Lactose Intolerance: A Comprehensive Guide to Symptoms, Causes, and Management

about lactose intolerance

If you find your digestive system doing all kinds of strange things after consuming dairy, you may very well be sugaring from lactose intolerance. Lactose intolerance affects as many as 48% of Americans and is commonly mistaken as an allergy to milk or dairy. However, it’s actually a digestive issue where the body is unable to properly break down the lactose (sugar) found in milk and dairy products. While undigested lactose won’t hurt you, it can produce some pretty uncomfortable symptoms but with a few simple tips, you can easily manage and reduce them and maybe even still enjoy some dairy from time to time.

What is Lactose Intolerance?

Many people confuse lactose intolerance as being a dairy or milk allergy as many of the symptoms overlap but there is a clear distinction between the two. A dairy or milk allergy is a problem with the immune system, whereas lactose intolerance is a problem with the digestive system. More specifically, lactose intolerance is a common digestive problem where the body is unable to digest lactose, a type of sugar mainly found in milk and dairy products.

Another clear distinction between the two are the symptoms. A dairy or milk allergy will produce symptoms such as wheezing, itching and a rash. Lactose intolerance causes symptoms including:

  • Bloating
  • Diarrhea
  • Gas
  • Nausea
  • Stomach cramps and pains
  • Stomach rumbling

These symptoms typically develop within a couple of hours after consuming something that contains lactose and the severity of them often depends on the amount of lactose consumed. Additionally, some people can still eat a small amount of lactose without experiencing any major problems, while others cannot even stomach – pardon the pun – even the smallest amounts.

What Causes Lactose Intolerance?

There are three types of lactose intolerance and each is based on the cause:

  • Primary lactose intolerance: The most common type, primary lactose intolerance occurs when the body doesn’t produce enough lactase, making it difficult for the body to digest.
  • Secondary lactose intolerance: This type of lactose intolerance occurs when lactase production decreases after an injury, illness or surgery involving your small intestine. It can lead to additional digestive issues, such as celiac disease, bacterial overgrowth, intestinal infection and Crohn’s disease. 
  • Congenital or developmental lactose intolerance: A rarer form of lactose intolerance where babies are born with this problem due to an insufficient lactase level.

There are also a variety of risk factors that may increase your chances of being lactose intolerant, such as:

  • Age: The issues usually appear in adulthood.
  • Family history: If you have a family history of lactose intolerance, you may be at a higher risk of developing it yourself.
  • Ethnicity: Lactose intolerance has been found to be more prominent in African, Asian, Hispanic and American Indian individuals.
  • Premature birth: Babies born prematurely may not have sufficient amounts of lactase, as this gets produced late in the third trimester.
  • Diseases associated with the small intestine: If you already experience problems with your small intestine, such as bacterial overgrowth, Crohn’s disease or celiac disease, you may be at a higher risk for being lactose intolerant.
  • Cancer treatment: Certain types of cancer treatments, such as radiation and chemotherapy, done on your stomach or intestines can increase your risk of developing lactose intolerance.

Tips for Managing Lactose Intolerance

While there is no known cure for lactose intolerance, there are many things you can do to manage and even reduce your symptoms.

Choose Lactose-Free Products

The most obvious thing to do to start treating your lactose intolerance symptoms is to eliminate lactase products by choosing lactose-free alternatives. Some examples are:

  • Lactose-free milk such as soy milk, rice milk, almond milk, oat milk, etc.
  • Lactose-free yogurts and cheeses

Try Different Dairy Products

Originally, people suffering from lactose intolerance were told to avoid all dairy products. Today, many health experts suggest trying different dairy foods to see which ones you can still enjoy (with as few symptoms as possible). This allows you to still get calcium and other important nutrients from such products.

Supplement Calcium and Vitamin D

If you aren’t consuming any or enough dairy products, make sure you take the proper supplements to get all of the essential nutrients. Calcium and Vitamin D are often recommended.

You may also want to increase your intake of calcium and vitamin D-rich foods. Some excellent options for calcium are orange juice, winter squash, edamame, almonds, blackberries, figs and oranges. For vitamin D, some great sources are tuna, orange juice, sardines, beef liver, soy milk, oatmeal, salmon and mackerel.

Take a Supplement That Helps with Digesting Lactose

Taking lactase supplements or substitutes can help with the digestion of lactose. This allows you to get the essential nutrients from dairy in your diet without experiencing severe symptoms. 

Start with Small Amounts

As mentioned previously, some people can consume small amounts of lactose and experience zero symptoms, but experience severe symptoms if they have a little too much. So, always start with small amounts of milk products to see how your body reacts. This will also help you determine just how much you can enjoy before you start to develop symptoms.

Implement the 80/20 Rule

Since many health experts recommend that you should still have some dairy in your diet, the 80/20 rule can be great help. This consists of a diet that’s composed of 80% dairy-free food and only 20% dairy.

Opt for Dairy Products That Have Naturally Lower Levels of Lactose

Dairy products, such as hard cheese, kefir, butter, yogurt, sherbet and sour cream are naturally lower in lactose. So, try to snack on these options instead of items with high lactose content.

Avoid High-Lactose Foods

With the prior mentioned, it’s highly recommended to avoid foods that naturally contain higher levels of lactose, such as:

  • Milk and heavy cream
  • Condensed and evaporated milk
  • Ice cream
  • Cottage cheese and ricotta cheese
  • Cheese spreads

Read Food Labels

The most important thing you can do when living with lactose intolerance is read the food labels. Lactose is often added into products that would otherwise be lactose-free, including bread, cereals, lunch meats, salad dressing, cake and cookie mixes and coffee creamers. Even dried vegetables may have lactose added. So, keep an eye out for ‘lactose’ on those labels.

Additionally, you’ll want to search food labels for ingredients that contain lactose, such as butter, cheese, cream, dried milk, milk solids, powdered milk and whey.

Check Your Meds

You’d be surprised at how many medications have lactose added into them as a filler. This is particularly true for medications that come in white tablets. So, make sure you check your medications, especially birth control pills and antacids. If you’re still unsure, speaking with a pharmacist can help.

Use Fruit Juice as a Substitute for Dairy in Recipes

Depending on the recipe, fruit juice can be an excellent lactose-free alternative to dairy products. This is a common baking and cooking hack that works with almost every recipe.

Consume Dairy with Other Products

When you are consuming dairy, make sure to pair it with other foods. For example, instead of eating just cheese, have cheese and crackers. This will help reduce any potential symptoms.

Lactose intolerance is generally harmless and won’t cause you any danger. But it can create some pretty debilitating and uncomfortable symptoms if not managed properly. Fortunately, there are many simple things you can do to effectively manage your lactose intolerance and reduce your symptoms.

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