Fructose Malabsorption: Causes, Symptoms, and Treatment

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Fructose MalabsorptionOur body does a lot of things that we may have never thought of. It processes the food that we eat, and turns the bits and pieces into fuel that we burn for energy. But what if you couldn’t process one of those bits and pieces entirely?

Take fructose, for example. Fructose is sugar naturally found in many whole fruits and vegetables. It also comes in a variety of food products, a number of which are good for you.  Let’s say you can’t process all of the fructose from a particular meal, what does your body do with it?

The inability to absorb all of your dietary fructose is called fructose malabsorption. We will take a look at fructose malabsorption causes and symptoms, fructose malabsorption treatment, and a list of fructose malabsorption foods to eat and the ones to avoid. Think of this as a beginner’s guide to fructose malabsorption.

What Are the Causes and Symptoms of Fructose Malabsorption?

Despite the fact that somewhere around 30% to 40% of the population is afflicted with fructose malabsorption, there is a good chance that you may not have heard of it. As mentioned, fructose malabsorption is caused by the body’s inability to completely absorb the fructose in foods.

That unprocessed fructose just kind of sits in your guts and ferments. This is usually caused by damage to your stomach’s biome or bacteria, but can also be caused by a gluten allergy or parasites like worms. Fructose malabsorption symptoms can be separated into two categories: short-term symptoms and long-term symptoms. Short-term symptoms of fructose malabsorption can include:

  • Excessive gas
  • Bloating and distension
  • Indigestion
  • Diarrhea
  • Fatigue or lack of energy
  • Stomach and or abdominal pain
  • Nausea or even vomiting (vomiting is usually only in the case of large amounts of fructose being consumed)

The longer fructose malabsorption goes on, the more serious the symptoms can become. Long-term fructose malabsorption symptoms can include:

  • Sugar craving
  • Blood triglyceride levels raised
  • Poor mineral and vitamin absorption
  • Poor skin, nails, and hair
  • Difficulty gaining weight
  • Heart disease
  • Osteoporosis

Many of these symptoms can also lead to other health issues. Poor mineral absorption, for example, can lead to conditions like anemia. Osteoporosis can lead to severe bone issues. The tricky part about all of this is that many of the symptoms of fructose malabsorption are similar to other issues, especially digestive ones. How do you if fructose malabsorption is the actual cause? And then, how do you treat it? The first step is to go to a doctor and get a proper diagnosis.

Diagnosing Fructose Malabsorption

Diagnosing fructose malabsorption can be a difficult due to its similarities to other digestive issues. The question becomes, “How does a doctor diagnose someone with fructose malabsorption?” The doctor will first ask you about your medical history. Many of the questions may pertain to your diet. This is done as a way to quickly rule out certain other causes that have fructose malabsorption-like symptoms. Following that, you will more than likely move on to do some tests.

The fructose malabsorption test that works best for detecting the problem is called a breath test. After fasting for eight to 12 hours, you will be administered a dose of fructose, usually in the form of a drink. After taking the fructose, a breath sample will be collected. That sample is checked to see how much fructose is left in your system (unabsorbed) by measuring the amount of hydrogen in your breath.

After the results of the breath test are in, you may also have to do a blood test. The blood test checks for low amounts of mineral that would also signal fructose malabsorption.

After these tests are done, and you are found to have fructose malabsorption, you can move on to treatment.

Treatment of Fructose Malabsorption

You’ve now been diagnosed with fructose malabsorption. That means there is good news and bad news. The bad news is that, at the moment, there is no guaranteed fructose malabsorption cure. If you have fructose malabsorption, you may have to learn to live with it. That being said, there is also good news.

Fructose malabsorption is relatively easy to treat, so you can continue to live life comfortably. There are several treatment components open to you.

1. Lower Your Fructose Intake

There’s an old joke about a patient who goes to the doctor and says, “My arm hurts when I shake it. How can I stop it from hurting?” “Don’t shake your arm,” the doc replies. That idea kind of applies here. Lower the amount of fructose you consume. Remember that you have a problem digesting fructose but not an intolerance. So, you can have some fructose, just try to tone it down.

2. Combine Glucose with Fructose

Fructose absorption can actually increase with the absorption of glucose. Eating fruits and fruit products with equal portions of glucose and fructose (strawberries and applesauce) can be used to help balance the fructose absorption.

3. Take Probiotics

Probiotics may be able to help you reset your stomach bacteria. Try eating probiotic-enriched foods like certain brands of yogurt, or you can take the probiotics via a pill.

As we previously stated, there isn’t a sure-fire way to deal with fructose malabsorption, but there are ways to deal with it. Most of it revolves around the foods you can eat and the foods you should avoid.

Foods to Eat and Avoid for Fructose Malabsorption

You may be to avoid many symptoms of fructose malabsorption by learning the best foods to avoid and which foods to eat. Once again, remember, you can have some fructose, just not a huge amount. With that in mind, we’ve compiled these fructose malabsorption food lists of what to avoid, foods you can eat in moderation, and foods you can eat with no worries.

Foods You Can Eat
Fruits Limes, cumquat, lemons, grapefruit.
Vegetables Celery, Swiss chard, escarole,  mustard greens, pea pods, pumpkin, shallots, spinach, potatoes (white).
Dairy Unsweetened milk, cheese, yogurt.
Proteins Meat (fresh, not breaded), fish (fresh or tinned without sauce), eggs, grains, seeds (amaranth, millet, poppy, pistachios, sesame, tahini, sunflower, flax seed), nuts.
Breads and Cereals Barley, breads and pasta without fructose or gluten-free, wheat-free rye bread, corn meal, grits, grouts, oatmeal, porridge (cooked oatmeal), rice (white), rice or buckwheat noodles, rye flour, tortilla, cornflakes (non-flavored), plain muffins.
Foods to Avoid
Fruits Apples, dates, grapes (black), guava, honeydew melon, cherries lychee, mango, nashi fruit, papaya, figs, pears, persimmon, plumes, prunes, star fruit, sultana, quince, watermelon, dried fruits, fruit compotes and jams, raisins.
Vegetables Artichoke, green peppers, radishes, green cabbage, kale, leeks, eggplant, lettuce (iceberg), pickles (e.g. sweet cucumbers), turnips, squash, tomatoes, watercress.
Dairy Sweetened milk products, ice cream
Proteins Meat, fish (if processed, sweetened, or commercially breaded)..
Breads and Cereals Sweetened breakfast cereals (or with raisins, honey), brown rice.
Foods You Can Eat in Moderation
Fruits Avocado, kiwi, bananas, boysenberries, blueberries, cantaloupes, cranberries, pineapple, blackberries, grapes (white), jack-fruit, mandarins, oranges, passion fruit, rhubarb, strawberries, raspberries, tamarillo, nectarines, peaches.
Vegetables Asparagus, carrots, turnip greens, dandelion greens, beets, cauliflower, endive, lettuce, mushrooms, onions, green onions, soy, sweet potatoes, zucchini.
Proteins Legumes, nuts.
Breads and Cereals Wheat (including dinkle, kamut, sourdoughs, spelt, wholemeal and wheat products: biscuits, noodles, pasta, pastry).

You Can Cope with Fructose Malabsorption

Fructose malabsorption may sound pretty worrisome, especially when you think about the number of foods that have fructose in them. But the thing to remember is that you can still eat fructose, just be conscious of how much you are eating and know when to stop. Hopefully, we have armed you with enough information to handle a diagnosis, and still enjoy many of the foods you do today.

Related Articles:

Fructose Intolerance: When Your Body Hates Fruit Sugar

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