Lactase deficiency

What is lactase deficiency?

This is a condition affecting millions worldwide and refers to the insufficient production of the enzyme lactase in the small intestine. This enzyme is essential for breaking down lactose, the sugar found in milk and dairy products, into simpler forms like glucose and galactose for proper absorption. Without adequate lactase, lactose remains undigested, leading to symptoms such as bloating, diarrhea, and abdominal discomfort. This article explores the distinct types of lactase deficiency, their causes, and practical strategies for management.

Types of lactase deficiency

Primary lactase deficiency
Primary lactase deficiency, the most common type, occurs naturally with age. Many individuals experience a gradual decline in lactase production after infancy, as milk consumption decreases. This condition is particularly prevalent in regions like Asia, Africa, and South America, where a high percentage of the population experiences reduced lactase activity as adults.
Secondary lactase deficiency
Secondary lactase deficiency arises due to damage to the small intestine from conditions such as infections, Crohn’s disease, or celiac disease. This type of deficiency can be temporary if the underlying issue is treated, allowing lactase production to recover over time.
Congenital deficiency
A rare genetic disorder, congenital lactase deficiency is present from birth. It prevents infants from producing any lactase, making it impossible for them to digest breast milk or formula containing lactose. This lifelong condition requires strict avoidance of lactose-containing foods and specialized medical management.

Symptoms and impact

The deficiency manifests in a variety of gastrointestinal symptoms after consuming lactose-rich foods. These include:

Bloating and gas
Abdominal cramps
Diarrhea
Nausea

The severity of symptoms varies depending on the individual’s lactase activity level and the amount of lactose consumed. The symptoms result from the fermentation of undigested lactose by gut bacteria in the large intestine, leading to the production of gas and other byproducts.

Managing lactase deficiency

Although the deficiency cannot be cured, there are several strategies to manage its symptoms and maintain a nutritious diet.

Dietary adjustments
A lactose-reduced or lactose-free diet is a primary approach. Many people find relief by substituting regular dairy products with lactose-free versions or plant-based alternatives like almond or soy milk. Hard cheeses and fermented products like yogurt may also be easier to tolerate due to their lower lactose content.
Lactase supplements
Lactase enzyme supplements are widely available in tablet, capsule, or liquid form. These supplements can be taken before consuming lactose-containing foods, and help to reduce associated discomfort.*

Differentiating from other conditions

It is crucial to distinguish lactase deficiency from other conditions such as milk allergies. Unlike lactase deficiency, which involves an enzyme shortfall, milk allergies trigger an immune response to milk proteins. Understanding the difference ensures appropriate dietary and medical interventions.

You can read more about the topic in our knowledge bank or you can contact one of our dieticians for personalized advice. If you’re facing symptoms and don’t know where they come from, you can take the intolerance test for more information:

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.