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Questions Even I Couldn't Answer

Updated January 15, 2000
All right, I admit it. Every once in a while I get a question even I can't answer.

Usually that's because somebody writes in with a symptom or a reaction that I've never heard anyone else mention.

But just because it's new to me doesn't mean that others of you haven't undergone exactly the same thing. The collective life experience of a million people is always greater than any one.

If you can shed any light on these, send a response to me, Steve Carper, at SteveCarper@CompuServe.com.

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


Q. Does LI affect the color of stools in children? MY 15 month old will have green stools then after about 3 weeks it will return to normal.

    I'm pretty sure the answer is no, because I can't ever remember running across anything like this - and I would definitely remember green stools. The only distinctive feature I can find is that they would be greasy and foul-smelling. However, so many other things are different for children that young that I am hesitant to rule out a color change. Talk to your pediatrician. An LI test can easily be performed. If you don't get satisfaction, try to talk to a pediatric gastroenterologist.
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Q. About 1 1/2 years ago my son, now eight years old, started having night terrors. He usually can drink milk and eat ice-cream in the morning and sleep okay at night. Can you tell me anything more?

    You are the first person out of the hundreds who have contacted me ever to have used the words "night terror" in conjunction with LI, so I really don't have anything to say about it. I've never seen any such connection in the medical journals either. But I honestly doubt that lactose has anything to do with it.
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Q. For several months I have been using a product bought in General Nutrition Stores called Natural Brand Milk Digestant. Each tablet contains: Lactase 25mg, Rennet 2mg. What is the rennet, which I assume is ground up animal stomach, doing?

    Rennet is the enzyme that coagulates the curd (protein) in cheesemaking. I don't have the foggiest idea of what conceivable use it would have in the digestive tract. Health food stores love adding other enzymes to inadequate amounts of lactase. However, since you also say that these pills work for you, I would just use them and not worry about it.
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Q. Has there ever been any studies on milk and attention deficit?

    I'm not aware of any, but I focus very strictly on lactose intolerance and not milk allergies, where any discussion of this subject would likely be. If anybody knows more about this subject, please let me know.
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Q. Have you ever heard of a lactose intolerance that is worse during the summer? Every summer, I go through a month or two of horrible gas when I consume milk products. The rest of the year my symptoms are much more mild.

Q. Do you know of any connection between chronic fatigue (ME) and lactose intolerance?

    I have to give the same answer to both of these questions.

    I have never run across any reference to a connection in any medical journal article. That doesn't necessary mean that no connection exists: that's not the sort of thing that doctors in the LI field study. But I can't think of any mechanism that would create a connection either.

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Q. I was wondering about freeze dried Acidophilus (500mg). Is this effective with the problem of lactose intolerance? Is it as effective as Lactaid?

    Reports vary. What live cultures do is reduce your symptoms because less gas is produced. They will not prevent some of the other problems, like the excess water that enters your intestines. Several people have given me glowing reports about acidophilus pills, but I don't know if the freeze-dried version will work just as well. Have people out there tried some? Please let me know.

    Lactaid (or any other lactase pill) probably works better on the great majority of people, as long as it is taken correctly. For more info about lactase, look at the Lactase page in the LI Basics section of my web site.

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Q. If I can digest one slice of cheese fine (but no more than that), how long do I need to wait before I can eat another slice of cheese without taking lactaid?

    Excellent question! (This is what people say when they don't have a clue to the answer.)

    All I can say is that your body is continually manufacturing a supply of lactase. As long as you don't overwhelm that supply, you're fine. Digestion is a slow process and it takes several hours for the food to leave your stomach and go through the intestines.

    What does this mean in practice? That you have a lactose threshold. You can eat up to that threshold without symptoms. There is no way of knowing what that threshold is without a lot of trial and error. (And even then, there are a million other factors involved. Look at the Lactase page in the LI Basics section of my site.)

    You should be safe if you don't have lactose from one meal to the next, since that gives your intestines time to clean out. If you nibble constantly on foods that contain lactose, however, you may find you have a problem.

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Q. I'm seeking information linking back pain to lactose intolerance. Have you seen any documentation of this?

