Q:
I am lactose intolerant, I had the symptoms for awhile and after talking with a nurse I changed my diet and that has helped. But would it be of any benefit going and getting an actual test (if there is one) or talking more about it with a health care person. I now use soy milk or lactase milk, but it really sucks not eating cheese and cream cheese, do you have any suggestions? And I heard that I may still be able to eat yogurt is this true? Thank you.
A:
Development of lactose intolerance is a normal process in most humans as they age. Incidence is higher in non-whites and in persons of Mediterranean descent, and lowest in persons of northern European descent.
There are tests for the lack of the enzyme "lactase" including the relatively insensitive lactose tolerance test, measurement of exhaled hydrogen after a measured dose of oral lactose, and the "gold standard" which is demonstration of low lactase activity in an intestinal biopsy specimen (biopsy obtained by swallowing a "capsule" that collects the specimen).
Treatment is generally by diet, as you have undertaken. Successful treatment with lactose avoidance tends to confirm the diagnosis without special tests. Yogurt that is fully digested by the lactobacillus bacteria has the lactose in it removed, and so will probably not cause symptoms. Best advice is to eliminate lactose from the diet for a while and, if the symptoms go away, try adding small amounts of foods you'd like to be able to eat, and see whether the symptoms return. Usually you can identify a satisfactory diet to remain on.
Since lactose is an important part of dairy products, which also are a prime source of calcium, be sure to get enough calcium in your diet, especially if you are female, by taking calcium supplements if you maintain a lactose-free diet.
~The Doc
