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Fructose Malabsorption and fatty liver disease

There is still some fierce discussion over whether dietary fructose intolerance is connected to non-alcoholic fatty liver disease (NAFLD) or its more severe form, the NASH syndrome (non-alcoholic Steatohepatitis). Several research projects have been conducted on humans up to now which conclude that a connection is possible. It has in fact been proven in animal experiments (rats) that there is a connection between increased feeding of fructose and a fatty liver, as well as in a study on the influence of excessive ingestion of fructose on the fatty degeneration of organs in people who are overweight.

fatty_liverThe fact is that many people affected by fructose malabsorption also suffer from a fatty liver. This can be down to many reasons. Whether a direct connection exists will surely be the subject of research in years to come. Another possible cause is the psychological stress to which patients are exposed. Special attention should be drawn to the social isolation of patients if the condition remains undetected. Because of the effects of diarrhoea and the continuous feeling of nausea many patients withdraw more and more from their social surroundings and plan their leisure time more and more according to where they can find available toilets rather than having fun.

Symptoms of a fatty liver

A fatty liver does not cause any symptoms most of the time, and in some cases only causes very minor symptoms! Some symptoms that have appeared repeatedly and have been described by several patients are:

  • Feeling of fullness
  • Lack of drive/ see also "Depression and fructose malabsorption"
  • Feeling pressure in the right of the abdomen
  • Discomfort when lying on the right side (nausea, pain)
  • Flatulence, wind
  • General physical and mental deterioration of performance and drive

What do I do to counter a fatty liver?

This question cannot be fully answered here as it is necessary to assess the cause of the fatty liver! This can only be done by a medical professional!

General advice:

  • Complete avoidance of alcohol
  • Low-fat and low-fructose diet
  • Well-balanced endurance sports regime (no extreme sport!)
  • Normalisation of body weight
  • Specified course of treatment for liver disease, for example with milk thistle extract (watch out for added lactose and/or sorbitol)
  • Stop smoking

Depression and fructose malabsorption

Fructose malabsorption goes hand in hand with the malabsorption of the amino acid tryptophan, which means that too little tryptophan is being absorbed from the food. Tryptophan is metabolised into serotonin, the "happy" hormone. If there is no tryptophan, then no serotonin can be produced. This appears to be an important fact if you consider the most recent findings, according to which serotonin is important for the healing process in liver cells. Read more in the Food Intolerance Network article: Fructose malabsorption and depression

If you have been given a diagnosis of fructose malabsorption, then it certainly won't harm to have your liver values checked out!

Sources include:
(1) Lesurtel M., Graf R., Aleil B., et al, Platelet-Derived Serotonin Mediates Liver Regeneration, Science, 7.April 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

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