About all

Can lactose intolerance develop later in life. Lactose Intolerance: Causes, Symptoms, and Management in Adults

by alexxlab

Can lactose intolerance develop later in life. What are the symptoms of lactose intolerance. How is lactose intolerance diagnosed. What treatments are available for lactose intolerance.

Understanding Lactose Intolerance: A Common Digestive Issue

Lactose intolerance is a digestive condition that affects millions of people worldwide. It occurs when the body is unable to properly digest lactose, a sugar found in milk and dairy products. This condition can develop at any age, even in individuals who previously had no issues with dairy consumption.

The primary cause of lactose intolerance is a deficiency in lactase, an enzyme produced in the small intestine that breaks down lactose into simpler sugars. When lactase production decreases, undigested lactose moves into the colon, where it ferments and causes uncomfortable symptoms.

Key Facts About Lactose Intolerance:

  • It is not a true allergy but rather a digestive issue
  • Can develop at any age, including adulthood
  • May be triggered by other medical conditions
  • Severity can vary from person to person

Recognizing the Symptoms of Lactose Intolerance

Identifying lactose intolerance can be challenging, as symptoms may vary in intensity and can be similar to other digestive disorders. However, there are several common signs to watch for after consuming dairy products.

Common Symptoms of Lactose Intolerance:

  • Bloating and abdominal discomfort
  • Gas and flatulence
  • Diarrhea or loose stools
  • Nausea
  • Stomach cramps

These symptoms typically appear within 30 minutes to 2 hours after consuming lactose-containing foods or beverages. The severity of symptoms often correlates with the amount of lactose consumed and an individual’s level of lactase deficiency.

Types of Lactose Intolerance: Primary and Secondary

Lactose intolerance can be categorized into two main types: primary and secondary. Understanding the difference between these types can help in determining the underlying cause and appropriate management strategies.

Primary Lactose Intolerance

Primary lactose intolerance is the most common form. It occurs when lactase production naturally decreases over time, typically beginning in childhood or adolescence. This type is often genetically predetermined and more common in certain ethnic groups, including those of African, Asian, Hispanic, and Native American descent.

Secondary Lactose Intolerance

Secondary lactose intolerance is a temporary condition that results from damage to the small intestine. This damage can be caused by various factors, including:

  • Gastrointestinal infections
  • Celiac disease
  • Inflammatory bowel diseases (e.g., Crohn’s disease, ulcerative colitis)
  • Surgeries involving the small intestine
  • Certain medications

In many cases, treating the underlying condition can help restore lactase production and alleviate lactose intolerance symptoms.

Diagnosing Lactose Intolerance: Medical Tests and Procedures

If you suspect you may be lactose intolerant, it’s essential to consult with a healthcare professional for proper diagnosis. Several tests can help confirm lactose intolerance and rule out other potential digestive issues.

Lactose Tolerance Test

This test involves consuming a liquid containing high levels of lactose and then measuring blood glucose levels over a period of time. If glucose levels don’t rise as expected, it indicates that the body is not properly digesting and absorbing lactose.

Hydrogen Breath Test

The hydrogen breath test is another common diagnostic tool. After consuming a lactose-containing beverage, breath samples are collected and analyzed for hydrogen content. Elevated levels of hydrogen in the breath suggest lactose malabsorption.

Stool Acidity Test

This test is primarily used for infants and young children. It measures the amount of acid in the stool, which increases when lactose is not properly digested.

Managing Lactose Intolerance: Dietary Adjustments and Supplements

While there is no cure for lactose intolerance, various management strategies can help minimize symptoms and maintain a balanced diet.

Dietary Modifications

The most effective approach to managing lactose intolerance is to reduce or eliminate lactose-containing foods from the diet. This may include:

  • Avoiding milk and milk-based products
  • Choosing lactose-free or reduced-lactose dairy alternatives
  • Incorporating non-dairy calcium sources (e.g., leafy greens, fortified plant-based milks)
  • Reading food labels carefully to identify hidden sources of lactose

Lactase Enzyme Supplements

Over-the-counter lactase enzyme supplements can be taken with dairy products to aid in lactose digestion. These supplements provide the enzyme that the body lacks, allowing for better tolerance of lactose-containing foods.

Gradual Introduction of Dairy

Some individuals may be able to tolerate small amounts of lactose, especially when consumed with other foods. Gradually reintroducing dairy products in small quantities can help determine personal tolerance levels.

