Modifying Paleo for FODMAP-Intolerance (a.k.a. Fructose Malabsorption)

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You may also get: Enterocytes have specialized transporters, or carriers, embedded into the membrane that faces the inside of the gut. It's always a great time to detox and rejuvenate your body. After a period of a couple of weeks, you can try adding in either the starchy vegetables eliminated in the modification for SIBO or some of the FODMAP fruits and veggies choose whichever food you miss the most. I was soo happy.

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I have a treadmill stress test scheduled to look for heart disease. Is there another way to gather this information? Not yet a subscriber? To access the paid content on this site, please subscribe to Mayo Clinic Health Letter. You will be redirected to Mayo Clinic Marketplace to complete your order. Subscribe Already a subscriber? Just wondering why some of those things would be ok for someone who is fructose intolerant?

I am 10 weeks pregnant and it has come up that I am deficient in the amino acid Tryptophan, and that is the reason for my constant nausea. The good news is that aversions are really normal this early and your body should have nutrient stores to burn though and it should be a whole lot easier to stick to Paleo once you hit the second trimester. In the meantime, you can try things like spinach or bananas by themselves which can help.

But, even better would be to try and get some organ meat maybe hide it in a smoothie or something? You really just have to self-experiment to see what works for you. I was waiting for someone to write about this with clarity for a long time. Chemical intolerance is very much on my radar maybe because my brother is allergic to chlorine and chloramine.

I look forward to read that. This was really enlightening. I have days when I experience painful bloating and gas. It can be really tough to eat just a regular Paleo diet without all these extra restrictions.

I wish I had a better solution…. I am very interested in the Paleo diet. I am gluten sensitive and have been trying to stay away from any foods that are not going to bring nourishment to my body. Legumes are rich in lectins, saponins and phytic acid saponins probably being the biggest problem in legumes. Phytic acid binds to minerals in your food and makes them more difficult to absorb. I will hopefully have a post going into more detail about phytic acid sometime this fall.

However, many people do tolerate occasional consumption of legumes not peanuts , especially when traditionally prepared typically sprouted and fermented , which reduces the amount of lectins and saponins.

I typically suggest trying some time without weeks then reintroducing and seeing how you feel. Thanks for sharing this. I was just wondering if I had an increase in bloating and gas from cherries.

Is that probiotics on the avoid side? I thought probiotics were safe! Sigh… I think I might have some of this because I notice a negative gut reaction when I eat fruits my tummy starts to rumble and I get very bloated with sugar.

This is highly dependent on the manufacturer, so just check out the ingredients list. Food sources of probiotics are still good kombucha, fermented veggies, water kefir and even coconut milk kefir for some people. Well fermented veggies like sauerkraut are tolerated by man people who get symptoms from eating cabbage because all those good bacteria digest the FODMAPs for you before you eat it. But, I get very bloated when I eat too much sugar.

But thank you for the great info! Thank you for this great post! The chart you posted is very helpful! Thanks so much for this post! One day I looked up and realized I had ended up on a Paleo diet!

Now I have a name for it: Yup, sounds about right! Now, I am in a dilemma, and I hope you can help me. I just got braces! I want to avoid sugar as much as possible — not only because my body is better of without it, but also because sugar feeds bacteria and you really have to watch that with braces.

Any tips or ideas? I eat lots of kale already so I plan to blend that with my brand-new immersion blender and my homemade bone broth. Also, any tips for low-sugar protein containing fruit smoothies? How do people get their protein in fruit smoothies? Sorry this post is so long! I really like how you delve into subjects and really try to understand and inform.

The stereotypical Paleo protein powder is egg white protein powder some people also use grass-fed whey protein, which you can get from Tropicial Traditions http: What I do for my husband is to make shakes with whole raw eggs. I typically add 3 eggs for protein, half an avocado or some coconut milk for fat, green juice or orange juice or more coconut milk for liquid, and banana, mango or berries for sweetness. Sometimes I add spinach too.

You could adjust the fruit to your needs or even just go for a sweeter vegetable juice like carrot or beet. I hope this helps! I seem to have a problem with Coconut Oil. Could this have something to do with Fodmap intolerance? Or could it be perhaps that I just need to use a tiny bit to get used to it and build my body to get used to it?

I take a capsule of virgin coconut oil from GNC and have had no problems, but would love to cook with it. I too have issues with Coconut Oil. I began taking spoonfuls of it as I read it is anti-fungal my naturopath diagnosed me with Candida but after several weeks I began noticing extreme racing heartrates. I have very severe fructose malabsorbtion and have been trying to go Paleo for the past year, thanks so much for this! From my research and experiences tomatoes are an absolute no-no, same with iceberg lettuce, eggplant and ginger.

