Lactose Intolerance: Complications

The following are the most important diseases or complications that may be contributed to by hereditary lactase deficiency:

Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93).

Malabsorption syndrome – wide spectrum of disorders resulting from impaired absorption of substrates from the intestine (see below).

Musculoskeletal system and connective tissue (M00-M99).

Osteopathy – bone diseases

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).

Failure to thrive

The following are the major diseases or complications that may be contributed by secondary lactase deficiency:

Mouth, esophagus (food pipe), stomach and intestine (K00-K67; K90-K93).

Dysbiosis
Malabsorption syndrome – wide range of disorders resulting from impaired absorption of substrates from the intestine (see below).

Musculoskeletal system and connective tissue (M00-M99).

Osteoporosis (bone loss)

In people with primary lactase deficiency, due to low enzyme activity, lactose ingested via milk and dairy products, consumed in small amounts, cannot be broken down into the two monosaccharides glucose and galactose. Depending on the extent of the lactase deficiency, more or less lactose passes into the bacterially colonized large intestine. There, lactose is broken down by bacteria to lactic acid, acetic acid, carbon dioxide and hydrogen. The bacterial breakdown of the lactose molecules into smaller molecules results in an increase in osmotic pressure and thus an influx of water into the interior of the intestine. In addition, the cleavage products formed during breakdown, especially low-molecular-weight acids, have an irritating effect on the intestinal mucosa and increase the contraction waves of the smooth muscles of the intestine (peristalsis ↑).Finally, the increase in peristalsis and the influx of water into the interior of the intestine lead to the clinically typical symptoms associated with disaccharidase deficiency.Patients with constantly watery diarrhea have an increased need for fluids and vital nutrients (micronutrients). In particular, they lose high amounts of water-soluble vitamins and electrolytes. In addition, the individual vital substances (micronutrients) are less easily absorbed due to the reduced retention time in the intestine. Affected individuals should pay attention to increased fluid intake and a high intake of:

B vitamins, such as vitamin B2, B3, B5, B6, folic acid and B12.
Vitamin C
Electrolytes, such as sodium, potassium, calcium, magnesium and chloride.
Zinc

When renouncing milk and dairy products – vital substance deficiency (micronutrients).

