How does Lactaid (lactase enzyme) work to manage lactose intolerance?

How Lactaid Works to Manage Lactose Intolerance

Lactaid works by providing the lactase enzyme that breaks down lactose into simpler sugars (glucose and galactose), allowing lactose-intolerant individuals to digest dairy products without experiencing uncomfortable symptoms. 1

Mechanism of Action

Lactose intolerance occurs due to a deficiency in the enzyme lactase, which is normally produced in the small intestine. This enzyme deficiency is particularly common in adults, with prevalence varying by ethnicity:

• 10-15% in Northern Europeans
• 60-80% in Blacks and Latinos
• Up to 90-100% in Asians and American Indians 2

When lactase is insufficient, undigested lactose passes into the colon where it is fermented by bacteria, causing:

1. Gas production (hydrogen, methane)
2. Increased water in the intestine
3. Rapid intestinal transit

These processes lead to the classic symptoms of lactose intolerance:

• Abdominal pain and bloating
• Excessive flatulence
• Diarrhea 2

How Lactaid Supplements Function

Lactaid contains exogenous lactase enzyme (β-galactosidase) that:

1. Hydrolyzes lactose into its component monosaccharides (glucose and galactose)
2. Allows these simple sugars to be absorbed in the small intestine
3. Prevents undigested lactose from reaching the colon 3

The effectiveness of Lactaid has been demonstrated in clinical studies showing:

• Significant reduction in breath hydrogen excretion (a marker of lactose malabsorption) 4, 3
• Decreased incidence of lactose malabsorption (from 100% to 48.9% in one study) 5
• Reduction in intolerance symptoms (from 51.1% to 13.3%) 5

Practical Application

For optimal effectiveness, Lactaid should be taken:

• Immediately before consuming dairy products
• In sufficient quantity based on the lactose content of the food
• With consideration that different commercial lactase preparations vary in effectiveness 4

Important Clinical Considerations

• Dosing matters: The standard dose of 9900 FCC units has been shown effective in reducing symptoms and breath hydrogen after lactose challenge 3

• Individual response varies: The degree of lactose malabsorption varies greatly among patients with lactose intolerance, but most can tolerate up to 12 oz of milk daily without symptoms when using appropriate enzyme supplementation 2

• Not all products are equal: Studies comparing different lactase preparations have shown significant differences in their ability to reduce symptoms and breath hydrogen excretion 4

• Temporary lactose intolerance: In some cases, such as during chemotherapy, lactose intolerance may be temporary due to bowel mucosal injury and can resolve after treatment discontinuation 1

Pitfalls and Caveats

1. Self-diagnosis issues: Many adults believe they are lactose intolerant but do not actually have impaired lactose digestion 2

2. Calcium intake: Lactose-intolerant patients must ensure adequate calcium intake if avoiding dairy products 2

3. Lactose as excipient: Lactose is a common excipient in many medications, but most people with lactose malabsorption can tolerate amounts <12g, so medications rarely cause symptoms 1

4. Symptom threshold variation: Different individuals have different thresholds for symptom development, which affects how much lactase supplementation is needed 1

By providing the missing lactase enzyme, Lactaid effectively addresses the root cause of lactose intolerance, allowing affected individuals to enjoy dairy products with reduced or eliminated digestive symptoms.