Lactose Intolerance Information

Lactose intolerance is the impaired ability to digest lactose (milk sugar). Lactose is a sugar naturally found in milk and is sometimes referred to as "milk sugar". 
It is digested by an enzyme called "lactase", which is found in the small intestines of most people. However, many people don't produce enough lactase to adequately digest milk sugar. These individuals are " intolerant" to milk sugar. 

How Common Is Lactose Intolerance?
Symptoms
Lactose Intolerance in Babies
Symptoms in Babies
Why It's a Serious Health Problem
Lactose Intolerance Is Not Milk Allergy
How Is It Diagnosed?
How Is It Treated?
Which Foods Contain Lactose?
Which Dairy Foods Contain the Most Lactose?
Your Next Step

How Common Is Lactose Intolerance? 
More than 50 million Americans are lactose intolerant. 
Nearly two-thirds of the world's adult population has some degree of difficulty with digestion of milk sugar because of a lactase deficiency:

  • 97-100% of African Blacks
  • 90-100% of Asians
  • 70-75% of North American Blacks
  • 70-80% of Mexicans
  • 60-90% of Mediterraneans
  • 60-80% of Jewish descent
  • 10-12% of Middle Europeans
  • 7-15% of North American Caucasians
  • 1-5% of Northern Europeans

Lactose Intolerance Symptoms 
The most common lactose intolerance symptoms are:

  • Intestinal cramps or discomfort
  • Gas
  • Bloating
  • Diarrhea

One study has suggested that women with lactose intolerance are more likely to have depression or PMS (premenstrual syndrome). 
Lactose intolerance symptoms are almost identical with symptoms of other chronic disorders such as irritable bowel syndrome or celiac disease. Studies show that as many as 70% of lactose intolerant people don't link their symptoms to consumption of milk sugar. So it's possible that you may actually have lactose intolerance instead of "indigestion" or "irritable bowel". 

Lactose Intolerance In Babies
Lactose or milk sugar intolerance is not commonly observed in infants (although they may have an allergy to milk proteins). The lactase enzyme reaches its maximum level in the human intestine soon after birth and declines after age 3 1/2, so symptoms of insufficient lactase may not begin to show up until after this age.

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Symptoms of Baby Lactose Intolerance 
If your baby has any of the following symptoms, he or she may have lactose intolerance, although a milk allergy is more probable.

  • Colic
  • Crying
  • Spitting up (reflux)
  • Gas
  • Loose stools
  • Eczema
  • Ear infections

If your baby has any of the above symptoms, we recommend that you call our clinic at 206-264-1111 and schedule an appointment to determine the best way to improve your baby's health. 

Why Lactose Intolerance Is a Serious Health Problem
Inability to digest and absorb lactose leads to irritation of the lining of the intestines. This irritation in turn leads to a weakened digestive system that exposes you to future systemic disorders. In addition to an inability to absorb needed nutrients, a weakened digestive system is more susceptible to attack by parasites, yeast and pathogenic bacteria, which worsens the problems in your intestines and exposes you to chronic disease. 
The inability to digest lactose may also be just the tip of the iceberg. Lactose intolerant people often have other problems that indicate the presence of a dairy allergy, not just a lactose intolerance. 

Lactose Intolerance Is Not a Milk Allergy - But Is Easily Confused with Milk Allergy
Lactose intolerance is your intestine's reaction to milk sugar. A milk allergy is a systemic immune reaction against milk proteins.
Some symptoms of milk allergy can be similar to lactose intolerance symptoms. If you have any of the symptoms listed above, you could have lactose intolerance, a milk allergy, or both. 

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How Is Lactose Intolerance Diagnosed?
A simple self-test for lactose intolerance is to drink at least two 8-ounce glasses of milk on an empty stomach and note any intestinal symptoms that develop in the next four hours. The test should then be repeated using several ounces of cheese (which does not contain much lactose). 
If you get symptoms from milk but not cheese, then you probably have lactose intolerance. If symptoms occur with both milk and cheese, you may be allergic to dairy products. 
However, this self-test is not conclusive because you may unknowingly be consuming lactose. Lactose is "hidden" in hundreds of food products and medications. 

