What is lactose intolerance?
The most common digestive problem, Lactose intolerance aka Lactase deficiency is a person’s ability to digest a natural sugar ‘lactose.’
You become lactose intolerant if your small intestine stops producing enough lactase enzyme
The lactase enzyme breaks down the lactose sugar.
During this process, the undigested lactose moves into the large intestine, and the bacteria usually present there interacts with the unprocessed lactose sugar and causes bloating, gas and diarrhea.
Can you become lactose intolerant all of a sudden?
Yes, it is possible to become lactose intolerance at any point in life.
Although, in most cases, people start experiencing it at an earlier point in time.
Most people with this condition experience symptoms only when they consume foods containing lactose.
Therefore, it is ideal for tracking what one drinks daily so that you can identify what upsets your stomach.
This way you could also pinpoint if there are other products (other than dairy) to cause your symptoms.
When you do not experience diarrhea after drinking milk, it means your lactose intolerance is probably not that severe.
What are the symptoms of being lactose intolerant?
Typical lactose tolerance symptoms include the following, about 30 minutes to two hours after having any milk-based food item:
- Abdominal pain or cramping
- Nausea, sometimes accompanied by vomiting.
However, if you experience symptoms such as hives or wheezing immediately after having milk, it is probably a milk allergy that you are suffering and not lactose intolerance.
What foods to avoid if you are lactose intolerant?
The foods not recommended for lactose intolerance depends on the severity of the condition.
If you are not severely lactose intolerant, you need not refrain from consuming dairy products.
But if it is mild to moderate in severity, you will not have any problem digesting yogurt or other milk products consumed along with food.
If you are a severe intolerance to lactose, you might experience symptoms even with small amounts of dairy consumption.
Common foods to avoid will be food substances with Lactose such as:
- Dairy products (Milk, Yogurt, Cream, Butter, Cheese, Ice cream)
- Certain Baked foods like bread, Cookies, cakes, Pancakes
- Other eatables like pancakes, ready-to-eat cereals, instant soups, candy, salad dressings, deli meats, drink mixes, margarine, etc
- Certain OTC medications too might contain lactose.
Read the label carefully to see if there is any dairy or lactose-present items on the ingredient list (Whey, Curd or Yogurt, Dry milk solids, milk powder).
How do you know you are lactose intolerant?
You know you are lactose intolerant id you experience the following symptoms within 30 minutes to a couple of hours following dairy consumption:
- Abdominal Pain, cramps, bloating
- Rumbling or gurgling sounds in your stomach (Borborygmi)
- Nausea (Sometimes accompanied by vomiting)
Lactose intolerance diagnosis
If you have been experiencing lactose intolerance symptoms and your doctor thinks you have it, he/she will ask you questions to know your complete medical history and perform a physical examination.
Before making a diagnosis, your doctor will suggest that you avoid dairy products for a short period and watch out if your symptoms subside.
Your stool samples can also help in making the diagnosis- a watery, loose or foamy stool can indicate that you are lactose intolerant.
However, to confirm the diagnosis, your doctor might order the following tests:
Hydrogen breath test
- The most accurate one for which you will have to breathe into a machine several times over a couple of hours.
- High levels of hydrogen indicate you are lactose intolerant. Before taking this test, you will have to avoid smoking, certain foods, and medications.
- Also, this test isn’t recommended for infants or young children as it can lead to severe diarrhea.
Lactose Tolerance test
- Measures your blood sugar after you consume lactose-containing foods.
- Post-midnight of the day before you take the test, you should refrain from eating or drinking anything.
- On the day of the trial, you will be asked to consume a liquid containing lactose (which might provoke symptoms such as gas or abdominal pain).
- Your blood will then be tested every 30 minutes for the next 2 hours.
- You might test positive for lactose intolerance if your blood sugar levels do not rise.
- This test is not meant for infants, young children or the diabetic.
How do I test myself for lactose intolerance?
Since lactose intolerance isn’t any severe disorder, you can do this Home DIY test.
Refrain from consuming dairy and all other lactose-containing foods for several days.
Later, on a free morning, drink a couple of large glasses of skim or low-fat milk.
If you develop symptoms within fours hours, you can ascertain your diagnosis of lactose intolerance.
