Digestion

What is Lactose Intolerance?

Lactose intolerance is defined as the body not quickly digesting lactose, which is a natural sugar found in milk and dairy products. The lactose moves into the large intestine or colon. Since it’s not absorbed correctly, it can cause gas, abdominal pain, and bloating. It’s a condition, which is quite common in adults,  the majority being Native Americans, Asians, Africans, and South Americans.

The cause of lactose intolerance is the person becomes deficient in the enzyme lactase that is produced in the small intestine. When he has milk or dairy products in his diet, he will have difficulty digesting them. The gas (flatulence and bloating), diarrhea and cramping are the results of the undigested lactose being digested by bacteria in the intestine.

When a person is an infant, the production of lactase is the highest. By the age of 3, it’s beginning to decrease. As the lactase decreases by adulthood, people will naturally reduce the amounts of milk and dairy products they eat. Because of this, they will need to find another source of calcium in their diet.

Lactose intolerance occurs because of one of three reasons; those reasons being congenital, secondary, or developmental or primary. Congenital is rare and is due to a mutation in the gene responsible for the production of lactase. This is discovered in infancy. Secondary intolerance is due to diseases that destroy the lining of the intestine. An example is a celiac sprue. Another cause of secondary lactose intolerance can be caused by exposure to intestinal parasites such as giardia. The most prevalent reason is a deficiency of lactase. This varies among different ethnic groups. In some cultures, dairy products are not consumed, and this can lead to intolerance. If a person is deficient in lactase but shows no symptoms, then this isn’t considered lactose intolerance.

Diagnosis of lactose intolerance starts by making a list of symptoms. Sometimes lactose intolerance is confused with other conditions such as milk allergy or irritable bowel syndrome. Your doctor can do several tests to determine if you are lactose intolerant. These tests include the lactose tolerance test, the hydrogen breath test, and the stool acidity test. An elimination diet and a blood test are also used.

Lactose Intolerance Diagnosis

The symptoms of lactose intolerance can be mild to severe, which depends on how much lactose your body makes. They begin, usually, 30 minutes to 2 hours after eating or drinking milk products. The symptoms include:

  • Gas
  • Bloating
  • Cramps or abdominal pain
  • Gurgling or rumbling in your “belly.”
  • Loose stools or diarrhea
  • Nausea
  • Vomiting

Many people suspect they may have lactose intolerance. The best way is to avoid milk products to see if symptoms go away. You can then try adding small amounts back into your diet to see if the symptoms reappear. The best evidence is if every time you eat dairy products, you feel sick.

It’s common to develop lactose intolerance as you get older. You may never have any problems when you were young, but then suddenly you are lactose intolerant. Primary Adult Lactase Deficiency refers to the reasonable condition for most people in whom lactase production has practically ceased. If you think you are lactose intolerant talk to your doctor to rule out any other problem.

Many people self-diagnose by eliminating milk and milk products from their diet. The problem with this self-test is that there are so many processed foods that contain milk; it’s challenging to eliminate all lactose. Another problem is that people don’t test long enough. Also, people could experience a placebo effect.

An easier self-test would be to use a milk challenge. The person fasts overnight and then drinks a glass of non-fat milk in the morning. After 3 to 5 hours of not eating or drinking anything further, the person should develop symptoms, if they are lactose intolerant. Non-fat milk is consumed because the fat in milk could cause symptoms. This test isn’t without problems. If the person has a milk allergy, although rare, it could cause symptoms. Milk allergy is an allergy to milk proteins. Also, if a person usually doesn’t consume a lot of milk, then a full glass of milk could cause symptoms.

How will your doctor diagnosis lactose intolerance? He or she usually can tell by asking questions about your symptoms. Sometimes a doctor may order a hydrogen breath test, a stool acidity test, or a blood test to confirm his diagnosis. These tests will help determine whether you are digesting lactose normally. This is because other conditions such as irritable bowel syndrome can have the same symptoms, so it’s hard to diagnose by symptoms alone.

Lactose Tolerance Tests

The most common tests are:

The Lactose Tolerance Test– This test involves fasting or not eating before the test and then drinking a liquid containing lactose. Several blood samples are taken over 2 hours to measure blood glucose or blood sugar level. These samples will measure how well the body can digest lactose. Typically, when lactose reaches the digestive system, the enzyme lactase breaks it down into glucose and galactose. The liver then changes the galactose into glucose, which enters the bloodstream and raises the blood’s glucose level. If, however, lactose is incompletely broken down, the blood glucose level doesn’t rise, and a diagnosis of lactose intolerance is confirmed. This test can produce false positives.

