Lactose intolerance isn’t just a problem for a few that have to be picky about what they eat. It is actually quite widespread in the population and most of us have at least some mild symptoms without realizing. Only severe cases are detected and treated with a lactose-free diet, and the rest experiences uncomfortable symptoms once in a while, but it’s not really a big deal for them.
As you try to find something that might improve your lactose intolerance, you may come across probiotics. Actually, it wouldn’t be the first time that probiotics help people digest nutrients they are unable to process by themselves. So, is it really possible that probiotics help with lactose intolerance?
Lactose intolerance vs. Dairy allergy
First off, we should make clear the difference between having a lactose intolerance and suffering from a dairy allergy. They are very often confused because the symptoms are sometimes misleading and similar to each other. However, a dairy allergy is much more dangerous, especially if you develop a very serious reaction and anaphylaxis, which may sometimes compromise your breathing and become lethal.
In principle, lactose intolerance is a problem in your digestive system. Dairy allergy is a problem with your immune system.
In lactose intolerance, your body is not able to process lactose, the main sugar we find in milk. You need an enzyme called lactase to break down this sugar and help your body absorb the nutrient. But since you can’t digest lactose, it stays in the intestines and goes into two different pathways. It either stays unchanged increasing the solute concentration of the stool and causing diarrhea, or breaks down by fermentation and creates intestinal gas and bloating problems. Either case is uncomfortable, but not dangerous.
In dairy allergy, the immune system reacts against the protein and other substances in milk. Your body believes it is a dangerous pathogen and starts an overactive inflammatory response. You can have gastrointestinal symptoms very similar to those found in lactose intolerance, but this time you also get a skin rash, and might also experience trouble breathing and other severe symptoms.
The difference between lactose intolerance and dairy allergy is a key aspect of treating each problem. You won’t be able to fix dairy allergy with a lactose-free diet because lactose is not probably the main concern. It is the protein and other substances in milk. Similarly, if probiotics help lactose intolerance, they won’t be a quick fix if you have a dairy allergy. In these cases, you should stay away from dairy as much as possible.
Lactose intolerance and yogurt
Health authorities and medical experts recommend yogurt for people with lactose intolerance, which may not sound appropriate if you remember that yogurt comes from milk. But actually, yogurt is also a functional food that is required in your diet and will not cause the same symptoms as whole milk. The main difference is that it goes through a fermentation process, it is filled with probiotic strains, and have enzymes that allow your gut to process milk without causing annoying symptoms.
It is very likely that you won’t have any problem at all if you consume yogurt instead of whole milk. Similarly, vegans have different types of plant-based yogurt options to choose from.
Yogurt is different from milk because the bacteria used in the fermentation process contains very high levels of the enzyme that converts lactose into simple sugars. The enzyme acts during the fermentation process, and also in your intestine to help the organism digest the molecules of lactose. Moreover, there are certain types of yogurt that contain less molecules of lactose, especially Greek yogurt. This type is even safer for people with lactose intolerance.
Can probiotics help with lactose intolerance?
According to scientific evidence, there’s a high chance that probiotics might help with lactose intolerance. However, as stated above, every patient experiences lactose intolerance differently, and there’s no way to generalize and state an absolute truth. Certainly, there’s a very low chance you will experience intolerance symptoms with yogurt, but that doesn’t mean that eating yogurt with milk will turn healthy bacteria into a digestive enzyme supplement. It is possible, but not always true.
The same goes with probiotic supplements. They can help digesting lactose by populating your gut and providing the enzyme lactase for the processing and absorption of this molecule. But the process will not be automatic because the pills are made with colony forming units, not enzymes. First we need to populate the gut with good bacteria, and only then you might experience an improvement in your symptoms.
And still, there’s no way to be completely certain. If you read this article carefully, you would understand the predicament. Intestinal bacteria can break down lactose, but in the process they may release gas molecules and contribute to the bloating and abdominal cramp symptoms.
So, the only way to know how your body will react is trying by yourself. Luckily for you, lactose intolerance is not as severe or dangerous as dairy allergy, and you can try a few weeks supplementing with probiotics before trying Greek yogurt for a week or two. If you feel fine, try with regular yogurt for a week or two. And if you’re still asymptomatic, try a bit of whole milk and feel free to increase the dose gradually, but only if you don’t have gastrointestinal problems.
Learn to listen to your body and ask your doctor if you have a doubt or don’t feel sure about supplementing with probiotics. Remember that every patient with lactose intolerance experiences the same problem, sometimes in a different way, and the recommendations for patients with mild symptoms are definitely not the same as those for patients with severe gastrointestinal problems.
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Pei, R., Martin, D. A., DiMarco, D. M., & Bolling, B. W. (2017). Evidence for the effects of yogurt on gut health and obesity. Critical reviews in food science and nutrition, 57(8), 1569-1583.
Leis, R., de Castro, M. J., de Lamas, C., Picáns, R., & Couce, M. L. (2020). Effects of Prebiotic and Probiotic Supplementation on Lactase Deficiency and Lactose Intolerance: A Systematic Review of Controlled Trials. Nutrients, 12(5), 1487.