Lactose intolerance vs. milk and dairy allergy. The differences!

Lactose intolerance and milk allergy are two conditions that seem similar, and many people think they are the same thing. But that is not the case. Different mechanisms cause them and affect the body.

Today we are clearing things up!

Lactose intolerance involves the digestive system: if you are intolerant, it is because your body does not produce lactase, the enzyme needed to digest lactose by breaking it down into glucose and galactose. Lactose is the main sugar in milk and is used in many recipes as an excipient. In intolerant individuals, instead of being digested normally in the stomach and small intestine, lactose moves into the colon, where it is broken down by bacteria and causes all the symptoms we know... namely bloating, gas, diarrhea, and various other discomforts already described here.

All these symptoms are certainly annoying and can lead to a different lifestyle compared to others, but they are not directly dangerous to the organism.

A milk allergy, on the other hand, involves the immune system and is therefore more serious. If you are allergic, your body reacts to the proteins in milk and other dairy products as if they were dangerous invaders of the body, enemies.

In fact, upon contact with a milk protein or another milk product, your body reacts by releasing substances that cause allergic symptoms, just as in other allergy cases. This allergic reaction can be mild (manifesting with skin rashes) or severe (difficulty breathing, loss of consciousness). Milk allergy is one of the most common allergies, especially in children. As many as 2 out of 100 children under the age of 4 are allergic to milk.

Symptoms of a milk allergy:

Some symptoms of lactose intolerance and milk allergy can be the same. These mainly include digestive system disorders, including:

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

In addition, dairy allergy can cause a reaction in other parts of the body, even creating skin and lung problems:

  • Skin rash
  • Hives
  • Swelling, often in the lips and face
  • Wheezing
  • Difficulty swallowing
  • Blood in the stool, especially in children.

Am I lactose intolerant or allergic to milk?

Milk allergy is more common in children (under 4 years old). As you get older, your digestive system is less likely to react to milk, but it could happen under the following conditions:

1. You have other allergies

2. You have eczema

3. One or both of your parents have a food allergy or have other conditions such as hay fever, eczema, or asthma

The answer is in the test.

The first thing to do if symptoms similar to those of an allergy appear is to go to your family doctor. They will review your medical history to fully understand the symptoms and how your body reacts to dairy products. Then you will undergo tests to confirm whether it is lactose intolerance or a milk allergy.

To learn about the tests available for lactose intolerance, you can read this other article on our blog.

Let's look at the tests for milk allergy instead:

Skin prick test: a small drop of liquid containing milk proteins (the allergen) is placed under the skin on the forearm or back with the help of a painless needle. If a raised bump surrounded by itching and red skin appears, a dairy allergy is likely.
Blood test: the amount of specific antibodies in the blood is measured.

Be careful: both tests can return false positives. Always seek assistance from an allergist, who will be able to explain the results.

If an allergy is still suspected but not confirmed, the doctor might have you perform an oral food challenge. You will be asked to eat various foods that may or may not contain milk in increasing amounts to see if you react to the food containing milk.

Lactose intolerance is manageable by limiting the quantity of food and drink we consume or by orally supplementing the lactase enzyme. A milk allergy is not manageable in the sense that allergens must necessarily be avoided.

In healthy individuals, approximately 6000 FCC ALU of lactase enzyme are needed to digest a 120 ml glass of milk. However, since you cannot be sure how much lactose is in your meal and you do not know the exact state of your body, if you want to ensure a pleasant meal containing lactose, you can take advantage of LACTOSOLUTION, the innovative lactase enzyme that hits the market as the ideal solution to all lactose intolerance problems. With a high concentration of lactase enzyme (15000 FCC ALU) enclosed in a small tablet, you will go back to feeling free and normal.

Living with a milk allergy

If you have a dairy allergy, you will need to avoid all dairy products and other foods that contain dairy and milk proteins.

Rule number one: always read food labels. Look for milk, milk proteins, milk powder, derivatives in general, and everything that makes you suspect the presence of milk proteins.

Milk proteins are found in many foods you wouldn't expect. Some canned tuna, energy drinks, and even chewing gum contain them.

And do not eat low-lactose foods if you have a dairy allergy. They still contain milk proteins that can cause allergic reactions.

In the event that your allergy is well-managed with anti-allergic medication and you manage to eat meals containing milk proteins, a LACTOSOLUTION tablet before the meal can significantly help you avoid problems.

1. Venter C, Brown T, Meyer R, Walsh J, Shah N, Nowak-Wegrzyn A, Chen TX, Fleischer DM, Heine RG, Levin M, et al.: Correction to: Better recognition, diagnosis and management of non-IgE-mediated cow's milk allergy in infancy: iMAP-an international interpretation of the MAP (Milk Allergy in Primary Care) guideline. Clin Transl Allergy 2018, 8:4.

2. Host A, Jacobsen HP, Halken S, Holmenlund D: The natural history of cow's milk protein allergy/intolerance. Eur J Clin Nutr 1995, 49 Suppl 1:S13-18.

3. Heine RG, AlRefaee F, Bachina P, De Leon JC, Geng L, Gong S, Madrazo JA, Ngamphaiboon J, Ong C, Rogacion JM: Lactose intolerance and gastrointestinal cow's milk allergy in infants and children - common misconceptions revisited. World Allergy Organ J 2017, 10:41.

4. Petriz NA, Parisi CA, Busaniche JN, Evangelista P, Mehaudy R, Orsi M: Natural history of immunoglobulin E-mediated cow's milk allergy in a population of Argentine children. Arch Argent Pediatr 2017, 115:331-335.

5. Arvonen M, Virta LJ, Pokka T, Kroger L, Vahasalo P: Cow's Milk Allergy in Infancy and Later Development of Juvenile Idiopathic Arthritis: A Register-Based Case-Control Study. Am J Epidemiol 2017, 186:237-244.

6. Nosan G, Jakic M, Jager M, Paro-Panjan D: Prognostic accuracy of clinical signs and diagnostic tests in cow's milk allergy in newborns. Pediatr Neonatol 2017, 58:449-454.

7. Cuomo B, Indirli GC, Bianchi A, Arasi S, Caimmi D, Dondi A, La Grutta S, Panetta V, Verga MC, Calvani M: Specific IgE and skin prick tests to diagnose allergy to fresh and baked cow's milk according to age: a systematic review. Ital J Pediatr 2017, 43:93.

8. Franco JM, Pinheiro A, Vieira SCF, Barreto IDC, Gurgel RQ, Cocco RR, Sole D: Accuracy of serum IgE concentrations and papule diameter in the diagnosis of cow's milk allergy. J Pediatr (Rio J) 2017.

9. Mousan G, Kamat D: Cow's Milk Protein Allergy. Clin Pediatr (Phila) 2016, 55:1054-1063.

10. Dontje B, Hulshof L, Sprikkelman AB: [Cow's milk allergy]. Ned Tijdschr Tandheelkd 2015, 122:318-321.