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Oxalates Part II: Addressing when you have Mast Cell Activation Syndrome and Histamine Intolerance

I knew I had Mast Cell Activation Syndrome and Histamine Intolerance. But I hadn’t figured out the Oxalate piece yet. 

My husband and I were going on vacation. It was at the end of December. That was the time of year when my excruciating joint pain always flared up.  

During these flares, I would have to use a cane to walk. And even then, I was struggling to walk to the bathroom.

We’d planned on some beach time, which I was desperately craving. But the muscle and joint pain meant it took me 2 full days just to get packed.

Then… I had to use a wheelchair at the airport. There was no way I could walk through the terminal. It was the first time I had to use a wheelchair.

I tried to look on the bright side. I mean, hey – you get through security so much faster! But it was hard to take so many people staring at me with pity. Or worse: looking at me with bewilderment because I “didn’t look sick.”

I was just 31 at the time. 

I hadn’t figured out this strange pattern of cycles. My joints would get much better from April to October. I could walk just fine then. But when fall hit, I always became so much worse.

The pain was like having ground glass rubbed into my joints. It was excruciating!

In my late 20s/early 30s, I had to wear orthopedic style shoes because of the pain. That’s hard to swallow for a young woman. After all, those shoes aren’t exactly stylish!

I saw so many doctors. I was told I had a rare form of rheumatoid arthritis. But the heavy medications didn’t help at all. They just made me feel worse.

Then I was told it must be related to sunlight changes. That I needed melatonin. And to use a sunlamp in the winter. Well, that didn’t change anything.

I was even told several times by doctors that I must want to be sick. They thought I was attached to being ill for some reason. Looking back, this was so dismissive and disrespectful.

This was definitely the most challenging time of my life – not just physically, but emotionally, mentally, and spiritually. Even socially – I lost many of my friends during this time period. 

Have you had this happen, too? 

Well I didn’t give up. No matter how hard it got. No matter how often I wanted to give up.

Finally, I learned about oxalates! And the pattern finally made sense! 

I wasn’t crazy!

Here’s what I finally figured out…

When I went gluten-free, I replaced wheat with even higher oxalate grains and nuts. Like almond flour, quinoa, and millet.

And I was eating very high oxalate foods much, much more often in the wintertime.

As I worked on lowering my oxalate foods (and taking some targeted supplements), my joints and muscles stopped hurting. 

My pain levels dropped from a 7-9 every day to a very manageable 4-6 on my pain scale.

It was like getting a new lease on life! And I even got to trade in my orthopedic shoes for a few pairs of cute shoes!

But I made 1 major mistake. I didn’t know how to lower oxalates slowly.

Lowering oxalates too fast can cause oxalate dumping. So, I want you to know how to avoid that!

No matter what, do NOT go on a low oxalate diet cold turkey! Oxalate dumping is miserable and awful.

I’m going to show you how to lower oxalates in a safer way.

But first, let’s review what oxalates are. 

What you need to know about oxalates if you have Mast Cell Activation Syndrome or Histamine Intolerance 

Oxalates are naturally occurring microscopic crystals. They’re high in certain plants. Which means they often show up when we’re trying to eat healthy. These plants can include different types of:

  • fruits
  • vegetables
  • grains
  • beans 
  • nuts
  • seeds. 

You’ll learn about which ones specifically are high in oxalates down below. 

Unfortunately, oxalates act as a so-called “anti-nutrient,” which means they can do more harm than good. 

These anti-nutrients are basically poisons made by plants to keep animals (and humans) from eating them. They are also a type of natural antibacterial or antiviral for plants. 

While that’s all great for the plants, it’s bad news for us.

In our bodies, the sharp oxalate crystals can cause inflammation and pain. Especially when they build up to high levels.

Most people know about oxalates because of their role in kidney stones. However, oxalates can show up in other conditions as well. 

