Wednesday, December 14, 2011

GF Bread

So now that I’ve posted my GF mix I can post the GF bread that we use.  Since I used to make all my own bread we surely do miss the homemade bread coming out of the oven and eating it still warm, melting in your mouth.  We will eat GF bread out of the oven, but it’s just not the same.

GF bread is always best the day it’s made.  While some GF breads need to be eaten right away I do find that this recipe will last 2-3 days before it’s dried out and needs to be toasted.  So in that way it’s a good thing.  Since we have a good wrap recipe we tend to gravitate to them and not eat bread that much, but we do use the GF bread more for toast, like eggs and toast, french toast, or grill cheese.  As far as GF breads go this one is delicious.  Every now and then I need to remind myself how excited I was when I found this recipe as we thought it was just delicious after trying various other not so delicious GF breads.  I guess the reality is that we haven’t stopped grieving the loss of real bread yet … but eventually we will get over it and just accept this as our new bread and our new way of life.

Gluten Free Sorghum Bread (makes 14-16 slices)

Dry Ingredients:

  • 2 1/8 cups GF Mix
  • 3 tbsp sugar (this is a bit more then I’d like to see in bread, you can reduce it, but we find the bread is drier then)
  • 1 tbsp xanthan gum
  • 1 tbsp instant yeast
  • 1 1/4 tsp salt

Wet Ingredients:

  • 2 eggs
  • 1 egg white
  • 1 cup water
  • 2 tbsp vegetable oil
  • 1 tsp white vinegar


  • For raisin bread add cinnamon to the dry mix and after you have mixed the dry ingredients into the wet ingredients add 3/4 cup raisins (if tolerated).



In a large bowl mix together the dry ingredients.  Stir well to make sure the xanthan gum has been well distributed.  Set aside.


In another bowl with an electric mixer mix together the wet ingredients with a paddle and not a bread hook as you would with wheat bread.


With the mixer on low slowly add in the flour mixture


Continue to mix until it is well combined, if necessary scrap down the sides with a spatula.  It should be the consistency of a thick batter.


Turn your mixer to medium speed and beat the batter for four minutes.


After four minutes the batter should appear smoother and thinner.


Pour the batter into a greased loaf pan. ( I usually do a double batch since this bread freezes well.)


Now the loaf needs to rise.  Place it uncovered in a draft-free place.  I usually put it in my oven.  I will turn my oven to 200F and let it start to preheat for 2 minutes and then turn it off.  This makes a nice warm place for the bread to rise.  (My mixer cannot do four loaves at a time, but I will do two batches of two loaves right after each other … I figure if I have all the stuff out I might as well make it worth the mess)


Let the bread  rise for 30 minutes, or until it reaches the edge of the pan … if you do not use the oven this may take closer to 60-75 minutes.


Since I let the bread rise in the oven this means that I need to remove it to preheat the oven.  This is why I usually check the bread after 30 minutes to see how it’s doing.  It can continue to rise on the counter (although at a slower pace) while I wait for the oven to preheat.  You will note that two loaves are larger, this is because they were the first batch I made.  If there is a noticeable different then I will start baking the first two loaves and place the second two in about 10 minutes later.    Since there is no gluten in this bread it can only rise slightly over the top of the loaf pan, if it rises to far it will flop over and start running down the sides as the xanthan gum is not strong enough to hold it together like gluten does.

  P1090121 P1090120

Preheat the oven to 350F and once it is heated place your bread in oven for 35-45 minutes (this fluctuates from one oven to the next).  Remove the bread from the bread pan as soon as possible.  I do find it does not always shake out right away after taken from the oven, but if I leave it in the pan for about 5-10 minutes it will gather some moisture and loosen up.  Otherwise, carefully scrap a knife along the edges to loosen it.  Cool completely on rack (or eat warm).


You now have a nice moist loaf of gluten free bread.  Slice it up and enjoy it.

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We will also slice the loaf and put it in the freezer, that way we can take out slices as we need them.  We do find that bread that comes out of the freezer tastes is drier and better as toast … but since we use GF bread mostly for toast (and Crepes/Wraps instead of bread) this works fine for us.


Or … you can slice it and put it in the oven to dry it out and make bread crumbs.  Usually I use the ends of the bread or “old” dried out bread for this, but sometimes I’m low on bread crumbs and need to just make a couple loaves into crumbs.




Gluten Free Mix



  • 6 cups/parts sorghum flour
  • 2 cups/parts potato starch
  • 1.5 cups/parts tapioca starch

Mix together and store in container.

Use this GF mix to replace wheat-flour in your recipes.   When replacing wheat with a GF mix you will also need to add xanthan gum to the recipe.  Xanthan gum is like your gluten, and replaces the gluten that these flours do not have.  I usually use 1 tsp of xanthan gum per 1 cup of GF Mix.  For those extremely sensitive to corn you may want to be careful with xanthan gum as it is often derived from corn.  If this is the case, you may want to consider using Guar Gum.  Personally I like xanthan gum better as it seems to work a bit better, but that is just my preference, both are commonly used.

