Lactose Intolerance vs. Dairy Allergy: Symptoms, Diagnosis, Living With

Written by WebMD Editorial Contributors

• Symptoms
• Am I More Likely to Have Dairy Allergy?
• Getting Tested
• Testing for Lactose Intolerance
• Testing for Dairy Allergy
• Living With Lactose Intolerance
• Living With Dairy Allergy
• More

Lactose intolerance and dairy allergy sound a lot alike. Many people think they’re the same thing. But, how they’re caused (and how they affect your body) are very different.

Lactose intolerance involves the digestive system: If you have it, your body doesn’t make lactase, the enzyme needed to digest lactose. That’s the sugar in milk. Instead of digesting normally in your stomach and small intestine, undigested lactose moves into your colon, where it’s broken down by bacteria and causes bloating and gas. It can be uncomfortable, but it’s not dangerous.

Lactose intolerance is common in adults – about 30 million Americans have it by age 20. It’s more common in people with Asian, African or Native American heritage and less common in people with a northern or western European background.

Dairy allergy involves the immune system: If you have it, your body reacts to the proteins in milk and other dairy products as if they’re dangerous invaders. It releases substances that cause allergy symptoms. This allergic reaction can be mild (rashes) to severe (trouble breathing, loss of consciousness).

Dairy allergy is one of most common allergies, especially in children. As many as 2 in every 100 children under 4 years old are allergic to milk. It’s even more common in babies.

Some symptoms of lactose intolerance and dairy allergy may be the same:

• Diarrhea
• Nausea; sometimes vomiting
• Abdominal cramps
• Bloating
• Gas

But dairy allergy can also cause a reaction in other parts of your body, including the skin and lungs:

• Rash
• Hives
• Swelling, often in the lips and face
• Wheezing
• Tightness in throat
• Trouble swallowing

There may be blood in the stool (poop) too, especially in babies.

Anaphylaxis is a serious, life-threatening allergic reaction and often begins minutes after you eat a food you’re allergic to, but sometimes it can happen hours later. It usually involves more than one symptom in more than one part of your body at the same time.

If you have a severe allergy or if you’ve ever had anaphylaxis in the past, talk to your doctor about carrying an injectable epinephrine (Adrenaclick, Auvi-Q, EpiPen, a generic auto-injector, Symjepi) to slow down or stop the allergic reaction.

You’re more likely to develop dairy allergy if:

• You have other allergies
• You have eczema
• One or both of your parents has a food or other allergy, like hay fever, eczema or asthma
• You’re young. Milk allergy is more common in children. As you get older, your digestive system is less likely to react to milk, but you’re likelier to have lactose intolerance.

First your doctor will take your medical history to understand your symptoms and how your body reacts to dairy foods. Then you’ll be tested to confirm whether it’s lactose intolerance or a dairy allergy.

Lactose tolerance test: You’ll drink a liquid that contains a lot of lactose. About 2 hours later, the amount of glucose (sugar) in your bloodstream will be measured. If your glucose level doesn’t rise, you’re not digesting the lactose in the drink.

Hydrogen breath test: You’ll drink a liquid that contains a lot of lactose. Then, the hydrogen in your breath will be measured at regular intervals. If you’re not digesting lactose, it will be broken down in your colon, releasing hydrogen that can be detected in your breath.

Stool acidity test: Babies and children who can’t be tested otherwise can have their stool tested for lactic acid caused by the breakdown of undigested lactose in the colon.

Skin prick test: A small drop of liquid containing the dairy allergen is placed under your skin on your forearm or back. If a raised bump surrounded by itchy red skin appears, a dairy allergy is likely.

Your doctor might have you take a blood test too, which measures the amount of certain antibodies in your blood.

Both tests can have “false positives.” You can test positive for an allergy even though you really don’t have it. Your allergist will explain the results.

If an allergy is still suspected but not confirmed, your doctor may have you take an oral challenge. You’ll be fed different foods that may or may not contain milk in increasing amounts to see if you react to food that contains milk.

Lactose intolerance is easily managed, mostly by limiting the amount of dairy food and drink you consume. You can also try lactose-reduced ice cream and milk, or take lactase enzyme supplements when you eat dairy products to help your body digest lactose.

If you have dairy allergy, you’ll need to avoid all dairy foods and other foods that contain dairy products.

Staying safe means reading food labels to see if milk or ingredients containing milk are included. Milk proteins are found in many foods you wouldn’t expect. Some canned tuna, energy drinks and even chewing gum contain them. And don’t eat lactose-reduced foods if you have dairy allergy. They still contain the milk proteins that can cause allergic reactions.