Can you test for lactose intolerance at home?
Yes, you can do this simple test for lactose intolerance at home:
- Drink two glasses of skim milk on an empty stomach and see if you develop symptoms like gas, bloating, diarrhea or stomach ache for the next 3-4 hours.
- If you do, it suggests that you are lactose intolerant.
- You might want to repeat this test using lactase-treated milk and confirm the diagnosis if you do not experience any symptom.
- But If you have chronic gastrointestinal discomfort, it is recommended that you consult a doctor for further evaluation.
Genetic testing for lactose intolerance?
Handpicked article for you: Know Your Genes: Lactose Intolerance Genes
Is lactose intolerance genetically inherited?
Primary lactase deficiency which is the most common cause of lactose intolerance throughout the world is caused by an inherited genetic fault running in families.
Congenital lactase deficiency or congenital alactasia is the disorder where infants suffer from not being able to digest lactose present in breast milk or formula, causing diarrhea.
Such infants might even develop dehydration and weight loss if they do not switch to lactose-free infant formula.
Congenital lactase deficiency in infants is inherited in an autosomal recessive pattern (Both copies of the LCT gene in each cell is mutated).
The parents being individuals with the autosomal recessive condition each carries one copy of the mutated gene, pass it over to their child without experiencing symptoms themselves.
The type of variations in the regulatory element in the MCM6 gene inherited from one’s parents decides the ability to digest lactose in adulthood.
One copy of the altered regulatory element is enough to sustain lactase production.
Individuals who haven’t inherited such variations from either parent will have a certain degree of lactose intolerance.
How long does it take for lactose intolerance symptoms to go away?
Lactose intolerance symptoms begin about 30 minutes to 2 hours after consuming lactose-containing foods.
The symptoms to disappear might take as long as it makes your body to digest and eliminates lactose.
For some individuals, it could be about 12 hours while for others it could be much longer.
Your body will have to force the undigested dairy substance through your system and in that process, you might experience pain and discomfort.
Digestive system transit time (the time is taken to digest and eliminate any substance) can be tracked by using enough activated charcoal capsules appropriate for your weight.
When you jot down the start and finish time (when you see charcoal in your stool) will optimally be 12-18 hours.
How long does lactose intolerance attack last?
The duration of lactose attack might vary from person to another.
Depending on how much lactose is taken, whether it was part of a meal or whether it was in liquid form and about how sensitive a person’s intestines are.
The symptoms might be mild or severe and might last for a short duration or for quite a long time.
What are the levels of lactose intolerance?
There are four types of lactose intolerance with a different cause for each class.
Primary Lactose Intolerance
The most common form that makes one’s body to prevent secreting lactase enzyme by about age 5 (as early as two years old in the case of African-Americans).
Since lactase levels decrease, dairy products get challenging to break down.
Individuals with primary lactose intolerance secrete decidedly fewer amounts of lactase enzyme, and that makes it hard for them to digest dairy products by the time they turn adults.
This type is genetic and is common among Africans, Asians, Hispanics, Mediterranean and south Europeans and less common among north or western Europeans.
Secondary Lactose Intolerance
It occurs due to any illness or injuries or post surgeries.
Any such conditions might affect your small intestine and lead to a reduction in lactase secretion.
Celiac disease and Crohn’s disease are the two most common intestinal diseases linked to low lactase secretion.
Developmental Lactose Intolerance
It occurs in premature babies. It usually lasts only for a short duration after birth and goes away on its own.
Congenital Lactose Intolerance
A rare type that happens when there is no lactase or a minimal amount of the enzyme produced by the small intestine right from birth.
It is a genetic disorder, and both parents have to pass the condition to their children.
How do you fix lactose intolerance?
Although there’s isn’t any definitive method to boost your body’s lactase production, you can avoid the discomfort caused by lactose intolerance by following these:
- Avoid large servings or dairy like milk, etc
- Include small servings of dairy in your regular meals like butter, cheese, etc
- Consume lactose-reduced dairy, and ice cream
- Drink regular milk after adding lactose-digesting liquid or powder.
How can I increase lactose tolerance in my body?
There are certain ways to increase lactose tolerance including:
Switch to low-lactose dairy products
Since dairy products do not all contain the same amount of lactose, like, cheddar, or ripened cheeses, they can be easily tolerated by any lactose intolerant individual.
