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Lactose FAQ

LACTOSE INTOLERANCE

Let’s learn about lactose and why some people are intolerant to it.

All milk and dairy products contain a carbohydrate or sugar component, and this is what lactose is. An enzyme called lactase is what breaks down lactose in the digestive tract.

This lactase enzyme declines in most people after they are weaned from mothers breast milk and formula. Up to 75% of adults suffer from lactose intolerance because of an absence of enough lactase enzyme to break dairy products down.

As a whole humans can have minimal amounts of lactose and tolerate this quite well, but products that have over 7gm+ of lactose per 100gm generally cause issues. The following table shows the amounts of lactose per 100gm in common dairy foods. 

Please note that people with lactose intolerance can often still tolerate anything that has less than 1gm of lactose per 100gm unless they are severely intolerant or allergic.

Here is a simple dot point table of dairy foods and how much lactose they contain per 100gm, the amounts do vary depending on the brand:

  • Butter – 0.1 – 1gm of lactose per 100gm
  • Ghee – 0gm of lactose per 100gm
  • Parmesan cheese – 0.06gm per 100gm – this is a very low lactose cheese
  • Ricotta cheese – 0.3gm per 100gm – this is a wet cheese, so it has more lactose
  • Cottage cheese – 4gm per 100gm
  • Buttermilk – 4 – 5gm per 100gm
  • Whole milk – 4-8gm per 100gm
  • Skimmed milk – 4.5gm per 100gm
  • Greek yoghurt – 3 to 5gm per 100gm
  • Soured cream – 3.2gm per 100gm
  • Whole cream – 5gm per 100gm
  • Condensed milk – 13gm per 100gm
  • Skim milk powder – up to 50gm per 100gm
  • Whey powder – up to 72gm lactose per 100gm

What does it mean to be lactose intolerant?

When someone is diagnosed as lactose intolerant, it means that they have insufficient lactase enzyme. Primarily what happens is that rather than being broken down, the lactose reaches their colon and excessive amounts of hydrogen are produced. As you can imagine, this causes embarrassing gas scenarios, and also lots of bloating and cramping.

Like many other food intolerances, lactose intolerance is on the rise. Some of the reasons for this include poor diets that are high in processed foods, sugars and excessive caffeine. These foods all damage the delicate gut lining and cause digestive issues, including intolerances. Transient lactose intolerance can also be caused by conditions such as celiac disease. When wheat is removed from the diet, the gut may heal enough to manage lactose again.

Can lactose intolerance be caused by consuming dairy?

No, it can’t. However, if you do have a deficiency in lactase enzyme when you consume dairy products, your symptoms will worsen.

These are the main symptoms of lactose intolerance:

  • Mild to severe Bloating
  • Abdominal pain and cramping that can also be mild to severe
  • Diarrhoea or constipation – it’s common for this to alternate
  • Skin breakouts – acne, eczema, itchy skin, any kind of red skin irritation
  • sinus pain, congestion and other flu-like symptoms
  • Snoring – due to throat swelling and inflammation

How do I get a diagnosis of lactose intolerance?

There are a couple of different ways that lactose intolerance can be diagnosed.

Via your GP you can have a hydrogen breath test, which involves drinking lactose and having the amount of hydrogen you excrete recorded over several hours. If the hydrogen levels are high, this signals a possible lactose intolerance.

You can also have an IgG food intolerance blood test, which involves a blood draw and can show up lactose as an issue for you.

You can also use our non-invasive food intolerance test, which uses a few strands of your hair and will show up ALL of your intolerances in one test. This is because over 700 items are covered, and whichever foods your body is having issues with will be shown on your test results.

Click HERE to book your hair test.

First steps after a diagnosis.

After your initial diagnosis, things can seem a little scary, and you can be left wondering what to eat and how to tackle your diet now.

Let’s break it down into simple steps that you can follow:

Firstly remove all dairy from your diet. When you do this entirely, you give your body a chance to recover and to remove the inflammation caused by dairy consumption. You will probably notice that your symptoms reduce quite quickly if you stick firmly to no dairy consumptions. 