The Hydrogen Breath Test– This test measures the amount of hydrogen in your breath. Very little hydrogen usually is detectable in your breath. However, undigested lactose in the colon is fermented by bacteria and produces various gases, which includes hydrogen. The hydrogen is absorbed from the intestines, carried through the bloodstream to the lungs, and ultimately exhaled. In this test, you drink a lactose-loaded beverage, and your breath is analyzed at regular intervals. Elevated levels of hydrogen and methane in your breath indicate improper digestion of lactose. Certain foods, medications, and cigarettes can affect the accuracy of the test, and you should avoid them before taking the test. You should check with your doctor to make sure you aren’t taking medications that might interfere with your test results.

The lactose tolerance and hydrogen breath tests should not be given to infants younger than six months of age, because a massive load of lactose can be dangerous to infants. They are more likely to develop diarrhea and become dehydrated.

Problems with the breath test are that it is long and tedious and that the amount of lactose can play a role in the outcome of the trial. If there is a spread of bacteria from the colon into the small intestine, this could cause a false result. Lastly, conditions that speed up the movement of lactose through the small intestine could produce a misdiagnosis.

Stool Acidity Test – This test is safe to be used for testing infants and young children and measures the amount of acid in their stool. Undigested lactose fermented by bacteria in their colon creates lactic acid and other fatty acids that can be detected in a stool sample. Glucose may also be present in the stool sample, a result of unabsorbed lactose in their colon.

Intestinal Biopsy – The biopsy is obtained by endoscopy or by special capsules, which are passed through the mouth or nose and into the small intestine. Lactase levels are then analyzed. The biopsy isn’t frequently used, because specialized procedures, which aren’t always available, are required.

Treating Lactose Intolerance

Treating lactose intolerance is accomplished by eliminating lactose from the diet. People must learn which foods to avoid. Some people can get away with just eating small amounts of lactose-containing foods throughout the day. Some people can eat yogurt with no problem. Milk containing lactase is available. Also, people can supplement lactase in the form of chewable tablets, or swallow tablets or capsules. Children and woman who need calcium in their diets can eat calcium-rich foods such as greens and fish or can take calcium supplements. Supplementing vitamin D is also essential.

Although there’s no cure for lactose intolerance, you can treat it by limiting or avoiding milk products. Some people drink milk with reduced lactose. Most have up to 70% of the lactose removed from the milk, but it’s also available in 100% lactose-free. Some people will substitute soy milk or soy cheese, but it’s been shown recently that soy isn’t as good for you as it was touted.

The only soy that doesn’t have harmful toxins is fermented soy such as soy sauce. Tofu isn’t fermented soy. It’s curdled soy milk. The Chinese first started eating soybeans about 2,500 years ago, after they figured out how to ferment them. They didn’t eat unfermented soybeans as you may have heard. It’s used as a condiment, but only in small amounts. The Japanese probably started eating miso, which is also fermented, about 1,500 years ago.

Soy increases the body’s need for vitamin D. Vitamin D is extremely important in the body’s immune system, and it may be beneficial to supplement it in the form of D3 or Cholecalciferol form, especially in the winter when there’s little sun. MSG, which is a potent neurotoxin, is formed in soy food processing. Soy increases the body’s need for vitamin B12, which people are already in need of because most people don’t assimilate it well.

Vitamin B12 is essential for energy. If you are tired all the time, you might me lacking vitamin B12. Soy contains high levels of aluminum, which is toxic to the kidneys and nervous system. Aluminum has also been associated with Alzheimer’s Disease. You can learn more about the dangers of soy in the book The Whole Soy Story: The Dark Side of America’s Favorite Health Food.

The enzyme lactase is available in chewable tablets or swallow-capsules to aid in the digestion of lactose.

The big concern for people who don’t eat milk or milk products is how to get enough calcium. Calcium is vital for children, teens, pregnant women, and menopausal women; although, menopausal women also need to be using a quality natural- progesterone cream to prevent osteoporosis.

