Is This a Milk Allergy? Or Lactose Intolerance?

Milk makes you sick, but you don’t know why. In this article, we’ll take a closer look at what could be causing your discomfort as we explore the difference between milk allergy and the more prevalent lactose intolerance.

(Pixabay / Pezibear)

What is happening in my body?

• Milk allergy is a result of your immune system reacting to proteins found in milk. There is nothing wrong with these proteins, but your body gets confused and perceives them as harmful invaders in the same class as germs. In order to protect your body from this perceived threat, your immune system triggers the release of chemicals into your body. The irony is that these chemicals do nothing to the milk proteins. Rather, they make you feel crummy.
• Lactose intolerance has nothing to do with your immune system. Rather, it has to do with an enzyme called lactase. Lactase is an enzyme that breaks down the sugar found in milk. That sugar is called lactose. Your body should produce enough lactase all on its own to break down the lactose contained in milk. However, if you cannot produce enough of this enzyme, you will find yourself feeling miserable every time you ingest dairy products.

What are the symptoms of these two conditions?

• Milk allergy:
  • Gastrointestinal problems (cramps, gas, bloating, nausea, diarrhea, constipation)
  • Swelling of the mouth or throat
  • Skin rashes (such as eczema or hives)
  • Itchy, swollen eyes
  • Runny or stuffed-up nose
  • Sneezing
  • Coughing or wheezing
  • A hoarse cry (in children)
  • Rare but possible: Anaphylaxis, which is a life threatening condition that may involve fainting, a weak pulse, low blood pressure and difficulty breathing due to constricted airways

• Lactose intolerance:
• • Gastrointestinal problems (cramps, gas, bloating, nausea, diarrhea, constipation)

As you can see, both of these conditions cause gastrointestinal problems, but the similarities generally stop there.

How common are these conditions?

• Milk allergy is the most common food allergy among infants and young children. It affects about 2.5% of U.S. children under the age of 3. Among kids who have food allergies, roughly 50% will be allergic to milk.
  Milk allergy is more common in white children as shown by these statistics published in the Official Journal of the American Academy of Pediatrics in 2013:
  • 55% of pediatric milk allergy occurs in white children
  • 20% of pediatric milk allergy occurs in Hispanic children
  • 17% of pediatric milk allergy occurs in African American children
  • 4.7% of pediatric milk allergy occurs in Asian children

Fortunately, milk allergy is much less common in adults as up to 80% of children outgrow their milk allergy by age 16.

• Lactose intolerance is much more common than milk allergy and affects about 65% of the global population. Almost everyone is born with the ability to digest milk. In fact, it is extremely rare to see lactose intolerance in kids under age 5. Lactose intolerance tends to develop after this point. It is not uncommon for people to drink milk without any problems, then develop lactose intolerance in adulthood.

Genetics/race seem to play a role in the tendency toward lactose intolerance. For example, according to the National Institutes of Health:

• • 60-80% of African Americans are lactose intolerant
  • 60-80% of Ashkenazi Jews are lactose intolerant
  • 80-100% of American Indians are lactose intolerant
  • 95% of Asian Americans are lactose intolerant
  • 2% of people of northern European origin are lactose intolerant

Can I get a diagnosis?

Milk allergy. Talk to your doctor about a food allergy test. There are numerous kinds. At AllergyEasy, we offer a skin test, which involves injecting small amounts of food proteins under your skin to see how your body reacts. The resulting bump on your skin can help us gauge your sensitivity to the food protein.

Lactose intolerance. In order to diagnose your lactose intolerance, your doctor may administer one of the following:

• Hydrogen breath test. Your doctor will have you drink liquid with high levels of lactose, then measure how much hydrogen you are breathing out. If you’re emitting a lot of hydrogen, this indicates that your body isn’t digesting and absorbing lactose very well.
• Lactose intolerance blood test. For this test, your doctor will have you ingest a drink with a high concentration of lactose. Then, they will administer a blood test to measure your glucose levels. If these levels stay steady, you aren’t properly digesting and absorbing lactose.

Are there treatment options?

Who wants to eat a piece of chocolate cake without a tall glass of milk? Or skip out on your morning bowl of corn flakes? Or not dunk an Oreo cookie? These are the things you have to miss out on when your body can’t tolerate milk for one reason or another. Is there a way to drink milk and feel good again? Well, it depends.

• Milk allergy used to be deemed untreatable, and people were simply advised to stay away from dairy products if they reacted to them with allergy symptoms. That has changed. A treatment known as immunotherapy is helping people become desensitized to milk proteins.At AllergyEasy, we prescribe sublingual immunotherapy, which means that a “serum” containing allergenic food proteins (including milk proteins) is dispensed under the tongue. This can be done at home. Over time, your body becomes desensitized to these proteins so that you can eat more of the dairy products that you love without fear of negative reactions. This is the same principle behind allergy shots (also known as subcutaneous immunotherapy), which have been used to treat pollen allergies for decades. Allergy shots have not been shown to be safe and effective for food allergies, but sublingual allergy drops have.
• Lactose intolerance has no known treatment; however, there are some fairly simple ways to manage your symptoms.
  • Eat smaller portions. Some people can get away with eating small portions of dairy. Their body may not be able to handle a tall glass of milk, but it may do fine with a small cup of it, which may be just enough to wash that chocolate cake down.
  • Supplement with lactose-free alternatives. Food manufacturers have caught up to the prevalence of lactose intolerance, and you’ll now find plenty of lactose-free alternatives that were not available in the past. Make sure to check the labels on these products. Since lactose is a sugar, some manufacturers will add refined sugars as a substitute. These can make the milk products taste sweet and delicious, but they may give you added sugars that you don’t want in your diet.
  • Pop a lactase enzyme pill. These handy over-the-counter tablets contain the lactase that your body cannot produce. They don’t work for everyone, but they allow some people to eat dairy without missing a beat.
  • Take probiotics. This is another one that isn’t helpful across the board, but some people report being able to tolerate dairy better when they are actively taking probiotics.
  • Know what you need to avoid. Not all dairy products contain the same amount of lactose. For example, hard cheeses and yogurt tend to contain less lactose. You may be able to find a sweet spot where you can get your dairy fix with a few favorite items that don’t upset your stomach as much as others.

If you’re looking for help with milk allergy treatment—or any other food allergy treatment—contact AllergyEasy. We work with primary care physicians across the country, supplying them with turnkey allergy test programs, as well as highly effective treatment programs that help them treat their food-allergic patients using sublingual immunotherapy.