Lactose Intolerance: Symptoms, Causes, & Solutions

[Evo]

There is no need to completely avoid milk products if you are lactose intolerant. You may not even need to avoid them at all if you follow the advice below, it's not an allergy.

How is lactose intolerance managed?
Although the body’s ability to produce lactase cannot be changed, the symptoms of lactose intolerance can be managed with dietary changes. Most people with lactose intolerance can tolerate some amount of lactose in their diet. Gradually introducing small amounts of milk or milk products may help some people adapt to them with fewer symptoms. Often, people can better tolerate milk or milk products by taking them with meals.

The amount of change needed in the diet depends on how much lactose a person can consume without symptoms. For example, one person may have severe symptoms after drinking a small glass of milk, while another can drink a large glass without symptoms. Others can easily consume yogurt and hard cheeses such as cheddar and Swiss but not milk or other milk products.

The Dietary Guidelines for Americans 2005 recommend that people with lactose intolerance choose milk products with lower levels of lactose than regular milk, such as yogurt and hard cheese.

Lactose-free and lactose-reduced milk and milk products, available at most supermarkets, are identical to regular milk except that the lactase enzyme has been added. Lactose-free milk remains fresh for about the same length of time or longer than regular milk if it is ultra-pasteurized. Lactose-free milk may have a slightly sweeter taste than regular milk. Soy milk and other products may be recommended by a health professional.

People who still experience symptoms after dietary changes can take over-the-counter lactase enzyme drops or tablets. Taking the tablets or a few drops of the liquid enzyme when consuming milk or milk products may make these foods more tolerable for people with lactose intolerance.

http://digestive.niddk.nih.gov/ddiseases/pubs/lactoseintolerance/

 

[nucleargirl]

And how are you handling the bloating? My sister-in-law gets really cramped up along with the bloating, and has had to switch to soy substitutes, etc. During holiday family pot-lucks she sometimes only eats dishes that either she or my wife brings, just to be on the safe side.

yeah, I think I don't have it as bad as other people - I don't get cramps... it kind of just moves along... so it starts about 3-4 hours after drinking milk, and its all gone by around 8 hours after comsumption.

Day 2 update: Man, today was a double whammy! Had beans on toast AND a glass of milk for lunch! lol! but somehow I think they canceled each other out in my stomach so the after effects were not too bad at all :)

 

[nucleargirl]

thanks Evo! that's a good link.

 

[lisab]

yeah, I think I don't have it as bad as other people - I don't get cramps... it kind of just moves along... so it starts about 3-4 hours after drinking milk, and its all gone by around 8 hours after comsumption.

Day 2 update: Man, today was a double whammy! Had beans on toast AND a glass of milk for lunch! lol! but somehow I think they canceled each other out in my stomach so the after effects were not too bad at all :)

Beans on toast? Are you British?

 

[turbo]

Beans on toast? Are you British?

That's my father's dream breakfast. My home-made baked beans on toast. His gout keeps him from indulging too much, though.

 

[nucleargirl]

yeah! baked beans on my homemade bread with cheese on top! yum!
and tomorow I'm going to have (almost) full English breakfast! lol! we just happen to have bacon, beans, black pudding, tomatoes and eggs at home!

 

[missmariss]

No! I am going to defy my body and genetics! I made my body intolerant, I WILL make it tolerant again! I'm going to drink milk! all the time! see who's the boss!

Actually, this does have some merit to it.

While I wouldn't suggest starting off by drinking more dairy than you ever have before, it is true that the more lactose you consume, the more tolerant you become. Also, if you cut down on consumption of glucose, your body will more readily absorb lactose as an energy source.

To put it simply : there's something in your DNA called an operon, it has two functions.
One : if there is lactose present, it will trigger the production of the lactase enzyme
Two : if there is a lack of glucose, it will trigger the production of the lactase enzyme

So if you slowly introduce lactose back into your diet, as well as cut down on your intake of glucose, it's likely that you will redevelop a higher tolerance for lactose. That being said, people will milk allergies have been known to confuse this for lactose intolerance. ALLERGIES ARE NOT INTOLERANCE! Intolerance is the inability to digest something, we all have fiber intolerance, our stomachs are not designed to digest it so it moves on through us at a rapid rate. If you are allergic to milk it is usually the protein which makes you sick, and if you were to introduce more and more dairy into your diet you could become seriously ill.

