OT: Fructose Malabsorption IBS Nutrition FATIGUE

I'm duplicating this post, which I shared in another thread, so that I can reach more people who may benefit from this information. To see the other thread and more of my personal story, (on the topic of Chronic Fatigue Syndrome, hypothryroid, adrenal fatigue, folic acid) click here:
viewtopic/t52164/Chronic-Fatigue-Hypoth ... -Acid.html

I have something to share with you--something that may help many of you, especially if you have bowel problems of any kind, including IBS. This is brand-new, cutting edge research out of Australia and the UK. It may affect as many as 40% of the population. What is it? FRUCTOSE MALABSORPTION.

It isn’t really a disease, from everything I have read it is simply a variation on normal—some people just can’t absorb as much fructose as other people. As much as 30-40% of central Europe has this. The tricky part is the fact that the modern diet is FULL of fructose and it is in foods that you NEVER would have thought. For example, the carbohydrate in wheat is composed of long chains of fructose called fructans. So, when you eat a lot of wheat, even whole wheat, you are getting a lot of fructose! So, here is the thing. The bowel can only absorb so much fructose and when it gets past the point where it can’t absorb anymore it causes SERIOUS bowel problems—it is now being investigated as the number one cause of IBS! And it explains why a lot of people think they have Celiac and then test negative but KNOW they feel better when they avoid wheat.

This can actually happen to anyone (fructose malabsorpters or not)—remember when you were a kid and the peaches or watermelon or whatever fruit tasted so good you just wanted more and more and your parents or grandparents warned you not to eat too much because you would get a belly ache? That is why—the average person can handle about 25 g of fructose in a “meal” and after that—tummy troubles are the result! And just THINK about all the high fructose corn syrup that is present in processed foods! Yikes—most Americans are consuming way too much fructose, regardless of whether they have fructose malabsorption or not! Think of the people guzzing HFCS sweetened soda or fruit juices all day!

So, what does this have to do with me and my symptoms? Well, I’ve ALWAYS had digestion issues. I had IBS for years and they ran all kinds of tests (and found nothing). In more recent times, I’ve just had very frequent loose stools—ongoing every day. I don’t have the pain and discomfort of IBS anymore, I just go A LOT more than other people. It became my new normal and since it wasn’t painful and I have so many other things to think about, I just ignored it as a “symptom.”

Turns out, all these bowel problems (caused by fructose malabsorption) leads to not absorbing the nutrients from your food—most notably I have read that the top three nutrients that become deficient with this syndrome are: FOLIC ACID, tryptophan (the amino acid that turns into serotonin--deficiencies would cause mood problems) and zinc. Well, I’ve seen improvement in my symptoms when I included ALL THREE of those in my supplement regimen. Noticable improvement! And goodness knows that I may have various other deficiencies as well, which could be contributing to my symptoms.

All this, when I’ve been EATING VERY WELL. Eating whole grains, fruits and vegetables like I know I’m supposed to. I haven’t bought white bread for probably 10 years! I mean really—just before I stumbled across this information, I was thinking 2 things: all my research into all the various individual symptoms I have keep coming back to DIGESTION. Food allergies are caused by poor digestion. All the nutrient deficiencies are associated with poor digestion. And I kept thinking these nutritional deficiencies just do not make any sense because I eat so well! Then I was reading the Wikipedia article about alternative treatments for depression and came across the words: fructose malabsorption. Totally stumbled upon it!

So, I’m going to give this new diet a try--it is called the FODMAPS diet. It is a really new discovery. Most of the research is going on now in the UK and Australia. There is very little information out there. I have found one self-published book and one book written for people with IBS (I only bought the latter because the first one didn't look terribly accurate in its info). I bought that book to learn more about the diet. I need to know how much fructose is in various foods so I can plan my diet accordingly. Just in the past 2 days, I have made only minor adjustments to my diet and have already seen an improvement in my bowel habits (of course that could be only a coincidence). It is very early, but I am very, very hopeful. I should be able to continue eating a very healthy diet, just making slightly different choices and eating less of certain things so as not to overdo it. Juicing may not work for me because my favorite thing to juice with all my veggies is apples which has a lot of fructose. Time and experimentation will tell!

I am just at the beginning of the learning curve on this. But I just HAD to tell all my friends here, since this is potentially such a common thing, and requires only dietary changes to try to cure--the best way to cure anything in my opinion! (I hate taking prescription drugs but will do it if I have to--to stay sane!) You all do your research and tell my what you think! I sincerely hope this information helps someone else. That is why I'm here, after all.

Jen

Very informative new information. Thank you for this post.

socknitster wrote:...top three nutrients that become deficient with this syndrome are: FOLIC ACID, tryptophan (the amino acid that turns into serotonin--deficiencies would cause mood problems) and zinc...

Thanks for sharing! I have problems absorbing zinc (appears to run the last 3 maternal generations). Serotonin too. And I have sorta soft yet brittle nails regardless of how much protein, omega 3s I consume. I avoid wheat but not been religious about it -- your post makes me think I also need to investigate this as I too have decided that I simply am not digesting as I should. I have religiously avoided fructose since I learned it directly causes fatty liver. I, too, go often, normal texture tho since I avoid fructose but your post makes me think I'm getting it indirectly such as in wheat and who knows what else... Got some investigating to do -- thanks so much Jen!

socknitster wrote:...going to give this new diet a try--it is called the FODMAPS diet...HAD to tell all my friends here, since this is potentially such a common thing, and requires only dietary changes to try to cure--the best way to cure anything in my opinion! (I hate taking prescription drugs but will do it if I have to--to stay sane!) You all do your research and tell my what you think! I sincerely hope this information helps someone else. That is why I'm here, after all.

Sorry, I should have given some links this morning but someone came to the door and then suddenly my day got very busy and I haven't had a chance to sit down until now!

