unsure of FM vs HFI

[ann]

Hi, thanks for a wonderful site. Lots of good info.

So, I'm new to this, and wondering if I have FM or HFI (unlikely, as I'm 50 yrs old). I'm scheduled to have a breath test of FM on June 12, and am getting nervous about going through with it based on what I've read here, and how much better I've been feeling in just 10 days of getting fructose out of my diet...am afraid of making myself ill all over again.

So, I'm 50, sickly as an infant, fussy, spitting up a lot, always covered with skin rashes, etc. Did ok until about age 12, during which time I liked some sweet stuff, but avoided the really sweet stuff if allowed: didn't like raisins or sugar in my oatmeal, disliked bananas and raisin cookies and grapes that my mom usually packed for me, emphatically didn't like syrup on my pancakes, and developed a dislike of doughnuts from a very young age. But I did like other fruits, just didn't eat a lot of them. Was always very thin as a child, but with a very distended belly much of the time.

From my teens on, always never quite well, developed severe, frequent migraine, that I soon started calling "sugar headaches" as they always seemed to come on after eating something sweet. Have continued to be plagued by almost daily headaches, until the past week, when they seem to have just evaporated on avoiding fructose!!! This is nothing short of a miracle, to be an entire week headache-free. (The main reason I'm scared of the oral fructose challenge for the breath test). Most days for years I've had low grade nausea (that I've blamed on the migraines) and a distended belly in spite of being very thin.

At age 40 I was diagnosed with diabetes thought to be an adult form of type 1 diabetes, the autoimmune kind, even though antibody tests were negative. I was about 90 lbs, 5'1" and they didn't think it was the more common type 2 diabetes. I needed insulin to control it, until I changed my diet, and now I can just barely diet-control it without insulin. Very interesting to me, after being off fructose just 10 days, the blood sugar is noticeably better, in spite of eating a LOT of rice. I have had numerous episodes of hypoglycemia after eating, (not related to any insulin use, as I've been off insulin for about 8 years now, and the oral diabetes pills they tried me on never helped lower the sugar, so never continued them). My sugar has been as low as 44 by my meter after eating. Off fructose now, I'm not getting nearly so many hypoglycemic episodes.

Other things I experience very shortly after eating are lightheadedness, sudden fatigue/weakness, and sometimes, sleepiness. These are better, too, in just a week, though not completely gone.

My synthroid (thyroid) pill, which I take on an empty stomach, usually has caused mild nausea for about an hour after taking...just looked it up, and it contains "confectioners sugar" as a filler.

Only other medical thing is that my cholesterol and triglycerides run high, and in the past have had unexplained elevated liver enzymes (during a time I WAS eating a lot of sugar), and high uric acid levels.

My dad, who is also very thin, and also with an atypical diabetes (for which he does use insulin) was sickly as a child and says his mother was very careful with his diet as he had multiple food allergies. He said he's always been "allergic" to fruits, vegetables, and whole grains; his preferred food were always meat, dairy, and processed white flour products. My mom, disgusted, said he's conveniently allergic to anything with nutritional value. Over the past several years, he's developed mild kidney disease (in spite of very good diabetes control).

For the past several years, I've followed Dr. Fuhrmans high vegetable diet (vegan, with lots of beans, vegs, and fruits) in an attempt to get rid of headaches, and improve my lipids...lipids have improved (but still too high), and the rest of my symptoms got a lot worse, especially the headaches and fatigue.

So I really don't know if I have bad FM, or if HFI is a possibility. I'd like to continue to avoid meat, to help the lipids stay down. I seem to do fine on brown rice, but I think oatmeal is more problematic, maybe because I tend to eat more of it at one sitting than I do the rice. ANY fruit, and any legume, brings on symptoms. So do most cruciferous vegs. Lettuce and spinach are OK, so this past week I've been eating brown rice, oatmeal, spinach, lettuce, a squeeze of lemon juice, mushrooms, and some cinnamon (the cinnamon may be a problem though; I'm not entirely symptom-free yet).

Anyway, I have to decide whether to go through with the FM hydrogen breath test. I'm wondering, would someone with HFI also show fructose malabsorption? Or do they absorb fructose normally from the intestine, but then not be able to metabolize it?

IF I have a form of HFI, it can't be too bad, in that I've survived to this point, in spite of eating fruit...I have some sweets aversion, but not to the degree I've read about on this site.

Anyway, thanks to anyone that's managed to read this far! Any thoughts appreciated. Ultimately, I'll continue to avoid much fructose, but sure would like to know what's going on, and if I can avoid meat AND fructose that would be great...I really don't want to take statins.