Since I hate having to mix the GF mix up all the time I purchased a Tupperware Larry Carry-All container, which holds approximately 55 cups of flour.  It is very handy having it pre-mixed as I can just pull this container out and bake like I would when baking with wheat, instead of having to pull all kinds of flours out and mix them all up first. 


I have tried a variety of Gluten Free mixes over the pass couple years, but once I found this mix I have never looked back and never tried another mix.  This one is as close to real flour as it’s going to get and so I’m sticking with it.  I love how my baking turns out with this, none of that rice flour texture, and only a mild taste different (which after eating GF for a while you don’t even notice).  Actually it’s so close to real flour that I will have to tell people that they have just eaten Gluten Free baking as it does an excellent job of making wheat flour-like squares and loaves.  I really love this GF mix and once I found this mix I was better able to stick to the GF diet because I actually liked what I was eating. 

Sorghum flour may be a bit harder to find then other Gluten Free flours.  I have no idea why this is as in my opinion it is one of the best gluten-free options out there.  I also have no idea why rice flour is so common when it has such a odd taste and texture and does not make a very good replacement in recipes.  My original search for sorghum flour was disappointing as I would only find it at the Bulk Barn sold in small packages (and not in bulk) for $5 for 500grams.  Yes, that’s right $10 for a kilogram of the stuff.  I did buy it and that’s when I fell in love with it.  And so I had to undertake the task of trying to find it for cheaper.  Thankfully it did not take me long to find a local health food store that would sell it to me in bulk, with a 10kg bag costing me $17.  To me this is a reasonable price as far as alternative flours go and I was just recently even more excited when someone introduced me to a place that sell all of the above flours for much cheaper then what I am currently pay. 

I encourage people looking for alternative flours to look around, check out the local Health Food stores or Asian food markets and ask if they will order for you in bulk.  I now just have to call and order a 10kg bag of whatever type of flour I need instead of having to go to the bulk food store and scope out what I need.  Flour prices fluctuate but these are the prices I have been able to find my common flours for:

  • sorghum – 10kg bag for $17
  • tapicoa starch – 10 kg bag for $26
  • potato starch – 10 kg bag for $29
  • oat flour – 10 kg bag for $19
  • xanthan gum - $23/kg

Based on the above prices it would cost you $0.33 per cup of GF Mix, plus $0.07 for 1 tsp xanthan gum. So to replace 1 cup of wheat flour (which costs approximately $0.15 per cup) in a recipe it would cost $0.40.

These prices were much cheaper then the Bulk Barn where most people would go to in my area for alternative flours and larger quantities.  And as I mentioned it pays to look around as I just found out that there is a place I can get these flours for a fair amount cheaper, the only problem being that I have to buy a minimum amount of $400 to get it at that price.  So if you know more then one person using Gluten Free flours then a place like this would work very well for you … right now I’m debating whether it is worthwhile to go to such a place as I really don’t have the space to store excessive amount of flour, even if we do go through it relatively fast.   I am still holding hope that with time, as GF products become more and more widely used, the prices of these flours will come down and be closer to the price of regular wheat flour …but for the time being, we make the best of what we have.

Further information on xanthan gum:

Further information on guar gum:

Further information on sorghum flour

Tuesday, December 6, 2011

Oat Crepes/Wraps

Oat Crepes (or Wraps as they are called in our house) are a staple in our house.  They make a yummy sweet breakfast, they replace bread for our lunches and are also great for snacks or dessert.  These wraps serve as a standard crepe in our house as well as a replacement for wheat tortilla wraps.  It took some adjustment to get used to the idea of them being like a tortilla, but now that we are used to it we like them and would take them anytime over GF bread.  Matthew loves his wraps and is rather unhappy if there are no wraps for lunch each day.  I am glad that we have found sometime to replace bread that is portable and more edible then GF bread.  We find the GF breads are just not bread and while we have found a decent recipe our preference is still to eat GF bread as toast (unless it’s just fresh out of the oven) or for french toast.  I’m not sure how we would survive without our Crepes/Wraps

Since these are made with oat flour they are not suitable for those who are gluten free.  I keep thinking I should try learn to make a GF wrap, but I’m happy with these and just haven’t gotten around to trying out new recipes (we did at one point but when we couldn’t find a suitable one we resorted back to these).  The biggest issue with the wraps is that they have to be eaten the same day they are made.  There is no making a batch ahead of time that you can just scoop from.  I make the girls wraps in the morning before school and then make fresh ones for Matthew and I at lunch.  If they are not eaten by the end of the day I throw them out as they will be tough and yukky the next day.  While you cannot fry a huge batch a long time ahead of time, you can make the batter several days ahead and leave it in the fridge.  I usually make a big batch of batter and then fry them up as needed.  This makes it relatively simple, only requiring about 5-10 minutes (depending on how many you are frying and how many pans you use at a time) to fry them up before you sit down to eatP1080730.

Oat Crepes – 18-20 crepes

  • 2 cups oat flour
  • 1 cup GF mix
  • 1 cup tapioca flour
  • 1 tsp salt
  • 5 eggs
  • 2/3 cup canola oil
  • 3 1/2 cups water

Mix above ingredients with a mixer until a thinner pourable consistency.  You will learn with time what consistency you want it.  If they are not spreading easily throughout the pan when you make them then add more water to make it thinner.



