How Do I Know if I Am Lactose Intolerant or Allergic to Milk?

Medically Reviewed on 6/11/2021

Lactose intolerance or milk allergy?

Lactose intolerance is caused by a deficiency of an enzyme (lactase) that helps digest the sugar (lactose) in milk. Milk allergy, on the other hand, is an adverse immune reaction to proteins found in milk. The symptoms of the two conditions are different.
Lactose intolerance is caused by a deficiency of an enzyme (lactase) that helps digest the sugar (lactose) in milk. Milk allergy, on the other hand, is an adverse immune reaction to proteins found in milk. The symptoms of the two conditions are different.

Lactose intolerance is caused by a deficiency of an enzyme (lactase) that helps digest the sugar (lactose) in milk. Milk allergy, on the other hand, is an adverse immune reaction to proteins found in milk. They are completely unrelated conditions except that they share a common cause: milk and dairy products. Patients with lactose intolerance will have symptoms limited to the gut (gastrointestinal tract). However, patients with a milk allergy may present with respiratory as well as gastrointestinal tract issues.

Symptoms of a milk allergy are usually seen immediately or within a few minutes following the exposure, but symptoms could also take up to 20 hours to appear. Symptoms of milk allergy are

Milk allergy is potentially life-threatening and can be as severe as an anaphylactic shock, which can be fatal. If you suspect you or a family member has a milk allergy, then allergy testing is highly recommended, especially if they also have asthma. Milk allergy should be evaluated by an allergist. They will take into consideration the patient’s history, blood work and other diagnostic tools to diagnose a milk allergy and choose an appropriate course of action. With the use of immunotherapy treatment, it may be possible to try milk again. In these cases, a food challenge can be the final assessment of the tolerance of milk.

Lactose intolerance is caused by a deficiency of an enzyme (lactase) that helps digest the sugar (lactose) in milk. Milk allergy, on the other hand, is an adverse immune reaction to proteins found in milk. The symptoms of the two conditions are different.
Lactose intolerance is caused by a deficiency of an enzyme (lactase) that helps digest the sugar (lactose) in milk. Milk allergy, on the other hand, is an adverse immune reaction to proteins found in milk. The symptoms of the two conditions are different.

Symptoms of lactose intolerance may occur within minutes or hours after consuming lactose-containing products. Symptoms are

Lactose intolerance is the inability to break down the sugar or lactose in dairy products due to the lack of the enzyme lactase. This inability causes the production of excess gases, hydrogen and methane, resulting in gut discomfort. Levels of these gases can be tested through a breath test to identify the condition. Although this condition is uncomfortable, it’s not usually dangerous or life-threatening. Patients with lactose intolerance may need to meet a gastroenterologist for further evaluation. Individuals need to just limit the amount of lactose consumed in one sitting or eat it with other foods. Other options are

  • Using milk that has lactase added, which breaks down the lactose before consumption.
  • Taking a lactase tablet that helps the body digest the lactose.

It’s important to note that the amount of lactose varies in different foods. For example, yogurt and cheese will naturally have less lactose because some of it has been broken down during the fermentation process. Hence, these may be better tolerated by those with lactose intolerance. Lactose intolerance is often seen as people age when the production of lactase naturally decreases. Lactose intolerance is also more prevalent in certain ethnicities: Asians, Africans, Native Americans and those of Middle Eastern descent.

Dietary differences:

  • The dietary implications depend on the condition people have. With a milk allergy, it is recommended to eliminate all milk products from the diet.
  • With lactose intolerance, it is not always necessary to remove all milk products. Certain milk products, such as aged, hard cheese, butter or probiotic-rich plain yogurt have very little lactose in them, which might be tolerated by the body. However, this depends on the severity of lactose intolerance.

Alternatives:

  • Both milk allergy and lactose intolerance are manageable conditions with slight dietary modifications.
  • There is evidence to suggest that breastfeeding can reduce the risk of allergies, but it should be acknowledged that it’s not always possible for women to breastfeed.
  • Several alternatives are available for individuals with a milk allergy. Hypoallergenic formulas containing hydrolyzed proteins are safe to consume and least likely to cause an allergic reaction.
  • Soy-based formulas are also an alternative. However, soy may be an allergen for some people.
  • Lactose intolerance can be managed by dietary modification and lactase enzyme supplementation. These products are available in many grocery stores and are just as healthy as regular milk and milk products.
  • Alternative sources of milk nutrients (such as calcium, vitamin A and protein) include fish, broccoli and leafy greens, oranges, almonds, Brazil nuts, dried beans, tofu and products with labels that show they have added calcium or vitamins.

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Medically Reviewed on 6/11/2021
References
WebMD: "Lactose Intolerance vs. Dairy Allergy." https://www.webmd.com/digestive-disorders/lactose-intolerance-or-dairy-allergy

Food Allergy Research & Education: "Milk Allergy vs. Lactose Intolerance." https://www.foodallergy.org/resources/milk-allergy-vs-lactose-intolerance