Nutritional Considerations for Lactose Intolerant Individuals

Maintaining a balanced diet while managing lactose intolerance is crucial for overall health. Dairy products are significant sources of essential nutrients, particularly calcium and vitamin D. Therefore, it’s important to ensure adequate intake of these nutrients through alternative sources.

Alternative Sources of Calcium and Vitamin D

  • Fortified plant-based milks (e.g., soy, almond, oat)
  • Leafy green vegetables (e.g., kale, spinach, collard greens)
  • Calcium-fortified juices and cereals
  • Canned fish with soft bones (e.g., sardines, salmon)
  • Nuts and seeds (e.g., almonds, sesame seeds)
  • Vitamin D-fortified foods or supplements

Consulting with a registered dietitian can be helpful in developing a well-balanced meal plan that meets nutritional needs while avoiding lactose-containing foods.

Lactose Intolerance vs. Milk Allergy: Understanding the Difference

It’s important to distinguish between lactose intolerance and milk allergy, as they are two distinct conditions with different causes and management approaches.

Lactose Intolerance

  • Digestive issue caused by lactase deficiency
  • Symptoms are generally limited to the digestive system
  • Can often tolerate small amounts of lactose or lactose-reduced products
  • Not life-threatening

Milk Allergy

  • Immune system reaction to milk proteins
  • Can cause systemic symptoms, including skin reactions and respiratory issues
  • Requires complete avoidance of milk and milk products
  • Can be severe or life-threatening in some cases

If you’re unsure whether you have lactose intolerance or a milk allergy, it’s crucial to consult with an allergist or gastroenterologist for proper diagnosis and management.

Living with Lactose Intolerance: Tips for Daily Management

Adapting to life with lactose intolerance may require some lifestyle changes, but with proper management, it’s possible to maintain a healthy and enjoyable diet. Here are some practical tips for daily management:

Reading Food Labels

Become familiar with ingredients that may contain lactose, such as:

  • Milk solids
  • Whey
  • Casein
  • Milk powder
  • Buttermilk

Planning Ahead

When dining out or traveling, plan ahead by:

  • Researching restaurant menus in advance
  • Carrying lactase enzyme supplements
  • Packing lactose-free snacks

Experimenting with Dairy Alternatives

Explore a variety of dairy alternatives to find products that suit your taste preferences and nutritional needs. Options include:

  • Plant-based milks (e.g., almond, soy, oat, coconut)
  • Non-dairy yogurts and cheeses
  • Lactose-free ice creams and desserts

Monitoring Tolerance Levels

Keep a food diary to track your reactions to different dairy products and serving sizes. This can help you identify your personal tolerance threshold and make informed decisions about your diet.

By implementing these strategies and working closely with healthcare professionals, individuals with lactose intolerance can effectively manage their condition and maintain a healthy, balanced diet. Remember that lactose intolerance is a common and manageable condition, and with the right approach, it need not significantly impact your quality of life or nutritional well-being.

Mayo Clinic Q and A: Lactose Intolerance Can Develop at Any Age

  • By

    Liza Torborg

DEAR MAYO CLINIC: What would cause someone to become lactose-intolerant later in life? I’m in my 40s and have never had an issue with dairy, but, now, I can’t seem to have it without problems. Do I need to see a doctor to be tested for allergies, or should I just avoid dairy?

ANSWER: Lactose intolerance isn’t a true allergy, and it can develop at any age. In some people, lactose intolerance may be triggered by another medical condition, such as Crohn’s disease. In others, it develops without a specific underlying cause. It would be a good idea to have your condition evaluated by your doctor to confirm that what you’re dealing with truly is lactose intolerance.

Lactose intolerance results from a problem with the carbohydrate lactose, a type of sugar found in dairy products. When you eat or drink dairy products, enzymes in your small intestine digest lactose, so the body can make energy. In people with lactose intolerance, a certain enzyme, called lactase, is missing from the body. When those people eat dairy products, the body has no way to break down the lactose. This leads to fermentation of the sugar in the intestines and triggers symptoms, such as diarrhea, nausea, abdominal cramps, bloating and gas.

Sometimes, lactose intolerance develops when the small intestine’s production of lactase decreases after an illness, injury or surgery involving the small intestine. This is called secondary lactose intolerance. Among the diseases associated with this kind of lactose intolerance are celiac disease, bacterial overgrowth and Crohn’s disease. Treatment of the underlying disorder may restore lactase levels and improve symptoms.

