Those of us who suffer from lactose intolerance, are deficient in the production of the lactase enzyme in our small intestines. The only way to cope with this problem is to take the enzyme as a supplement. There are different ways to get lactase and many different brands, so what works? What are the best lactase supplements?
Lactase in General
A National Institutes of Health report in the World Journal of Gastrology states that all studies done have found lactase enzyme supplements to be safe and effective. However, there are several things that contribute to or deter from lactase effectiveness.
- Obviously the amount of enzyme consumed will effect digestion.
- Milk pre-treated with lactase is slightly more effective than pills taken with milk.
- How much fat there is in the dairy product has an impact. Whole milk is easier to digest than skim milk; plain yogurt is easier than fat free yogurt; and so on.
- The more non-dairy food consumed with the dairy, the better the digestion of lactose will be–e.g. a bagel slathered with cream cheese would be easier to digest than a bowl of ice cream.
Lactase, in all forms, is artificially made from fungi in a laboratory. This causes some people to question whether it is safe. But severe allergic reactions are rare and consist of itching, rash, dizziness and trouble breathing.
The negative side effects reported from taking lactase are stomach cramps, nausea and vomiting. But since these can also be side effects of lactose intolerance, it isn’t clear if the lactase actually caused these things, or if it was the lactose the person ingested without taking enough lactase to offset the lactose, or if the reaction was to a different ingredient in the tablet of liquid.
A study done in 2010 showed that lactase in soft gel, tablet, or chewable reduced lactose intolerance symptoms of bloating and diarrhea significantly better than the probiotic lactobacillus reuteri, or a placebo. A similar study in 2014 confirmed these results.
Why giving a probiotic, which helps one to digest milk, does not reduce the gas, bloating and diarrhea of lactose intolerance, remains unclear. There is some evidence that long term use of such probiotics can reduce the intolerance, allowing the user to ingest some lactose once again. But this is not a sure result. (I personally tried it with zero positive results.) So if you try probiotics, do not expect a miracle cure.
Plain yogurt is naturally lactose reduced. Yogurt is made of milk fermented by lactic acid bacteria (like aged cheese). The NIH report cited above, explains that when the bacteria break down lactose, during fermentation, they reduce it by 25 to 50%,
However, sweet acidophilus milk (which is unfermented milk with L. acidophilus bacteria added) does not reduce lactose or reduce the symptoms of lactose intolerance. This is because the L. bulgaricus bacteria in yogurt is much more effective than the L. acidophilus bacteria, due the construction of its own cell wall. Also the time for fermentation in sour milk and yogurt allows the bacteria to work, unlike in sweet milk.
Ratings and Reviews
There are not very many useful surveys of various lactase supplements, and there are dozens of different brands!
Webmd conducted a small survey of sixteen users of generic lactase–no brand names mentioned–so that’s not very helpful.
eSuppliments rated the 10 best lactase supplements. Among the top five are:
- Lactaid Fast Act because it’s fast and chewable.
- Kirkland because it’s cheap and effective.
- Schiff Digestive Advantage presumably because it is a lactase supplement plus probiotic. The problem is that it has less lactase per dose than the others. From my personal experience with this product, if you need lactase in a hurry, this is not the product for you; if you want to take something every day with the hope of long term improvement, then this might be a good product.
Gleaning from what I could find on lactase reviews, it seems that Lactaid is the “gold standard” of lactase. Some said house brands were not as effective as Lactaid, (I have personally found this to be true), but one person said Target’s house brand was more effective than Lactaid.
After effectiveness, the most important consideration was cost. Consumer Lab found that price for lactase supplements varied from $.08 to $6.79 for equal amounts of lactase (enough for a high lactose meal), so cost is a major factor to consider. My advice is to know what you are buying. Most of the expensive lactase brands have other digestive enzymes or probiotics added to them. If you don’t need these things, don’t pay for them, or consider if you might actually save money by buying them separately.
Amazon’s ratings of its lactase products (click on this link and type in lactase enzyme into search bar to see them) showed four to five stars on its products. The products included tablets, chewables, capsules and liquid drops.
You need to know your own gut. A food/supplement diary might be helpful in this. Test products to find the one that works for your symptoms, for your budget, and for your life-style.
I hope this article has given you some ideas of where to start. Fortunately most products do work for most people, so hopefully your search will be one of refinement. Best of luck to you!
Please leave me your comments and experiences with lactase.