Your gut handles small amounts of fructose just fine, but when you eat too much, it gets overwhelmed and lets the extra pass through to your liver.
Evidence from Studies
Supporting (2)
Community contributions welcome
Metabolism: Diabetes mellitus promotes hepatic fructose uptake
The study shows that when people have diabetes, more fructose from food ends up in the liver, which fits with the idea that the gut can only handle so much fructose before the rest goes to the liver.
Recent Progress on Fructose Metabolism—Chrebp, Fructolysis, and Polyol Pathway
The study shows that the small intestine helps break down fructose before it reaches the liver, but if too much is eaten, the intestine can get overwhelmed and let fructose through.
Contradicting (1)
Community contributions welcome
Fructose and the dietary therapy of diabetes mellitus
The study assumes fructose goes straight to the liver to be broken down, like alcohol, and doesn’t support the idea that the small intestine handles most of it first.
Gold Standard Evidence Needed
According to GRADE and EBM methodology, here is what ideal scientific evidence would look like to definitively prove or disprove this specific claim, ordered from strongest to weakest evidence.