, or being able to pee out two quarts at a time, I used to be really good at that,-

[laughter]


Sally Norton: -those are all symptoms of oxalate irritation in the bladder, in the urinary tract. This is again, it's so different in each person, right? So, some people tolerate more oxalate than others. That's clear in the fatal dose. Somewhere between 3 grams and 15 grams is what it takes to kill you acutely with oxalate. 3 grams and 15 grams, that's a huge gap. Some people get away with it more, but also there're the circumstances, we can't always distinguish. But waking up with any kind of urinary irritation, oxalate is the major toxin in urine. No question. Oxalate is the number one toxin that leads to chronic kidney disease and problems with the kidney, but also with the entire urinary tract. You can end up with a problem of bladder stones and not know it. 

But with interstitial cystitis, this is pain in the bladder. It's like having a permanent rash where the mast cells and the other protective immune cells that live in the bladder lining are constantly being irritated and turned on. They are so turned on, their numbers are increased. They're like a mad army trying to protect you, just getting pissed off after every time your bladder fills up with oxalate, which is cyclic too. So, your symptoms with this kind of ebb and flow a little bit and some days you can't drive across town without having to stop at two or three gas stations and other days, you almost feel like a normal human being. That's really reflective of this behind the scenes, completely unstudied management that the body does when oxalate is moving through and out of the urine. 


Cynthia Thurlow: It's really fascinating because some of what I talk about on intake with women is, do you get up at night to urinate? And for some people it's, "Oh, I drank too much water, I got up twice. That's my norm." Other people, it is habitual, chronic. Then we start thinking, is it a sleep issue? For me, this is now on my radar to be asking people talk to me more about your diet. Because as an example for constipation, one of the things that I have recommended as a frontline agent other than eating more bitter green foods is a tablespoon of fresh ground flax and a tablespoon of fresh ground chia seeds that you can put on a salad or you can put in a smoothie. Thinking about how these things, they seem pretty benign, but over time, they can add up in a susceptible individual. 

You mentioned vulvodynia, and I think for a lot of women, these are symptoms that sometimes they're uncomfortable talking about. Maybe they're not even talking to their GYN or their midwife about it. But understanding like pain in the vulva or the vaginal area definitely could be a symptom of many things, but not something that you want to ignore. Understanding as you mentioned that oxalate toxicity, you mentioned that for kidney stones or nephrolithiasis, 80% are primarily calcium oxalate and they impact 12% to 15% of the population. I would imagine some of them are underreported. I think sometimes people just have flank pain, it goes away and they don't think about it again. 

Has it been your experience that once people are conscientious about their diet, reducing the oxalate level that they have a complete remission in their stones? Because some people just seem to deal with them on a frequent basis. I had a lot of patients in cardiology that it was like, every six months, they would end up going in for lithotripsy or procedures or end up in the emergency room because they were in so much pain. 


Sally Norton: Well, the high drama of kidney stones is one type of kidney stone. And then like you say, there's actually asymptomatic kidney stones, and there's the possibility of passing kidney stones without a lot of symptomatic drama too. So, there is a huge mystery around how many of us are being affected by kidney stones. My experience is the low-oxalate diet is super critical to anybody with any kind of kidney problems, especially kidney stones of any type of stone. Even though, there's 20% of stones might be from something else, it's still the pathology of oxalate is always contributing to pathologies in urine and kidneys. So, you never want to leave a troublemaker on the table when you're having something as serious as this kidney stone problem repeated over and over again, particularly.

The interesting thing is that the kidney stone problem is partly reflective of the fact that the whole body is accumulating oxalate. Body accumulations of oxalate not only create nanocrystals and microcrystals that damage and harm tissue and tissue function and glandular function and so on, they're an irritant to the immune system. The immune system tries to protect the local tissue and itself from these oxalate crystals, especially when there's too much and they're building up gradually over time. It tries to bury them in these wrappers that keep them from interacting directly, so that you can have this going on with no symptoms. The problem with changing your diet is now you're giving the tissues permission to get rid of those deposits. And that turns back on inflammation that can create symptoms locally, but it also re-releases, mobilizes previously immobilized silent oxalates. The cells have to dissolve it down, which is a messy process, and then can release oxalic acid back into the bloodstream. 