Consume lactose-containing foods alongside other foods
When you are digesting other foods simultaneously, gastric emptying can get slower, and lactose which makes up just a small proportion of the total food you consume will not be creating many problems.
You will only be requiring a smaller amount of the enzymes in your small intestine to break down the lactose.
Take Fermented dairy products
The bacteria present in yogurt and kefir can produce a lactase-like enzyme which can make your food to digest even though it contains lactose.
Take Lactase supplements
Before you eat any dairy substances.
This will allow it to break down lactose into glucose and galactose so that your body can absorb the sugars without experiencing symptoms.
Opt for Lactose-free dairy products
It can be consumed since the manufacturers have already applied lactase to the product so that you won’t require an enzyme to break down the lactose in.
Slowly increase lactose tolerance
Once you start increasing the amount of lactose in your diet, your body will start responding to it by increasing its lactase production.
Does lactose intolerance get worse as you age?
Yes, it gets more noticeable with age.
Although Lactose intolerance symptoms can start as early as two years old, it can take until one reaches adolescence or adulthood for the symptoms to start appearing typically.
Mostly prevalent among adults, the condition can develop with age, and you might discover that you have it once you get older.
Can lactose intolerance get worse over time?
Lactose intolerance might be genetic or environmentally influenced.
When left untreated, can make the symptoms worse or you might even develop new symptoms.
It can develop slowly, and the symptoms may be similar to other digestive problems.
Can you become lactose intolerant as an adult?
Except for sporadic cases, every infant can produce lactase enzyme which helps the small intestine digest the lactose sugar.
But with age, one’s lactase levels can start to decline, and it can prevent the lactose you eat from going to your colon without being digested.
The bacteria there might break down the sugar and cause flatulence and fluid in that process.
It is quite common for people to develop lactase deficiency in adulthood.
Per the NIH report, about 65% of the global population has a lowered ability to digest lactose after infancy.
Also, genetic factors can be equally responsible for lactose intolerance.
Your body tends to secrete the enzyme lactase only when instructed to so so by the gene LCT which can get less active over time and result in lactose intolerance.
The condition which can begin as soon as a person turns two years old, may not manifest itself until a person reaches adolescence or adulthood.
Are you born lactose intolerant?
Although possible, it is something scarce.
Only about one in 60,0000 newborns can be born with lactose intolerance.
In such cases, the baby cannot digest milk are likely to suffer abdominal pain, bloating, diarrhea, flatulence, and nausea.
Born with lactose intolerance or getting ti later in life depends on the differences in our DNA, both usually inherited from one’s parents but in different ways.
Can lactose intolerance be cured?
Although there isn’t any cure for lactose intolerance, most of them who are affected can manage their symptoms by making dietary changes including:
- Getting advice from an experienced dietician who can advise you about what foods you should include or exclude.
- Replacing dairy with lactose-free alternatives
- Eating lesser lactose-containing foods or trying to cut down on them completely.
Some cases of lactose intolerance caused by certain conditions like gastroenteritis are only temporary and tend to improve soon.
But certain other cases like an inherited genetic fault or other long-term underlying condition can last for a long duration.
Do eggs have lactose in them?
No, eggs are neither a dairy product nor do they contain lactose or any other milk protein.
It is perfectly safe for lactose intolerant individuals to eat eggs.
Can you eat cheese if you are lactose intolerant?
Being lactose intolerant doesn’t mean that you should entirely refrain from having all dairy products altogether.
You can eat cheese which has low lactose levels. For example, Cheddar cheese only contains about 0.2 gms of lactose.
You can check the nutrition label on cheese packets to find out the amount of lactose in it.
Just look for the facts under “Sugar,” since the sugar present in cheese is lactose.
If it reads 0, not more than half a gram of lactose per ounce is present. (8-ounce glass of milk contains 12 grams of lactose).
Here’s a list of low-lactose cheeses:
- Cheese with trace levels (<0.5g) of lactose– Natural, aged cheese like Cheddar, Parmesan & Swiss.
- Cheese with Low levels (<5g lactose)– Fresh unripened cheese like Mozzarella, Ricotta, cream cheese and cottage cheese.
