How Do I Know If I Am Lactose Intolerant?

[wilbragirl]

Is lactose intolerance ALWAYS a part of celiac disease? What about cheese? One source tells me only 'aged" (i.e., brick) cheeses like cheddar,etc. Another source tells me most cheese are ok. What about cottage cheese? Is there a specific dairy product that sets off L.I. or is it all dairy products? Milk doesn't seem to bother me, but I eat a lot of different kinds of cheeses...sometimes I have problems, others no.

I'm at a loss...

[francelajoie]

When I was diagnosed with Celiac, my doctor said I might also be lactose inteolorent. She said to go on a gluten-free and lactosde-free diet for 3 to 6 weeks, or until you feel better. Then, start slowly introducing dairy back into your diet. I found out I can digest lactose when i feel good. If I get glutened, I cannot at all take it so I stop it again until I'm back to normal.

[tarnalberry]

Lactose is a complex sugar, made up of two other sugar molecules, that is unique to mammalian milk. The body needs to produce an enzyme, lactase, to break it into it's two components so that the body can use it to make energy. If it doesn't get broken down by your body, it moves on through the digestive tract and is metabolized by bacteria in your intestines, which produce gas as a by-product of the process. This is what causes the gas and bloating that is the overwhelming classic symptom of lactose intolerance. It is often connected to celiac disease, because the disease damages the intestinal villi, and it is the very tips of these villi that release the lactase into the digest tract.

Starting at a natural weaning age, people naturally lose the ability to produce lactase. In some cultures, it happens so slowly that you don't notice for decades, if ever. But the majority of the world's population develops a noticeable level of lactose intolerance by the time they reach adulthood. (Those cultures don't rely so heavily on regular dairy products.) It makes a big difference, however, how quickly you reduce your production of lactase, because the body makes so much, initially, that it won't cause a problem that you're making a bit less. It is not like celiac disease in that the lactose causes an immune reaction.

Any processing done to fluid dairy (milk) to separate out the components of fat or protein will reduce the amount of lactose, because lactose is a sugar. So, for instance, curdling the proteins of milk to make cheese removes a good portion of lactose. Hard cheese have more lactose removed than soft cheeses. Processing of dairy to culture it also reduces the lactose content, because the bacteria that are used to culture dairy feed off of the lactose, reducing how much of it is in the remaining product. A good way to tell if something may have a lot of lactose or a little is to look at the nutrition label - if it has a fair amount of sugar/carbs listed (like milk), then it has a fair amount of lactose. If it's mostly protein (or in the case of cream, fat), then it has less lactose. (The exception here is yogurt that has sugar added to it, of course.)

The easiest way to determine if you're lactose intoleranct is run an experiment:

1. have a full glass of milk

2. wait four hours and see if you experience any bloating or gas

3. take some lactaid tablets (over the counter lactase in a pill form) in a fairly high dose and wait a minute or two

4. have a full glass of milk

5. wait four hours and see if you experience any bloating or gas

If you get bloating/gas in the first case, and not the second (or significantly less in the second), you're lactose intolerant.

If you get symptoms with both cases, you are more likely casein intolerant. Casein intolerance is an immune reaction to the protein in milk. (Side note: 'intolerance' isn't strictly used in these senses - and 'intolerance' to a sugar like lactose or fructose generally isn't an immune reaction, because immune reactions primarily revolve around larger molecules, usually proteins.) ALL dairy has casein - it is a distinguishing characteristic of mammals. There are different subtypes of casein, however, and most people are intolerant to only one or a few. Most people who are casein intolerant are most sensitive to the primary caseins found in cow's milk, so they may find they can drink other milks (that have a much smaller proportion of that subtype of casein) without symptoms, but there is still that subtype of casein in other mammals' milk, so there may still be a reaction.

The fact that you say milk doesn't bother you but cheese does leads me to believe that it's a casein intolerance, because milk has more lactose but less casein than cheese. If it were a lactose problem, milk should bother you more than cheese does.

[CMCM]

Is lactose intolerance ALWAYS a part of celiac disease? What about cheese? One source tells me only 'aged" (i.e., brick) cheeses like cheddar,etc. Another source tells me most cheese are ok. What about cottage cheese? Is there a specific dairy product that sets off L.I. or is it all dairy products? Milk doesn't seem to bother me, but I eat a lot of different kinds of cheeses...sometimes I have problems, others no.

I'm at a loss...

I don't think it is always part of celiac disease. My mom was diagnosed 40+ years ago....she had malabsorption so bad and it took so long to actually diagnose her that she nearly died. Despite how bad her intestinal damage was, she has never had any problem at all with dairy.

