Lactose Intolerance Products Review (Lactase Enzyme Supplements and Lactose-Free Milks)

Choose the Best Lactase Enzyme Supplement and Lactose-Free Milk. Find a CL Approved Lactose Intolerance Product.

Medically reviewed and edited by Tod Cooperman, M.D.

Last Updated : 05/15/2021 | Initially Posted: 10/28/2011

Lactase Supplements Reviewed by ConsumerLab.com

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Table of Contents

Update

Update:
Lacteeze: (12/11/2011) ConsumerLab.com was notified by Gelda Scientific on 11/28/11 that its product, Lacteeze, contained lactase from yeast. Unlike some of the supplements tested, the source of the lactase is not listed on the label, nor is the amount of lactase activity, and supplements typically contain lactase derived from fungal sources. The Lacteeze product showed no detectable enzyme activity using the standard testing methodology for fungal lactase preparations -- an assay conducted at an acidic pH to determine activity measured in ALU (Acid Lactase Units). However, lactase from yeast functions at a more neutral pH. Consequently, ConsumerLab.com retested Lacteeze using a method specifically for yeast-derived lactase conducted at a more neutral pH and found it provide approximately 2,000 NLU (Neutral Lactase Units) of activity per 5 drops (about 0.2 mL), which is the amount the label suggests be added to 1 liter of milk. One NLU is equal to one ALU, but at a neutral pH.

Results for Lacteeze below (under "What CL Found" and "Test Results by Product") have been updated to reflect its activity at neutral pH. Although Lacteeze may be effective at reducing lactose when added to milk (which has a neutral pH), it remains listed as "Not Approved" because of failure to comply with FDA labeling requirements for dietary supplements as discussed below.

What Is Lactose Intolerance?

Many people develop gas, abdominal bloating and pain, and even diarrhea and nausea after consuming milk or dairy products due to lactose maldigestion an inability to properly digest lactose, a sugar found in milk. These symptoms, collectively called lactose intolerance, may begin anywhere from 30 minutes to 2 hours after consuming milk or dairy products and range from mild to severe, based on the amount of lactose consumed and the amount a person can tolerate. People who can tolerate lactose produce sufficient amounts of the enzyme lactase (also known as beta-galactosidase) in their small intestines to convert lactose into glucose and galactose, which are absorbed from the intestine into the bloodstream. People who are lactose intolerant do not produce a sufficient amount of lactase. As a result, lactose (which is a larger sugar than glucose and galactose and can't be absorbed) remains in the intestine and is fermented by bacteria, creating gas, and can pull excess water into the gut, which can cause abdominal pain and, in some cases, diarrhea. For most people, lactose intolerance is due to a gradual decline in lactase production, which begins after about age 2 but is generally not noticeable until late adolescence or adulthood. Nearly everyone with lactose intolerance can tolerate some amount of lactose in their diet. Some studies suggest that most lactose maldigesters can consume 12 grams of lactose (the amount in an 8 ounce glass of milk) with few if any symptoms. (Gaskin, Am J Lifestyle Med 2009; Shaukat, Ann Intern Med 2010).

About 25% of Americans are believed to be lactose maldigesters, of which only 20% to 30% may experience the symptoms of lactose intolerance (Gaskin, Am J Lifestyle Med 2009). Lactose maldigestion is most common in people with Asian, African, and Native American ancestry and is much less common in those with Northern European ancestry (Vesa, J Am Coll Nutr 2000). Lactase deficiency (and lactose intolerance) may also result from injury to the small intestine from severe diarrheal illness, celiac disease, Crohn's disease and chemotherapy.

Some people confuse milk allergy with lactose intolerance. The two conditions are not related. Milk allergy, which typically occurs in the first year of life, involves an allergic reaction to milk protein, and lactase supplements will not help. For more information, see the article from the National Institutes of Health for more about lactose intolerance and how it is diagnosed.

How to Treat Lactose Intolerance:

The two main approaches to reducing symptoms of lactose intolerance are reducing exposure to lactose in the diet and taking a lactase enzyme supplement (ConsumerLab.com tested several for this report) when eating foods containing lactose. The dietary approach has essentially three components: knowing which foods contain lactose and avoiding them; switching to milk products that are naturally lower in lactose; and switching to milk pre-treated with lactase to be essentially free of lactose (several of these milks were tested for this report). Consuming smaller amounts of dairy multiple times during the day instead of at one time and some people may better tolerate milk or dairy products by taking them with meals. Other less proven approaches include the use of probiotics, and colonic adaptation (gradually increasing your lactose consumption over a period of time to reduce symptoms).

