Lactose intolerance is one of the most common food intolerances. A reduced ability to digest lactose is one of the major causes, and this affects 65 percent of the world’s adult population. (1) Many people choose to completely cut out dairy as a way to avoid the gastrointestinal symptoms that frequently come along with eating dairy foods. But is true lactose intolerance really the cause of their digestive distress, or are many people prematurely eliminating dairy because of a perceived inability to digest milk products? And is it possible to cure lactose intolerance, even as an adult?
The major reason some people can’t digest dairy products is they lack the enzyme lactase, which is necessary to break down lactose in the small intestine. It has been determined that continued genetic expression of this enzyme, known as lactase persistence, is dependent on ancestry and racial background. (2) The ability to consume dairy probably gave early herdsmen a distinct survival advantage, allowing for the spread of the gene in certain regions of the world such as northern Europe and parts of Africa; today, only about 40% of the world’s adult population maintain full lactase function following childhood. (3, 4) Lactase deficiency makes digesting dairy products more challenging for these individuals.
However, true lactose intolerance is rarely diagnosed by medical testing, and adults frequently mistake their gastrointestinal symptoms as a sign that they are unable to digest dairy products at all. Studies have shown that even diagnosed “lactose malabsorbers” are capable of consuming moderate amounts of dairy, tolerating an average 12 grams of lactose when administered in a single dose (the lactose content found in 1 cup of milk) with little to no symptoms. (5)
Can lactose intolerance be cured?
Why dairy is worth eating
You may be wondering why eating dairy even matters; after all, there are many examples of ancestral cultures that had no dairy in their diets and maintained superb health. However, it is believed that certain ethnicities may have had physical adaptations to their low calcium diet, and also traditionally consumed animal foods that are higher in calcium but probably not so appetizing to us Westerners, such as fish heads, bones, and skin. (6, 7) Therefore, they were able to meet their individual calcium needs without milk and dairy.
Calcium is a mineral that is difficult to get adequate amounts of in a modern Western diet without the inclusion of dairy. While the adequate levels of fat soluble vitamins A, D, and K2 reduces the amount of calcium an adult needs to maintain bone health, it can still be challenging to get enough calcium simply from leafy greens and bone-in fish. Several studies have shown that individuals with lactose intolerance have lower bone density and are at higher risk for fractures and osteoporosis, likely due to their inadequate calcium intake. (8, 9, 10) This risk is possibly exacerbated by low K2 consumption, as grass-fed dairy is one of the best sources of vitamin K2.
Pastured dairy products, in particular, are also a good source of the fat soluble vitamins A, D and K2 – which can also be difficult to obtain elsewhere in the diet. In fact, the only other significant sources of K2 are goose liver and natto, foods that aren’t typically eaten or easy to find. And, as I pointed out in a recent article, dairy is the primary source of the natural trans-fat conjugated linoleic acid (CLA), which may have anti-cancer and other beneficial properties.
By taking certain kinds of probiotics and consuming fermented dairy on a regular basis you can improve, if not eliminate, many of the symptoms of lactose intolerance that come with eating dairy.
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Using probiotics to cure lactose intolerance
Studies have shown that supplementation with probiotics, in addition to consuming yogurt that has been enhanced with certain types of bacteria, can alleviate symptoms of lactose intolerance by modifying the metabolic activity of microbiota in the colon. (11, 12, 13) These bacteria may even produce their own lactase enzyme, and consuming lactose from dairy products can promote the growth of these bacteria in the colon. Over time, these effects can lead to greater lactase content in the gut, improved lactose digestion, and eventually the elimination of intolerance symptoms.
If you plan to use yogurt and probiotics to improve your digestion of dairy products, it’s important to start slowly and build up tolerance gradually. Often, negative effects from dairy consumption come from simply eating more lactose in one sitting than one’s gut can completely metabolize. I recommend starting with probiotic supplementation first, and focusing on bifidobacterium longum, a strain that has been shown to efficiently metabolize lactose. (14)
Jarro-Dophilus, a shelf-stable probiotic that doesn’t require refrigeration, is one option. Taking prebiotics is another way of significantly increasing bifidobacterium levels; in fact, some studies suggest prebiotics are more effective than probiotics at doing this. Biotagen is the prebiotic I use in my clinic. Remember to start at a very low dose and build up slowly over time with both pre- and probiotics to avoid any unpleasant side effects.
