Lactose Intolerance and Bones

Explore the connection between lactose intolerance and bone loss.

| June 2018

  • People with osteoporosis often feel pressured to eat dairy products, even if they’re lactose intolerant.
    Photo by Unsplash/Kim Gorga
  • "The Whole-Body Approach to Osteoporosis" by R. Keith McCormick will help you address osteoporosis.
    Cover courtesy New Harbinger Publications

The Whole-Body Approach to Osteoporosis (New Harbinger Publications, 2008) by R. Keith McCormick will help you address and prevent osteoporosis. While medication can sometimes help, it won't fully address the underlying causes of your osteoporosis or osteopenia. To restore bone health, you'll need a targeted program combining the best bone-building strategies from traditional and holistic medicine. 

The inability to effectively digest lactose, the natural sugar within milk, is called lactose intolerance. This condition often leads to abdominal pain, gas, bloating, and diarrhea when milk products are ingested. In its less severe form, it is referred to as lactase deficiency and may exhibit no symptoms at all. Both conditions are caused by a shortage in the production of the digestive enzyme lactase. This enzyme breaks down lactose into smaller sugar molecules that can readily be absorbed into the bloodstream. When the lactase enzyme is deficient, lactose sits and ferments in the gut, providing a virtual banquet for hungry gut bacteria.

Don’t confuse lactose intolerance with an allergy to milk. Lactose intolerance is caused by the deficiency of an enzyme needed to digest the sugar in milk, whereas a milk allergy results from an immune reaction to the proteins found in milk. The two most abundant proteins in milk are casein and whey. Although casein is the most allergenic, whey contains alpha-lactalbumin and beta-lactoglobulin, which may also cause allergic responses. Both conditions can cause abdominal pain, gas, bloating, and diarrhea. But milk allergy, unlike lactose intolerance, may exhibit such signs or symptoms as skin rashes, runny nose, ear infections, eczema, and black rings around the eyes (allergic shiners).

Lactose Intolerance and Bone Loss

As with gluten sensitivity, lactose intolerance can also affect skeletal health adversely. To reduce digestive distress, people who suffer from lactose intolerance often avoid calcium-rich dairy products. This, of course, dramatically reduces their calcium intake. But the low bone density seen in people with lactose intolerance is not all due to insufficient dietary calcium. Research led by Dr. Barbara Obermayer-Pietsch (2007) of the Medical University of Graz, Austria, showed that lactose intolerance actually impairs calcium absorption. Also, undigested lactose alters the pH of the digestive tract, which leads to bacterial overgrowth and, you guessed it, inflammation. This, of course, becomes a chronic source of pro-inflammatory cytokines and systemic inflammation if the person continues to consume dairy products.



Causes of Lactose Intolerance

Children can be born lactose intolerant, but this is fairly rare. More commonly, we either see a gradual age-related decline in a person’s ability to digest lactose or a more abrupt, genetically determined loss of lactase production from a condition called adult-type hypolactasia. Lactose intolerance can also develop as a result of long-standing gut irritation. GI disorders such as irritable bowel and gluten intolerance or parasitic infections such as giardia often lead to intestinal permeability, which then reduces lactase production and creates intolerance to lactose.

Testing for Lactose Intolerance

Lactose intolerance is easily identified by simply avoiding dairy products for two weeks, monitoring your signs and symptoms, and then drinking milk. If your symptoms return, it’s a good indication that you’re lactose intolerant. To differentiate lactose intolerance from an allergic response, your doctor may have to order one of the following two tests.

Lactose tolerance test. For this test, you will be required to ingest a lactose-laden drink and then have several blood draws over the next two hours. If you are unable to digest lactose, your blood glucose level, which should ordinarily rise, will remain steady.

Hydrogen breath test. If you’re unable to digest lactose, bacteria will cause it to ferment, which releases hydrogen gas. The gas is absorbed into the bloodstream, carried to your lungs, and then released through capillaries as you exhale. The level of hydrogen in your breath can then be measured.

The Importance of Alternative Calcium Sources

People with osteoporosis often feel pressured to eat dairy products, even if they’re lactose intolerant. I can’t tell you how many times I’ve been asked, “But don’t you eat dairy?” If you don’t produce enough lactase, and 60 to 70 percent of adults don’t, then you should consider excluding dairy from your diet. A recent study (Obermayer-Pietsch et   al. 2007) concluded that individuals with adult-type hypolactasia should eliminate even hidden sources of lactose, such as those found in processed meats, bread, cakes, and drinks, because even small amounts can interfere with the absorption of calcium. If you’re lactose intolerant, you should read the labels on food products.

Although some lactose-sensitive people can tolerate yogurt because its bacteria culture produces some lactase, you’ll still need to find alter- native sources of calcium if you eliminate dairy from your diet.  Eat more high-calcium foods such as kale, broccoli, bok choy, sardines, and soy milk. We’re fortunate because many foods are now fortified with calcium. But even with all of these great sources, if you are lactose intolerant and avoiding dairy products, you’ll need to supplement your diet with calcium.

More from The Whole-Body Approach to Osteoporosis:


Reprinted with permission: New Harbinger Publications, Inc. copyright © 2008 by R. Keith McCormick










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