Is it a Dairy Allergy or Lactose Intolerance?
Lindsay Knake
| 4 min read
If consuming dairy milk, cheese or ice cream makes you feel unwell, how do you know whether it’s lactose intolerance or a dairy allergy?
Let’s look at the symptoms of each and how to manage the conditions.
What is lactose intolerance?
Dairy products contain a type of sugar called lactose. Lactose intolerance causes digestive distress after eating or drinking dairy products, according to the Cleveland Clinic. People who have intolerance lack the enzyme lactase, which breaks down lactose in the small intestine, leaving larger molecules the gastrointestinal (GI) tract cannot absorb. The undigested lactose leads to extra water and gas in the colon. This is called lactose malabsorption.
Symptoms of lactose intolerance include:
- Abdominal bloating
- Intestinal gas
- Stomach pain and cramping
- Stomach grumbling and growling
- Diarrhea
- Nausea and vomiting
As digestion can take up to 36 hours, symptoms may occur for a day or two after consuming dairy. While these symptoms are uncomfortable and may even be significant enough to interfere with daily life, lactose intolerance isn’t seriously harmful. As everyone has a different gut microbiome, individuals may have a different reaction to lactose. While some people with lactose intolerance could tolerate a small amount of dairy, others may not be able to digest any amount of milk products without discomfort.
Lactose intolerance often develops after childhood as most people produce less lactase as they age. The causes of lactose intolerance include genetics, conditions such as Crohn’s disease and irritable bowel syndrome, treatments like radiation therapy and premature birth, according to the National Institutes of Health (NIH).
About 36% of people in the United States have lactose malabsorption, per the NIH. Asian, Black, Hispanic and Native American people are more likely to have lactose intolerance.
What is a dairy allergy?
A dairy allergy is the body’s reaction to a protein in milk, either casein or whey, or both. The immune system sees the protein as a threat and attempts to remove it. An allergy reaction is a full body response, rather than only a GI one.
Symptoms of a dairy allergy include:
- Stomach pain
- Nausea and vomiting
- Swelling
- Hives or rash
- Wheezing and/or shortness of breath
- Itching or tingling in the lips and mouth
- Anaphylaxis in severe cases
Allergic reactions can be immediate and even life-threatening with even a small amount of a milk product, according to the Cleveland Clinic.
Fewer than 5% of people in the United States may be allergic to dairy, according to a study. About 2% of children in the U.S. are allergic to milk, according to the Cleveland Clinic. Milk allergies generally appear in a baby’s first year, but most children born with a milk allergy outgrow it by age 16.
How to manage lactose intolerance and dairy allergy
For those with a dairy allergy, avoiding dairy products is the primary treatment, according to the Mayo Clinic. If a person with a milk allergy consumes dairy and has severe symptoms such as difficult breathing, seek immediate medical attention.
Parents of children with a dairy allergy or adults with a milk allergy should talk to their primary care provider (PCP) about prevention and other treatments.
For those with lactose intolerance, skipping dairy will help you avoid the symptoms. People may also use lactase supplements made of the enzyme to aid digestion. Lactose-free dairy products or milk alternatives can also help those who struggle to digest dairy.
People should discuss taking lactase supplements with their PCP, especially if they are a child or are pregnant or breastfeeding.
While skipping dairy is important for health, people who can’t eat it should also ensure they are consuming other forms of calcium and Vitamin D. Add more of the following foods to your diet:
- Alternative milks and yogurts
- Fish such as sardines and salmon
- Leafy greens such as spinach and kale
- White beans
- Chia seeds
- Fortified foods
Image: Getty Images
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