Fructose intolerance in association with histamine intolerance

Unfortunately, histamine intolerance rarely comes alone. Fructose intolerance or fructose malabsorption is the most common comorbidity of histamine intolerance, even more so than gluten and lactose intolerance.

Currently, about 30% of children and about 20% of adults in Germany are affected.

In this blog post, you will learn about the typical symptoms of this intolerance, possible causes, consequences, and also diagnosis and testing options. Jeanine from our team suffers from fructose intolerance in addition to histamine intolerance and reports on her journey.

Fructose intolerance explained:

Brief description:
Fructose intolerance essentially describes a limited or insufficient absorption capacity of less than 25g of fructose per hour. This is triggered by a transport disorder.

Unlike histamine intolerance, fructose is not broken down by an enzyme, but rather via a transport protein – the GLUT-5 transporter. Its limited absorption capacity can be further inhibited by the additional intake of sorbitol in food. Substances such as L-alanine, L-glutamine, and L-proline can, in turn, promote the absorption of fructose. In addition, the simultaneous intake of glucose can promote fructose breakdown.

When the transport protein is impaired, the fructose is not absorbed initially, but instead enters the large intestine. Here, it is metabolized by the gut bacteria. This process produces gases, which can trigger various symptoms.

Typical symptoms after consuming fructose-containing foods with fructose intolerance or fructose malabsorption

• Flatulence & bloating
• Nausea
• Irregular bowel movements
• Soft stool & diarrhea
• Headaches
• Acne & skin redness
• Extreme fatigue
• Low iron levels

When histamine and fructose intolerance occur together, the search for suitable foods can quickly become complicated. Our organic vegetable broth is suitable for a low-histamine and low-fructose diet, is low-FODMAP, gluten-free, lactose-free, and vegan – and can be used in many ways for cooking and seasoning.

Possible causes of fructose malabsorption

• Gastrointestinal diseases/viral infections
• Dysbiosis of the gut flora (imbalance of gut bacteria)
• Genetic predisposition (Hereditary Fructose Intolerance (HFI) = genetic defect)
• Certain medications

Possible consequences of fructose malabsorption

• Nutrient deficiencies (e.g., folic acid and zinc)
• Immune deficiency
• Anemia

Testing options/diagnosis

Fructose malabsorption can be diagnosed using an H2 breath test. In addition, it is helpful to keep a 7-day food-symptom diary to confirm the diagnosis and rule out a "fructose overload" as the cause of the complaints.

Fructose intolerance and histamine intolerance: personal tips and suggestions

I, too, Jeanine from the HistaFood team, am affected by fructose intolerance in addition to histamine intolerance.

Two years ago, I received a diagnosis of histamine intolerance and switched my diet to low-histamine foods. Nevertheless, after many meals, especially after breakfast with a lot of fruit, I continued to have digestive problems.

I kept a food diary for a while, and my naturopath suspected fructose intolerance at the time.

I then had an H2 breath test for lactose and fructose intolerance at a gastroenterologist's and received the diagnosis.

As a result, I ate a strictly low-fructose diet for a few weeks to relieve my gut. Over time, I became very insecure and thought I should just stop eating any fruit and vegetables at all. Added to this, of course, was the histamine intolerance and the associated restrictions, so I was very frustrated and desperate.

I started researching low-fructose alternatives on the internet a lot and realized that there are also many low-histamine and low-fructose foods. This helped me not to view my diet solely as a restriction and to change my perspective.

Now I cook delicious low-histamine and low-fructose dishes and adapt recipes for myself so that I can also enjoy a homemade piece of cake. My tolerance threshold has increased over time, so I can eat quite a bit of fruit and vegetables again.

Here are a few more tips for you:

• Continue to eat fruit and vegetables in the amounts you tolerate, as these foods contain many nutrients that are important for the body and the gut.
• When choosing foods, pay attention not only to the fructose content but also to a balanced fructose-glucose ratio. Glucose increases the absorption of fructose in the gut.
• Pay attention to the sorbitol content of foods, as sorbitol inhibits the absorption of fructose in the gut.
• Certain foods, especially fruit, are often better tolerated when heated beforehand. For example, even an apple containing fructose can be tolerable in small quantities.
• Depending on the severity of the fructose intolerance, potatoes are often not well tolerated. Therefore, I soak the potatoes in water for 24 hours before consumption. This can help improve tolerance.
• Especially with fructose intolerance, the dose makes the poison - small amounts are generally well tolerated. If I have already eaten a relatively large amount of fructose in the morning, I make sure to eat low-fructose for the rest of the day to prevent complaints.
• Try out new, higher-fructose foods in small quantities every now and then and find your tolerance threshold. It can increase over time as well.
  

Especially when histamine and fructose intolerance occur together, having the right basic equipment can make everyday life with your diet easier. In our HistaBasic set, you will find a selection of foods and supplements for your everyday life. The included foods are suitable for a low-histamine and predominantly low-fructose diet (organic vegetable sauce is not suitable for a low-fructose diet) as well as being gluten-free, lactose-free, and vegan.

*Sources

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