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Fructose Malabsorption: Nutrient Deficiencies and Symptoms to Watch Out For

Updated on July 13, 2013

When the foods you eat cause digestive upset, they move through the digestive tract too quickly; this is why nutritional deficiencies occur -- your body doesn't have enough time to absorb the nutrients in the food. Some of the symptoms of fructose malabsorption can be attributed to nutritional deficiencies. Those below are all interconnected to one another - for instance, folic acid deficiency can lead to anemia; so it is important to address each nutritional deficiency and their symptoms as just one small piece of a bigger dietary puzzle.

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Folic Acid and Folate Deficiency

Folic acid is important in the development of red blood cells and in regulating iron levels in the body. Folic acid deficiency is a risk factor for cardiovascular disease, so it is important to make sure you are getting enough. Other symptoms of low folic acid include:

  • Anemia
  • Brain fog
  • Behavioral and mood disorders
  • Diarrhea (like we need anymore of that!)
  • Headaches
  • Heart palpitations
  • Mental depression
  • Pregnancy complications
  • Sore or swollen tongue

The American Association for Clinical Chemistry says that folic acid deficiency in fructose malabsorbers is due, in part, because a lot of our folic acid intake derives from intestinal bacteria. People with fructose malabsorption usually have unbalanced intestinal flora, which leads to a lack of available folic acid.

Folic acid sources:

Leafy vegetables are the primary naturally-occurring source of folic acid; but many products, like breakfast cereals, are fortified with folic acid.

Zinc Deficiency

Zinc is a mineral that plays an essential role in brain functioning and the health of the reproductive organs. It is also a necessary part of the enzymatic reactions that must take place in order to digest proteins.

Zinc deficiency can cause sexual dysfunction, hair loss, diarrhea, brain fog, lack of appetite and other symptoms.

Foods with the highest levels of dietary zinc are oysters, lobster and red meat. Other sources include soy products, sea vegetables, beans, nuts and seeds. Like folic acid, zinc is often a fortified ingredient in packaged foods.

Iron Deficiency Anemia

Iron deficiency is probably the most common and most recognized nutrient deficiency on this list. Iron deficiency anemia is characterized by fatigue, pale skin, head rushes upon standing, restless legs and a compromised immune system. Anemia can be inherited or dietary-related, but the reason it needs to be addressed is that low levels of iron in the blood prevent adequate oxygen from reaching the brain.

Here is a nice list of iron rich foods to look over. In addition to eating foods high in iron, make sure not to drink tea with your meals. The tannins in tea will leach minerals like iron and calcium from your food, keeping them out of your bloodstream.

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Tryptophan and Depression

Tryptophan is an essential amino acid, and fructose malabsorption makes it harder for the body to absorb it in the intestines. When tryptophan levels drop too low, then you become deficient in serotonin. This leads to early signs of mental depression, which is a very common symptom in people with fructose malabsorption and IBS.

It is possible to increase tryptophan levels by eating a high-protein diet, which is recommended for fructose malabsorbers anyway. FructMal-safe sources of tryptophan include:

  • Beans (as long as you can tolerate galactans)
  • Dairy products (if you aren't lactose intolerant)
  • Eggs - highest
  • Fish
  • Oatmeal
  • Poultry
  • Pork
  • Red Meat
  • Sesame and pumpkin seeds
  • White rice
  • Potatoes (russet) - lower levels

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Vitamin D Deficiency

Vitamin D is important for calcium absorption and bone health. Vitamin D deficiency causes premature aging, muscle weakness, fatigue and joint pain. Most people already know that sun exposure is a good way to increase your level of vitamin D, but if you have fructose malabsorption, there is a good chance it won't be enough. Consider supplementation.

Now that you know what nutrients you need more of, the next step is to ensure better absorption of the foods you do eat.

Digestive enzymes help with bloating and gas and improve nutrient absorption

Even on a very restrictive diet, fructose malabsorbers will often have lingering digestive symptoms that seem to have no explanation. By the time most people are diagnosed, the intestines are damaged and can have an imbalance of good and bad bacteria. Until this is resolved, digestion of any food at all, even the most well tolerated, can cause distress to the intestines.

It might be helpful to speak to a dietitian about your remaining symptoms to try to pinpoint a culprit in something you are eating, but you may find that taking a digestive enzyme with meals is enough to give your gut that extra little boost it needs. Oftentimes, because of the processed nature of our foods, the body is not getting enough necessary digestive enzymes (they are stripped from the food during processing), so supplementation is necessary.

Address multiple nutrient deficiencies with "super foods"

Nutritional yeast is packed with nutrition for people like us. A sprinkling of nutritional yeast gives foods an added boost of B-vitamins, folic acid, selenium, zinc and protein (great for vegetarian FructMals). Plus, it adds flavor to your foods. Those with fructose malabsorption can struggle with trying to find ways to add flavor to meals, now that so many things are off limits. Nutritional yeast incorporates a "cheesy" flavor to dishes, which is especially nice for those who can't eat dairy, either. Start small, though, to make sure you can tolerate it; and those with candida issues will want to avoid it entirely.

If you aren't eating chia seeds, you probably should be. According to WebMD, one ounce (2 T) of chia seeds contains 4 grams of protein and 11 grams of fiber. Add to that a healthy dose of omega-3 fatty acids, antioxidants, and calcium, and you've got one powerful little super food. Sprinkling these on your morning cereal or into a bowl of oatmeal will help a carb heavy breakfast keep you full until noon. Add them to a salad or make some chia pudding for an afternoon snack.

Now that you have a diagnosis, it's time to start eating for optimal health. If you aren't getting enough nutrients in your diet, either because you are still having FructMal symptoms or because your elimination diet isn't varied enough, it is important to do something about it before any long term side effects take hold.

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      ashleigh 2 years ago

      If you have trouble absorbing nutrients its best to avoid synthetic vitamins like folic acid,its much harder to absorb synthetic so do ur research and find the best absorbable form