Letzte Aktualisierung am 7. December 2023 von Dr. Michael Zechmann-Khreis
Fatty liver due to fructose intolerance?
Whether fructose intolerance is associated with non-alcoholic fatty liver disease(NAFLD) or its “inflammatory” form, the NASH syndrome (non-alcoholic steatohepatitis (inflammation of the fatty liver) is associated with steatohepatitis. still being hotly debated. There are now several studies on humans, who consider a connection to be probable. In fact The connection between excessive Fructose feeding and fatty liver already in animal experiments (rats), as well as in a study on the influence of excessive fructose and sugar consumption on the fatty degeneration of organs in fat people.
It is repeatedly reported in Internet forums that many people with fructose intolerance suffer from a fatty liver. There could be many reasons for this. Whether there is a direct connection will certainly be investigated in the coming years. It is interesting to note that increased IgE levels can occur in NASH6).
A connection cannot therefore be clearly confirmed at present.
Symptoms of fatty liver
Fatty liver usually causes no or only very minor symptoms! Some symptoms that occur repeatedly and have been described by some patients are
- Feeling of fullness
- Lack of drive / cf. depression with fructose malabsorption
- Feeling of pressure in the right abdomen
- Discomfort when lying on the right side (nausea, pain)
- General physical and mental reduction in performance and lack of drive
What to do about fatty liver?
This question cannot be fully answered here, as the cause of the fatty liver must be determined! Only your doctor can do this!
In our western world, the phenomenon of an “affluent liver” is becoming increasingly common. It is quite normal for the liver to store fat droplets. If you eat too much and consume too many calories, the amount of fat in the liver increases. The liver becomes fatty and turns into a “fatty liver”. This form of fatty liver can disappear again through dietary measures and exercise. The aim is to exercise and minimize calorie intake. Sugars (mono- and disaccharides) are the main contributors here. Therefore, you should not consume more than 25-50 grams of such added sugars (lactose, fructose, sucrose, …) per day. Added means that they do not occur naturally in food. In other words, sugar in fruit is ok, sugar in coffee or sausage is not. Recent studies show that a balanced microbiome (intestinal flora) can contribute to an improvement in fatty liver disease8), although the data situation here is still relatively uncertain and new findings can be expected in the coming years.
- Abstaining from alcohol
- Low-fat and low-fructose or low-sugar diet (less than 25 added sugars per day)
- Balanced endurance sport, plenty of exercise in the fresh air
- Slow weight normalization
- Intake of certain intestinal bacteria – in consultation with the doctor
- No smoking4)
Depression and fructose intolerance?
There can be various reasons for depressive moods due to fructose intolerance.
According to a study7) , fructose malabsorption is associated with reduced absorption of the amino acid tryptophan, i.e. slightly less tryptophan is detectable in the blood of fructose malabsorbers than in the blood of non-intolerant people. Tryptophan is converted into the happiness hormone serotonin in the body. If little tryptophan is available, only little serotonin can be produced. The fatal thing is that the body knows that it needs tryptophan and you are inclined to eat more foods that contain this substance. However, almost all of these foods also contain a lot of fructose. You also often hear that you should eat more fruit, as it is healthy and helps. However, this does not help, but drastically worsens the situation if you have intestinal fructose intolerance. However, this study has never been reproduced or is debatable. Therefore, this effect has not been proven. It is therefore not advisable to take tryptophan without a previous blood count.
However, depressive moods (not depression) and fructose intolerance often occur together. There can be various reasons for this. If the intolerance is not treated and the body continues to consume fructose, the symptoms described will occur. In the long term, these symptoms also lead to a deterioration in mental and social health. Other possible causes are the psychological stress to which patients are exposed. The social isolation into which a patient with undiagnosed fructose intolerance falls should be mentioned here in particular. Due to the diarrhea and constant nausea, patients withdraw more and more from social life, planning their leisure time more according to available toilets than fun. Other intolerances and their physical consequences can also exacerbate depressive states.
Fructose intolerance can therefore be associated with depressive symptoms in several ways. be associated with mood swings. A medical clarification of all options is always recommended!
In the case of severe depression, medical clarification is urgently required!
How do I get rid of depression?
If the depressive states are exclusively (!) due to fructose intolerance, they are very likely to disappear if an appropriate low-fructose diet is followed. You can also take tryptophan as a dietary supplement as a precaution. Here it is important to consult the doctor treating you, who must first determine an actual deficiency via the blood. In addition, taking tryptophan is certainly associated with health risks, which is why this substance should never be substituted without medical supervision.
(1) Lesurtel M., Graf R., Aleil B., et al, Platelet-Derived Serotonin Mediates Liver Regeneration, Science, April 7, 2006
(2) Ledochowski M, Widner B, Bair H, Probst T, Fuchs D.; Fructose- and sorbitol-reduced diet improves mood and gastrointestinal disturbances in fructose malabsorbers; Scand J Gastroenterol. 2000 Oct;35(10):1048-52.
(3) Stanhope, K.L.; Schwarz, J.M.; Keim, N.L.; et.al; “Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans” in The Journal of Clinical Investigation, doi: 10.1172/JCI37385
(4) Mallat, A.; Lotersztajn “Cigarette smoke exposure: A novel cofactor of NAFLD progression?” in Journal of Hepatology 51 (2009) 430-432, 2009
(6) personal Interview, Univ.Doz.Dr. A. Provost
(7) M. Ledochowski, B. Widner, C. Murr, B. Sperner-Unterweger & D. Fuchs “Fructose Malabsorption is Associated with Decreased Plasma Tryptophan”, Scand J Gastroenterol 2001 (4)
(8) Boursier, J; Maeh Diel, A; “Nonalcoholic Fatty Liver Disease and the Gut Microbiome”, Clin Liver Dis, 2015