Secondly, visit your local health food store and ask them to show you their dairy-free range of products. They will have things like bread, crackers, biscuits, dips, yoghurts and other non-dairy products that you can use. If you don’t have a local health food store, then go online to find dairy-free products.

After six weeks of being strictly dairy-free, you can use the table above and introduce low lactose foods first. Wait a couple of days after each dairy food that you try so that you can get a good gauge on how much you can tolerate and what dairy foods you are still reacting too. Everyone’s tolerance levels are different, and you may find that you can have some natural yoghurt and parmesan, for example, and still be ok.

Safe foods for the lactose intolerant:

Luckily these days, being lactose intolerant doesn’t mean that you can’t have coffee, custard or baked goods. There are loads of milk alternatives to try, and these include all of the plant-based milk options.

  • Soy milk – bonsoy is a great brand
  • Almond and other nut milk
  • Oat milk
  • Rice milk
  • Coconut milk
  • If it’s tolerated well by your body, then lactose-free milk is also an option

For coffee, Bonsoy is a great substitute. It doesn’t have a soybean aftertaste like many other soy milks, and it froths up well. Many people also enjoy almond milk in their coffee.

In terms of cooking, oat milk and rice milk are excellent replacements for baked goods.

Oat milk is also great in porridge and smoothies, and you can also trial coconut milk here and see what your taste preferences are.

Coconut and almond yoghurts are readily available these days too. It’s about trialling the different options to find out what works well with your taste buds and your body.

Here is a list of other non-dairy foods that you can use to substitute for dairy products:

  • Non-dairy condensed and evaporated milk, these can be found in coconut or soy
  • Dairy-free chocolate
  • Alternative yoghurts such as coconut or almond
  • Coconut or cashew ice creams
  • Vegan cheeses and spreads – usually made with nuts and or savoury yeast flakes for that cheese flavour. You can use savoury yeast flakes in cooking and to make cheese sauces too.
  • If you want to use a protein powder, make sure it is plant-based. Pea based ones are a good option.

Wholefoods are ALL lactose-free. These are foods that are still whole, the way that nature intended them to be: eggs, nuts and seeds, vegetables, fruits, legumes and lentils

Foods to avoid for the lactose intolerant:

If you are lactose intolerant, the best option is to avoid ALL dairy foods. This obviously includes all types of cow’s milk, including buttermilk and milk products.

  • Yoghurt and any type of Yogurt or probiotic drinks
  • Ice cream unless it clearly states its lactose or dairy-free
  • Cream and all other cream products such as sour cream, quark etc
  • Butter and all butter products
  • Cheesy spreads and all types of cows milk cheeses
  • Chocolate and hot chocolate if it contains dairy milk
  • It’s also a good idea to check all processed and pre-made foods for any dairy products in the ingredient listing

Are there any dairy foods that lactose-intolerant people CAN consume?

This is an interesting question because the amount of lactose that someone with lactose intolerance can handle will differ significantly from person to person. Dairy products are also digested differently depending on what other components they contain. Things like natural Yogurt and hard cheese like parmesan, for example, are usually quite easy to digest compared to milk and ice cream. 

This list contains dairy foods that have lower lactose content, making them easier to digest. However, everyone is different, and you need to test out your tolerance levels in order to know if you can have certain dairy foods or not:

  • Parmesan, aged cheese and feta cheese are often well tolerated
  • Ghee has virtually no lactose and is excellently tolerated.
  • Butter seems to be well tolerated also, but its very individual and you need to test it for yourself
  • Properly fermented Greek yoghurts and kefir are also well tolerated because the bacteria have pre-digested the lactose

Is Yogurt ok for lactose-intolerant people to eat?

This depends on the type of yoghurt and the person. If you look at the table above that states the lactose levels in different foods, you can see that Greek yoghurt has between 3 to 5gm of lactose per 100gm. Foods with under 1gm lactose per 100gm are generally well-tolerated, but anything above that needs to be tested by the individual to see if they can tolerate it or not.

