Lactose Intolerance - Part 2

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.

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. Lactase Drops Are Available for Sale Online

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.

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

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.
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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

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This article originally posted on the Center For Food Allergies website.
Image thanks to on dark_phantom on Photobucket