• Dr. Dooreck with Joie Meyer | Public Health

Breaking Down Lactose Intolerance

Updated: Feb 1

Lactose intolerance affects many people worldwide, and some people don't even know that they're lactose intolerant. This blog post explains more about the causes, symptoms, and ways to treat lactose intolerance.

Have you ever felt an upset stomach after drinking a glass of milk or having a milkshake?

Good news, you are not alone.

About 65% of the world's population has a reduced ability to digest lactose after infancy.

Lactose intolerance is extremely common among East Asians, Hispanics, and African Americans.

Symptoms can include bloating, diarrhea, gas, and stomach discomfort. Although there is no way to “cure” this, there are steps you can take to prevent this from happening.

Let's first break down what causes lactose intolerance, and how it can be diagnosed.

What is lactose intolerance?

Put simply, lactose intolerance occurs when your body can't break down lactose.

Lactose is the natural sugar that's found in dairy products like milk and cheese. In order for you to digest these foods, your body has to break the sugar down. There is an enzyme in your body called lactase that does this. However, some people don't have enough lactase in their bodies to break all of the lactose down. When this happens, the lactose moves from the small intestine into the large intestine, which is what causes feelings of bloating and an upset stomach

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What causes lactose intolerance?

When you're a baby who gets all your nutrition from milk, your body is making lots of lactase to digest it all. However, when you get older and replace milk with other foods, lactase production naturally decreases. This is completely natural. For some people, however, lactase levels get too low and they can't digest dairy easily anymore.

Lactose intolerance can also be triggered by other medical conditions, such as Crohn's disease.

Sometimes, this can be genetic.

Some people are unable to produce lactase enzymes, even in infancy. Evolutionary, countries that have historically consumed more milk in their diets got better at tolerating it.

How is lactose intolerance diagnosed?

If you experience constipation, diarrhea, bloating, excessive gas, and stomach pain after consuming dairy products, you may be suffering from lactose intolerance.

This can be confirmed by your gastroenterologist in different ways, such as:

  • Hydrogen Breath Test: You will drink a liquid with a lot of lactose in it, and have the hydrogen in your breath measured shortly after. Higher levels of hydrogen will indicate lactose intolerance.

  • Lactose Tolerance Test: You will drink a liquid with a lot of lactose in it, and two hours later, have your blood tested for glucose levels. Glucose levels that stay the same will indicate lactose intolerance.

  • Stool Acidity Test: A stool acidity test can be used for infants or children, and will determine if lactic and other acids were created from the undigested lactose in the body.

How do I manage being lactose intolerant?

Some people with lactose intolerance can still eat small amounts of dairy products without getting sick.

Many people can take lactase pills or drops before eating, such as Lactaid or Dairy Ease, that allows them to digest dairy products. There are also many lactose-free alternatives to dairy products!

Here's one of the many resources available to help guide you.

Read the American Society for Nutrition breakdown some plant-based milk alternatives here.

If you are lactose intolerant, you should talk with your doctor about how to avoid calcium or vitamin D deficiencies.

⛔️ It is always advised to speak to your doctor 🥼 directly and make clinical decisions with him 👨‍⚕️ or her 👩‍⚕️ regarding medications or testing.

You can also ask a licensed nutritionist = LN or registered dietitian = RD.

Here are some takeaways on this from a public health point of view.

Your lactose intolerance does not need to control you. By keeping a healthy and balanced diet, you can prevent symptoms and distress.


I eat a high fiber, mostly plant-based 🌱 diet, no red meat, drink 4 liters of water a day, exercise, and am focused on keeping nutrition simple. I am sharing what works for me and what I routinely recommend to my patients.

"Balance. Portion control. Keep nutrition simple. Eat Smart. Eat Healthy. 🌱 🌾 🌿"

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