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What is lactose intolerance and is it the same as a milk allergy?

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Answer

Lactose intolerance is the inability to digest lactose, found in animal milk (including human milk, which, in fact, has about twice has much lactose as cow's milk). An enzyme called lactase is required to digest lactose. When this enzyme is missing, the following symptoms may occur: abdominal cramps, diarrhea, gas, a feeling of bloatedness. Symptoms may occur within an hour, or up to several days later. The intensity of symptoms varies widely.

DIAGNOSIS

Lactose intolerance can be self-diagnosed by eliminating milk and dairy products from your diet for two weeks, then reintroducing milk (a glass or two), and seeing what happens. Your doctor can administer a couple of tests to confirm lactose intolerance (basically involves drinking a sweet drink containing a lot of lactose on an empty stomach and monitoring blood levels of glucose -- no rise in glucose means the lactose is not being absorbed; the other involves checking breath levels of hydrogen).

TREATMENT

If you are diagnosed with lactose intolerance, you have a variety of options. Lactase is available by prescription (Lactaid), and can be added to milk (drops) or taken with food containing dairy products (tablets). Some people may have adverse reactions to this medication, however (in tablet form -- the reaction is believed to be allergic. Drops seem to be ok.). Lactose reduced milk and cheeses are available in some areas. Aged cheeses, yogurt and sour cream may be tolerable (most of the lactose has already been converted). You can find your level of lactose tolerance by either cutting out dairy products entirely and slowing working them back into your diet, or you can slowly eliminate them until you stop having difficulties. Tables indicating lactose content for milk and milk products are available.

Some believe that lactose intolerance is, in fact, the human (and mammalian) norm, rather than an aberration, citing in support statistics that indicate most of the world's population is lactose intolerant (Europeans and those of European descent being the exceptions), and the tendency to lactose intolerance with increased age.

MILK ALLERGY

Milk allergy, on the other hand, involves an allergic reaction to one or more of the proteins in milk (casein, lactalbumin, lactoglobulins). An allergic reaction to milk may include: eczema, rash, mucous buildup, wheezing, asthma, rhinitis, pneumonia, anaphylaxis. The type and severity of symptoms varies widely. Because a true milk allergy may involve mast cells in the mouth and throat, it is possible to have an allergic reaction to milk or milk products before they are digested. It is possible to be both lactose intolerant AND allergic to milk.

DIAGNOSIS

The bad news is, diagnostic tests for milk allergy -- for food allergy in general -- are hit or miss. One source I have claims that a negative is accurate, but false positives are common. Another states that the extracts used in allergy tests tend to lose potency quickly so you might test negative on a test and STILL be allergic. Elimination diets are the best test you have available to you. If you suspect milk allergy, eliminate milk and milk products for two or more weeks, and see what happens. If you can convince your physician to conduct a double-blind test on you, you may be able to confirm the diagnosis.

TREATMENT

The worse news is, no cure is available -- avoidance, and symptom control via antihistamines, etc. are the best you can do. (For now, at least, this is true of all food allergy, at least according to the conservative medical community -- but research is ongoing. I have a reference to a study by the National Jewish Center for Immunology and Respiratory Medicine in Denver which claims successful desensitization to peanuts in people who had a life history of allergic reaction to them. There's a dim hope, at least.)

[The National Jewish Center for Immunology and Respiratory Medicine in Denver has prepared a report about successful desensitization to peanuts in patients with a life history of allergic reaction to them. The address for that group is: National Jewish Center for Immunology and Respiratory Medicine, Public Affairs Department, 1400 Jackson Street, Denver, CO 80206 303-398-1079, 800-222-LUNG (5864)]

Answer

Lactose intolerance is the inability to break down the sugar in milk, lactose. There are varying levels of lactose intolerance, based upon how much of the enzyme "Lactase" your body has. The more it has, the better the ability of your body to break down the sugar, and the more tolerance you have. Since cow milk is not a natural thing for humans to drink (nor any milk past age 2), it makes sense that people will develop primary lactose intolerance over their life time and it is not uncommon for adults to develop the symptoms of lactose intolerance which include but are not limited to; diarrhea, stomach cramps, bloating, gas and nausia. If a young child has any of these symptoms, contact their doctor, as it is possible to be born lacking lactase.


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