{"id":313257,"date":"2024-09-09T10:55:56","date_gmt":"2024-09-09T10:55:56","guid":{"rendered":"https:\/\/www.nahrungsmittel-intoleranz.com\/therapy-for-fructose-intolerance\/"},"modified":"2025-01-05T10:23:34","modified_gmt":"2025-01-05T10:23:34","slug":"therapy-for-fructose-intolerance","status":"publish","type":"page","link":"https:\/\/www.nahrungsmittel-intoleranz.com\/en\/therapy-for-fructose-intolerance\/","title":{"rendered":"Therapy for fructose intolerance"},"content":{"rendered":"\n<p>The treatment of <a href=\"https:\/\/www.nahrungsmittel-intoleranz.com\/en\/what-is-fructose-intolerance\/\" target=\"_blank\" rel=\"noreferrer noopener\">fructose intolerance <\/a>should always be supported by a state-certified and recognized <a href=\"https:\/\/www.nahrungsmittel-intoleranz.com\/en\/expert-search\/\" target=\"_blank\" rel=\"noreferrer noopener\">nutritionist <\/a>. Treatment and a life with a needs-based and tasty diet is possible. <\/p>\n\n<h1 class=\"wp-block-heading\" id=\"h-das-drei-phasen-programm\">The three-phase program<\/h1>\n\n<h2 class=\"wp-block-heading\" id=\"h-karenzphase\">elimination diet<\/h2>\n<div class=\"wp-block-image\">\n<figure class=\"alignleft is-resized\"><img decoding=\"async\" width=\"1024\" height=\"719\" src=\"https:\/\/www.nahrungsmittel-intoleranz.com\/wp-content\/uploads\/\/dane-deaner-1561445-unsplash-1024x719.jpg\" alt=\"Eggs, meat, fish, rice and potatoes are particularly suitable for the elimination phase.\" class=\"wp-image-2195\" style=\"width:300px\" srcset=\"https:\/\/www.nahrungsmittel-intoleranz.com\/wp-content\/uploads\/dane-deaner-1561445-unsplash-1024x719.jpg 1024w, https:\/\/www.nahrungsmittel-intoleranz.com\/wp-content\/uploads\/dane-deaner-1561445-unsplash-300x211.jpg 300w, https:\/\/www.nahrungsmittel-intoleranz.com\/wp-content\/uploads\/dane-deaner-1561445-unsplash-768x540.jpg 768w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\">Eggs, meat, fish, rice and potatoes are particularly suitable for the elimination phase.<\/figcaption><\/figure>\n<\/div>\n<p>In the first two weeks of treatment for fructose intolerance, fructose, sugar and sugar alcohols should be avoided as much as possible to allow the intestines to recover.\nIt is also important to avoid flatulent foods such as pulses, cabbage and too much fiber in the first few weeks.\nAfter around two weeks (maximum four weeks, although the recommendation is two weeks), these foods can then be slowly reintroduced into the diet.\nIt is important to drink 2-3 liters of fluids per day (water, no carbonated drinks, no alcohol).   <\/p>\n\n<p>It is wrong to assume that people with fructose intolerance should no longer consume any fructose at all.\nAfter the elimination diet, you should start with small amounts of fructose &#8211; both free and bound &#8211; and slowly increase the amount.\nCompletely avoiding fructose or consuming too little fructose can worsen fructose intolerance.  <\/p>\n\n<p>The chapter elimination diet is very complex and you should definitely seek advice from a <a href=\"https:\/\/www.nahrungsmittel-intoleranz.com\/en\/expert-search\/\">state-certified nutritionist<\/a>. We have also written a <a href=\"https:\/\/amzn.to\/47lGd5f\">book about elimination diet for fructose intolerance<\/a>, which explains this period in great detail and contains many recipes. <\/p>\n\n<p>As soon as you feel better (which will be soon) and there are no more symptoms, you can end the elimination diet and continue the treatment of fructose intolerance with the test phase.<\/p>\n\n<h3 class=\"wp-block-heading\">Basic points of the elimination diet<\/h3>\n\n<ul class=\"wp-block-list\">\n<li>Always start the elimination diet in consultation with your team of doctors and\/or dieticians<\/li>\n\n\n\n<li>Do you have time to focus on your diet in the coming weeks? The elimination diet should be taken during a stress-free period.<\/li>\n\n\n\n<li>Lent is a good time to do this, as you don&#8217;t have to expect any social pressure because you are fasting.<\/li>\n\n\n\n<li>Concentrate on eating, i.e. don&#8217;t read the newspaper or watch TV at the same time.