More common than secondary lactose intolerance is primary lactose intolerance. People who develop primary lactose intolerance start life making normal levels of lactase — a necessity for infants, who get all their nutrition from milk. As children replace milk with other foods, lactase production normally decreases. It stays high enough, though, to digest the amount of dairy in a typical adult diet. In primary lactose intolerance, lactase production declines below normal at some point for reasons that are unclear. The low amount of lactase then makes milk products difficult to digest and leads to lactose intolerance symptoms.

Your doctor can confirm a diagnosis of lactose intolerance with a clinical test. One that’s often used is a lactose tolerance test. It assesses your body’s reaction to a dose of lactose. After you consume a drink containing lactose, a sample of your blood is taken to measure glucose levels. If your glucose level does not rise, it means your body isn’t properly digesting and absorbing the lactose.

Alternatively, another test called the hydrogen breath test may be used. This test also requires you to consume a drink that contains high levels of lactose. Your doctor next measures the amount of hydrogen in your breath. Normally, very little hydrogen is detectable. However, if your body doesn’t digest the lactose, the fermentation reaction in your colon releases hydrogen and other gases. Your intestines absorb those gases, and you exhale them. Larger-than-normal amounts of hydrogen measured during this test are a sign that your body isn’t fully digesting and absorbing lactose.

If you have lactose intolerance, there isn’t a way to cure it. The most effective way for people with lactose intolerance to get relief from symptoms is to lower the amount of dairy products they eat. You may be able to use dairy products that have reduced levels of lactose or are lactose-free. Some people who have lactose intolerance benefit from taking lactase enzyme supplements, as well.

If test results do not point to lactose intolerance, your doctor may recommend additional tests to check for another condition that could be causing your symptoms, such as a milk allergy, intestinal disorders or other problems within your digestive tract. — Dr. Rohit Divekar, Allergic Diseases, Mayo Clinic, Rochester, Minnesota

Related articles

Mayo Clinic Minute: What is a breast medicine specialist?

Many people think that a breast health specialist only treats cancer, but the truth is that these doctors handle a wide range of breast-related conditions.
Dr. …

By Sonya Goins • July 7, 2023

Mayo Clinic Q and A: Proper posture and body alignment

DEAR MAYO CLINIC: My grandmother lives with me, and she is always nagging me to “stand up straight” and “put your shoulders back.” She says good …

By Mayo Clinic Staff • July 7, 2023

Can You Get It as You Get Older?

Written by Susan Bernstein

Do you get gas, bloating, or even diarrhea after you eat dairy foods? You may be lactose intolerant. This is when you can’t digest lactose, the type of sugar found in dairy products.

Lactose intolerance isn’t a serious health condition, but symptoms can be uncomfortable. You may have stomach upset or gas about 30 minutes to 2 hours after you eat or drink any dairy food.

Lactose intolerance is caused by low levels of lactase, an enzyme that helps you digest lactose in dairy foods, says Laura Acosta, a registered dietitian at the University of Florida in Gainesville.

“Some people are able to tolerate lactose throughout their lives, but others become more lactose intolerant as they age,” usually caused by your genes, she says. “Some people stop producing lactase, or produce less of it, as they reach adulthood and beyond.”

Lactose intolerance is more common among people of Southeast Asian, East Asian, West African, Native American, Hispanic, or Italian ancestry because they’re more likely to carry the gene mutation that causes the condition, says Vijaya Surampudi, MD, assistant professor of medicine at the University of California, Los Angeles.

“We have the highest amounts of lactase when we are young because as babies, we feed on milk. But we often make less and less lactase as we age,” she says. “About 65% of people may experience lactose intolerance at some point in their lives.”

There’s a wide range of lactose intolerance, with some people having no tolerance for dairy, while others can manage to digest foods like hard cheeses or yogurt, she says.

It’s fairly common to notice the signs of lactose intolerance appear as you get older, says Christine Lee, MD, a gastroenterologist at Cleveland Clinic in Ohio.

“This enzyme production can decrease over time in some people, so most people can experience some degree of lactose intolerance as they get older,” Lee says. You can also become lactose intolerant if you have an illness, infection, or take a medication that affects the bowels or intestines.

