“Just some stomach pain, a bloated tummy and feeling very tired.” Five years ago, if people asked me what happens when I have too much fructose, I would reply in this brief and incomplete manner, too embarrassed to go into further detail regarding my gut.
Nowadays I’ve become much more talkative. Whenever the topic of fructose malabsorption arises, I try to be as open as possible, while revealing the symptoms many of us encouter when exposed to excess amounts of fructose and sugar in our food. And people seem to appreciate it. Questions keep on coming and my recipes seem to be in demand.
But occasionally symptoms do slip my mind, simply because I tend to forget just how awful I was feeling before I received my liberating diagnosis.
That’s why today, I’ve decided to go all in by preparing a complete list (help me out if I forgot something) of health problems connected to fructose malabsorption; symptoms we tend to endure far too long before opening up mostly because we are ashamed to talk about them and that we never expected to have the same cause: Excess fructose. Shall we?
Fructose Malabsorption can cause the following symptoms and health problems:
- Diarrhoea on a regular basis
- Constipation on a regular basis
- Bad breath*
- Smelly flatulence/gas*
- Headaches and brain fog/cloudiness (also trouble concentrating)
- Extreme bloating (from fermentation in the gut), causing some people to ask you if you are pregnant
- Indigestion, stomach pain and cramping
- Loud gut sounds (gurgling and grunting)
- “Muffintop”, excess abdominal fat*
- Cracked nails
- Acne and blemished skin
- Fatigue/extreme tiredness
- Weak immune system
- Joint pain
- Low iron levels
- Moodiness, lack of energy and motivation, early signs of depression
- Anxiety attacks
- Binge eating and ongoing sugar cravings
*Bad breath: Fructose, if not broken down properly by the body and thus passed on to the large intestine, is fermented by the gut bacteria, ultimately leading to gas and bad breath. (That’s one reason why fructose malabsorption can be detected through a hydrogen breath test). Proper oral hygiene is essential, but does not resolve the problem itself. Trouble literally lies deeper down. Reaching for chewing gum to cover mouth odor usually even makes problems worse as gum contains sorbitol, which causes the same reactions in a fructose troubled stomach.
*Flatulence: With or without a sensitivity to certain foods, nobody is free from winds. Raw onions lead to airy reactions in almost all of us. Even being without food for a couple of hours makes the stomach bottle up air, resulting in non-smelly winds following the first meal. After all, that excess air needs to go somewhere. So what’s different with fructose malabsorption? Once again, the biggest difference is the smell. As excess fructose starts to ferment in the large intestine flatulence from fructose malabsorption is almost always connected to severe odor. Rotten farts may be funny among teenage boys, but for the rest of us it can quickly turn into a nightmare. Just imagine lunch with a client or dinner with your new date.
*Muffin-top: The first time I read about “muffin-tops” I couldn’t help but smile. What a nice name for such a widespread phenomenon among (overly) well-fed Westerners. A muffin-top describes excess fat around the abdomen “spilling” over the waistline and thus resembling the upper part of a freshly baked muffin. But why does the muffin-top make such a regular appearance these days? Unlike glucose, but just like alcohol and meds, fructose is processed by your liver. Whenever we dump more fructose on our liver than it can actually handle, that fructose is transformed into fat. Of course, high amounts of fructose are not the only villain to blame for a flabby belly, but first studies confirm that a high-fructose diet does prompt a rapid weight gain, especially visceral fat around the waist line. (see here and here)
When and how do symptoms related to fructose malabsorption occur?
An onset of fructose malabsorption may occur at any age. Symptoms vary from person to person and the volume of fructose intake. Sometimes a meal will provoke symptoms, sometimes it won’t.
Symptoms may appear shortly after consumption, a couple of hours or even up to 3 days later. You won’t necessarily experience health issues all the time. But, similar to patients suffering from Irritable Bowl Syndrome (IBS), constipation, bloating and gas are probably part of your daily life.
Without the right diagnosis and without making crucial changes to your diet, symptoms tend to get worse over time. With me it got to the point that I almost stopped noticing the ever-present stomach pain, headaches, bloating and fatigue in my life. Today however, thanks to many small dietary changes (e.g. less fruits, no sugar, no wheat, no onions, using the low FODMAP diet for guidance)and lots of discipline, I have most of my symptoms under control, without denying myself a balanced diet. (Yay!)
Do you know any other symptoms related to fructose malabsorption? What symptoms troubled you the most? Which ones are you still having difficulties with?