Do you ever have those moments where you are enjoying a creamy scoop of ice cream, only to have your stomach bloated, cramping, and needing to go to the bathroom? Well, this uncomfortable scenario is all too familiar for millions in the United States, and is possibly due to a condition called lactose intolerance.
Lactose intolerance is a digestive condition caused by the body’s inability to properly digest lactose, a sugar naturally found in dairy products. The sugar lactose is typically broken down by lactase in the gut. Without adequate lactase, lactose remains undigested in the gut, causing various digestive problems. This condition affects about 65% of the world’s population.
Symptoms generally appear within a couple of hours after consuming dairy products and include bloating, diarrhea, abdominal cramps, nausea, and gas. Depending on sensitivity and the amount of lactose consumed, some may also experience fatigue, headaches, or skin issues. The condition can be genetic or triggered by digestive diseases, infections, or medical treatments that damage the small intestine.
Managing lactose intolerance naturally involves dietary changes, such as reducing dairy intake or switching to plant-based alternatives. Lactase supplements and probiotics can also help ease symptoms and support digestion, allowing individuals to enjoy more flexibility in their diet.
Read on for more information about lactose intolerance, including its symptoms, causes, and natural treatments.
What Is Lactose Intolerance?
Lactose intolerance is a gastrointestinal condition caused by the body’s inability to digest lactose, a sugar naturally found in milk and dairy products like cheese, butter, and ice cream. Lactose is a disaccharide (a sugar formed from two simple sugars) consisting of galactose and glucose. The body needs the enzyme lactase to break down lactose before it can be absorbed.
However, individuals with lactose intolerance lack sufficient lactase, making it difficult to properly digest lactose-containing foods and drinks. Experts estimate that 65% of the world’s population is lactose intolerant, with the condition more commonly seen in adolescents and young adults. The prevalence of lactose intolerance also varies with ethnicity, with African Americans, American Indians, Asian Americans, and Hispanics having the highest risks. In contrast, North Americans, White Northern Europeans, and Australians have the lowest risks of lactose intolerance.
What Are the Symptoms of Lactose Intolerance?
The symptoms of lactose intolerance are mostly digestive, including diarrhea, abdominal bloating, stomach pain and cramps, nausea, and gas. These symptoms usually manifest within 2 hours of ingesting lactose, starting as early as 30 minutes after lactose consumption.
Below are some common symptoms of lactose intolerance:
- Diarrhea
- Abdominal bloating
- Stomach cramps and pain
- Nausea and vomiting
- Gas
- Rumbling sounds in the stomach
Some people may experience other symptoms, such as headaches, loss of concentration, joint and muscle pain, rash, and urinary symptoms.
The severity of symptoms depends on how much lactose is consumed, the residual amount of lactase in the intestine, and how fast lactose moves into and through the intestine. Fatty foods can reduce the rate at which food enters the small intestine, which may reduce symptom severity. However, foods like coffee or hot peppers can accelerate gastric emptying, leading to more severe lactose intolerance symptoms.
What Causes Lactose Intolerance?
Lactose intolerance is caused by a deficiency in the lactase enzyme (this enzyme breaks down lactose to glucose and galactose), leading to undigested lactose within the intestinal tract. Unabsorbed lactose in the intestine can cause fluids to enter the bowel, causing diarrhea. Intestinal bacteria may also ferment the undigested lactose, causing gas, bloating, and other abdominal symptoms.
There are different causes of lactase deficiency, and they are examined below.
Primary Lactase Deficiency
Also known as lactase non-persistence, primary lactase deficiency is the most common cause of lactose intolerance. Lactase levels are highest at birth because infants rely exclusively on milk (through breast milk or formula) to meet their nutritional needs for at least their first 6 months.
Lactase levels gradually decline in people with lactose non-persistence, although symptoms don’t appear until after age 5. A genetic component to lactase non-persistence means you are more likely to have lactose intolerance if your parents also do.
Secondary Lactase Deficiency
Secondary lactase deficiency occurs due to external and non-genetic factors, like injury to the small intestine and infections. Usually, addressing the underlying cause of lactase deficiency can restore lactose tolerance. Common causes of secondary lactase deficiency include:
- Crohn’s disease
- Celiac disease
- Ulcerative colitis
- Gastroenteritis
- Extended antibiotic use
- Chemotherapy
- Surgery
Congenital Lactase Deficiency
Congenital lactase deficiency (CLD) is a genetic disorder where lactase activity is reduced or absent from birth. CLD is often diagnosed during the first few days of the newborn’s life due to symptoms like severe osmotic diarrhea. Congenital lactase deficiency is an extremely rare condition, but it can be potentially life-threatening if the diagnosis is delayed.