Ann

[nicoleh]

Hi Ann,
your story is very very familiar to me! sounds exactly like my mother, 53. only difference is mum always vomited when she ate sugar. But like you, she eats fruit and veg, but always has hypos, trouble sleeping, excessive urination at night, sore legs (lactic acid buildup). The metabolic specialist thinks mum probably has HFI, but she is still waiting on blood tests. My DD (obviously her grandchild) has a presumptive diagnosis of HFI pending DNA tests.

I would cancel that FM test if you don't want to feel very sick - get yourself to a metabolic specialist for dna testing or send blood to Dr Tolan in Boston yourself if that is available to you.

On another note, re blood lipids and meat:
I am a nutritional medicine student and have also completed animal nutrition university studies. (I have completed as much nutrition training as a dietician, just yet to graduate on the more advanced pharmacology and work experience.)

Here's some information for you to consider if you wish:what you have been told about saturated fat and meat causing heart disease is all plain wrong!

meat does not cause elevated cholesterol. dairy fat (butter) actually LOWERS your chance of having a heart attack! Saturated fat does not have any convincing links to heart disease. If you are a woman (presumably you are given your name!) then having high cholesterol does not have any links to heart disease. In fact, the higher your cholesterol, the longer you typically live for! Cancer rates go UP when cholesterol levels are LOWERED. (as does suicide, depression and more). I can provide references for any of these statements if you need.

Unfortunately you have probably made your chances of having a heart attack worse by going vegan. Your B vitamins may have been reduced (B12 almost certainly) which elevates some of the risk factors. Worse though, studies conclusively show that when you reduce fat in the diet (as vegan diets do) the size of your LDL (bad cholesterol) particle changes - from large and fluffy, which is known to be harmless, to small and dense, which is known to be more likely to lodge in arteries:
www.ncbi.nlm.nih.gov/pubmed/7625363
Unfortunately this is one of many areas that Dr Fuhrman seems to have neglected to mention in his literature (I've read a lot of it - I don't find much of it to accurately reflect the current state of the nutrition research, sadly).

what really causes (or at least is a marker for) heart disease is high homocysteine (from not enough B12, folate and B6), high blood sugar levels (well, high insulin actually), high triglycerides and probably high cortisol levels (from too much stress) and high iron levels. What causes high insulin, high triglycerides and depletes B vitamins? SUGAR! (especially fructose). The other big culprit is vegetable oils (you know, the ones you're supposed to eat so you dont' eat too much saturated fat!).

see this link:http://www.ncbi.nlm.nih.gov/pubmed/23459228
it also mentions oxidised cholesterol (powdered egg and milk is BAD) and trans fats/hydrogenated oils - which is what it refers to in talking about 'fried foods' OR if vegetable oils are used for frying they are very unstable and are also bad.

If you cut the fructose out of your diet and started eating more meat (including fatty meats), more butter and full-fat dairy, I bet your lipid levels would fall. My cholesterol levels have gone from 8 mmol/L down to 6 with a reduction in carbs (mostly fructose) while still eating a tonne of fat.

While you're at it, you can get your real heart disease risk factors examined: If you get a doctor to test your iron, homocysteine, C-reactive protein (high is a risk) Lpa (high is a risk), LDL cholesterol particle size and triglycerides. Some of these tests may not be available without a specialist's referral though. Iron should be on the LOW side. high iron is a definite risk factor - you can start giving blood if it's high, or just bleed a bit, lol.

Even if I haven't managed to convince you to take another long look at the real truth about heart disease and cholesterol, the news still isn't good for you: it is not possible to eat a balanced HFI-safe diet while remaining vegan. You must get folate from liver or lots of leafy greens (and too many won't suit you if you have HFI, you'll discover), or from raw cow's milk. zinc will be extremely deficient if no meat is included, calcium will be v. low without bone broths, sardines or dairy etc etc. In fact, since the HFI diet requires the use of white flour in order to get enough carbohydrates in long-term, and as white grains leach minerals and B vitamins from your body, you will need to make up for that by eating the most vitamin and mineral rich foods. these are almost exclusively animal foods. In fact for every single "essential" micronutrient, the most concentrated source is an animal food - without exception. Even vit C - adrenal glands are the most concentrated source - though admittedly most people don't get it that way! (it's the one thing you'll almost certainly need to supplement on the HFI diet. other things you can find if you eat a wide range of.... animal products!)

Anyway, hopefully that information is of use to you. please feel free to put it aside if you don't want to question what you have been told in the past - I know some of it sounds very surprising.

Good luck,
Nicole

[charlie]

Blimey....... Depress the poor lady why not...........

Only kidding........

