What's it like to try the elimination diet? What were the results?
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Probably the most common way that people self-diagnose lactose intolerance is
by an elimination diet, a diet that eliminates milk and milk products.
There are several problems with this type of "testing."
Milk products are so common in prepared foods from the supermarket or restaurant
that it is likely that an elimination diet that is not rigorous (i.e.,
does not eliminate all milk-containing products) will still include substantial amounts of
milk. Thus, persons with severe lactase deficiency attempting an elimination
diet may be ingesting enough lactose to have symptoms and erroneously conclude
that lactose intolerance is not responsible for the symptoms.
People often make the assumption that they are lactose intolerant based on
a short trial of elimination. A short trial may be adequate if symptoms are
severe and occurring daily, but not if the symptoms are subtle and/or variable.
In the latter case, an elimination diet may need to be continued for several weeks.
Because symptoms of lactose intolerance are subjective and variable, there
always is the possibility of a "placebo effect"
in which people think they feel better eliminating milk when, in fact, they are
If an elimination diet is to be used for diagnosing lactose intolerance, it
should be a rigorous diet. A rigorous diet requires counseling by a dietician or
reading a guide to a lactose-elimination diet. The diet also needs to be
continued long enough to clearly evaluate whether or not symptoms are better. If
there is doubt about improvement on the diet, particularly if symptoms normally
fluctuate in intensity over weeks or months, repeated periods of lactose
elimination should be tried until a firm conclusion can be drawn. Elimination of
all milk products should eliminate symptoms completely if lactose intolerance
alone is the cause of the symptoms.