Lactose Intolerance, Milk Protein Intolerance & Dairy Milk Allergy. What’s the difference?

Many people get confused about the differences between lactose intolerance, milk protein intolerance and dairy milk allergy, so in this article I’d like to help explain these conditions.

Dairy Milk Allergy

Dairy milk allergy is one of the most common allergies people suffer from, especially children and babies. It is caused by an immune system response to the allergens present in dairy milk and any products which contain dairy milk.

If you have a dairy milk allergy and you consume dairy milk your body identifies the proteins in the milk as dangerous which causes it to react by releasing histamine and other chemicals which cause allergy symptoms.

Symptoms of a dairy allergy can vary, with many of them presenting similarly to lactose intolerance, such as:

  • Abdominal cramping
  • Bloating
  • Diarrhoea
  • Gas
  • Nausea
  • Vomiting

However, dairy milk allergy can also create more severe allergic reaction symptoms affecting the lungs and skin, such as:

  • Hives
  • Rashes
  • Nasal stuffiness
  • Runny nose
  • Watery eyes
  • Difficulty breathing
  • Facial swelling
  • Throat tightness
  • Difficulty swallowing
  • Wheezing
  • Vomiting

If you suspect that you might suffer from a dairy milk allergy it is important to get an official diagnosis from your GP. This is done through a simple blood test. As long as you do not have severe allergic reactions to dairy milk, it is important to get a correct diagnosis from your GP before you begin to remove milk and dairy products from your diet. This is because in order to get a positive allergen result, the blood test needs to detect the presence of antibodies which are produced by the body upon contact with dairy milk.

If your result confirms that you do have a dairy milk allergy you will need to avoid all dairy and products which contain dairy. This means you will need to thoroughly read all food ingredient labels to make sure they do not contain any milk or milk products.

Unfortunately, milk proteins are widely used in food manufacturing and can be found in foods which you would not expect, such as in some bread and even some potato crisps!

It’s also important to note that lactose-free products cannot be eaten if you have a diary milk allergy because although they do not contain lactose, they are still made from the milk protein which causes the actual allergy.

However, even if you have a dairy milk allergy it’s still really important to ensure you are getting enough calcium in your diet. Calcium is a mineral which is found in dairy milk and dairy foods, along with other sources, such as tinned fish with bones, mussels, oysters, kale, baked beans, spinach, broccoli, sushi nori sheets and almonds.

It is extremely important to include calcium in our diets because it promotes bone strength, muscle movement, healthy blood clotting and sustains healthy heart function. If we do not get enough calcium in our diet to maintain our blood calcium levels, the body removes calcium from our bones to normalise the levels. However, over time this can lead to our bones becoming brittle and more prone to breaking. This is known as osteoporosis.

The recommended daily calcium intake for adults are:

  • A female aged 19-50 is 1000mg per day.
  • A female over the age of 50 should take 1300mg per day.
  • Pregnant and breastfeeding women aged 14-18 should have 1300mg per day.
  • Pregnant and breastfeeding women aged 19-50 should have 1000mg per day.
  • A male aged 19-70 is 1000mg per day.
  • A male over the age of 70 is 1300mg per day.

It is easier for the body to absorb calcium from food sources than in supplement form, so if you have a dairy milk allergy you should opt for non-dairy milks and non-dairy foods which have been fortified with added calcium. You should also try to include regular portions of calcium-rich foods in your diet.

A 300mg serving of calcium can generally be found in:

  • 250ml of fortified non-dairy milk.
  • 200g of fortified non-dairy yoghurt.
  • 40g of fortified non-dairy cheese.
  • 80g of tinned salmon with bones.
  • 45g of tinned sardines with bones.
  • 100g of firm tofu set with calcium carbonate.

If you think you might struggle to eat 1000mg of calcium a day you could also consider taking a calcium supplement. They are widely available now, can be purchased quite cheaply and are often available in a chewable form. If you do opt to take a supplement, to maximise their absorption try to eat them with food. So, if you’re having 2 a day, try to take one in the morning with breakfast and one in the evening with dinner.

It might also be worth considering taking a vitamin D supplement alongside your calcium supplement because it helps to promote calcium absorption. (In fact, many calcium supplements come with vitamin D in them too.)

Milk Protein Intolerance

Milk protein intolerance is caused when the body has an adverse reaction to the protein in cow’s milk. It is not the same as dairy milk allergy because it is not an immune system allergic reaction to milk. It is caused by the gut having an adverse reaction to the protein found in the milk because it cannot be tolerated.

Common symptoms of milk protein intolerance include:

  • Diarrhoea
  • Bloating
  • Gas
  • Abdominal cramping

The symptoms of milk protein intolerance can be avoided by avoiding eating all dairy and products which contain dairy. As with a dairy milk allergy, this means you will need to thoroughly read all food ingredient labels to make sure they do not contain any milk or milk products.

Also, as with dairy, lactose-free products cannot be eaten if you have a milk protein intolerance because they are still made from the milk protein which triggers the intolerance.

However, even if you have a milk protein intolerance it’s still really important to ensure you are getting enough calcium in your diet, so you should opt for non-dairy milks and non-dairy foods which have been fortified with added calcium. You should also try to include regular portions of the calcium-rich foods listed above in your diet.

Lactose Intolerance

Lactose intolerance is a common digestive issue and occurs when the body is not able to digest lactose, a natural sugar which is found in milk and dairy products. Normally people naturally digest lactose by producing a substance called lactase.

However, people with lactose intolerance do not produce lactase, so the lactose sugar remains in the digestive system and is fermented by the gut bacteria. As a result, gas is produced which causes the symptoms related to lactose intolerance, such as:

  • Bloating
  • Gas
  • Diarrhoea
  • Abdominal cramps
  • Abdominal pain
  • Nausea
  • Stomach rumbling

Lactose intolerance can be temporary, which is often the case in children, or it can be permanent, which tends to be the case for adults who develop the condition. Many people also tend to find that their symptom severity is linked to the amount of lactose they consume. For instance, some may not be able to tolerate a dash of milk in a hot drink whereas others can tolerate a small glass of milk without experiencing any symptoms.

As you have read, the symptoms of lactose intolerance can be similar to dairy milk allergy and milk protein intolerance, so it is important to get a correct diagnosis from your GP before you begin to remove milk and dairy products from your diet. It also enables you to rule out other health conditions, such as irritable bowel syndrome (IBS).

If your GP diagnoses a lactose intolerance they will recommend that you remove all milk and dairy products from your diet for at least 6 weeks. You will then slowly try reintroducing dairy back into your diet in order to identify what you can potentially tolerate and how much of it you can have.

This reintroduction stage (also sometimes called a ‘challenge phase’) is often best done under the care of a dietitian because they can help you through the process to ensure the reintroduction is done correctly. They can also make sure your diet remains nutritionally sound throughout the elimination and reintroduction stages, so you do not become calcium deficient.

The symptoms of lactose intolerance can simply be avoided by not eating any products which contain lactose. This means you will need to thoroughly read all food ingredient labels to make sure they do not contain lactose. However, many dairy products are now available in lactose-free forms, so to ensure you are meeting your calcium nutritional needs, just opt for lactose-free options instead when you’re shopping.

You can also purchase lactase supplements in tablet or liquid forms which you can take alongside lactose-containing foods to help you digest the lactose. This is handy if you really enjoy certain foods which contain lactose, but they are not available in a lactose-free form, such as speciality cheeses etc.

If you suspect you have a lactose intolerance, dairy protein intolerance or a dairy allergy get in contact with me at hello@lesleyreiddietitian.co.uk to discuss your issues further.

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