Hi Ann, welcome on board, an interesting story and similar to someone else who joined recently but can't remember who. First question is do you need a diagnosis? If not then I would do a full elimination first as you can get just as good an idea of what you may be reacting to without over stressing your system. But obviously keep in touch with those overseeing your medical needs if there is any problems relating to blood sugar. It certainly sounds as though sugars are not suiting you, which one is the use tigon and why.

There is a section on my pro board about how to do elimination diet.

Where in the world are you as others in your area may know where to get more advice.

[ukbill]

Welcome to the board from me also.

I am not certain if you are HFi form what you have said but the Hydrogen breath test will prove nothing. We with HFI , also prove positive on that test, so the test is useless and also possibly dangerous for an HFI.. although I suspect your system has developed ways to cope that have avoided you dieing so far

I am glad you are feeling and instant improvement to your health since removing Fructose from your diet.

You (like everyone else) will be far healthier for doing so, at least of the refined Sucrose and HFCS type of sugars anyway, there are still arguments out there that Fruit and Vegetables are healthy for people (without HFI) but not fruit Juice of course this is no good for anyone.

[colormist]

Hi Ann,
I'm chiming in with the others here and I'm going to go out on a limb and say you have HFI. I would frequently eat fruit, vegetables, and event tried to be vegetarian there for a few years. I knew something was wrong because I didn't like sweets and being stuffed in a room full of birthday cake and/or cinnamon rolls made me nauseated just by smelling everything.

Had I not had my coworker insist that my aversions to sweets was psychosomatic, then I probably would have never started doing research and found what my condition might be. I was actually quite certain I had FM at first, because HFI is so rare and the statistical odds weren't in my favor.

Once I heard about the FM oral test (drinking a sugary substance and having the doctor's test your breath) I became extremely anxious. I don't like sweet drinks at all. Even the thought of having to drink cough syrup made me gag. They would have to tie me down to a chair and force me to drink that stuff because I knew I wouldn't cooperate. Since you are having health problems currently and since you are not certain of your dietary diagnosis, you might want to try an elimination diet first. If you do have HFI, then the hydrogen breath test will make you very ill. Fructose tends to hang around in HFIer's system for about a week. The kidneys do their best to purge the system, but I still get hypoglycemic for about a week afterward. It takes a long time for me to feel normal after an accidental fructose ingestion.

[ann]

Wow, thank you, all of you, for your in-depth, thoughtful, replies. Lots of food for thought, for me.

Yes, colormist, I am pretty nervous about going through with the breath test; it doesn't take a lot of imagination for me to realize the results could be very bad for a long long time afterwards. Like you, I also am downplaying the possiblity of HFI just based on the statistical rarity, and my age, but so much seems to fit, though I would have it to a milder degree than many others here. My husband is pushing for me to go through with the test, just because he's thinking a diagnosis of any kind will help, but I don't know, if I pay for it by being really sick afterwards, and if the end result is the same, namely, that I'll be avoiding fructose anyway.

Thanks, UKBill, I wondered if the HFI folks would also have trouble absorbing fructose. And to Charlie, too, yes, I'm not sure how I can rationalize the test, other than giving validity to my dietary choices when faced with other peoples' disapproval when they see me avoiding fruit and so many vegs. Especially if it's been cooked especially for me!!! This low fructose diet is so contrary to most peoples' concept of what constitutes a healthy diet.

Nicoleh, thank you so much for the nutrition info, too. I'm still reviewing your links and the other links they have led me to find. Interestingly, I see a preventive cardiologist, and on May 3rd, shortly before I found this site, he told me I should cut out all fruit from my dietand all sugar (which I'd already done), as it would improve not only my lipids, but what he called mitral valve prolapse syndrome (which he says I also have, the main symptom being fatigue and very labile blood pressures....mostly too low but then rapid heart beat after eating and position changes).
So, I went out last night and got some salmon for dinner!!! First meat I've had in several years.
If you see this, what do you think of hemp seed? Seems to be a good source of both protein and omega 3s, but maybe it's too high in vegetable fat? Also don't know about the fructose content. I'm wondering if I remained mostly vegetarian, with lots of brown rice, some spinach, lettuce, and mushroom, a little hemp, and some salmon, if this would both be low enough fructose and generally balanced enough. I was so brainwashed by Dr. Fuhrman's message that it'll likely take me awhile to really get into meat again.

By the way, I'm in N. Carolina, USA. I am looking at pursuing the 23andme test or Dr. Tolan's, if I can find someone willing to order it for me.

