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Q And A Clearinghouse
3rd Quarter, 1998

Updated October 29, 1998

This page answers the questions that arrived in the third quarter of 1998.

Send your questions to me, Steve Carper, at SteveCarper@CS.com.

Remember, I personally answer all questions that you send me, no matter what. The ones that are of sufficiently general interest get posted here, where I hope they can do the most good.

If you don't spot your question here, be sure to check my Q and A Quick Finder Index.


Q.a. Some years ago a doctor told me citrus fruits contain milk sugar, which experience tells me is the case. Is this information well known? I have never seen any reference to it in the literature.

Q.b. A girlfriend who is LI claims that chicken contains lactose and causes the exact same symptoms for her as a nice big glass of milk. I think she's whacked. Is she?

    a. This information is missing from the literature because there is no foundation to it. Milk sugar is found in milk and nowhere else in nature. The sugar in citrus fruits is fructose.

    b. You bet she is. Lactose comes from milk. Period. But people with LI often have problems with other foods and confuse the symptoms.

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Q. If I take lactose pills or lactose-reduced milk, is this depriving the baby of any needed nutrients during pregnancy or breastfeeding?

    Absolutely not. All that happens is that the lactose, the sugar in milk, is broken down to its parts. This is exactly what occurs in digestion. Your body gets exactly the other nutrients it would otherwise get.

    If lactase pills work for you, then take them as often as needed. If you are still bothered by symptoms, then you may want to try less milk and either increase your consumption of other foods high in calcium or take calcium supplements. But LI will be the least of your concerns.

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Q. Other than cost, is there a problem with using lactase tablets at every meal (or every lunch)? Is there a limit on how many one should take?

    No problems and no limits, although after the first few you're probably not going to get much additional help by taking more.

    For more information on everything lactase, see the Lactase page in the LI Basics section of my web site.

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Q. Is burping a symptom of LI?

    Not normally. The gas almost always comes out the other end. You should have your doctor look at stomach-related problems rather than intestine-related problems like LI.
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Q. I'm at the end of my first week of eating no dairy products to see if I am LI. Can I simplify this work a bit and assume that if the nutrition breakdown shows 0% calcium, that there is no lactose in the product?

    Nope, sorry. Lactose is milk sugar. It has absolutely nothing to do with calcium.

    The only way to tell whether a product is lactose free is to study the ingredients list and make sure that there are no milk products on it. If you aren't sure what all the names for milk products are (and many people don't know that whey is mostly lactose) you should check the Dairy section of my web site and take a look at the various pages there.

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Q. Does being allergic to mother's milk necessarily mean being allergic to cow milk? What's the best way to tell if a 5 month old is allergic?

    As far as I know, no infants are ever allergic to mother's milk itself. The allergy is to something in the milk. It is possible, if the mother is drinking cow's milk, for some of the proteins to filter through into the milk. The cow's milk itself is the true culprit. Of course, some other contaminant may be to blame, anything from corn to onions or about a zillion others.

    The way to tell if an infant is allergic depends very much on the specifics of the allergy. However, in many cases an allergic infant will react with a rash or welt if you simply put a few drops of milk on an arm. In other cases, you will have to notice a pattern of reactions to drinking the milk itself. If you're really concerned, a formal allergy test can be done.

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Q. Do you know any cases in which the intake of dairy products is reduced to zero?

    I have had people tell me that that cannot have any lactose, no matter how small an amount. I think that the condition is rare among people who have lost their lactase-producing ability naturally. However, people who have secondary lactose intolerance -- lactose intolerance that is the result of damage to the intestines -- are more likely to be completely intolerant.

    Damage to the intestines can come in many ways: from medicines, from surgery, from intestinal diseases. If you've ever suffered any problems with your intestines that may have left them damaged, then they may heal in time. Or they may be permanently damaged. Your doctors should be able to tell whether this is the case from your medical history, so if they have not raised this as a possibility, then your problem may be from another cause.

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Q. Do lactose intolerant people get their reactions with an hour of eating the food that they are intolerant to or are the cramping and diarrhea a much longer-delayed reaction?

    I wish I could give you a better answer, but I'm stuck with "it depends." Some people seem to feel the effects right away. At other times, and in other people, it can be delayed several hours.

    However, if you regularly have cramping and diarrhea an hour after every meal with lactose and not after meals that have none, then I'd have to say lactose intolerance is a good bet. In any case, I'm glad you're seeing your doctor. There is a very accurate test for lactose intolerance that your doctor can arrange. Of course, most doctors will try to rule out the more serious diseases with similar symptoms first, so don't be surprised if you're asked to take other tests in the beginning.

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Q. I have recently been diagnosed as Lactose intolerant and have been experiencing tremendous pain in my legs when I am jogging. Is there a relationship and what can I do about it

    As far as I know, there is no relationship between LI and any health symptoms outside the intestines. I would investigate the usual causes of leg pain (shin splints, back inflammation, etc.) before looking to milk as the problem.
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Q. Do you have a list of items that contain casein?

    Unfortunately, I don't have a list, nor do I know of a source. There may be as many as 100,000 individual products found in supermarkets and health food stores, many of them from regional or local sources. And the list constantly changes as products enter and leave the market, and as companies change their recipes. It's just not practical for people who do this as a hobby or a sideline to tackle anything that big.

    All I can suggest (besides reading every ingredients list every time -- it becomes automatic after a while, believe me) is to check with some of the others on the web.

    You might start with looking at my LI Links page for sites with more information about casein.

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Q. Do you think taking lactase artificially in tablet form would induce the body's natural mechanism to decrease its natural production. In other words do I become dependent on this tablet forever?

    There is no evidence that using (or not using) lactase tablets has any effect whatsoever on the body's natural supply of lactase. For most people, the lactase-making ability declines with age. Nothing is known that will slow it down; nothing (other than actual damage to the intestines) is known that will speed it up.

    You may need to use lactase tablets forever, but that is only because your natural amount of lactase will be forever insufficient.

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