Changing Your Diet To Reduce Lactose
Although the body's ability to produce lactase cannot be changed, the symptoms of lactose intolerance can be managed with dietary changes.

Avoiding Lactose:
The following table shows the approximate amount of lactose in common dairy foods. In the preparation of certain dairy products some of the lactose is removed or digested through fermentation. These include hard cheeses such as Swiss and cheddar, mozzarella, yogurt, buttermilk, and kefir. Yogurt may offer additional benefits. One study found that lactose from yogurt was generally better tolerated that an equal amount of lactose from milk (Marteau, Br J Nutr 1990).

Amount of Lactose in Common Dairy Foods¹
Product	Lactose (grams)
Milk (whole, 2%, 1%, Skim Milk) (8 oz cup)	12.47²
Goats Milk (8 oz cup)	9³
Macaroni & Cheese Dinner (boxed with dry sauce mix) (8 oz)	8.37⁵
Yogurt (plain) (6 oz)	6³
Cottage Cheese, low fat, 2% milk fat (4 oz)	3.28
Strawberry Ice Cream (4 oz scoop)	2.92
American Cheese, pasteurized, processed (1 oz - approx. 1 slice)	1.53
Buttermilk Pancake (frozen, ready-to-eat) (3 pancakes)	1.22
Cream Cheese (1 oz)	0.91
Buttermilk Waffle (frozen, ready-to-eat) (1 waffle)	0.53
Sour Cream (1 Tbsp)	0.42
Buttermilk Salad Dressing (lite) (2 Tbsp)	0.31
Cheddar Cheese, sharp (1 oz)	0.07
Swiss Cheese (1 oz)	0.02
Mozzarella (1 oz)	0.02
Note: 8 ounces (oz) = 1 cup; 6 oz = cup; 4 oz = cup ¹Unless otherwise noted, data sourced from: USDA/ARS, Nutrient Data Laboratory, Standard Reference, accessed October 27, 2011. Values provided by USDA are averages. Lactose content varies by product and the lactose content of a specific product would need to be verified by a vendor. ²Lactose content varies slightly in milks. 12.47 grams represents the average amount for the four types of milk listed in the USDA database ³Sourced through the American Dietetic Association website: www.eatright.com, accessed October 27, 2011 ⁴Amount listed is for the dry powder mix and does not include any additional milk added when cooking. ⁵USDA Nutrient database lists the lactose amount per 100 grams. Assumed 244 grams/cup in calculation.

In addition to being exposed to lactose directly from dairy products, milk and milk products are often added to processed foods. People with lactose intolerance should be aware of the many food products that may contain even small amounts of lactose, such as:

· bread and other baked goods

· waffles, pancakes, biscuits, cookies, and mixes to make them

· processed breakfast foods such as doughnuts, frozen waffles and pancakes, toaster pastries, and sweet rolls

· processed breakfast cereals

· instant potatoes, soups, and breakfast drinks

· potato chips, corn chips, and other processed snacks

· processed meats, such as bacon, sausage, hot dogs, and lunch meats

· margarine

· salad dressings

· liquid and powdered milk-based meal replacements

· protein powders and bars

· candies

· non-dairy liquid and powdered coffee creamers

· non-dairy whipped toppings

Checking the ingredients on food labels is helpful in finding possible sources of lactose in food products. If any of the following words are listed on a food label, the product contains lactose:

· milk

· lactose

· whey

· curds

· milk by-products

· dry milk solids

· non-fat dry milk powder

Lactose is also used in some prescription medicines, including birth control pills, and over-the-counter medicines like products to treat stomach acid and gas. These medicines most often cause symptoms in people with severe lactose intolerance.

Switching to Lactose-Free Dairy Products:
If you prefer not to give up milk or certain dairy products, a number of lactose-free dairy products are available, such as the lactose-free milks tested in this report. Most studies, although not all, have shown benefit with lactose-reduced milk (Vesa, J Am Coll Nutr 2000).The milk will taste sweeter because added lactase breaks down the lactose into simpler, sweeter sugars. In addition, because lactose-free milk is typically ultra-pasteurized, its shelf life is generally several weeks longer than that of regular pasteurized milk. Other lactose-free milk products are available, such as lactose-free ice cream, cottage cheese and even egg nog. As noted earlier, some hard cheeses naturally contain little lactose and some brands (e.g., Cabot and Finlandia) list certain cheeses to be lactose-free or 100% lactose free. Be aware there is no FDA definition for the terms "lactose free" or "lactose-reduced." Even without an exact definition, from the FDAs perspective a lactose-free product should not contain any lactose, and a lactose-reduced product should be one with a meaningful reduction when compared to regular milk or dairy products.

