Do probiotics engage in lactose intolerance?

Although lactose intolerance is widespread, a lot of people still do not know what it is. In the text, we will not only explain the reasons of its occurrence but we will also answer the question whether probiotics will help you with the treatment.

Currently, approximately 65 % of adults worldwide suffer from lactose intolerance. It is most common in Asian and African countries where approximately 70 – 100 % of the population suffers from it.

In Europe, the occurrence of lactose intolerance is lower (on average 28 %) but it depends on the specific country. While in Scandinavia the rate is around 2 %, in southern Italy it is up to 70 %. Even though lactose intolerance is widespread, a lot of people still do not know what it is and they often interchange it with an allergy to cow’s milk protein. The options for this disease solution are often unclear.

Probiotics can help to alleviate the symptoms of lactose intolerance. They are living microorganisms that are able to break down lactose, maintain a healthy intestinal microflora and restore intestinal balance.

However, in order to understand the real mechanism of their effect, you need to become more familiar with lactose intolerance.

What is lactose intolerance

Lactose intolerance is an enzymatic disorder in which the enzyme lactase, which is responsible for breaking down lactose in the small intestine, is missing or not working.

Lactose is a milk sugar occurring in milk and dairy products. It is a disaccharide that is indigestible and must be broken down into simple sugars that the body can use.

Under normal circumstances, lactose is broken down in the small intestine into glucose and galactose which are then absorbed into the blood.

In the case of lactose intolerance, lactose does not break down and is transported into the large intestine where specific intestinal bacteria begin to ferment it. By their action, gas and toxic substances start to be produced. This leads to the cause of health problems.

Typical symptoms

Common symptoms are abdominal pain, bloating, flatulence, diarrhea (in some cases constipation), nausea and vomiting. Individual symptoms occur approximately in 30 – 120 minutes after taking lactose-containing foods.

In addition, people with lactose intolerance have been shown to be at greater risk of developing diseases such as cancer.

This is probably due to changes in the intestinal microbiome and excessive production of toxic substances (acetone, acetaldehyde, ethanol, peptides) which arise due to improper lactose digestion.

The difference between intolerance and allergy

Always remember that lactose intolerance is not an allergy. While intolerance is a digestive disorder, cow’s milk protein allergy is an immunological disorder.

Symptoms of cow’s milk protein allergy include digestive problems (diarrhea, bloating, vomiting), skin problems (eczema, face swelling) and breathing difficulty (a cold, asthma).

What types do we know

In the simplest way it can be divided into permanent and transient. Transient intolerance may occur due to disturbance of the intestinal microflora after overcoming infectious disease, acute diarrhea or after taking antibiotics.

It usually lasts one to three weeks for the intestines to heal, the intestinal microflora to recover and the intestinal balance to return.

It can also be divided into acquired and innate. An example of acquired lactose intolerance is the above-mentioned transient intolerance caused by disruption of the intestinal microflora.

Another example is the declining ability of the body caused by age to produce the enzyme called lactase which reduces the body’s ability to break down lactose.

Effective treatment

The basis is the elimination or restriction of lactose intake, i.e., the restriction of milk and dairy products consumption.

However, it should be noted that while some patients tolerate a certain amount of lactose, others require a strict lactose-free diet.

In addition, not every dairy product has a high lactose content. The examples are hard and ripening cheeses and fermented dairy products. The last group of products is even beneficial for people suffering from lactose intolerance.

Nowadays, there are plenty of lactose-free dairy products on the market in which lactose is broken down. In other words, it is not present there.

There also exists a number of plant-based foods that do not naturally contain lactose. Thanks to this progress, people with lactose intolerance are not deprived of valuable nutrients existing in milk and dairy products (e.g. calcium).

Pharmaceutical preparations which contain the enzyme called lactase are another possibility. They help to digest lactose and thus improve the tolerance of milk and dairy products.

Last but not least, probiotics that are able to convert lactose to lactic acid, which is safe for people with lactose intolerance, are very beneficial.

That is the reason why all fermented dairy products or acidophilic products are suitable for people with lactose intolerance.

Effects of probiotics on lactose intolerance

Probiotics are living microorganisms that have a large number of beneficial effects on human health.

They have a positive effect on the intestinal microflora and its renewal, strengthen immunity, lower cholesterol levels in blood and fight diarrhea and constipation.

They also improve the clinical symptoms of inflammatory bowel disease and help to solve food intolerances including lactose intolerance.

The mechanisms of the effect of probiotics on the solution of lactose intolerance are very diverse. For all of them, we will mention at least the following ones:

  • They increase the ability of intestinal microorganisms to break down lactose.
  • They fight bacteria that produce gas from lactose and cause bloating.
  • They regulate the permeability of intestinal cells, i.e., they ensure the proper barrier function of the intestines.
  • They maintain constant and low levels of short-chain fatty acids that can contribute to causing diarrhea and pain when present in high concentrations.

Probiotics can also serve to prevent occurrence of transient lactose intolerance which occurs due to negative changes in the intestines. The reason is their ability to regulate and support the viability of the intestinal microflora and thus restore balance to the intestines.

The sooner the intestines function properly, the faster the lactose digestion returns to normal.

Along with probiotics, you should take vitamins during intolerance, especially B6 which is involved in regulating of activity of intestinal bacteria. Prebiotics are another important component. They support the reproduction and growth of probiotic microorganisms.

The effect of probiotics on lactose intolerance has been studied by researchers in many studies. Individual findings prove the positive effect of consuming probiotics on alleviating the symptoms of lactose intolerance and improving the symptoms of this disease.

If we were to answer the question of whether probiotics are an effective solution to lactose intolerance, the answer would be: They are an excellent dietary supplement that helps to alleviate the negative effects of this disease. We can only recommend them to you.

Author’s note: However, it should be noted that each patient is specific and treatment cannot be standardized. The reaction of the intestine to individual foods, substances or probiotics is individual in each person. The doctor must thus adapt the treatment to the specific person.

Lactose Intolerance by Country 2022 (worldpopulationreview.com)
Definition & Facts for Lactose Intolerance | NIDDK (nih.gov)
Rozdiel medzi alergiou na bielkovinu kravského mlieka a intoleranciou laktózy – ImunoVital
Laktózová intolerancia – príznaky a prejavy – ImunoVital
Lactose intolerance: An update on its pathogenesis, diagnosis, and treatment – ScienceDirect