Popular pharmacy: lactose hidden in pills causes gas

By Joe Graedon, MS,

and Teresa Graedon, Ph.D.


Q. You recently wrote about foods that cause gas. People should know that many pills contain lactose as a filler. Although it may be a small amount in each tablet, for those with lactose intolerance it is a repeated small insult to the digestive tract. It can cause gas, bloating, cramps, and diarrhea.

I don’t understand why lactose is still used when many adults cannot digest it. Some of my prescriptions aren’t available without lactose, so I take a lactase enzyme pill every day just to counteract the lactose.

I wrote to the Food and Drug Administration to remove this charge from our drugs. So far, I have had no response.

A. Lactose (milk sugar) is indeed a filler in many medicines. Manufacturers like to use it because it is available and helps them get active ingredients into pills of the right size and shape. Over-the-counter medicines may contain lactose, including certain digestion aids.

To find out if a drug contains lactose, see the DailyMed website. Searching for any drug will provide data on inactive ingredients.

Q. A few years ago I saw a new doctor because I had found a lump in my breast. My mother died of a rare type of breast cancer, so I was anxious.

My blood pressure was so high in the examination room that the doctor called an ambulance and sent me to the hospital. If a doctor or nurse came to check my pressure, it went up, but when they walked away, it went down. They made me wear a monitor at home and was diagnosed with white coat syndrome.

Waiting for the results of a breast cancer test made me very anxious and my blood pressure skyrocketed. I’m not even sure I need blood pressure medication. I measure it at home and take my readings with me. Do I really need medication if my pressure is high only in the doctor’s office?

A. Doctors disagree on the need to treat white coat hypertension. Some believe this signals reactivity to stress. Because people are exhausted in many different circumstances, these doctors believe drug treatment is appropriate.

An Italian study of nearly 1,200 elderly people with high blood pressure found that white coat hypertension slightly but not significantly increased the risk of a cardiovascular event (American Journal of Hypertension, November 1, 2017).

You can ask your doctor to reduce your medication. To prepare for this conversation, you can read our eGuide on Blood Pressure Solutions. This electronic resource can be found under the Health eGuides tab at It provides information on non-drug approaches, appropriate measurement techniques, and the pros and cons of drugs.

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