In addition to this supplement, I suggest consuming a few spoonfuls of a high quality full-fat yogurt every day, with each meal if possible. This will introduce beneficial bacteria into your gut that are effective lactose metabolizers, and by slowly increasing the amount of yogurt you eat every day, you may be able to work up to eating two or more servings of fermented dairy every day.
If you tolerate the yogurt well, and want to try diversifying your dairy intake, my next recommendation is to start including full-fat hard cheeses (raw if possible); these cheeses are great sources of calcium and vitamin K2 and are very low in lactose. One ounce of hard cheese contains about a third of the recommended intake of calcium, and gouda is the best source of vitamin K2 of all cheeses. (15) These hard cheeses are extremely low in lactose, and make a nutrient-dense addition to a whole foods diet. As you become more tolerant of dairy products, you can try higher lactose items such as soft cheeses, cream, and even fluid milk. Just remember to stick to the full fat and grass-fed versions as often as possible.
Of course, another option to try is raw milk. Anecdotal evidence from raw milk drinkers around the country suggests that many people who cannot tolerate pasteurized milk have no trouble drinking raw milk. (16) Research conducted on this theory, however, indicates that truly lactose intolerant individuals do not experience any benefit from drinking raw milk over pasteurized milk. (17)
The best way to figure out which dairy products work for you and your digestive system is simply to try them yourself. By taking the time to introduce lactose fermenting bacteria through probiotics and high quality yogurt, you may find your lactose intolerance symptoms decreasing over time. Of course, if you’d rather eat fish heads to get your calcium, feel free to skip the dairy!
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I developed a problem with dairy after I returned to the US from a month-long work trip to Africa. I had contracted giardia in Ethiopia, and I took a strong dose of antibiotics. The drugs worked, thankfully, but my gut was all out of balance. It took me a month to finally get some probiotics. A naturopath friend recommended a probiotic taken with yogurt, slippery elm tea, marshmallow root tea, and okra. The probiotic I found had these herbs in it, and it also had psyllium husk, which is very commonly used in India. The reasoning behind these herbs/foods is that they are slimy when mixed with water, and their sliminess helps to soothe and heal the mucosal lining of the gut.
After about 3 days using all of the above, my gut normalized. It was like a night/day experience. I weighed 110 before my trip, and lost 12 pounds as a result of the illness and the gut issues. After healing my gut, I was able to get back up to about 110, thank goodness! Hope this can be helpful for others.
We suspected that my daughter could be lactose intolerant or have some sort of milk allergy when she was about 3 years old. She used to get rashes and chalazia (kind of like styes) in her eyes all of the time along with stomach aches and we couldn’t figure out why. We tried raw milk. When she started drinking some raw milk her condition improved. When we switched her completely to raw milk we saw almost 100% improvement. She now only drinks raw milk. We also avoid high lactose foods. She’s ok with most cheeses, butter and yogurt. Recently, she had some regular old ice cream at a birthday party……and nothing happened. I think it’s possible that the past couple of years of drinking raw milk every day may have healed her.
So… I’ve always loved milk. All of my life.It’s my favorite. I’m 26 and I’ve never stopped drinking it. It’s so delicious. All the time. When I don’t have time to eat breakfast, I make myself a big cup of chocolate milk with heavy whipping cream added in – or I eat some string cheese. My eggs have cheese and cream in them. My Chicken Pot Pies have cream in them. Everything I eat has to have milk, cream, or cheese, all I can only eat or drink at full fat (because nothing else is worth the effort.)
Incidentally, I’ve also always had huge stomach problems all of my life (as well as a really bad cough). Embarrassingly, I appear to be gassier than other people, and have chronic constipation. So I decided to start paying attention to when the stomach issues happen. I’m drinking milk less often, but when I do have a glass, I notice that that’s when I get gassy and stomach-achy. Milkshakes are pretty much the worst.
Because I cannot live without dairy, I shall try your suggestions and see if my digestion improves while still consuming milk products.
Dr. Kesser, I love dairy and can’t seem to stay away from it. I’m not a fan of soy but would love to continue to eat cereal, ice cream and cheese. My lactose intoleration kicks in directly after I conune a lactose product
Luisa – you’re right about raw milk being illegal for human consumption in many states. It’s perfectly acceptable for pets, however. We buy raw milk from a local independent grocer for our pets. We do have to call ahead and ask for it – they don’t keep it in the public refrigerated/dairy case.