In some cases, it can happen in enough tissues that it's so much coming from so many places that it's worse than post spinach smoothie. It's like, you just drank two spinach smoothies at once by releasing the old ones from your thyroid gland and your arm tendons, and that can set you up for more kidney stones. What I've seen is in postmenopausal women who've had this history of eating healthy, they are the ones who are the most likely group to have their first kidney stone ever when they go on a low-oxalate diet. 


Cynthia Thurlow: It's almost cruel. Most of my listeners are in perimenopause and menopause. As if we're not dealing with enough to understand that we do something that ultimately will do good and then we end up with a kidney stone almost seems a little bit cruel. [crosstalk] 


Sally Norton: But that can be fixed and prevented. 


Cynthia Thurlow: Yes.


Sally Norton: That's why you need to really understand it. Because even if you're mobilizing oxalate from the tissues, if you've had a history of putting up with it, your kidneys are inherently able to put up with it. You just need to make sure that you have enough citric acid, and a good pH, enough magnesium, and so on in your urine and in your body to prevent that clumping of the oxalate crystals. A lot of us have the power to pee out oxalate crystals without them becoming stones. You can tell, if you've ever produced cloudy urine, chances are that's that crystal urea that also involves. When the kidneys are filling up with crystals fast, the tubules will dilate and release those crystals, but sometimes, the tubules will just shed their cells. It's like, "Okay, guys, you got to go. Sorry. You're gone." This suicidal mission that this body is willing to do, "We're going to give up some cells, slough off cells." So, you get both crystals and cells, and that debris is invisible one by one. But when you have so much of it, it's refracting light and it makes it look milky and cloudy. 

So, if you can produce cloudy urine, that's a sign of good kidneys. Just need enough citrate. We really recommend lemon juice or other forms of citric acid. And even acetic acid can help a little bit. That's vinegar. But really, lemon juice, citric acid, or ways of alkalizing the body, because all of this causes acidity that-- Turned on inflammation causes acidity, oxalate causes acidity, and so on. The stress and tissues cause acidity. So, if you get enough minerals, citric acid-- Check your pH of your urine. You can prevent the kidney stone. The thing is, you have to be willing to believe that that's possible. Most people are like, "Oh, I'm invincible. I've always eaten well, now I'm going to do this right thing and not eat spinach and chocolate so much," and forget that you rather need to juice lemons. 


Cynthia Thurlow: [crosstalk] And it's interesting, I've always loved lemons squeezed into my water in my feeding window. And so, unknowingly, as I was reading your book, I was like, "Ah, I had no idea that that's probably helping me." Let's briefly touch on, and you were starting to allude to it. You mentioned supplements and things that can be helpful. You also talk quite a bit in the book about mineral bathing. And so, I know some of the people who are listening are curious, "Okay, if we eliminate these things or go on a lower oxalate diet, what are other things that we can help support our body with?" And so, let's end our discussion talking about that. 


Sally Norton: Calcium is an important binder of oxalate and helps the body remove oxalate. So, it's really a great idea to increase your calcium consumption. If you're going to use supplements, which I encourage, I recommend starting with one like 250 mg dose of calcium citrate or other form of calcium at bedtime. Because nighttime is when the body does its janitorial work and does a lot of healing and repair. So, you're likely to be involved in oxalate-clearing metabolism overnight, which is one reason why you get that nighttime urination problem. That can persist in some people when they're on a low-oxalate diet if they're clearing oxalate. So, having calcium at night can help you sleep better. It's calming. Same with magnesium. You usually have both magnesium and calcium at bedtime. 

