Lactose intolerance - anyone?

boron

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I've found some interesting evidence-based facts about lactose intolerance (LI) which I intend to include in my article. Before that, I'd like to hear from anyone who has LI:
1. At which age did you start to experience symptoms?
2. Time between lactose ingestion and symptoms?
3. Which exact amounts of milk or lactose do or do not trigger symptoms in your case?
4. Which dairy products can you tolerate? Ricotta, mozzarella and cottage cheese?
5. Do you have problems with foods other than dairy products?

For me, this is a reality check.
I'm about to reveal those facts a bit later.
 
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Drachen Jager

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1) mid 20's
2) Depends mostly on exercise. If I'm idle up to 2 hours, if I'm exercising vigorously 10-15 minutes.
3) Depends mostly on the fat content of the milk I find. Skim milk is fine, I have it for breakfast all the time, fattier milk, butter or cream the dose is much lower. A very rich ice cream or fatty-milk dessert may only take a spoonful for me to notice symptoms.
4) Cheese and Yoghurt have nearly no lactose in them so they're fine, but you should know that if you're doing research.
5) Nope

Be very cautious of BS masquerading as science. It sounds like you've found some highly suspect information from your lead-in.
 

Shakesbear

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I've been LI all my life but was only diagnosed in my early 20s. Every time I was ill as a child the doc said I had gastro enteritis. Just after my 21st birthday I'd spent an evening watching tv with my dad and I got up to turn the tv off and fainted. Next day dad took me to the docs who referred me to a local hospital. The idiot I saw there thought I had a stomach ulcer and said I had to have milk with every meal. I have never been so ill. I lost an a lot of weight and was off work for nearly three months. When I went back to see said idiot he realized that he may have made a mistake - and said I was not to have any more milk. I started to feel better. MY GP sent me for a blood test and when he got the results he was a tad gobsmacked as I had not absorbed any lactose - the stuff I had been given to drink on an empty stomach (concentrated lactose in water) had literally gone straight through me. I could not eat any dairy produce for several years after that. I can eat certain cheese - Cathdral City, Edam, and some types of Brie. They have little if any effect on me. Though I find that if I have cheese three or four times a week it does make me ill. I cannot drink milk - the mere idea of it makes me heave. Time between lactose ingestion and symptoms can vary - it depends, I think, on what I have to eat with what ever has the lactose in it. For example a fresh cream cake like a chocolate éclair has little effect, but a slice of sponge cake that has whipped cream as its' filling will make me ill. I have never thought about the time between ingestion and symptoms and I am sorry, but I am not going to pig out on a cream cake for you. I'd love to - but I really do not like the results. What triggers symptoms is hard to define - I know that if I had a coffee with milk I would be ill (recent BAD experience) yet instant cappuccino (Nescafe) has no effect unless I have three or four a day, which I don't. Problems with other food - not so much. I love English tomatoes and eat them a lot when in season - they only 'disagree' with me if I have them in a very oily salad dressing. The only other food that does not like me is Cadbury's Dairy Milk, but then I don't like it! PM me if there is anything else you want to know.

Just thought - soya milk also makes me heave, but some soya based desserts, e.g. Alpro, do not.
 

Persei

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I was like this since I was born, the reaction comes half an hour later, I can have butter, yakult and cheese without problems and I also have gluten intolerance.

I am able to tolerate lactose now, but I,am still lactose free
 

McMich

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I'm not but my husband is:

1. At which age did you start to experience symptoms?
-since birth when he was first switched from formula to cow's milk. His mother is LI, so it does not surprise me in the least that he is, being that you have to get the bacteria to digest lactose from someone- I assume the mother plays a large part of it.
2. Time between lactose ingestion and symptoms?
-as little as an hour to a couple hours
3. Which exact amounts of milk or lactose do or do not trigger symptoms in your case?
-cannot have any milk without having symptoms, and only limited milk products
4. Which dairy products can you tolerate?
-he does fine with most hard cheeses, and small amounts of soft cheese or sour cream
5. Do you have problems with foods other than dairy products?
-no- in fact he can tolerate a much larger range of foods than I can.
 

boron

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@ Drachen Jager, I've read some serious research articles about LI.

