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Lactase 1900 A

Also known as: Lactase, β-galactosidase, lactase enzyme, Lactase 1900 A, Lactase enzyme

Overview

Lactase is a digestive enzyme (EC 3.2.1.108) that breaks down lactose, a sugar found in dairy products, into simpler sugars: glucose and galactose. Naturally produced in the small intestine, supplemental lactase is typically derived from microbial sources like Aspergillus or Kluyveromyces species. Its primary use is to aid individuals with lactase deficiency or lactose intolerance, helping to alleviate gastrointestinal symptoms such as bloating, diarrhea, and abdominal pain after consuming lactose-containing foods. Lactase supplementation compensates for insufficient endogenous lactase production, thereby improving lactose tolerance. The efficacy and safety of lactase supplementation are well-established through numerous randomized controlled trials and meta-analyses, making it a widely recognized and effective intervention for managing lactose intolerance.

Benefits

Lactase supplementation offers significant benefits primarily for individuals with lactase deficiency or lactose intolerance. The most prominent effect is a substantial reduction in common gastrointestinal symptoms like bloating, diarrhea, and abdominal pain following lactose ingestion. Meta-analyses consistently demonstrate that lactase supplementation improves lactose digestion, evidenced by reduced breath hydrogen levels, a reliable marker of lactose maldigestion. This benefit is particularly strong for individuals with confirmed lactase deficiency, including those with inflammatory bowel disease (IBD) who may experience secondary lactose maldigestion. While evidence is mixed, some studies suggest it may also reduce crying time in infants with colic linked to lactose intolerance. The effects are acute, occurring shortly after ingestion with lactose-containing meals, and are supported by high-quality evidence, including systematic reviews and meta-analyses, showing statistically significant symptom improvement compared to placebo.

How it works

Lactase functions by enzymatically hydrolyzing the disaccharide lactose into its constituent monosaccharides, glucose and galactose, directly within the small intestine lumen. This process breaks the β-1,4-glycosidic bond in lactose. By cleaving lactose, lactase enables these simpler sugars to be readily absorbed through the intestinal wall into the bloodstream. In individuals with lactase deficiency, this natural breakdown is impaired, leading to undigested lactose reaching the colon and causing symptoms. Supplemental lactase acts locally in the gut, compensating for the deficient endogenous enzyme at the intestinal brush border, thereby facilitating proper lactose digestion and preventing malabsorption symptoms. It is not absorbed systemically.

Side effects

Lactase supplementation is generally considered safe with a favorable safety profile due to its localized action in the gut and minimal systemic absorption. Side effects are rare and typically mild, primarily involving gastrointestinal discomfort if excessively high doses are consumed. Allergic reactions are exceedingly uncommon but could theoretically occur in individuals sensitive to the microbial source of the enzyme. There are no significant reported drug interactions with lactase. It is not contraindicated for any specific conditions, though caution is advised for individuals with known allergies to enzyme sources. Lactase is considered safe for use in special populations, including infants and children, when administered appropriately and within recommended guidelines, making it a well-tolerated option for managing lactose intolerance across various age groups.

Dosage

The optimal dosage of lactase varies depending on the individual's degree of lactase deficiency and the amount of lactose consumed. Typical recommended doses range from 3000 to 9000 FCC (Food Chemicals Codex) units per meal. For larger lactose loads, a higher dose may be necessary to effectively digest the lactose. There is no established maximum toxic dose, and dosing is generally guided by symptom control. Lactase supplements should be taken immediately before or concurrently with lactose-containing meals or beverages to ensure the enzyme is present in the small intestine when lactose arrives. It is available in various forms, including tablets, capsules, and drops, with drops being suitable for infants. Since the enzyme acts locally in the gut, factors like gastric pH and intestinal transit time can influence its activity, but no specific cofactors are required for its function.

FAQs

Is lactase supplementation effective for lactose intolerance?

Yes, numerous randomized controlled trials and meta-analyses confirm that lactase supplementation significantly reduces symptoms of lactose intolerance and improves lactose digestion.

Can lactase be used in infants?

Yes, some evidence suggests lactase can be used in infants, particularly for those with colic linked to lactose intolerance, though individual results may vary.

Are there side effects?

Lactase is generally safe with minimal side effects, which are rare and usually mild gastrointestinal discomfort if very high doses are taken.

When should lactase be taken?

Lactase supplements should be taken just before or simultaneously with any lactose-containing foods or drinks to ensure optimal enzyme activity during digestion.

How quickly does it work?

Lactase acts immediately upon contact with lactose in the digestive system, providing acute relief during the digestion of lactose-containing meals.

Research Sources

https://pmc.ncbi.nlm.nih.gov/articles/PMC4942986/ – This systematic review and meta-analysis by Misselwitz et al. (2016) found that lactase supplementation significantly reduces symptoms and breath hydrogen levels in adults with lactose maldigestion. It also noted a higher prevalence of lactose maldigestion in Crohn's disease patients, suggesting a potential benefit in this subgroup. The study highlights the effectiveness of lactase in improving lactose tolerance.
https://bspghan.org.uk/wp-content/uploads/2024/05/lactase-for-infantile-colic-a-systematic-review-of-randomized-clinical-trials.pdf – Nau et al. (2024) conducted a systematic review of six RCTs on lactase for infantile colic. While three studies showed a significant reduction in crying time, the results were mixed regarding breath hydrogen, and heterogeneity prevented a meta-analysis. The review suggests potential benefits but calls for more consistent research.
https://pubmed.ncbi.nlm.nih.gov/27411934/ – This meta-analysis and review by Szilagyi et al. (2016) explored the link between lactose maldigestion and inflammatory bowel disease (IBD), particularly Crohn's disease. It concluded that lactose maldigestion is associated with small bowel involvement in Crohn's and that lactase supplementation can improve symptoms in IBD patients experiencing lactose intolerance, despite potential confounding factors.