Can Lactose Intolerance Go Away? Yes, and No

What you need to know:

The common type of lactose intolerance is the primary form (primary lactose deficiency. This is by far the most widespread type of lactose intolerance.

Primary lactase deficiency affects over 65% of people worldwide (reference). Unfortunately, this type of lactose intolerance doesn’t go away on its own. Primary lactase deficiency can be controlled by dietary avoidance of lactose.

However, other less common types of lactose intolerance can go away independently. See the table summary below:

As we explained in summary above, the answer to whether lactose intolerance is a lifelong disease or not depends on its type.

Below, a more detailed explanation of the different types of lactose intolerance.

A. Primary lactase deficiency (lactose intolerance).

• The most common form (more than 90%)  of lactose intolerance.
• It results from the gradual decline of lactase enzyme activity with age.
• Symptoms start to develop during adolescence and early childhood.

It is the most widespread type in the community; it results from a gradual decline in lactase enzymes (which break down lactose present in milk and dairy).

People with primary lactase deficiency often experience life-long symptoms every time they consume lactose. So, it doesn’t go away completely.

However, Symptoms improve or completely go away when you restrict lactose-containing foods and drinks from your diet.

Does primary lactase deficiency go away with lactase enzyme supplements?

No, Lactose intolerance doesn’t improve completely with lactase enzyme supplements. In addition, the response to lactase enzyme supplements (whether added to foods or taken orally) is variable.

You may or may not experience symptom improvement after taking lactase supplements. In addition, it rarely leads to a complete resolution of symptoms (reference).

Learn More: What does the lactase enzyme do?

Does lactose intolerance go away with a lactose-free diet?

The lactose intolerance symptoms completely resolve with a lactose-free diet. However, the disease (intolerance) itself still exists, meaning that symptoms will recur if you eat lactose.

So, staying on a lactose-free diet doesn’t help the reversal of the condition, But improves the symptoms.

B. Secondary lactase deficiency.

Secondary lactose intolerance develops when a disease or drug destroys the small intestine lining cells (the lactase enzyme). It is a less common form, and it can develop at any age, even later in life.

Common causes include:

• An attack of severe gastroenteritis.
• Celiac disease.
• Crohn’s disease (a type of inflammatory bowel disease).
• Ulcerative colitits.
• Chemotherapy.
• Antibiotic use.

Secondary lactose intolerance goes away after the treatment of the primary disease. For example, severe attacks of gastroenteritis lead to maldigestion and lactose intolerances lasting for weeks.

The intestinal lining eventually heals in most cases, and lactose intolerance goes away. However, Some may continue to suffer from lactose intolerance for years or even a lifetime.

C. Congenital lactase deficiency.

An autosomal recessive disease (genetic disease) causes early absence or decreased lactase in infants. It is different from primary lactase deficiency.

The baby with congenital lactase deficiency develops symptoms soon after birth due to the absence or deficiency of the enzyme. It is a rare and more severe form, and it doesn’t go away when the baby grows older.

D. Developmental lactase deficiency.

Developmental lactase deficiency occurs due to incomplete maturation of the small intestine (the site of lactase enzyme).

Developmental lactase deficiency affects preterm babies born between 28 to 73 weeks of pregnancy. The symptoms of lactose intolerance develop soon after birth. However, it improves with age (due to the maturation of the small intestine).

Bonus: does lactose intolerance go away during pregnancy?

Lactose intolerance improves during pregnancy but doesn’t go away completely.

One study found that women with lactose intolerance can handle lactose better during pregnancy (especially in late pregnancy or the third trimester).

The improvement is thought to be due to the slow down of your digestive system (More time for lactose to be digested) and the better handling of lactose by the intestinal micro-organisms.