Fructose And Anxiety

[India]

I was following the FODMAPS diet for a while but recently reintroduced a number of foods into my diet, especially apples and pears. I'm pretty sure these don't agree with me but due to our complicated UK health service, I need to wait to see a hospital consultant who can refer me for a fructose intolerance test.

Thing is, my anxiety is back and it's bad! It was terrible before going gluten and soy-free but I'd almost forgotten how it was to live this way. I'm working longer hours and somewhat stressed at present but I shouldn't be this bad. I wonder if reintroducing other troublesome foods has caused it - so, has anyone else experienced fructose/FODMAPs-related anxiety?

Thanks for any advice you can offer

[gf-soph]

I haven't personally as I haven't got to the reintroduction stage to find out. But I do know that others on the FM yahoo group I'm on have definitely commented on it.

For people with FM, undigested fructose can bind to tryptophan and stop it absorbing. Tryptophan is a precursor to serotonin, which is important for regulating mood. So there is a physiological reason why fructose can impact on mood!

[cassP]

oh wow... i never thought that fructose malabsorption could be linked to anxiety ?? i was only aware of the DEBILHITATING "LABOR LIKE" doubled over PAINFUL CRAMPING

hmmm

& u mention your health care system and waiting for an intolerance test... i never had one- i diagnosed myself. of course i understand wanting the answers.. i was like that with Celiac. but after i connected the dots- and eliminated high fructose situations- that was enough for me.

i guess maybe in the future i'll test out apples or pears... but idk- the pain is way too fresh in my mind

im still testing my limits from time to time with onions & garlic... cause i LOVE my food, and i cant cut everything out... plus the dont kill me like pears, dates, and prunes

[India]

Thanks for your replies! I'm really interested to hear about the fructose/tryptophan/serotonin link, which would make a lot of sense.

I'm going to eliminate apples, pears etc again but so many foods make me feel unwell that I think a fructose intolerance test would be a useful thing to do. I really struggling with eliminating foods because each time I eliminate several things, I start to get my tell-tale symptoms of being run-down, which especially worries me as I'm doing this without much professional support. I tried an elimination diet over summer but felt completely spaced out and lost so much weight I missed a period.

If I had a positive fructose intolerance test, it's also something definite I can show my GP to suggest that maybe I don't just have IBS and my tiredness and brain fog are in fact not caused by depression (a coeliac diagnosis wasn't enough to convince him...)

[cassP]

Thanks for your replies! I'm really interested to hear about the fructose/tryptophan/serotonin link, which would make a lot of sense.

I'm going to eliminate apples, pears etc again but so many foods make me feel unwell that I think a fructose intolerance test would be a useful thing to do. I really struggling with eliminating foods because each time I eliminate several things, I start to get my tell-tale symptoms of being run-down, which especially worries me as I'm doing this without much professional support. I tried an elimination diet over summer but felt completely spaced out and lost so much weight I missed a period.

If I had a positive fructose intolerance test, it's also something definite I can show my GP to suggest that maybe I don't just have IBS and my tiredness and brain fog are in fact not caused by depression (a coeliac diagnosis wasn't enough to convince him...)

WHAT?????!!!!!! so, you're a diagnosed Celiac- and your GP thought that had NOTHING to do with Ibs, depression, or brain fog?????? Good LORD... i really should become a doc OY VEY

i understand wanting answers. i would avoid the big culprits like pears, dates, prunes for now just to be happy...

also- if you're fatigued- you may want to test for thyroid, and any vitamin deficiencies- and ask for the test results yourself- for example- a doc might tell his patient his B12 is "fine" when in fact it might be 2 points away from causing Neuropathy

so ya... these docs are crazy

there are reasons for your "Ibs" and feeling fatigued & depressed or anxious.

good luck

[gf-soph]

The thing about fructose and fodmaps is that it isn't like gluten and celiac where you have to totally avoid them. Often you have some amount that you can tolerate, you can get a lot of information about the best way to test it out.