Works great.
😉
@DavidRN—thank you so much for replying to my question! I will definitely try to find some raw milk in my area (I’m in NC), although I’ve heard that it’s “illegal” in our state?! Don’t know if that’s true or not, but I will ask around and go to my local health store to see what they have to say about it, also.
Thanks, again! 🙂
Hi Luisa — I haven’t tried the suggested raw milk/probiotic stuff suggested on this website yet, but just wanted to let you know that I buy lactase drops from Amazon and successfully use them (with a mortar and pestle) to mix with lactose-containing pills when necessary. I mash them up together and add to a drink. They don’t always taste good, but it’s possible to get down. I’ve also had luck with one local pharmacy (Kroger) and mentioning that I’m lactose intolerant — they research the specific drug and find out if there is a lactose-free version available. Good luck.
I have been lactose intolerant for almost 20 years. I was diagnosed with lactose intolerance test 14 years ago. I have not been able to drink milk, ice cream, or any diary except for occasional cheese. In the last month I have been able to digest everything including chocolate!!! I am not sure if it is due to the consumption of Kefir or the fact is that I am pregnant. I can not believe this, It is great news.
Luisa, I had a similar situation with dairy as you have had. I and later my wife also tried raw milk, and an occasional pint of raw milk yogurt from a great clean dairy, problems were solved within a few weeks. I also found I can now eat commercial ice cream without an difficulty. So, if you can find it, I would suggest trying it out, raw milk can be an experiment that may solve many problems.
Ok, I’m going to try and make this short and sweet, if I can…so, here goes: A couple of years ago, I got a horrible stomach virus from eating tainted meat, that I guess destroyed all of my good intestinal “flora,” as they call it. I couldn’t keep anything down for a week! Well, so maybe a year later, I became severely lactose intolerant (after lots of expensive testing to see what was wrong with me, the doctor FINALLY suggested that I might try eliminating dairy from my diet for a few days to see if that helped, and it did!). Before that, I had never been lactose intolerant before in my life, or ever had any adverse reaction to dairy. So, now that I know I am lactose intolerant, and I have eliminated drinking cow’s milk (I drink almond milk now, and I love it!),I still LOVE pizza and ice cream, so when I eat it, I will take a “Lactaid” chew-able tablet 10 min. before I eat, and that really helps a LOT, although I do still have bad (loose, wet, smelly) poops (sorry for the graphic details!), but I’m not in severe pain like I used to be when going to the bathroom (severe abdominal pain, bloating, gas, nausea, constipation, followed by severe diarrhea). Ok, so now you know my history, here is my question: Am I going to be lactose intolerant for the rest of my life??!! (I am only 32 yrs. old) Also, should I try raw, unpasteurized, organic milk? I’ve heard that it can actually be tolerated by lactose-intolerant individuals. Thanks so much for reading, and I hope to hear back from someone soon!
Hi Luisa,
I had a very similar situation where I became lactose intolerant quite suddenly around 24 years old after a series of incidents – some food poisoning while travelling, followed by antibiotic heavy dental surgery. I made my normal milk smoothie and within an hour I was throwing up and on the toilet at the same time!! very worse symptoms. That continued whenever I ate dairy until I eliminated dairy completey from my diet. long story short: I was able to tolerate some quantities of low-lactose products such as butter, and hard cheese (very few lactose intolerant people should have problems with butter and very hard cheese, i.e. parmigiano reggiano, 4 year old cheddar etc). But yogurt was still a problem for me. In the past month however I have begun to ferment and consume kefir and that has made a HUGE difference…I have added back small quantities of other dairy, i.e. cream in scalloped potatoes, quiche, etc. I am actually experiencing less symptoms from eating those things than my brother who is not at all lactose intolerant (but probably does have some issues with dairy). So get on the kefir, lady!
Since I started following a paleo plan about a year ago, I started eating dairy occasionally about 3 months ago. It hasn’t gone well. I believe I have figured out that it has been the dairy that triggers allergies, I will start sneezing and sometimes having a full on allergy attack within hours of eating (full fat no added ingredients, but not raw milk) yogurt. I would never have made the connection before cleaning out my diet. I suspect that this may be more of a mild allergy than intolerance, but have no idea, and I’ve not really figured out where to start for finding out. This helps give me a direction. I think I will try probiotics to see if they can help.
