Do not be surprised if:

• You have a temporary worsening or onset of urinary issues like penis pain, redness, urinary frequency or urinary urgency.
  
  
• Strange rashes appear that you have not seen before. This can include livedo reticularis, which is an inflammation of blood vessels that makes them show up vividly in the skin, looking a little like a road map.
  
  
• Oxalate crystals can cause gum problems, and in rare cases can lead to reabsorption of the roots of teeth, which starts to make the teeth become loose. If symptoms of this type begin, you may need more antioxidant protection.
  
  
• Behavioral regressions and/or speech regressions. These may be caused by oxalates circulating that were in cells. This will pass, but it can be a really difficult time. Supplements may help and probiotics help as well. Do work closely with your doctor until this time passes if it gets severe.
  
  
• You see an onset of diarrhea including sometimes very sandy stools and stools with black specs. (This may be oxalate, but we don't yet have stool testing to confirm that.)
  
  
• Rarely, in some children, infections of streptococcus may reappear, along with symptoms known as PANDAS, and we are not certain why this happens. It may be that in past infections, oxalate crystals formed around the bacteria, and the bacteria was later liberated when the crystals broke down under the influence of the diet. This will need to be studied, but a similar mechanism has been noted when oxalate crystals have formed around other infectious agents like e. coli.
  
  
• Negatives are generally positives in that these symptoms shouldn't show up in someone unless they have had an oxalate problem, and these bad periods seem to be followed by resolution of issues that were problems before.
  
  
• Your child starts being willing to eat foods he avoided before and stops craving high oxalate foods.
  
  
• You get ravenous during "dumping" stages, or you end up satisfied with less food after being on the diet for some time.
  
  
• Your child who has not grown for a long time suddenly has a growth spurt.
  
  
• Your child's OAT or a 24 hour oxalate test measured oxalate within the normal range or not very high, and your child still ends up being a very positive responder to the diet. Differences in the sulfur chemistry in autism may make it where oxalate has trouble collecting in kidney tubule cells so that it can leave through secretion into the urine. This issue is being studied.