Preheat your non-stick frying pan until it’s good and hot.  With a soup ladle pour the batter into the frying pan with one hand and use your other hand to roll the pan around so the batter spreads evenly over the bottom of the frying pan (you can pick the pan up and actually turn it on it’s side each way to get the batter to move quickly from one side the next).  You want the crepe to be as thin as possible, so you need to do this quickly.  If your batter is not spreading quickly over the bottom of the pan try to add a bit more water so it is thinner.  Again, this will take time to figure out the exact amount to fill your soup ladle for the size pan that you are using.

Allow the crepe to brown until your edges begin to curl away from the side of the pan, don’t leave it too long or you will have dry/tough edges.  You should be able to freely push it around in the pan when it’s ready to flip.


Place your flipper under the crepe and quickly turn it over


You will see a neat honeycomb pattern on the side you just fried.  Allow the second side to fry for about one minute, it does not have to go long.


Transfer crepe to a plate.  The crepes will be stiff at this point.  Place another plate on top of the crepe to lock in the moisture


Add more crepes as you fry them.  Allow them to sit for a few minutes so that they soften and will be easy to roll up .  If you are doing several crepes by time you add the last one the first ones are ready to be eaten and so you can just flip the plates over and start from the bottom … or what now would be the top.


It will take some time to adjust to the idea of a softer texture wrap compared to a tortilla or pita wrap.  But we have found that these have been a life-saver as we prefer them by far over GF bread.  We will put meat and cheese with lettuce and mayo on them, sunbutter, tuna salad and lettuce, egg salad, golden cane syrup, or for dessert strawberries and whip cream … lots of different possibilities.  This is not to say that there aren’t times where we still say “oh, how I miss bread”, but having these wraps has certainly made lunches easier and more endurable. 

Wednesday, November 16, 2011

Our Challenge List

After going through the cleanse process and starting to reintroduce new foods I found myself sitting down and looking at all the various lists that I had regarding what was okay and not okay to eat when one has FM.  I needed to go through those lists to get a better grip of what was commonly considered okay.  It took some time to gather the various lists and go over them and over them and try to determine which was the most consistent information.  I remember being quite baffled and frustrated at the time.  Finally I developed a list that I thought was pretty consistent with what I had read.  I wanted my own list so I wasn’t always flipping through the various lists trying to determine what to try next or what was sort of okay.  I’m glad I took the time to do this as after that I could just look at my list and stick with it.

This does not mean that the items on this list are all safe for those with FM.  What it means is that they are the mostly commonly tolerated foods or non-tolerated foods.  Each person is very different when it comes to FM, so it becomes an individual trial of the most commonly tolerated foods to determine what you can or cannot eat.  Remember to only introduce one new food every 5-7 days and not to overeat on the trail food.  Eat a small portion of the new food (e.g. 1/4-1/2 a banana, 2 strawberries) and then wait for 3-4 days to see if there is any reaction.  Consider trying it a second time before moving on to a new food … this would mean it would actually be  8 days before you introduce a new food.

At the time of making the list we already had added a few veggies back into our diet.  So the list below is a copy of what I compiled at that point in our diet. 


Currently Can Eat

Currently Can Eat











Gr. Peppers

Pears (P)




Watermelon (F/P)

Milk – cheese, yogurt, etc







Peach (F)








Onion (F)

Peanut butter


Garlic (F)

Pumpkin seeds

Future Possibilities/Trials

Future Possiblities/Trials

Nectarine (P)

Sesame Seeds



Cherries (P)




Plums (P)



Green beans








Swiss chard


Green beans









*Mushrooms (P)



*Cauliflower (P)



*Broccoli (F?)



*Peas (F/P)



Beets (F)


Cabbage (F)


* low overall fructose

# medium overall fructose

(P) Polyols

(F) Fructans

**Tolerated tryptophan foods are good for those with FM as they help the body to process seretonin which is often hindered from being produced as it should in the intestines of those with FM. Eating extra tryptophan can help to reduce mood/emotional struggles