<\/li>\n\n\n\n<li>Keep a food and symptom diary<\/li>\n\n\n\n<li>Deficiency symptoms: Deficiency symptoms can occur with untreated fructose intolerance due to the intestine-damaging diet.\nYour doctor should therefore carry out blood work before the elimination diet to detect any deficiencies.\nHowever, you don&#8217;t need to worry about developing deficiencies during the elimination diet.\nAfter the elimination diet, however, you should make sure you eat a balanced diet.   <\/li>\n\n\n\n<li>Watch out for additional intolerances or allergies.<\/li>\n\n\n\n<li>Watch out for other illnesses that could make your fast dangerous. This applies, for example, to liver diseases or eating disorders.<\/li>\n\n\n\n<li>You should not start an elimination diet while taking antibiotics.<\/li>\n\n\n\n<li>Don&#8217;t let others influence you. We live in a culture where everyone believes they are an expert &#8211; especially when it comes to nutrition.<\/li>\n<\/ul>\n\n<h3 class=\"wp-block-heading\">Eating and drinking during the elimination diet<\/h3>\n\n<ul class=\"wp-block-list\">\n<li>Use <a href=\"https:\/\/www.nahrungsmittel-intoleranz.com\/tabelle-fructosegehalte\/\">our fructose table<\/a> or the &#8220;<a href=\"https:\/\/www.frag-ingrid.com\/\" target=\"_blank\" rel=\"noreferrer noopener\">Ask Ingrid!<\/a>&#8221; app<\/li>\n\n\n\n<li>Counting grams&#8221; is not useful, as fructose tables only ever give guide values or the experiences of others.<\/li>\n\n\n\n<li>Start the first few days without any vegetables, fruit or sugar.<\/li>\n\n\n\n<li>It is best to drink only tap water and herbal teas (e.g. aniseed-fennel-caraway).<\/li>\n\n\n\n<li><strong>Caffeine and cigarettes:<\/strong> If you only want to drink your coffee or tea with sugar, replace it with stevia products (check the list of ingredients) or dextrose.\nOther sweeteners are not recommended, as many people also have a poor tolerance to them.\nAfter the elimination diet, you can test sweeteners individually and include them in your diet again if necessary.\nIt is even better to remove coffee from your diet completely.\nCaffeine puts the body in a state of stress, which often affects the stomach.\nYou should therefore generally avoid caffeine during the elimination diet.\nCigarettes should also be avoided, as nicotine causes the intestines to become agitated. <strong>Black tea <\/strong>is often &#8211; but not always &#8211; tolerated.       If you can&#8217;t do without caffeine, you should give it a try. The tannins in black tea are good for the stomach. Green tea or mate tea are also usually well tolerated.<\/li>\n\n\n\n<li>Always cook fresh food yourself.<\/li>\n\n\n\n<li>Do not eat ready-made products.<\/li>\n\n\n\n<li>Eat small portions, but rather several times a day.<\/li>\n\n\n\n<li><strong>Flatulence and bowel sounds are normal.  <\/strong>What we tend to forget, especially those of us with intolerances, is that our digestive system is loud and smelly.\nGases and unpleasant odors are produced during digestion.\nOur intestines sometimes gurgle, bubble, pinch and our digestive system lets the resulting gases escape through the only two possible openings, the mouth and the anus.   That is quite normal. Our chair is also sometimes firm, sometimes softer. Not every twinge and gurgle, every soft stool and every burping is a symptom or indication of too much consumption of fructose, lactose, sorbitol or other substances.<\/li>\n\n\n\n<li><strong>Don&#8217;t make any exceptions!<\/strong>  You can cope well with the elimination diet without chocolate or sweet sins.<\/li>\n<\/ul>\n\n<h2 class=\"wp-block-heading\" id=\"h-die-testphase\">The test phase<\/h2>\n\n<p>Depending on your mood, you can start by consuming small amounts of fructose.\nYou should pay close attention to your body&#8217;s reactions &#8211; and continue to keep a <a href=\"\">food and symptom diary<\/a>.  Now you can eat household sugar and long-chain sugars such as inulin or oligofructose in small quantities again. The test phase usually lasts a few weeks to months and varies greatly from person to person.