What's the story on sorbitol?

[kim55]

What is the relationship of sugar alcohols such as sorbitol and maltitol to HFI? I have always avoided them along with anything else sweet, but sometimes I want just a little of something sweet so I ate half of a sorbitol-sweetened chocolate cookie and had dramatic, severe GI symptoms. I didn't think it was related to HFI because my non-HFI son has always had a problem with sorbitol too, but now I read that people with HFI should also avoid sorbitol. So I am curious about the connection--do sugar alcohols also break down into fructose? Or is it something else? My reaction to sorbitol is very different from my reaction to fructose, which generally involves nausea and/or a sick or feverish feeling all over.

[Debra]

Yes Sorbitol does break down into fructose and people with HFI have a noticeable reaction to it.
Maltitol and Xylitol are sugar alcohols that do not break down into fructose but are still tolerated in differing amounts by different people. Sometimes I let myself have one cookie or candy made with maltitol per day and I'm careful do not do that too many days in a row.
I like baking with glucose and I try to eat one glucose rich food per day. I find I really need the sugar since I cannot eat any fruits and I am very sensitive to vegetables too. My liver enzymes elevate quickly with small amounts of fructose. In spite of that I still have a healthy liver...no fatty liver, inflammation or cirrhosis..etc.

[Tammy]

There are different opinions on this board on the subject of safe sugars. Some believe it's better to just avoid them all. I believe they are fine as long as they are the correct ones. My daughter is one who loves her chocolate.
This list is from the U of Boston's website.
www.bu.edu/aldolase/HFI/treatment/sugar_table.htm
It works well for us. Hope it helps when you need something sweet.

[anastazya]

I can't eat any sugars....and even have difficultly with glucose. I'm hoping the glucose problem will fix itself as my body heals, but for right now, my Lactaid Milk is sweet enough for me. I'm glad there are people who can eat more sugars. Gives me hope. : )

[julienc]

As most have said here, Sorbitol is a definite no. It metabolizes into fructose.

As far as I know, aspartame is the primary sweetener that is safe for HFI. As much as I detest sweets, I do have a craving for Cool Whip and will eat a spoonful or two of the "sugar free" version (with aspartame) every now and then.

Almost all chewing gum has sorbitol, but you can now find some that are sweetened with xylitol. I do just fine with this. I had clear reactions to gum with sorbitol, but I do not react to the xylitol in this small amount.

Good luck.

[colormist]

I'm in agreement with Julie. I've had some delayed (and definite reactions) with sorbitol. It doesn't come on as quickly as fructose, but it does.

Xylitol seems to be fine, though. It's also great for cavities!

[boron]

Xylitol and other polyols (mannitol, maltitol, erythritol...) are not metabolized into fructose, but these polyols are produced from various plants including sugar cane, so the actual *product* you buy may contain traces of sucrose, fructose...

Erythritol is produced from glucose. It is completely absorbed in the small intestine, it is not metabolized and is quickly eliminated through the kidneys so it has no calories. Unlike most other polyols, it does not cause bloating or diarrhea, since it does not likely reach the colon, where bacteria could ferment it.

Only few healthy people can safely consume more than 50 g fructose at one sitting, since the transporter protein for fructose in the small intestinal wall has a limited capacity (which varies a lot from person to person). Individuals that cannot absorb 20 g fructose in one meal are considered to have fructose malabsorption (FM) and some may have a problem with even 1 g fructose. Many people with FM cannot tolerate certain amounts of polyols.

It means, if you have HFI, it's not only you have a problem with the *absorbed* fructose or sorbitol, but, like we all, you can have a problem with certain amounts of *non-absorbed* fructose and polyols, which are fermented by colonic bacteria, which produce gas and certain substances that irritate the colon, possibly resulting in bloating and/or diarrhea.