Are You Really Lactose Intolerant?

By Scott Tindal


When clients can't lose those unwanted pounds or if they experience digestive issues like bloating, irregular bowel movements, pain, or discomfort, they often suspect they are lactose intolerant. Lactose intolerance is a real condition and its prevalence is dependent upon your genetics. However, it is important to distinguish between primary lactose intolerance, which is typically inherited, and secondary causes of lactose intolerance. (1) Secondary causes of intolerance, such as celiac disease, infectious enteritis, or Crohn’s disease, can cause lactose to not be digested fully by the body. (2)


If you are lactose intolerant, you have identified a direct connection between lactose intake from dairy products and symptoms including discomfort, diarrhea, constipation, bloating, skin irritation, and cramping. A lactose allergy, although similar, will cause more severe symptoms and can lead to vomiting, malabsorption of nutrients, and blood in your stool. If you think you might have a lactose allergy or intolerance, you should immediately contact your doctor or allergy specialist to guide you through testing and removing these foods from your diet.


That said, if you are allergic to lactose or have a lactose intolerance, it will not prevent you from losing body fat. Weight gain is an energy imbalance issue, meaning that you are consuming more food and fluid than you are using. Even if you switch to a dairy-free diet, without changing your other dietary habits, you will likely continue to struggle with weight loss.


If you believe you have an allergy or intolerance, removing lactose from your diet is the best first step. Consider following the steps listed below to determine if lactose is to blame for your symptoms and discomfort or if a broken gut is actually the underlying issue behind your unexplained symptoms of GI distress and weight-loss plateau.



First, is your gut to blame?

The gut is home to trillions of living organisms that help to regulate digestion, inflammation, immune response to food and pathogens, and even emotional health. When the gut microbiome is caught in a dysbiosis (bacterial imbalance), it can lead to chronic inflammation, unexplained GI distress, increased illness, skin irritation, and a variety of other issues. These symptoms can happen randomly and lead you to believe that you have an unidentified food allergy or intolerance. Healing your gut may be the answer to restoring normal digestion and relieving discomfort.


Gut health is a journey, and an elimination diet is a great way to start the healing process while also helping you to identify a potential lactose intolerance. Although an elimination diet takes dedication and patience, it is the ultimate way to repair the gut and identify foods that are causing discomfort.


Finally, if you are ready to go all in on healing your gut and identifying food intolerances, consider testing the health of your gut with the Ixcela gut health test. The Ixcela test will not tell you which foods you are sensitive to, but it can help you to better understand the status of your gut health and offer personalized recommendations to improve your gut so you can start feeling better.


Test Your Gut



Starting an Elimination Diet

An elimination diet removes all potential irritants from the diet for three to five weeks and then slowly reintroduces one food at a time to help identify food sensitivities or intolerances. This time also allows your gut to heal and restores the beneficial bacterial community living in your gut. If you are confident that dairy is the food causing your discomfort and other symptoms, start by eliminating dairy and continue your normal diet. If you find that the discomfort continues, consider following a stricter elimination diet like the ones outlined in the article, Which Foods Are Causing Your Discomfort? A Test Might Not Be Able to Tell You.


During the elimination diet, you should consider recording your sleep quality, mood, energy, digestion, and bowel movements. Consider starting a food journal to capture information about your daily intake and the positive or negative symptoms that you experience.



Reintroduce

Once you have tried a lactose-free diet for three to four weeks, reintroduce a small amount of dairy (less than one serving) after week five to reassess your signs and symptoms. If no symptoms occur, try a different variety of dairy like one full serving of milk, cheese, or yogurt at the start of week six. Try this for two or three days and monitor changes. Everyone is different. Some dairy-intolerant individuals can tolerate plain, fermented dairy products or hard cheeses, but not soft cheeses, whole milk, or ice cream.

To avoid excessive intake leading to discomfort from fullness, it is important to include the proper portion size of dairy foods. As you introduce dairy, practice mindful eating techniques and assess for fullness. If you find that you are able to include a small amount of dairy without any discomfort, you do not have a dairy intolerance.

However, if eating a small amount of dairy leads to discomfort, bloating, diarrhea, chronic constipation, pain, or skin irritation, repeat the elimination process and consider avoiding dairy products. Contact your doctor or an allergy specialist if you experience severe symptoms for longer than four hours.


Take-Home Message

Lactose intolerance is a real issue for many people and its degree of severity varies case by case. It can adversely affect your gut and produce symptoms of discomfort, but it is unlikely to be the cause of weight gain. Resolving an intolerance will probably not help with losing body fat, but it can help you start feeling better and therefore have the motivation to start a wellness journey. If you follow the steps above and find that you have an intolerance, stick with a lactose-free diet and continue to avoid any foods that cause discomfort or negative symptoms.

For more information about how to pinpoint potential food intolerances and allergies, check out the article, Which Foods Are Causing Your Discomfort? A Test Might Not Be Able to Tell You.


Resources

  1. “Lactose Intolerance - Genetics Home Reference - NIH.” U.S. National Library of Medicine, National Institutes of Health, ghr.nlm.nih.gov/condition/lactose-intolerance.
  2. Mattar, Rejane, et al. “Lactose Intolerance: Diagnosis, Genetic, and Clinical Factors.” Clinical and Experimental Gastroenterology, Dove Medical Press, 5 July 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3401057/.



About Ixcela

Photo: Jessica Petrucci

Ixcela helps individuals measure and improve their internal wellness. Using a simple pinprick blood test, Ixcela measures key metabolites and then makes personalized recommendations to improve gut health through exercise, dietary habits, and supplements.