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Lactose Intolerance Symptoms and Causes

Lactose FAQ - What are lactose intolerance symptoms and causes?

This article is a collection of FAQ and information about lactose intolerance. We have aimed to cover all of your questions about lactose, including what it is, what it means to have a lactose intolerance, possible causes, symptoms, how to get a diagnosis of lactose intolerance, foods to avoid if you are diagnosed with it, dairy foods that you can consume, things that can help you deal with and possibly recover from a lactose intolerance and a whole lot more. It’s important to note that there is a difference between lactose intolerance and dairy intolerance. If you have a question that isn’t covered, please let us know, and we will endeavour to include it for you as we regularly update this article. Let’s get started!

What is lactose?

Lactose is simply the sugar/carbohydrate component of milk and dairy products. It is broken down in the body by an enzyme called lactase.

Why are some people lactose intolerant?

Lactase enzyme production declines with age, and a large percentage of adults (up to 75%) experience lactose intolerance at some point because they no longer have the enzymes needed to break it down.

Most people can tolerate a small amount of lactose naturally, but anything over 7 to 12gm will generally cause discomfort. Some dairy foods are naturally low in lactose, and others much higher. The following table shows you how much lactose is in common dairy foods, and it’s worth noting than anything under 1gm per 100gm is generally well tolerated by people with lactose intolerance:

Dairy food Amount of lactose per 100gm
Butter 0.1 to 1gm depending on the brand
Feta cheese 0.5gm
Mature hard cheeses 0 to 0.1gm
Parmesan 0.06gm
Ricotta 0.3gm
Butter oil/ghee 0.01gm
Buttermilk 4 to 5gm
Cottage cheese 4gm
Quark 3 to 4gm
Sour cream 3.2gm
Greek yoghurt 3 to 5gm
Ice cream 7gm
Condensed milk 9 to 13gm
Skim milk powder Up to 50gm
Skim milk 4.5gm
Milk chocolate 9.5gm
Whey powder 72gm
Whole milk 4 to 8gm
Cream 5gm

What is lactose intolerance/what does it mean?

Due to inadequate lactase enzyme in the digestive tract, the lactose is not broken down properly. This allows it to freely pass through the digestive tract until it reaches the colon, where the bacteria degrade it and produce excessive hydrogen. This causes gas, bloating and cramping pain.
Lactose intolerance is becoming quite prevalent in our modern world and is in part due to poor gut health. Our guts are assaulted daily with caffeine, sugar, processed foods and chemicals (I am writing this as I drink a coffee, case in point!). Over time these toxins build up and cause damage to the lining of our GUT. Conditions such as gastroenteritis, coeliac and gluten sensitivity also damage the intestinal lining and may cause transient lactose intolerance.

Does consuming dairy cause lactose intolerance?

Consuming dairy does not cause lactose intolerance directly; however it does exacerbate the symptoms. If your body doesn’t produce enough lactase enzyme to digest lactose efficiently, then you will be throwing fuel onto the fire by consuming dairy and can expect symptoms to appear.

Lactose intolerance symptoms include:

Is itchy skin a sign of lactose intolerance?

  • Bloating
  • Abdominal pain
  • Diarrhoea or constipation – can alternate
  • Skin breakouts, including itchy skin, eczema and acne
  • Flu-like symptoms, especially sinus pain and congestion
  • Snoring – due to throat swelling
  • Poor concentration and memory – particularly in children.

There can be other symptoms as well, but these are the most common ones.

Diagnosis of lactose intolerance/ How do I find out if I am lactose intolerant?

Lactose intolerance can be diagnosed via a non-invasive breath test. The patient drinks some lactose, and over the next few hours, the amount of hydrogen excreted is recorded. If the levels are high, this signals that the lactose sugar was not broken down efficiently and lactose intolerance is present.

Lactose intolerance can also be shown via our food intolerance test. We recommend this option because you will get ALL of your intolerances covered in one test. There are over 700 items that we test for, which means that any of the things your body reacts to will most likely come up in our testing process alongside lactose if it is an issue for you.

What to do now?

Once you are diagnosed with lactose intolerance, the fun begins. The first thing to do is to remove dairy from your diet altogether. You may notice that your symptoms reduce or disappear quite quickly. However, your digestive tract still needs some help to heal. Specific nutritional and herbal medicines will assist in this process, and this is where your naturopath can support your healing.

Dairy is in many food products, and so you may also feel somewhat daunted at the thought of having to remove it altogether. Your health food store will have a range of bread and other dairy-free products, so make sure you go in and have a good talk to them.