Dear Dr. My 7Months baby having lactose in tolerance she was getting motion more after she was getting reddish colour on back side near excretia canel what we should we do. She was crying.
Hi There- I had post surgical pelvic radiation
22 years ago. I’ve had Lactose Intolerance, Gastritis & IBS. My tumor was 1mm from my bowel. I was extremely sick for the first 5-10 years. I’ve not been able to tolerate Dairy Products since. My husband does Palio, on & off. We started Ideal Protein in October. I lost 15 lbs. pretty quick. My birthday rolls around in March & I threw caution to the wind. My bowels are incontinent, I’ve gone through 468 baby wipes each week. I’ve been very itchy, everywhere. I’m being tested for Celiac. I’m actually wearing adult diapers & need cortisone, triple antibiotic on a wipe & plug the hole, as it’s raw… I’ve returned to Ideal Protein & today, I have not messed my pants. I take MANY MEDS, that contain Lactose. I eliminated most meds w/lactose in them. I have Chronic Migraines
& my back blew in the late 90’s w/12 issues. I take Lactaid, Beano, Gas X, extra strength pro-biotic. I’m going to check out the GAPS
Diet, am wondering if I may take vitamin D…
Back to no processed foods, no starch, nothing white, ect… I HATE THAT MOST MEDS ARE FILLED W/LACTOSE! I now have to take much less of them, take Lactaid w/the ones I can’t do without & am. Looking for alternatives, in the interim, ie, liquid meds & injections… I literally lived in our restroom for 3 weeks, when I was on OXY & realized, that was the only med. changed, they ordered a brand for me & kept my name on it. I quit OXY a few years ago & now use Topical Voltaren, for pain… Thank you for your time & consideration!
Sincerely, Lynne
I don’t know what my milk issue is, honestly.
I was diagnosed (via the usual myriad prick-test allergy torture) as a very young child with many allergies, milk and dairy being a primary instigator. Since I grew up not knowing dairy, I didn’t miss it *too* much ;-> I always wanted ice cream, but so far as I knew, sherbet *was* ice cream…so I managed okay. Cheese I never knew until I was in my early teens. I handled that okay, and then went crazy with it to the point I ate more cheese than meat.
Since I’ve modified my diet (by prescription of our endocrinologist) to a restricted-carb and paleo-ish regime, I’ve lost most of my cheese cravings, although I do eat some. However, I still cannot deal with true milk – whole, raw, or LactAid™. It’s even worse now — I can’t even eat pudding made with milk anymore. I tried with alternate milks (coconut and almond) but it just doesn’t set up well, so I figured I’d have to just give that up.
I’m not especially avid to have milk…but I would like to have an occasional pudding, or some such nonsense (which probably isn’t on “The Diet” anyway!). But I’m reluctant to subject myself to the fermentation and subsequent misery that tempting my gut with milk seems to create. Yogurt processes fine! and kefir, and the alternate milks (although I don’t drink them without additives – like a whey shake).
Now I’m curious again about whether there’s any future for me with puddings at all. Anybody have similar experience or suggestions? Or a recommendation from the author! =D
Hi D-
I’ve done Kozy Shack, Tapioca & Rice pudding’s w/no sugar added. I also found Mousse’s as well, Gluten Free only 70 calories a serving, made by Sans Sucre Mousse Flavors- Choc, straw, French Van, Mocha Cap, cheesecake, Choc cheesecake & lemon. I put the mousse envelope in a cup first, the. Whisk 3/4 cup of Almond, Lactaid, soy or rice milk. It’s light & guilt free! They say they contain milk, I can’t see it in the ingredients however! Almond Milk is nice & thick! They didn’t bother my lactose intolerance, I’d take Lactaid w/first bite & Extra strength Probiotic in AM, I got them @ The Chrismas Tree Shops, if you owned now by Bed Bath & Beyond, if you live where there is no Christmas Tree, I can mail them to you. TheTapioca is from WalMart!
Good Luck
Thanks Lynne! the mousse sounds yummy. I’ll try some with almond or coconut milk. And WalMart is everywhere 😉
I hope I can make it work for me!
~vicki~
I do not have gastro problems with dairy but I end up with joint problems. If I eat dairy more than one day my knee will end up hurting to the point that I can barely walk. It also effects the joints in my hands.