Lactase Supplements
Supplements containing the enzyme lactase can be taken to increase the amount of lactase in your digestive system. Fortunately, lactase is not destroyed in the stomach, so pills do not have to be enteric-coated. The lactase found in supplements is generally made from fungal or yeast sources. The source does not seem to matter; what does matter is the amount of activity of the enzyme -- that is, how much lactose the enzyme can digest in certain period of time. This activity is measured as ALU (acid lactase units), which is defined by the Food Chemical Codex (FCC) and is why some products refer to ALU as FCC lactase units. Be sure to choose a product that shows you the ALU level (most, but not all, do). Some products may only provide a milligram (mg) amount of lactase enzyme, but this won't help you understand what you're buying.

So what's the right dose of a lactase supplement? Although 3,000 ALU can help those with lactose intolerance digest about 20 grams of lactose from milk (the amount in about 1 1/2 cups), 6,000 ALU provides greater benefit (Lin, Dig Dis Sci 1993). For digesting larger amounts of lactose (50 grams), approximately 10,000 ALU has shown benefit (Sanders, Clin Pharm 1992). Many products on the market have a recommended dose per meal of 9,000 ALU, which should be sufficient for most diary-containing meals.

It is best to take lactase supplements just as you begin to eat, rather than before you eat (Gao, Nagoya J Med 2002). The supplement will not help if taken after a meal although taking an additional pill during a long meal may help. Lactase is not destroyed by acids in the stomach, but it will not normally work well in the stomach due to the high acidity, preferring the less acidic environment of the intestine. However, lactase has been shown to work in the stomach when taken with a large glass of milk, which buffers the acidity (Gao, Nagoya J Med 2002). In such a situation, it is possible that fast acting chewable lactase supplements may be preferable since the lactase can be released sooner than from a normal tablet or capsule, allowing it to start working a little earlier.

Lactase Added to Milk

Lactase (typically sold as a liquid or powder) can also be added directly to milk to reduce the amount of lactose and the associated symptoms of lactose intolerance. A study found that the addition of 2,000 ALU of lactase enzyme to 500 mL of milk (about 2 cups) was effective in reducing the symptoms of lactose intolerance, particularly when the mixture was left for 24 hours before drinking (Lami, Am J Gastr 1988). As noted in the Update above, the lactase used to convert milk is a special type that works best at a neutral pH, while the lactase in dietary supplements works best in the acidic environment of the upper digestive system. The lactase enzymes intended for use on refrigerated milk tend to be derived from the yeast Kluyveromyces lactis (or K. lactis).

A study in 2011 compared the effects of adding four different brands of lactase enzyme to cold milk. Within 24 hours (while being refrigerated), lactose levels were reduced by 58% to 99%, depending on the lactase enzyme used. The fat content of the milk did not matter. Because lactase continues to eliminate lactose over time, even the enzyme with the lowest (58%) 24-hour lactose reduction was able to reduce 79% of lactose at 48 hours and 88% by 72 hours. Similarly, cutting the dose of any enzyme in half achieved about the same results in 48 hours as a full dose achieved in 24 hours. That is, you can use less enzyme if you give it more time (Horner, J Dairy Sci 2011).

Probiotics
Several studies have been conducted using probiotics (i.e., live, beneficial bacteria that live in the gut) to alleviate symptoms of lactose intolerance. Many probiotic organisms naturally digest lactose by fermentation. This may cause less water to be pulled into the gut by excess lactose, helping reduce abdominal discomfort and diarrheal symptoms. On the other hand, the fermentation process also creates gas. Unfortunately, many studies with probiotics have not shown a benefit, although there is some evidence that certain strains, may offer some help (Saltzman, Am J Clin Nutr 1999, Levri, J Fam Prac, 2005). A study showed that 2-weeks of supplementation with B. longum (in capsules) and yogurt enriched with B. animalis modified the gut flora enough to eliminate symptoms in a group of Chinese lactose-intolerant participants (He, J Appl Microbiol 2008). A trial with acidophilus milk showed no benefit (Newcomer, Am J Clin Nutr 1983) although a trial with milk cultured with strains of S. bulgaricus showed benefit (Mustapha, J Dairy Sci 1997).

