Lactase is a digestive enzyme involved in the breakdown of lactose, the sugar found in milk and other dairy products. Lactase, produced in the lining of the small intestine, breaks down lactose into smaller sugar molecules (known as glucose and galactose) so they can be digested. If you are lactose intolerant , it is because you cannot make enough lactase on your own.
Taking lactase supplements, available in capsules, chews, and other forms, can reduce or prevent many of the symptoms that can occur when a person with lactose intolerance consumes dairy products, including stomach cramps, diarrhea, and gas.
What is lactase used for?
Approximately 70% of the world's population is lactase deficient, according to a 2019 study published in the American Journal of Clinical Nutrition , with the highest prevalence among people of East Asian, West African, Arab, Jewish, Greek, or Italian descent .
In rare cases, lactose intolerance can occur at birth, a condition called congenital lactase deficiency (LCD). But experts now understand that the gradual decline in the ability to produce lactase after early childhood is a very common human trait and a more common cause of intolerance.
Fortunately, most people with lactase deficiency never develop symptoms of lactose intolerance. But for sufferers, symptoms can range from mild to significant and usually appear half an hour to a few hours after consuming dairy products .
Lactase supplements (taken before meals) can help these people consume more dairy products, allowing them to meet their dietary calcium needs, as well as help them overcome the symptoms of lactose intolerance.
However, there is at least some controversy among patients about the effectiveness of supplements.
Despite the benefits of lactase supplements, little research remains to support their effects. While scientists agree that supplements are safe, there hasn't always been a consensus on how well they work.
According to a 2010 study published in the European Review of Health and Pharmaceutical Sciences , lactase supplementation has shown clear superiority in reducing lactose intolerance compared to the probiotic Lactobacillus reuteri .
A 10-day study in 60 adults showed that a single lactase supplement taken 15 minutes before meals was better able to normalize lactose metabolism (as measured by a lactose breath test) than a 10-day course of L reuteri. Additionally, lactase supplementation was better at relieving major gastrointestinal symptoms, especially gas.
Despite the positive results, a 2014 study from BioMed Research International reported significant variability in response to lactase supplementation. Of the 96 adults who received lactase supplements, only 21.88% showed complete normalization with a lactose breath test, while 17.71% did not respond completely.
This suggests that other factors may contribute to the inability to metabolize lactose or, alternatively, that other types of lactase may be required for lactose metabolism in certain individuals.
Lactase supplements alone cannot directly improve bone health. But because they can help people with lactose intolerance eat more dairy products without any consequences, they can make it easier to consume adequate amounts of calcium. Of course, it can help build and maintain healthy bones, while reducing the risk of bone loss and osteoporosis .
According to a 2019 study published in the journal Nutrients , when people with lactose intolerance avoid or cut down on dairy, they are at risk for bone loss and fractures. But intolerance alone does not significantly affect adults' ability to absorb calcium (the same is true for lactase deficiency).
All people, including people with lactose intolerance, are advised to consume three servings of dairy products a day. Lactase supplements can help you with this.
Possible side effects.
Lactase supplements are considered safe and well tolerated with no known side effects.
However, people with diabetes should be careful when taking lactase supplements. When ingested, lactase breaks down into simple sugars, which can raise blood glucose levels. While this may not cause any major problems, it is important to check your blood sugar 20-30 minutes after taking your dose to be safe.
In rare cases, lactase supplements are known to cause allergic reactions. In one reported case, a woman who took lactase supplements for her children, but never took them, experienced a severe whole-body allergy known as anaphylaxis .
Call 911 or go to the nearest emergency room if you develop hives, rashes, shortness of breath, wheezing, dizziness, dizziness, heart palpitations, or swelling of the face, tongue, or throat after taking a lactase supplement .
If left untreated, anaphylaxis can lead to shock, coma, respiratory or heart failure, and death.
Pregnant or lactating women should not take lactase supplements, as there is insufficient information to guarantee its safety. It is also unknown if lactase supplements can interact with other medications or supplements.
Dosage and preparation
In addition to capsules and chewable tablets, lactase supplements are sold in powder and drop form. They can be safely stored at room temperature in a sealed container. Never use an expired supplement.
The standard dose is 6,000 to 9,000 international units (IU) immediately before a meal that contains dairy products. Others have found that adding 2,000 IU of powdered lactase to two cups (500 milliliters) of milk can help relieve symptoms.
Generally, start with a low dose and gradually increase until desired control is achieved. Although you can't overdose on lactase, taking small doses can lower the impact on your blood sugar and help you save money.
Make sure you take lactase supplements before your first dairy intake. If you eat for more than 20 to 30 minutes (for example, at a picnic or banquet), take another 2000 mg dose with meals to enhance the protective effect.
However, just because you are taking lactase supplements does not mean that you are eliminating dairy products. If you are lactose intolerant, it is important to monitor your intake by avoiding excess cream, cheese, or milk if possible (or at least reducing your portions).
What to look for
Lactase supplements, widely available for purchase online, can be found in many health food stores, drug stores, and supplement stores. You don't need a prescription to buy lactase supplements.
Food additives are not strictly regulated by the US Food and Drug Administration (FDA). To ensure quality and safety, look for brands that are certified by independent third parties, such as the United States Pharmacopeia (USP), NSF International, or ConsumerLab.
Lactase is not derived from dairy, so supplementation is not a problem if you are vegan. However, the coating on which some capsules are composed can be made of animal gelatin. If you are concerned about this, look for products labeled 'vegan'.
Most lactase supplements are made from a compound called beta-galactosidase, obtained from the fermentation of Aspergillus niger or Aspergillus oryzae mushrooms. Beta-galactosidase is often included in broad-spectrum digestive enzyme supplements, including vegan products like VeganZyme.
I have been taking lactase supplements but they don't seem to be helping. Why?
This could be because you're not taking a high enough dose, not taking the recommended amount of time, or consuming more dairy than your body can handle, even with supplements. Some people may just need to completely eliminate lactose.
If you can't control your symptoms with lactase supplements, ask your doctor for a referral to a gastroenterologist or allergist for further evaluation. You may also wonder if you really have lactose intolerance. People often diagnose themselves or their children as lactose intolerant when they are actually allergic to milk .
What are other sources of calcium besides dairy products?
Dairy products are the main source of calcium, but without them, you can get enough calcium. If lactase supplements don't work for you, you can achieve the recommended daily calcium intake of 1,000 milligrams (mg) per day for women ages 18 to 50 and men ages 18 to 70 with the following food sources:
- Stool: 100 mg per cup
- Bok choy: 74 mg per cup
- Fortified whole wheat bread: 30 mg per slice
- Broccoli: 21 mg in 1/2 cup
A daily calcium supplement can also help you meet your needs.
Frequently asked questions
Lactose tablets like Lactaid contain the digestive enzyme lactase, which helps digest lactose, a sugar found in milk and dairy products. People with lactose intolerance do not produce enough lactase to break down this sugar. The addition of the enzyme lactase helps prevent lactose intolerance symptoms.
In rare cases, a very serious allergic reaction known as anaphylaxis can occur. If you have symptoms such as shortness of breath and swelling of the face, tongue, or throat, call 911 or go to the nearest emergency room. Also, people with diabetes should monitor their blood sugar level after taking a lactase supplement, as it can raise blood sugar levels.
Yes, lactase enzyme supplements like Lactaid can be taken every day. In fact, it is safe to take lactase with every meal.