Foods Containing Calcium

  • Almonds
  • Apples
  • Apricots
  • Avocados
  • Bananas
  • Blackberries
  • Black Turtle Beans
  • Blueberries
  • Bok Choy
  • Boysenberries
  • Broccoli
  • Cabbage
  • Canned Sardines
  • Cherries, sour
  • Cherries, sweet
  • Chickpeas
  • Chinese Cabbage
  • Clementines
  • Collards
  • Crabapples
  • Cranberries
  • Currants
  • Dates
  • Elderberries
  • Figs
  • Gooseberries
  • Grapes
  • Grapefruit
  • Kale
  • Kiwi
  • Lemons
  • Limes
  • Loganberries
  • Mangos
  • Melons, cantaloupe
  • Melons, honeydew
  • Navy Beans
  • Nectarines
  • Okra
  • Olives
  • Oranges
  • Papayas
  • Peaches
  • Pineapples
  • Pomegranates
  • Plums
  • Raisins
  • Raspberries
  • Salmon
  • Sesame Seeds
  • Strawberries
  • Tangerines
  • Tofu
  • Tortillas, corn
  • Tuna
  • Turnip Greens
  • Watermelons
  • White Beans

Swiss chard, rhubarb, and spinach contain oxalates that prohibit the absorption of their calcium, so they aren’t considered a good source of calcium. The idea that low-calcium causes osteoporosis is a myth. Although necessary, your body also needs other minerals such as manganese, boron, zinc, and copper.

Make sure you are getting enough protein in your diet because amino acids are part of the bone matrix; therefore, essential to healthy bones. Another very important nutrient that’s important in the prevention of osteoporosis is omega-3 fatty acids, which is ideally obtained in krill oil. Lastly, exercise such as weight lifting, which builds muscle, will also strengthen your bones. It stimulates the osteoblasts to make new bone. See an exercise specialist get exercises to build the muscles in the arms and hip areas.

If you aren’t eating a diet rich in fresh fruits and vegetables, and need to take calcium, the best-absorbed calcium is calcium citrate. Calcium requires acid to be absorbed into the body. Taking calcium containing antacid, which reduces acid in the stomach isn’t a logical source of calcium. Taking any medication, which reduces stomach acid, will of course, also interfere with calcium absorption. But taking too much calcium can lead to problems such as kidney stones.

Stay away from prescription drugs of the bisphosphonate type such as alendronate, ibandronate sodium, and risedronate sodium. Their half-lives, the time it takes for half of the drug to be metabolized, is years. This means that once you have taken the drug, it can never be eliminated from your body until the day you die. The way these drugs work is they turn off the natural mechanism your body has of destroying old, weak bone by cells called osteoclasts.

This leaves only the osteoblasts, which are the cells that make new bone. The drug becomes part of the bone matrix, and the bone appears to be denser, because of the medication incorporating itself into the bone, but actually, it isn’t denser and is weak bone. If the drug kills the osteoclasts, they can’t remove old bone, so the osteoblasts can’t make new bone.

The process of removing old bone and making new bone is called remodeling and occurs at the same spot on a bone surface. This remodeling maintains the current bone and only is slightly out of balance after the age of 35, where the amount of bone deposited lags a little behind what is resorbed.

Vitamin D is important for calcium absorption and very important for healthy bones in general. The body makes Vitamin D from exposure to the sun. As stated previously, when taken as a supplement, it should be the D3 or Cholecalciferol form. Resent findings show many people to be deficient in Vitamin D. Your doctor can do a test to determine if you are lacking.

Since Vitamin D is a fat-soluble vitamin, it’s possible to get too much; therefore, it’s essential to have your levels tested periodically. Your body will need to be supplemented with more Vitamin D in the winter months compared to the summer months. You shouldn’t need to supplement in the summer unless you test low, because you don’t get enough sunlight. Children especially shouldn’t take a multi-vitamin containing vitamin D, because they could get too much in the summer when they are outside playing in the sun. If you ask to have, your vitamin D levels checked to insist that your doctor research which labs he has available to perform the correct test.

The true test is 25(OH)D. It’s also called 25-hydroxyvitamin D. There are several different companies that the Food and Drug Administration have approved to perform vitamin D testing. DiaSorin is the gold standard for all other labs. Their radioimmunoassay (RIA) method for measuring total vitamin D levels is the gold standard, not because it’s more accurate, but because it’s the one used in almost every major vitamin D study, on which the recommended blood levels for clinical efficacy are based. For other testing methods to provide clinically relevant results, the test values must agree with DiaSorin RIA results, since those were used to establish the recommended levels.

Lactose Intolerance Supplements

Lactase supplements containing the enzyme lactase can be used if a person chooses to consume lactose. They’re produced by using the fungi aspergillus and are similar to the enzyme produced in the small intestine. Timing is of the essence, as the enzyme must reach the small intestine before the lactose-containing food.

Lactase is available in liquid form, which can be added to milk before drinking it. Chewable tablets can be chewed before eating lactose-containing food. A third form is swallow-capsules. These can be found in drug stores, vitamin stores, or grocery stores. They’re available in the brand name or generic.