Lactose intolerance in connection with histamine intolerance

This combination is quite a challenge and can make everyday life considerably more difficult. Approximately 14% of the German population suffers from lactose intolerance. Globally, around 70% of people are lactose intolerant. In many countries, this is perfectly normal. What does lactose intolerance mean, and where does this condition come from?

How can I tell if I am lactose intolerant?

Being lactose intolerant essentially means that you don't tolerate milk sugar, also known as lactose, well or at all. But how can you tell? There are typical symptoms that many people with lactose intolerance experience after consuming lactose-containing foods. Some of these symptoms even resemble those of histamine intolerance. These symptoms include:

• Flatulence
• nausea
• Stomach ache
• Diarrhea

The first signs of lactose intolerance usually appear 15 minutes to 2 hours after consuming lactose-containing foods. However, in most cases – unlike histamine intolerance – the symptoms only affect the gastrointestinal tract. The severity of the symptoms ultimately depends on the degree of the intolerance. But what exactly determines this?

Lactose intolerance testing: Lactose intolerance is tested using a hydrogen breath test. You can have this done, for example, by an internist.

What happens in the body in cases of lactose intolerance?

To determine the causes of lactose intolerance, it's essential to first understand how lactose metabolism works in the body. Normally, lactose is broken down in the small intestine and then further metabolized. However, in cases of lactose intolerance, the body cannot properly break down lactose because the enzyme responsible for this breakdown, lactase, is either not present in sufficient quantities or is completely absent.

If this is the case, the lactose is not broken down by lactase in the small intestine, but is later consumed by the bacteria living in the large intestine.
This so-called fermentation process produces gases and other substances that can then lead to the typical unpleasant symptoms.

The possible causes

There are two forms of lactose intolerance, which differ in their severity and treatment options. Primary lactose intolerance is usually caused by genetics. This form is present from birth and is significantly less common than the secondary form.

Secondary lactose intolerance is often caused by intestinal issues and can frequently be alleviated or resolved. Causes include:

• Intestinal infections (viruses, bacteria, parasites)
• chronic inflammatory bowel diseases (IBD), such as ulcerative colitis, Crohn's disease
• Celiac disease

We would like to show once again that most forms of food intolerance do not "just happen" , but are often the result of another problem in the body that you should definitely address.

Which foods contain lactose?

When shopping in the supermarket, it's sometimes not so easy to figure out where lactose might be hidden. That's why we've put together a short list for you.

So what should you avoid eating if you have lactose intolerance? The following foods contain lactose – either naturally or as an additive:

• Milk from all animals (cow, sheep, goat, buffalo, etc.)
• Cheese from all animals, with the exception of some goat and sheep cheese varieties (these are then declared accordingly as "lactose-free")
• Butter and margarine
• all products containing milk powder (e.g. vanilla pudding, caramel candies)
• Ready-made products, such as instant meals, instant mashed potato powder, frozen vegetable stir-fries, etc.
• Sausage products, such as liverwurst, canned sausages and especially reduced-calorie sausage products
• Protein concentrates (sports nutrition)
• Additives to medications

Many products containing lactose can also be problematic for people with histamine intolerance, depending on the severity of the condition! Highly processed convenience foods, in particular, should be avoided, as they often contain additives and a whole host of other ingredients. If you suffer from both histamine and lactose intolerance, you need to pay special attention to which foods your body can tolerate.

Treating lactose intolerance - Lactose-free forever?

The treatment for lactose intolerance depends primarily on whether it is genetically determined or not. If the body produces too little lactase due to genetics, it is advisable to live as lactose-free as possible. While lactase supplements can certainly alleviate symptoms, the goal should be to avoid putting any strain on the body in the first place.

In the secondary form of lactose intolerance, the tolerance for lactose can certainly increase again if the underlying causes are addressed.

Sources

1. https://www.zora.uzh.ch/id/eprint/13122/1/04_Laktoseintoleranz_2.08V.pdf
2. https://www.ernaehrungs-umschau.de/fileadmin/Ernaehrungs-Umschau/pdfs/pdf_2010/03_10/EU03_2010_markt_produkte.qxd.pdf
3. https://www.uniklinik-duesseldorf.de/fileadmin/Fuer-Patienten-und-Besucher/Kliniken-Zentren-Institute/Institute/Institut_fuer_Allgemeinmedizin/Forschung/Publikationen/070312_MD_2012_ZH-final-1.pdf
4. https://www.sge-ssn.ch/media/merkblatt_ernaehrung_und_laktoseintoleranz_2013_21.pdf
5. https://www.oege.at/index.php/bildung-information/diaetetik/allergien-unvertraeglichkeiten/55-bildung-information/diaetetik/allergien-unvertraeglichkeiten/1810-laktoseintoleranz