<\/p>\n\n<p>The bottom line is: find out what you can tolerate and don&#8217;t let others influence you!\nEveryone reacts differently to different amounts of fructose and everyone reacts differently to the same amounts from day to day, because the composition of the food, exercise or stress also play a role.\nHowever, this does not mean that every body reaction is due to fructose.\nDon&#8217;t make the mistake of immediately interpreting every twinge and tweak as a symptom.    It is completely normal for the bowels to make noises and for you to have bowel movements from time to time.<\/p>\n\n<p>This test phase should also be accompanied by a qualified nutritionist, especially to prevent deficiency symptoms and unbalanced eating. In particular, the supply of<strong> vitamins and minerals<\/strong> such as vitamin A, vitamin C, folic acid, potassium, magnesium and zinc can be at risk in people with fructose intolerance, as they consume little fruit and vegetables. Well-tolerated types of fruit should therefore be eaten regularly. It can also be useful to take vitamins via dietary supplements (prescribed by your doctor).<\/p>\n\n<p><strong>A few more helpful everyday tips:<\/strong><\/p>\n\n<ul class=\"wp-block-list\">\n<li>Fructose is less well tolerated on an empty stomach than on a full stomach.<\/li>\n\n\n\n<li>Many sufferers tolerate fructose better in the afternoon than in the morning.<\/li>\n\n\n\n<li>High-fat meals slow down the intestinal passage, allowing more fructose to be absorbed.<\/li>\n\n\n\n<li>Exercise reduces intestinal transit, which is why you tolerate less fructose before exercise than after exercise.<\/li>\n\n\n\n<li>&#8220;Light&#8221;\nProducts often contain incompatible sweeteners.\nLight sodas in particular sometimes contain fructose instead of sucrose as a sweetener.\nAlways read the list of ingredients.   <\/li>\n\n\n\n<li>Instead of honey or sugar, you can use rice syrup, erythritol, stevia or dextrose (including rice syrup). You should not use any other syrups! Sugar is usually tolerated in moderation, as it consists of equal parts fructose and glucose. Not all sugar alcohols are incompatible. Xylitol and erythritol in particular are considered to be relatively well tolerated. Please test this individually.<\/li>\n<\/ul>\n\n<h2 class=\"wp-block-heading\" id=\"h-die-dauerernahrung\">The permanent diet<\/h2>\n\n<p>If you know your limits and your digestion a little better, you should move on to permanent diet or long-term diet.\nThis is the last phase of therapy.\nThe aim here is to ensure a near-normal diet which, above all, meets the patient&#8217;s needs and requirements.\nToday, general nutritional guidelines are no longer recommended, but an individually tailored diet.\nThe advantage of individual nutritional therapy is that it can be tailored to the needs and possible other stresses.\nHowever, this type of nutritional therapy should always be developed with a professional and not on your own or through advice on internet forums.     <\/p>\n\n<p>The permanent diet has shown that an annual <strong>fructose fast<\/strong>, i.e. elimination diet of 1-3 days, increases the body&#8217;s ability to tolerate fructose. This recommendation for the treatment of fructose intolerance comes from the observations and feedback of many sufferers here on the nmi portal and is therefore not included in the official recommendations of the professional associations. <\/p>\n\n<h1 class=\"wp-block-heading\" id=\"h-therapie-der-fruktoseintoleranz-akute-massnamen\">Treatment of fructose intolerance: Acute measures<\/h1>\n<div class=\"wp-block-image\">\n<figure class=\"alignleft size-full is-resized\"><img decoding=\"async\" width=\"1024\" height=\"1024\" src=\"https:\/\/www.nahrungsmittel-intoleranz.com\/wp-content\/uploads\/Waermflasche_Tee_KIBing.jpg\" alt=\"Treatment of fructose intolerance, created with KI Bing, 9.9.2024\" class=\"wp-image-313259\" style=\"width:300px\" srcset=\"https:\/\/www.nahrungsmittel-intoleranz.com\/wp-content\/uploads\/Waermflasche_Tee_KIBing.jpg 1024w, https:\/\/www.nahrungsmittel-intoleranz.com\/wp-content\/uploads\/Waermflasche_Tee_KIBing-300x300.jpg 