Side note here, you don’t have to remove dairy entirely forever unless you have an allergy. The goal is to remove it for six weeks completely and strictly to allow your digestive tract to heal, and then slowly introduce small amounts back into your diet and wait to see if you react. This is how you can discover your tolerance levels. Using the table above, introduce low lactose foods first such as butter and hard cheeses. Wait a couple of days between each trial so that you know for sure which foods you react to.

What foods CAN lactose intolerant people have?

Please know that there are plenty of milk alternatives that you can use. The following is a list of readily available milk substitutes:

  • Oat milk
  • Rice milk
  • Soy milk
  • Almond milk
  • Other nut milk – hazelnut, macadamia etc.
  • Coconut milk and coconut evaporated milk – make sure they are 100% dairy-free
  • Lactose-free milk may also be an option for you, give it a try and see if you can tolerate it

I personally am intolerant to cow’s milk and find that Bonsoy is a fantastic substitute in coffee and tea. It is quite milky and does not have that soybean after taste that many soy milks do. 

For porridge and cereals, oat milk is excellent. It’s also lovely in smoothies, with a small amount of coconut milk added, maybe two tablespoons.

For cooking, rice and oat milk are good because the flavour is not strong. You will not taste it in a cake or biscuit recipe.

As far as yoghurts go, Try coconut yoghurt! It is really lovely and quite rich, so you don’t need a huge amount. 

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

  • Coconut evaporated milk and condensed milk, make sure it is 100% dairy-free
  • Dark chocolate made without milk or chocolate labelled dairy-free
  • Coconut yoghurt, almond yoghurt, goats milk yoghurt
  • Dairy-free probiotics
  • Dairy-free ice creams – these are often made with coconut milk and can be quite delicious.
  • You can try lactose-free ricotta and cottage cheese
  • Plant-based cheeses and spreads – these are made with nuts and oils instead of dairy
  • Savoury yeast flakes – these give a delicious cheesy flavour to savoury cooking and can be sprinkled onto casseroles and bakes or added to things like a dairy-free white sauce or pasta sauce to give the cheesy flavour
  • Pea or other plant-based protein powders – just avoid the ones that are made from cow’s milk

All non-dairy wholefoods including meats, vegetables, fruits, nuts, seeds, eggs, legumes and dairy are lactose-free. If your only intolerance is to lactose, then you can freely eat as much of these whole foods as you like, which gives you plenty of variety and nutrition to choose from. 

If you are unsure what food intolerances you have, we encourage you to take our food intolerance test. The results can be life-changing and allow you to remove unpleasant symptoms and get back to living your life to the fullest.

What foods should you avoid if you are lactose intolerant?

This list includes foods that contain lactose, the naturally occurring milk sugar.

  • Cow’s milk & buttermilk
  • Evaporated and condensed milk
  • Cow’s milk cheeses – soft cheeses contain more lactose, and harder more aged cheeses are often very low in lactose and can be better tolerated
  • Yoghurts and yoghurt milks
  • Yakult and acidophilus milk drinks
  • Ice cream
  • Cream and sour cream products
  • Butter and butter products
  • Cheese spreads and other cheese products
  • Cottage and ricotta cheeses
  • Hot chocolate mixes that have dairy milk powder in them
  • Chocolate chips and cooking chocolate that contains dairy
  • Dairy milk chocolate – go for dark chocolate that does NOT contain milk or dairy-free chocolate
  • Dairy-based probiotics
  • Whey protein powder
  • Also, look out for dairy in processed and packaged foods, sauces, pre-made desserts and lollies etc. This includes pre-made bread and biscuits/cakes; some of them do contain milk or butter products.

What dairy foods can lactose intolerant people consume?

The answer to following food questions is not a straight forward yes or no, the reason being that individuals with lactose intolerance can handle differing amounts of lactose depending on the severity of their intolerance. Dairy products also differ in their digestibility, with yoghurt and aged hard cheeses being much easier to digest.

The following dairy foods are lower in lactose and generally much better tolerated, however, it is still a very individual thing, and you do need to test your tolerance levels as mentioned above:

  • Butter
  • Ghee
  • Hard cheese such as parmesan and aged cheddar
  • Feta
  • Kefir
  • Properly fermented yoghurt

Can lactose intolerant people eat yoghurt?

Generally speaking, yoghurt tends to be well tolerated. This is because it is a fermented food, and the bacteria digest the lactose within the yoghurt before you’ve even consumed it. Interestingly a recent study has shown that when people with lactose intolerance ate yoghurt, they were able to digest 66% more of the lactose compared to if they just drank milk!

