What is the treatment for lactose intolerance?

Treatment of Lactose Intolerance

The primary treatment for lactose intolerance is a lactose-reduced diet tailored to individual tolerance levels, with potential supplementation of lactase enzymes. 1

Dietary Management

Lactose Restriction

• Most lactose intolerant individuals can tolerate small amounts of lactose (less than 240ml of milk) without significant symptoms 1
• Complete elimination of dairy is not recommended due to nutritional concerns 2
• Start with reducing lactose intake until symptoms disappear, then gradually reintroduce to find personal tolerance threshold 3, 4

Practical Dietary Approaches:

1. Gradual introduction: Start with small amounts of lactose-containing foods and gradually increase to determine tolerance level
2. Consume lactose with other foods: Eating dairy products with meals rather than alone slows digestion and improves tolerance 2
3. Choose lower-lactose dairy options:
   • Hard cheeses (cheddar, swiss, parmesan)
   • Yogurt with live active cultures (bacteria help digest lactose)
   • Fermented dairy products (kefir, buttermilk)

Hidden Lactose Awareness

• Check food labels for "hidden lactose" in non-dairy products such as:
  • Baked goods
  • Breakfast cereals
  • Processed meats
  • Medications (as excipients) 1, 4

Enzyme Replacement Therapy

• Lactase enzyme supplements can be taken before consuming lactose-containing foods 3, 5
• Available as over-the-counter tablets or drops
• Effectiveness varies between individuals and products 6

Probiotic Supplementation

• Certain probiotic strains with β-galactosidase activity may aid in lactose digestion 6, 5
• Can help improve gut microbiome adaptation to lactose 4
• Consider as an adjunct to dietary management, not as a replacement

Nutritional Considerations

• Ensure adequate calcium intake (1000-1200 mg/day for adults) through:
  • Lactose-free dairy products
  • Calcium-fortified non-dairy alternatives (soy, almond, rice milk)
  • Calcium-rich non-dairy foods (leafy greens, canned fish with bones, fortified cereals)
• Monitor vitamin D intake, which may be compromised with dairy restriction 4, 2

Special Considerations

• Secondary lactose intolerance (due to gut injury from infection, medications, etc.) may be temporary and resolve with treatment of the underlying condition 1
• In cancer patients, chemotherapy can cause secondary lactose intolerance requiring temporary dietary adjustments 1
• For children with lactose intolerance, specialized formulas and products are available to ensure proper nutrition 7

Common Pitfalls to Avoid

1. Complete dairy elimination: Unnecessarily restrictive and may lead to nutritional deficiencies, especially calcium and vitamin D 2
2. Misdiagnosis: Symptoms of lactose intolerance can overlap with irritable bowel syndrome and other gastrointestinal disorders 1
3. Ignoring hidden sources: Failing to check for lactose in medications and processed foods 4
4. Overlooking secondary causes: Not investigating potential underlying conditions causing temporary lactose intolerance 1

Remember that lactose intolerance is not an allergy and small amounts can usually be tolerated. The goal is to find a balanced approach that prevents symptoms while maintaining good nutrition.