Fructose Malabsorption

[Allyann]

Just wondering if Fructose Malabsorption is common with ME/CFS? My mother has just been diagnosed and I am following a similar low fructose diet and the fluid is just falling off me. I know that there is something that is inflaming my stomach as I had a gastroscophy last year. It wasn't Celiac as I was tested then. I will go for tests once I have saved enough money.

 

[Folk]

Hey @Allyann
I've developed Fructose Malabsorption too. Prior to this I "only" had FMS symptoms, then after, I developed the whole ME/CFS scenario. I was going downhill more and more, with the worst stomach pains ever untill I cut fructose. I started getting better then. That was an year ago, now I'm much better (not like before the crash but still). I got tested for SIBO and I was strongly positive. I've treated but haven't tried fruit after it. Will try it soon though.

According to Dr. De Meirleir 45.8% of his ME/CFS patients has Fructose Malabsorption.
That's the only Dr. I've seen mentioning it.

Hope this helps

 

[Allyann]

Thanks @Folk, I look into Dr De Meirleir and see if I can dig up some papers

 

[voner]

Just wondering if Fructose Malabsorption is common with ME/CFS? My mother has just been diagnosed and I am following a similar low fructose diet and the fluid is just falling off me. I know that there is something that is inflaming my stomach as I had a gastroscophy last year. It wasn't Celiac as I was tested then. I will go for tests once I have saved enough money.

Allyann,

check out this info on SIBO...(small intestine bacterial overgrowth).. it might help your understanding. if you search the Internet or even this site for "Dr. Pimental" and "SIBO", you'll get more information on SIBO..

http://www.cortjohnson.org/forums/resources/small-bacterial-overgrowth-treatment-site.52/

 

[Tracey Anne]

Hi, I have a problem with fructose but had no idea what it was. I have come to my own conclusion that my liver doesn't process fructose well. I didn't realise that 1, fructose is processed by the liver, 2, that regular sugar is half fructose and half glucose, 3, corn products ie modified maize starch etc (in masses of foods, filler in medication tablets...) are fructose.

When I ate too much fructose for my system to deal with, these are the symptoms I experienced: nausea, weight on my brain, feeling slow, headache, nasty taste in my mouth, tiredness, vagueness, apathy, felt depressed, needed to pee a lot, my breathing went very slow - I lost the urge to breathe in and I had to go and lie down. After a day or so of eating fructose, I had a feeling that I was being poisoned.

My thoughts on this is that the fructose was acting on my body like alcohol, so with too much I developed a hangover.

This is not the FODMAPS issue, it's fructose itself.

Anyway just a thought.

I have to keep fructose to an absolute minimum - like spinach and kale.

Tracey Anne

 

[dejurgen]

There are several potential problems with fructose.

I strongly believe I have fructose malabsorption. Fructose malabsorption is the inability of the (small) bowel to absorb fructose well.

All people have a limited ability to absorb fructose. But plenty can absorb all the fructose they eat in a day well enough to not cause any significant (absorption) problems. For example some people can absorb 10 times as much a day then others. Note that eating too much fructose is unhealthy in many other ways.

Fructose also is easier absorbed when there is glucose in the meal. There is a transporter that can co-transport combined 1 molecule of fructose and 1 molecule of glucose. So when the ratio of available glucose to fructose is greater then 1, more fructose can be absorbed and it will go easier and faster. Note that they both need to be available at the same time. Combining fast free fructose and starch releasing slow glucose may not get everything out of this co-transporter.

That is for example why I had once such strong reaction to eating nothing but a single apple in the morning. Apples contain a fructose to glucose ratio far higher then 1.

I believe that the major problem with fructose malabsorption is that plenty of "free" fructose reaches the large bowel. The large bowel is full of gut bacteria. They are accustomed to digesting "slow" to "very slow" food like fibers. Fructose on the other hand is like a fast rocket fuel. That in my opinion "attracts" and feeds different bacterial strains that are of the more pathogenic "multiply as fast as you can" type.
I believe once those are settled in in the gut, they also outnumber the "good" gut bacteria when it comes to feeding on "medium speed" carbs like many of the FODMAP foods. By doing so, they compete away many of the good bacteria I think.

I do not believe fructose malabsorption is a genetic disease. In most pre-industrial societies people with it would have no problems with it. It is only recently that the amount of fructose in our diets multiplied compared to what is was historically. They even add it to meat now! Also, in most parts of the year high fructose foods were scarce during most of the year except during the season of (naturally ripe) fruit.

There are several other problems with fructose too, like for example hereditary fructose intolerance (HFI). There the body lacks the enzymes to process fructose well and amounts in the blood pile up to dangerous levels.

I think needing to pee a lot may be a mechanism to dump fructose out of the blood. So @ Tracey Anne: maybe get a fructose intolerance test.

I have plenty of the same symptoms minus the frequent urinating problems Tracey Anne has when eating too much fructose or eating foods with too high fructose to glucose ratio. But I do get a nasty diarrhea from it with plenty of gut pain, often gut bleeding and afterwards weeks of oscillations between constipation and diarrhea. This oscillation is more rare, but it points to FODMAP issues being able to cause both constipation and diarrhea problems.

Note that plenty of "slow carbs" also decompose to basic sugars including fructose and glucose.

 

[Tracey Anne]

Hi,
Thanks for your thoughts. I agree with what you write - we now have access to fructose in a way that wouldn't have been possible throughout most of our human history.

However, despite being delighted to have come across the FODMAPS information - thinking, yes this is it - FODMAPS weren't the answer for me.

I came across an article by a group in Been, Switzerland called 'Fructose and lactose intolerance and malabsorption testing: the relationship with symptoms in functional gastrointestinal disorders' by C.H. Wilder-Smith, A. Materna, C. Wermelinger & J. Schuler

They found that 'non-GI co-morbidity was common in FGID (functional gastrointestinal disorders), especially in the central nervous system, musculoskeletal and atopic categories. An elevated prevalence of non-GI functional syndromes, including fibromyalgia, migraine and chronic fatigue is reported in FGID. Over 50 pet cent of our patients reported CNS symptoms, with fatigue being most frequent.'

I found the article fascinating as food is my main trigger and sugar/carbohydrates the main culprit.

The article can be found online, for free.

Tracey Ann