The Breath Hydrogen Test. The best way to find out if you are lactose intolerant is to get a breath hydrogen test, which is available through your doctor, or our clinic. This test is simple to do and is relatively accurate. It is the "gold standard" for detecting lactose intolerance. 
With the breath hydrogen test, you fast overnight, eat a dose of lactose in the morning and collect breath samples at timed intervals. If the lactose isn't broken down by the lactase enzyme in the small intestine, it travels to the colon and undergoes bacterial fermentation. Due to fermentation, hydrogen levels in your breath will rise within 1-2 hours. 
If you want to be tested for lactose intolerance using the breath hydrogen test, call our clinic at 206-264-1111. 

How Is Lactose Intolerance Treated?
Lactose Avoidance. The most effective treatment is to avoid foods and medications that contain lactose, primarily milk and milk products. However, some people who are lactose intolerant are also intolerant of other sugars, such as table sugar. So, besides avoiding lactose-containing foods, you may also need to avoid foods containing other sugars and certain carbohydrates. 
People have differing levels of the lactase enzyme, and there are differing levels of lactose in dairy products -so it's possible that you can consume some dairy. Milk, ice cream and yogurt contain quite a bit of lactose. 
However, fermented dairy products that contain lactose - such as yogurt and kefir - are more easily digested. In addition, lactose-reduced milk is available in some supermarkets. 

Lactase Enzyme Supplementation. You can take lactase enzyme supplements to prevent symptoms when consuming lactose-containing dairy products. Lactase drops may be added to regular milk 24 hours before drinking to reduce lactose levels. Lactase drops, capsules, and tablets may also be taken orally immediately before a meal that has lactose-containing dairy products. Lactaid and lactaid liquid is one of the popular lactase products. 
The degree of lactose intolerance varies by individual, so a greater or lesser amount of oral lactase may be needed to eliminate symptoms of lactose intolerance. 

Calcium Supplementation. Dairy products are a plentiful source of calcium. If you can't consume diary products, some physicians recommend that you take supplemental calcium. 
A typical amount of supplemental calcium would be 1,000 mg per day. 

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Which Foods Contain Lactose?
Obvious Sources

  • All cheeses
  • Butter, many margarines
  • Goat's milk
  • Half-and-half cream
  • Ice cream and many sherbets
  • Milk (whole, skim, dry powdered, evaporated)
  • Yogurt

Hidden Sources

  • Artificial sweeteners containing lactose
  • Breads, biscuits and crackers, doughnuts made with milk
  • Breading on fried foods
  • Breakfast and baby cereals containing milk solids
  • Buttered or creamed foods (soups and vegetables)
  • Cake and pudding mixes, many frostings
  • Candies with milk chocolate
  • Cookies made with milk
  • Hot dogs, luncheon meats, sausage, hash, processed and canned meats
  • Mayonnaise and salad dressings made with milk
  • Nondairy creamers (except for Coffee Rich)
  • Pancakes, waffles, toaster tarts
  • Pizza
  • Weight loss products
  • Many prescription drugs: birth control pills, thyroid medication and medications for gastrointestinal disorders (such as Reglan and Xanax)
  • Many types of vitamins
  • Foods containing whey, casein, caseinate, or sodium caseinate

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Which Dairy Foods Contain the Most Lactose? (grams per indicated quantity)

Milk: whole, low-fat, skim

1 cup 9-12
Buttermilk

1 cup

9-12

Goat milk

1 cup 9
Fat Free dry milk

1/3 cup

12

Half and half

2 tbsp. 1
Light cream

2 tbsp.

1

Whipped cream

2 tbsp. <1
Sour cream

2 tbsp.

1

Condensed milk, whole

2 tbsp.

4
Evaporated milk

1 tbsp.

3

Butter, margarine

1 cup trace
Yogurt, low-fat

1 cup

5

Cottage cheese

1/2 cup 2-3
Ice cream

1/2 cup

6-9

Sherbet

1/2 cup 2
Cheese: American, Swiss, blue

1 oz.

1-2

Cheese: Cheddar Parmesan

1 oz. 1-2
Cream cheese

1 oz.

1-2

Your Next Step 
If you're a member of an ethnic group that has a high risk of lactose intolerance, and if you consume dairy products at all, it's advisable to get a breath hydrogen test so that you can determine to what extent you have lactose intolerance. 
Lactose intolerance is something that you need to deal with if you want to improve or preserve your health. Call 206-264-1111 today.

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