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Milk allergy – Symptoms & causes

Overview

Milk allergy is an atypical immune system response to milk and products containing milk. It’s one of the most common food allergies in children. Cow’s milk is the usual cause of milk allergy, but milk from sheep, goats, buffalo and other mammals also can cause a reaction.

An allergic reaction usually occurs soon after you or your child consumes milk. Signs and symptoms of milk allergy range from mild to severe and can include wheezing, vomiting, hives and digestive problems. Milk allergy can also cause anaphylaxis — a severe, life-threatening reaction.

Avoiding milk and milk products is the primary treatment for milk allergy. Fortunately, most children outgrow milk allergy. Those who don’t outgrow it may need to continue to avoid milk products.

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Symptoms

Milk allergy symptoms, which differ from person to person, occur a few minutes to a few hours after you or your child drinks milk or eats milk products.

Immediate signs and symptoms of milk allergy might include:

• Hives
• Wheezing
• Itching or tingling feeling around the lips or mouth
• Swelling of the lips, tongue or throat
• Coughing or shortness of breath
• Vomiting

Signs and symptoms that may take more time to develop include:

• Loose stools or diarrhea, which may contain blood
• Abdominal cramps
• Runny nose
• Watery eyes
• Colic, in babies

Milk allergy or milk intolerance?

A true milk allergy differs from milk protein intolerance and lactose intolerance. Unlike milk allergy, intolerance doesn’t involve the immune system. Milk intolerance requires different treatment from true milk allergy.

Common signs and symptoms of milk protein intolerance or lactose intolerance include digestive problems, such as bloating, gas or diarrhea, after consuming milk or products containing milk.

Anaphylaxis

Milk allergy can cause anaphylaxis, a life-threatening reaction that narrows the airways and can block breathing. Milk is the third most common food — after peanuts and tree nuts — to cause anaphylaxis.

If you or your child has a reaction to milk, tell your health care provider, no matter how mild the reaction. Tests can help confirm milk allergy, so you can avoid future and potentially worse reactions.

Anaphylaxis is a medical emergency and requires treatment with an epinephrine (adrenaline) shot (EpiPen, Adrenaclick, others) and a trip to the emergency room. Signs and symptoms start soon after milk consumption and can include:

• Constriction of airways, including a swollen throat that makes it difficult to breathe
• Facial flushing
• Itching
• Shock, with a marked drop in blood pressure

When to see a doctor

See your provider or an allergist if you or your child experiences milk allergy symptoms shortly after consuming milk. If possible, see your provider during the allergic reaction to help make a diagnosis. Seek emergency treatment if you or your child develops signs or symptoms of anaphylaxis.

Causes

All true food allergies are caused by an immune system malfunction. If you have milk allergy, your immune system identifies certain milk proteins as harmful, triggering the production of immunoglobulin E (IgE) antibodies to neutralize the protein (allergen). The next time you come in contact with these proteins, immunoglobulin E (IgE) antibodies recognize them and signal your immune system to release histamine and other chemicals, causing a range of allergic signs and symptoms.

There are two main proteins in cow’s milk that can cause an allergic reaction:

• Casein, found in the solid part (curd) of milk that curdles
• Whey, found in the liquid part of milk that remains after milk curdles

You or your child may be allergic to only one milk protein or to both. These proteins may be hard to avoid because they’re also in some processed foods. And most people who react to cow’s milk will react to sheep, goat and buffalo milk.

Food protein-induced enterocolitis syndrome (FPIES)

A food allergen can also cause what’s sometimes called a delayed food allergy. Although any food can be a trigger, milk is one of the most common. The reaction, commonly vomiting and diarrhea, usually occurs within hours after eating the trigger rather than within minutes.

Unlike some food allergies, food protein-induced enterocolitis syndrome (FPIES) usually resolves over time. As with milk allergy, preventing an FPIES reaction involves avoiding milk and milk products.

Risk factors

Certain factors may increase the risk of developing milk allergy:

• Other allergies. Many children who are allergic to milk also have other allergies. Milk allergy may develop before other allergies.
• Atopic dermatitis. Children who have atopic dermatitis — a common, chronic inflammation of the skin — are much more likely to develop a food allergy.
• Family history. A person’s risk of a food allergy increases if one or both parents have a food allergy or another type of allergy or allergic disease — such as hay fever, asthma, hives or eczema.
• Age. Milk allergy is more common in children. As they age, their digestive systems mature, and their bodies are less likely to react to milk.