Quality Concerns and Tests Performed:

Lactase Supplements
To assess the accuracy of the supplement labeling of lactase products, ConsumerLab.com purchased and tested several such products for their amounts of lactase enzyme activity. Products were also checked for potential contamination with lead.

Lactose-Free Milks
To assess the accuracy of the nutritional labeling of lactose-free milks, ConsumerLab.com purchased and tested several such products for their amounts of lactose and other sugars.

What CL Found:

Lactase Supplements (To be taken orally)
Among the ten products sold as supplements selected by ConsumerLab.com for testing, nine are to be taken by orally, and all of these were found to provide the lactase activity listed on their labels. Through its voluntary Quality Certification Program, ConsumerLab.com identified an additional three oral lactase products that met their label claims. The amount of lactase activity across products ranged from just 125 ALU to 9,500 ALU to per unit.

(The one supplement meant to be added directly to milk, and not by mouth, Lacteeze Drops, is discussed further below.)

Cost:
9,000 ALU was the most common unit dosage, and is considered a potent dose. We, therefore, selected this amount of lactase activity as a benchmark to compare product cost -- calculating the cost to obtain 9,000 ALU of lactase activity from each product.

The lowest cost to obtain 9,000 ALU of lactase was 8 cents from Kirkland (Costco) Signature Fast Acting Lactase. The next lowest was equate (Walmart) Fast Acting Dairy Digestive Supplement at 12 cents. Although both Kirkland and equate were labeled "fast acting" caplets, ConsumerLab.com found that equate pills were able to break apart in solution in just about 2 minutes, much sooner than Kirkland pills, which took about 27 minutes. The equate caplets, therefore, may be faster acting than the Kirkland's.

The lowest cost to obtain 9,000 ALU from chewable tablets (which may act a little faster than regular tablets in some situations) was Lactaid Fast Acting Vanilla Twist Flavor at 20 cents, followed by CVS Pharmacy Dairy Relief Fast Acting Vanilla Twist Flavor at 21 cents. However, the best value among the four fast acting products appears to be equate, as it breaks apart very rapidly yet costs significantly less than the chewable tablets.

The most expensive product from which to get 9,000 ALU of lactase was KAL Lactase Enzyme. Each softgel provided only 125 ALU, so over 70 pills would be needed to provide 9,000 ALU costing $6.79. The suggested dose of the KAL product per meal was 2 pills (about 19 cents), yielding just 250 ALU of lactase -- an amount far below what is commonly used and is of questionable benefit.

Among the most expensive products tested was Garden of Life Raw Enzymes ($1.98 to obtain 9,000 ALU). However, unlike some of the other products in this review, Garden of Life Raw Enzymes lists additional enzymes for digesting starches, fiber, fats, and proteins, as well as probiotics, vitamins and minerals. Enzymedica Lacto was also more expensive than most products (42 cents to get 9,000 ALU), but it, too, included additional digestive enzymes.

Liquid Drops (To be added to milk)

One of the products that ConsumerLab selected to test, Lacteeze Drops, did not list an amount of enzyme activity but claimed to reduce lactose content 70 to 80% within 24 hours after adding 5 drops to 1 liter (about ¼ gallon) of milk while being refrigerated. It can also be used on formula and breast milk. In initial testing, Lacteeze (liquid drops) contained no ALU activity and this was confirmed in a second laboratory. As noted in the Update above, ConsumerLab.com was later informed that the product contains a different type of lactase not identified on the label that functions at a more neutral pH than the other products in this review (which are intended to work in the acidic environment in the stomach and upper intestine). Testing at neutral pH found 2,000 NLU (Neutral Lactase Units) per 5 drop dose (NLU and ALU are equivalent, but at different pH levels).

The enzyme activity of Lacteeze may be sufficient to significantly reduce the lactose content of milk. However, this product remains "Not Approved" by ConsumerLab.com because its label did not comply with U.S. FDA labeling regulations, failing to list in its "Supplement Facts" the amount or activity of its key ingredient. It also makes implied disease claims without indicating that the statements have not been evaluated by the FDA and that the product is not intended to treat or prevent disease.