Thank you again, all of you...
Ann

[colormist]

I did a quick lookup for hemp seeds in nutritional database and found this: nutritiondata.self.com/facts/custom/629104/2 (BTW: These types of databases are vital for people with HFI). On the left in the sugar content, it says 0.0g of sugar. That's a safe enough result to at least use them on a trial basis (once a week) until you can gauge whether or not you have a reaction. I think the general safe tolerance for unsafe sugars for HFI is 100mg (0.1 grams)--someone please correct me if I'm wrong. I think, before diagnosis, I was closer to 20g of sugar a day. I thought I felt find. As I slowly cut out the sugary foods (sugar-free bread, no veggies, no fruit, no brined meat, no cereals with added sugars or that contained unsafe ingredients) my tolerance for sugar dropped. It wasn't that I tolerated the sugars, it was more that my body thought being sick was normal.

[ukbill]

Ann watch out for Fiber in foods it converts into Sucrose in the gut.. ie Brown Rice & whole hemp seed, are you sure its only the seed you are eating too much will give you a High of course.

I have to keep ultra low in fiber so to keep things works so to speak I take a none digestible plant fiber called Physillium husks.

The first time (or up to a week) you use it be aware its a "cleansing" detox type product.. so expect green slimy poo for up to a week. (this is not the only thing which will do this many "detox" things will do this also, after this you will never get it again..)

I do not know why this happens but do not be alarmed if it dose, if you have taken strong detox things before you will most likely not get it as it seems to be a once in a lifetime type experience.

Hope this helps?

[ann]

colormist, thanks for the link. I agree, a cautious approach is the best. I saw on Dr. Tolan's site that the input from people with HFI was generally no nuts/seeds. One question re the safe upper simit for sugars that you mention: is the 100 mg for fructose, or for fructose plus sucrose? Any other unsafe sugars I should be aware of, other than sorbital? Also, if you don't mind the personal questions, what do you eat for plant food? Anything? I'm a bit worried about overdoing it even on the green leafies.

Which leads me to Bill's remark, to beware of fiber. Am I right in thinking it's only soluble fiber that could be a problem? Seems strange in that I see that oatmeal is generally regarded as safe, but it's pretty high in fiber, with a good portion being soluble, which I think means, digestable, but maybe I'm wrong on that. I've wondered how many people here really are able to tolerate oatmeal, or for that matter, brown rice, and if so, do they limit the quantities. Bill, I saw in one of your other posts that you said it was awhile before you realized that "tolerated" foods didn't necessarily mean "foods to thrive on"...do you eat spinach/lettuce, and if so, do you have to limit the amounts? Pardon the personal question, and don't feel obligated to answer anything you'd rather not! I may start another thread along the lines of "what are you all really, really, able to eat?" Although I'm a lot better after this small number of days of avoiding fructose, I'm not great, but have also been having 1 c frozen spinach (cooked) per day, 3 or 4 leaves of romaine lettuce/day, plus about 1 1/2 c of "spring mix" baby salad greens/day. Also a wedge of lemon squeezed over the greens. Also one clove of raw garlic. Is this too much? Of course I realize it's individual, but I don't really have a feel yet for how the HFI diet translates into everyday life.

Anyway, thank you both, again, for all the help!

Ann

[ukbill]

I am not certain, some places state that Psillium husks are soluble (they certainly bulk up into a massive amount of gel)

Yet the stuff is also known to be none digestible.. so it is both soluble (in that it forms gel) but none digestible as well. confusing Yes?

I do not get on too well with the finely ground stuff I think it has too many "edges" which allows the acids etc to digest more of it.
It is also the devil itself to get it into a drinkable solution.. it clumps up something nasty..

[nicoleh]

HI Ann,
so glad you took that well. I just re-read my post and realised why Charlie made that comment. I didnt' mean to come across so strongly - it's just an area I'm passionate about.

Glad to hear you managed some salmon - hopefully it was wild caught! (a luxury that us aussies can't get down under, unless you pay through the nose for frozen imported stuff).

Hemp seed is unfortunately too high in omega 6's. pumpkin seeds are better and I think a small quantity are ok for HFI? I am on the HFI diet myself - actually a very strict version - because my DD is breastfeeding and fructose in my diet DEFINITELY affects her, even in tiny quantities. being a bubby, and still recovering from her old diet full of veg, her tolerance of fructose is in the single digit milligrams range. I am therefore trying to keep mine to under 20mg.

Brown rice is too high in fructose for DD (databases agree), lettuce - I can get away with small amounts of the outer leaves of red coral lettuce, or a very bitter dark romaine. rocket is ok for her. spinach is ok, swiss chard/silverbeet is not. But I wouldn't be able to eat a lot of any of these things.