If that's going well for you, then you can add it again and again. You can take calcium four times a day to make sure that calcium exists in the colon. We're really taking the calcium, so it exists in the colon as a binder to encourage excretion by way of the colon, because the kidneys have to do so much of the work. But the colon is happy to help out. When it sees kidney stress, it sees acidity in the body that turns on these transporters in the colon that will pull oxalate out of the blood. If you have calcium there, that helps encourage them. The right bacteria there would encourage them. They're still trying to figure out how to bring back the bacteria that help to degrade oxalate in the colon. That's been a very difficult scientific puzzle, because there's a whole ecosystem of bacteria that need to be able to work together, so those bacteria can survive. 

So, we don't have a good way to do that. The calcium is a great stand in for that and it works great. Now, some people, the calcium encourages excessive clearing from tissues. They have to be really careful. So, that's why we just start with one dose and check that out for a while and see if that's making anything worse in terms of signs that your body may be really eager to upchuck the stuff out of its tissues. Some bodies are just spilling so badly, they're so done with all these deposits and have a pretty strong immune system that's like muscular and ready to get it out of the system. It's better to have the recovery of your health, recovery of oxalate deposits in the body. Really, it's going to take decades anyway. Rushing to a finish line is just rushing into toxicity. So, you want to support in ways that support slow release. 

And keep the inflammation down, because all of this requires inflammation to get it out of your system. I really encourage people to try to use sauna in those kinds of anti-inflammatory practices to keep bringing the body back down, down, down from inflammation, because in the clearing process, you could be up for a decade of elevated inflammation just dealing with the crystal deposits in your thyroid gland and so on. It's really important to not be in chronic inflammation, and see that-- If you do have symptoms that they're cycling off, they're just not all the time cycling on and off. One of those symptoms I mentioned earlier should circle back to that is this change in your mood and motivation where you lose your ump [unintelligible [01:00:53]for life, because what I call the flat affect or you just have apathy for everything. Things that you normally care about, you do not care about, that's the neuroinflammation showing up when you turn on the inflammation for the oxalate clearing, and the direct effects of oxalate, and the mobilization of them, and a higher level of inflammation. You need things like sauna, time in nature, art, balance, relaxation, rest. You need all those things, you really have to work on correcting the inflammation. 


Cynthia Thurlow: Well, I think it's so important and messages that other guests have identified. Taking care of yourself, stimulating that parasympathetic nervous system, resting more, exercising less, leaning into things that you can easily do from home. You have a great recipe for mineral bathing, which incorporates several of the things I talk about, especially because I'm so magnesium focused, things that I definitely encourage patients to do. Please let my listeners know how to connect with you, how to purchase your book, which I really enjoyed reading. It's a great reference point. I think the one thing that I really took away from reading the book was the fact that even myself, as much as I think I know and understand about oxalates, there was a lot of really good information that was new for me and definitely tweaks that I need to do within my own diet. 


Sally Norton: Yes. So, please come visit me at my website, which is, sallyknorton.com. You need the K to find the right Sally. And in there, you'll find lots of just discussions on different pages. There's a shop page where you can get a cookbook PDF with 180 recipes and some other downloads. Many of them free. You can join a group class. The book is available worldwide as either a print book, an eBook, or an audiobook. I really do encourage people to take a deep look at the book, and feel free to take your time with it, and reread it a hundred times if you have to. I've reread it a few thousand times, having had to write the thing. I still can read it and still like, "Yeah, I did manage to put together a lot of concepts, big stuff, and try to jam it down into relatively simple stuff." Some people think, "Yeah, this is a giant manual." But actually, it's the simplified version of a reality that you're not getting from anywhere else. 


Cynthia Thurlow: I would agree. Thank you again for your work. Today, it's been a pleasure connecting. 


Sally Norton: What an honor to be with you. And thank you for sharing this with your listeners. I so appreciate it. 


Cynthia Thurlow: If you love this podcast episode, please leave a rating and review, subscribe and tell a friend.



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