Lactose intolerance and use of probiotics
March 15 2017 by
Ray Sahelian, M.D.


Lactose is a disaccharide sugar that consists of galactose and glucose molecules. Lactose makes up around 2 to 8% of the solids in milk. The name comes from the Latin word for milk, plus the -ose ending used to name sugars. In the young of mammals, an enzyme called lactase is secreted by the intestinal villi, and this enzyme cleaves the lactose molecule into its two subunits for absorption. There is a no calorie natural sweetener you may be interested in called stevia.


Lactose intolerance definition

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 lactase, which is produced by the cells that line the small intestine. Lactase breaks down milk sugar into two simpler forms of sugar called glucose and galactose, which are then absorbed into the bloodstream. Not all people deficient in lactase have the symptoms commonly associated with lactose intolerance, but those who do are said to have lactose intolerance. The problem underlying lactose intolerance is a lack of lactase an enzyme produced by the lining of your small intestine. Lactase breaks down lactose so that it can be absorbed into your bloodstream. A deficiency of lactase leads to problems in breaking down and absorbing milk sugar.

Symptom of Lactose Intolerance
Also called lactase deficiency, it means you aren't able to fully digest milk sugar (lactose) in dairy products. It's not usually dangerous, but symptoms of lactose intolerance can be uncomfortable enough to steer you clear of the dairy aisles. Lactose intolerance can make dining a challenge, requiring some recipe substitutions or avoidance of some foods altogether.
     Common lactose intolerance symptoms include nausea, cramps, bloating, gas, and diarrhea, which begin about 30 minutes to 2 hours after eating or drinking foods containing lactose.


Natural remedy
Ter Arkh. 2013. The role of small bowel microflora in the development of secondary lactase deficiency and the possibilities of its treatment with probiotics. After a 14-day course of therapy with the combined probiotic bifiform, restoration of eubiosis in the small bowel lumen was achieved in 70% of the patients, as shown by the lesser degree of bacterial overgrowth syndrome and by normalization of the lactase test. In the comparative placebo group, 68% showed no clear positive changes, SLD and BOS remained. The changes in the small bowel intraluminal microflora, which developed after prior intestinal infection, played a great role in the development of SLD. Bifiform belongs to the currently available probiotics and may be recommended to correct SLD in patients with PIBS resulting from the impaired microbiota of the small bowel and to prevent BOS.


Br J Nutr. 2014 Feb 10. Safety of soya-based infant formulas in children. Soya-based infant formulas (SIF) containing soya flour were introduced almost 100 years ago. Modern soya formulas are used in allergy/intolerance to cows' milk-based formulas (CMF), post-infectious diarrhoea, lactose intolerance and galactosaemia, as a vegan human milk (HM) substitute, etc. Modern SIF are evidence-based safety options to feed children requiring them. The patterns of growth, bone health and metabolic, reproductive, endocrine, immune and neurological functions are similar to those observed in children fed CMF or HM.


Lactose free diet and food
If you are on a lactose free diet, or a lactose reduced diet, you may drink reduced-lactose or lactose-free milk. Rice milk or soymilk, and prepared drinks made with soy may be included in your diet. You may also try cheeses, yogurt, and kefir (cultured milk drink) because they contain less lactose than regular milk. Use bread made without milk products. Pasta, potatoes, rice, and many types of crackers may be added into your diet. Cereals made without lactose, milk, or whey may also be eaten. You may have all types of fruits and vegetables, along with legumes, beans, peas, nuts and seeds. These may be eaten raw, or cooked without adding milk products, such as cheese or cream sauces. You may also drink fruit and vegetable juices. On a low lactose or lactose-free diet you may eat any fresh or frozen cooked plain meats, fish and poultry (chicken).

Q. Does raw milk help?
   A. Raw milk make little or no difference.

Ann Fam Medicine. 2014. Effect of raw milk on lactose intolerance: a randomized controlled pilot study. Raw milk failed to reduce lactose malabsorption or lactose intolerance symptoms compared with pasteurized milk among adults positive for lactose malabsorption. These results do not support widespread anecdotal claims that raw milk reduces the symptoms of lactose intolerance.

Q. I am lactose intolerant. Could you tell me is colostrum is suitable for people who are lactose intolerant? I have Crohn's disease and have been taking colostrum for a couple of weeks and I have noticed increased bloating and cramps but because of my Crohn's I cant tell if this is caused from the colostrum or just my Crohn's playing up again. I am lactose intolerant however and was wondering if the colostrum could have set off a lactose intolerance reaction.
   A. There is very little lactose in colostrum, so it depends on how lactose intolerant you are and the amount of colostrum ingested. It also could depend on the product itself. Some brands may have a little more lactose than other brands depending on how many hours after calving the colostrum is harvested.


Q. I am considering a Probiotic supplement formula (Probiotic supplement formula, bifidobacterium longum, breve, lactobacillus rhamnosus casei plantarum, pediococcus, lactococcus,) for helping my ulcerative colitis. Per the website the following Other Ingredients are also used: Potato starch, magnesium stearate and ascorbic acid. Contains dairy (milk and casein peptide) and soy. I am lactose intolerant and am concerned with the "Contains dairy (Milk and casein Peptide)" Is this a problem or is there another Probiotic available without dairy products as most people with ulcerative colitis also are lactose intolarant.
   A. Dairy products contain a number of substances including fatty acids, sugars and proteins. Lactose is a sugar. Those who are intolerant to lactose cannot manage a high load of lactose but are able to manage a small intake. The amount of dairy in this probiotic product is very very small and it is mostly in the form of protein, not lactose. It is possible that there may be traces of lactose but it would be extremely rare for a person to not tolerate this minute amount of lactose even if they are generally lactose intolerant. We are talking about possible lactose amounts in the milligrams or micrograms as opposed to the tens of grams of lactose found in a serving of a dairy product. One gram equals 1000 milligrams. One milligram equals 1000 micrograms.