Just a few of these include:

  • joint pain
  • muscle pain
  • brain issues
  • food intolerances

You can check out more background information about oxalates in this post:

Oxalates and the Mast Cell Activation Syndrome | Histamine Intolerance Connection

Have you checked your oxalate levels yet? If not, you can do that with this test:

>>> Great Plains Organic Acid Test with Oxalate Markers 

>>>CANADA Great Plains Organic Acid Test

So, if you know you have oxalate issues – what should you do? Let’s cover that next.

Steps to look into if you have Oxalate Issues with Mast Cell Activation Syndrome or Histamine Intolerance

  1. If you are eating high oxalate foods, step these down very slowly. Do NOT go low oxalate cold turkey. This can cause oxalate dumping and can make you feel really bad.

See the next section on oxalate foods.

  1. Consider B6, if low. Check your B6 levels. If you have low B6, this is a very clean option: Start slowly with sprinkles and gradually increase.

  2. Consider oxalate binders. Oxalate binders are supplements that are used to attach to oxalate molecules. When oxalates are bound, they are not absorbed. Instead, they are removed from the body through the urine and stool. Take with meals. Start very low and slow

Now, most oxalate sites will tell you to use citrates. That’s fine if you don’t have Mast Cell Activation Syndrome or Histamine Intolerance.

But if you do have Mast Cell Activation Syndrome or Histamine Intolerance, citrates won’t work so well for you. This is because citrates are from fermentation. So they are naturally high in histamine.

Here are safe options for those with Mast Cell Activation Syndrome and Histamine Intolerance:

  • Biotin 
  • Calcium
  • Magnesium Malate

Oxalate binders can be really helpful, but they aren’t the only thing to think about. Let’s look at high oxalate foods next.

Foods High in Oxalates to be aware of if you have Mast Cell Activation Syndrome or Histamine Intolerance

Wondering which foods are high in oxalates? 

I was surprised when I first learned how many “healthy” foods were high in oxalates. Things like root vegetables, nuts, and greens. 

If you have high levels of oxalates, these are the top foods to avoid.

Highest Oxalate Foods in the Western Diet:

  • Almonds
  • Beets
  • Chocolate
  • Plantains
  • Rhubarb
  • Spinach
  • Sweet potatoes
  • Swiss chard

That list is a great place to start. When you’ve spent some time off those foods, you can tweak your diet further.

But again, if you have high oxalates, DON’T reduce these high oxalate foods too fast. This could make you really sick. You want to reduce those high oxalate foods slowly.

If you go too fast, you could start experiencing oxalate dumping. Let’s talk more about that next…

How to Avoid Oxalate Dumping and Reduce Oxalate Foods Slowly if you have Mast Cell Activation Syndrome or Histamine Intolerance

If you find out you have high oxalate levels, DO NOT GO LOW OXALATE COLD TURKEY!

This is very important! Why?

Because switching to only low oxalate foods all at once can make you very ill. You may cause “oxalate dumping.” Believe me, you don’t want to start dumping oxalates in large amounts.

What is oxalate dumping?

Oxalate dumping is the fast release of oxalates into your bloodstream. Basically, your body sees this as its chance to detox and it starts eliminating oxalates as fast as it can. 

Oxalate dumping can increase the symptoms you already have. Plus, it can spark new ones, due to the sudden detox.

But it’s not good to get rid of the stored oxalates all at once. It’s like opening the floodgates… and all you have is a few narrow winding streams. You know what’s going to happen: They are going to overflow.

Your body is not going to be prepared to handle all these oxalates just yet. It will see this spike in oxalates in the bloodstream as poison. To respond to the poison, it will set off your immune system. This can show up as inflammation and sometimes debilitating pain.

You will need a step-by-step plan to s-l-o-w-l-y start reducing oxalates in your body. 

Start out by simply eliminating the list of 6 Highest Oxalate Foods in the Western Diet mentioned earlier. 

If you’ve been using a lot of almond flour, almond butter, and almond milk, don’t go cold turkey on almonds. Start reducing your dependence on these products and using alternatives listed above instead.