Elimination Diet Meal Ideas

It’s bland and boring, but it’s low in fructose and fructans
  • eggs – fried, boiled, scrambled
  • bacon (look at ingredients find something sweetened with sugar or maple syrup),
  • hashbrowns (check ingredients for type of oil used)
  • ham mixed into a scrambled egg or on the side (again check ingredients on ham that it’s sweetened with sugar)
  • fried potatoes (a safer option then hashbrowns)
  • # oatmeal/porridge– can use oats or oat bran, cooked in water, add a small amount of lactose-free milk when eating
  • GF pancakes with margarine or butter or topped with an egg
  • #oat crepes/wraps* – filled with egg, bacon and/or ham
  • GF bread* or toast
  • plain cheerios # (this is if gluten intolerance is not suspected as cheerios are made with oats and have wheat starch added)
  • GF bread* or toast
  • oat wrap* with:
    • okay lunch meat
    • mayonnaise and chicken/turkey
    • egg salad (mayonnaise, egg, salt)
    • tuna salad (mayonnaise, tuna, salt)
  • rice paper wraps (usually found in the Asian food section of the grocery store) with same as above – we often put two “papers” together to make a firmer, easier to hold wrap
  • soup
    • fry ground beef, chicken, turkey, add salt and water, bring to boil, add rice or white rice noodles
    • cook chicken pieces in water with salt for a couple hours, remove meat and add to broth, add bit more salt, bring to boil, add white rice noodles
  • pasta salad
    • use white rice noodles, cook until done, add tuna, mayonnaise, salt
This list may seem short, but you can make potatoes in a variety of ways as well as use a variety of meats to keep things a bit more interesting
  • white potatoes
    • cooked, mashed, baked, french fries (watch ingredients if getting store-bought)
  • white rice
  • white rice noodles – check ingredients carefully, most gluten free rice noodles are made with brown rice.  Look for rice sticks or vermicelle in the Asian food section, these are white rice AND much cheaper then rice pasta, these also come in various size that can be used in soup or like spagetti
  • non-processed meat seasoned with salt and pepper
    • steak,  unseasoned roast, ham (check ingredients as these are usually seasoned but often with okay ingredients), pork chops, whole chicken, chicken legs/thighs, unseasoned chicken breasts (usually you have to buy the fresh kind to get it unseasoned), turkey, venison, ground beef, chicken, turkey, pork, etc., fish, seafood ….etc, etc.
    • meatloaf – mix together 1lb ground beef, 3/4 cup oatmeal, 1 egg, 1/2 cup lactose-free milk or water and salt – bake in oven at 350 for 45 minutes
  • fried rice
    • fry ground beef/chicken/turkey, add salt, add cooked cold white rice, fry together until warm, can also add scrambled eggs to rice mixture  (later you can fry in some tolerated vegetables)
  • Confetti Rice
    • mix 1 cup instant white rice, 1 can of canned ham, chicken or turkey, salt, with 1 cup water, microwave for 10 minutes, sprinkle with grated cheddar cheese if desired, microwave another 1-2 minutes  (later if able to tolerate peas and/or green pepper you can also add some of these)
  • boiled egg
  • plain potatoe chips
  • toast with margarine or occasionally cheddar or cream cheese
  • GF pancakes – make small cookie size pancakes, add some margarine for extra flavour  or a sprinkle of sugar
  • GF cookies – store bought ones are hard to find that are not made with brown rice or unsuitable sugars
  • meringue cookies
  • GF crackers – Glutino makes crackers with white rice
  • water!!!  Drink lots!!
  • kool-aid made with 1/2 amount of sugar
  • green (decaf) tea or rooibos tea
  • ice tea (homemade, not storebought)
  • powder Gatorade - (some premade kinds can be okay, but it is not always clear if they are made with HFCS, whereas the powder form is made from sugar and dextrose)
  • limited amounts of lactose-free milk
  • egg whites/meringues*
  • pavlova*
  • jello (not sugar-free, use regular) in small servings
  • homemade popsicles – made with kool-aid or mix kool-aid and jello
  • ice pops (check ingredients – in Canada these are made with sugar and dextrose)

*recipe to follow in future posting
# avoid if you suspect gluten intolerance

Tuesday, November 15, 2011

High Fructose Foods

So we talked about safe foods, but it’s probably good to also list the high fructose foods … the ones you want to avoid completely and not even take in small amounts … at least not until you are confident in your diet

  • Pears
  • Apples
  • Watermelon
  • Mango
  • Honey
  • High Fructose Corn Syrup (HFCS) also called glucose/fructose
  • Fructose
  • Onion*
  • Garlic*
  • Asparagus*
  • Wheat*
  • Brown rice*
  • Canned fruits sweetened with pear juice
  • Fruit juices


These are the foods you will pretty much always find on the various “To Avoid” lists.  The foods that have the most amount of fructose (in relation to glucose) or fructans.  There are more foods to avoid, and more foods can be divided by what’s usually safe and what’s often bad, but those foods are often very different from one individual to the next, whereas the above listed foods usually will cause problems and it is just best to stay away from them.

What to Eat During the Elimination Diet

What can you eat on the elimination diet?  This is million dollar question.  What is truly safe for those with FM is always a pondering question.  The answer that many foods are out for the first bit and the diet is very basic because FM is so individual that you need to stick to the very basic most safe low/no-fructose foods.

One thing I want to stress is the necessity to take wheat and brown rice out of your diet.  Wheat and brown rice, as well as onions and garlic, contains fructans (which I’ll get into in another post).  I also recommend that you keep these out of your diet for at LEAST one month, the longer the better.  For myself and many others they have found wheat to be a problem, but because it is a fructan it seems to sometimes cause a different reaction then fructose and so we are often fooled into thinking that it is okay.  For myself, fructose causes gas and bloating as the most obvious symptoms.  Fructans give me brain fog and make me extremely tired.

Another thing that would be wise to do is to eliminate as much dairy as possible and use lactose-free products if you are using dairy.  Many (dare I say the majority) of people with FM also have Lactose Intolerance. 