 

[nucleargirl]

ah no no, I am sure I am not allergic to milk cos I've been drinking my whole life with no problems until recently. I think my intolerance developed cos I cut out milk for 6 months, so now I'm trying to make my body used to having it around again.

um... I'm not so sure about the operon thing... I know its in bacteria, but I've not heard of it in humans...

thanks for the support tho! I know my body will see sense soon :)

 

[missmariss]

Wow apparently I didn't understand that bio class as well as i should have haha!

You're absolutely right, it is in bacterial dna, not human. Is it possible though that one of these types of bacteria is one of the kinds found in our stomachs?

 

[nucleargirl]

Wow apparently I didn't understand that bio class as well as i should have haha!

You're absolutely right, it is in bacterial dna, not human. Is it possible though that one of these types of bacteria is one of the kinds found in our stomachs?

yeah! that is possible actually! its e.coli! maybe there's a kind that's already in our guts and not givng us food poisoning... wow! this is well cool! if we could somehow modify this bacteria to produce more lactase... either modify existing bacteria or make a new harmless type and make it into a pill... I think there's money in this!

 

[mugaliens]

Here's an interesting graphic showing lactose intolerance by geographic and ethnic groups. It ranges between 0.3% for Basques and 100% for Native Americans. I find that last one interesting, as the five runners-up are all Asiatic.

 

[nucleargirl]

Alright! Update: so its been a month since I started the experiment :) during which I have pretty much eaten some milk product every day, and now... I feel much better!
Yesterday I had 2 cups of chocolate milk and had cereal for breakfast, and I didnt have very much bloating and gas at all! I'd say a lot less than before. And today I had a huge bowl of rice pudding for lunch and I feel good right now! had a little gas in the afternoon but nothing out of the ordinary! lol
who knows! maybe its working, or maybe I am just getting really tolerant of myself...
we'll see! more updates later!

 

[Borek]

Thank you for the information. While I am not really interested in the information about your gases I appreciate fact that you remembered to post an update, it doesn't happen too often - most people just disappear without traces.

Could be others just explode, leaving traces all over, but not on the forum.

 

[nucleargirl]

You're welcome Borek! I enjoy these updates too much to forget!

 

[lisab]

Wow, I must admit, I'm surprised at the outcome of your experiment. I thought for sure you'd be in too much discomfort, and have to give up.

I'm happy for you !

 

[nucleargirl]

:) thanks Lisa!

 

[Evo]

Good going nucleargirl!

 

[bobze]

Lactase (the enzyme responsible for digesting lactose, a galactose/glucose disaccharide) is pretty unique because it is the only brush-border enzyme (that's the intestinal-cell/lumen border) kept in amounts near equivalent to "need".

The expression of lactase declines for most adults throughout life. However, your body can respond to the presence of lactose in the lumen by upregulating production of lactase (its a pretty convoluted regulatory pathway).

So for a significant portion of adults, ingesting lactose (milk sugar), even later in life can lead to more expression of lactase and thus better lactose digestive capabilities. In those adults that have difficulty digesting lactose, they lack the regulatory capabilities of those who can digest lactose.

Even if you continually eat lactose products throughout life, your digestive efficiency declines with age.

Sorry I didn't see this earlier, I could have saved you a month and some discomfort nucleargirl!Edit: I'd like to correct my first sentence. Trehalase (for digesting trehalose, a sugar found exclusively in mushrooms) is also kept in low concentrations in the brush border as well. Other enzymes though, like sucrase-isomaltase are kept in excessive amounts ensuring complete digestion of those sugars to their monosaccharides.

 

[Borek]

Sorry I didn't see this earlier, I could have saved you a month and some discomfort nucleargirl!

I think you have missed the point. She was aware of the potential problems and she decided to check if she can force "upregulation of production of lactase". Obviously it worked.