For example,

Instead of almond flour, try white rice flour, cassava flour, and/or flax meal.

Instead of almond butter, try coconut butter (coconut manna).

Instead of almond milk, try coconut milk or flax milk.

There really are great alternatives to most high oxalate foods. It may take a bit of time to restock your pantry, but it will all be worth it in the end. Feeling good is a great reward.

Again, just make sure you go very slowly. Reduce oxalate foods just a little at a time.

My good friend and oxalate expert Monique Attinger, taught me that you can alternate high and low oxalate days to go even slower.

For example:

Monday – higher oxalate day

Tuesday – slightly lower oxalate day

Wednesday – higher oxalate day

And continuing like this to step things down.

However you do it, be sure to listen to your body. And if you start feeling worse, back up and get guidance from an oxalate expert

If you have a history of kidney stones, definitely get help from an oxalate expert before stepping foods down.

Foods low in Oxalates and Histamines

As you’ll see, there are many foods that are low in oxalates AND low in histamines, too!

Here are foods to focus on:

Low Oxalate/Low Histamine Foods List 

Also, we have marked lectins with an “L”. 



  • Arugula
  • Asparagus
  • Basil
  • Bok choy
  • Broccoli
  • Broccolini
  • Brussels sprouts
  • Cabbage – Chinese
  • Cabbage -Red & Green
  • Cabbage – Nappa
  • Cauliflower
  • Celery
  • Celeriac or Celery Root 
  • Chives
  • Cilantro
  • Collards
  • Cucumber – L
  • Daikon radishes
  • Dandelion greens
  • Endive
  • Escarole
  • Fennel
  • Garlic
  • Green Split Peas
  • Kale- Lacinato or Dinosaur, not Curly
  • Kohlrabi
  • Leafy greens
  • Lettuce – Butter
  • Lettuce – Endive
  • Lettuce – Leaf Green & Red
  • Lettuce – Iceberg
  • Lettuce – Romaine
  • Leeks
  • Lentils – L
  • Mesclun
  • Mint
  • Mizuna
  • Mustard Greens
  • Onions-any kind
  • Parsley-flat leaf or Italian only
  • Parsley Root
  • Peppers, bell or hot – L
  • Perilla
  • Radishes
  • Rutabaga /Swede
  • Scallions / Green Onions
  • Shallots
  • Squash – Butternut – L
  • Squash – Spaghetti – L
  • Squash – Summer – L
  • Squash – Winter – L
  • Turnip
  • Watercress
  • Yellow Split Peas
  • Zucchini – L


  • Apple
  • Apricot – fresh
  • Blueberry
  • Cherry
  • Cranberry – fresh
  • Cantaloupe (rock melon) – L
  • Figs-fresh
  • Fruit dishes made with allowed ingredients
  • Honeydew – L
  • Lemon – 1/2 tsp (not always tolerated in elimination)
  • Lime – 1/2 tsp (not always tolerated in elimination
  • Mango
  • Nectarine
  • Passion Fruit
  • Peach
  • Pear – Bartlett or Bosc only
  • Raspberries – ¼ cup (not always tolerated in elimination)
  • Watermelon – L


  • Beef – (only if unaged)
  • Bison (only if unaged & not ground)
  • Chicken
  • Duck
  • Eggs – if tolerated
  • Goose
  • Lamb
  • Ostrich
  • Pork
  • Quail
  • Rabbit
  • Salmon (frozen), must have been gutted and frozen within 30 minutes of catch (like Vital Choice Fish King Salmon*)
  • Turkey
Nuts and seeds
  • Coconut Meat, fresh
  • Coconut Milk – 100% Coconut Milk only, no additives
  • Flax seed
  • Macadamias – 1/4 cup or less
  • Pecans – 1/4 cup or less
  • Pumpkin seeds – L
  • Sunflower seeds – L
  • Tiger Nuts – (20 or under is Moderate Ox)

