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Got Milk? Got Lactose?

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For many people, a warm glass of milk at bedtime induces sweet dreams and a good night’s sleep. But for the 40 million Americans who are lactose intolerant, even a tiny sip of milk at any time of the day or night creates a gastric nightmare.

According to the National Digestive Diseases Information Clearinghouse (NDDIC) lactose intolerance is the inability to digest significant amounts of lactose, the major sugar found in milk. Lactose intolerance is caused by a shortage of the enzyme lactose, which is produced by the cells that line the small intestine. Lactose breaks down milk sugar into two simpler forms of sugar called glucose and galatose, which are then absorbed into the bloodstream.

Symptoms of lactose intolerance usually occur with 30 minutes to one hour of ingestion and often include severe abdominal pain, diarrhea, flatulence and bloating. Symptoms can be mild or severe, depending on how much lactose a person has ingested.

Although lactose intolerance is a nuisance, it does not pose a serious health threat and can be easily treated by dietary changes. In planning meals, people with lactose intolerance should make sure that each day’s diet includes enough calcium, even if dairy products are not included. Many non-dairy foods are high in calcium, including dark green vegetables such as broccoli or fish with soft, edible bones, such as salmon and sardines. A holistic dietician can help you plan meals that will provide the most nutrients with the least chance of causing discomfort.

People who suffer from lactose intolerance should be on the lookout for “hidden lactose.” Some products labeled non-dairy, such as powdered coffee creamer and whipped toppings, may actually include ingredients that are derived from milk and therefore contain lactose. Learn to read food labels with care, looking not only for milk and lactose, but also for words such as whey, curds, milk by-products, dry milk solids and non-fat dry milk powder. If any of these words are listed on the label, the product contains lactose.

Lactose is used as a filler in more than 20 percent of prescription drugs (including many types of birth control pills) and in about 6 percent of over-the-counter medicines. This may not matter to you if you take medication only occasionally, but if you take it every day, it could cause symptoms. Complicating matters is the fact that lactose may not be listed under the inactive ingredients on the label. To find out if what you’re taking contains lactose, ask your doctor or pharmacist, or contact the drug’s manufacturer.

The degree of intolerance differs with each person. The best way to assess your tolerance is first to get all lactose out of your system by avoiding all lactose-containing foods for three to four weeks. Then start with very small quantities of milk or cheese. Monitor your symptoms to see how much or how little dairy food you can handle without experiencing discomfort. Once you know your limits, management becomes a little easier.

There are some supplements in the market which are helpful to some people with lactose intolerance. Lactose enzyme tablets or drops contain the enzyme that breaks down lactose, reducing the amount your body must digest on its own. You add drops directly to liquid dairy products, but they take up to 24 hours to break down the lactose in the product. You can take tablets just before a meal or snack. Calcium supplements are helpful for people who have lactose intolerance and are unable to eat dairy products in any form. Visit your local health food store to review the supplements that are available to treat lactose intolerance.