Lactose

Recently, a patient came to see me with a Lactose Intolerance Test that her cardiologist had ordered. After analyzing it, he had informed her that it was “normal”... But it wasn't! Could it have been a distraction? Or perhaps an uncertainty about how to interpret the test? Whatever the reason, the fact is that she, the patient, was consuming milk and its derivatives normally - foods that are bad for her - because of a misinterpretation by the health professional. She was eating these products because a professional failed to inform her of her intolerance. Suggestion: choose your professionals well.

Lactose is a disaccharide sugar found in animal milks such as cow's, goat's and buffalo milk. Vegetable milks, on the other hand, do not contain lactose. A disaccharide is made up of two linked monosaccharides; in the case of lactose, these are glucose and galactose. In a person who digests lactose properly, by having and secreting sufficient quantities of the enzyme lactase (in its normal active form, which breaks down lactose into these two sugars) in the intestines, lactose is broken down into these two simple sugars, and glucose crosses the intestinal barrier, reaching the blood, where it raises blood glucose. In lactose intolerant people, the fermentation of undigested lactose is mainly carried out by harmful bacteria and generates gas, discomfort, poor digestion and absorption of other foods, inflammation, among other problems.

In the Lactose Intolerance test, the fasting patient takes a large amount of lactose in one go and has their blood glucose tested just before ingesting it and then after 30, 60 and 120 minutes. If you're not intolerant, your blood glucose will increase by more than 20 points compared to your baseline. For example, if fasting blood glucose is 80, but 60 minutes after eating lactose it reaches 108, this patient is not lactose intolerant. However, if none of the measurements after ingestion increase by more than 20 points in relation to the fasting value, this means that the patient does not metabolize lactose correctly and is therefore intolerant.

We know that in “normal” people (in terms of lactase production), increases in lactose in the intestines increase lactase production. However, this has a limit, and more and more people are unable to digest milk and milk products properly, even in small quantities. Most adults no longer digest it (more than 60%), and more and more children over the age of 7 are also starting to show lactase deficiency early on. This can lead to a number of problems, including disorders and diseases such as body itches, allergies, malnutrition, mood disorders, reflux, among others.

Understand that not being lactose intolerant does NOT guarantee that milk is not bad for you! This is because milk can be harmful to most people due to several different mechanisms, which usually occur in combination:

• It increases the production of mucus in various parts of the body (airways, sinuses, ears, lungs, vagina, intestines, urinary tract, etc.), which can lead to easier local reactions and inflammation.
• Allergy or intolerance to milk proteins (there are several, the most problematic being casein).
• Lactose intolerance (explained above).

My tip is that you take “more complete” tests at least every year and be accompanied by professionals who know how to interpret them and correlate them correctly with your symptoms and health goals.