Choosing good quality Greek yoghurt with very little added sugar is the best option when trialling yoghurts to see what you can tolerate. It’s a very individual thing, and so the best way to find out if you can eat yoghurt is to simply try it a little bit at a time and see how your body reacts.

Can lactose intolerant eat sour cream?

Sour cream is also well tolerated because it is a fermented product. If it is the properly fermented version, then it will have a low level of lactose, and it is also generally eaten in small quantities.

However, if you are severely lactose intolerant, then the best option would be to go for a lactose-free sour cream or one made from non.dairy milk.

Like all of these foods, you need to test a little bit out to see how you react personally.

Can lactose intolerant people eat paneer?

Paneer is a soft cheese with high water content, meaning there is more lactose in it than hard cheeses. If you are moderately or severely lactose intolerant it would be best to avoid this type of cheese.

If your intolerance is only mild, the best thing to do would be to test out a small amount of paneer and see if you react.

There are also recipes readily available online, and you could try making a version of paneer with lactose-free milk.

Is Ghee safe for lactose intolerant people?

Ghee is considered a lactose free product because it is pure butterfat. The milky watery part of the butter that contains the lactose is removed when making Ghee, with the fat portion being all that is left. So yes it is generally safe for the lactose intolerant.

How does lactose intolerance differ from a dairy allergy?

Intolerances and allergies are very different. This has been discussed in detail in our article titled ‘Your food intolerance Journey ‘. Please refer back to this article for the full explanation. Still, in brief, this is the difference between lactose intolerance and a lactose allergy:

  • An allergy is life-threatening and caused by the immune system reacting to proteins in food.
  • An intolerance is not life-threatening, but it does cause some uncomfortable symptoms like bloating, diarrhoea and brain fog. It’s not related to the immune system directly. Instead, it is caused by a deficiency in lactase enzyme in the digestive tract. In the case of lactose intolerance, it is the undigested milk sugar that causes the issue.

Do probiotics help lactose intolerance?

Yes, studies have shown that taking particular strains of probiotics can indeed help you manage the symptoms of lactose intolerance. A 2019 systematic review of 15 clinical studies showed a positive relationship between taking probiotics and lactose intolerance. Certain strains of probiotics were shown to modify the metabolic activity of the bacteria in your colon, which is what alleviates the symptoms. 

Bifidobacterium longum is the strain of probiotic that has been shown to metabolise lactose most efficiently.

Lactobacillus acidophillus has also been shown to have benefits in reducing reactions to lactose.

When using probiotics to help improve lactose intolerance symptoms, it’s essential to start with minimal amounts and work your way up slowly. Introducing large quantities of bacteria that your gut isn’t used to may cause cramping, wind and other stomach upsets. Start with a quarter dosage for the first few days, increasing to the full dosage over two weeks.

Should humans consume dairy?

This is a question that comes down to personal belief rather than science, mainly because the Science swings both ways and the facts are mixed in with opinion.

Looking at the facts, we know that humans are the only species that consumes milk from another animal, and also the only species that continue to drink milk after weaning during infancy. 

However, we also know that dairy is an excellent source of calcium, protein and fat-soluble nutrients such as vitamins K, D and A. This is especially true of organic and grass-fed dairy, which offers abundant nutrients for development, health and wellness.

Bringing science and history into the equation, we discover that cultures that consume the least amount of dairy also have the lowest osteoporosis and bone fracture rates. Studies show us that dairy does not strengthen bones as advertising leads us to believe, and the saturated fat levels in dairy may also be harmful to cardiovascular health. This does depend heavily on the quality of the dairy, and whether it has been heavily processed or not.

If you do enjoy consuming dairy, the healthiest option is to go with small amounts of fermented grass-fed dairy occasionally. This includes yoghurt, kefir and fermented cheeses. The lactose in these products is broken down by the bacteria, so they are generally quite well tolerated. Ghee is also a nutrient-rich option that is very well tolerated because it has virtually zero lactose, as mentioned above.

Can I become a vegetarian even though I'm lactose intolerant?

Absolutely! Being a healthy vegetarian does not rely on the presence of dairy in your diet. If you are worried about the calcium component of foods, then please know that there are some very rich plant-based sources of calcium. These include sesame seeds, broccoli, spinach and other leafy greens, chia seeds, hemp seeds and beans/legumes such as soybeans and lentils. These sources of calcium are also very easily absorbed by your body, so with a rich and varied plant-based diet, you won’t be missing out on calcium or protein. 

