The most important point in the treatment of lactose intolerance is, of course, the avoidance of products that contain lactose. Which products will contain how much lactose depends on the type of production method (also see article "What foods contain lactose?" or the tables in the download area)
Lactose should be completely avoided in the first 4-6 weeks after the diagnosis (lactose, but not milk protein itself!), in order to grant the intestine a phase of regeneration. Then you can start with the slow introduction of small amounts. Everyone has to establish for themselves just how much lactose they can tolerate!
Special attention needs to be paid to the amounts of hidden lactose in ready meals, bread and sausage products! During this phase it would be best to talk to a qualified dietician who can assist you during these weeks.
The enzyme lactase, which breaks up the milk sugar, can be bought in the form of enzyme supplement tablets and taken with the meal. These supplements are usually quite costly, but they will make it possible to visit a restaurant or accept an invitation to go for a meal without running into further trouble.
Care needs to be taken by those 75% of lactose intolerant patients who also suffer from fructose malabsorption. Some of these lactase supplements will contain additives, such as sugar alcohols like sorbite, which in turn will cause the worsening of fructose malabsorption! In 2008 some pharmaceutical companies (in Germany and Austria) reviewed their procedures and all supplements in this area are now being offered without sugar alcohols. In the U.S. some products still contain such additives.
So: Always read the table of contents before you buy a lactase supplement at the pharmacy!
The description of the amount of lactase in lactase supplements is described with a unit that is not familiar to the average consumer: FCC
This means: Food Chemical Codex. This is a unit that describes the purity of substances in food chemistry. The FCC was developed in the USA at the end of the 50ies and was first published in 1966(1). In the lab 1g lactose is broken down by 200 FCC. In your body you will need some more FCC.
Rule of thumb: 1g lactose is broken down by around 1000 FCC lactase.
These amounts differ, however, depending on the individual! It is better to take too much lactase rather than too little!
Occasional dietary mistakes are not harmful (just very uncomfortable). Since milk is an important source of calcium it is advisable to talk to your doctor or a qualified dietician about alternative sources of calcium (e.g. fizzy tablets). Here, too, it is very important to read the table of contents!
Portal for food intolerance (german)