Lactose intolerance

Learn more about lactose intolerance

Find out here how lactose intolerance develops, what lactase is, how to detect a lactase deficiency and how Lactrase® can help you.

Symptoms of lactose intolerance

The symptoms caused by lactase deficiency include

• Abdominal cramps
• Flatulence
• Bloating
• Diarrhea
• Dizziness

If the symptoms mentioned occur after consuming dairy products, it may be a case of lactose intolerance (milk sugar intolerance). Due to the similarity of the symptoms, lactose intolerance is often confused with irritable bowel syndrome (irritable colon). Your doctor will be able to help you clarify the situation or answer any questions you may have.

Types of lactase deficiency

A distinction is made between three types of lactase deficiency:

Primary lactase deficiency

This is the most common form of intolerance. In Germany, approx. 15-20% of adults are affected, worldwide it is observed in 70-90% of the adult population.

In infants, the amount of lactase in the small intestine is very high, as it is needed to break down the lactose contained in breast milk. Later on, the amount of lactase decreases continuously in most people for genetic reasons, as the enzyme is no longer needed.

Source: Deutsche Gesellschaft für Ernährung e.V.

Secondary lactase deficiency

A secondary deficiency can occur as a result of intestinal diseases such as Crohn’s disease, coeliac disease or infections, in which the mucous membrane of the small intestine is damaged and impaired. Once the disease has healed, the lactose intolerance usually disappears.

Congenital lactase deficiency

This form of deficiency occurs very rarely. It is due to a genetic defect which means that the body cannot produce lactrase in the small intestine. In this case, infants must be fed a strictly lactose-free diet.

Determining lactase deficiency

A lactose load test can be used to determine whether a lactase deficiency is present. This involves drinking lactose dissolved in water (approx. 25 – 50g) on an empty stomach. Breath samples (H2 breath test) or blood samples (blood sugar test) are then taken at regular intervals over 2-3 hours.

H2 breath test

If there is a lactase deficiency, the lactose supplied is not or not completely broken down in the small intestine. From there it reaches the large intestine, where it is broken down by large intestine bacteria to form hydrogen (H2). The resulting hydrogen is absorbed via the intestinal wall and then enters the lungs via the bloodstream, from where it is exhaled. The hydrogen content of the exhaled air can therefore be used to determine whether lactose, which has not been broken down in the small intestine due to a lactase deficiency, has reached the large intestine.

Blood sugar test

This test is used to determine whether the lactose supplied has been broken down by sufficient lactase in the small intestine. If this is the case, the blood sugar level rises as the glucose released during the breakdown passes through the intestinal wall into the blood. However, if there is a lactase deficiency, the breakdown of lactose in the small intestine is impaired and the blood glucose level does not rise or only rises slightly.

Both the H2 test and the blood glucose test are usually carried out by specialists in internal medicine and gastroenterologists.

Genetic test

During the genetic test, the doctor takes a swab of the buccal mucosa. This is sent to a specialized and certified laboratory for examination.

The genetic test provides information on whether you will develop a primary lactase deficiency in the course of your life, but not on whether this deficiency is already present. This can only be determined with the lactose load test described above.

Using Lactrase®

The activity of the lactase contained in Lactrase® is expressed in FCC units. The higher the FCC units, the more active the lactase is – and the more lactose it can break down.

The amount of lactase you need depends primarily on

• how much lactase your body produces itself
• and on the amount of lactose contained in the meal.

Lactrase® is available in an activity range from 1500 to 32000 FCC units. This makes it the most comprehensive range on the market, including the highest activity worldwide. Whether you have low sensitivity or high lactose content in the meal – with Lactrase® you will find the optimum amount of lactase for you. Higher FCC units also offer you the option of reducing the number of tablets or capsules to be taken.

It is best to test individually which activity is sufficient for you. We recommend starting with two capsules or mini-tablets of Lactrase® 3300 or one capsule or mini-tablet of Lactrase® 6000 for every 5 g of lactose in your meal. The lactose content of a variety of dairy products can be found in this lactose content table.

You can increase the number of capsules or mini-tablets without hesitation and according to your personal requirements. If you want to consume a large amount of lactose, for example a large glass of milk, a large coffee or several scoops of ice cream with cream, we recommend taking Lactrase® 12000 or Lactrase® 18000. Both preparations are also suitable if you are sensitive to even small amounts of lactose.

The capsules or tablets should be taken immediately before or with food or drink containing lactose. When using capsules, it is also possible to open them and dissolve their contents in food or drink that is up to 50°C warm. This is an alternative that can be particularly useful for children.