What is the recommended dose of Lactaid (lactase) for lactose intolerance?

Recommended Lactase Dosage for Lactose Intolerance

For most individuals with lactose intolerance, a dose of 3,300-9,000 FCC units of lactase enzyme taken immediately before consuming lactose-containing foods is recommended to effectively reduce symptoms.

Understanding Lactose Intolerance

Lactose intolerance occurs when individuals have inadequate amounts of the enzyme lactase, which is needed to digest lactose (milk sugar). This condition affects approximately:

• 15% of people of northern European descent
• Up to 80% of Blacks and Latinos
• Up to 100% of American Indians and Asians 1

Common symptoms include:

• Abdominal pain and bloating
• Excessive gas
• Watery stool
• Diarrhea

Effective Lactase Dosing

Recommended Dosage

• Standard effective dose: 3,300-9,000 FCC units of lactase enzyme taken immediately before consuming lactose-containing foods 2, 3
• Higher doses (9,000 FCC units) provide better symptom relief than lower doses 3
• The enzyme should be taken just before consuming lactose-containing foods for maximum effectiveness

Evidence for Effectiveness

Research has demonstrated that:

• A single dose of 9,900 FCC units of lactase significantly reduced breath hydrogen concentration (a marker of lactose malabsorption) and decreased symptoms of abdominal cramping, belching, flatulence, and diarrhea 2
• A dose of 9,000 FCC units reduced hydrogen exhalation by 33% compared to placebo 3
• Even a dose of 3,300 FCC units showed a 29% reduction in hydrogen exhalation 3

Tolerable Lactose Intake

Most individuals with lactose intolerance can actually tolerate small amounts of lactose without supplementation:

• Moderate-quality evidence indicates that 12-15g of lactose (approximately 1 cup of milk) is well tolerated by most adults with lactose intolerance 4
• The degree of lactose malabsorption varies greatly among patients, but most can ingest up to 12 oz of milk daily without significant symptoms 1

Optimizing Lactase Effectiveness

To maximize the benefits of lactase supplementation:

1. Take immediately before consuming lactose-containing foods
2. Consider combining approaches: The combination of lactase enzyme with yogurt cultures has shown synergistic effects, reducing hydrogen exhalation by 46% compared to placebo 3
3. Adjust dosage based on lactose content: Higher lactose meals may require higher enzyme doses
4. Be consistent: Take with every lactose-containing meal or snack

Alternative Management Strategies

In addition to lactase supplementation:

• Consider lactose-reduced or lactose-free dairy products
• Consume dairy as part of meals rather than alone
• Hard cheeses and yogurt with live cultures are often better tolerated
• Ensure adequate calcium intake through non-dairy sources or supplements if dairy intake is limited 1

Caution

Lactose is a common excipient in many pharmaceutical compounds, but most people with lactose malabsorption can tolerate amounts less than 12g, so medications rarely cause symptoms in these individuals 5. However, some particularly sensitive individuals may experience symptoms even with small amounts of lactose.