What to do if your body can’t handle lactose

October 1, 2018

Did you know our ability to digest milk after our infant years is a result of genetic changes?  The human body is amazing in its ability to adapt.  As diets changed with the domestication of animals, the human body adjusted to be able to digest milk after infancy.  Changes in the genome that control the production of the enzyme lactase are to thank.  Lactase breaks lactose down into glucose and galactose, which the body can efficiently absorb.  If there isn’t enough lactase to handle the amount of lactose eaten, that’s when the GI symptoms start.  You know, the abdominal pain, diarrhea, gas, bloating, and borborygmi (fancy word for grumbly belly).  Even with a minimal amount of lactase in your system, your body can likely handle a small amount of lactose, about a half cup of milk, without any GI symptoms.

There are multiple causes of lactase deficiency, or lactose intolerance as we often think of it.  One cause is the natural decrease in the human body’s production of lactase as it ages.  Other causes include a GI infection, IBD, IBS, SIBO, and abdominal surgery.  You may be wondering, “What can I do about it?  I love milk, and more importantly cheese and ice cream!”  There is one potential solution on the horizon: lactobacillus.  You may have seen it written on your yogurt container this morning or on a bottle of probiotics.  It’s a genus, or group, of bacteria.  Certain strains of lactobacillus are commonly found in healthy guts and specific strains may help with the digestion of lactose by producing lactase at the right point during digestion.  More research is needed in this area though to clear up the data from conflicting reports on the effectiveness in reducing GI symptoms associated with lactose intolerance.

While we wait for more data on lactobacillus, there are two other ways you can still enjoy dairy products.  The first strategy is to take a lactase tablet before eating lactose containing foods, like milk and ice cream.  If you take this route, start with small servings until you know how much of each lactose containing food you are able to digest without symptoms.  The second strategy is to avoid lactose containing foods.  With more and more lactose free products on the market, this is getting easier to do.  Plus, some dairy products are naturally low in or free of lactose.  For example, butter and aged cheese are extremely low in lactose, and ghee is lactose free.  For low lactose and lactose free recipes, check out the ETP recipes page.

Long story short, lactose intolerance is normal.  Lactose tolerance is also normal.  And either way, you can still enjoy cheese and ice cream!

If you’re interested in the scientific details, check out the following scholarly journal articles.

Deng Y, Misselwitz B, Dai N, Fox M. Lactose Intolerance in Adults: Biological Mechanism and Dietary Management. Nutrients. 2015 Sep 18;7(9):8020-35.

Pakdaman MN, Udani JK, Molina JP, Shahani M. The effects of the DDS-1 strain of lactobacillus on symptomatic relief for lactose intolerance – a randomized, double-blind, placebo-controlled, crossover clinical trial. Nutr J. 2016 May 20;15(1):56. 

Also review the corrections in:

Pakdaman MN, Udani JK, Molina JP, Shahani M. Erratum to: the effects of the DDS-1 strain of lactobacillus on symptomatic relief for lactose intolerance – a randomized, double-blind, placebo-controlled, crossover clinical trial. Nutr J. 2016 Oct 3;15(1):83.

 



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