Can't Tolerate a Bit of Lactose. Really?

Vicky Ferguson's food column in the Grand Rapids Press tackles a lactose intolerance issue.

A friend says she has lactose intolerance. She insists she cannot tolerate even the least bit of milk in food. She can't tolerate cheese but says she's OK after eating frozen yogurt. How could it be?

How could it be, indeed?

I often get people who tell me they are sensitive to any amount of lactose, no matter how small. Often these people say they can detect the lactose used as a filler in a single pill, a tiny amount by any standard.

I have to believe them, since I'm not in their bodies. Undigested lactose is fermented by the bacteria that live in the large intestine, so it's possible that even a normally tiny amount might set them off.

But eating frozen yogurt without any problems?

That's odd. Yogurt is known for being auto-digesting. That is, the active cultures in yogurt manufacture enough lactase to digest the lactose that is in the yogurt.

Getting active cultures in frozen yogurt is much harder. Cold knocks out the cultures, making them non-active. Some frozen yogurts do a better job than others of adding more cultures to the product so that they will activate in the warmth of your system. Maybe the questioner's friend has found a brand that is especially good at this.

Still seems odd.

Ferguson fumbles around with a general answer that doesn't do much to address the real issues, but has a good point when she writes:

Perhaps your friend has more going on than lactose intolerance, such as irritable bowel syndrome. If that is the case, there could be a lot of bothersome foods, such as higher-fat spicy foods, raw foods, etc. It can be difficult and frustrating to pin down which food caused which symptom.

Very true, and very frustrating.