I would suggest you also ask your cardiologist about CoQ10 supplements, both for heart disease prevention and your valve issue. He may not know much about it, you may have to provide him with your own research information. Stuff by Dr Peter Langsjoen (?sp) (cardiologist) will be the best source of info. he uses CoQ10 in all his patients very successfully - usually instead of statins with better results.

it's ok if it takes you a while to get back into meat. If (and only if) you tolerate dairy that may be better for you, and if you can get some good quality organic milk that would be good. We drink certified raw milk straight from our cows but that is a personal choice based on weighing up the benefits vs risk of bacterial contamination. You could research that too (if you want to know what to eat, especially with HFI, you'll be doing a lot of reading!). Raw cow's milk provides folate and vitamin C, which is why I drink it, especialy with my current diet. but I have good stomach acid and I know the farmers and the risk.

With the diet you propose - bearing in mind that you will probably need to eat white rice - you could lack vitamin D (depending on your sunlight exposure. in summer, without sunscreen, half an hour (or less if you're fair) in the sun in the middle of the day with most of your body exposed should be plenty. do less if you burn, but a slight pink tinge is optimal.) In winter, you would not get enough. you could do lots of egg yolk from pastured chickens (but watch, some suggest that fructose could be in US eggs - here they seem ok for some reason), prawns (shrimp to you) and oily fish like salmon. Otherwise a supplement would be in order.

The biggest thing missing from the diet you suggest would be vitamin A. a whole lot of really good quality butter, or a little liver pate, would fix that. B vitamins might be a bit iffy. If you ate a wide range of dairy products and a small amount of either offal meats (preferably liver) or shellfish (mussels, oysters, clams) then you'd probably be ok. offal and shellfish are much better sources of nutrients than normal muscle meats. and if you're worried about animal welfare, shellfish are a pretty good choice - not having a brain and all.

Oh, and bone broths for calcium and other minerals. heaps and heaps. www.westonaprice.org for info on how to make a good bone broth - try the search box, or contact them. (broth is also a very tasty thing to have on hand to make sauces, gravies, stews etc.) At least this doesn't involve having to eat mouthfuls of meat, if you find that hard.

I"ll leave the others to answer questions about what fibre they tolerate. either type can be fermented, and it can ferment into fructose. I think the issue is minimal though as the main problem is that most of the high fibre foods are also too high in fructose (Fruit, veg, wholegrains, nuts, most seeds - all out anyway). so there's a limited amount of fibre available to you anyway.

here's another myth: you need fibre to make you go! YES, you do get constipated if you go on a meat and dairy and eggs and white flour diet, but fibre isn't necessary to fix that. a good probiotic will do wonders.

I only started my own HFI diet a month or so ago - took me a while to accept that I had to - and within days I was in trouble! Most of our stool consists of bacteria, not fibre, so I figured that supplementing some bacteria would help. now I'm taking 1/4 teaspoon of a mixed, 8 species probiotic first thing in the morning and once more at night. NO dramas! If I forget one day, I'm ok-ish. forget two - BAD!

You need to start slowly with a probiotic too, as it can cause bad bacteria in your gut to die-off - especially if you've just dramatically reduced sugars in your diet, as they feed the baddies. So you'd start with just a tiny pinch. You could also get probiotic capsules, but I wouldn't recommend you start with them as the dose to start is too high - and if they're in a capsule they may require said capsule to protect them from stomach acid, so you can't empty it to halve the dose. powdered formulas are obviously designed to survive it without protection.

Finding a "safe' probiotic is hard! most have added fructooligosaccharides (in fact, if it says prebiotics as well, it's almost certainly these FOS - not safe for HFI!). Many have some plant extracts, one even had added pure fructose - enough to make me want to gag, though I don't have HFI!

One powdered one I recommend is here:
www.iherb.com/solaray-multidophilus-powder-5-billion-2-5-oz-71-g-ice/37553?rcode=wjg177

(If you bought it through that link you'd get $5 off the price.)

anyway, I hope some of that helps!

my mum is going through the same thing as you right now, though she's never been vegan - still just working out what she can eat and feeling much better but struggling with being emotionally ready to change her diet I think. totally understandable!

Bill, I'd be really interested to hear if you'd ever tried probiotic and if it worked for you?

[ann]

Nicoleh, thank you again for such a helpful reply. Wow, there do seem to be some ways and means to make this work and not be too deficient in vitamins. I had trouble digesting the fish, I think maybe because it'd been a long time since I'd had any meat, so I'll go slow at the beginning. I used to drink raw goats milk that I'd get from a farm outside the city; it was really good, but this was years ago. I'm not sure they are still even there, but I do remember it was so good! I'd make a yogurt drink with it, to make it last longer until I could drive out there again.

Regarding the B vitamins, I thought even white rice was OK to supply enough? I've been checking crono-meter.com for nutritional analysis (unfortunately they don't give a break down on the kind of sugar in foods), but don't know how accurate it is. I need to do something to my computer to be able to access nutritiondata.com, and when I get whatever I need to get installed to get into that site, looking forward to the info there as it comes so frequently recommended by others here, too.

