Living with Lactose Intolerance
What do Lionel Richie, Cyndi Lauper, and Kylie Jenner have in common?
Like 65% of the human population, all three are lactose intolerant. While this is the majority of people, not everyone is affected equally.
Interestingly, lactose intolerance in adulthood occurs most often among those of East Asian descent. In fact, as many as 90% of Eastern Asians, 80% of American Indians, 65% of Africans and African-Americans, and 50% of Hispanics experience lactose intolerance to varying degrees.
Meanwhile, only about 5% of people of Northern European descent are lactose intolerant. This has been attributed to a long history of consuming unfermented milk products. 80% of Caucasians have a gene that preserves the ability to produce lactase into adulthood.
Contrary to popular belief, lactose intolerance is not the same as a milk (or dairy) allergy.
While lactose intolerance does not affect the immune system, an allergy to milk and dairy is caused by an abnormal response of the body’s immune system to milk and products containing milk.
Allergies can also cause anaphylaxis — a severe, life-threatening reaction that does not happen with lactose intolerance.
Then what is lactose intolerance?
Lactose intolerance is basically a common digestive problem, caused when the body is unable to digest lactose, a type of sugar mainly found in milk and dairy products.
The inability to digest lactose occurs when the small intestine doesn’t produce enough of the enzyme, lactase, which helps digest the milk sugar, lactose.
During digestion, lactase usually turns milk sugar into two simple sugars, glucose and galactose, which are absorbed into the bloodstream through the intestinal lining.
However, being lactose intolerant means lactose moves into the colon, instead of being processed and absorbed. In the colon, normal bacteria interact with undigested lactose, causing the signs and symptoms associated with lactose intolerance.
What are some of the symptoms?
These can vary from person to person, ranging from mild discomfort to a severe reaction. It all depends on how much lactase your body produces, and how many dairy products you consume.
- abdominal pains
Did you know there are different types of lactose intolerance?
There are three types of lactose intolerance, each caused by different factors.
Primary lactose intolerance
This is the most common type and is inherited. It develops when the body’s lactase production decreases, often due to becoming less reliant on milk and dairy products. This typically occurs after the age of 2, when breast- or bottle-feeding stops, though symptoms may not be noticeable until adulthood.
Secondary lactose intolerance
This type occurs when the small intestine decreases lactase production after an illness, injury, or surgery involving your small intestine.
Diseases associated with secondary lactose intolerance include:
- intestinal infection
- celiac disease
- bacterial overgrowth
- Crohn’s disease
Symptoms can be improved, and lactase levels restored by treating these underlying disorders, though it can take time.
Congenital or developmental lactose intolerance
Though rare, it’s possible for babies to be born with lactose intolerance caused by a lack of lactase.
This disorder is passed through generations through an autosomal recessive inheritance pattern, where both the mother and the father must pass on the same gene variant for the child to be affected.
These infants have diarrhea from birth, as they are unable to digest lactose. This condition was fatal before lactose-free infant formulas were invented.
Premature infants can also have lactose intolerance due to an insufficient lactase level, which usually improves as they get older.
How to tell if I have lactose intolerance?
Based on your symptoms and your response to reducing the amount of dairy in your diet, your doctor might suspect lactose intolerance.
This can be confirmed by conducting one or both of the following tests.
Hydrogen breath test
After drinking a liquid containing high levels of lactose, your doctor will measure the amount of hydrogen in your breath at regular intervals.
Breathing out too much hydrogen indicates that lactose isn’t being completely digested and absorbed.
Lactose tolerance test
Two hours after drinking a liquid containing high levels of lactose, blood tests will be conducted to measure the amount of glucose in your bloodstream.
If glucose levels don’t rise, this shows that your body isn’t digesting and absorbing the lactose-filled drink properly.
Can my lactose intolerance be cured?
Unfortunately, there is no cure or medication for the condition.
But with careful lifestyle changes, lactose intolerance can be managed, and the symptoms reduced.
How can I manage it?
Start by maintaining good nutrition
While avoiding dairy products helps you reduce your symptoms and discomfort, many of them provide important vitamins and minerals.
Milk and other dairy products, for example, contain calcium, protein, and vitamins, such as A, B12, and D.
Lactose also helps your body absorb a number of other minerals, such as magnesium and zinc. Your body requires these vitamins and minerals to develop strong, healthy bones.
Thankfully, these vitamins and minerals can be found in other food sources.
For example, calcium is found in many other foods like:
- broccoli and leafy green vegetables
- canned salmon or sardines
- milk alternatives, such as soy milk and rice milk
- almonds, Brazil nuts, and dried beans
A lack of calcium and vitamin D increases the risk of osteoporosis, a condition that results in bones becoming thin and fragile.
Get sufficient vitamin D from eggs, liver, yogurt, and spending time in the sun.
You can also opt for vitamin supplements but be sure to consult your doctor first.
- What exactly does vitamin D do for us? Read here.
- Here are 5 ways to fight osteoporosis and maintain healthy bones.
Try limiting your dairy intake
Since the severity of your condition depends on how much lactase your body produces, you might still be able to have some milk products, such as skim milk, without symptoms.
Gradually introducing dairy products into your diet might also increase your tolerance for dairy products.
- Opt for smaller servings of dairy
Have small servings of milk at a time, up to 4 ounces, or 118 milliliters. The smaller the serving, the less likely it is to cause gastrointestinal problems.
- Have milk during mealtimes
Drinking milk with other foods slows the digestive process and may lessen symptoms of lactose intolerance.
- Try different types of dairy products
Dairy products have differing levels of lactose. Hard cheeses, like Swiss or cheddar, for example, have smaller amounts of lactose and generally cause no symptoms.
Yogurt is also typically easier to digest than milk for people with lactose intolerance. The live bacteria used in the culturing process produces the enzyme that breaks down lactose.
- Going lactose-free
Alternatively, try probiotics
Probiotics are living organisms present in your intestines. They help maintain a healthy digestive system. Probiotics are also available as active or “live” cultures in some yogurts or as supplements in capsule form.
What foods should I avoid?
Milk and other dairy products are not the only sources of lactose. Foods that commonly contain lactose include:
- cakes and biscuits
- cheese sauce
- cream soups
- milk chocolate
- scrambled eggs
it’s also important to check ingredient labels for sources of “hidden lactose”, like milk solids, non-fat milk solids, whey, and milk sugar.
- muesli bars
- breakfast cereals
- some instant soups
- some processed meats, such as sliced ham
- salad cream, salad dressing, and mayonnaise
Even certain types of medication contain lactose!
Roughly 20% of prescription medications, such as birth control pills, and 6% of over-the-counter drugs, like treatments for stomach acid, contain lactose.
Inform your doctor or pharmacist when obtaining new medications if you have severe lactose intolerance.
As the discomfort caused by symptoms of lactose intolerance might interrupt your daily life, it’s important to monitor and take note of your body’s response to the triggers. Fortunately, if you’re a part of the 65% who are lactose intolerant, lactose-free options are more readily available at supermarkets and restaurants to help you keep a balanced diet.
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