Fructose Malabsorption

Another path on the road to discovery...

I have reached the end of the Whole 30 cleanse, with mixed results.  If you've never heard of the Whole 30, I urge you to check it out:

It is a fantastic program based on the Paleo diet designed to help you kick sugar and eat clean.

Anyway, I went into it whole hog.  Totally psyched, ready to go.  I bought a companion book called Well Fed to teach myself to do weekly batch cooking, to save time preparing meals (lunch and dinner) to ensure that I was eating optimally healthy food every single day.  It was lovely, and beautiful, this food- fresh, local, grass fed meats; organic fruits and veggies, local when available.  Oh, I was so excited!

However, within a few days of starting my poor guts were in complete dismay.  I was bloated, and had so much extreme embarrassing gas; I was miserable to be around my boyfriend.  Hell I was miserable to be around myself.  I was doing everything correctly- portion sizes, balanced plates, enough protein, carbs and fat.  What was I doing wrong?  I tried to pin point what I was reacting to, but it seemed like I was reacting to everything!  

As it turns out, I was.

I began to research coconut, as it seemed the worst offender.  I mean, there I was, almost 2 weeks in, clothes as tight as ever- when all the claims were that by week 2 people were feeling better, clothes looser, sleeping great, feeling awesome.  Me?  No sleep, I was in agony, bloated up and uncomfortable.  When I began to look around, I came upon Fructose Malabsorption.  I recalled reading about that backin '08, just before I discovered Paleo.  Remember- I've been at this a long time!  Back then I was experimenting with Raw, and really working hard to be at my healthiest.  I ran across FM, but was then so swept up into Paleo that I forgot all about it.

Well!  I began to read and discovered some very interesting things.
1.  People with IBS, as they age, become more likely to develop "leaky gut syndrome".
2.  People with leaky gut become more sensitive to different foods, leading the person to assume they have food sensitivities (i.e. "I can't eat gluten"- totally me)
3.  People with IBS, leaky gut- are extremely likely to also be suffering from FM and quite possibly SIBO- small intestine bacterial overgrowth.

I just sat there cringing.  Take a look at the typical FODMAP diet- the diet that helps you avoid the things you can't eat:
Well, the "NO" list pretty much sums up everything I love to eat.

Every night I would fry up some onions and garlic to season my meat... I often ate apples or mango for dessert... avocados were my main source of fat (along with coconut butter, which I blamed for all my symptoms)... and was pounding nuts like it was my job.

Shocking.  I was already on an elimination protocol, with the Whole 30- why not make life more interesting?  Wow- what a boring couple of weeks, but a DRASTIC improvement.  I followed the guideline strictly.  Within 2 or 3 days, I lost 5 inches off my belly because the bloat- both water and gas- went away.  I began to sleep better, finally.  I couldn't believe it.

So what the heck was I eating?

For breakfast, I would drink some home made bone broth.  It's delicious, and helps heal the gut lining and fortify the body.  Great.  Then some eggs (all local, free running) with a small amount of greens like baby bok choy or kale.  (I later found out those need to be eaten with caution, in small amounts.  Sigh.)  Maybe a 1/2 a banana to round it out.  Then for lunch, chicken, string beans and carrots.  To get enough fat, I just ate a spoonful of coconut oil; I was at a total loss on how to fulfill that part- I hate olives.  And for dinner, ground beef with tomatoes, a small amount of green peppers and some hot sauce (carefully chosen to not have "no" ingredients).  In all, not bad, tasty...

I invested in a book called "IBS-free, at last!" which is a more in-depth guide on how to get clear of symptoms.  I've read some conflicting things though.  Different sources argue about which foods will trigger; I've seen some foods listed as OK in one and NO on another.  It's very confusing.  The folks that really seem to know what's going on are out of Australia, Dr.Shepherd and co.  I guess I would trust them first, as they were the ones to pioneer research into this condition.  Either way, it seems to be trial and error for every patient.  The book advocates a strict trial for 2 weeks and then doing challenges on the body with foods to see what is tolerated and what is not.  That makes sense to me.  See, there are 3 categories that are avoided: foods with a lot of fructose, or fructans, or polyols.  For more info on that, read up on some other sites that provide lots of great resources etc.  I'm just stating what I  know here, based on what I've read over the past few weeks.  What I do know is that I am avoiding everything and feel great.

Want to know the kicker?  The safest sweet thing to eat if you have FM is SUGAR.  Yep, you read that right.  What a kick in the pants.  Ideally I guess it's best avoided altogether, but when sweets are wanted, you need to avoid honey, and even powdered Stevia.  No wonder I was reacting!  Powdered stevia is extremely processed and acts like a sugar alcohol (polyol) in the body.  Ppppffffrrrrttt!!!  Yep.

So.  I have been on the FODMAP diet for about a week now, with notable difference.  I'm bored as hell with all this restriction though, but that will improve now that the Whole 30 is over.  I will have to be careful about what I reintroduce, as I'm prone to going crazy over sweet things and I'd prefer not to be a sugar slave again.

I have also read some accounts that FM can be healed.  And that it cannot.  I know "leaky gut" can be healed, by decreasing inflammation.  This is done by strictly following an elimination diet to avoid introducing things which irritate the lining, and by taking herbs to soothe- like slippery elm, licorice herb tea (actually one of my favorites!), glucosamine, and omega fatty acids.  Supposedly following the FODMAP pretty strictly means that those foods can be reintroduced later, but not in large amounts.  The way it's laid out in the IBS book says that you can eat them, but not all together, and not too many of them in a single day.  So it's as if you have a daily allowance of FODMAP foods that you can consume in one day; once you reach your quota, you're done.  Any more than that, and it's Windy City for you!  Well, and pain, bloat, embarrassment...  Symptoms can linger as long as 2 weeks so it really isn't worth it.

If you think this is what you're suffering from, don't be a dolt like me and go it alone- find a dietician or a Dr who knows what IBS and FM really are about.  There is no need to suffer.  There are tests that can be done to determine which type of FM you have- breath tests to figure out which bacteria are prominent based on the type of gases you exhale.  I'm too impatient for that, so I'm doing it the hard way with the elimination (the "poor person's diagnosis"- or the Wise Woman's way, in my mind.)  Don't take my word for it.  Go without those foods for a few days and see what happens, you might bes shocked.  I was.

What does this mean for my future?  I'm going to have to be so careful.  No honey, no stevia.  Limited maple syrup and limited (organic, fair trade) sugar.  Yikes.  Limited apples!  I might die!  Seriously though, it's going to be a tough but rewarding journey if this is truly what is going on.