Another lactase liquid reviewed by ConsumerLab is Seeking Health Lactase Drops, which was tested and Approved through ConsumerLab's Quality Certification Program in 2021, after initial publication of this report. It was found to provide its listed enzyme activity of 750 ALU. It claims that "7 drops is enough to reduce lactose in 1 pint of milk over 24 hours." As with Lacteeze, this would seem to be true.

Cost:
To help compare Lacteeze drops and Seeking Health Lactase Drops, we deteremined how much of each you would need to reduce a significant amount of lactose in a half-gallon of milk, based on their serving suggestions). This worked out to 9.5 drops of Lacteeze (for 65 cents) or 28 drops of Seeking Health (for $1.38). If you find these amounts don't sufficiently reduce lactose in your milk after 24 hours of refrigeration, you can use more drops or, to save money, just give the treated milk more time, since the lactase will continue to work and does not get "used up." Similarly, as a savings tip, if you are willing to wait 48 hours, you can halve the suggested initial dose and get about the same lactose reduction that you would get in 24 hours with a full dose. By making your own lactose-free milk this way, you could save money and avoid having to pay a premium for lactose-free milk.

Lactose-Free Milks
ConsumerLab.com selected 3 popular brands of lactose-free milk to test. For ease of comparison, we chose the fat-free versions of each. All three products, Lactaid Fat Free Milk, Land O Lakes Dairy Ease Fat Free Milk, and Organic Valley Lactose Free Organic Fat Free Milk, passed our tests -- no lactose was found in any product. (It is possible that a very small amount of lactose could be present -- less than 0.1 gram per cup -- due to the detection limit of the test, but such an amount would likely be insignificant.)

As expected, all lactose free milk products were mildly sweet in our taste test (noticeably sweeter than regular milks) since the lactose had been converted to the sweeter and more absorbable sugars, glucose and galactose. The milks were all similar in appearance to one another as well as to regular skim milk.

All three products listed one cup as providing identical amounts of calories (90) and percentages of the Daily Values for calcium (30% DV) and vitamin A (10% DV). All claimed vitamin D as ingredient. However, while Lactaid and Organic Valley indicated that they provided 25% of the Daily Value of vitamin D, Dairy Ease listed no DV amount, suggesting that it does not contain a significant amount of vitamin D. There were small differences among the products in the amounts of protein (Dairy Ease had 1 gram more), sugars (Organic Valley had 1 gram more), riboflavin (Dairy Ease had 5% more of the DV), and vitamin B-12 (Lactaid and Dairy Ease provided 15% of the DV, while Organic Valley had none.)

Be aware that some lactose-free milk are "calcium-fortified" and provide as much as 50% of the Daily Value for calcium, i.e., 650 mg per cup. That's a lot of calcium and more than is recommended in a single serving. If you're going to drink a cup or more of milk within a short period of time, it may be safer to avoid calcium-fortified milks. Milks that are not calcium fortified generally provide 30% of the Daily Value per cup, and that's plenty.

Cost:
A half gallon of the Lactaid and Land O Lakes Dairy Ease were the same price ($4.29) when purchased by ConsumerLab.com. Like many organic products, a half gallon of the Organic Valley was somewhat more expensive by 40 cents, selling for $4.69. Lactaid, but not Dairy Ease, claimed to be produced from cows not treated with artificial growth hormone.

Test Results by Product:

Listed alphabetically below are the test results of the 10 lactase supplements and 3 lactose-free milks selected for review by ConsumerLab.com. Also shown are results for 3 lactase supplements that passed the same testing through ConsumerLab.coms Voluntary Certification Program, as well as information about a supplement similar to one that passed testing.

Also shown below are the labeled serving sizes and claimed amounts of lactase (in ALU or NLU) in supplements. If a product is listed as Approved, it was found to contain the labeled amount of lactase or, if a milk, to be lactose-free. The full list of ingredients and nutrients is available for each product by clicking on the word Ingredients in the first column. For more information about testing go to How Products Were Evaluated.

How to Pick a Product
Choose among products that are Approved (3rd column). To save money, compare the costs shown in the last column. If you want a product with special features (e.g., chewable tablets, extra ingredients, organic milk, etc.), expect to pay more than for the lowest cost product. For supplements, focus on the ALU per unit (1st column) and per serving (2nd column). You'll want at least 3,000 ALU per serving -- 6,000 ALU is probably better, and 9,000 ALU is even better for meals rich in dairy.

