From the Research
The most effective approach to managing lactose intolerance is to start with small amounts of lactose, around 4-8 grams, and gradually increase as tolerated, as this allows individuals to find their personal tolerance threshold and minimize symptoms. This approach is supported by the fact that lactose intolerance varies widely between individuals due to differences in lactase enzyme production, and that undigested lactose can cause symptoms like bloating, gas, and diarrhea when it reaches the colon and is fermented by bacteria 1.
When it comes to lactose intolerance testing, a dose of 25-50 grams of lactose dissolved in water is typically used, as this amount is likely to induce symptoms in individuals with lactose intolerance 2. However, for daily management, it's best to start with smaller amounts and gradually increase as tolerated, rather than trying to consume a large amount of lactose at once.
Some individuals may also find it helpful to use lactase enzyme supplements, which can be taken with dairy foods to help break down lactose and reduce symptoms, with a typical dosage of 1-2 tablets before consumption 3. Additionally, probiotics and prebiotics may also be beneficial in managing lactose intolerance, as they can help to promote the growth of beneficial bacteria in the gut and improve lactose digestion 4.
It's also important to note that lactose intolerance can be part of a wider intolerance to variably absorbed, fermentable oligo-, di-, monosaccharides and polyols (FODMAPs), which is present in at least half of patients with irritable bowel syndrome (IBS), and that a low FODMAP diet may be necessary to improve gastrointestinal complaints in these individuals 3.
Overall, the key to managing lactose intolerance is to find a balance between consuming enough lactose to meet nutritional needs, while also minimizing symptoms and discomfort. This can be achieved through a combination of gradual experimentation to find individual tolerance thresholds, the use of lactase enzyme supplements and other therapies, and a comprehensive understanding of the underlying biology and diagnosis of lactose intolerance 5, 1, 2.
Some key points to consider when managing lactose intolerance include:
- Starting with small amounts of lactose and gradually increasing as tolerated
- Using lactase enzyme supplements to help break down lactose
- Considering the use of probiotics and prebiotics to promote beneficial bacteria in the gut
- Being aware of the potential for lactose intolerance to be part of a wider intolerance to FODMAPs
- Working with a healthcare provider to develop a personalized management plan that takes into account individual needs and circumstances.