The story of a person with lactose intolerance is very typical. The severity of symptoms varies depending on the person's ability to tolerate lactose.

The tolerance threshold varies from individual to individual, symptoms can appear in many forms, and generally, in most of our patients, these complaints begin within a period of half an hour to 2 hours, appearing anywhere between 3 minutes and 72 hours after lactose is consumed.

The main complaints described by patients are: 

• Increased bowel movements
• Gas
• Weakness
• Diarrhea
• Abdominal cramps
• A feeling of fullness in the abdomen
• Nausea
• Edema
• Formless stools
• Bloating

However, there are tests used to determine lactose absorption. These are:  

• Lactose tolerance test: After 12 hours of fasting, a liquid containing lactose is drunk. Blood samples are taken at 2-hour intervals. The levels of galactose and glucose, which should rise in the blood after lactose absorption, are measured. If lactose is not fully broken down, blood glucose levels do not rise, and this indicates a need for treatment.

• Hydrogen breath test: The amount of hydrogen in a person's exhaled breath is measured. There is normally a very low amount of hydrogen in exhaled breath. When lactose is not digested, it is fermented by bacteria found in the large intestine. As a result, various gases, including hydrogen, are released. The hydrogen gas that forms is absorbed from the intestines, enters the blood, and is expelled through the lungs. During the test, after patients drink a liquid containing lactose, their breath is analyzed at regular intervals. A rising hydrogen level indicates that lactose digestion is impaired.

• Stool acid test: Fermentation occurs in the intestines due to undigested lactose. In this case, it is natural for the intestines to accumulate lactic acid. Over time, this lactic acid is expelled naturally along with stool. If a higher-than-normal amount of lactic acid is found in the stool test, this means there is a suspicion of intolerance in you.

• The electroacupuncture method (Vegatest) and HRV systems (Reviquant, ProQuant): These are the tests that are easiest to apply in practice.

TREATMENT OF LACTOSE INTOLERANCE

The treatment of lactose intolerance would seem very simple: avoid all products containing lactose. But how practical is this in daily life?

Hidden lactose is present in many foods prepared and offered to us by the food industry. In other words, this is not just about dairy products. It is found in numerous products such as milk sugar, biscuits, chewing gum, sausage products, powdered sauces, sauces, instant soups, sweeteners, and nut butters.

Dietary supplements and even many medications are processed with lactose as a carrier!

The holistic and regulation medicine approach is to repair the damaged intestinal mucosa, rebuild the gut flora, and help the body produce its own enzyme.  

The main treatment principle for people with lactose intolerance is to keep all foods containing lactose out of the diet for periods that vary depending on the type of intolerance. In the primary form, lactose-containing products need to be removed from the diet for life; in the acquired form, the amount should be restricted with age; but if it is secondary to an illness, lactose-containing products should be prohibited until the underlying illness is treated. This is most commonly seen in lactose intolerance developing due to gut flora imbalance, where milk, dairy products, and lactose-containing foods need to be strictly removed from the diet for a minimum period of two to three months.

In my clinical experience, I have observed that lactose intolerance appearing in adulthood is most often underlain by past chronic infections, the presence of intestinal parasites, and secondary autoimmune diseases of the digestive system. To be successful, these underlying conditions must be treated. One of the most important precautions is initially rebalancing the microbiological environment and, if necessary to rebuild the gut flora, cleansing the intestines through colon hydrotherapy. 

As long as people with lactose intolerance continue to consume milk and dairy products, they trigger inflammation. By applying neural therapy together with individually tailored probiotic, prebiotic, enzyme, and orthomolecular support aimed at regulating the gut flora, we can have a major effect on the intestinal structure, both reducing existing inflammation and initiating physiological tissue-building processes.

In my personal experience, these microbiologically active preparations that we recommend for overcoming lactose intolerance usually need to be taken intensively over a longer period. A certain amount of willingness and discipline is essential on the patient's part to be successful. Depending on the severity of the intestinal complaint, in addition to these basic medications, special organ preparations that can particularly strengthen the building process are also used.

In individuals with long-standing gut flora imbalance, we also observe dysfunction of the liver, gallbladder, and pancreas. The detoxification and strengthening of digestive glands such as the liver and pancreas is particularly important. 

During the period when problematic products are avoided, we use, in parallel, neural therapy for regulation treatment, elimination of an underlying interference field center if present, correction of the gut flora that has developed in adulthood, and, since we have observed that probiotic support alone is not sufficient for this, orthomolecular support, phytotherapy, and microbiological treatments. How to return to a normal diet should then be shaped through follow-up checks.

In severe forms, daily intake is limited to a maximum of 1 to 2 grams. In infants with congenital lactase deficiency, neither breast milk nor lactose-containing substitute milk should be given, as serious developmental disorders could otherwise occur.

Since the tolerance threshold differs in each person, and many people can consume small amounts of lactose, a completely lactose-free diet (maximum 1 g/day) is very rarely needed. Generally, a low-lactose diet (maximum 8-10 g/day) is sufficient. In contrast, healthy adults can consume 20-30 g of lactose per day.

Prefer yogurt instead of milk.

We can define lactose products in three categories:

• Products made from milk powder
• Lactase enzyme added into milk
• Plant-based products (soy, almond, coconut, etc.)

The most common types are products with lactase enzyme included in dairy products and products made from milk powder. There are many lactose-free dairy products on the market. During the production process, the lactase enzyme is added with the aim of breaking down milk sugar (in other words, pre-digesting it). Lactose-free products are sweeter than other dairy products.

WHICH ADDITIVES CONTAIN DAIRY PRODUCTS

No additive (E-numbers) contains milk protein or any other milk component. When we say milk components, we are always talking about milk powder, casein, whey, whey powder, yogurt, yogurt powder, and similar substances. For this reason, it is most ideal to give up all ready-made products.

Dr. Hüseyin NAZLIKUL,  M.D.,  PhD.
IFMANT = President of the International Federation of Neural Therapy
President of the Scientific Neural Therapy Regulation Association