Vital substance(macro- and micronutrients)	Deficiency symptoms
Vitamin A	Fatigue, loss of appetite Decreased production of antibodies and weakened immune system. Diseases of the respiratory tract, respiratory infections due to changes in the mucous membrane. Disorders of spermatogenesis Anemia (anemia) Increased risk of Tumors of the lung, bladder, prostate, larynx, esophagus, stomach and intestine. Kidney stone formation Drying up to cornification of mucous membranes Attrition of cell and tissue mass of salivary glands and larynx, regression of organs. Dry, brittle nails and hair Dry, rough, itchy skin with rashes Decreased sense of smell, touch, hearing disorders. Deficiency symptoms in children Growth disorders of the long bones Dentin disorders – disorders in the formation of dental tissue. Malformations of the auditory, digestive and genitourinary tracts
Vitamin D	Loss of minerals from bones – spine, pelvis, extremities – results in Hypocalcemia (calcium deficiency). Decreased bone density Deformities Muscle weakness, especially at the hips and pelvis Increased risk of later osteoporosis Formation of osteomalacia (softening of the bones) Symptoms of osteomalacia Arthralgia (bone pain) – shoulder, spine, pelvis, legs. Spontaneous fractures, often in the pelvic ring. Funnel chest “Map heart shape” of the female pelvis. Loss of hearing, ringing in the ears Disturbed immune system with repeated infections. Increased risk of colorectal carcinoma (carcinoma of the colon (intestine) and rectum (rectum)) and breast carcinoma (breast cancer) Deficiency symptoms in children Impairment of the development of bones and teeth. Formation of rickets, that is, decreased mineralization of bones with a tendency to spontaneous fractures and bone bending. Symptoms of rickets Disturbances in the longitudinal growth of bones Skeletal changes – skull, spine, legs. Atypical heart-shaped pelvis Delayed retention of deciduous teeth, jaw deformity, malocclusion
Vitamin E	Lack of protection against radical attack and lipid peroxidation. Decreases the immune response Myopathies – disease of muscle cells due to inflammation of muscle tissue. Shrinkage as well as weakening of the muscles Neuropathies – disease of the peripheral nervous system, neurological disorders, disorders in neuromuscular information transmission. Reduced number and lifetime of erythrocytes (red blood cells). Deficiency symptoms in children Anemia (anemia) Impairment of blood vessels leads to bleeding Disturbances in neuromuscular information transmission. Neonatal retinopathy – disease of the retina, visual disturbances. Bronchopulmonary dysplasia (BPD) – chronic lung disease that occurs primarily in premature, low birth weight infants when these infants are artificially ventilated for prolonged periods of time [3.1].
Vitamin K	Blood coagulation disorders leading to Hemorrhage into tissues and organs. Bleeding from body orifices Small amounts of blood in the stool can cause Decreased activity of osteoblasts leads to. Increased urinary calcium excretion. Severe bone deformities
Vitamins of theB group, such as vitamins B1 and B2	Disorders in the central and peripheral nervous system leads to Nerve disease in the extremities Diseases the muscles Muscle pain, wasting and weakness, involuntary muscle twitching. Hyperexcitability of the heart muscle and increase in heart rate (tachycardia); decrease in cardiac output (HMV). Palpitations and heart failure, shortness of breath. Memory loss Sleep disturbances General state of weakness Decreased antioxidant protection; decreased production of antibodies during infections. Impaired collagen synthesis resulting in poor wound healing. Impaired metabolism of fatty acids, proteins, carbohydrates, iron as well as pyridoxine. Increased risk of Light sensitivity (photophobia), increased burning tears, lens opacities and cataracts. Anemia (anemia) due to decreased production of red and white blood cells and platelets
Calcium	Demineralization of the skeletal system increases the risk of Decreased bone density Tendency to stress fractures of the skeletal system. Muscle cramps, tendency to spasm, increased muscle contraction. Cardiac arrhythmias Blood clotting disorders with increased bleeding tendency Increased excitability of the nervous system, depression. Hypertension (high blood pressure) Osteoporosis, especially in women with estrogen deficiency (menopause). Formation of osteomalacia Symptoms of osteomalacia Arthralgia (bone pain) – shoulder, spine, pelvis, legs. Spontaneous fractures, often in the pelvic ring. Funnel chest “Map heart shape” of the female pelvis. Bone softening as well as bone deformities. Deficiency symptoms in children Decreased bone density in newborns Impaired development of bones and teeth Formation of rickets – reduced mineralization of bones with a tendency to spontaneous fractures and bone bending. Symptoms of rickets Disturbances in the longitudinal growth of bones Deformed skeleton – skull, spine, legs. Atypical heart-shaped pelvis Delayed retention of deciduous teeth, jaw deformity, malocclusion of teeth. Disturbances in the longitudinal growth of the bones Additional vitamin D deficiency leads to Hyperparathyroidism (hyperparathyroidism) – enlarged parathyroid tissue and increased production of parathyroid hormones. Hypercalcemic coma
Molybdenum	Nausea (sickness) Severe headache, central visual field defects. Visual disturbances Hyperexcitability of the heart muscle and increase in heart rate (tachycardia), decrease in cardiac output (HRV). Tachypnea – accelerated respiratory rate. Coma Amino acid intolerance with deficient degradation of sulfur-containing amino acids – homocysteine, cysteine, methionine. Urolithiasis (kidney stone formation) Alopecia (hair loss)
Zinc	Disturbances in the functioning of the immune system Inhibition of cellular defense leads to increased susceptibility to infection Wound healing disorders and mucosal changes, as zinc is required for connective tissue synthesis Increased keratinization tendency Acne-like symptoms Blood clotting disorders, chronic anemia Reduction of the sense of smell and taste, reduction of vision, night blindness, sensorineural hearing loss. Depression, psychosis, schizophrenia. Metabolic disorders, such as. Weight loss despite increased food intake Failure of beta cells in the pancreas – high risk of developing adult-onset diabetes (type 2 diabetes mellitus) Instead of zinc, the toxic cadmium is integrated into the biological processes, which leads to Inflammatory changes in the mucous membranes of the nose and throat. Cough, headache, fever Vomiting, diarrhea, cramping pain in the abdominal regions. Renal dysfunction and increased protein excretion. Osteoporosis, osteomalacia LeadsDeficiency symptoms in children:Low concentrations of zinc in plasma and white blood cells (leukocytes) cause. Malformations and deformities especially of the central nervous system. Growth disorders and retardation with delayed sexual development. Skin changes in the extremities – hands, feet, nose, chin and ear – and natural orifices. Wound healing disorders Hair loss Acute and chronic infections Hyperactivity and learning disability
Biologically high quality – animal – protein	Disturbances in digestion and in the absorption of vital substances (micronutrients) and resulting water and electrolyte losses. Muscle wasting
Amino acids such as lysine, threonine, methionine, tryptophan.	Weakened immune system High susceptibility to infection due to leukocytopenia (decreased production of white blood cells). Increased risk of urinary tract infections Hyperactive nerve activity Accumulation of heavy metals in the body Deficiency of growth hormones Growth disorders in children Disorders of the nervous system leads to Mood swings, anxiety, depression Poor concentration and performance Sleep disorders Hyperactive nervous activity Disturbances in growth and bone maturation Uric acid metabolism disorder – increased uric acid concentration in the blood