Fats and Oils

  • Avocado oil – cold pressed 
  • Butter – Grass fed
  • Coconut oil – Extra virgin 
  • Flax oil – Cold pressed 
  • Ghee – From grass fed cows
  • Macadamia Nut Oil 
  • MCT oil
  • Meat drippings -Fresh
  • Olive oil – Extra virgin 
  • Palm oil – Extra virgin  (unprocessed)
  • Salad dressings – Homemade with allowed ingredients
  • Sesame Oil 

Spices and Herbs

  • Basil
  • Cardamom
  • Caraway
  • Chives
  • Cilantro
  • Curcumin powder (can replace turmeric if oxalates are a concern)
  • Dill
  • Fennel – Fresh only, dried is high Ox
  • Garlic
  • Ginger
  • Lemongrass
  • Oregano
  • Parsley – Flat Leaf only (curly is high ox)
  • Peppermint
  • Rosemary
  • Saffron
  • Sage
  • Salt – only unrefined such as Real Salt, Celtic Sea Salt, Himalayan Sea Salt
  • Shallots


  • Coconut Sugar (used sparingly)
  • Inulin
  • Monk fruit – only 100% monk fruit, no fillers
  • Stevia

The above sweeteners do not raise blood sugar levels.

Remember, anything that raises blood sugar levels increases histamines!

Homemade sweets with allowed ingredients are okay.


  • Baking powder
  • Baking soda
  • Cocoa butter (white chocolate with no additives) 
  • Cream of tartar
  • Homemade relishes with allowed ingredients
  • Leftovers – freeze right after cooking


***These dairy products are technically low histamine. But many people have casein and lactose issues. So only if tolerated.

  • A2 milk – plain
  • Cream (from grass fed cows)
  • Cream cheese (from grass fed cows)
  • Ghee from grass fed cows
  • Goat milk
  • Grass fed butter
  • Ricotta cheese (from grass fed cows)
  • Sheep milk
  • Coconut Water – Fresh
  • Coffee – preferably avoid caffeine. If you must drink coffee, then only lower histamine, mold free brands like Purity Coffee*
  • Dandelion Root Tea
  • Herbal teas, except green, black, and white
  • Juice – Pure freshly squeezed juices of allowed fruits and vegetables – limit fruit juice due to sugar
  • Mineral Water – Plain and carbonated
  • Water – with fresh squeezed lemon or lime (if tolerated)
Remember to freeze leftovers right after cooking! You can find great low histamine, low oxalate recipes here

Bottom Line and What to Do

If you’re overwhelmed and wondering where to start, here’s a checklist: 

  1. Check Oxalate Levels by using this test: 

    >>> Great Plains Organic Acid Test with Oxalate Markers

    >>>CANADA Great Plains Organic Acid Test

  2. If oxalates come back high, try adding B6 and safe oxalate binders (Start very slowly)
  3. Slowly lower oxalates from foods (Start by eliminating the top 6 listed earlier)
  4. If you need more guidance, seek out oxalate experts. There is a great FB group called Trying Low Oxalates you can use.
  5. Be sure to read the MastCell360 guide on the Common Root Causes behind Mast Cell Activation Syndrome:

If you still don’t see improvements, talk to your healthcare specialist about these: 

I never want you to limit foods if it’s not necessary so please work closely with your doctor. 

*Some links in this website are affiliate links, which means Mast Cell 360 may make a very small commission if you purchase through the link. It never costs you any more to purchase through the links, and we try to find the best deals we can. We only recommend products that we love and use personally or use in the Mast Cell 360 practice. Any commissions help support the newsletter, website, and ongoing research so Mast Cell 360 can continue to offer you free tips, recipes, and info. Thank you for your support!

References on Oxalate Issues for those with Mast Cell Activation Syndrome or Histamine Intolerance

Brzica H, Breljak D, Burckhardt BC, Burckhardt G, Sabolic I. Oxalate: from the environment to kidney stones. Arh Hig Rada Toksikol. 2013;64:609 30.

Chaplin AJ. Some observations on the demonstration of calcium oxalate in tissue sections. Stain Technol. 1974;49:165-73.