Premature Birth
Babies born too soon (between weeks 28 and 37 of gestation) may have developmental lactase deficiency due to their underdeveloped intestines being unable to produce enough lactase. Lactase activity and levels usually increase as the baby ages and the small intestine matures.
Natural Treatments for Lactose Intolerance
The natural treatments for lactose intolerance revolve around dietary modifications and supplementation. People with secondary lactase deficiency may need to combine these natural treatments with additional medical care to address the underlying condition.
Here are the natural treatments for lactose intolerance in more detail.
Dietary Modifications
Changing your dietary components and patterns is the most typical natural treatment for managing lactose intolerance. Milk and milk products are direct triggers for lactose intolerance symptoms. Therefore, reducing your intake or eliminating these foods from your diet can significantly reduce the frequency and severity of symptoms.
If you are lactose intolerant, it is essential to know the foods that do contain lactose to guide your dietary choices. Below are some lactose-containing foods:
- Cheese
- Milk
- Ice cream
- Whipping cream
- Butter
- Margarine
- Mashed potatoes
- Pancakes
- Protein whey
You do not have to cut these foods entirely from your diet, as they still contain important nutrients necessary for maintaining a healthy life. What’s more, most people can tolerate small amounts of these dairy products. However, if your symptoms are very discomforting, even with tiny amounts of lactose, you need to see a clinical nutritionist for a suitable approach to bridging nutritional gaps.
For people living in and around Panama City, Florida, the Bay Clinic of Chiropractic is a good stop to get personalized care for your condition and symptoms. Dr. Tony Salamay is the clinic’s lead functional medicine doctor and an experienced clinical nutritionist in Panama City, FL, helping you find a dietary strategy that works for your symptoms. Contact us at (850) 785-9372 or through our email at info@thebaydoctor.com.
Do Plant-Based Milk Alternatives Work for Lactose Intolerance?
Plant-based milk alternatives (PBMA) are lactose-free products typically made from nuts, seeds, rice, coconuts, oats, and legumes. Common examples of PBMA products are almond milk, soy milk, coconut milk, and oat milk. These PBMA products are growing in popularity among lactose-intolerant people because they do not cause intolerance symptoms when taken.
While these PBMA products get around the lactose intolerance problem, they often lack the necessary nutritional balance to replace dairy milk. As such, many PBMA products are not the best options as direct replacements for milk, in terms of nutritional benefits.
However, some PBMA products are fortified with some of the main nutrients in milk, like calcium, protein, potassium, vitamin D, and vitamin B12. These fortified PBMA products (like fortified soy milk or fortified almond milk) can help overcome both lactose intolerance symptoms and the nutritional deficits of regular plant-based dairy alternatives. Ensure you consult with your healthcare provider before adding them to your diet.
Supplements
Supplements cannot cure health conditions on their own, and the same applies to lactose intolerance. However, supplements can help to fill the nutritional gaps left by reducing the intake of dairy products and temporarily providing enough lactase to break down lactose.
Regardless of the approach, choosing the right supplements is essential. The right supplement differs for different individual needs. Therefore, you should contact your healthcare provider before using any supplement to manage your symptoms.
Here are some supplements that can help manage lactose intolerance symptoms.
Lactase Supplements
Lactase is the enzyme that breaks down lactose into galactose and glucose through a process called hydrolysis. Lactose-intolerant people do not have enough lactase in their intestines, allowing lactose to enter the bowel and causing lactose intolerance symptoms.
There is no way to naturally increase lactase levels. However, lactase supplements can temporarily boost lactase levels, making the digestion of lactose much easier. These lactase supplements may come in pills or drops and should be used before or with the lactose-containing product.
Most lactase supplements have to be used between 15 to 30 minutes before consuming dairy or with the first bite or sip of dairy. You should check the label of the particular product you are using to be sure of its correct usage. Also, do not take a higher dose than you need.
Probiotics
Probiotics are live microorganisms that benefit the body when consumed in adequate amounts. Some benefits of probiotics include reduced gastrointestinal symptoms and improved immunity, which likely result from their role in maintaining a healthy microbial community in the gut.
