Lactose is natural sugar found in dairy products. It requires lactase, an enzyme produced within the intestines, to digest it. Usually, this enzyme is produced by the small intestinal villi. In Celiac disease (CD) (and in some with Dermatitis Herpetiformis), the intestinal villi becomes damaged (flattened) and this can impair the production of lactase. Immune reactions to ingested gluten can cause this damage. Loss of this brush border (another name for microvilli) enzyme results in a condition called lactose intolerance.
With lactose intolerance, the lactose passes undigested into the colon and then it is broken down by commensal bacteria. This process produces CO2 and hydrogen which can cause abdominal discomfort, bloating, flatulence, and possibly diarrhea. With a gluten intolerance, this may be temporary, since lactase production may resume once a gluten-free diet has commenced and the bowel has healed.
Other factors can cause villi damage and this could affect the production of lactase as well. Food allergies can also affect the villi and sometimes the reactions can lead to flattened intestinal villi. For example, flattened villi have been found in people with soy and milk allergies. Theoretically, this could lead to lactose intolerance.
As well, there is some evidence that a lectin intolerance can affect the intestinal villi. This could potentially lead to a lactose intolerance if the villi were no longer able to produce lactase to digest the lactose in diary. For people suffering with a lectin intolerance, a paleolithic diet may be helpful.
In some, the lactose intolerance may be persistent. In fact, it may appear to be a permanent condition. This could be due to ongoing accidental ingestion of the offending food that is causing villi damage, the presence of bowel infections, or perhaps a state of dysbiosis in the bowel could hinder the production of lactase as well. In this situation, further testing for infections, further diet modification to remove the offending foods or probiotics might help. Unfortunately, even with all of these interventions, the damage could be permanent. An ongoing lactose free diet may be needed along with lactase supplements when necessary. Perhaps, the persistent damage has occurred for too long in some who were undiagnosed for years.
With this in mind, I think everyone with a lactose intolerance should be tested for a gluten intolerance since it can be an underlying trigger. It is important to diagnose the cause, not just the symptoms.
NATURAL WAYS TO REDUCE LACTOSE INTOLERANCE
There are a number of foods and supplements you can take to help reduce the unpleasant digestive symptoms experienced after eating dairy foods.
Probiotic bacteria that are useful for lactose intolerance include Lactobacilli, Bifidobacteria and Streptococci. Bifidobacterium longum is one that is very efficient at metabolizing lactose, although these bacteria are all capable of producing lactase to improve lactose digestion. While probiotics are live strains of good bacteria, prebiotics are the nourishment this bacteria needs to stimulate growth. Eating prebiotics as well as taking a probiotic supplement helps to significantly build the levels of bacteria. Some good choices of foods containg inulin, the most common form of prebiotic, are asparagus, garlic, leek, onion, and artichoke.
Apple Cider Vinegar
ACV can be a very effective way to reduce, even eradicate, lactose intolerance. It helps to balance the body. Try one tablespoon in ½ to one full glass of water every morning. Adding ¼ teaspoon of bicarb soda (baking soda) to the ACV before adding the water seems to help. It will take several weeks to improve and you must be diligent and not skip a day.
Taking 1-2 teaspoons of virgin coconut oil daily may help reduce intolerance. Alternatively, use coconut milk as a milk replacement in many recipes.
Even though yoghurt is a dairy product, a few spoonfuls of good quality, full fat yoghurt with each meal introduces beneficial bacteria to your gut. Many people with lactose intolerance can digest yoghurt because it has live bacteria in it to help break down the lactose and improve digestion.
Sauerkraut and kimchi are foods made from fermented cabbage that contain good bacteria which helps to re-populate the gut and regulate the digestive system. Drink the juice of the sauerkraut as well as eating it. Kim chi is quite spicy. It will take a few weeks for the bacteria to build up to sufficient levels to reduce symptoms.
Lactase Enzyme Supplements
Lactase is an enzyme produced in the small intestine that breaks down lactose in the body. When a person does not produce sufficient lactase they experience the symptoms of lactose intolerance. Lactase supplements are a small pill that is taken with foods containing lactose. They are useful as a temporary measure or when you are eating large quantities of dairy foods, but may not be so good for the long term. Adding the enzymes to milk a few hours before drinking it helps break down the lactose. You can get them from health food stores. Some people become immune to the pills over time. It may also not always be clear when you are about to eat dairy foods. I once watched a famous chef on TV divulge that the secret ingredient in his amazing clear chicken stock was cow’s milk. One other problem with lactase supplements is that when the lactase appears in the gut from another external source the requirement on the body to produce its own lactase enzymes is removed, and you may very easily go from producing some if insufficient amounts of lactase to producing none at all.