300w, https:\/\/www.nahrungsmittel-intoleranz.com\/wp-content\/uploads\/Waermflasche_Tee_KIBing-150x150.jpg 150w, https:\/\/www.nahrungsmittel-intoleranz.com\/wp-content\/uploads\/Waermflasche_Tee_KIBing-768x768.jpg 768w, https:\/\/www.nahrungsmittel-intoleranz.com\/wp-content\/uploads\/Waermflasche_Tee_KIBing-100x100.jpg 100w, https:\/\/www.nahrungsmittel-intoleranz.com\/wp-content\/uploads\/Waermflasche_Tee_KIBing-500x500.jpg 500w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n<\/div>\n<p>If you forget to follow a diet or simply go overboard, you will be plagued by the usual <a href=\"https:\/\/www.nahrungsmittel-intoleranz.com\/symptome-behandlung-der-fructoseintoleranz\/\">symptoms of fructose intolerance<\/a>. A few tricks can help here: you can place hot water bottles on your lower abdomen. This treatment relaxes the stomach. You can also drink yarrow, fennel, caraway tea and other decongestant teas. Heartburn can be counteracted with suitable medication or teas. Nausea can also be treated with ginger tea, which is low in fructose, or appropriate medication. Please always discuss these measures with your doctor. He or she will work with you to find the right medication.       <\/p>\n\n<p>Of course, it is important not to go overboard in the first place or to avoid the symptoms from the outset.\nIf you get diarrhea, it is advisable to use soft toilet paper and to lubricate the anus with a skin cream or wound healing ointment after a bowel movement. <\/p>\n\n<h2 class=\"wp-block-heading\" id=\"h-der-traubenzucker-trick\">The glucose trick<\/h2>\n\n<p>The absorption of fructose is significantly improved by the simultaneous intake of glucose.\nAs glucose facilitates the absorption of fructose in the small intestine, the intake of glucose can improve the tolerance of fructose-containing foods. <\/p>\n\n<p>What is particularly important here is that glucose is absorbed very quickly, whereas fructose remains in the intestine for a relatively long time.\nThis means that if you consume 1g of fructose and 1g of glucose, you will have an excess of fructose after a short time, as the glucose has been absorbed more quickly.\nIt is therefore advisable to consume more glucose than fructose.  <\/p>\n\n<p><strong>Caution: This trick should only be used rarely &#8211; and after the elimination phase &#8211; as excessive consumption of glucose has negative effects on insulin levels and other nutritional factors.<\/strong><\/p>\n\n<h2 class=\"wp-block-heading\">Enzyme for ingestion<\/h2>\n\n<p>Help is now also available in tablet form for intestinal fructose intolerance: the enzyme <strong>xylose isomerase<\/strong> (often also called glucose isomerase).\nThis enzyme converts fructose into glucose in the small intestine, but also glucose into fructose.  In principle, the &#8220;glucose trick without glucose&#8221; is used here, as the fructose eaten is converted to glucose and then absorbed. The enzyme has the property of always wanting to create a balance between fructose and glucose.\nThis means that if equal amounts of both sugars are present, it no longer converts fructose.  However, as glucose is absorbed very quickly, there is no equilibrium in the intestine and almost all the fructose can be metabolized. In theory, however, this also means that an additional intake of glucose would suppress the effect. But the glucose is absorbed so quickly that even then there is an imbalance. This means that if you take this enzyme, you don&#8217;t need any more glucose.<\/p>\n\n<h3 class=\"wp-block-heading\" id=\"h-einnahmeempfehlung-und-produkte\">Recommended intake and products<\/h3>\n\n<p>Important: The enzyme is deactivated above approx. 60\u00b0C, which means that you should not open the capsules and stir them into hot food or leave them in a hot car while on vacation.\nIt is best to take the capsules whole with plenty of water directly before a meal rich in fructose.\nPlease always refer to the package leaflet of the respective product.  <\/p>\n\n<h3 class=\"wp-block-heading\" id=\"h-warum-ein-enzym-zur-therapie-einnehmen-bei-einem-transportprotein-problem\">Why take an enzyme as therapy for a transport protein problem?