Managing Lactose Intolerance

Would it surprise you to hear almost 2/3 of the world’s population is deficient in the ability to digest lactose? After infancy, 65% of the world’s population has some difficulty with lactose absorption, with the only group not having noticeable issues being those of Northern European descent.

When you consume dairy products with the sugar lactose, the body will use lactase, a gastrointestinal (GI) enzyme, to break-down the lactose into two molecules, glucose and galactose. In a person without lactose intolerance, this process occurs seamlessly with few noticeable issues. However, in a person who is lactose intolerant, his/her body does not possess enough of the enzyme lactase to appropriately digest the lactose. Hence, that lactose does not get broken down into usable components, and ferments in the GI tract, typically causing a range of uncomfortable issues such as nausea, gas, bloating, cramping, diarrhea and other unpleasant feelings.

How Do I Know If I’m Lactose Intolerant?

The first step is always to record your eating habits in a journal. Before going to any doctor or taking any tests, be clear on what you are actually consuming on a daily basis, and record how you feel after meals. The more detail, the better! Not only will this help give you direction, but if you do see a doctor, s/he will ask if you can describe your eating habits. Having a journal makes this conversation much more actionable.

The two most popular tests a medical professional can run to help you understand whether you are lactose intolerant (or even simply deficient) are the lactose tolerance test and the hydrogen breath test.

  • In the lactose tolerance test, a patient is given lactose and within two hours, blood samples are taken to measure blood sugar levels that will determine if the body is properly converting lactose to glucose & galactose.
  • In the hydrogen breath test, after drinking a lactose solution, the medial professional will measure the hydrogen present in your breath at consistent intervals. Too much hydrogen in the breath indicates the body is not digesting/converting the lactose efficiently, which likely indicates a deficiency in the lactase enzyme.

What Are My Options If I’m Lactose Intolerant?

Dr. Lam’s article, below, does a nice job of explaining options in more detail. In summary, you have three options:

  1. Eliminate all lactose-containing foods. This is certainly possible, especially with milk substitutes like almond milk, coconut milk, and so on. In fact, Dr. Lam highlights the potential of a Lactose Intolerant Diet, including substitute foods (ie, fermented milk & yogurts) and possible risks. Keep in mind, however, that this elimination will likely cause a deficiency in key vitamins & minerals, such as D, K, calcium & magnesium. So, be sure you are consuming alternative foods that can help you obtain enough of these critical micronutrients, or consider supplementation.
  2. Supplement with lactase enzymes. A popular OTC supplement, Lactaid, is a supplementary enzyme taken with food containing lactose that gives the body some help in digestion. While not fool proof, it certainly can help reduce/minimize side effects from the lactose, and is a reasonable option for those who are slightly-to-moderately deficient in the lactase enzyme.
  3. Improve your digestive tract. While a deficiency in converting lactose to glucose & galactose may be real, you may also have other GI issues that need to be addressed. A stressed, overworked or damaged GI tract will only make something like lactose intolerance worse, so take steps to revive your GI. Some great ways to do this are:
    1. Confirming you do not have irritable bowel syndrome (IBS) or colitis. A combination of blood and stool tests run by your GI doctor can help determine whether these are present.
    2. Eliminating leaky gut
    3. Understand if you have celiac (gluten intolerance) and make dietary changes to address
    4. Introduce probiotics and bone broth to your diet
    5. Replace vegetable cooking oils with coconut oil
    6. Check your adrenal health and ensure you are not operating in an over-taxed, stressful state

As with ANY health issue, the first step is to identify commonalities and consistencies of symptoms, then be ready to share those with a health professional that is ready to help you get to the root cause of your issue.

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