Lactose intolerance - What is it? Plus effective management strategies

Lactose intolerance - What is it? Plus effective management strategies

Firstly, what is lactose?

Lactose is a disaccharide (di = 2, saccharide = sugar) therefore it means 2 sugars, which is composed of galactose and glucose. 

We lose the capacity to digest lactose via a genetically programmed reduction in lactase synthesis. Lactase is the enzyme that breaks down lactose for absorption.

This means, that as we age we make less lactase and therefore can’t absorb lactose as well as we once could.

When lactose isn’t broken down properly it gets fermented by bacteria in the colon. This action produces gas which leads to bloating, flatulence & cramping. When we have high levels of sugar (lactose) in the bowel it creates an osmotic gradient, this is what leads to those loose & watery stools.


So you love milk and other dairy products, what can you do about it?

There is also secondary lactose intolerance – now this is due to trauma or illness that damages the microvilli of the small intestine where the lactase enzyme is secreted. In this instance you can work on fixing the gut to improve lactose tolerance.

Secondary adaptation is another option, where continued daily ingestion of lactose results in adaptation, increasing absorption and tolerance (I want to note here though, that although this is the case for lactose, we have not seen the same adaptation with fructose intolerance).


Whilst working on investigating the cause and healing the gut to increase lactose tolerance (especially for those who have secondary lactose intolerance). Here are some effective lactose intolerance management strategies

  1. First and foremost – eating a low lactose diet. I know this one sounds obvious, but educating yourself around which foods are high in lactose. For instance, butter is commonly avoided, but in actual fact it only contains trace amounts of lactose, so you most likely won’t react and can therefore continue to enjoy butter as part of a healthy diet. Other commonly mistaken foods that are actually low lactose include – hard cheese, sour cream, cottage cheese, mozzarella cheese. Education is key here!
  2. Lactase enzymes - Administration of supplemental lactase alongside a lactose rich meal is very useful for improving absorption and reducing symptoms associated with lactose intolerance. All supplements vary in efficacy. If one doesn’t work then trial another.
  3. Probiotics – Yakult! Yep I said it, ‘Yakult’ – Even though this drink is high in sugar, it is the only source of probiotic strains that have been trialled and are successful in reducing signs and symptoms associated with lactose intolerance. These are Lactose metabolising organisms that aid lactose digestion in the gut - Lactobacillus casei shirota and Bifidobacterium breve found in Yakult
  4. And lastly – Lactulose – This is a prebiotic produced from lactose. Studies have shown a significant reduction in signs and symptoms of lactose intolerance and reduced hydrogen in breath test (associated with lactose malabsorption). Be careful with this one though, you must start low and slowly build-up the dose. This is a very effective strategy at reducing those signs and symptoms, but you have to get the dose right. Tip – take your dosage in the evening before bed. I promise adaptation to the microbiota will occur, it just takes a little bit of time.
Back to blog