I tried a probiotic last year, called VSL#3-DS, which made me very bloated and sick feeling. Turns out it has lots of prebiotics in it, plus being very high dose, so what you say, makes sense.
Thanks for the link on a probiotic that would work!

I think I will avoid all nuts/seeds for now...

I've been wondering, for you as a (presumed) carrier, of the recessive gene, do you experience any ill-effects from a lot of fructose? Do you feel better on a low fructose diet? I'm wondering to what degree there are different levels of these enzymes in people that technically arent' HFI, but who might fall somewhere lower on the spectrum of able-to-tolerate-fructose. I feel for your mom, changing her diet at an older age...I hope she is experiencing enough improvement in well-being that it helps motivate. She is so lucky to have you there to help!

Thanks again for all your help to me!
Ann

Your daughter is very lucky to have you as her parent; so is your mother, to have you as her daughter.

[nicoleh]

HI Ann,
sorry to hear the fish didn't agree with you so well. If it was farmed fish, you may find wild much better; farmed fish are fed weird pelleted food and antibiotics (usually). I feel icky if I eat farmed salmon.

Definitely starting up again slowly is the way to go. Vegetables are easier to digest than meat, in one sense, because they require less stomach acid to break it down and not much bile from the liver. However, living on a meat-free diet depletes you of vitamins (particularly B12) and zinc which are what is needed for good stomach acid in the first place! so the less meat you eat, the less well you'll digest it. re-starting slowly is often needed. You'll probably find fats a bit iffy too until your liver is happier off fructose. I don't know how long that will take you, but after DD has any fructose by accident, she'll not digest fats well for 3 weeks afterwards. eating small quantities of fat at each meal, and eating at regular times, will help prime your liver to produce bile and the gallbladder to release bile "on cue" for a meal.

to improve stomach function, try drinking some acidic (lime juice, if you tolerate that much fructose, or vinegar in water) solution before eating. Also, eat your food warm, it's much easier to digest. Bone broths, as mentioned earlier, help greatly with digestion. you can make beef, lamb, chicken, fish - whatever flavour you prefer. Once you've been having meat for a while your B12 should be improved a little and stomach acid production should be ok on its own without the lime water.

the goat milk sounds good, but you should bear in mind that goat milk is not a source of folate so don't rely on it for that. cow's is better for folate, if you tolerate it. any kind of milk will supply much needed riboflavin, but keep it in a dark place if it's in a clear bottle as light destroys riboflavin.

Yeast extract (if you can get a fructose free one) may also be a good source of the B vitamins (except B12, unless a synthetic B12 is added).

white rice is usually enriched with b vitamins in the US, thus it being ok - however I believe that enrichment may involve coating the rice in some sort of sugar - check with an American about that. we don't have that here. If not enriched, I don't believe it's an adequate source of much.

I don't know if I'm feeling better or worse on this diet! my sore throats used to be badly exacerbated by sugar, including fruits. (infections after eating 1 date etc). That had subsided for a while with natural treatment, but now they're back - probably enjoying a feast on all the white flour I'm eating, which I never used to touch. On the other hand, my energy is pretty good - perhaps better than it was a few months ago. My kinesiologist said the headaches I'm getting more of on this diet are a liver detox that will last a few weeks - a good thing - and that generally my body particularly liked the fructose free diet. I craved fruit and maple syrup for a week after I started. now I don't want them at all - except for the variety. I also have little desire for sweet veg - I started to eat a bean the other day and didn't want to finish it - didn't enjoy it enough for the risk to DD from that tiny amount of fructose. On the other hand, I"d really really like more salad leaves and I like the bitter greens more than ever now. Oh for some cabbage! I miss the variety, the refreshing cool-ness of those foods. but I'm definitely not craving the fructose sweetness.

Thank you for the lovely things you said. I've just been blessed with a bit of a gift for this; I can take no credit.

[colormist]

Ann,
I think 100mg is for ALL unsafe sugars. The list of unsafe sugars is really, really long. I made a somewhat debatable list here: fructose-free.tumblr.com/post/15777874026/which-sugars-to-avoid-with-hfi Thankfully most have the word sugar or fructose in them.

I don't eat much in the way of plant food. I might have one serving a day (dark green lettuce on a burger, cooked spinach as a side dish, green beans, a couple small pieces of celery with my chicken wings, or a couple tablespoons of black beans in my burrito). Any more than that and I tend to feel pretty ill. I used to be able to tolerate more, but I'm pretty sure that was because I was always sick and didn't know what not-sick felt like.

[ann]

Nicoleh, you may have been blessed with a gift for this, but your kindness in helping complete strangers is a blessing for which I'm sure we're all grateful, and something you can certainly take credit for!!!