Most cheeses are low in lactose, but yogurt is only 20-30% lower in lactose than regular milk. Still many LI individuals tolerate yogurt much better than milk.

It is interesting that you can tolerate skim milk better than whole milk. Do you think that fat in general irritates you?

Shakesbear, I've PMed you.
 

backslashbaby

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1. At which age did you start to experience symptoms?
Mid 30's.

2. Time between lactose ingestion and symptoms?
An hour or two.

3. Which exact amounts of milk or lactose do or do not trigger symptoms in your case?
A small McDonald's sundae is my limit. Milk itself is worse, so I'd have to have less than that.

4. Which dairy products can you tolerate?
Yogurt.

5. Do you have problems with foods other than dairy products?
Yes, but I have an ulcer, so I assume those are because of that.

eta: now that I've read everyone else's :) I can't do cheese without taking supplements. And I can't even do a large latte! That amount of skim milk will do it. That's how I noticed what it must be, because I love cheese and lattes :) The enzymes in pill form work like a charm.

Shakesbear, it really hurts and is uncomfortable! I had no idea before I got it.
 
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Drachen Jager

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@ Drachen Jager, I've read some serious research articles about LI.

Most cheeses are low in lactose, but yogurt is only 20-30% lower in lactose than regular milk. Still many LI individuals tolerate yogurt much better than milk.

It is interesting that you can tolerate skim milk better than whole milk. Do you think that fat in general irritates you?

Shakesbear, I've PMed you.

No, in general I'm fine with fats, though I find I feel ill if I have a lot of some types of saturated fat (though not ill in the same way as I do for lactose intolerance), coconut in particular. I'm just fine with bacon, mayonnaise, fatty cheese and yoghurt, most fatty things really. Somehow, in spite of that, I manage a fairly trim figure. ;)

I find taking lactase pills allows me to eat whatever I want as far as dairy products, so I'm quite certain it's the sugar. I'd always just assumed that in the process of removing the fat, much of the lactose sugar is also changed or removed.
 

boron

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OK; thanks everyone and I'd appreciate more...

Results of some studies about LI:
- LI is very common, up to 100% (yes) adults in some Asian regions may have it.
- Most individuals with LI can tolerate at least 12 grams lactose (240 mL cup of milk) in a single occasion, or 2 cups per day, but surprisingly many LI individuals cannot tolerate even lactose-free milk (psychological reaction, maybe).
- Yogurts, either with active cultures or pasteurized, are usually better tolerated than milk. Most hard cheeses are well tolerated.
- Boiled milk may be tolerated easier than raw milk, goat's milk easier than cow's milk, whole milk easier than skim milk (probably because skim milk passes the stomach faster), milk with some solid food easier than milk alone.
- Hydrogen breath test for lactose can be false negative in up to 20%.
- Symptoms may decrease after regular consumption of yogurt with live culture.

Source:
http://www.jacn.org/content/19/suppl_2/165S.full
 
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GeorgeK

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I've found some interesting evidence-based facts about lactose intolerance...

That sounds suspicious for either the latest fad in buzz words or articles that are shaky on science.

The main distinction that a patient needs to understand is the differences and overlap between whether they have lactose intolerance or a milk allergy, and some people have both.
 

boron

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That sounds suspicious for either the latest fad in buzz words or articles that are shaky on science.

Interesting that now two of you have found the term "evidence based facts" highly suspicious, because this should mean "based on the results of studies" or, in my case, "based on clinical trials in humans," but is, obviously, so often used by marketers and pharmaceutical companies that it got a bad reputation.

I've provided two sources, here are two more:
efsa
ajcn
 
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backslashbaby

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OK; thanks everyone and I'd appreciate more...

