Lactose Intolerance – Helpful Information

May 7, 2026    Jane Jackson, RN, CRC    BHealthyRN

Lactose Intolerance – Helpful Information

May 12, 2026       Jane Jackson, RN, CRC         BHealthyRN

Lactose intolerance is common worldwide with over 110K internet searches last month just in the US alone – according to Wordstream. Lactose intolerance is the inability to digest lactose – a sugar in cow and goat milk products – because the small intestine cannot produce adequate lactase, an enzyme responsible for the breakdown of lactose. LactAse splits lactOse into fragments that can be absorbed and processed through the intestinal lining. In the United States, lactose intolerance affects millions of people.

Signs and symptoms of lactose intolerance can begin 30 minutes to 2 hours after eating or drinking lactose-containing foods. Severity levels will vary among individuals. 

Common signs and symptoms include:

• Diarrhea/Constipation
• Nausea and/or Vomiting
• Stomach Cramps
• Bloating
• Gas

While lactose intolerance can cause significant discomfort, it is not life-threatening.  There are three types of lactose intolerance.

• Primary lactose intolerance – most common – lactase production falls off sharply by adulthood, making milk products difficult to digest.
• Secondary lactose intolerance – decreased lactase production after an illness (such as Crohn’s, irritable bowel syndrome, enteritis, ulcerative colitis, or celiac disease), gastric injury, or surgery involving your small intestine.
• Congenital or developmental lactose intolerance – rare – is an inherited inability to produce lactase passed from generation to generation.

(Note – Premature infants can have lactose intolerance because the small intestine does not develop lactase-producing cells until the late 3rd trimester)

Four factors increasing the risk of developing lactose intolerance include:

• Aging – usually appears in adulthood. Uncommon in children.
• Ethnicity – varies across populations and may be higher in some ethnic groups.
• Damage to the small intestine – conditions such as bacterial imbalance, celiac disease, and Crohn’s will impair lactase production.
• Cancer treatments – radiation therapy and chemotherapy can cause damage to the lining of the small intestine. 

Dairy products are a highly nutritious source of protein, calcium, and other vitamins, such as A and D. Many people with lactose intolerance can manage symptoms without giving up all dairy products by using dietary modifications and, in some cases, lactase supplements.

Most lactose-intolerant people know not to consume milk products, but often overlook foods that contain a dairy product as an ingredient.  Such as

• Bread
• Cereals
• Soups
• Deli meat
• Pancake mix
• Candies
• Cookies

These products contain dairy and dairy components such as

• Cream
• Condensed milk
• Dried milk
• Evaporated milk
• Milk powder,
• Curds
• Whey

Lactose is in cow, goat, sheep, human, and buffalo milk and products made from these. Plant-based alternatives may be an option for some individuals. Their calorie, fat, protein, and water content can vary by product. For many years, soy milk has been a popular substitute. There are more sources of lactose-free milk products – here are some alternatives

• Rice milk
• Almond milk
• Oat milk
• Hazelnut milk
• Hemp Milk
• Pea Milk
• Cashew Milk
• Macadamia Milk
• Coconut Milk
• Potato Milk
• Flax Milk
• Sunflower Milk

Some people with lactose intolerance may tolerate yogurt with active live cultures better than other dairy products. Live cultures in yogurt may help reduce lactose content, but tolerance can vary from person to person.

Calcium is necessary for maintaining a strong and healthy skeletal system.  One of the most common sources of calcium is dairy products.  Lactose intolerance will affect calcium levels.  Here is a list of foods high in calcium

• apricots
• broccoli
• collard greens
• dried figs
• kale
• calcium-fortified orange juice
• rhubarb
• salmon 
• sardines
• spinach
• tofu
• yogurt

Note:  Lactose intolerance is not the same as a milk allergy.  Lactose intolerance specifically refers to the inability to digest lactose, the milk sugar.  A milk allergy is an allergic immune system response to one or more of the milk components.

For individuals who prefer to continue consuming dairy products, over-the-counter lactase enzyme products are available.

Here are some features to consider when researching over-the-counter lactase enzyme products

• Lactase products vary in enzyme strength, so it is helpful to review the label directions for serving size and use.
• Additional ingredients included, such as probiotics, vitamins, and minerals
• Dosing instructions – how much and when to take the supplement

While lactose intolerance can cause significant discomfort, it is generally not considered life-threatening. There are three types of lactose intolerance.

Note – Follow the product label instructions and consult a healthcare professional if you have questions about appropriate use.