Fructose intolerance in association with histamine intolerance

Unfortunately, histamine intolerance rarely occurs in isolation. Fructose intolerance or fructose malabsorption is the most common accompanying symptom of histamine intolerance, even more so than gluten and lactose intolerance.

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

In this blog post, you'll learn about the typical symptoms of this intolerance, possible causes , consequences , and also diagnostic and testing options . Jeanine from our team suffers from both histamine intolerance and fructose intolerance and shares her experience.

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 by a transport protein – the GLUT-5 transporter . Its limited absorption capacity can be further inhibited by the additional intake of sorbitol in the diet. Substances such as L-alanine, L-glutamine, and L-proline can, in turn, promote fructose absorption. Furthermore, the simultaneous intake of glucose can also promote fructose breakdown.

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

Typical symptoms after consuming fructose-containing foods in cases of fructose intolerance or fructose malabsorption

• Bloating & Distended Stomach
• nausea
• Irregular bowel movements
• loose stools & diarrhea
• Headache
• Acne & skin redness
• extreme fatigue
• low iron levels

Possible causes of fructose malabsorption

• Gastrointestinal diseases/viral infections
• Dysbiosis of the intestinal flora (imbalance of intestinal bacteria)
• genetic predisposition (Hereditary fructose intolerance (HFI) = genetic defect)
• certain medications

Possible consequences of fructose malabsorption

• Nutrient deficiencies (e.g. folic acid and zinc)
• immunodeficiency
• anemia

Testing option/diagnosis

Fructose malabsorption can be diagnosed using a hydrogen breath test. In addition, it is advisable to keep a 7-day food and symptom diary to confirm the diagnosis and to rule out excessive fructose intake as the cause of the symptoms.

Fructose intolerance and histamine intolerance: personal tips and suggestions

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

Two years ago I was diagnosed with histamine intolerance and changed my diet to low-histamine foods. Nevertheless, I still experienced digestive problems after many meals, especially after breakfast with lots of fruit.

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

I then had a hydrogen breath test for lactose and fructose intolerance done by a gastroenterologist and received the diagnosis.

Following this, I followed a strict low-fructose diet for a few weeks to give my gut a break. Over time, I became completely uncertain and thought I should just stop eating any fruit or vegetables altogether. On top of that, there was my histamine intolerance and the associated restrictions, leaving me feeling very frustrated and desperate.

I started doing a lot of research online about low-fructose alternatives and realized that there are also many low-histamine and low-fructose foods. This helped me to stop seeing my diet as just a restriction and to change my perspective.

I now cook delicious low-histamine and low-fructose meals and adapt recipes so that I can also enjoy a homemade piece of cake. My tolerance level has increased over time, so I can eat quite a lot of fruit and vegetables again.

Here are a few more tips for you:

• Continue eating fruits and vegetables in the amounts you tolerate, as these foods contain many nutrients that are important for the body and intestines.
• When choosing foods, don't just look at the fructose content, but also at a balanced fructose-glucose ratio. Glucose increases the absorption of fructose in the intestines.
• Pay attention to the sorbitol content of foods, as sorbitol inhibits the absorption of fructose in the intestine.
• Certain foods, especially fruit, are often better tolerated if heated beforehand. For example, even a fructose-containing apple may be tolerated 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 eating them. This can improve their tolerability.
• Especially with fructose intolerance, the dose makes the poison – small amounts are usually well tolerated. If I've already eaten a relatively large amount of fructose in the morning, I make sure to eat a low-fructose diet for the rest of the day to prevent symptoms.
• Try introducing new foods with a higher fructose content in small amounts from time to time to find your tolerance level. It can also increase over time.
  
  

*Sources

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