Complications

Children who are allergic to milk are more likely to develop certain other health problems, including:

• Nutritional deficiencies. Because of dietary restrictions and feeding challenges, children with milk allergy may have slowed growth as well as vitamin and mineral deficiencies.
• Reduced quality of life. Many common, and sometimes unexpected, foods contain milk, including some salad dressings or even hot dogs. If you or your child is severely allergic, avoiding milk exposure may increase stress or anxiety levels when it comes to making food choices.

Prevention

There’s no sure way to prevent a food allergy, but you can prevent reactions by avoiding the food that causes them. If you know you or your child is allergic to milk, avoid milk and milk products.

Read food labels carefully. Look for casein, a milk derivative, which can be found in some unexpected places, such as in some canned tuna, sausage or nondairy products. Question ingredients when ordering in restaurants.

Sources of milk

Obvious sources of allergy-causing milk proteins are found in dairy products, including:

• Whole milk, low-fat milk, skim milk, buttermilk
• Butter
• Yogurt
• Ice cream, gelato
• Cheese and anything that contains cheese
• Half-and-half

Milk can be harder to identify when it’s used as an ingredient in processed foods, including baked goods and processed meats. Hidden sources of milk include:

• Whey
• Casein
• Ingredients spelled with the prefix “lact” — such as lactose and lactate
• Candies, such as chocolate, nougat and caramel
• Protein powders
• Artificial butter flavor
• Artificial cheese flavor
• Hydrolysates

Even if a food is labeled “milk-free” or “nondairy,” it may contain allergy-causing milk proteins — so you have to read the label carefully. When in doubt, contact the manufacturer to be sure a product doesn’t contain milk ingredients.

When eating out, ask how foods have been prepared. Does your steak have melted butter on it? Was your seafood dipped in milk before cooking?

If you’re at risk of a serious allergic reaction, talk with your health care provider about carrying and using emergency epinephrine (adrenaline). If you have already had a severe reaction, wear a medical alert bracelet or necklace that lets others know you have a food allergy.

Milk alternatives for infants

In children who are allergic to milk, breastfeeding and the use of hypoallergenic formula can prevent allergic reactions.

• Breastfeeding is the best source of nutrition for your infant. Breastfeeding for as long as possible is recommended, especially if your infant is at high risk of developing milk allergy.

• Hypoallergenic formulas are produced by using enzymes to break down (hydrolyze) milk proteins, such as casein or whey. Further processing can include heat and filtering. Depending on their level of processing, products are classified as either partially or extensively hydrolyzed. Or they may also be called elemental formulas.

  Some hypoallergenic formulas aren’t milk based, but instead contain amino acids. Besides extensively hydrolyzed products, amino-acid-based formulas are the least likely to cause an allergic reaction.

• Soy-based formulas are based on soy protein instead of milk. Soy formulas are fortified to be nutritionally complete — but, unfortunately, some children with a milk allergy also develop an allergy to soy.

If you’re breastfeeding and your child is allergic to milk, cow’s milk proteins passed through your breast milk may cause an allergic reaction. You may need to exclude from your diet all products that contain milk. Talk to your health care provider if you know — or suspect — that your child has milk allergy and develops allergy signs and symptoms after breastfeeding.

If you or your child is on a milk-free diet, your health care provider or dietitian can help you plan nutritionally balanced meals. You or your child may need to take supplements to replace calcium and nutrients found in milk, such as vitamin D and riboflavin.

Harm of milk: how dairy products affect the skin

We have all heard at least once how someone we know completely refused “milk”, and a miracle immediately happened to the skin. Milk is increasingly considered the cause of eczema, acne, dullness and is regarded as the number one enemy for our face.

This is confirmed by data from the Vegan Society, according to which the number of vegans in the UK has quadrupled over the past six years. Of those, almost 600,000 eliminated dairy products to improve their health, skin condition, and energy levels. The breakfast menu now includes oat milk, vegan cheeses are widely available in supermarkets near the house, and ice cream is made not from cream, but from cashew nuts. The vegan diet has become more varied, but the question still remains – will cutting out animal milk make for healthy skin?

“Despite the suggestion that dairy products contribute to skin problems, current evidence is very limited and conflicting,” says nutritionist Megan Rossi. “Most of the studies done so far are observational—they can be useful, but you still can’t make a final decision based on them. There are a number of factors that make it difficult to assess the relationship between nutrition and skin condition. For example, people who drink a lot of milk may consume less fiber and more sugar, and this is what negatively affects their health and appearance. ”

Beautician Debbie Thomas asks her clients with acne to analyze their diet and lifestyle. “Yes, dairy can cause some skin problems, but not all,” says Thomas. – Nevertheless, acne most often appears with an excess of sugar, stress – during it, certain hormones are produced in the body. Or with more serious disorders – for example, with polycystic ovary syndrome.

