Incidence of lactose intolerance in Kashmir.
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We recently observed 2 lactase-deficient women with Graves' disease who consistently developed severe diarrhea after ingestion of thionamide (methimazole and propylthiouracil) tablets containing lactose as carrier. The strict temporal relationship between ingestion of lactose-containing tablets and appearance of intestinal symptoms, as well as the absence of side effects following ingestion of methimazole tablets without lactose as carrier, provided the clue for the diagnosis. To our knowledge, severe diarrhea resulting from carrier lactose has not been previously reported for antithyroid drugs, and should be considered in occasional cases of patients with gastrointestinal symptoms on thionamide therapy.
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Nineteen of 20 healthy Oriental adults living in the United States developed abdominal cramps and diarrhea after ingesting an amount of lactose equivalent to that in one quart of milk; 14 reported similar symptoms after one or two glasses of milk; all had consumed milk as infants without having such symptoms. Two of 20 Caucasians tested were intolerant to milk and lactose. Many Orientals therefore may have a genetically determined lactase deficiency that may lead to intolerance to milk. Since lactase deficiency is also common among Negroes, the bulk of the world's adult population is probably intolerant to milk.
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