Lactose intolerance? 5 questions with answers

Why does lactose intolerance occur?

Lactose is a sugar that is found in milk. It is an essential molecule for our body to obtain energy, and it eases the absorption of other substances such as calcium, vitamin D, vitamin B2, magnesium or other proteins.

Lactase is the enzyme responsible for “breaking” the lactose molecule into two basic components so that they are absorbed by the intestinal wall and pass into the blood. When there is not enough lactase enzyme in the small intestine to break down all the lactose, is when intolerances occur.

What are the symptoms?

Discomfort, digestive spasms, flatulence, intestinal noise, nausea or vomiting may be some of the symptoms produced by lactose intolerance. When fermenting, the undigested sugars form acids and gases that cause discomfort throughout the digestive tract.

In addition, the high concentration of lactose draws liquid to the small intestine and causes diarrhea. In some patients, acute diarrhea inhibits the suitable absorption of certain nutrients (vitamins and minerals) as they are eliminated too quickly.

Over time, other symptoms may appear, for instance, fatigue, weight loss, delay of growth, low iron, dizziness, loss of concentration, muscle pain, oral ulcers, etc.

What types of intolerances exist?

Primary intolerance (genetic and incurable) It is the most common one. It is due to the progressive loss of lactase production, so people suffering from it start noticing how milk intake causes them more and more symptoms.

Secondary intolerance (temporary and curable) It is caused by certain pathologies that damage the small intestine (gastroenteritis, intake of certain medicines, irritable colon, etc.). It is usually cured once the pathology that causes it has been cured, as the intestinal mucosa can regenerate.

Congenital intolerance (from birth and incurable) It is a very rare form of intolerance that involves the total absence of lactase production. There are very few cases in the world.

Does everyone suffer intolerance at the same level?

Some people do not notice any symptoms throughout their lives if they do not exceed a certain amount of lactose a day. Therefore, some patients can perfectly eat cheese (that contains a little lactose if it is hard cheese) or yogurt (where, thanks to some bacteria, some of the lactose has turned into lactic acid). Some people can digest up to 12 g of lactose without any problem (equivalent to a glass of milk), but others may present some symptoms with simple traces.

What should I do if I suffer from lactose intolerance?

• Change your diet. Avoid foods containing lactose, mainly dairy products. Plant-based drinks are the best alternative for breakfasts, snacks or smoothies.
• Try to eat foods rich in calcium, such as spinach, tofu, beans, broccoli, cabbage, etc.
• Not consuming dairy products may cause a deficiency of calcium, vitamin D, vitamin B2, vitamin A and proteins. If you cannot get the necessary amount through your diet, there are nutritional supplements that can help you do so.
• Sunbathe moderately to enhance the absorption of vitamin D.
• Read properly the labeling of foods, as in the elaboration of many of them there have been added some dairy products in the form of whey, lactic ferments or proteins in variable amounts. Be careful with bread, breakfast cereals, soups, puddings, croquettes, pizzas, sausages, ready meals, margarin, sauces or sweets. Lactose may also be present as an excipient in some medicines.