If you're only bothered by fructose, there are ways to minimise symptoms e.g. choose safe fruits, or have small amounts of problem foods and combine with sucrose or dextrose.

Are you working off the most recent information about what fruits and veggies contain fructose and fructans? The lists to change over time. I definitely react to a wide range of fructans but I hope to be able to work out a safe amount over time. I'm about to try out some legumes, and a good tip is to soak them for 12 hours in water with some bicarb soda, it helps to reduce the raffinose in the legumes.

With the garlic, have you tried making garlic oil? Some of the people in the group make it by soaking several cloves of garlic in oil, then removing the garlic and using the oil. The sugars aren't oil soluble, so you can get the garlic flavour without the problematic sugars. Likewise you can try frying onion in oil, then removing the onion and cooking with the oil. Could be worth a try!

[India]

Cass - Yup, my doctor is a muppet He understands I have coeliac disease but thinks I also have IBS. I've explained that for me prunes have the opposite effect to most people but he doesn't really grasp the idea of additional food intolerances causing ongoing problems. He especially doesn't recognise non-GI issues as coeliac/intolerance symptoms. Massively helpful, he is. My B12 was pretty low (240s) but he doesn't like supplements (though he loves prozac) so I bought my own sublinguals and my last test had improved some at a little over 300, yay. I've had my thyroid checked and it was ok.

I'm cutting out the high fructose fruits again for sure. I do think my problems built up over a few days so I need to figure out what I can tolerate.

Soph - I've found myself confused by the different FODMAP lists out there - if you can recommend a recent one, I'd be really grateful. I'm intrigued by the raffinose/bicarb trick as I'm trying to eat as widely as possible. Garlic oil sounds good too - my onion-free, garlic-free lasagne was pretty bland! Do you try the trick of cooking with onion but taking it out of the finished dish?

Thanks to both of you btw

[gf-soph]

The best lists are available on the fructose malabsorption yahoo group, as members upload the lists given to them by dieticians. There is a 2010 updated FODMAP handout by Sue Shepard, who is the pioneer in the area. There are also research papers that have worked out the exact composition available there. If in doubt about lists, trust ones by Shepard or ones that are linked in to published research.

There's also a great article by Barrett and Gibson (Clinical Ramifications of Malabsorption of Fructose and Other Short-chain Carbohydrates) that is a great overview of the area. It's also available on the yahoo group page.

I'm doing a very strict elimination diet at the moment so haven't been trying out the garlic and onion ticks yet, but I'm assured they work. It makes sense as it's the various sugars in FODMAPS that cause problems, and sugars dissolve in water, and either not well, or not at all in oil (not sure). I'm not sure why the bicarb works, but I found a research paper that showed that the levels of raffinose did decrease more when soaked in bicarb and water compared with just water.

Hope you have some luck with cutting down on the fodmaps, I think it's something that can help a lot of people if they just knew about it!

Sophie

[cassP]

India- 240s is TOO LOW! i think you should take sublinguals and then test your level in a few months... some members say you can overdose, but i think if you test your levels and make sure they're in range, you would be fine. mine was 640- i was shocked cause im so fatigued- but maybe it's my thyroid.

for me: i avoid pears, apples, prunes, grapes, dates, raisins.

i can do 1/2 of a mango

bananas are best eating more ripe- and i stick to just 1/2.

adding a tsp of regular table sugar to a banana or mango helps too.

garlic and onions i keep to a minimum. green onions bother me more. lettuce and romaine bother me more than baby greens & mixed herbs. even with the mixed greens, i still need to not overdo it. i think too adding fats & proteins to the salad can help balance out any fructose.

gf_soph: omg, legumes wreck my digestive tract. i wonder tho if it matters what form it is in. because im fine usually with hummus... but i had an indian dish weeks ago with WHOLE garbanzo beans in it- and i was in AGONY, like i had eating 5 Prunes, or 1 Pear

[India]

Thanks, Sophie! I'll have a look at the group. I'm aware of Sue Shepherd but I'll check if I'm using the latest list.

