Information On Lactase

Lactase is an enzyme that is in the lining of the gut. This enzyme degrades lactose, which is in milk. If a person does not have enough lactase, the body cannot digest the lactose in most milk products. Instead, the lactose is used by bacteria, gas is formed, and the person experiences bloating, abdominal pain, and sometimes diarrhea. Other indications of lactose intolerance could include heartburn, irritable bowel syndrome, nonseasonal asthma and migraine.

Some causes of lactose intolerance are well known. For instance, certain digestive diseases and injuries to the small intestine can reduce the amount of enzymes produced. In rare cases, children are born without the ability to produce lactase. For most people, though, lactase deficiency is a condition that develops naturally over time. After about the age of 2 years, the body begins to produce less lactase. However, many people may not experience symptoms until they are much older.

Fortunately, a whole menagerie of bacteria, fungi, and other little critters have learned to live on lactose by making their own lactase. Some of these are the ones in our intestines that help ease the problems of undigested lactose. Others are known as dairy yeasts, and have been used for centuries to make yogurt and other fermented dairy products.

The lactase from one dairy yeast called Kluyveromyces lactis would get destroyed by the acidity in our stomachs if we took it in pill form, but it proved to be perfect to add to milk. This is the lactase that is used in lactase drops. A fungus known as Aspergillis oryzae, though, creates a lactase that works best under high acidity, so manufacturers seized it for use in lactase pills.

This most common food intolerance affects at least one out of ten people. Between 30 and 50 million Americans are lactose intolerant. Certain ethnic and racial populations are more widely affected than others. As many as 75 percent of all African-Americans and Native Americans and 90 percent of Asian-Americans are lactose intolerant. The condition is least common among persons of northern European descent.

There are a couple of diagnostic tests. The most common tests used to measure the absorption of lactose in the digestive system are the lactose tolerance test, the hydrogen breath test, and the stool acidity test. These tests are performed on an outpatient basis at a hospital, clinic, or doctor's office.

Normally, when lactose reaches the digestive system, the lactase enzyme breaks down lactase into glucose and galactose. The liver then changes the galactose into glucose, which enters the bloodstream and raises the person's blood glucose level. If lactose is incompletely broken down the blood glucose level does not rise, and a diagnosis of lactose intolerance is confirmed.

The lactose tolerance and hydrogen breath tests are not given to infants and very young children who are suspected of having lactose intolerance. A large lactose load may be dangerous for very young individuals because they are more prone to dehydration that can result from diarrhea caused by the lactose. If a baby or young child is experiencing symptoms of lactose intolerance, many pediatricians simply recommend changing from cow's milk to soy formula and waiting for symptoms to abate.

Fortunately, lactose intolerance is relatively easy to treat. No treatment exists to improve the body's ability to produce lactase, but symptoms can be controlled through diet.

For those who react to very small amounts of lactose or have trouble limiting their intake of foods that contain lactose, lactase enzymes are available without a prescription. One form is a liquid for use with milk. A few drops are added to a quart of milk, and after 24 hours in the refrigerator, the lactose content is reduced by 70 percent. The process works faster if the milk is heated first, and adding a double amount of lactase liquid produces milk that is 90 percent lactose free. A more recent development is a chewable lactase enzyme tablet that helps people digest solid foods that contain lactose. Three to six tablets are taken just before a meal or snack.

Lactose-reduced milk and other products are available at many supermarkets. The milk contains all of the nutrients found in regular milk and remains fresh for about the same length of time or longer if it is super-pasteurized.

Milk and other dairy products are a major source of nutrients in the American diet. The most important of these nutrients is calcium. Calcium is essential for the growth and repair of bones throughout life. In the middle and later years, a shortage of calcium may lead to thin, fragile bones that break easily (a condition called osteoporosis). A concern, then, for both children and adults with lactose intolerance, is getting enough calcium in a diet that includes little or no milk.

Recent research shows that yogurt with active cultures may be a good source of calcium for many people with lactose intolerance, even though it is fairly high in lactose. Evidence shows that the bacterial cultures used in making yogurt produce some of the lactase enzyme required for proper digestion.

Clearly, many foods can provide the calcium and other nutrients the body needs, even when intake of milk and dairy products is limited. However, factors other than calcium and lactose content should be kept in mind when planning a diet. Some vegetables that are high in calcium (Swiss chard, spinach, and rhubarb, for instance) are not suitable because the body cannot use their calcium content. They contain substances called oxalates, which stop calcium absorption. Calcium is absorbed and used only when there is enough vitamin D in the body. A balanced diet should provide an adequate supply of vitamin D. Sources of vitamin D include eggs and liver. However, sunlight helps the body naturally absorb or synthesize vitamin D, and with enough exposure to the sun, food sources may not be necessary.

