When Derrick Barreiro dines out, he has to make a quick cost-benefit analysis. Vegan dishes are a safe bet, but sometimes Mr. Barreiro, who is lactose intolerant, takes the risk and eats something that contains milk or cheese. In those cases, he opens his wallet, rips open a packet of Lactaid tablets and pops them into his mouth.
“People know I leave a trail of Lactaid wrappers wherever I go,” said Mr. Barreiro, a creative director in Brooklyn. “They’re like my bread crumbs.”
Even so, the supplements don’t always work. “It can still be a gamble even if I take a few before eating.”
Mr. Barreiro is exactly the type of person being targeted by a new class of supplements containing lactase — the enzyme that helps the body digest lactose, a sugar in dairy products — each promising higher efficacy, more convenient packaging, healthier ingredients or some combination of the three.
In 2023, Khai Pham left his job at an orthodontics start-up to create Milky, a supplement that contains about 20 percent more lactase than a Lactaid Fast Act tablet but is half as thick and can easily fit into a wallet.
“I just could never remember to take the Lactaid tablets with me,” Mr. Pham said. “It was like having an umbrella but never remembering to bring it with you when it was supposed to rain.”
Milktab, a company founded last year by Raymond Lei, a serial entrepreneur, sells what it calls “the most powerful lactase pill ever made.” The tablets contain three times more lactase than Fast Act tablets and other generic brands, as well as protease and lipase enzymes, which break down milk fats and casein, a protein.
People who struggle to digest dairy products make up 65 to 70 percent of the global population, according to the National Institute of Diabetes and Digestive and Kidney Diseases. More than one-third of Americans are estimated to be lactose intolerant, with susceptibility often dictated by genetic makeup; Native Americans, African Americans and an estimated 90 percent of Asian Americans cannot digest lactose properly.
Many of them can identify with Mr. Barreiro’s struggle to determine the proper dosage of lactase, though some experts question whether consumers may be confusing shiny packaging with products that are actually more effective.
Dr. Morgan Allyn Sendzischew Shane, a clinical professor of gastroenterology at the University of Miami, said lactase supplements, regardless of the producer, are generally ineffective. “They can help a little bit,” Dr. Shane said. “But for many people who are severely lactose intolerant, no amount of supplement is going to give you the freedom to drink a milkshake.”
Even for those with less severe forms of lactose intolerance, it can be difficult to gauge how much lactase their body needs, as the symptoms are transient and unpredictable. “Dairy foods have very different levels of lactose in them, so there’s a dosage difference between a tall glass of milk and a piece of hard cheese,” said Dennis Savaiano, a nutrition science professor at Purdue University and an expert on lactose intolerance.
But consumers at their wit’s end are eager for alternatives. Cale Weissman, an editor living in Queens, had struggled to digest dairy foods since he was a child, and found that Lactaid didn’t work for him. “I stopped eating dairy for about nine months and felt a lot better,” he said.
He was still curious about his underlying issues. After “going down some internet rabbit holes,” he suspected he might be sensitive to casein. His research brought him to Milktab, which worked for him.
Mr. Lei of Milktab said the product has about 10,000 customers so far. Mr. Pham, who has promoted his brand at ice cream pop-ups and through man-on-the-street interviews, declined to share Milky’s sales numbers, but said he expects sales revenues to triple in 2025.
At $29 for 45 tablets, both Milky and Milktab are about six times more expensive than Lactaid’s most powerful supplement, or generic brands. But some customers say that’s a small price to pay for an alternative to taking several doses of Lactaid.
“We didn’t know there were alternatives,” said Claire Ohara, a California-based instructional assistant who, along with her husband, switched to Milktab a few months ago. “We liked the branding and the fact that we would only have to take one pill.”
In an emailed statement, a representative for Lactaid pointed out that “the amount of lactose consumed, the timing of ingestion, individual tolerance, and lactase deficiency all factor into how well the lactase enzyme works for individuals,” and encouraged consumers to “consult their health care provider if symptoms continue after using the product.”
Dr. Shane, the gastroenterology professor, doubts any of these new products will be a silver bullet for an age-old problem. But the market for lactose-targeting products is only growing. Moops, a lactase enzyme syrup that comes in a small bottle with a pump, claims to be stronger than Lactaid and comes in flavors like salted caramel and strawberry milk. LactoJoy touts its affordability ($17.99 for 45 pills) and lack of “unnecessary additives.”
Happy Cow, founded in 2019, sells its lactose intolerance treatment in a chocolate form that is now carried at Target and other major retailers. And the founders of Bactose ($40 for 14 pills) claim that their probiotic supplement can facilitate a person’s natural production of lactase, fending off intolerance issues for a full month.
None of these companies are being held to the same standard as a pharmaceutical company developing a new drug. Dietary supplement makers aren’t required to prove that their products support a bodily function like lactose digestion, and the variables of human digestion can be hard to overcome even if someone is regimented about their lactase intake.
“You could take a supplement with thousands of units of lactase at exactly the right time,” Dr. Shane said. “But there are a lot of factors that are just out of your control.”
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