The Flaw in the Plan

I have Fructose Malabsorption. I reject the idea that this is for life, so I set out to find a cure. But there is a Flaw in The Plan.

The Dilemma

I don’t want to go back to eating poorly, i.e. eating bread and sugar and processed junk, but I react to most fruits and veggies, and eating like that that is simply not sustainable. Not only that, but it means something more sinister is going on here. If there is one upside to acne I’ve acknowledged, it’s that I have a very visible (too visible, dang it!) sign that things are troubled inside.

When I realized fructose was giving me a problem, I let in a lot of other foods that I thought were “safe”. This included a lot of potatoes, rice, corn chips, plantains, celery and cucumbers: starch and FODMAPS. I’m always trying to gain back some of the weight I lost when I first went Paleo, but I’ve mostly been unsuccessful. I thought adding back in more dense carb sources would help. You guys, I was eating over 2000 (nutrient-dense!) cal/ day, sitting at a desk, and not really gaining. But my stomach was ballooning out and my acne was coming back.

On top of that, I’m going to be studying abroad for the next 10 months and traveling throughout Europe and Asia. The program is in English, but that is definitely not going to help me in restaurants.

I had to find a solution, and fast.

The Solution

I did some research (I recommend The Paleo Dietician’s book Digestive Health With REAL Food, which is the most positive, happy book I’ve read on this stuff) and realized that a potential cause of my malady is small intestinal bacterial overgrowth (SIBO). My symptoms fit the bill, and the bacteria overgrowth can prevent someone from absorbing all the nutrients from their food. It’s suspected that SIBO can cause FructMal. Heal the SIBO and heal the FructMal, right?

(Of course, FructMal can also cause SIBO – this is why you should not do what I’m doing and go find a practitioner to work with. I don’t know which one caused which in me and this is definitely slowing progress.)

It’s a chicken-and-egg scenario and if you’re doing an elimination diet for both, which I am, it leaves you with very few actual foods to eat. The goal is to starve out the overgrowth of bacteria, and eventually start adding foods back in as the bacteria levels normalize.

I started with the veggies recommended in the book: Spinach, zucchini, green beans, and carrots.

My dad has Lyme, so “die-off” (or “herxing”, short for the Herxheimer reaction, caused by toxins from dying bacteria) is a reaction I’m quite familiar with. I sure had some , too – headaches, tiredness, trouble focusing, being emotionalĀ  . . .

. . . .and my face exploded.

The Flaw

That was really frustrating. The bloating that had been getting steadily worse and worse over the last few months finally went away, but my face had not looked that bad since before I dropped fructose. Why is it my lot in life to choose between being bloating or having acne??

I finally determined that carrots and green beans, while lower in fructose than most veggies, can cause problems for some FructMals; for someone who is extra sensitive, like me, they had to go.

A week ago I cut those out and my face is healing again. It’s slow progress, and I can’t say I’ve been entirely faithful to the elimination (ice cream, you guys . . . ice cream). It’s not easy eating 1800 calories of meat and fat – mostly fat. Usually I fall short. For a week I went through a phase where I had no appetite for anything. Now I am pretty much a carnivore, but augmented with spinach and squash (including zucchini).

The Kind-of-Happy Ending

Although my face is pretty much The Destination Spot where every little dead bacteria sends its toxins, I’ve noticed some improvements after the initial Herx:

  • Blood sugar regulation
  • Stable mood and energy
  • No longer freezing when I don’t eat
  • No weight loss (amazingly!)
  • Better sleep
  • Calmer mind (sweet relief)
  • Less bloating
  • Picking urges significantly decreased!!

The silver lining is that I do seem to be going in the right direction. I would love to eat all sorts of fruits and veggies, but that just isn’t in the cards for me. I have to undo 23 years of “eat anything I want” first. That may have bothered me at one point, but I’m okay with this for now. We’ll see what happens in Europe . . .


(I’m making a list of all the foods I can and can’t eat and am translating them into five different languages – my mood is improved but I’m still a crazy list maker!)


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