Expert: Dr. Kristina Conner - 6/24/2007

Question
Let me first thank you for taking the time to attend to my question.  I feel this particular question can be best answered by a ND such as yourself.  I am a very health 24 year old Caucasian male.  Almost two years ago, I started experiencing a dull, chronic nausea.  It seems to be centered about an inch below my sternum.  In other words, if I press firmly directly below my sternum it is very tender.  This is my only symptom.  There is no bloating, diarrhea, or any other GI symptoms.   My appetite is normal.  I do not drink or smoke and eat a healthy diet.  I never have the urge to vomit.  I have seen many MDs and have had a multitude of tests, all which were normal.  Abdominal CT, endoscopy, CBC, gall bladder sonogram, and food allergy testing were all normal.  GERD has also been ruled out.  Basically, I have stumped the MD community.  

My nausea is relatively persistent, yet some days are better than others.  I keep a food journal but have been unable to see any solid patterns between the foods I eat and my nausea.  I suspect I have some food intolerance which I have not yet been able to figure out.  I have tried a dairy free and a gluten free diet to no avail.  

My latest suspicion is that I may have a fructose intolerance.  This is because, as you know, fructose is mainly digested in the liver and the skin below my sternum is right above the left lobe of my liver.  On a related note, diabetes types I and II are very common in my family, although I am not diabetic.  I suspect that my liver is somehow irritated by my diet since it does include fruit, vegetables, whole grains, and nuts.  These foods are, of course, either loaded with fructose or a form of fructose.  My questions are these:  Do you feel that I would benefit from trying a fructose (and sucrose) free diet?  Do you think this may be my issue?  Do you know of any herbs or supplements which would aid my liver in digesting fructose?

Thank you so very much for any input you can provide!  It is very much appreciated.


Answer
Hi Jonathan
First, thanks for your question.  When you have undergone significant health assessments already, it can be frustrating to not find answers.  So the fact that you are still continuing to search is important, because obviously there is something going on, despite your medical assessment to the contrary.  Trust your judgment because you know your body best.  
A true fructose intolerance is rare, and I assume that was already ruled out.  For a milder sensitivity, though, you can still do some investigation.  A true allergy may have been ruled out, but most MDs will only do one type of testing.  They will not test for a food intolerance.  This can be done by some holistic MDs (www.holisticmedicine.org)  or naturopathic doctors (www.naturopathic.org); I'd suggest a consult with a practitioner no matter what else you do.  They can guide you with individualized recommendations.  An elimination diet for 2-3 weeks might be a good idea, then reintroducing foods one at a time.  It sounds like you have done some of this already.  But a stricter elimination diet takes out sugar, dairy, soy, wheat, gluten, corn, and other foods all at once, and often yields better information than taking out one food at a time.  Again, a ND or holistic MD could help you with this process.  
Another area I'd look into is digestive enzymes and/ or HCl, which you may be low in.  Supplementing with these often helps your body restore normal function, along with diet changes.  A mixture of enzymes usually works best.  Hydrochloric acid is usually alone or with pepsin, an enzyme.  
Keep looking because you can find the cause for your symptoms, and because your searching may uncover issues that you can prevent for the future.  Good luck in your continued search.  
Dr Conner