It’s common in naturopathic practice to help patients uncover food reactions. One of the most common food reactions is lactose intolerance.

Lactose Intolerance: How Undigested Milk Sugar Can Lead To Digestive Disturbance

Lactose intolerance is a condition where it is difficult to digest milk sugar, or lactose. Symptoms typically include gas, bloating, abdominal pain and diarrhea (although in adults diarrhea is not a prominent symptom). It occurs when the body does not produce enough lactase, the digestive enzyme responsible for breaking down lactose. When lactose is not properly digested, it cannot be properly absorbed in the small intestine, and subsequently the lactose moves into the colon where bacteria digest the milk sugar, producing gases responsible for symptoms. A lab test called the lactose hydrogen breath test is available that can provide a definitive diagnosis of lactose intolerance. More simply, lactose intolerance can be concluded if the above symptoms occur within a few hours after consuming a large serving of lactose containing foods (> 2 servings of lactose containing foods/day) and completely resolve within 5-7 days of avoiding lactose containing foods. While lactose containing foods are best avoided in lactose intolerance, low lactose dairy products can often still be enjoyed. 

Lactose Containing Dairy Products (including cow, goat and sheep) To Avoid In Lactose Intolerance:

• Milk products (milk powder, milk solids, evaporated milk, condensed milk)

• Milk, buttermilk

• Yogurt, kefir

• Ice cream

• Fresh or processed cheeses - cottage cheese, cream cheese, ricotta, goat’s milk chevre, queso fresco, mozarella, processed cheese slices or spreads

• Sour cream, cream fraiche

• Cream

Low Lactose Dairy Products You Still May Be Able To Enjoy:

• Ghee*

• Butter*

• Homemade 24 hour yogurt*

• Yogurt cheese “Labneh” from homemade 24 hour yogurt*

• Hard or aged cheeses (generally cheeses aged 1 month or more) - Cheddar, Parmesan, Gouda, Brie, Camembert, Feta

• Lactose-free milk (Available brands - Natrel)

• Lactose-free yogurt (Available brands - Liberte)

  * Items with asterisk tend to be best tolerated in lactose intolerance

Tried A Lactose-Free Diet And Still Experiencing Symptoms? It May Be Time To Talk With A Naturopathic Doctor About A Dairy Allergy Or Dairy Sensitivity:

Dairy Allergy: Dairy allergy, also referred to as cow’s milk protein allergy, involves an immediate immune mediated (IgE) reaction to dairy proteins. Dairy allergy generally presents with acute concerns such as asthma and anaphylaxis, although eczema can also occur. Lab testing for dairy allergy includes skin prick testing and/or a blood test for IgE antibodies. Strict avoidance of all components of dairy are advised unless your allergist has recommended otherwise. 

Dairy Sensitivity: Dairy sensitivity involves an immune reaction to dairy proteins but is non IgE mediated and onset of symptoms are delayed, occurring beyond 2 hours after eating dairy. The delayed onset of symptoms can make it harder to identify this type of food reaction. Unlike lactose intolerance, symptoms of dairy sensitivity are typically associated with symptoms of inflammation rather than malabsorption. Symptoms of dairy sensitivity can include gastrointestinal symptoms (reflux and constipation are common), nasal congestion, eczema or an exacerbation of a preexisting inflammatory condition. The elimination-challenge diet is the gold standard to assess dairy sensitivity. A blood test for IgG antibodies is also available.

To book an appointment with a Naturopath at Juniper Family Health, please contact the clinic at 778-265-8340 or info@juniperfamilyhealth.com or click here to book online.

References:

1) Lactose Intolerance: Clinical manifestations, diagnosis and management. UpToDate. Accessed October 2018. This topic was last updated Jan 15, 2018.

2) Milk Allergy: Clinical feature and diagnosis. UpToDate. Accessed October 2018. This topic last updated Jun 18, 2019.