CONSUMERLAB.COM RESULTS FOR LACTASE SUPPLEMENTS AND LACTOSE-FREE MILKS Click on beneath a product name to find a vendor that sells it. To find retailers that sell some of the listed products click here.
Product Name and Suggested Daily Serving (Click on "Ingredients" for Full List and Special Designations)	Lactase Activity (ALU)^1a in Suggested Dose Per Dairy-Containing Meal	-- TEST RESULTS -- (See How Products Were Evaluated)
		OVERALL RESULTS: APPROVED (Passed) or *NOT* APPROVED (Failed)	Provided Claimed Lactase Activity	Broke Apart Properly	Free from Unaccept-able Levels of Lead	Calculated Cost Per 9,000 ALU or NLU of Lactase² Additional Key Ingredients, Product Notes, and/or Special Designations³ (Price Paid Per Package)⁴
Lactase Supplements (Oral)
CVS pharmacy Dairy Relief Fast Acting Vanilla Twist Flavor (9,000 ALU per chewable tablet, one to three per meal with dairy)⁵ Dist. by CVS Pharmacy, Inc. Ingredients	9,000 to 27,000 ALU	APPROVED		N/A		$0.21 Chewable, Kosher ($12.79 for 60 chewable tablets)
Enzymedica Lacto (9,500 ALU per capsule, one or more per meal with dairy)⁶ Mfd. by Enzymedica, Inc. Ingredients	9,500 ALU	APPROVED		N/A		$0.42 Additional enzymes; Vegan, kosher ($39.98 for 90 capsules)
equate Fast Acting Dairy Digestive Supplement (9,000 ALU per caplet, one to three per meal with dairy)⁷ Dist. by Wal-Mart Stores, Inc. Ingredients	9,000 to 27,000 ALU	APPROVED				$0.12 *Best value "fast acting" lactase supplement* ($6.98 for 60 caplets)
Garden of Life Raw Enzymes Women 50+ & Wiser (1,890 ALU per vegetarian capsule, one to three per meal with dairy, up to nine per day)*⁸ Dist. by Garden of Life, LLC Ingredients	1,890 to 5,670 ALU	APPROVED		N/A		$1.98 Additional enzymes probiotics, vitamins, and minerals; Vegetarian ($37.46 for 90 vegetarian capsules)
KAL Lactase Enzyme 250 mg (125 ALU per softgel, two per meal with dairy) Mfd. by Nutraceutical Corp. Ingredients	250 ALU	APPROVED (But very low dose)		N/A		$6.79 ($5.66 for 60 softgels)
Kirkland Signature Fast Acting Lactase (9,000 ALU caplet, one to three times per meal with dairy)⁷ Mfd. by Guardian Drug Company, Inc. Ingredients	9,000 to 27,000 ALU	APPROVED				$0.08 *Lowest cost lactase supplement* ($14.79 for 180 caplets)
Lactaid Fast Act Vanilla Twist Flavor (9,000 ALU per chewable tablet, one to two times per meal with dairy)⁵ Dist. by McNeil Nutritionals, LLC Ingredients	9,000 to 27,000 ALU	APPROVED		N/A		$0.20 Chewable ($6.49 for 32 chewable tablets)
natural Factors Lactase Enzyme (9,000 ALU per capsule, one per meal with dairy) Mfd. by Natural Factors Canada Ingredients	9,000 ALU	APPROVED		N/A		$0.21 ($12.57 for 60 capsules)
Nature's Plus Say Yes to Dairy (3,000 ALU per chewable tablet, one per meal with dairy) Mfd. by Natural Organics Laboratory, Inc. Ingredients	3,000 ALU	APPROVED		N/A		$0.60 Chewable ($10.02 for 50 chewable tablets)
Puritan's Pride Lactase Enzyme (1,750 ALU per softgel, one to three per meal with dairy)* Mfd. by Puritan's Pride, Inc. Ingredients	1,750 to 5,250 ALU	APPROVED		N/A		$0.77 ($8.99 for 60 softgels)
Solgar Lactase 3500 (3,500 ALU per chewable wafer, one per meal with dairy)* Mfd. by Solgar Vitamin and Herb Ingredients	3,500 ALU	APPROVED		N/A		$0.61 Chewable; Vegetarian ($14.30 for 60 chewable wafers)
Source Naturals Lactase Digest (3,000 ALU per vegetarian capsule, one to three times per meal with dairy) Dist. by Source Naturals, Inc. Ingredients	3,000 to 9,000 ALU	APPROVED		N/A		$0.28 Vegetarian ($4.26 for 45 capsules)
Similar to Approved Lactase Supplement**
Zygest Lactase Enzyme (1,750 ALU per softgel, one to three per meal with dairy) Mfd. by Vitamin World, Inc. Ingredients	Similar to: Puritan's Pride Lactase Enzyme
Lactase Drops (to Add to Milk)
Lacteeze (Activity not listed. Suggests adding 5 drops to a liter of milk. See below for more details⁹) Mfd. by Gelda Scientific Ingredients	Enzyme activity not listed. Claims to "reduce lactose content of milk, formula, and breast milk"	NOT APPROVED Label lacks "Supplement Facts" panel and FDA disclaimer	Found 2,000 NLU^1b per 5 drops (equal to 2,000 ALU) (See Update above)	N/A		$1.55 Amount needed to reduce lactose in ½ gallon of milk in 24 hours: 9.5 drops (65 cents) Kosher ($11.99 for 7 mL liquid, providing 174 drops; $0.34 per 5 drops)¹⁰
Seeking Health® Lactase Drops (750 ALU per 7 drops, 7 drops per pint of milk over 24 hours)^*13 Dist. by Seeking Health, LLC Ingredients	750 ALU (per 7 drops)	APPROVED		N/A		$4.14 Amount needed to reduce lactose in ½ gallon in 24 hours of milk: 28 drops ($1.38) ($17.96 for 0.5 fl oz [15 ml] bottle, providing 364 drops); $0.35 per 7 drops)
Lactose-Free Milks
Product Name and Suggested Serving Size (Click on "Ingredients" for Full List and Special Designations)	Lactose Free¹¹		Taste and Appearance		Cost per Cup of Milk (8 oz or 240 mL)¹² Notable Features (Price Paid)¹²