<\/h3>\n\n<p>Fructose is transported<a href=\"https:\/\/www.nahrungsmittel-intoleranz.com\/en\/fructose-intolerance-what-happens-in-the-body\/\" target=\"_blank\" rel=\"noreferrer noopener\"> through the small intestinal mucosa<\/a> by the transport proteins<a href=\"https:\/\/www.nahrungsmittel-intoleranz.com\/en\/fructose-intolerance-what-happens-in-the-body\/\" target=\"_blank\" rel=\"noreferrer noopener\"> GLUT-5<\/a>, among others. If these transporters are missing or do not function properly, the fructose reaches other parts of the intestine, is digested by the bacteria living there and the typical symptoms occur. The orally ingested xylose isomerase intervenes beforehand and converts the fructose into glucose in the small intestine, which can then firstly also be absorbed via other transport mechanisms (GLUT-2, SGLT-1) and secondly sets the &#8220;glucose trick&#8221; in motion.<\/p>\n\n<h3 class=\"wp-block-heading\" id=\"h-helfen-diese-mittel-auch-bei-sorbitintoleranz\">Do these remedies also help with sorbitol intolerance?<\/h3>\n\n<p>No, as described above, fructose is converted into glucose and vice versa. However, sorbitol is not metabolized. Therefore, these products do not help if you have a sorbitol intolerance. In the case of pure fructose intolerance, sorbitol can also lead to problems, as it impairs fructose absorption.\nThis means that the little bit of fructose that someone with fructose intolerance could absorb is not absorbed.\nHowever, if no fructose is present because it has been converted by xylose isomerase, sorbitol &#8211; in small quantities &#8211; does not cause any problems, even if you are fructose intolerant.\nThis is because there is no fructose involved and small amounts of sorbitol, without having fructose in the intestine at the same time, are not a problem with fructose intolerance.   <\/p>\n\n<h3 class=\"wp-block-heading\" id=\"h-quellen\">Sources:<\/h3>\n\n<p class=\"has-small-font-size\">1) Rainer Klinke, Hans-Christian Pape, Stefan Silbernagl (eds.): <em>Lehrbuch der Physiologie<\/em>, 5th edition.\nThieme, Stuttgart 2005<br\/>2) Zechmann-Khreis, M., Nahrungsmittel-Intoleranzen:   <em>Elimination diet, healthy eating &amp; well-being: Understanding and living with lactose, fructose, histamine.\nNutrition guide with over 100 recipes and a nutrition plan <\/em>, MZK verlag, 2020<br\/>3) Denisova, V., &amp; Rubin, D. (2022).\nLactose and fructose intolerance. <em>Tagliche Praxis<\/em>, <em>65<\/em>(4), 581-595.<br\/>4) Benardout, M., Le Gresley, A., ElShaer, A. &amp; Wren, S. P. Fructose malabsorption: causes, diagnosis and treatment.   <em>Br.\nJ. Nutr. <\/em> <strong>127<\/strong>, 481-489 (2022).<br\/>5) Tuck, C. J., Ross, L. A., Gibson, P. R., Barrett, J. S. &amp; Muir, J. G. Adding glucose to food and solutions to enhance fructose absorption is not effective in preventing fructose-induced functional gastrointestinal symptoms: randomized controlled trials in patients with fructose malabsorption.  <em>J. Hum. Nutr. Diet.  <\/em> <strong>30<\/strong>, 73-82 (2017).<br\/><br\/><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The treatment of fructose intolerance should always be supported by a state-certified and recognized nutritionist . Treatment and a life with a needs-based and tasty diet is possible. The three-phase program elimination diet In the first two weeks of treatment for fructose intolerance, fructose, sugar and sugar alcohols should be avoided as much as possible [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":313260,"parent":0,"menu_order":21,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_lmt_disableupdate":"","_lmt_disable":"","wprm-recipe-roundup-name":"","wprm-recipe-roundup-description":"","footnotes":""},"class_list":["post-313257","page","type-page","status-publish","has-post-thumbnail","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Therapy and treatment of intestinal fructose intolerance<\/title>\n<meta name=\"description\" content=\"What you can do to treat fructose intolerance. 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