 

[bobze]

I think you have missed the point. She was aware of the potential problems and she decided to check if she can force "upregulation of production of lactase". Obviously it worked.

Yes, like I pointed out. That's not new news (I believe most of this was worked out in the late 90's) Hence the save you a month and experiment

 

[nucleargirl]

Yes, its going to be a long-term (if not life-long) experiment for me! I want to be able to eat milk without problems. I'm still young so not worried about digestive efficiency declining. Maybe experiment is the wrong word - its more like lifestyle change!

 

[gascap]

That is great for you. It did not work so well for me. My realization came when I was in my early 30s but nothing has helped to mitigate it. And just for the record there are certain things I have discovered are absolute no-nos Cream is one and CoolWhip is the other.
I will venture into a piece of pizza once in a while but I stay with lactiad capsules and lactose free milk or soy milk for comfort. The surprise was when I had some throat problems when eating a Salmon filet and later discovered that they are often coated with Casein, which is milk protein as I understand it.

 

[Borek]

The surprise was when I had some throat problems when eating a Salmon filet and later discovered that they are often coated with Casein, which is milk protein as I understand it.

How is milk protein related to lactose intolerance? I can be missing something but I don't see a connection.

 

[bobze]

How is milk protein related to lactose intolerance? I can be missing something but I don't see a connection.

Its not. Lactose intolerance is the result of not having enough lactase along the digestive epithelium (particularly in the jejunum). Lactase, is normally only kept in low amounts, so its easy for there to not be enough lactase to digest the lactose sugars.

If one were to consume too much lactose, the increase in a non-diffusable substrate changes the osmolar concentration of the lumen of the GI. This is what leads to diarrhea (osmotic diarrhea) and the other symptoms associated with lactose intolerance.

If you had a reaction to milk proteins (namely casein) you'd be having an allergic reaction to milk, not an intolerance to lactose (which is possible, though much more rare).

 

[Proton Soup]

If you had a reaction to milk proteins (namely casein) you'd be having an allergic reaction to milk, not an intolerance to lactose (which is possible, though much more rare).

my microbiology professor just yesterday stated in lecture that most lactose "intolerance" was actually an allergic reaction, but didn't elaborate. if so, that would make sense that casein causes problems for some, but I'm not quite sure what to make of it.

 

[ebits21]

Here's an interesting graphic showing lactose intolerance by geographic and ethnic groups. It ranges between 0.3% for Basques and 100% for Native Americans. I find that last one interesting, as the five runners-up are all Asiatic.

It's perfectly logical, Native Americans are a migration of Asians and therefore share many traits with them.

 

[bobze]

my microbiology professor just yesterday stated in lecture that most lactose "intolerance" was actually an allergic reaction, but didn't elaborate. if so, that would make sense that casein causes problems for some, but I'm not quite sure what to make of it.

Hmm, I don't know. I'm skeptical of that claim, which would imply allergic reaction being more prevalent than lack of an enzyme (which is in low capacity anyway). I've always learned its the other way around, but I'm not saying that is necessarily right. I've never looked into it before.

Anecdotally there is some things that lead me to believe your professor is wrong. Namely, that if the allergic reaction was predominant than this manifestation would be more common while the patients were children. Since lactose intolerance is generally a problem of aging, and as we age we have less lactase in the digestive epithelium, it would be counter-intuitive to think most cases of lactose intolerance (we see most in adults) are from allergies.

More anecdotal; can't say that I have ever known anyone with an allergy to milk (this would be a huge deal and drastically alter their life from the time they were a baby). Nor have I yet to a scratch test come up positive for a milk allergy, but I haven't seen that many scratch tests yet.

Anyway, could you ask your Prof for more information or look into it? I don't have time right now, block exams in T-minus 96 hours!

 

[nismaratwork]

Hmm, I don't know. I'm skeptical of that claim, which would imply allergic reaction being more prevalent than lack of an enzyme (which is in low capacity anyway). I've always learned its the other way around, but I'm not saying that is necessarily right. I've never looked into it before.