Below is an idea of the safe foods to eat.  As you can see this is very limited and you will find yourself eating a lot of protein … remember the goal is to feel better and relieve your pain and heal your gut so that it can better absorb the foods that it does get.








WHITE potatoes


WHITE rice

100% cane sugar in moderation



WHITE rice noodles







Zucchini #

Rhubarb #


Canola margarine


Spinach #

Pumpkin #


Canola oil




Lactose-free milk in moderation




Low lactose items in moderation **




White vinegar




Mayonnaise – look for a natural mayonnaise without the added garlic and lemon etc. or make your own

  • *If you suspect gluten intolerance then it is best to avoid these
  • **Butter, sour cream, cream cheese, cottage cheese, hard cheeses (cheddar, parmesan)
  • # Most people can tolerate these items. If you can avoid them for the first part of the elimination diet this would be best, but realizing that you may find you need some fruit and veggies these would be the best options in very small amounts

The Elimination Diet

So you feel relieved that you now have a diagnosis and you know that you have FM, but then you turn to the computer to get a list of foods you can and cannot eat and you discover that every list says something different.  Talk about confusing and discouraging.  If you’re lactose intolerant you remove milk from your diet and after a time slowly reintroduce foods on the list that are low in lactose, if you’re gluten intolerant you look at the list of grains/flours that have gluten in them and remove them from you diet.  If you’re fructose intolerant (malabsorbant) you can’t find a list … or you can find lots of lists, but they’re all different and you have no idea what you can and cannot eat. 

It’s a bit overwhelming at first, overwhelming and frustrating.  It is a constant battle of evaluating everything you eat and every symptom you have, small or big, to try piece together what may have cause that, what did you miss or what did you accidently eat when you thought you were doing so good.  This is usually one of the biggest challenges of FM, trying to understand the diet and what works for you.  And in the end, even if you’re with a support group that can help to guide you, it all comes down to trial and error and what works for you.  There is no magic list, you have to trial the foods yourself to figure out what you can handle and what you cannot, you have to stay focused on the long task of reintroducing foods.  Depending on your level of sensitivity you may find this a challenging process or it may go okay if you are not extremely sensitive. 

One of the purposes of the Elimination Diet is to help you determine how sensitive you are and to give yourself a clear indication of what foods are okay, but the main purpose of the elimination diet is to get yourself to a point of feeling well again, to rid yourself of those symptoms that sent you searching for an answer in the first place.  This process usually takes about 5-7 days.  It is recommended to stay on the elimination diet for at least one week, preferably two weeks, this gives you system a chance to clean out as well as some time to recuperate, the more recuperation time the better the reintroduction of foods will go.  Some people have spent more time on the very basics because they just feel better that way.  The problem I encountered with the elimination diet is the lack of variety.  The lack of variety makes it hard to stick to, but it also means lack of nutrition.  I suffer from IBS-C and was left wondering if the constipation was still there because of the lack of fiber, fruits and veggies in the diet.  Unfortunately I was unable to reach a stage of feeling well as I could not get rid of the constipation (later I discovered this was a side-effect from my medication) but after a couple weeks on the elimination diet I decided I had to move forward to try and get more food into the diet.  There is no clear cut answer on how to go about it, you have to go on how you feel and what you think is best for your body, but it is definitely recommended to aim for at least one week on the very basics to get your system cleaned out.

After you have given your system a chance to clean out and hopefully feel better then it’s time to start trialing food.  This is where it almost gets more difficult.  You feel like you made it through those first days of eating nothing and now you’re ready to go, but the battle has only begun.  It is recommended to only introduce ONE new food every 4-5 days.  Reactions times can vary from immediately to up to 3 or 4 days after you have eaten a offensive food.  With time you will learn what your reaction time usually is and you may be able to adjust your reintroduction times, but as much as you want to rush things it is best to take it slow.  The next big battle is against cheating … oh it’s so tempting to just have a little bit of something bad … but that means you’ve messed up your system and have to clean it out again.  That means you have to go back to the basics for 5 days or so to give your body a chance to be recuperate otherwise you will not truly know if it’s the new food you introduce that is the problem or the food you ate when you cheated.   As you can imagine adding one new food every 5 days means it takes a LONG time to build up your food list … and that’s if things go well.  If you introduce a food that you react to you need to make sure you give 4-5 days of healing time before you try something new. 

I give credit to anyone who is able to stick out the elimination diet without cheating or getting sidetracked.  It is a difficult journey and I will admit that there were many times where I just “had to have” that “bad snack”.  Only to regret it shortly after I ate it, realizing that I was never going to get ahead if I kept picking at those things I missed so much.  It’s hard, and it’s frustrating, but it does get better.  It is also very much a mental battle.  You have to WANT to get better and WANT to go through the process.   There will be discouraging times where you can’t figure out what’s effecting you or you feel like you will never feel better, but you need to keep at it.  You need to also come to a point of accepting that this is a permanent change.  I think that was one of my biggest problems, I thought our FM issues were mild enough that we could get away with just removing the worst items and still being “normal”.  I had to come to terms with the fact that if we truly wanted to feel better then we had to change how we eat.  Many people find it useful to keep a record of the foods they eat and any symptoms they have each day so that they can better evaluation what is happening and be able to look back over time to see if there is a consistent pattern.