Results of some studies about LI:
- LI is very common, up to 100% (yes) adults in some Asian regions may have it.
- Most individuals with LI can tolerate at least 12 grams lactose (240 mL cup of milk) in a single occasion, or 2 cups per day, but surprisingly many LI individuals cannot tolerate even lactose-free milk (psychological reaction, maybe).
- Yogurts, either with active cultures or pasteurized, are usually better tolerated than milk. Most hard cheeses are well tolerated.
- Boiled milk may be tolerated easier than raw milk, goat's milk easier than cow's milk, whole milk easier than skim milk (probably because skim milk passes the stomach faster), milk with some solid food easier than milk alone.
- Hydrogen breath test for lactose can be false negative in up to 20%.
- Symptoms may decrease after regular consumption of yogurt with live culture.

Source:
http://ajcn.nutrition.org/content/26/4/393.full.pdf

I didn't even know yogurt counted as the same kind of dairy as easily as I can eat that. I don't eat many hard cheeses, so I don't know, but low-fat mozzarella is a favorite and I always have to take the pills. I don't drink whole milk, so I don't know about that either.

My symptoms do seem to be worse sometimes and not others with the same triggers, so the yogurt culture may be what I don't notice. I eat a lot of yogurt, because I do love dairy and it makes a good dessert with fruit in it :)

It is better with other food, I think. A latte on an empty stomach will get me bad without the pills, but the same thing with a big, big meal won't bother me. I consume it all more slowly then, too, of course.
 

Drachen Jager

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Interesting that now two of you have found the term "evidence based facts" highly suspicious, because this should mean "based on the results of studies"

I think that's because the phrase 'evidence based facts' is redundant. If a fact isn't based on evidence it's not a fact, and for that matter, many things that ARE based on evidence are actually NOT facts at all. Many people believe that inoculations lead to mental disorders because of one flawed study which has now been completely discredited, that doesn't stop that study from being used as 'evidence', although the connection between inoculations and mental disorders are most certainly not factual.

"Based on evidence" is a highly suspect phrase because you're saying you have evidence, and you're extrapolating supposed 'facts' from that evidence, rather than proving things by use of evidence, just as a film 'based on real-life events' is essentially telling you 'yeah, we ginned it up a bit, because a completely honest translation would have bored you'.
 

boron

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I think I wanted to say "evidence based information," but now I myself am getting annoyed with this. I'll stick with "human clinical trials."
 

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OK; thanks everyone and I'd appreciate more...

Results of some studies about LI:
- LI is very common, up to 100% (yes) adults in some Asian regions may have it.
- Most individuals with LI can tolerate at least 12 grams lactose (240 mL cup of milk) in a single occasion, or 2 cups per day, but surprisingly many LI individuals cannot tolerate even lactose-free milk (psychological reaction, maybe).
- Yogurts, either with active cultures or pasteurized, are usually better tolerated than milk. Most hard cheeses are well tolerated.
- Boiled milk may be tolerated easier than raw milk, goat's milk easier than cow's milk, whole milk easier than skim milk (probably because skim milk passes the stomach faster), milk with some solid food easier than milk alone.
- Hydrogen breath test for lactose can be false negative in up to 20%.
- Symptoms may decrease after regular consumption of yogurt with live culture.

Source:
http://ajcn.nutrition.org/content/26/4/393.full.pdf

Mate, that paper is from 1973 and is a study of a very small cohort. The information is 40 years out of date.

A high incidence of LI in Asian populations is well established, and not unexpected given that until the last few decades the consumption of cow's milk in those geographical regions was very minimal for centuries.
 

boron

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GeorgeK

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The AJCN article is fairly worthless due to selection bias and sample size. They don't mention how they determined whether someone had lactose intolerance or not. Generally if they don't mention the methods it's by self reporting which is often wrong.

I don't ahve any problems with the other article.
 

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Perhaps I need more coffee, but I'm not sure what the point of this thread is? If you're writing a health article and citing the published literature, why would you want to collect anecdotal evidence from strangers on the internet?