On the other hand, I thought for a good 20 years I had lactose intolerance. Perhaps I do...but thru testing for celiac etc. I found out I am at the very least casein sensitive, which is a different thing from lactose intolerance. Casein is the milk protein, and lactose is the milk sugar. I have heard many people on this site say that when they stop eating gluten, later on they don't seem to suffer from the lactose intolerance any more. But if you are casein sensitive, that won't go away just as gluten sensitivity/celiac disease won't go away.

I have read that cheese actually has a much lower level of casein than milk.

Ultimately, the way to really figure out what works for you is to eliminate things from your diet for a period of time (at least a couple of weeks), and then re-introduce that food and see how you react.

[mtdewpeg]

I am pretty new to this gluten free diet. My GI Dr. just said to avoid gluten. He never told me what not to eat. He did set me up with a nutritionist, which I see this Friday. I can drink milk and eat all dairy products without any problems, so I am hoping I won't have to give them up. I hope the nutritionist works with me to find a diet that will work for me. I am on disability and don't have much money to buy all of those special foods.

[mushroom]

Just a small note about lactose intolerance - the degree of lactose products you tolerate can vary. I could not come near milk, cream, ice cream, froqen yogurt (not really yogurt) even using Lactase enzymes, but I could eat all cheeses, sour cream, butter, ricotta (anything with cultures or enzymes added) without any problem. So you just have to experiment and see what works for you.

[zeeclass6]

I've had lactose intolerance for 15 years. It started after my second child was born, which was also when my Hashimoto's began.

When you are lactose intolerant, you will react worse to dairy products that are more milky and lower in fat. For instance, if you have a fat-free milkshake and are a huge gurgling gasbag for the next 12 hours, that's a big sign. (That's when I first suspected I had a problem, LOL).

Dairy products that are higher in fat, like regular milk, cream, or butter may not affect you quite as much.

I have lactose intolerance symptoms when I try to eat lowfat cheeses (even hard lowfat cheeses). For years I could eat those products just fine as long as I took a Lactaid pill along with them. But as the years rolled on, I began to notice that sometimes I had symptoms DESPITE taking one, or even two Lactaid pills -- or even other digestive supplements that contain Lactase enzyme and other digestive enzymes.

That was the point where I began to suspect another problem and now here I am, being gluten free. Turns out that gluten was actually causing some of these problems, and I had no idea. Maybe gluten was making everything worse for me.

I found some lactose-free yogurt at Whole Foods the other day. I ate it; it was delicious. I did NOT take a lactaid pill with it. It already had lactase enzyme in it. I had absolutely no symptoms afterward. So I suspect that perhaps I don't have a casein problem, only a lactose problem.

[mushroom]

zeeclass6, my lactose intolerance developed just like yours, except I could always eat yogurt I think it was maybe the degree of damage in our guts - it starts out quite patchy at first, but theoretically it could continue to cover the whole small intestine

[zeeclass6]

For years I could eat yogurt just fine without a lactaid pill. Then a few years ago I started to notice symptoms afterward, so I started taking a lactaid pill with the yogurt. Then even that didn't help. I was actually surprised that the lactose-free yogurt I found at Whole Foods didn't bother me at all.

What really sent my digestive system into a tailspin was trying dairy-based Kefir. I tried it for the probiotics. Wow, it was awful. Sewer farts. I mean...wow really awful foul disgusting....I couldn't control it and couldn't go out in public for a few days until it calmed down. I tried drinking kefir with and without lactaid pills. Didn't make any difference. Bluck. I like the IDEA of keffir, but that stuff sure doesn't like me! BTW, I tried the keffir before I went gluten-free. I'm kind of afraid to try it again. The gross farts were totally uncontrollable -- they would just seep out. I felt like an old incontient Grandma who was engulfed in a foul brown cloud, LOL.

zeeclass6, my lactose intolerance developed just like yours, except I could always eat yogurt I think it was maybe the degree of damage in our guts - it starts out quite patchy at first, but theoretically it could continue to cover the whole small intestine

[marjean]

I am pretty new to this gluten free diet. My GI Dr. just said to avoid gluten. He never told me what not to eat. He did set me up with a nutritionist, which I see this Friday. I can drink milk and eat all dairy products without any problems, so I am hoping I won't have to give them up. I hope the nutritionist works with me to find a diet that will work for me. I am on disability and don't have much money to buy all of those special foods.

I was diagnosed with Celiac 5 years ago. I have always done pretty much my own cooking(no packaged things, etc.)..I find that the food you buy that are gluten free arent neccesarily good for you. Once in awhile a muffin or whatever(pkgd gluten free) are good, but all in all they are not that good. I make my own food, and to avoid any cross contamination I just dont eat out. I drink one glass of milk a day and see no problems so far..eat more fruits and egetables..and i eat leaner meat..