I know what the next question is … “what can I eat on the elimination diet?”

Wednesday, October 5, 2011

What is Fructose Malabsorption?

The simple answer would be that FM is when the intestines are unable to properly digest fructose, leaving a person with various health problems.

More complex?

Our intestines are only able to digest so much fructose per sitting.  When one has fructose malabsorption that means that they are not able to digest as much as the average person can.  If a person is not able to digest 25 grams of fructose per sitting they are considered to have FM.  25 grams of fructose is a lot of sugar in a sitting.  There are varying degrees of FM sensitivity, some can only absorb about 1 gram of sugar per serving and others can absorb closer to 20-25g. 

Fructose is a simple sugar called a monosaccharide (from the greek meaning single sugar) found in many plants and often called fruit sugar.  The body uses monosaccharide for energy.  Pure, dry fructose is a very sweet, white, odorless, crystalline solid and is the most water-soluble of all the sugars.  Fructose occurs naturally in fruits, some vegetables, honey, sugar cane, sugar beets, wheat, and some other plants.  Fructose is found commercially in sucrose (table/white sugar) and high fructose corn syrup (knows as fructose/glucose in Canada), as well as crystalline fructose.

A person with FM has an inability of the small intestines to break down fructose into smaller molecular fragments for digestion.  The fructose ends up progressing down to the large intestines where bacteria breaks it down into methane gas, hydrogen gas, carbon dioxide and fatty acids.    This results in bloating, diarrhea, flatulence, abdominal pain, nausea and lethargy.  Symptoms generally appear two to 24 hours after ingesting fructose-containing food.  Because this usually causes diarrhea this also results in important vitamins and minerals being lost and over time a person can develop nutritional deficiencies,  commonly calcium and iron, but long term can lead to anemia and osteoprosis.

It should be mentioned that Fructose Malabsorption was previously called Dietary Fructose Intolerance and is still sometimes referred to as this.  Fructose Malabsorption is different then Heriditary Fructose Intolerance (HFI).    In HFI a person lacks the enzyme to break down fructose, thus it can cause liver and kidney problems, as well as be fatal. Fructose Malabsoprtion (FM) although not always pleasant it is not life-threatening and is easily manage by diet. In HFI you must adhere to a very strict fructose-free diet whereas with FM you can learn to adjust your diet according to what you can tolerate.

Links to further reading:

Tuesday, October 4, 2011

Symptoms of Fructose Malabsorption?

The symptoms of FM are very widespread, but the most common ones are:

  • bloating
  • (smelly)  flatulence
  • diarrhea
  • constipation
  • stomach pains/cramps
  • acid reflux/indigestion/heartburn

The other common symptoms that people will complain about are:

  • vomiting
  • brain fog/fuzzy head/difficulty concentrating
  • aching eyes
  • fatigue 
  • headaches
  • mood disturbances
  • depression
  • trouble sleeping
  • joint pains

(*italics denotes symptoms that I get)

If you look at this list you can see that it would be rather hard to come to the conclusion that FM is what is ailing a person by these symptoms. Those with FM are usually diagnosed with IBS, and unfortunately that's as far as the doctors go.  I’m not sure why they find it acceptable to just diagnose a person as having IBS.  That to me is like saying “you have cancer” and leaving it at that.  Cancer is a broad term used to explain a larger variety of illnesses, but to tell someone they have cancer does not tell them anything about the cancer they have, what form they have, how they got it, how to treat it, etc.  IBS is just a broad term that tells a person they have something going on with their intestines/bowels.  But what is causing the irritation?  How do you treat this irritation?  IBS classifies the symptoms but does nothing to help a person fix the cause of the symptoms.  I don’t need a doctor to tell me I have IBS, I know that, but what I need to know is what caused this syndrome and how am I going to treat it. 

Many people with FM are left undiagnosed for years before they finally stumble across FM, often after having tried many different medications,  diet changes, and evaluated what they are eating for quite some time.  Some people are fortunate enough to have a doctor who is aware of FM and will send them for the test, but many doctors are not aware of FM or that there is a test for it.  There are also many doctors who believe that there is no such things a FM (leaving patients extremely frustrated and “lost”).  There is slowly becoming more awareness of FM, but it is still widely unheard of.  While there is a test for FM the ultimate test is the diet, as this is what will truly tell you the severity of your FM, and if you couldn’t have the FM test done, then it will help you to determine if FM is what is ailing you.

Managing your low-fructose diet is done by managing your symptoms.  When the symptoms are under control the diet is under control (that is if there aren’t other things to factor in also, which there often is).

Where to Start?

