Why You Get More Lactose Intolerant As You Get Older

Cheese is the ultimate comfort food — well, and ice cream, milk and butter. Is there anything these ingredients don’t make better? Unfortunately for our taste buds, dairy can become harder for our bodies to digest as we age.

If you find yourself unable to drink coffee with heavy cream or eat anything too cheesy without getting sick, then you could be lactose intolerant ― even if you never had a problem before.

Lactose is the natural sugar found in dairy products. According to the American College of Gastroenterology, our bodies rely on a digestive enzyme called lactase to help break down lactose into simple sugars (called glucose and galactose). The small intestine then absorbs these and they reach the bloodstream as nutrients.

If lactose isn’t properly digested, it moves to the colon and is broken down by fermentation. This results in uncomfortable symptoms like abdominal pain or cramping, excess gas, diarrhea and/or the sudden urge to have a bowel movement.

Approximately 75% of the world’s population lose their ability to digest lactose as they get older. We consulted with experts to figure out exactly why this happens, plus some advice on how to deal:

Drinking milk is necessary for our survival…at first.

“As infants, humans produce significant amounts of lactase to digest the lactose found in breastmilk,” said Linna Goelz, a naturopathic medicine doctor at Sonoran University of Health Science. “Historically, once breastfeeding was done and solid foods were introduced, humans no longer consumed lactose-containing food.”

And because humans weren’t eating as much lactose-containing food, their bodies adjusted and naturally began “to produce less and less lactase enzymes over time, which means we are unable to digest dairy properly,” according to Goelz.

This “gradual reduction” of lactase production is called lactase nonpersistence or acquired lactase deficiency. Dr. Janese Laster, a board-certified gastroenterologist and founder of Gut Theory Total Digestive Care, said that this is “a natural process occurring in the majority of humans” after infancy.

You might notice these symptoms as a kid, or they could pop up in adulthood depending on how slowly your body’s production of lactase declines. Or you could be part of the approximately 25% of humans who don’t notice a change at all.

Ask your parents if they became more lactose intolerant with age, and that can give you a clue into your own future. “The ability to digest lactose into adulthood is contingent on the specific gene variants inherited from parents, influencing the level of lactase activity present,” Laster said.

She explained that your body’s ability to break down dairy depends on the person. “While some may struggle with digesting fresh milk, they might find relief in consuming certain dairy products like cheese or yogurt, thanks to the fermentation process that breaks down a significant portion of lactose,” she continued.

Dr. Menka Gupta, a functional medicine doctor at Nutra Nourish, noted that lactose intolerance is more common among people of Southeast Asian, East Asian, West African, Native American and Hispanic descent “because they’re more likely to carry the gene mutation (APvegetOA2, MCM6).” However, it could happen to anyone.

Of course, your gut is complicated, and there can certainly be other reasons why it’s not breaking down dairy products as well as it used to.

“External factors such as gastrointestinal illnesses, accidents leading to small intestine injury, surgeries affecting the small bowel, or conditions like Crohn’s disease can contribute to the development of lactose intolerance,” Laster explained. “After a gastrointestinal illness, there might be a temporary reduction in the body’s lactase stores, impacting lactose tolerance.”

Other things that could cause an increase in lactose intolerance include infections, inflammatory or autoimmune diseases like gastroenteritis, celiac disease, Crohn’s disease, ulcerative colitis, chemotherapy and antibiotics, according to Gupta. These “cause injury to intestinal mucosa, commonly known as leaky gut.”

Although a natural decline of lactase production cannot be reversed, there are ways you can help manage your lactose-intolerance symptoms.

Our experts recommend the following:

• Narrow down which dairy products give you the worst symptoms and eliminate those. Items like hard cheeses, butter and ghee may be easier to digest as they have less lactose than milk or ice cream.
• Limit the quantity of lactose consumed per meal.
• Eat fermented dairy, like probiotic yogurt or kefir, to help break down lactose.
• Avoid other known food sensitivities and allergens. For example, if your stomach is sensitive to hot sauce, then eating it will decrease your lactase production even further and may worsen your symptoms.
• Switch to plant-based, non-dairy products when you can.
• Take probiotics, specifically those with Bifidobacterium, Saccharomyces, and Lactobacillus strains.
• Take a lactase supplement before consuming dairy products to help mitigate symptoms.

Keep in mind that nothing can truly “cure” lactose nonpersistance. “While alterations in the microbiome might enable individuals to tolerate various forms of fermented dairy better, it is improbable for gene expression changes to occur that would substantially elevate lactase activity to levels observed in childhood,” Laster said.

You should always talk to your doctor before starting any new supplements or if you are concerned about your increased lactose intolerance. Gupta said “it is important to find out the cause of your lactose intolerance,” which can be done via various tests.

“Your doctor can recommend appropriate course of action by either removal lactose from your diet or taking steps to improve your gut health,” she added.