Papaya has more fructose than glucose too. I have had indigestion all my life. Eating was a minefield. Finally, thyroid issues were discovered. Addressing that alleviated some of those symptoms. But there were more. Not too long ago I gave up gluten and dairy. That initially helped a lot, especially with my arthritis. But recently the old gassy, bloating symptoms have returned. I vacillate between the joy of discovering and addressing intolerances and the despair that my gut will just never get well.

As someone following a very restricted diet, I totally understand the mixed emotions. Is there a way to slowly wean off the PPIs? Of all the Paleo books out there, Practical Paleo has the most thorough protocol for healing the gut and digestive support including supplements you can take to help get your gut healed which should help get off the PPIs.

Thanks for such a wonderful post! If they go right through you, I would definitely avoid eating them! But if I eat a lot of fuctose, then bad things happen too. And then add insoluble fiber to the mix, which then makes it even more complicated since many sources of FODMAPS also have some insoluble fiber. Also, many people with autoimmune disease are very sensitive to sugar. So that might actually be the issue with the banana pucks and the macaroons.

It can take a while to figure out where your individual tolerance is. Thank you for your thoughtful reply. I do have hope that I am at least on the right path. Thank you for your insights. I have endometriosis and PCOS which being primal has done wonders for. Science with Sarah is always my highlight. Blessings upon you and your family. The first thing I did was fill up a big spice jar of asafoetida at my co-op.

I noticed one blog mentioned that asafoetida contained gluten. I googled it and have found that come up again on other sites. I contacted my co-op. It could very well be stress. Just thought it would be important that everyone knows that asafoetida can be glutened.

Very concise and easily explained. I was just wondering how up to date your list was as other sources put kale on the avoid list as it is related to cabbage, broccoli and the other cruciferous vegetables. I know they are constantly researching foods and sometimes they do move around on the list. I see that the post date of this chart was August Aglaée does have an updated list on her site. Dear Sarah You are amazing! Thank you for all of your hard work and dedication to this cause.

I await your new book, but cannot pre-order as I need the Kindle version, I live in Turkey and sending anything here for the states is painful. Will it come out in a Kindle version? This blog was perfect for me. I have been eating for Candida elimination for the last 6 months and decided to start to add back some fruit since it is season now. I was shocked to become so sick from a few cherries. I had no idea that fruit was a problem for me. You are a life saver! I wish you perfect health and prosperity.

Thanks for the info. I am here because I ate a good amt of garlic they other night and thought I was dying! Bad pain, nasusea bloat gas and constipation. I started doing Whole30 in March, it helped my gut dramatically, and now follow Paleo since then.

Anyway the pain the other night has me researching and I wonder if I have a sensitivity to fructans. Or just cut out the fructans? If I have a problem digesting them should I take a probiotic as well? I currently do not. I need a nondairy probiotic…. Thanks for all the info!

By far, far, far the highest fructan foods are from the allium family onions, leeks, garlic. Oh, and the green part of alliums are okay, so you could buy green garlic looks like a leek and just use the green part, or use chives, or the greens of green onions, etc. My favorite probiotic is Prescript-Assist: I can eat polyols on a rotational basis. I have a lot of trouble with fructans and am wondering if there is a particular enzyme that is best to help digest them? Or did you go straight to the enzyme supplement?

Thank you for answering about the palm shortening! I wanted to try out the Paleo low fodmap diet. I printed out the food list.

But I keep wondering if I should add in the SIBO recommendations as well and just do a great big elimination diet all at once. Is there a chart for that? Does it take out all carbs? I feel that I need some carbs. I eat white rice, popcorn, and fruits and vegetables and tiny amounts of maple syrup or honey for my carbs. I was going to cut out the honey, and popcorn.

I have bloating that I cannot totally figure out. I have done lots of things with my doctor antibiotics, h pylori protocol, many probiotics, l glutamine, aloe, etc. I already eat a good amount of vegetables, healthy fats, and proteins, and am gluten and dairy free. I never really eat out or eat unhealthy oils or sugar. I have been diagnosed with pcos and other health issues but really think the root may have been mercury issues, and I have already worked on that, and am doing much better.

Just wondering because I bloat up more readily eating roast starchy veggies such as sweet potato than the same veggies in say a blended soup. Hi Sarah, I am thinking of starting the Paleo diet for an auto-immune condition. It all seems very overwhelming, but promising. Do you know of any person or organizations that I could contact that would be able to assist me in setting up an acceptable food list and just give me direction?

Thanks so much for all your hard work! Your website is incredible! In the meantime, I would suggest contacting Mickey Trescott of autoimmune-Paleo. My book will also have complete food lists and will be out just two weeks from tomorrow. You could also try the facebook group The Paleo Approach Community.

Cabbage is an absolute no go…as is any vinegar and any squash even spaghetti squash. What is the problem exactly with nuts?? I usually have 20 or 30 grames of nuts every day, is this too much? Sarah has more information about nuts here: Is soy lecithin isolated free of phithostrogen and allergens tha would be safe for people with leaky gut. I feel that if that the case would be helpful to have the soylent food replacement to help the diet.