Do you have any suggestions on how I can turn this around? It’s very hard to not eat dairy in the American diet. 🙂
i have a daughter 1 and half year..she suffered from dhyearea a month ago that leads to laaysctose intolernc..how can i cut off milk she is fond of milk always crying for it…please tell me the solution..doctor suggestd lactose free milk for 10 days..but after it problem reapear.
hijab: you can use different type of “milks”, like coconut-milk or soya-milk. If you live in the USA try to avoid any kind of GMO product. You can also try lactose free milk from different producers, my impression was that they don’t have the same quality. Also lactose intolerance can be caused also by other problems, like grain intolerance, so try also to reduce the amount of grain your kid eats. I think there should be some tests for it.
Zsolt, You just hit the nail on the head. When I went gluten free I did not realize I was doubling the amount of GMO’s I was consuming. A few years back I was lactose intolerent (for 20 years), there was a company that had a cure for it about 5-7 years ago, They would have you eat yougart and take Pre or pro biotic’s (their formula) It was very expensive but it worked. It actually changed my life, I can drink moderate amounts of milk straight (2 cups), milk in a receipe is not a problem. The reason I came to this site was to try to get the name of the company, for a cousin. If anyone know’s of the company I’m trying to think of let me know. I believe it had Lact- something in it’s name.
Five years since I started having gastro problems. I think I had an ulcer (not h-pylori, but rather from too much aspirin & other pain relievers, and stress.) I then started becoming intolerent to dairy. A couple years later I stopped all dairy, with only a very occassional and very rare bite here and there. I considered myself dairy-free. I started pro-biotics about a month ago and noticed that the fungus on my feet cleared up. It was the kind that looks like your heels are just really dry and cracked, but I now know is actually caused by yeast overgrowth (I know, gross!). I feel much better and have started introducing dairy back in my diet with no problems. I don’t think I’ll go back to drinking milk like I used to (2 gals/wk). I am used to the rice and almond milk now. As someone who loves to bake, I’m glad I can go back to baking using regular ingredients. I have researched cultured butter and even made some of my own! I am really excited about being able to include some dairy in my diet again. I wonder now if it was mostly IBS that was bothering me. It’s kind of like: which came first, the chicken or the egg?….did my IBS cause me to not tolerate dairy? or did my dairy intolerence cause IBS? I don’t know, but it’s a very interesting subject. I now know just about everything there is to know about the subject.
Thanks for listening to me and I appreciate your article above.
Hey everyone. What an amazing post, pretty cool stuff here. Everything that I’ve ever read has been about avoiding diary or foods with lactose. So I did just that for a long time until recently. You see, I started taking a fiber supplement every day combined with a probiotic every other day for the past 6months. A few weeks ago I was tempted to have a thick slice of cheddar cheese on my breakfast sandwich so I did. Amazingly I had no adverse reaction, so I started doing it every day for breakfast. I still keep my dairy intake low, but I now have been introducing more and more dairy and are doing great. I think that the extra fiber combined with the probiotic has really helped my digestive system. Thank you for writing this article and giving me justification behind what I am experiencing. I want to share this with everyone. I was so excited that I’m sharing this information on my blog I just started as well. Cheers to eating CHEESE again. 🙂
Weird how I can’t drink regular milk, but I’m fine when I eat cheese. Well anyway, I hope this works, this article was helpful. Thank you.
What would be the downside of of making yogurt from grass fed raw milk? Does the heat needed in the yogurt making process damage the lactase (like pasteurization does?) Any other drawbacks?
Also, in college biology 101 during the basic 101 level of genetics we did several tests on ourselves. One of these was whether or not you could taste “bitter”. I could not. Does this mean that I cannot use bitters (sweetish/ swedish) as a digestive aid? Do bitters work if you can’t taste bitter.
Thanks.
I have the same concern, so I make yogurt without heating the milk. It’s easier, and works fine. It may not be as thick as other homemade yogurt, but it will be fine. And kefir doesn’t need to be heated, either. And I will say that while I tolerate the raw milk yogurt, it didn’t help me to digest lactose. But kefir is helping me to digest lactose. And my husband does better with the kefir, too. I think it’s more powerful, to be honest. But I will admit to not yet having learned to like it. I add it to smoothies. 🙂
Not sure about your question about bitters. I would say to try it and see if it helps you. It won’t hurt you, and we’re all different.
I drank raw kefir every day for two months before my first pregnancy. By the time I was pregnant I was able to drink fresh raw and pasteurized milk for the first time in two decades.