Fructose intolerance is a hereditary disorder whereby the body does not contain the enzyme aldolase B. This protein is necessary to convert glycogen derived from fructose into glucose for use as energy in cells. However, when a person lacks aldolase B, toxic substances build up in the liver and hypoglycemia, or dangerously low blood glucose levels, results. Fructose intolerance is almost always identified during infancy, as most types of formula and baby food contain fructose.
Physical Indications
During a basic physical examination, health care professionals typically place their fingers just below the ribcage and ask you to inhale. If the doctor can feel your liver during this test, it may indicate a swollen liver. Usually, a swollen spleen also accompanies fructose intolerance; together these conditions are called hepatosplenomegaly. Consistent with a damaged or dysfunctional liver, another physical sign is jaundice, or a yellowing of the skin. Although these are classic indications of fructose intolerance, they can also indicate a series of other disorders, including those associated with alcoholism and a hepatitis infection. Therefore, further tests and an assessment of any other existent symptoms are necessary for a conclusive diagnosis.
Symptoms
Symptoms of fructose intolerance include vomiting, poor feeding, convulsions, liver damage, hypoglycemia and lethargy. These symptoms are more likely due to fructose intolerance when they exhibit a pattern of occurring shortly after eating, particularly foods that contain fructose, such as fruits, or sucrose, which is table sugar. However, these symptoms can indicate other ailments, as well; according to MedlinePlus.com, early symptoms of fructose intolerance are akin to galactosemia, while later symptoms align with those resulting from liver disease.
Tests
Health care professionals use various tests to detect fructose intolerance, each which target a different aspect of the body that a fructose intolerance affects. These include a blood sugar test to determine whether hypoglycemia is present, genetic testing to determine whether there is a hereditary proclivity, liver function tests and biopsies to determine whether there are any dysfunctions are damage, urinalysis to determine what the body is excreting, enzyme tests to determine whether there's a presence of aldolase B and blood clotting tests. Usually, more than one test is necessary to result in a conclusive diagnosis of fructose intolerance.
Diagnosis and Treatment
A conclusive diagnosis usually results from several indications. Doctors render positive diagnoses based on elevated urine glucose, urate, bicarbonate, lactate and protein levels. Positive diagnoses also result from elevated blood serum uric acid, lactate, bilirubin and fructose levels as well as reduced glucose, proteins and bicarbonate levels. Treatment usually involves nutritional therapy, usually by eliminating fructose. Those who deviate from this diet and incur fructose intoxication several times or frequently may experience growth retardation, liver disease, liver failure, gout, bleeding, seizures and death.
References
- MedlinePlus.com: Hereditary Fructose Intolerance
- "Life Cycle Nutrition: An Evidence-Based Approach"; Sari Edelstein and Judith Sharlin; 2009
- MedlinePlus.com: Hepatomegaly
- "Genetic Diseases of the Kidney"; Richard P. Lifton, Stefan Somlo and Gerhard H. Giebisch; 2009
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