Following a low-oxalate diet involves cutting out those foods with medium and high oxalate content and focusing on foods on the low end. Women might also take calcium citrate with food as it binds to the oxalates and helps them leave the body (the calcium citrate must not have Vitamin D as it inhibits the oxalate-binding process).
When I visited the vulvodynia specialist in August, he affirmed my suspicion that a low-oxalate diet probably isn't a worthwhile pursuit for someone with vulvodynia. Here's my reasoning:
- The original study linking oxalates to vulvodynia involved one woman. Initially this woman had abnormally high oxalate levels. After three months of following a low-oxalate diet and taking calcium citrate, she saw a reduction in her vulvar pain. After a year, she was pain-free, and she'd see a flare if she missed her calcium citrate. But again, that was one woman.
- A follow-up study involved 130 women with vulvar pain and 23 without. Of the women with vulvar pain, only 59 had elevated oxalate levels in their urine. These women followed low-oxalate diets and calcium citrate routines for three months, after which only 14 saw an improvement in their pain and only 6 were able to have pain-free sex. In other words, the data didn't favor a vulvodynia-oxalate causal link, though it indicated that some women's symptoms might improve with the diet.
- Oxalate charts (PDF) are inconsistent. For instance, the first two charts I linked to rate zucchini as low in oxalates, and the third chart says it's high in oxalates. I'm not sure how these sources get their data, but I read somewhere (that I can't find now) that while foods have oxalate patterns, actual oxalate content varies according to how the food was grown. So eating a low-oxalate diet that respects every published chart leaves you with very few foods to eat!
It could be that I didn't follow the diet or take the calcium citrate long enough, but my skepticism about the diet makes me unwilling to try it again. If anyone has seen results from the diet or the calcium, please let me know!