Dorothy FarrarFructoseallergie
Apart from the genetically caused fructose allergy ( fructose intolerance ), the other manifestations can be treated very well with the help of modern diagnostics and therapy. Those affected can thus be given the help that, in most cases, enables them to lead a life with almost no restrictions. Provided that certain basic rules regarding the choice of food are heeded.
What is a fructose allergy?
A fructose allergy, intolerance or intolerance can be based on the one hand on a disturbed fructose intake from food or on the other hand on a disturbed breakdown of fructose in food. If the absorption of fructose is disturbed, there is an intestinal fructose intolerance (fructose malabsorption).
causes
A malfunction of the GLUT-5 TRANSPORTER or other transporters (scientific clarification is still pending) is probably due to intestinal fructose intolerance. Alternatively, the number of transporters may not be sufficient. The result is that the absorption of fructose through the small intestine does not work. It simply remains in the intestines before being transported further into the large intestine.
Various bacteria in the large intestine metabolise fructose into gases such as CO2 and hydrogen as well as into short-chain fatty acids . The CO2 content causes abdominal pain and flatulence. The short-chain fatty acids create an osmotic gradient that causes watery diarrhea.
Another cause is the disrupted breakdown of fructose (hereditary or benign fructosuria). Thyroid patients (SD sufferers) are also increasingly complaining about fructose intolerance. In the form of a fructose absorption disorder in the small intestine.
There can also be hereditary fructose intolerance, which is based on a genetic defect in fructose metabolism. Here, the breakdown of fructose in the small intestine takes place only slightly or not at all. Fructose malabsorption (intolerance) is also based on a fructose absorption disorder in the small intestine. Fructose cannot be properly absorbed by the small intestine, although in principle it is capable of doing so. This form of malabsorption does not only affect SD sufferers. In the case of incurable, genetically determined fructose intolerance, the enzyme aldolase B is completely missing. However, this is necessary so that fructose-1 phosphate can be split into dihydrozyacetone phosphate and glyceraldehyde.
When to the doctor?
A fructose allergy begins with the suspicion of the patient. If most types of fruit are very poorly tolerated and trigger typical allergy symptoms, you should not wait long before you get clarification from your doctor. Most of the time, a fructose allergy only manifests itself in mild allergy symptoms, but severe physical reactions to contact with a fruit can also occur.
Before this happens, a doctor should therefore examine whether a fructose allergy is actually present or whether cross-allergies may still exist. Allergy sufferers need to find out as quickly as possible which substances they are allergic to so that they can stay away from them in the future and protect themselves from life-threatening allergic reactions . Furthermore, the patient himself cannot determine whether it is really a fructose allergy or an allergic reaction to isolated fruits that have nothing to do with fructose.
For this reason, too, the allergy test by the doctor is absolutely necessary. The doctor can then also explain which foods contain fructose and what the patient must watch out for in the future in order to protect themselves from allergic reactions. If allergic symptoms that are more severe than usual occur in an already diagnosed fructose allergy, the doctor should also be consulted, since even with mild allergies it is possible that the body suddenly reacts more violently than usual for no apparent reason.
symptoms and course
Possible symptoms:
The most common symptoms, which can also occur with a time delay, include abdominal pain and bloating (flatulence) as well as diarrhea (diarrhea) and nausea. Contrary to diarrhea , in some cases short-term constipation or long-term constipation/sluggish bowels (constipation) also occur. Rarely, the transport of stool comes to a complete standstill (faecal impaction).
Other symptoms include reflux symptoms ( heartburn ), vomiting and tiredness as well as dizzy spells.
Those affected often complain about a depressive mood and headaches up to migraine attacks. The fact that the symptoms vary in severity from day to day is felt to be very stressful. There are days when fruit that was well tolerated the day before or last week suddenly leads to complications. In SD sufferers, the symptoms range from nausea and vomiting to inflammation of the gastric mucosa .