The National Library of Medicine has evidence that probiotics can also help manage lactose intolerance symptoms, like abdominal cramping, diarrhea, and vomiting. Specific strains like Lactobacillus acidophilus (DDS-1 strain), Bifidobacterium lactis, and Lactobacillus casei support lactose digestion by breaking down lactose in the gut. These strains may be found in fermented products like yogurt and kefir.
Interestingly, yogurt contains lactose, as it is produced from fermented milk. However, the bacteria in yogurt can provide the enzyme β-galactosidase, which can promote lactose digestion and reduce lactose intolerance symptoms. Still, caution in choosing the products to use is critical, as some yogurt products may not contain the right strain or sufficient bacteria to improve lactose intolerance symptoms.
Frequently Asked Questions
How Can You Check for Lactose Intolerance at Home?
You can check for lactose intolerance at home by assessing your symptoms when you consume milk or milk products, such as cheese and ice cream. Lactose-intolerant people usually experience digestive symptoms like bloating, diarrhea, and stomach pain within 2 hours of ingesting lactose.
A more accurate way of checking for lactose intolerance is to visit a medical practitioner and undergo physical examinations and medical tests. Health practitioners will usually start by assessing your medical and family history, as the most common cause of lactose intolerance (primary lactase deficiency) is genetic.
After assessing your history, health practitioners may physically examine you for abdominal bloating, rumbling sounds, tenderness, and pain. Then, for confirmation, they may order medical tests such as hydrogen breath, stool acidity, and milk tolerance tests.
What Is the Difference Between Lactose Intolerance and Milk Allergy?
Lactose intolerance refers to digestive symptoms caused by the body’s inability to digest lactose, while milk allergy is an immune system response to proteins in milk and milk products. Milk allergy generally appears as early as the first year of life, while lactose intolerance appears later in life, usually around adolescence.
Lactose intolerance and milk allergy also differ in their severity. Lactose intolerance causes discomforting gastrointestinal symptoms like diarrhea and bloating, but these symptoms are not life-threatening. In contrast, milk allergy can cause life-threatening symptoms like anaphylaxis (characterized by breathing difficulties and a drop in blood pressure).
How Can You Tell the Difference Between Lactose Intolerance and IBS?
Irritable bowel syndrome (IBS) is different from lactose intolerance in its triggers and symptoms. IBS has multiple potential triggers, including stress, infection, hormone imbalance, and inflammation, while lactose intolerance is triggered by milk and milk products.
IBS and lactose intolerance can both cause gastrointestinal symptoms like abdominal pain, diarrhea, and bloating. However, IBS can also cause constipation, rectal bleeding, and unexplained weight loss, which are rarely observed in lactose intolerance.
Can You Improve Your Tolerance to Lactose?
Yes, it is possible to improve your tolerance to lactose by gradually increasing your intake of dairy products. Extended exposure to lactose can cause the intestinal microbiome (normal organisms living in the intestine) to adapt to the sugar and become more tolerant. The increased tolerance will be observed as milder lactose intolerance symptoms.
Increasing dairy intake to raise tolerance may be tricky if done on your own. You should not hesitate to inform your healthcare provider about the right procedure for increasing dairy intake. Also, most people with lactase non-persistence (the most typical cause of lactose intolerance) can already tolerate small amounts of lactose (around one cup). Therefore, you need to immediately stop taking dairy products if even a tiny amount of dairy products is causing severe symptoms.
While you can improve your tolerance to lactose, it is impossible to naturally increase lactase activity by increasing lactose consumption. Do not fall for fad diets online that claim to increase lactase secretion. However, you can still temporarily increase lactase levels by taking lactase supplements.
Conclusion
Lactose intolerance refers to the body’s inability to digest lactose, causing gastrointestinal symptoms like abdominal bloating, cramps, vomiting, and diarrhea. While not life-threatening, these symptoms can cause significant discomfort.
Managing lactose intolerance involves dietary modifications, mainly by reducing the amount of lactose-containing foods and drinks you consume. However, these foods and drinks may also contain important nutrients, so you may need a diet plan to compensate for nutritional gaps. Additionally, lactase and probiotic supplements can help manage lactose intolerance symptoms.
The Bay Clinic of Chiropractic is here to help with a personalized lactose intolerance diet plan. Contact us at (850) 785-9372 or info@thebaydoctor.com to get started.
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