Lactaid Fat Free Milk (1 cup [240 mL]) Dist. by McNeil Nutritionals, LLC Ingredients			Noticeably sweeter than regular skim milk, but mild.		$0.54 Vitamins A and D added Ultra pasteurized and homogenized; From cows not treated with artificial growth hormone ($4.29 for half gallon)
Land O Lakes Dairy Ease Fat Free Milk (1 cup [240 mL]) Dist. by WhiteWave Foods Ingredients			Noticeably sweeter than regular skim milk, but mild. Slightly darker hue than the other products.		$0.54 Vitamins A and D added (but amount of vitamin D not listed) Ultra-Pasteurized ($4.29 for half gallon)
Organic Valley Lactose Free Organic Fat Free Milk (1 cup [240 mL]) Dist. by Organic Valley Ingredients			Noticeably sweeter than regular skim milk, but mild.		$0.59 Vitamins A and D added USDA Organic and ultra pasteurized; Produced without antibiotics, synthetic hormones or pesticides ($4.69 for half gallon)
N/A Not applicable. Only applies to non-chewable caplets and tablets. ^* Tested through CL's Voluntary Certification Program prior to, at time of, or after initial posting of this Product Review. ^** Product identical in formulation and manufacture to a product that has passed testing but sold under a different brand. For more information see CL's Multi-Label Testing Program. Canadian Product ^1a Lactase enzyme unit activities in supplements are measured in ALU (Acid Lactase Units) as defined by the Food Chemical Codex (FCC). ^1b NLU = Neutral Lactase Units. These are equivalent to ALU but in neutral pH as opposed to acidic pH. ² Amounts shown are for general comparison purposes and are calculated from the price paid by ConsumerLab.com (without tax or shipping) and amounts of lactase enzyme listed on the labels or, if not listed, on amounts found. Unit amounts of some products may not provide exactly 9,000 ALU of lactase enzyme. Prices may vary by retailer and number of pills per package. ³ Not tested but claimed on label. ⁴ Prices will vary by retailer and number of pills per package. ⁵ Label reads: Chew one caplet with your FIRST BITE of dairy foods. You may adjust the dose if necessary to two caplets with your FIRST BITE of dairy foods. If you continue to eat dairy foods after 30-45 minutes, taking an additional caplet is recommended. ⁶ Label reads: One capsule at the beginning of each meal that contains dairy. More may be taken as needed. ⁷ Label reads: Swallow one caplet with your FIRST BITE of dairy foods. You may adjust the dose if necessary to two caplets with your FIRST BITE of dairy foods. If you continue to eat dairy foods after 30-45 minutes, taking an additional caplet is recommended. ⁸ Label reads: Adults take 1 capsule 3 times per day with meals. You may gradually increase up to 9 capsules per day. Contents may be mixed in your favorite raw juice or water. ⁹ Label reads: Milk: Add 5 drops of Lacteeze to 1 litre of milk and refrigerate for 24 hours. This will convert 70-80% of lactose. To convert more, refrigerate for longer or increase the dose to 8-10 drops. Breastfeeding: Express a few tablespoons of breastmilk into a sterilized container and add 4 drops of Lacteeze. Shake well and wait 5 minutes before giving mixture to baby prior to breastfeeding. Bottle Feeding: (Expressed Breastmilk or Baby Formula) Add 4 drops of Lacteeze per 50 mL of warm warm [sic] feed, shake well and wait 30 minutes prior to consumption. Do not refrigerate. Advanced Preparation: Add 2 drops of Lacteeze per 50 mL of warm feed, shake well and wait 5 minutes before refrigerating for 4 hours. ¹⁰ Cost calculation for Lacteeze based on 25 drops/mL (1 mL = 20 - 30 drops). ¹¹ No lactose detected with limit of detection at 0.096 grams of lactose per 8 oz cup. ¹² Prices may vary by retailer. ¹³ Product added on 4/12/2021.
Unless otherwise noted, information about the products listed above is based on the samples purchased by ConsumerLab.com (CL) for this Product Review. Manufacturers may change ingredients and label information at any time, so be sure to check labels carefully when evaluating the products you use or buy. If a product's ingredients differ from what is listed above, it may not necessarily be of the same quality as what was tested. The information contained in this report is based on the compilation and review of information from product labeling and analytic testing. CL applies what it believes to be the most appropriate testing methods and standards. The information in this report does not reflect the opinion or recommendation of CL, its officers or employees. CL cannot assure the accuracy of information.
Copyright ConsumerLab.com, LLC, 2011. All rights reserved. Not to be reproduced, excerpted, or cited in any fashion without the express written permission of ConsumerLab.com LLC.

