Member Case Study: Lactose Intolerant?

author : AMSSM
comments : 1

Question from Sassafrass - Lactose Intolerant?
I've got symptoms similar to what I've read can occur from lactose intolerance, visited the doctor, where she tested my thyroid (waiting on results), suggested that I avoid dairy/lactose for the next couple of weeks, and see what happens. She also suggested putting me on a medicine, which I've forgotten the name, but starts with an L, because I'm visiting the bathroom 4-5 times or more a day, plus vomiting/nauseous on several occasions (I'm not taking it yet).

I'm kind of freaking out about not being able to have dairy-one, because I love it, I eat/drink milk, yogurt, ice cream, cheese alot...., and two, because I know I get nutrients/vitamins from the dairy, and don't want to become deficient in something...

So, my question is, how do you deal with your lactose intolerance, what do you eat throughout the day, for snacks, etc....how do you deal with it? I've tried 8th Continent soy milk-it doesn't taste good, but I forced myself to drink it for the calcium, etc . Also, I just started taking a calcium supplement.

And, second question, if it's not lactose intolerance, anyone else have an idea what it might be?

Answer

Michael A. Yorio, MD - I’ll start with your second question first and say that without taking a history and examining you it’s hard to say what else it could be. There are too many other causes of diarrhea, nausea and vomiting to list here so you may want to discuss with your physician why he/she came up with the diagnosis of lactose intolerance for you. 
 
That being said, lactose intolerance occurs because of the body’s inability to break down a specific sugar found in dairy products called lactose. Our bodies break down lactose in the intestines with an enzyme called lactase into simple sugars that can be absorbed into your body. If the enzyme is not present or reduced, the body cannot break down lactose and a cascade of events occur that can cause bloating, diarrhea, and pain in your belly. This will occur after drinking milk or other lactose-containing foods. Usually ingesting less than 8 oz of milk per day will be tolerated if you are lactose intolerant, but everyone is different. Sometimes lactase-containing medications can be used to assist your digestion of dairy products. The key nutrients that need to be replaced are calcium and vitamin D. The calcium supplement is a great idea, and you can also use fruit juices fortified with calcium, fortified cereals and spinach. Your goal should be 1200 mg of calcium a day. A daily multivitamin should fulfill your requirement for vitamin D. 
 
Most of the time lactose intolerance runs in the family, but there are some medical conditions that can cause lactose intolerance. These conditions can cause changes at the surface of the intestines, which can lead to a loss of the enzyme lactase or an increased irritability of the intestines and lactose intolerance. These conditions can be specific infections in the intestines, inflammatory conditions affecting the intestines, autoimmune conditions, and irritable bowel conditions. 
 
 
Michael A. Yorio, MD
ProHEALTHCare Associates
Lake Success, NY

Mark Snowise, M.D. - You will have your answer about lactose intolerance within two weeks of stopping dairy. If your symptoms persist, you likely do not have lactose intolerance. Usually we do not see a lot of vomiting with lactose intolerance. The symptoms are mostly bloating and diarrhea. Your symptoms could be anything form a simple infection to celiac spru (gluten allergy), Stomach ulcer or general inflammation (gastritis), irritable bowel or inflammatory bowel. If your symptoms do not improve with cutting out dairy you should see you primary care doctor.

If you do have lactose intolerance dietary modification will help and you can take Lactaide if you will be having anything with dairy products in them. You should be able to get adequate calcium if you take a supplement. Taking a combination of calcium along with vitamin D is the best way to go. The usually dosing is 1200mg of calcium daily with 800IU of Vitamin D daily. If these are taken in divided doses with food the calcium will be much better absorbed. Make sure that that you are taking in adequate protein from chicken and fish. You will not miss out on other nutrients, and if may even benefit from cutting down on the fat intake in ice cream and cheese.

Good luck

Mark Snowise, M.D.

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date: July 3, 2006

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AMSSM

The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

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The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

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