Chetyrkin SV, Kim D, Belmont JM, Scheinman JI, Hudson BG, Voziyan PA. Pyridoxamine lowers kidney crystals in experimental hyperoxaluria : a potential therapy for primary hyperoxaluria. Kidney Int. (2005) Jan;67(1):53 60.

Givler E. Lecture on Oxalates. Environmental Toxins and Genomics Conference. 2019.

Holmes RP, Ambrosius WT, Assimos DG. Dietary oxalate loads and renal oxalate handling. J Urol. 2005;174:943 7. discussion 947.

Owens S. Low Oxalate website. http://lowoxalate.info/

Siener R, Schade N, Nicolay C, von Unruh GE, Hesse A. The efficacy of dietary intervention on urinary risk factors for stone formation in recurrent calcium oxalate stone patients. J Urol. 2005;173:1601 5.

Ykelenstam Y. Low Oxalate Low Histamine Diet – The Missing Link?


  1. ecureuil77

    Which form of magnesium do you recommend as a binder? The link in your article goes to a Calcium supplement.
    I’m curious to find out, because the usual alternative is glycinate, but that turns into oxalate in the body for those of us producing it endogenously.
    Thank you for a really useful article.

    1. Beth O'Hara

      Hi! Thank you for addressing this issue. The link has been fixed and will now take you to the appropriate product.

  2. Leigh Ann

    I was very curious to see the magnesium that you recommended but when I clicked on that link it took me to the calcium. What is the magnesium you recommend? Thank you! Great article because I deal with both issues.

    1. Beth O'Hara

      Hi Leigh Ann, This has been resolved. Thank you for bringing it to our attention! You can click the magnesium link now and it will direct you to the proper product.

  3. Teresa

    Hi Beth,
    Thanks so much for this info! I have high oxalates on my Great Plains OAT. So I need to be careful.
    I was losing weight on the Low Histamine diet. I got down to 103 pounds which was scary! (I’m 5’4″)
    So I added back grains and am slathering them with ghee, and I’ve put on some weight. Yay!
    First I added organic quinoa and now organic white basmati rice. And I just bought some organic millet. All but the white rice appear to be high in oxalate. And after two days of organic basmati white rice, I’m not sure I’m tolerating it.
    Is organic basmati white rice a white rice low in oxalates? Or would you recommend another variety of white rice or a different grain or idea about my weight loss?
    Thanks so much again,

  4. Joel

    Recommendations for Magnesium and Calcium on Fullscript
    don’t work …they are the same link…what brand?

    1. Beth O'Hara

      Hi Joel,
      The link has now been fixed and will take you to the proper product. Thank you for bringing this to our attention!

  5. Tina Bensley

    Hi Beth,

    Thank you for all the information. YES! I am overwhelmed. I’m digesting a ton of information, from every direction. I have obligations and my time is limited right now. I’m busy all the time. Lucky for me I am retired. I just never seem to catch up

    Anyway, I have a trip to Baltimore in July to visit a Biochemical Dentist to deal with mercury fillings and other stuff. I’m from Baltimore. I need a competent Biochemical Dentist. I have no faith or trust in Florida’s Health care system. I call it the “we really don’t care health care system”. I have parasites and food sensitivities. Oh, and I forgot thrush and candida again. Plus a new cancer. It’s just skin cancer, not the killing kind but; it’s still for me worrisome. Cancer number three.

    I just have to take a breath and let this come to me rather than running around crazy. I don’t know how toxic I am so I can’t address what I don’t know.

    I hope to find a Functional Doctor while I’m up north. Hoping we can set up a Zoom as a way to communicate with a doctor I trust.

    With all the problems I have, I have conflicting food choices. So figuring that out is making my brain explode. I just need to step back.