Diagnose
Those affected must keep a food and symptom diary for at least two weeks. The evaluation is used by the doctor as a basis for the course of treatment, which also includes an H2 breath test. For this, a fructose solution must be drunk. At certain time intervals, a breath measuring device is blown to measure the hydrogen content in the air we breathe. If the test liquid is not properly metabolized, intestinal bacteria produce hydrogen, short-chain fatty acids and CO2, among other things. However, in some sufferers, the bacteria do not produce or consume hydrogen and produce methane instead. It is therefore important not only to measure the hydrogen content of these non-H2 producers, but also the methane content in the breathing air.
During the measurement, the blood sugar level should also be measured. With an existing intolerance, the sugar is not absorbed by the blood, the blood sugar level remains constant. If there is no intolerance, the blood sugar level rises because the sugar has been absorbed by the body.
A blood test to measure aldolase B and determine a fructose plasma level (no statutory health insurance benefits) and a genetic test are recommended. The blood test should be supplemented by determining pancreatic amylase, which is often elevated, and lipase, which is often too low. The levels of zinc , folic acid and tryptophan must also be determined.
complications
As a rule, the symptoms and complications of a fructose allergy can be avoided relatively well if the person concerned does without fructose altogether. There are no particular complaints or symptoms. However, if the patient takes fructose, the main symptoms are flatulence and constipation. Furthermore, the patients can also suffer from diarrhea or abdominal pain, which significantly reduces the patient’s quality of life. Furthermore, those affected are often tired and exhausted and the patient’s resilience drops significantly. The fructose allergy does not lead to heartburn or a severely irritated stomach.
The fructose allergy also often leads to hypoglycaemia, which in the worst case can cause the affected person to lose consciousness. The quality of life is significantly reduced by this complaint. A causal treatment of fructose allergy is not possible. However, the symptoms can be reduced with the help of a strict diet. There are no particular complications. This allergy can also occur together with other allergies or intolerances, which is why it should be checked by a doctor. The life expectancy of the patient is usually not reduced by this disease.
treatment and therapy
It is important to get to know your own body, to pay attention to its signals in order to better assess the tolerance or intolerance of certain foods with fructose. Nutritional counseling is required at every stage of treatment.
Acute treatment measures include placing a hot-water bottle on the stomach as well as drinking yarrow, fennel or caraway tea to relieve flatulence. If heartburn occurs, it can be counteracted with appropriate medication or types of tea. Anti-nausea medication may also be prescribed. All medications must be discussed with your doctor or naturopath.
The basic treatment of intestinal fructose intolerance consists of a two- to four-week waiting period. That means: There is no fructose at all. After this test phase, you can slowly approach your own tolerance limit. Only then will the permanent form of nutrition begin. The restrictions should be kept within limits. A complete avoidance of sugar or sugar alcohols is not advisable because it only increases the problem.
It should be noted that sausages, finished products (sorbitol as a humectant), legumes and medicines often contain sugar or accompanying sugars. Sweeteners as derivatives of fructose must also be taken into account.
With an intestinal cleansing, the body can heal, because any existing intestinal overgrowth can be cleaned up. Intestinal cleansing is done gently or is prepared with antibiotics. The latter variant should only be used in severe cases under medical supervision. In the long term, regular fasting (annual fructose abstinence) of about two weeks is helpful.
With the consumption of glucose, the absorption of fructose in the small intestine improves significantly. However, the total fructose content must be taken into account as well as a multitude of other parameters. Since glucose is absorbed more quickly than fructose, there is quickly an excess of fructose. Therefore, more glucose should be consumed than fructose.
But be careful: Only use this trick after the grace period. Also, too much glucose can cause insulin levels to rise. The enzyme glucose isomerase, also known as xylose isomerase, can be used to counteract this. It converts fructose into glucose in the small intestine, but also converts glucose into fructose, creating a balance.
prevention
Unfortunately, there is still no precise information on the genesis (development) of fructose intolerance. Therefore, it can only be recommended to prevent dangerous deficiency symptoms and irritable bowel syndrome. This is not a problem with a nutritionist and in most cases it hardly affects the quality of life at all.
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.