These conditions can also cause you to develop lactose intolerance later in life:

  • Crohn’s disease
  • Ulcerative colitis (UC)
  • Celiac disease
  • Injury or trauma to your small intestines

Foods. Any dairy foods or drinks can have lactose, so read food labels carefully. These foods or ingredients may trigger symptoms:

  • Cheese
  • Whey
  • Milk by-products
  • Dry milk
  • Butter
  • Curds
  • Ice cream
  • Heavy cream
  • Cottage cheese
  • Cheese spreads
  • Yogurt

Look for milk in ingredients lists in baked goods, chocolate candies, sauces, instant mashed potatoes, pancakes, or milk-based meal replacement or protein shakes. Even non-dairy coffee creamer or whipped toppings may contain some lactose.

Medications. Some medications like birth control pills or antacid tablets also contain lactose, but these may only cause symptoms in people with severe lactose intolerance. Check the labels of your prescription or OTC medications to see if they contain lactose. Ask your doctor or pharmacist if it’s OK for you to take them.

You may not have to give up all the dairy foods you enjoy if you develop lactose intolerance.

Some people with lactose intolerance may be able to eat or drink small amounts of dairy or switch to skim milk and have fewer symptoms. Some people can eat yogurt because it contains live bacteria cultures that help you produce the lactase enzyme to break down lactose.

“Cheese actually has very little lactose. In general, the harder the cheese, the less lactose it has. So many people with lactose intolerance can still tolerate cheese like Parmesan and Swiss in small amounts. This depends on an individual’s sensitivity,” Acosta says.

Talk to your doctor to identify what’s causing your lactose intolerance so you can make the right changes to your diet, Lee says.

“If it’s due to decreased production of lactase, then you can choose to take lactase tablets or drops, enzymes sold in most grocery stores without a prescription, or buy lactose-free milk products,” she says. Supplements are taken before a meal with dairy to help you digest the lactose.

If your lactose intolerance is due to a bowel disease or other health conditions, treat that illness first, she adds. “Always play it safe and discuss your symptoms with your physician.” Unexplained weight loss, bleeding, anemia, nausea, or vomiting may be signs of a more serious medical condition, not just lactose intolerance, she says.

As you age, you still need to get enough calcium even if you develop lactose intolerance. Calcium helps you maintain strong bones and teeth, and healthy muscles and nerves.

“There are many calcium-rich foods people can eat if they’re avoiding lactose,” says Allie Wergin, a registered dietitian/nutritionist with Mayo Clinic Health System. “These include lactose-free dairy products like Lactaid or Dairy Ease milks, where the lactose is predigested or hydrolyzed. This means the milk protein has already been broken down and is easier to digest.”

Other foods that are good sources of calcium, according to Wergin:

  • Calcium-fortified cereals and fruit juices
  • Tofu prepared using calcium sulfate
  • Canned salmon or sardines with bones
  • Plant-based soy, almond, oat, or rice milks
  • Leafy green vegetables like spinach, kale, bok choy, or collard greens
  • Broccoli
  • Almonds
  • Beans like garbanzo, kidney, or navy

“We recommend that you get calcium through your diet. There are different calcium supplements, including calcium carbonate, which is best absorbed if you take it with food, and calcium citrate, which you can take with or without food,” Surampudi says. Only take a calcium supplement if your doctor says you need one, she says.

Top Picks

Lactose intolerance | Symptoms, complications, diagnosis and treatment

People with lactose intolerance are unable to fully digest the lactose in milk. As a result, they develop diarrhea, gas, and bloating after eating or consuming dairy products. The condition, also called lactose malabsorption, is usually harmless, but its symptoms can be uncomfortable. Most people with lactose intolerance can manage the condition without giving up all dairy products.

Lactase deficiency, an enzyme produced in the small intestine, is usually responsible for lactose intolerance. Many people have low lactase levels but can digest dairy products without problems. If you are actually lactose intolerant, lactase deficiency leads to symptoms after you eat dairy products.

Signs and symptoms of lactose intolerance usually begin 30 minutes to two hours after eating or drinking foods containing lactose. General signs and symptoms include:

  • Diarrhea
  • Nausea and sometimes vomiting
  • Abdominal cramps
  • Inflate
  • Gases

Make an appointment with your doctor if you often experience symptoms of lactose intolerance after eating dairy products, especially if you are worried about getting enough calcium.

Reasons

Lactose intolerance occurs when the small intestine does not produce enough enzyme (lactase) to digest milk sugar (lactose).