However, because Yogurt is a fermented food, it is usually well-tolerated due to the bacteria digesting most of the lactose in the Yogurt. It’s also been shown in a recent study that lactose-intolerant participants who ate Yogurt could digest 65% more of the lactose compared to simply drinking milk.

If you want to trial yoghurt, choose a good quality Greek one that has little to no added sugar. Give your body a couple of days after you try the Yogurt to see if you have any reactions.

Is sour cream safe for the lactose intolerant?

Like Yogurt, sour cream is fermented, which makes it generally well tolerated. Well made sour creams will be properly fermented, which also lowers the lactose levels.

IF you want to try sour cream to see if you can tolerate it well, choose a well made good quality one and test out a small amount to see how you react personally.

Is paneer cheese safe for the lactose intolerant?

Paneer is a probable no for the lactose intolerant because it has high water content. The water content is where the lactose resides, so this type of cheese has much more lactose than hard cheeses.

It is best to steer clear of this unless your intolerance is only mild. In this case, you can test out a small amount and see how you react.

If you love this style of cheese, you could also try making your own with lactose-free milk; you can easily find recipes online.

Can lactose intolerant people eat ghee safely?

Ghee is made from pure butterfat, with all of the watery portion of the butter removed. This makes it a naturally lactose-free product. So yes, it is usually very well tolerated for lactose-free people.

How is a dairy allergy different from lactose intolerance?

Diary allergy is entirely different to lactose intolerance; in fact, in our previous article called ‘Your Food Intolerance Journey’, we have talked about this in detail. Please refer to that for the full explanation.

In brief, food intolerance is not an immune system reaction. Instead, in the case of lactose intolerance, it is caused by a deficiency in the lactase enzyme. This causes symptoms such as cramping, bloating, diarrhoea, headache and skin irritation, but it is not life-threatening.

A dairy allergy, or any food allergy, IS life threating. It is an immune reaction to protein components in dairy.

Does lactose intolerance respond to probiotics?

YES! There has been a recent systematic review done in 2019 that showed a definitive positive relationship between probiotic usage and lactose intolerance.

Both Bifidobacterium longum and Lactobacillus acidophilluswere shown to be beneficial in reducing reactions to lactose. These strains of probiotics were shown to modify the bacterial activity in the colon, which is believed to be what alleviates the symptoms of lactose intolerance.

If you are new to probiotics there are a couple of essential things you need to be aware of:

Firstly, make sure you are getting a dairy-free probiotic!

Secondly, start with a very small amount and work your way up to the recommended dosage slowly. You could cause cramping, wind and stomach upset if you start at the full does without any prior exposure to these probiotics.

Should people eat dairy?

There isn’t a clear cut yes or no to this question. The answer is based on personal belief, but here is what we know:

We know that humans are the only animal to consume milk from another species, particularly after weaning. No other animal does this.

However, we are also the only animal with the capability to farm and cultivate our own food.

Dairy is an excellent nutrition source, especially if it is organic, raw and grass-fed dairy. In saying this, we also know that it doesn’t strengthen bones and advertised, and in fact, may be a causative factor in osteoporosis due to acidity. This depends heavily on the processing of the dairy and if it is good quality or not.

If you love dairy and want to keep having it, the healthiest options are fermented products such as kefir, Yogurt and cheeses. Ghee is another highly nutritional and lactose-free option, as mentioned above.

Can lactose intolerant people still be healthy vegetarians?

Yes, definitely. Dairy is not a necessary component of a healthy vegetarian diet. Instead, the basis of a healthy and nutritious plant-based diet should be:

  • Many and varied sources of vegetables
  • Fruits
  • Nuts and seeds
  • Lentils and legumes
  • Eggs

Things like sesame seeds, broccoli and other leafy greens, chia and hemp seeds and legumes and lentils are also rich sources of calcium.

Vegan recipes these days are also often well balanced and rich in nutrients, so you can easily fulfil your bodies nutrient requirements with a well thought out plant-based diet. You can find some great recipe blogs and information about this with a google search.