It is ideal for looking for aged cheese compared to fresher ones and sugar <5g per serving. Also, higher the fat content, lower the lactose levels.
Do probiotics help with lactose intolerance?
Probiotics contain live bacteria or yeast which can supplement the gastrointestinal flora.
Studies have shown that probiotics offer health benefits like improving intestinal health, enhancing immunity and reducing serum cholesterol.
It can also help alleviate symptoms of lactose intolerance.
A study has emphasized the positive relationship between probiotics and lactose intolerance.
What milk is good for lactose intolerance?
The ideal type of milk recommended for the lactose intolerants is the Lactaid milk that contains cows milk without any lactose sugar.
The product is available in dairy sections at grocery stores. Other options include soy milk, almond milk, and coconut milk.
They also have a variety of ice cream and yogurt substitutes but no real cheese substitutes.
Being aware of the nutritional value of these substitutes is essential.
What foods should be avoided with lactose intolerance?
Foods to avoid if you have severe lactose intolerance:
- Dairy products including Milk, yogurt, butter, cheese, and ice cream.
- Some baked foods like bread, cakes, cookies, etc
- Other non-dairy foods with milk ingredients such as pancake mixes, Ready-to-eat cereals, instant soups, candies, cookies, salad dressings, deli meats, drink mixes, and margarine.
- You should look for the label to see if there is any dairy or lactose on the ingredient list (whey, curds, dry milk solids and milk powder)
How can I treat lactose intolerance at home?
You can try these at-home remedies to avoid the discomforts caused by lactose intolerance:
- Avoid larger servings of milk and dairy products.
- Include dairy products in your regular meals in small servings.
- Switch to lactose-reduced milk and ice cream.
- Use lactose breaking down powder/liquid to process your regular milk.
Does apple cider vinegar help lactose intolerance?
There is no evidence to prove the effect of vinegar in reducing lactose intolerance symptoms.
Although, it is not likely to do any harm either.
One Study shows that It can help control blood sugar levels.
What helps with stomach pain from lactose intolerance?
One study has shown that taking prebiotics (a nondigestible food ingredient which promotes the growth of beneficial microbes in one’s gut) reduced abdominal pain in lactose intolerant individuals.
Also, by becoming a staunch defense against lactose intolerance, the prebiotics has increased the lactose fermenting bacteria in about 90% of the subjects enrolled in the study.
Do I have IBS or lactose intolerance?
Sometimes the symptoms of IBS and lactose intolerance can be identical. But, there are distinct differences in why they occur and how it can be handled.
While lactose intolerance occurs because your body is unable to digest one specific type of food (lactose) present in milk, IBS can occur due to a lot of other things.
Though it can simultaneously occur, they are two different issues.
While both IBS and lactose intolerance can both cause Flatulence, bloating, abdominal pain and diarrhea.
IBS can cause constipation and might make one have mucus in their stool which will feel like the colon cannot be completely emptied.
IBS Symptoms can change over time, flare up, get better or even disappear totally.
Lactose intolerance can make you feel nauseatic.
You will start feeling the symptoms 30 minutes to a couple of hours after you consume dairy products.
IBS can occur if your colon muscles do not work correctly or you might have a problem with the signals between your brain and nerves in the gut or if you are sensitive to some triggers like stress or certain foods.
The cause of IBS is still a mystery, and it could be due to genetic factors, intestinal infections or long-term stress.
But on the other hand, lactose intolerance is understood better.
Your body cannot digest the lactose sugar, and your body lacks enough of the enzyme lactase.
Which cheese has the least lactose?
Naturally-aged cheese such as Cheddar, Parmesan, and Swiss cheese have trace levels of lactose.
Other Cheeses with the low lactose levels are Blue Cheese, Camembert Cheese, Cheshire cheese, Colby cheese, Pecorino style cheese, Romano style cheese, Harvati cheese, and Mozzarella cheese.
Recommended diet for lactose intolerance
The ideal diet for the lactose intolerant emphasizes on the foods to avoid more than about what to eat.
Needless to say, It is essential to avoid or reduce the amount of lactose-containing foods.
But It is also important to read food labels to exclude canned, boxed, frozen and prepared foods like bread, lunch meats, salad dressings, cake, cookie or pancake mixes, coffee creamers, etc., that contains lactose ingredients (like cream, cheese, butter, milk, milk solids, dried milk, whey, etc).