It’s hard to even know where to begin.  I remember the excitement of getting a diagnosis for Rebecca, and then the discouraging feeling when I began to read and research and couldn’t come up with any very consistent information.  I remember reading and reading and trying to put it all together … even now I have to keep reading and trying to understand since it’s a disorder that continues to change as more research is being done.  What we thought was okay at one point is no longer considered okay (e.g. rye) and what we were told to avoid before might be said to be allowed now (e.g. green beans).  But in the end they can say all that they want but it it still comes down to your individual sensitivity which can just leave you thoroughly  confused as so many things can factor into that sensitivity (sensitivity to other foods, medications, other illnesses, etc).  It’s been over a year of seriously trying to figure out my diet and I’m still very confused at times.  I know this sounds discouraging, but I also know that if I were a bit stricter I might be able to put a better finger on things.  At the same time I also realize that I have Wacko Steph Syndrome (which simply means nothing with me ever makes sense or follows the books) so I’m not a very good example.  Everytime I think I have it figured out something else changes things making me feel discouraged and lost (e.g. a recent change in medication).  I just *sigh* and keep trudging along reminding myself that while I don’t have it all figured out I’m a long ways ahead of where I used to be and this means I feel better then I used to.  Focus on the positive and deal with the negative.

That all being said I have to say that I do not have an extreme case of fructose malabsorption (FM).  I would say that in our house we are moderately sensitive.  We would be most sensitive then those who are mild and just have to avoid the worse fructose foods, but we are not so extreme as some who have a very very limited diet.  We are able to eat a good variety of food, especially since we removed wheat from our diet.  We found that wheat (fructans) was our biggest issue and once we removed that we were better able tolerate more fruits and vegetables.  So while we’re not the mildest case we are definitely not severe.  People who know us may think our diet is difficult and we have some severe sensitivity, in comparison to the many other FM people I have heard from, communicated with, I know that we have it pretty easy.

As I write my blog I want to remind people that I am not a doctor, I have no medical background and am not very good at understanding biology … although I have certainly had my abilities tested and trained in this area in the past years.  I am simply a FM sufferer and mother who wants to enjoy eating while keeping unwanted symptoms away so that we can feel healthy and enjoy our life.  My goal is to simply have a place where I can store information, for myself to go back to and for others to learn from.  A place where the information is gathered.  I realize that it is always best for one to do their own research, but this will provide a starting base and as much as possible I will try to provide links so others can read and learn from what I have read.  This will help me to remember where I found information as well.  So often I read something and keep it in mind when trying to figure things out, but then can’t remember where I read it to refer back to it. 

Welcome to my blog.  I am going to assume that since you are here you, or someone you know, has FM.  I am sorry that you have to deal with this, but with time you will better understand how to eat healthy and what your body can tolerate and this will help you to feel better.  It may seem overwhelming at first, but with time you will get a grip of it and feel more confident in determining what you can and cannot eat, what you can tolerate, how much you can tolerate, etc.  While FM sucks … it is manageable and treatable.

Wednesday, September 28, 2011


Some time ago I dedicate some space on my other blog to talk about Fructose Malabsorption (see here). Over the past two years we’ve struggled off and on trying to figure out Fructose Malabsorption and how it affects each person in our family. Due to the comments, e-mails, amount of people my sitemeter says come to this blog after searching Fructose Malabsorption, and the general confusion and frustration of trying to understand Fructose Malabsorption I thought I would take some time to write a bit about what I have learned through the various information that I have come across in the past years.

Probably a bit of history fill in will help here. As the blog previously talked about, we stumbled across FM when we were trying to figure out what was ailing Rebecca’s tummy. After her diagnosis a light bulb went on that this may be the reason why our little Matthew refused to eat any solids, was often sick, vomitting, constipated or sometimes had diarrhea, was so unhappy, and always crying. Indeed he had FM. Although this did not solve all his problems and it took another half a year to put together the rest of the equation (an intolerance to soy and rice as well, on top of milk), it was a step in the right direction for him.

With two people in the family having the same diagnosis it meant I was doing my share of reading and trying to understand what they could and could not eat, what to watch for, what the symptoms were, etc. This reading began to make me wonder if this could explain a few of my issues and so off I went for a FM test also. My test came back positive. When I went I also took Marietta with. Marietta complained often of odd headaches and just feeling icky but with no specific ailment, I figured she just wanted a fructose test too since the rest of us did. Well much to my surprise she also had FM, I was even more surprised when she was sick only minutes into the test. You would think with four people in the family having FM it would be easy to get a grip on the diagnosis and what we can and cannot eat, what symptoms come from what we do eat, etc. This has been far from the actual case.

After our initial trial with Rebecca on a low fructose diet and no success we allowed her to return to “normal” eating, only taking out the main and obvious fructose loaded foods (e.g. apples, pears, pop, juices, honey). She has constantly told us “I don’t have FM”. But regardless she has had a positive FM test and that means she must be aware of how fructose affects her body and take this into consideration when choosing what she eats. Rebecca does have some symptoms that could be related to FM, but it is very hard to tell whether that is the case or whether these are due to sometime completely separate... more on that in a later post.

Matthew was our child that had to obey the diet more strictly. Being young I really had no way of telling what he could or could not eat. His main symptom was that he turned miserable when he ate the wrong thing. There could be various different reason for this, the main one being that he’s uncomfortable or in some sort of pain and this is the way he shows his pain. The other reason could be a symptom of FM where eating too much fructose affects a persons mood (more on this later). Whatever the case, Matthew turned miserable, clingy, whiny, defiant, ignorant and annoying when he has too much fructose.