Interesting that you've found sweets, including sugar, to exacerbate sore throats. I virtually always get a sore throat (that can last several days) after eating any dried fruit (even, as you say, one date, though never like those; too sweet), but after eating fresh fruit as well (which I do like). I can truly understand missing the green leaves; I'm having a max of one cup per meal (raw measure), and wondering if A) this is a problem, because although I feel so much better after 2 1/2 weeks of this, I don't feel great yet), and B) still trying to get it into my head that this is plenty and not even necessary (if nutrients made up for elsewhere in the diet).

I'll watch the white rice; I've been using brown, but bought a bag of rice that doesn't say enriched, so hope it's OK (basmati).

Really REALLY helpful to hear that the stomach acid/bile function will take some time to rebuild, and that fructose my inhibit my ability to digest fat. My gastro told me I have a bad gallbladder (sluggish function, no stones) because in the past I've had a lot of trouble with fat, but then, I was eating plenty of vegs/fresh fruit at the time, as a vegetarian. So I'll be patient.

Colormist: thanks for the list of sugars you compiled, and great website!!! I've been snatching moments away from my kids, to read as much of it as I can,and not done yet! Look forward to reading more. 100 mg sure isn't much, so I see why you don't eat much plant food. I'm going to cut back further and try the white rice over brown, and hope this helps further.

Thank you both, again...

Ann

[nicoleh]

Hi Ann,
you're on the right track. For DD the biggest difference to her came when I switched from whole grain to white. That was even more of a difference than cutting out fruit! (I ate a fair bit of wholegrain I guess).

yes, sometimes fresh fruit would exacerbate my throat. better since I rebalanced my flora a bit with probiotics and very low sugar diet. worse now with white grain - but now I have a cold so I don't know what's really causing it this last week.

For the gallbladder try to have your meals at set times. it does have its own internal 'clock'. bitter herbs can also help with liver function. So a small sprinkling of low fructose herbs may be good. ginger also is a good digestive aid and basically fructose free.

You may benefit from taking some zinc picolinate for a while. it is absorbed without the need for a lot of stomach acid, and it, in turn, helps make the stomach work better. 25mg Zn, as picolinate, would be adequate. let me know if you need a link to a good one. (all supplements are cheaper bought online, I've found).

I was having about 1 cup at ONE meal per day a few weeks ago, of greens that is. that seemed ok with DD. I also had a spinach/fetta pastry for one meal or snack and a little pesto each day. that was the max veg I could get away with. I think you can keep your greens (for one meal at least) until you're fully off the wholegrain and then see if you still need to cut back more. There's some benefit to the dark green leaves provided there's no fructose in them, so keeping in one meal per day should be helpful.

coconut oil is the best fat for those who have liver or gallbladder issues (requires no bile) however I don't think it's reliably fructose free. you could check on that. otherwise butter or ghee is probably the next best bet. any oils you use should be unheated (use cold pressed pure virgin olive oil, or nut oils, sesame oil). polyunsaturated oils should be avoided unless cold pressed. so no sunflower, safflower, cottonseed, canola, soy or corn oils. all are heated on processing and are already rancid in the bottle. these will be the hardest for your body to handle. as your fat digestion improves you should be ok to use olive or nut oils for low temperature cooking, but never for deep frying. save that for much later when you can handle lots of fats - and stick to lard!

and yes, 100mg is hardly anything. dd's tolerance is around 9mg, based on her reactions. So I'm aiming to eat no more than around 20mg/day. easier than I thought, but harder than I like!

[ukbill]

I use Probiotic Yogurt with my breakfast.

I do not trust other probiotics they all seem to be available in a fructose based syrup. also the flora in my gut is adapted to digest the foods I eat.. ie Meat and more Meat. if I add Bactria that are mixed and grown for "normal " none HFi people the balance of Bactria will be more towards that's used to digest Fruit and vegetable Fibers than meat.. I do not have any Vegetable fibers in my diet. (well very few anyway)
I know if I overdo the Yogurt I get a few days of gut problems until things settle down again.

I am just getting over 4 days of food poisoning.. (bad chicken I think) so guts in torment still. this is my first day back on "normal " food well normal for ma anyway.. lost 6lbs though so not all bad. I am below 13 stone for the first time in years.!