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Both experts agree that the effect of dairy products on the skin is not a myth, but rather information that has not yet been fully confirmed by research. “Remember that acne speaks to your current state of health, severe inflammation on the face is the end result of reactions within the body. Therefore, it is important to individually determine what is causing the poor condition of your skin,” says Thomas. Experts advise keeping a food diary to keep track of what the skin reacts to negatively, so you can establish a connection between its condition and diet.

What else you need to know about milk:

The effect of milk on hormones

As you know, our diet and lifestyle affect hormones, and they, in turn, affect the skin. Pimples that appear during the menstrual cycle confirm this. “Cow’s milk and dairy products contain casein and whey protein, which increase levels of a certain hormone (insulin-like growth factor-1, or IGF-1). It is associated with increased production of sebum, which causes the development of acne, explains Rossi. “Studies have shown that people with acne have higher levels of the hormone IGF-1.” It has also been established in the West that the more sugar, dairy products and carbohydrates in the diet, the more often people experience skin diseases. But as Rossi notes, a clinical study has yet to show that dairy-only products cause skin problems.

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Milk and insulin levels proteins are broken down and converted into hormones that are very similar to insulin,” says Thomas. The higher its level, the more we are prone to infections and inflammatory processes, including on the skin. “Most often, people experience such inflammatory skin diseases as acne, eczema and rosacea,” the cosmetologist notes. “If inflammation becomes a long-term problem in the body, then eventually it reaches the skin – this leads to the rapid appearance of wrinkles and a deterioration in its appearance.”

All about lactose intolerance

“The body needs enzymes to break down lactose in milk. About 65 percent of people lose these enzymes during infancy. That is why, as we get older, the body develops lactose intolerance or allergy. It causes an inflammatory response in the body, ”says the nutritionist. If you suffer from bloating, nausea, or flatulence, then Rossi recommends using her author’s method – a three-step assessment of “record, limit, restore.” You can find it in book Eat Yourself Healthy , where you can find out how to live comfortably and safely with a food intolerance.

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Dairy products are different To improve your skin, know that not all “milk” is produced equally. A 2019 study found that there is a link between total milk consumption and acne on the face. “Interestingly, data on skin problems varied depending on the types of milk consumed – whole, semi-fat, or skim. It turned out that skimmed milk has the most negative effect on the skin, ”says Rossi. In contrast, fermented dairy products do not increase the risk of acne, so yogurt and cheese are more your friends than enemies. “Sour-milk products like yogurt and kefir can improve heart and bone health, as well as improve digestion and control weight,” she notes. So when it comes to dairy, as is often the case, it’s about finding balance and moderation, not total abstinence.

Hannah Coates/ Vogue.co.uk

Dermatologist Ballirano explains why collagen cosmetics don’t really work and in general rejuvenate your face.

However, in reality, the effectiveness of products that are so popular among women after thirty is very, very doubtful. A dermatologist, cosmetologist Tatyana Ballirano warned about this in a conversation with Life.

She noted that collagen is a structural part of the skin, it is from it that a kind of framework is formed, on the basis of which our skeleton and muscles are built. In the skin, collagen is responsible for elasticity, firmness and cell renewal. According to the doctor, somewhere after 30–35 years, the production of this protein decreases. Because of this, wrinkles appear on the skin, it loses its tone, and becomes dry. At the same time, unfortunately, it will not be possible to compensate for the lack of natural collagen with the help of “miracle creams and masks”. The thing is that this protein has too large molecules, so it will not be able to penetrate the skin and will simply remain on the surface.

“You need to understand that a collagen molecule is a protein and, of course, a foreign protein, according to the law of nature, cannot penetrate the skin transdermally. Therefore, when applying a cream, a mask with collagen, we will get an exclusively externally moisturizing effect. Collagen will moisturize, create a film, therefore, the skin will be visually stretched, but when you wash off the cream, you will not see the result,” our interlocutor explained to .

Dermatologists warn: Hand cream can be addictive

At the same time, Ballirano emphasized that one should not rely on 100% effectiveness of nutritional supplements that contain collagen, of course. Here we should take into account the fact that any proteins, when they enter the body, are digested by our digestive enzymes. According to the dermatologist, the only way to saturate the body with collagen is the delivery of amino acids inside. We are talking about mesotherapy, biorevitalization and not only.

“At home, this is microneedling, such a roller with needles. We apply serum with amino acids, peptides, vitamins. Needle RF is also effective when needles are directly injected into the skin, a high-frequency current is supplied, which also stimulates fibroblasts,” – summarized the doctor.