The Doctor Is In

By DAMON RASKIN, M.D. | Special to the Palisadian-Post

Q:I am in my mid-20s and have noticed that I have grown sensitive to lactose in the last year or two. This is a hot topic between my friends of the same age/range and begs the question: Can you actually develop lactose intolerance?

“Milk—it does a body good!” was an ad campaign seen on billboards and television commercials in the 1980s and 1990s. What the ad forgot to mention was that for those with lactose intolerance, milk will make the body react with gas, bloating, stomach upset and diarrhea. Not good at all!

People with lactose intolerance are unable to fully digest the sugar (lactose) in milk and most other dairy products. They have low levels of lactase which is the enzyme produced in the small intestine to help digest the lactose. The undigested sugar then moves into the colon and interacts with the normal bacteria found there to cause these unpleasant symptoms. Although lactose intolerance is not a serious or harmful health condition, the symptoms can definitely be uncomfortable. These signs usually occur from 30 minutes to two hours after eating or drinking foods that contain lactose.

Most people with lactose intolerance start out life producing enough lactase, as infants often get all of their nutrition from milk and need lactase to digest it. As children replace milk with other foods, the amount of lactase they produce normally drops, but there is still enough to digest the typical amount of dairy products consumed. With age, those with lactose intolerance have much further drops in lactase which leaves them unable to digest the milk sugar. There is often a genetic predisposition for this condition as well.

To answer your question, yes you can actually develop lactose intolerance, and increasing age is a risk factor. It is much more common in adulthood than in infants and children. Interestingly, it is also more prevalent in those of African, Asian and Hispanic descent. There is a wide range of lactose intolerance with some people having no tolerance for dairy, while others can manage to digest foods like hard cheeses and yogurt without difficulty.

In addition to what happens to lactase production with normal aging, there are certain illnesses, infections and medications that can bring on lactose intolerance later in life. Diseases such as Crohn’s disease, celiac disease or other intestinal infections may bring on this condition.

If you have this condition, and you cannot live without a slice of cheese pizza or a soft serve cone, sometimes your body still has enough of the enzyme to digest small amounts of dairy products. You can also try taking Lactaid, a pill that can help replace some of the missing lactase just for this purpose. It is often a matter of trial and error to see how many pills you need to be able to digest a certain amount of dairy in your diet. Always check food labels as dairy products may be hiding where least expected. There are also certain medications such as birth control pills and antacids that may contain lactose which are usually only problematic for those with severe lactose intolerance.

When those with this condition stop eating dairy products, it is important to try to get adequate calcium and vitamin D from other dietary sources and supplements. Tofu, sardines, almonds and garbanzo beans will help, and there are lactose-free milk products available on store shelves.

The bottom line (so to speak) is to listen to how your body reacts to dairy, and you can tell if milk will in fact do your body good … or not.