Concerns and Cautions:

Because the symptoms of lactose intolerance are general in nature, many people assume they are lactose intolerant without ruling out other, more serious gastrointestinal illnesses such as irritable bowel syndrome (IBS). It is important to rule out more serious causes of gas, nausea and diarrhea when determining if you are lactose intolerant. People who avoid lactose-containing foods often do not get enough calcium in their diets, and may therefore be at increased risk of osteoporosis and other health problems. Calcium supplements and other calcium-containing foods can help increase calcium intake. For detailed information on the proper dosages and types of calcium to use, see the Calcium Supplements Review.

Side effects from lactase supplements appear to be rare, and none were reported in a clinical trial (Montalto, Eur J Clin Nutr 2005). However, some people have reported nausea from lactase supplements, including a CL member who, in 2020, reported this occurring approximately one hour after taking lactase as a pill and also after taking it as a liquid. ConsumerLab contacted the makers of Lactaid and was told this is not a common side effect.

Lactase supplements may be derived from fungi to which some people may be allergic. Although rare, there is one report of an allergic reaction in a man who experienced burning in the mouth and throat and difficulty swallowing after consuming two Lactaid pills. Testing showed he was allergic to Aspergillus oryzae, the fungus from which the enzyme used in Lactaid was derived (Vesa, J Am Coll Nutr 2000; Binkley, J Allergy Clin Immunol 1996).

Information on this site is provided for informational purposes only. It is not an endorsement of any product nor is it meant to substitute for the advice provided by physicians or other healthcare professionals. The information contained herein should not be used for diagnosing or treating a health problem or disease. Consumers should inform their healthcare providers of the dietary supplements they take.

Latest Clinical Research Updates for Lactose Intolerance Products

Side Effects of Lactase Enzyme

11/14/2020

Lactase supplements (such as chewable pills or liquids) are promoted to reduce gastrointestinal symptoms when consuming lactose in dairy products. Although uncommon, side effects can occur. Learn about these in the Concerns and Cautions section of our Lactase Supplements and Lactose-Free Milks Review. Also see which lactase supplements passed or failed our tests.