Have you heard of it? My understanding is that soy lecithin does not have phytoestrogens or the more common allergens although sensitivity to lecithin is still possible , however lecithin by itself can contribute to a leaky gut, so taking it in supplement form is not something I recommend I have not heard of soylent. Very interesting, and something I realize I have to try. Finally, why are tomatoes ok, but not tomato sauce? We use sauces without sweeteners. But, is there a problem with cooked tomatoes?

The green part of leeks would be really good in chicken soup. I believe parsley and cilantro are fine. Unfortunately, you have to experiment. Thank you, ThePaleoMom and J. I actually had already made it last night before seeing these comments. I used carrots, celeriac thinking that perhaps the root would be better than the green? I will try the green onions and leek greens at some point as well, and may use them for a crockpot recipe instead of onions for later this week. I was so confused why a good doze of onion, garlic, and fermented drinks make me sick in my stomach.

I even looked up onion intolerance and the like to see if this was a known condition. Just one comment about saurkrat, not sure if it is just me or not, but I tried half a cup of it almost a week ago hoping it will help, but it really did hurt me. Fermented foods also trouble some people, or it may simply have been too large a serving. However, if I repeat for two or more days, its blimp city for me.

I do worry about not getting enough veggies, I mostly eat lettuce, and carrots in my soups. Interestingly, my parents have told stories about when I was a breast-feeding infant — if my mom consumed onions, I would get gassy and fussy.

I think that may be a suggestion that the FODMAP intolerance is pretty fundamental to my make-up and may be unlikely to resolve completely.

Now that I have a pretty good understanding of what my body wants, I can at least keep it from self-destructing. I just made the pumpkin well, acorn squash gingerbread muffins as a treat for my kids. I had one—they are very good! If you have any information on molasses, I would appreciate it. Does anyone have any suggestions for what the heck I can snack on??

Half of this battle is mental, I think, but I am feeling really frustrated. Dried fruit and coconut flesh are high in sugar and inulin fiber respectively, both of which Sarah recommends avoiding or consuming only in moderation on the AIP. Good snacks include small servings of protein perhaps jerky or leftovers from the day before or raw vegetables. Amazing, theoretic as well as practical book you have written!! If you have SIBO, you will need to address that with your physician.

You may find this book helpful: I have no digestion issues whatsoever. I would not remove them unless you have been diagnosed with or strongly suspect an intolerance to them.

You might consider looking into infections, histamine, or thyroid issues re: I was on docusate sodium, then I added senekot. Then the pharmacist told me to go on polyethylene glycol What about diet — should I be increasing insoluble fibre or soluble fibre, should I be reducing starches and sugars??? I have probiotics, but maybe I should take more than one pill a day. I also plan on making coconut kefir yogurt though that might have sugar in it too. I also take 50 mg Amitriptyline, mg pregabalin, mg azathioprine, and mg valproic acid.

I was doing ok with BMs with all those meds, but only started having issues after I started the new diet. I talked to my doctor about stopping the pantaprazole. She says to go ahead, but my pharmacist said to stay on because of the prednisone.

It was prescribed by the original specialist that diagnosed my illness and who prescribed the prednisone as well. The digestive track issues I think I could get immediate feedback once I get the diet right. I might even be able to alleviate illness symptom mostly fatigue and pain peripheral neuropathy from the illness — fancy way of saying nerve damage in my lower limbs. Ok so long post, I apologize. I hope you have some guidance for me.

Sarah does recommend a low-FODMAP diet if you have been diagnosed with any kind of SIBO or fructose malabsorption or strongly suspect those foods are a problem for you based on how you feel after you eat them.

Milk of magnesia and probiotics can help relieve constipation, as can any kind of fiber the general rule of thumb is to shoot for 9 cups of a variety of veggies and fruit per day as well as getting enough quality sleep and exercise.

Can coconut flour inulin actually cause bacteria overgrowth? Debating on whether just to cut back or cut them out completely for fear of creating an overgrowth. Do you know if a fermenting process would change the polyol content? I am thinking of water kefir. I add various friuts to the 2nd ferment and was thinking cherry juice might be nice and tasty. I know that the fermentation process converts fructose, but am not sure if it has any effect on the polyols.

On various lists I have seen almonds and cashews on the absolute no list and on the be careful list. Has there been an update? Thank you for all of the information! I always read conflicting information on coffee. I love the taste of coffee and drink 2 cups of decaf in the morning organic, swiss mountain process decaf. What is your opinion on the type of decaf I drink…should I stay away from all forms of coffee for a while?

Sarah discusses coffee in more depth here: What tests would you need to get done? Sarah discusses that here: Thank you for getting back to me! I started the AIP diet a few months ago. Anyone else gone through that?

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