    Tina – I’ll keep you posted and I’ll continue to look forward to your suggestions

    1. Beth O'Hara

      I am so sorry to hear about these challenges you are facing. I would really like to recommend the Gupta Program to you for helping with the stress and feelings of being overwhelmed you are facing. I understand it won’t take care of the specific health issues you mention here, but it can certainly help in the processing of stress related to those things. Perhaps it can offer you an aid to that step back that you are looking for. You can check it out here:


  6. may

    Hi, I appreciate this info and just wanted to let you know something you may not be aware of. Most bison is aged the same way beef is so usually I would think the issue is the same as with beef. I found some grass-fed and non-aged online but I had to search as most places were aged. This place I found ages the steaks, but not the stew meat, and has other really clean meat as well. (https://northstarbison.com/) I don’t work for them! Just trying to share info as it takes so long to find clean food.

    Also Native Forest has a “simple” coconut milk (organic coconut, filtered water only) that’s available everywhere, Natural Grocers, co-ops, online, etc. I mention this because you’ve said the aroyo-d was the only one you could find. That one isn’t organic but Native Forest is.


    1. Beth O'Hara

      Hi May! Thank you for sharing the website! I don’t see any un-aged bison on there when I check, unfortunately. Would love to try some. Yes, I do know about the Native Forest. I try to avoid cans, though, because the BPA free lining still isn’t non-toxic.

  7. Jonelle

    I ordered my Great Plains organic acid test a couple of days ago. I’ve started lowering my oxalates a few weeks ago will this affect my test results with false negative?
    Also broccoli is on your list as lower oxalates. Does broccoli sprouts fall into the lower category?

    1. Beth O'Hara

      Hi Jonelle,
      It will show us where you are now with the diet, so it’s ok. Yes broccoli sprouts should be low too.

  8. Heather Gratton

    Thank you for all this information, Beth! It’s extremely helpful!

    Quick question: where do chia seeds and tapioca fall related to histamines and oxalates?

    I’ve looked through your food list but may have missed them.


    1. Suz, Mast Cell 360 Team

      Chia seeds are lower histamine but high oxalate. Tapioca is medium oxalate at 1 Tablespoon, so it’s important to watch the quantities.

  9. Chera Hart

    Beth, I really want to thank you for all of the information you’ve provided on your site. It is so, extremely helpful! I am afraid I am having issues with oxalates, SIBO, MCA and Candida. Ugh! I knew I had Candida, which I’ve been working with a specialist on for about 8 months, and have only gotten worse. But, I’m starting to understand that the Candida is just a symptom of a deeper problem (a root cause of the Candida, histamine, etc.)

    So, now, I’m trying to figure out what I can eat! I have all the lists – Low FODMAP, Candida diet, Low Histamine, Low Oxalate. I’ve cross-referenced them all and it’s basically left me with lettuces, some herbs, olive oil, pumpkin seeds (in moderation) and chicken. Oh! I forgot rutabga! : ) to mention, there are basically no drinks besides water that I can have without reaction.

    I’ve been eating strictly these foods alone for the past 3 weeks.

    I think I may have lowered my oxalates too quickly, because I feel awful and the skin rashes I’ve developed are much worse. So, now I’m trying to figure out what I should do to add some moderate oxalates to help me feel better. Any suggestions?

    Thanks again so much for this good work you’re doing!

    1. Suz, Mast Cell 360 Team

      Hi Chera,
      It is important not to stop oxalates cold turkey. You can even just eat a few almonds a day to help with this. It sounds like your case is on the more complex side, and it would be best to work with someone 1:1 to make sure you are getting a good variety of foods and nutrition.

      Best regards,
      Suz, MC360

  10. Aaron

    Hi. I’m sensitive to histamine, lectins, and oxalates. I have a question about nuts.

    When you say to keep macadamias, pecans, and pistachios under a 1/4 cup, what exactly does that mean? Is that per day? Per meal? Is it cumulative across nuts, like only a 1/4 cup of nuts at a time? Or a 1/4 cup total per day?

    Could I have a salad with a 1/4 cup macadamias, 1/4 cup pecans, and 1/4 cup pistachios? Could I have that same salad twice per day?

    Thanks for your help.

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