Matthew also would sway between constipation or diarrhea when younger. Now we do not so much see changes in the stool texture as in it’s colour. It was not uncommon for Matthew to have florescent green stools – yes, florescent, bright green. A bit of online research on this tells me that this happens when a person is not properly processing food. Bile is green, which as it travels through the intestines becomes yellow and then brown. If food is not processing properly or going through the intestines too quickly then stools become yellow or green (like when one has diarrhea). So while Matthew may have formed stools, his colour indicates to us that they are not actually processing properly.

It’s been a challenge to figure out Matthew (just like the rest of us) because he’s was young and could not let me know if he has any other symptoms that would give us better indicators of what he can and cannot eat. While this is somewhat better now, it is still an issue trying to figure him out as he’s still too young to read what his body is telling him. At one point we had relaxed drastically on Matthew’s diet as we were no longer getting stool reactions, but he became more and more miserable. I tried to write it off as terrible twos ... but as it became more prolonged I realized we had to pull in the reigns again and see if he would do better ... he did! Thus I cannot deny that fructose is an issue for Matthew.

Marietta, who was originally thought to just be looking for attention, seemed to also suffer enough from FM to make us consider putting her on a low fructose diet. Her original symptoms that she had trouble explaining, except to say she just felt not well, were brain fog as well as issues with her eyes – tried and strained eyes, she would also suffer from chest pains (bloating?). But as time went on she became more like her mother with her first sign of eating the wrong thing being some terrible smelling gas. At one point she was a bit out of control in this area, but now is doing really well. Marietta is an observant child and so she is quite good at figuring out how what she eats affects her body. While we have the gas issue under control now she continues to get brain fog and sore/tired eyes from time to time that we are not always able to figure out the cause of.

Then there is myself. It was reading all the information about fructose malabsorption that made me begin to think …. “I wonder”. For years and years I have struggled with headaches and neck and shoulder pain. I have severe TMJ which I have spent over 5 years having treated and while that relieved some pain it wasn’t the only cause of headaches. I have seen the doctors - who’s form of treatment is usually some type of pain medication to cover the discomfort but not to get to the core of the problem and try to treat/fix it. I have done physiotherapy, chiropractors (in the past this was not affective, although recently I have found a chiropractor who’s technic is working well for me), acupuncture, laser treatment and massage therapy (feels great, love it, but again, it doesn’t get to the core of the problem it’s only treating the symptoms). The TMJ treatment was the only thing that brought some relief. The eye doctor discovered I had blepharitis and dry eye syndrome. Treatment of these has definitely eased my eye strain, but in the end I still had the neck and shoulder tension and headaches. The Rheumatoid doctors could not figure out my joint pains and “malfunctions”, which flared up some years back and while they are not near as bad, still cause some discomfort and issues from time to time. And then there were the bouts of fatigue that I would go through. It was when I began to have GI issues that I really put some thought into FM There were a lot of symptoms that could have lead to a million different possible problems, none of them being specific enough to indicate a specific problem. But given two of my children had FM and many of the common symptoms covered my list of issues it only seemed logical to try the test and see where it would lead me.

All of this has led to an interesting couple of years as we have tried to work our way through FM and understand our bodies better. We have come a long ways in the past two years with lots of ups and downs and confusion, but if we look back we can say that we’ve made improvement. It actually took a year before we broke down and got really serious about fructose. At first we thought we were just a mild case and we removed the worst and most obvious issue foods … but with time it became obvious that we had to pull in the reigns and get serious if we wanted to know whether FM was the problem we were dealing with. When Marietta and I got out of control in the smelly gas area we knew we had to do some work on things. Rebecca continues to exhibit no obvious signs, but she has to adhere to the diet and sometime I wonder if she needs a stricter diet. Matthew needs to keep his diet in line, although in comparison to before he has a nice variety of options.

I am not sure where I am heading with this blog, but I thought I would just start and see where it goes. I hope to be able to help others by sharing our experience and offering links to the research that I have read. I hope to offer guidance and just simply give people support if they are feeling lost. And hopefully I can also work a few recipes and such into the webpage to give some ideas. Most of the above post was actually written already almost two years ago when I first wanted to get a blog started, but time just never allowed for it. I had always put this project on the backburner thinking that other things were more important, but the more I encounter people that have questions the more I think that I need to put this on the front burner so the information it there and people can read it for themselves.

I am in no way shape or form a doctor or any sort of medical personnel. The only experience and knowledge I have is through our own experience and has been self-taught by the information I have found … mostly on the internet. I have spent time researching and continue to do so since FM information changes so quickly as doctors learn more about it. I want to be able to share what I have learned to make it easier for those who are looking for information. I know the lost feeling and the feeling of not knowing what to do and so I hope to offer guidance, but I also know that FM IS VERY DIFFERENT FROM ONE PERSON TO THE NEXT and I want anyone who reads this to keep this in mind. What works for us is not going to work for the next person. I can give ideas and offer help, but in the end if you have FM you are going to have to learn your own body and do what works best for you.

I hope that I can be of help and assistance to those who are reading this