Lactose intolerance patients with constant watery diarrhea – vital substance deficiency (micronutrients).

Vital substance(macro and micro nutrients).	Deficiency symptoms
Vitamin C	Weakness of blood vessels leads to Abnormal bleeding Mucosal bleeding Hemorrhage into the muscles associated with weakness in heavily used muscles Inflamed as well as bleeding gums (gingivitis). Joint stiffness and pain Poor wound healing Carnitine deficit leads to Symptoms of exhaustion, fatigue, indifference, irritability, depression. Increased need for sleep, decreased performance. Weakness of the immune system with increased risk of infection Reduced protection against oxidation increases the risk of heart disease, apoplexy (stroke) Deficiency symptoms in children Weakened immune system Recurrent infections of the respiratory tract, urinary bladder, and the auditory tube, which is connected to the nasopharynx via the tympanic cavity of the middle ear Increased risk of vitamin C deficiency disease – Möller-Barlow disease in infancy with symptoms such as. Hematomas (bruises) Pathological fractures associated with severe pain Wincing after every slightest touch – “jumping jack phenomenon”. Stagnation of growth
B vitamins,such as vitaminsB1,B2,B3,B5,B6	Disorders in the central and peripheral nervous system leads to. Nerve disease in the extremities, pain or numbness of the extremities. Muscle pain, wasting or weakness, involuntary muscle twitching Hyperexcitability of the heart muscle and increase in heart rate (tachycardia); decrease in cardiac output (HRV). Memory loss General state of weakness Impaired collagen synthesis resulting in poor wound healing Insomnia, nervous disorders, sensory disturbances. Impaired response of white blood cells to inflammation. Anemia (anemia) due to decreased production of red blood cells, white blood cells, and platelets Decreased production of antibodies Impairment of cellular and humoral immune defenses. States of confusion, headaches Gastrointestinal disorders, stomach pain, vomiting, nausea. Deficiency symptoms in children Disorders of protein biosynthesis and cell division. Disorders of the central nervous system Beriberi – disturbance of nervous function and cardiac insufficiency. Skeletal muscle atrophy Increased risk of cardiac dysfunction and failure
Folic acid	Mucosal changes in the mouth, intestines, and urogenital tract lead to Indigestion – diarrhea (diarrhea). Reduced absorption of nutrients and vital substances Weight loss Blood count disorders Anemia (anemia) leads to rapid fatigue, shortness of breath, decreased ability to concentrate, general weakness. Impaired formation of white blood cells leads to. Reduction of the immune response to infections. Decreased antibody formation Risk of bleeding due to decreased production of platelets (thrombocytes). Elevated homocysteine levels increase the risk of. Atherosclerosis (hardening of the arteries). Coronary heart disease (CHD) Neurological and psychiatric disorders, such as. Memory impairment Depression Aggressiveness Irritability Deficiency symptoms in childrenDisorders in DNA synthesis-restricted replication-and decreased cell proliferation increase the risk for Malformations, developmental disorders Growth retardation Maturation disorders of the central nervous system. Bone marrow alteration Leukocytopenia (deficiency of white blood cells) as well as thrombocytopenia (deficiency of platelets). Anemia (anemia) Injuries to the mucosa of the small intestine Disorders of protein biosynthesis and cell division
Vitamin B12	Decreased vision and blind spots Functional folic acid deficiency Weakened antioxidant protective system Blood count Anemia (anemia) reduces the ability to concentrate, leads to fatigue, weakness and shortness of breath. Reduction of red blood cells, larger than average and rich in hemoglobin (megaloblastic anemia). Impaired growth of white blood cells weakens the immune system Risk of bleeding due to reduced production of platelets. Gastrointestinal tract Tissue atrophy and inflammation of the mucous membranes. Rough, burning tongue Reduced absorption of nutrients and vital substances Loss of appetite, weight loss Neurological disorders Numbness and tingling of extremities, loss of sensation of touch, vibration and pain. Poor coordination of the muscles, muscle atrophy. Unsteady gait Spinal cord damage Psychiatric disorders Memory disorders, confusion, depression Aggressiveness, agitation, psychosis