Anecdotally there is some things that lead me to believe your professor is wrong. Namely, that if the allergic reaction was predominant than this manifestation would be more common while the patients were children. Since lactose intolerance is generally a problem of aging, and as we age we have less lactase in the digestive epithelium, it would be counter-intuitive to think most cases of lactose intolerance (we see most in adults) are from allergies.

More anecdotal; can't say that I have ever known anyone with an allergy to milk (this would be a huge deal and drastically alter their life from the time they were a baby). Nor have I yet to a scratch test come up positive for a milk allergy, but I haven't seen that many scratch tests yet.

Anyway, could you ask your Prof for more information or look into it? I don't have time right now, block exams in T-minus 96 hours!

Yeah, you're probably going to want to read this then! Oh children, they really are more than just little adults... they're a genuine pain in the posterior!

http://www.mayoclinic.com/health/milk-allergy/DS01008

Definition
By Mayo Clinic staff

Milk allergy is one of the most common food allergies in children. Although cow's milk is the usual cause of milk allergy, milk from sheep, goats and buffalo also can cause a reaction. And, some children who are allergic to cow's milk are allergic to soy milk too.

A milk allergy usually occurs a few minutes to a few hours after you consume milk. Signs and symptoms of milk allergy range from mild to severe and can include wheezing, vomiting, hives and digestive problems. Rarely, milk allergy can cause anaphylaxis — a severe, life-threatening reaction.

Avoidance is the primary treatment for milk allergy. Fortunately, most children outgrow a milk allergy by age 3.

MOST common?! I really would have guessed peanuts or nightshade relatives, and I'd have been wrong.

This is quite good, for one line I think you'll find supports the notion that lactose intolerance is distinct from milk allergy.

http://en.wikipedia.org/wiki/Milk_allergy

Difference between milk allergy and lactose intolerance Milk allergy is a food allergy, an adverse immune reaction to a food protein that is normally harmless to the non-allergic individual. Lactose intolerance is a non-allergic food sensitivity, and comes from a lack of production of the enzyme lactase, required to digest the predominant sugar in milk. Adverse effects of lactose intolerance generally occur after much higher levels of milk consumption than do adverse effects of milk allergy.

Bolding mine: I don't know about you, but I face-palmed there... of COURSE... you even mentioned scratch tests! Immune vs. Enzyme presents differently, and of course there's no risk of anaphylaxis from the latter.

 

[nucleargirl]

Hello all!
So, I was trying to eat milk everyday since like 6 months ago. I didnt stick to it very strictly cos I would forget or would have to work or something. Anyway, so in the past month or so... I have noticed no problems with milk anymore! I don't know if this is related to my diet, or to the radioactive iodine therapy I had in mid-March. But, awesome! no more bloating or otherwise! milk galore! ahhhh so, there is the possibility of your body changing! but I don't know the cause of my change so... this revelation might not be very helpful for anyone else...
also my skin has cleared up in the last week! I have no idea why!

So to elaborate: I think I was still intolerant in January cos I remember buying lactose free milk on holiday. But during Easter I was staying with someone and we had a cup of normal milk for breakfast every day, and I had no problems. so that's when I noticed I wasn't intolerant anymore. not sure exactly when it happened cos I wasnt really looking out for changes the whole time.

 

[Ouabache]

hahaha... Dont worry, I have opened all the windows so I don't suffocate from the... explosions.

If you didn't you would be hoisted by your own petard
I know I am replying to a dated post.

So, I was trying to eat milk everyday since like 6 months ago. I didnt stick to it very strictly cos I would forget or would have to work or something. Anyway, so in the past month or so... I have noticed no problems with milk anymore!

It seems to me, my h.s. biology instructor explained when we induce lactose intolerance by stopping consumption of dairy for a period, we could re-induce tolerance by reintroduction of dairy incrementally back to our diet. Your experience confirms her explanation.

It's perfectly logical, Native Americans are a migration of Asians and therefore share many traits with them.

My instructor of anthropology also pointed this out (that Native Americans populating both N and SA continents have the same common ancestry as the mongols of northern China). And based on his discussion of current knowledge, it seemed quite logical this occurred.

Just be sure you are tactful when explaining to a Native American that they didn't originate on the American continent. Several that I have mentioned this to, were not very receptive.