You can also opt for lactose-free foods, foods with naturally low levels of lactose (like hard cheeses & yogurt) or switch to non-dairy products like soy milk, tofu, etc.
But it is necessary to make sure your diet meets all the nutritional requirements.
Does Lactaid work?
Lactaid – the OTC pill taken by lactose intolerance people as a supplement to digest lactose.
Although the pill might work, it will not be as effective as having a normal lactase level.
A lactose intolerant individual will not be utterly deficient of lactase.
They might be okay with eating small amounts of lactose-containing food but might start feeling sick with more significant numbers.
That is when lactase supplements can help your body to digest lactose sugar.
The key to getting the pill to work depends on how much is appropriate for what type or amount of lactose-containing food.
While some individuals might need just a couple of pills to digest an ice cream, others might need two more.
It can be a trial-and-error process, sometimes less pleasant too.
But taking Lactaid can seriously help you enjoy dairy again.
However, not everyone with lactose intolerance can be magically helped by lactaid.
The effects of lactaid do not permanently help your body to secrete more of the enzyme lactase and might not be a complete replacement.
Per Mayo Clinic, lactase supplements taken before or alongside foods might not work for everyone. For people with substantial lactase deficiencies, it cannot be just supplemented by a pill.
Can lactose pills cause constipation?
Constipation hasn’t been reported to be a side effect of lactose pills.
They usually have minimal side effects. Many who take the pill do not have any severe side effects at all.
Can Tums help with lactose intolerance?
Dairy products are a significant source of calcium and the goal being 1200-1500 mg of calcium daily for bone health.
It is recommended that the lactose intolerant can take calcium supplements since they cannot drink enough milk or consume other milk products to meet the calcium requirement.
Antacids like tums have high amounts of calcium in them, and you can take them as a calcium supplement if you have to take antacids anyway.
Can you take Lactobacillus if you are lactose intolerant?
Lactic acid bacteria such as Lactobacillus bulgaricus and Lactobacillus acidophilus could be beneficial to lactose intolerant people.
One study has shown that a specific strain of Lactobacillus acidophilus might provide relief to lactose intolerance symptoms after four weeks of use.
What supplements should I take for lactose intolerance?
If you are lactose intolerant, you should take Vitamin D and Calcium Supplements to make sure you meet the nutrient requirements.
Also, you can take probiotics and prebiotic supplements that can aid in lactose digestion.
There are lactase supplements like Lactaid that replaces the deficiency of the naturally available enzyme.
Can you be slightly lactose intolerant?
Can you reverse lactose intolerance?
It is unfortunate that lactose intolerance cannot be reversed. But you can make a few dietary changes to treat and manage the condition well.
How does smoking affect your digestive system?
Smoking attributes to a lot of common disorders of your digestive system like GERD (gastroesophageal reflux), Heartburn, peptic ulcers, and liver diseases.
It also increases one’s risk for conditions such as pancreatitis, colon polyps, Crohn’s disease, gallstones, etc.
It can also increase your risk of cancers of the mouth, esophagus, stomach, pancreas, liver, colon and rectum.
Smoking can weaken your lower esophageal sphincter (the muscle connecting your stomach and food pipe) that keeps the contents from flowing back into the food pipe.
Because of this, the esophagus/food pipe which is not protected from acids can cause heartburn and damaging od the esophageal lining.
Persistent reflux can cause GERD, and chronic GERD can lead to other serious issues like bleeding ulcers, cancer, etc.
Smoking also increases the risk of H.Pylori infection which delays the healing of peptic ulcers and also causes it to recur.
Quitting smoking can help reverse some of the damages done to the digestive system it has caused.
It can also help improve symptoms of digestive diseases and keep them from turning worse.
What is the Prognosis of Lactose intolerance?
With many individuals experiencing improvement if symptoms with dietary changes and restrictions, the prognosis of lactose intolerance is excellent.
It is essential to make sure that a lactose intolerant person’s calcium intake is maintained and supplements are taken to prevent conditions like osteopenia or osteoporosis.
Find out which genetic variants of lactose intolerance you or your child have in Xcode Life’s Gene Nutrition report.