Calcium	Demineralization of the skeletal system increases the risk of Decreased bone density Osteoporosis, especially in women with estrogen deficiency. Bone softening as well as bone deformities – osteomalacia. Tendency to stress fractures of the skeletal system. Muscle cramps, tendency to spasm, increased muscle contraction. Cardiac arrhythmias Blood clotting disorders with increased bleeding tendency Increased excitability of the nervous system, depression. Increased risk of Hypertension (high blood pressure) Deficiency symptoms in children Impaired development of bones and teeth Decreased bone density in the newborn. Formation of rickets – decreased mineralization of bones with tendency to spontaneous fractures and bone bending. Symptoms of rickets Disturbances in the longitudinal growth of bones Deformed skeleton – skull, spine, legs. Atypical heart-shaped pelvis Delayed retention of deciduous teeth, jaw deformity, malocclusion of teeth. Additional vitamin D deficiency leads to Hyperparathyroidism (hyperparathyroidism) – enlarged parathyroid tissue and increased production of parathyroid hormones. Hypercalcemic coma
Magnesium	Increased excitability of muscles and nerves leads to Insomnia, difficulty concentrating Muscle and vascular spasms Numbness as well as tingling in the extremities. Tachycardia (rapid heartbeat) and cardiac arrhythmia, feeling of anxiety. Increased risk of Decreased immune response Myocardial infarction (heart attack) Acute hearing loss Deficiency symptoms in children Growth retardation Hyperactivity Insomnia, difficulty concentrating Muscle tremors, cramps Tachycardia (racing heart) and cardiac arrhythmias. Decreased immune response
Sodium	Fatigability, possible unconsciousness, apathy, confusion, lack of drive, decreased performance – short-term memory. Nausea, vomiting, anorexia (loss of appetite), lack of thirst. Hypertension (high blood pressure); tendency to collapse, hyperexcitability of the heart muscle and increase in heart rate (tachycardia); reduction in cardiac output (HZV). Muscle spasms Decreased urination
Potassium	Muscle weakness, muscle paralysis Fatigue, apathy Nausea (nausea) and vomiting, anorexia (loss of appetite), constipation (constipation), decreased bowel function until bowel obstruction. Decreased tendon reflexes Cardiac arrhythmias, cardiac enlargement, tachycardia, dyspnea
Chloride	Acid-base balance disorders Development of metabolic alkalosis Severe vomiting with high salt losses
Zinc	Disturbances in the functioning of the immune system Inhibition of cellular defense leads to increased susceptibility to infection Wound healing disorders and mucosal changes, as zinc is required for connective tissue synthesis Increased keratinization tendency Acne-like symptoms Blood clotting disorders, chronic anemia Reduction of the sense of smell and taste, reduction of vision, night blindness, sensorineural hearing loss. Depression, psychosis, schizophrenia. Metabolic disorders, such as. Weight loss despite increased food intake Failure of beta cells in the pancreas – high risk of developing adult-onset diabetes (type 2 diabetes mellitus) Instead of zinc, the toxic cadmium is integrated into the biological processes, which leads to Inflammatory changes in the mucous membranes of the nose and throat. Cough, headache, fever Vomiting, diarrhea (diarrhea), cramping pain in the abdominal regions. Renal dysfunction and increased protein excretion. Osteoporosis, osteomalacia LeadsDeficiency symptoms in childrenLow zinc concentrations in plasma and white blood cells cause. Malformations and deformities especially of the central nervous system. Growth disorders and retardation with delayed sexual development. Skin changes in the extremities – hands, feet, nose, chin and ear – and natural orifices. Wound healing disorders Alopecia (hair loss) Acute and chronic infections Hyperactivity and learning disability