What natural treatments or cures are available for lactose intolerance?

Lactose intolerance can be managed naturally, but there is no cure for it.

The best way to manage your lactose intolerance is to avoid consuming dairy products all together. However, there are times when you may not be able to prevent it, and so you can take specific enzymes that contain lactase in tablet form. This helps with digesting dairy products.

Taking certain probiotic strains, as mentioned above, can also help to increase the bodies ability to tolerate and even digest lactose. Consuming small amounts of kefir daily has been shown to help some people as well.

If your lactose intolerance is due to another condition such as SIBO or leaky gut, then treating the condition and healing the gut may also heal up the transient lactose intolerance. We have an article titled ‘SIBO and food intolerances’, where you can read a lot more about this scenario.

Can you be lactose intolerant to only milk and no other dairy products?

Essentially yes. Everyone is so individual with what they can and can’t tolerate, and thus no two people with lactose intolerance will have exactly the same reactions to dairy foods. For example, person 1 with lactose intolerance may be able to consume cow’s milk but not Yogurt or cheese, and person two may be able to have cheese but not cow’s milk or Yogurt. 

It is very possible for a person with mild lactose intolerance to only react to cow’s milk specifically, and yet be able to tolerate fermented Yogurt and cheeses perfectly fine. Because Yogurt and cheese are fermented products, the bacteria within them digests a lot of the lactose, but this does not happen with pure milk.

Do lactose intolerance symptoms last a long time?

Again this is really individual. Some people can have an immediate feeling of bloating and gas upon consuming lactose, and others may not react for a whole two days. The symptoms can last up to 4 days, or perhaps just one day. If they are occurring two days after consuming the food, it can also cause much confusion around what foods are causing the symptoms. In this case, keeping a food diary is a great idea. It gives you a way to help pinpoint the issues.

Taking our food intolerance test is even better, as it will show you what foods are the problem ones for you, and allow you to start healing.

How does it feel to be lactose intolerant?

In short, it feels like you are gassy and bloated ALL the time, often with uncomfortable wind pains and bowel urgency.

When the lactose intolerant person consumes dairy, they can have symptoms that last from 1 to 4 days. If they have dairy all the time, then their symptoms could be present constantly. They can include gas, wind pains, bloating, diarrhoea and things like brain fog, eczema, acne and postnasal drip as well.

Eating out is quite manageable because many restaurants cater for food intolerances and allergies. Phoning ahead to make sure your dietary requirements can be met is also a great idea; this way you won’t get stuck in an awkward situation.

My lactose intolerance causes so much gas, what can I do?

Gas is one of the most prevalent and most awkward symptoms of lactose intolerance; lets be honest!

The easiest way to remove it is to also remove dairy from your diet completely. When you do this for a few weeks, it allows your body to release all the gas and inflammation that the lactose caused. If you don’t remove dairy and you are lactose intolerant, your gas will most likely continue.

There are some simple remedies that you can try for the times that you accidentally consume dairy, or have a bit more than you can tolerate:

  • Grate 1 tsp fresh ginger into boiled water, allow to cool and then drink. Ginger can help to ease gas and fire up the digestive process.
  • Peppermint – Peppermint tea is known for expelling gas, so be warned. It does help ease the gas and bloating once the initial phase is over. Make a strong infusion for it to work well.
  • Diluting specific essential oils to rub on the abdomen can really help. Peppermint and ginger are excellent choices for this.

You can also try taking enzymes that have lactase in them. This can be a good option if you know that dairy is unavoidable at a function or event.

Is lactose intolerance hereditary?

Lactose intolerance has a powerful genetic link and runs in families. It is also highly prevalent in the Asian population, with up to 95% of people in some parts of Asian and Africa being affected by lactose intolerance. People of European descent are the opposite, with only 5% of Europeans exhibiting lactose intolerance. This is believed to be due to the presence of dairy in nomadic European culture, as it was an essential food and nutrition source during ancient times. In Asia, the opposite was true, and there was virtually no dairy in their diet. Therefore it is believed they did not need the lactase enzyme after weaning.