Good luck with your elimination diet

[India]

Yup, I think 240-odd is way too low, especially as I can have so many of the B12 deficiency symptoms. I'm taking sublinguals and I'm encouraged by the small improvement I saw in my last blood test.

I'm really not sure what I can tolerate or not. I tried a pretty strict FODMAP diet and didn't think I had seen much improvement. Pretty much everything still made me bloat and the waves of tiredness still bothered me, so I abandoned it when I had to go away for two weekends last month and it wasn't practical. Also, I get very rundown every time I rule out lots of different foods and I start getting sick. Some problems have definitely gotten worse though, so after tomorrow (because I bought a gorgeous gluten-free, corn-free, soy-free lemon cake I'm not about to waste!) I'm going to cut processed foods and all FODMAPs. Do you have any advice on identifying the worst offenders? I don't want to lose weight and make myself ill by missing out on foods unnecessarily.

[cassP]

i dont have very good advice as far as fodmap- BECAUSE all of us have kind of figured out trial and error. everyone seems to have a different relationship with fructose and fructans.

for ME: my biggest avoids are: Pears, Dates, Apples, Apple Juice, Grapes, Prunes. (i can do ONE prune, or ONE bite of a Lara bar, maybe a TINY handful of raisins- and that is IT)

still workin out the veggies- i dont eat salad alot, but when i do- its baby greens & NOT romaine or boston head).i have to minimize my garlic, sweet potatoes, parsnips, peas, onions, bell peppers. (i thought i was getting to where i could handle these veggies- but the shephards pie & RAW carrot/garlic dip i made this week had me bedridden one night... last night i had my shephards pie (w/sweet potatoes), but no garlic dip, plus i addded REGULAR table sugar to my iced tea--> and i was ok.) **sometimes adding the sugar to the meal can counteract some fructose.

legumes- i try to avoid. ( i know from a different diet that i TOTALLY believe in have experienced- that legumes do not do well with me.) like i said above- i have been okay with hummus, but an indian dish i had a month ago with whole garbanzo beans ruined the rest of my day and night- i was miserable.

in general- i do much better on a paleo/caveman type diet.

good luck hope i didnt confuse u

[gf-soph]

Yup, I think 240-odd is way too low, especially as I can have so many of the B12 deficiency symptoms. I'm taking sublinguals and I'm encouraged by the small improvement I saw in my last blood test.

I'm really not sure what I can tolerate or not. I tried a pretty strict FODMAP diet and didn't think I had seen much improvement. Pretty much everything still made me bloat and the waves of tiredness still bothered me, so I abandoned it when I had to go away for two weekends last month and it wasn't practical. Also, I get very rundown every time I rule out lots of different foods and I start getting sick. Some problems have definitely gotten worse though, so after tomorrow (because I bought a gorgeous gluten-free, corn-free, soy-free lemon cake I'm not about to waste!) I'm going to cut processed foods and all FODMAPs. Do you have any advice on identifying the worst offenders? I don't want to lose weight and make myself ill by missing out on foods unnecessarily.

I can't remember if I've asked already, but are you seeing a dietician through this? If not, can you? Are you able to find any basic nutritional supplements to take? There's no way I would have lasted on this elimination diet if I wasn't using sustagen. It has dairy and I think soy so it's no good for a lot of people, but you might be able to find some sort of supplement that is ok for you? You don't want to make yourself unwell or run down because of missing out on basic nutrition, which is what a dietician can also help with.

I would suggest that if you are still feeling very unwell and the fodmaps don't help that it might be worth looking into the RPA elimination diet instead. I've posted a bit about it and don't want to go on about it too much, but it helped with a lot of my more severe symptoms, especially restoring my normal mood, lifting brain fog, better digestion etc. It is hard work and it much better done with a dietician who can guide you, but it can work wonders and it has for me.

And basic advice - are you keeping a very detailed food and symptom diary? As you probably know a lot of food reactions can be delayed or build up over different meals, so diaries really are invaluable. List any symptoms you have and give them a severity score from mild to severely interfering.

Hope you find a combination that works out for you, I know how much of a pain it is!