Contrary to popular belief, lactose intolerance and a milk allergy are not the same thing at all. A true allergy involves the immune system over-reacting to a substance that is harmless to most people. In this situation, the person’s body creates antibodies (IgE) against a particular allergen (i.e. peanuts). The first exposure doesn’t usually cause a reaction but it sensitizes the susceptible individual so that future exposures will cause an allergic reaction. These are very different from the typical lactose intolerance symptoms.
A milk allergy is a reaction to the protein in the milk that causes a response at a cellular level. Symptoms can range from hives, excema, itchy eyes, to nausea, vomiting, diarrhea and abdominal pain to the most extreme symptoms which include swelling of the mouth, tongue and face and even anaphylaxis which is a life threatening condition where the person is unable to breathe.
Lactose Intolerance Symptoms
Lactose intolerance on the other hand does not involve the body’s immune system and, while unpleasant, is not life-threatening. Lactose intolerance occurs when the body does not make enough of the enzyme, lactase, which is responsible for breaking down lactose (the sugar in milk). Lactose must be broken down into two smaller sugars (glucose and galactose) in order to be absorbed into the blood.
Some people become lactose intolerant as they age and as their bodies start to make less lactase. A person may inherit a tendency to lactose intolerance. Another cause of lactose intolerance occurs after damage to the small intestine. Damage can be caused by illnesses such as Celiac disease or Crohn’s disease where chronic inflammation causes changes to the structure of the intestine. Severe diarrhea can also trigger lactose intolerance.
The most common lactose intolerance symptoms are gastrointestinal in nature and include flatulence (gas), bloating, abdominal pain, nausea and diarrhea. If you experience these symptoms after eating dairy products and thing that you may be lactose intolerant, talk to your doctor or naturopath. Your doctor will probably recommend that you completely eliminate dairy from your diet to see if your symptoms subside. If they do, your doctor will probably not recommend further testing. If the doctor feels a need to confirm the diagnosis with medical tests, however, she may order a hydrogen breath test (undigested lactose creates high levels of hydrogen compared to lactose that is properly digested) or a stool acidity test (undigested lactose leads to increased lactic acid in the stool).
Living with lactose intolerance requires finding the balance of dairy consumption that works for you. Depending on the severity of your lactase deficiency you may be able to consume a fair amount of dairy products before symptoms set in. Or, you may only be able to tolerate a very small amount of dairy or even none at all. It is helpful to keep a food diary when determining which foods set you off. It is interesting to note that not all dairy foods contain the same amount of lactose. Yogurt is generally lower in lactose than fresh milk, particularly if it is home made and fermented for longer than commercial yogurts generally are. Fermentation breaks down the lactose which is why those who are lactose intolerant can often eat yogurt. Hard cheeses like cheddar are also usually better tolerated than the softer cheeses. These days you can also buy lactose free milk. And, if you really, really want that Dairy Queen Blizzard but are afraid of the after effects, ask your pharmacist for the lactase enzyme which you take at the same time as your dairy products.
Finally, if you choose not to consume dairy products, ensure that you are getting your calcium from other sources.
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