    Sorry, but I've never seen anything on this. There are some people who may attribute back pain to a milk allergy, however, but I have nothing concrete on that either. You may want to search some milk allergy sites to see if you can find anything on the topic. Look on my LI Links page.
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Q. I love milk. I love milk products. But now that I quit smoking I can no longer digest them. Do you think it is possible for the cigs to cause this?

    I admit it; yours is the first time I've ever heard anyone suggest a connection between smoking - or stopping smoking - and LI. You seem to be doing the right thing, and a trip to the doctor is probably a pretty good idea about now. In the meantime, take plenty of those lactase tablets. They really do help.
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Q. My main symptom seems to be horrible, searing heartburn that can stop me in my tracks. There is some intestinal gas as well, but that is not the main problem. Can you shed some light on what might be going on? Is there something we're missing? Or is this just another variation on the LI theme?

    Let's recap. The normal symptoms of lactose intolerance are produced by undigested lactose being fermented by bacteria in the colon. That's a long way away from the stomach.

    Digestion is normally one way, but occasionally there is a backing-up, or reflux, of material. Heartburn is the best known example of this.

    Heartburn can have many causes, but none of them that I know of have anything to do with lactose. Few people realize that fats and chocolate, along with smoking and certain drugs, can cause the esophageal sphincter to leak. When you add that to coffee and alcohol, both of which stimulate acid production in the stomach, you have a huge range of common substances that can cause the problem, or at least make it worse.

    So I'm stumped. And I need to hear from you. Do other people out there combine symptoms of heartburn with the more usual ones of LI? Does anyone has an explanation of how lactose could contribute to heartburn? If you do, please e-mail me. I'd like to get to the bottom of this mystery.

And here's one person's response:

    I am severely lactose intolerant. The first thing that happens when I eat (or drink) something containing lactose is a nasty stomachache (you could call it heartburn). The stomachache persists until the lactose has cleared my system. Other lactose-intolerant family members have the same symptoms.

    I don't know if this is helpful, but your questioner might want to know he/she is not alone.

And a second's:

    I also get severe heartburn from dairy products, though I usually don't feel it for 2-3 days (this depends on how much dairy intake I have). I've found that I can tolerate low levels of dairy, sporadically. But if I have more than an ounce of cheese (or dairy) for a couple of days in a row, the heartburn sets in. It usually occurs at night (though not always) and I am literally up in pain most of the night.
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Q. I have noticed over the years that the severity of my LI waxes and wanes with the amount of physical activity I do. I recently started working out 4-5 days a week and noticed about a week or so afterward that the LI was "gone". I also noticed this several years ago when I was cycling about 20-25 miles a day for 4-5 days a week. Have there been any studies linking physical activity to a significant reduction in LI?

    No. Amazing as it might seem, long-term studies of individuals with LI are unknown in the medical literature. It's too bad, because we could probably learn 100 times as much from them as from the silly little drink-a-glass-of-milk-and-see-what-happens studies researchers have been doing for 30 years.

    Admittedly, it's much harder and far more expensive to study a group over a long period of time. And LI is not so serious that it rates a priority over doing a longitudinal study of the causes of heart disease, e.g.

    Still, I've been complaining for years that the medical community knows everything about LI except what's important to those who have it -- how to best live with it.

    While I'm off in a corner grousing, my only form of exercise, has anyone who does the real thing had the same experience of feeling fewer symptoms while exercising regularly?

    I recently received an e-mail from someone who told me that running increased his intolerance, exactly the opposite effect. I'm still waiting to find anything in the medical literature that might explain either case.

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Q. Do you know of any relationship between acne and being lactose intolerant?

    First, some necessary definitions. Milk allergy and lactose intolerance are totally different things. Lactose intolerance (LI) triggers gastrointestinal problems because the milk sugar, lactose, is not being digested. Milk allergy, on the other hand, is the reaction to the protein in milk, a reaction that often causes the skin to break out.

    So, no, there is no relationship between LI and acne. Could this person be suffering from a milk allergy instead? It's possible, although I can't find any mention of acne as a symptom in the material I have here. Lots of other skin reactions, including hives, rashes, dry skin problems of all sorts, but not acne specifically.

    All I can say is, go to a dermatologist or allergy specialist for a better answer.

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