What is Lactose Intolerance?

Lactose intolerance is a common digestive disorder where the body is unable to digest lactose, the main sugar found in milk and dairy products. This condition stems from a deficiency in lactase, the enzyme produced in the small intestine that is necessary to break dairy lactose down into glucose and galactose for absorption into the body.

Unlike proteins and fats, which can be broken down by various enzymes, lactose digestion depends primarily on lactase. Here’s how lactase functions in the body and how you can manage lactase levels:

Produced by the Body:

• Intestinal Production: Lactase is produced by cells lining the small intestine, specifically the enterocytes. The enzyme is located on the surface of these cells, where it helps to break down lactose into glucose and galactose, simpler sugars that the body can absorb and utilize for energy.

Signs and Symptoms of Lactose Intolerance

Individuals with lactose intolerance may experience various digestive symptoms shortly after consuming dairy products. These include:

• Bloating
• Diarrhea
• Gas
• Abdominal cramps
• Nausea, or
• Vomiting, (sometimes if large amounts of lactose are consumed)

Types of Lactose Intolerance:

• Primary Lactose Intolerance: The most common type, which results from a gradual decrease in lactase production triggered by aging or genetic factors.
• Secondary Lactose Intolerance: This form occurs when the small intestine’s ability to produce lactase is decreased by an illness, injury, or surgery affecting the intestine, such as celiac disease or Crohn’s disease.
• Developmental Lactose Intolerance: Seen in premature babies due to an underdeveloped small intestine, which usually improves over time.
• Congenital Lactose Intolerance: A rare condition where babies are born with little or no lactase activity due to a genetic mutation.

Factors Affecting Lactase Production:

• Genetics: The ability to produce lactase can be significantly influenced by genetic factors. Most babies produce lactase; however, in many, lactase production declines after weaning due to genetic programming. This decline can lead to lactose intolerance.
• Ethnicity: Lactose intolerance is more common in some ethnic groups than others. For example, it is highly prevalent in people of East Asian, West African, Arab, Jewish, Greek, and Italian descent. Dairy is pasteurized in America. It’s typically NOT in other countries.
• Age: Lactase production typically decreases with age, which means that even if someone was able to digest lactose during childhood, they might develop lactose intolerance later in life.
• Intestinal Health: Conditions that affect the small intestine, such as Crohn’s disease, celiac disease, or infections, can temporarily decrease lactase production.

Treatments for Lactose Intolerance

Medical and dietary approaches focus on managing symptoms and improving quality of life:

• Lactase Supplements: Over-the-counter products like Lactaid or Dairy Ease can be taken with dairy products to help digest lactose.
• Lactose-Free Products: Many dairy products are available in lactose-free versions, which have the lactose removed or broken down already.
• Dietary Management: Reducing or eliminating dairy products and finding alternative sources of calcium and vitamin D.

Holistic Treatments and Supplements

Holistic approaches to managing lactose intolerance include:

• Probiotics: Supplements containing Lactobacillus acidophilus and other beneficial bacteria can help improve lactose digestion and overall gut health.
• Prebiotics: These non-digestible fibers help nourish beneficial gut bacteria and can enhance digestive health, potentially improving lactose tolerance.
• Digestive Enzymes: In addition to lactase, broad-spectrum digestive enzymes can help improve overall digestion.
• Herbal Remedies: Herbs like peppermint and ginger can soothe digestive tracts and ease symptoms like bloating and cramps.

Lifestyle Adjustments

Implementing certain lifestyle changes can also help manage symptoms:

• Small Portions: Consuming smaller amounts of dairy may be tolerable for some individuals, as it allows lactose to move more slowly through the digestive system, giving more time for it to be digested.
• Fermented Dairy Products: Yogurt and kefir contain natural bacteria which can partially digest lactose, making them potentially easier to tolerate.
• Dairy Alternatives: Plant-based milks such as almond, soy (caution), coconut, and oat milk are naturally lactose-free and can be used as substitutes in various recipes. Caution for lectin content and artificial sweeteners in these products. Moderate consumption in alternative dairy products is recommended.

For those suspecting lactose intolerance or experiencing persistent symptoms after consuming dairy, it is advisable to consult with a healthcare provider. They can offer definitive diagnostic tests, such as the lactose tolerance test or hydrogen breath test, and help tailor an appropriate management plan based on individual needs and health conditions. This comprehensive approach allows individuals with lactose intolerance to maintain a balanced diet while avoiding discomfort, ensuring both nutritional needs and quality of life are addressed.