There are also plenty of delicious and well balanced vegan meal options that will fulfil your bodies nutrient requirements and your taste buds. A simple internet search will show you some great blogs and websites for nourishing vegan recipes.

Is there a way to cure lactose intolerance naturally?

This is an interesting question because strictly speaking, there isn’t a way to increase your bodies production of the lactase enzyme. There are however ways that you can manage lactose intolerance, and even improve your bodies tolerance levels to dairy products. 

Taking certain strains of probiotics has been shown to increase the bodies ability to digest lactose, along with consuming small amounts of fermented yoghurt or kefir. You can also take the enzyme lactase in tablet form, which helps with digesting dairy products. 

Many people who are having difficulties digesting lactose and milk products may also be suffering from leaky gut or SIBO. You can read more about this in our article titled’SIBO and food intolerances ‘. In these cases, completing a gut healing treatment plan with a Naturopath or holistic practitioner may result in the ability to tolerate dairy foods again without any issues.

Is there any treatment for lactose intolerance?

Not specifically, however, as mentioned above there are certain conditions that may be causing the lactose intolerance, and once these are addressed and healed then lactose may not be an issue anymore.

There are also specific probiotic strains that can help reduce lactose intolerance, and specific lactase enzymes available on the market that can help you tolerate dairy if needed.

Can you be lactose intolerant to just milk?

There are varying levels of intolerance, and so it is possible for some people to react to cow’s milk but not to yoghurt and cheese. Both yoghurt and cheese are fermented products, and the bacteria used to ferment them digests a lot of the lactose, which makes them generally easier to digest than plain milk. So yes, you can react to just milk and not to other dairy products.

How long do the symptoms of lactose intolerance last?

This is dependant on your individual digestive process, and how long it takes your body to digest and remove the lactose from your system. Symptoms can start anywhere from 30 minutes after eating lactose, to 2 days later. They can last a few days, and because they may take up to 48 hours to appear, it can create a lot of uncertain around which foods are causing the reaction.

Keeping a food diary of what you are eating and your symptoms is a good way to help pinpoint the foods you are reacting to.

What is it like to be lactose intolerant?

Quite uncomfortable! When someone who is lactose intolerant consumes dairy products, they can expect to get some bloating, gas and wind pains, diarrhoea and potentially brain fog and head fuzziness. These symptoms can last from 1 to 4 days, and if dairy is continuously consumed, they may be present constantly.

The best way to manage this is to remove dairy from the diet for a three month period, which allows the digestive system to rest and repair. After this time lactose intolerant people can slowly re-test dairy and find out what their tolerance levels are to things like yoghurt, milk, cheese and butter. Some people can’t have any, and others may be able to have certain types of cheese and yoghurts without issue. It’s very individual.

In terms of eating out and being social, people with lactose intolerance find it quite manageable. Many restaurants cater to food intolerances these days, and it’s always a good option to phone ahead if you aren’t sure and speak to the chefs about your needs.

How to get rid of gas caused by lactose intolerance?

The easiest way to do this is to remove dairy from your diet altogether. This will allow your digestive system to rest and release inflammation and excess gas. If you’re lactose intolerant and continue to consume dairy, you will most likely continue also to experience gas. 

If you’ve accidentally consumed dairy or had a bit more than your tolerance level, then some home remedies will help to expel the gas from your system. 

  • Ginger – grate 1 tsp fresh ginger into boiling water and take as a tea once it’s cooled. Ginger is wonderful for the digestive system and will help ease gas and pains.
  • Peppermint – make a strong peppermint tea infusion, this will help expel the excess gas
  • Essential oils of ginger and peppermint can also be diluted and rubbed onto the stomach to help ease pains and gas.

Taking lacteez enzymes when you do consume dairy also helps some people, and is a good option if you know you can’t avoid dairy while out or at a function etc. This product introduces more lactase enzyme into your digestive tract, which helps to digest the milk sugars before they reach the colon. If they aren’t digested by this time, then the bacteria in the colon will have a field day with the sugar (lactose) and create much gas and bloating.

Can lactose intolerance be inherited?

Yes! There is a strong genetic link in people with lactose intolerance. It also depends a lot on ethnicity. People with Asian descent have a very high propensity to lactose intolerance because dairy is not part of the cultural food in Asia. It’s estimated that up to 95% of people in some parts of Asia and Africa are affected by lactose intolerance. In Europe, it is very different, as dairy was a big part of the nomadic culture and helped immensely with nutrients and health. Only 5% of People of European descent exhibit lactose intolerance.