Although milk and foods made from milk are the only natural sources, lactose is often added to prepared foods. People with very low tolerance for lactose should know about the many food products that may contain lactose, even in small amounts.

Some products labeled nondairy, such as powdered coffee creamer and whipped toppings, may also include ingredients that are derived from milk and therefore contain lactose.

Smart shoppers learn to read food labels with care, looking not only for milk and lactose among the contents but also for such words as whey, curds, milk by-products, dry milk solids, and nonfat dry milk powder. If any of these are listed on a label, the item contains lactose.

In addition, lactose is used as the base for more than 20 percent of prescription drugs and about 6 percent of over-the-counter medicines. Many types of birth control pills, for example, contain lactose, as do some tablets for stomach acid and gas. However, these products typically affect only people with severe lactose intolerance.

Lactose is what is known as a compound sugar, because it is made by joining two simpler sugars: glucose and galactose. Glucose is the body's most important chemical, the energy source for every molecular activity. Most of what we eat is turned into glucose. That's the whole function of digestion. (Even the galactose is swiftly converted into more glucose.)

Even though lactose intolerance is widespread, it need not pose a serious threat to good health. People who have trouble digesting lactose can learn which dairy products and other foods they can eat without discomfort and which ones they should avoid. Many will be able to enjoy milk, ice cream, and other such products if they take them in small amounts or eat other food at the same time. Others can use lactase liquid or tablets to help digest the lactose. Even older women at risk for osteoporosis and growing children who must avoid milk and foods made with milk can meet most of their special dietary needs by eating greens, fish, and other calcium-rich foods that are free of lactose. A carefully chosen diet (with calcium supplements if the doctor or dietitian recommends them) is the key to reducing symptoms and protecting future health.

- Lactose Intolerance. NIH Publication No. 98-2751. National Digestive Diseases Information Clearinghouse
- Steve Carper's Lactose Intolerance Clearinghouse - Lactase! What? Where? How Many? How Much? Which? When? Why?

Discuss It!

Mary said:

Does lactase enzyme added to food interfere with multivitmain absorption taken at same time?

Michael said:

Oh, if only it were limited to the symptoms listed in your article--I could live with that. Every "toxin" in my body is routed out via the sinuses. As Lactose-free milk is priced as a luxury item and if I am to add Lactase to "standard" (preferably RAW) milk, how do I 'heat' it without burning?

Maryanne said:

Are you sure that the lactase enzyme comes from the LINING of the gut. I became lactose-intolerant after my appendix was removed. Perhaps lactase is produced there?

Josh said:

I take Lactase supliments when I eat dairy. I was wondering if I take the suplement, does my body start producing less, since I'm adding it, instead of my body NEEDing to make some

B said:

"Are you sure that the lactase enzyme comes from the LINING of the gut. I became lactose-intolerant after my appendix was removed. Perhaps lactase is produced there?" No, it's present in the lining of the small intestine (and hence 'produced' there). injury to the abdomen can disrupt or destroy production "Does lactase enzyme added to food interfere with multivitmain absorption taken at same time?" no, the multivitamin interferes with itself enough as it is. Half the vitamins/ minerals block absorption of others and taking a multivitamin is just plain stupid. "I take Lactase supliments when I eat dairy. I was wondering if I take the suplement, does my body start producing less, since I'm adding it, instead of my body NEEDing to make some" It's genetically determined, your body doesn't give a crap whether you add more supplement or not, it won't start producing less because of it.

b said:

what is lacase i still dont get it

[email protected] said:

Carol said:

I am lactose intolerant and have been managing my symptoms on a dairy free diet which I am happy to do and it works for me. I have recently been prescribed a drug for a serious health complaint which contains lactose and it has triggered unpleasant symptoms again. The benefits of the medication are so great that I don't want to stop taking it, and there is no alternative. My GP has suggested I take the Lactase enzime drops, but all the research I have done,and the directions on the pack tell me to add it to milk or to take it before eating food which contains Lactose.I cant find any advise as to how to use the enzime in my case. It seems I must have a severe intolerance.

Maria said:

Carol: There are pills called "lactaid" that you can take.

san said:

better u can aviod intaking milk products in empty stomach!!!!