As George said, LI is often self-diagnosed. In some cases, allergy to casein or other cow milk proteins is mis-diagnosed as LI, or LI is accompanied by an undiagnosed CMA. CMA can be IgE-driven or non-IgE driven, and can induce a type I or a type IV hypersensitivity reaction. The degree and severity of both LI and CMA vary from person to person, so each person has to determine their own tolerance. Those facts are all well established.
 

boron

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I find data for my articles on online medical magazines, but there's always some issue about my writing I'm not aware of and someone points it out. My aim in this thread is to find out what kind of information about lactose intolerance the actual sufferers find important and eventually cover that in my article.
 

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My aim in this thread is to find out what kind of information about lactose intolerance the actual sufferers find important

In that case, I don't understand why you posted a set of your own questions for people to answer, rather than asking people to post their questions that they'd like your article to cover?
 

boron

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As you can tell, people with lactose intolerance seem to be quite confident about what's good for them and what not so I do not expect many questions from them. From the answers, for example, it came out some people believe that whole milk is worse than skim milk, while the results of studies show just the opposite, so I need to find some explanation for that.
 

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1. At which age did you start to experience symptoms?
In the last year or so, so 25, 26.
2. Time between lactose ingestion and symptoms?
Half-hour to 2 hours.
3. Which exact amounts of milk or lactose do or do not trigger symptoms in your case?
Any amount of milk triggers symptoms. Ice cream is variable.
4. Which dairy products can you tolerate? Ricotta, mozzarella and cottage cheese?
Cheese never bothers my stomach. Butter is usually fine. Cream can be tricky; sometimes it's fine, other times absolutely not. I can't tolerate yogurt. Ice cream is irritating. Milk is a huge no-no. Any kind of cow's milk. If it's in a baked good, then I'm fine, but if I drink milk or it's in my tea or I have it with cereal, than no. I drink soy milk instead.
5. Do you have problems with foods other than dairy products?
Greasy food, fried food equals instant irritation. Overly sugary food gives me problems, too.

I should note that my mother is also lactose intolerant and she's East Asian, so, you know...I used to be able to drink milk by the boatload. Not anymore.
 

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I've never been formally diagnosed, but I've cut all milk and ice cream and most other dairy from my diet after suspecting I was LI for years, and I've seen a definite improvement in my digestion. Symptoms show up from half an hour to a few hours after eating/drinking dairy. I remember getting stomach cramps immediately after eating cereal with milk when I was a kid.

I can't eat ice cream at all, which is a shame since I love it. Frozen yogurt is okay, as are most cheeses. I can't drink milk at all. I use unsweetened almond milk on my cereal these days. I still cook with milk, but if I use half-and-half or cream in a recipe I sometimes have symptoms, although it depends how much I eat and what I eat with it. I don't have any other issues with food (although I'm also mildly hypoglycemic and have to watch my sugar intake--which is why I shouldn't actually be eating this Halloween candy right now).

incidentally, my symptoms aren't limited to digestive issues. I also get skin problems--not acne but one or two painful spots, usually on my face. It took me a long time to realize that was due to dairy products. That's what finally made me quit eating ice cream entirely. I recently talked to a coworker who's also LI and she says she has the same issue with her skin after eating dairy.
 

jaksen

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1. At which age did you start to experience symptoms?
At birth. I was a huge baby, over ten pounds, but couldn't be breast feed or given any milk formula. I survived on a soy formula, which was not common in the 1950's, when I was born.

2. Time between lactose ingestion and symptoms? Almost immediately.

3. Which exact amounts of milk or lactose do or do not trigger symptoms in your case? Any amount triggers symptoms.

4. Which dairy products can you tolerate? Ricotta, mozzarella and cottage cheese? I can tolerate none without a lactaid-type medication.

5. Do you have problems with foods other than dairy products?
Just chocolate, but I eat it anyways.
 

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incidentally, my symptoms aren't limited to digestive issues. I also get skin problems--not acne but one or two painful spots, usually on my face. It took me a long time to realize that was due to dairy products.
This may indicate an allergy to milk protein rather than an inability to digest lacose?