A common question I receive in practice is why some people can tolerate yoghurt and cheese, but they cannot seem to handle digesting milk. If that sounds like you, in this blog we are going to cover what lactose intolerance is, and it might shed some light onto why this is the case for you.

Lactose is a sugar found in cow’s milk and other dairy containing products. As a baby, most of us can digest this sugar as we make the enzyme lactase, which breaks it down into a form the body can absorb.

When this enzyme is deficient, instead of being broken down, lactose passes through to the colon where our gut bacteria ferment it instead. This can cause unpleasant symptoms such as gas, bloating, nausea, diarrhoea and general abdominal discomfort. Usually, these symptoms happen within about 20 minutes of having dairy, but if you’re having dairy more than once a day it could be happening all day! The level of symptoms will depend on the level of lactose inside the dairy you’re choosing to eat - and this is why some people struggle only with milk, whereas others can’t even handle a spread of butter on their toast.

Who is more likely to suffer from lactose intolerance?

Your ethnicity and genes play a large role in your ability to make lactase, with about 50% of the world’s population unable to make enough. If you are from eastern or central Asia you are more likely to be lactose intolerant, with 80-90% of Asians experiencing this. They are closely followed by African, indigenous north Americans, southern Indians and Hispanic populations.

We can also lose the ability to produce lactase at quite an early age with some people noticing symptoms as early as 5 years old. This is when your son or daughter starts complaining of tummy ache before bed when they have had a big bowl of ice cream for dessert!

The other common, and more short term version of lactose intolerance, can happen after a bout of gastro or a stomach bug that strips the digestive tract of the lactase enzyme (and everything else!). So if you or your kids suddenly seem dairy intolerant after gastroenteritis, you’ve probably got some short term lactose intolerance, and will need to remove it for a month or so to allow the gut to rebuild it’s lining.

Lactose intolerance vs dairy allergy

Lactose intolerance is not an allergy but more like a scale, with many of us able to consume dairy with no issues at all, while others can only tolerate it in small amounts. Some of the dairy products we consume like yoghurt, contain specific bacteria that help break down the lactose and ferment it, making it easier for us to digest. It also depends on the amount of dairy you are consuming each day - the more you consume, the more enzyme you need to digest it.

This is very different to a true milk allergy because in this scenario, your immune system is reacting to one or more of the proteins found in milk, and has nothing to do with enzyme deficiency.

With a milk allergy your body produces antibodies against these milk proteins (remembering lactose is a sugar), and some of your white blood cells called lymphocytes are sensitised. In this type of allergy, you will usually see symptoms arise within an hour of consuming a milk containing product and the reaction is much more severe. Symptoms can be anaphylactic type ones that involved difficulty breathing, skin rashes and vomiting.

Managing lactose intolerance

There are things you can do to manage lactose intolerance and avoid having unpleasant gut symptoms. Removing dairy from your diet is the most obvious treatment if your symptoms are severe. There are many great dairy-free recipes out there to make the transition easier. Use the code: DAIRYFREE to get 20% off this dairy free recipe book!

If your symptoms are mild, then removing dairy for a period of time and reintroducing it will allow you to pinpoint which products are the main offenders. Thinking back to the scaled approach, where we all have different tolerance levels, you might find that you can handle butter, but not milk. Or perhaps handle lactose free milk, but not full cream. There is a bit of trial and error, but the key initially is to remove it for long enough to allow the gut lining to heal, otherwise you won’t get far with your trial and error testing.

There are many good quality dairy free products on the supermarket shelf nowadays such as nut and coconut varieties that are both delicious and healthy, which could be used instead. You could also try using lower lactose containing products such as hard cheeses like parmesan and cheddar.

Alternatively, there are also specific enzymes you can take with dairy containing meals that help digest the lactose in foods reducing the severity of symptoms.

Sometimes, the only way to resolution is to work with a professional who can support you in truly healing your gut. It could be that even when you remove dairy, you’re not seeing the changes you’d like to, because there are multiple layers happening such as microbiome/gut bug imbalances, or inflammatory processes that need extra support.

Too much of a good thing

As with most foods, consuming a lot of one type will skew your digest health. If dairy is an issue for you, or you have tried these tips and haven’t seen any change, it sounds like you need some advice getting your health back on track.

I invite you to book a free 15min chat with me to see if I could be the right person for your digestive health.