First I'll send you where I started: http://en.wikipedia.org/wiki/Fructose_malabsorption
A wikipedia article about fructose malabsorption.

Here is a scientific article about it: http://onlinelibrary.wiley.com/doi/10.1 ... x/abstract

Here is a webpage by a dietician that I believe is in Australia and is working with patients in some of these trials on FODMAPS diet:
http://shepherdworks.com.au/disease-inf ... odmap-diet

Here is the amazon page for the book I just bought about IBS and FODMAPS diet. I got it yesterday, started reading it today--I've read about the first 4 chapters and so far I'm VERY impressed. http://www.amazon.com/IBS--Free-Last-Re ... 950&sr=1-4

That is what I know so far. If I learn about any new helpful web pages I will let you know. If I can help anyone avoid spending an entire day trying to find this info, I will! I'm just sorry it took me so long to get back to the computer. Busy, busy day.

I think this could be a contributing factor to my developing chronic fatigue syndrome. I'm feel like I'm finally getting to the ROOT CAUSES of my illness.

Interesting to note, if you are deficient in tryptophan, you are deficient in serotonin (and even an SSRI may not help--it is well documented that there are many people who have "treatment resistant depression" and I venture a guess that this may be why. Also, this logically moves to the point that if you are deficient in serotonin, you are deficient in melatonin. Since tryptophan makes serotonin and serotonin makes melatonin--this could lead to problems with sleep as well.

I've been taking a supplement called 5-HTP which is the chemical that is made from tryptophan and turned into serotonin (its an intermediate). I have found it supremely helpful. Far more helpful than SSRI's have been in the last year or so. I am taking an extended release form of it. As far as I know only two manufacturers make this extended release form. Natrol and Jigsaw. It lasts about 12 hours. Regular 5-HTP only lasts a few hours and has to be taken throughout the day. I take 3 tablets twice a day.

Anyway, I'm rambling when I should be hitting "submit."

Cheers,
Jen

I put a suggestion on pg 9 of your other thread...

Someone asked me if this is related to Celiac disease because they sound similar. According to my research, this is a common question.

Celiac disease is an intolerance to the protein in wheat called gluten which causes damage to the intestines in some way.

Fructose Malabsorption has to do with fructose, a fruit sugar, as well as some other carbohydrates. The term for them collectively is called FODMAP which stands for: Fermentable Oligo-, Di-, and Monosaccharides And Polyols.

They are not related because one is caused by a protein and one is caused by a carbohydrate, but they have a food in common that can be a trigger. Those who have celiac cannot tolerate ANY amount of wheat or gluten--indeed it is toxic to them. Those with fructose malabsorption can tolerate small amounts of wheat carbohydrates when all of their trigger carbohydrates are also kept to minimal amounts in the diet. Proteins have nothing to do with it.

I have never been tested for celiac. My doctor does not think it fits my other symptoms. Fructose Malabsorption is a relatively new discovery. First published about in 2007, I think, but I'm not sure. I have a lot of research yet to do, but I'm well underway.

The problem that occurs with these FODMAP carbohydrates is, the small intestine cannot absorb all the fructose and other FODMAP carbs in the diet--even though this is the part of the digestive tract where they are normally absorbed. They then travel on to the large intestine, where our NORMAL intestinal flora has a feast with all the extra carbs. What happens then usually is the large intestine fills with water and the bacteria produce tons of gases (their normal biproducts--that is where "gas" comes from). Then the individual will suffer intense cramping from the swollen bowel as well as watery diarrhea and profuse gas. Vascilating between constipation and diarrhea is the result and that is also the definition of IBS. That is why those who have learned about this believe it could be one of the causes of IBS. Indeed, the FODMAP diet has already helped many, many people in the short time it has been studied.

I forgot to add that there is a test for Fructose Malabsorption, but I don't know yet how common the test is or if it is available everywhere. It is a breath test for hydrogen. If these bacteria in the large intestine are feasting on these excess carbs that aren't supposed to be there, the gas they produce, some of which is hydrogen, dissolves in the blood and is carried to the lungs where we breathe it out. It can then be measured empirically. I think this test is done thru a gastroenterologist and I do not believe the test is new. I think that there is an older diagnosis called Carbohydrate Malabsorption that they used this test for. I do not know if the two things are one and the same (and they have simply realized which carbs are causing the problems) or if there is a distinction, but the test is the same regardless.

Jen

bump

Thanks for posting this, Jen. I don't have this, but recognize some friends who might, and it's very useful information to pass on.

You are certainly welcome.

Two quick things: I understand now why the very loose, watery diarrhea is part of fructose malabsorption. Those undigested carbohydrates and sugars pass from the small intestine, where they are normally absorbed, into the large intestine. In the large intestine, normally the intestinal walls absorb excess water and make a solid waste product that is easy to pass. However those carbs and sugars are present in the large intestine where they shouldn't be. All carbs and sugars exert osmotic pressure--they absorb water.

Think about when you put sugar on fresh cut strawberries. The sugar draws the water out of the strawberries and makes a puddle of sugar water in the bowl.

Now, think about the large intestine. Those carbs and sugars are pulling water into the large intestine instead of letting it leave as it should. The normal bacterial flora of the large intestine is having a feast on these carbs as well, producing lots of waste products--gas. So suddenly the large intestine is going beyond maximum capacity. This causes pain, gas and the sudden urgency of a very large watery bowel movement. This is IBS, folks. I've lived it.

At the risk of TMI, I will say this: Since my last child was born two years ago, I've had very soft, sometimes watery stools 3-4 times a day (sometimes more). Now, I've changed my eating habits slightly over the last week and I'm down to one solid movement a day. I also feel a lot better. There is definitely something to this, folks.