[ann]

Nicoleh, thanks, as always, for the tips...I'll look for the zinc. I went out to our local health food store (Whole Foods) looking for a vit c supplement, and was suspicious of sugar in all of them, so will look elsewhere before buying.
It's encouraging to hear that avoiding the whole grain may help me tolerate the green leaves better; I think of all the things I would miss most, it's the greens, but that may just be because I've been conditioned forever, to think of them as vital to a healthy diet! Fortunately, I really like lettuce and spinach, so a little of those should satisfy, and it doesn't have to be a full cup per meal. The bitter herbs idea sounds good, too.
I hope you're over your cold soon. I remember vividly how very frequently I'd get sick when my boys were very young, but then, of course, I was eating a lot of fresh fruit along with a variety of vegs, and I could never understand why, since I was eating so healthfully vegan, no added junk, that I would be ill more than most people I knew!
I've started doing a lot more reading re these dietary issues since you've brought up so many issues over these last few days...thanks!

Bill, Sorry to hear about the food poisoning! I hope you've been able to keep something down, and get plenty of rest.
Good point on the probiotics being formulated for a more varied diet than HFI allows. Also helps explain why I should try to be patient and give this time. It's really tempting to make an abrupt about-face, but don't think the sudden meat/fat would digest too well. Interestingly, to me, my interest in naturally sweet food is absolute zero now, though for some reason craving peanuts, which I rarely eat...

Anyway, hope you're both feeling better very soon, and thanks again for the replies.

Ann

[nicoleh]

Hi Bill,
sorry to hear about the food poisoning!

I agree that so many probiotics have fructose in them, it's a real minefield. it took me a while to find the one I sent that link to.

In terms of your flora (this is a topic I'm particularly familiar with, having had all sorts of flora dramas) they don't really get used to digesting anything in particular. What you need in there is what is required to feed the bowel - the species that produce substances which nourish the lining. This is the same for everyone as all bowels need nourishing with the same nutrients.

only certain food provide fuel to colonic bacteria. sorry bill, but meat is not one of them! Meat is usually very well digested by our own digestive enzymes and then absorbed before it even reaches the colon. If it's getting that far, it's putrefying, not being fermented, as only carbohydrates are truly fermentable. and if you've got putrefying meat in your gut, you can be certain that nasty pathogenic bacteria are also in there making you sick. chances are you don't.

The things that we need most help with digesting are fibres, as you say, and starches. The primary reason why someone on the HFI diet would need probiotics is for all the white grain that is involved. Most people these days do not digest starches terribly well. it does get through to the colon, and if you've got healthy bacteria going in there with it, it won't do too much harm as they will ferment it into good things. however, all the undigested starch will also very quickly "feed" any bad bacteria, yeasts and even worms. these pathogens do not produce substances that nourish the bowel - they produce toxins that poison the whole body and brain (a significant contributor towards such conditions as autism, dyslexia, depression and schizophrenia). Someone on the HFI diet probably needs probiotic supplements even more than other people, partly because white flours tend to constipate - and the probiotics can help digest them faster to stop that happening, and partly because the white flour intake is usually high and it is in absence of fibre. white flour encourages pathogens, fibre discourages them - so with this pro-pathogen diet, more good guys are needed to keep balance.

AAAnyway: re: the yoghurt Bill - I"ve been doing some serious digging, and much as I didn't agree with some of what she said, I think tikitavi was right, that partly fermented milk products do contain fructose. that could well be the source of your trouble. I'm making my own yoghurt tonight to make sure it's fully fermented (24 hours) and testing that. regular bought (sugar free of course) yoghurt has not been great for DD. My mother in law is a microbiologist, I'm going to get her to go through bacterial biochemistry with me to work out how much, if any, fructose could be produced by bacteria fermenting milk. I'll certainly publish my results here.

Hi Ann,
www.iherb.com/nutribiotic-sodium-ascorbate-crystalline-powder-16-oz-454-g/10178?rcode=wjg177

that is the only vit C I would use. it is 100% pure pharmaceutical grade sodium ascorbate which is the best, really the only 100% beneficial form.

and while you're there, this is the zinc I use:
www.iherb.com/thompson-zinc-picolinate-25-mg-60-tablets/16119?rcode=wjg177

When looking for a supplement, if you want to look elsewhere, get one with no magnesium stearate or vegetable stearate - both reduce the absorption of the active ingredients making them far less effective. we've tested that on ourselves as well as reading it in theory and it definitely happens. then you're just wasting money.

good luck,
Nicole

[ukbill]

Ann,

If you have not tried Basmati rice yet then you are in for a treat.

It is wonderful and fuller of flavour thatn any other rice.

I cook it in the microwave. depending on the batch it takes form 7 to 11 min to cook

I simply put a cup in a plastic bowel and pour boiling water over it until its covered by about 1/2" ass a pince of sea salt and wack it in the microwave on full power.

If its a little "nutty" then put it back in for a couple more min.

If its drys out on the top it needed a little more water or cover it with a plate while its cooking (although this might make it boil over a bit. )

Fluff it up with a fork and serve. simple!