Normally, lactase converts milk sugar into two simple sugars, glucose and galactose, which are absorbed into the bloodstream through the intestinal lining.

If you are lactase deficient, the lactose in food moves to the large intestine instead of being processed and absorbed. In the colon, normal bacteria interact with undigested lactose, causing the signs and symptoms of lactose intolerance.

There are three types of lactose intolerance. Various factors cause lactase deficiency underlying each type.

Primary lactose intolerance

This is the most common type of lactose intolerance. People with primary lactose intolerance begin their lives by producing large amounts of lactase, a must for babies who get all their nutrients from milk. As children replace milk with other foods, their lactase production usually decreases but remains high enough to digest the amount of dairy in a normal adult diet.

In primary lactose intolerance, lactase production drops dramatically, making it difficult for adults to digest dairy products. Primary lactose intolerance is genetically determined, which occurs in a significant proportion of people of African, Asian, or Hispanic ancestry. This condition is also common among Mediterranean or South European ancestry.

Secondary lactose intolerance

This form of lactose intolerance occurs when the small intestine reduces its production of lactase after illness, injury, or surgery involving the small intestine. Diseases associated with secondary lactose intolerance include celiac disease, bacterial overgrowth, and Crohn’s disease. Treating the underlying disorder can restore lactase levels and improve symptoms and signs, although this may take some time.

Congenital or developing lactose intolerance

This disorder is passed from generation to generation in a form of inheritance called autosomal recessive. Premature babies may also be lactose intolerant due to insufficient lactase levels.

Factors that may make you or your child more likely to become lactose intolerant, include:

  • Growing up. Lactose intolerance usually appears in adulthood. This disease is rare in children and young children.
  • Ethnos. Lactose intolerance is most common in African, Asian, Hispanic, and American Indian people.
  • Premature birth. Babies born prematurely may have low lactase levels because the small intestine does not develop lactase-producing cells until late in the third trimester.
  • Diseases affecting the small intestine. Small intestinal problems that can cause lactose intolerance include bacterial overgrowth, celiac disease, and Crohn’s disease.
  • Some treatments for cancer. If you’ve had radiation therapy for abdominal cancer or intestinal complications from chemotherapy, you’re at increased risk of lactose intolerance.

Explained how lactose intolerance affects women

Society

8476

Share

Lactose is a sugar naturally found in milk and dairy products. Lactose intolerance occurs due to lactose malabsorption. This is a condition in which the small intestine cannot digest or break down all the lactose a person eats or drinks.

According to the National Institutes of Health (NIH), most people with lactose intolerance can consume some lactose without any symptoms. This will depend on each case and their level of intolerance.

If a person is lactose intolerant, they will experience severe discomfort. The most common pains associated with the digestive system are bloating, diarrhea, and gas after eating foods or drinks that contain lactose.

Products containing lactose

Lactose is present in milk and all dairy products such as yogurt, cheese and ice cream. It is also present in many finished products. This long list includes: deli meats, crackers, salad dressings, cereals, breads and other baked goods.

Lactose intolerance should not be confused with milk allergy. The latter is caused by a problem with the immune system. Symptoms can range from mild (rash or itching) to severe (shortness of breath or wheezing). This is more common in children than in adults.

Calcium and vitamin D deficiency

Lactose intolerance can prevent you from getting enough calcium and vitamin D, which are important for bone health. It promotes bone health and reduces the risk of fractures. It also affects blood clotting, the functioning of the nervous system and the prevention of cardiovascular disease, explains the Spanish Society of Dietetics and Nutritional Sciences (SEDCA).

As for vitamin D, it is important for the proper absorption of calcium and phosphorus, so a deficiency can also reduce the levels of these minerals, which are essential for bone health, among other things. An association has also been found between adequate vitamin D levels and a lower risk of cardiovascular disease.

How does lactose intolerance affect women?

Women especially need to get enough calcium and vitamin D throughout their lives so that they can build and maintain bone density and reduce the risk of osteoporosis later in life.

According to the Office of Women’s Health (OASH), osteoporosis is a condition in which bones become weak and break more easily. And women have a higher risk of osteoporosis than men.

In particular, according to OASH, women are more likely to suffer from osteoporosis for the following reasons:

– Women tend to have smaller, thinner, and less dense bones than men.

– women tend to live longer and bone loss occurs naturally with age.

– In addition, women lose more bone mass after menopause due to very low levels of the hormone estrogen.

Subscribe

Authors: