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’m lactose intolerant and I’m trying to find a way to get rid of it I became lactose intolerant when I was pregnant with my son even since I was pregnant with him even after I gave birth i was lactose intolerance what should I do
take lactase pills they work great, get yourself onto amazon!!
https://www.amazon.co.uk/180-Caplets-Fast-Acting-Lactase/dp/B000HI0CKS/ref=sr_1_1?ie=UTF8&qid=1415496177&sr=8-1&keywords=lactase+pill
I have been using lactose pill since I was in high school I am going on 6 years out of high school and the pills just stopped working. I am curious if my stomach used to produce a small amount of lactose but I have lost them now. So possibly before the pills were able to supplement, but now the pills can’t work alone?
Robin, I have never been able to take the pills. I tried them after becoming LI and they made my symptoms worse. I would get horrible stomach cramps and have horrible gas.
I currently just consume lactose free Darigold milk, So Delicious coconut milk and Almond milk, So Delicious coconut yogurt and recently found our local store sells Green Valley lactose free products.
Lactose-free milk is regular milk with the lactase enzyme added. The pills are lactase and they will break down lactose (when you take it at the same time as your milk consumption).
If the pills did not work, you did not take enough. OR, you may have a milk allergy.
It maybe they changed the formula. Or r using less lactase per pill so they can make more pills for less money.
What happens if u take a larger dose of lactase pills?
I too became lactose intolerant after my pregnancy, thirty years ago. I began to use lactaid, but needed to increase the dosage over the years to 4 extra strength. A few years ago a friend told me that “Schiff’s Digestive Advantage” worked for her. It was worthless for me. I began to try other probiotics, and made cultured vegetables from the starter sold at http://www.bodyecology.com and had some improvement. After reading that some people can digest raw milk better than pasteurized, and that even regular pasteurized was better than ultra pasteurized, I cut out all the ultra pasteurized milk (most organic milk is ultra pasteurized) and found that I could digest regular pasteurized milk more easily than ultra pasteurized. Last year I was sick, and took an antibiotic. In the past, my lactose intolerance always got worse after an anti-biotic, despite having yogurt or kefir. This time I ate cultured vegetables. After the illness I slowly decreased the amount of lactaid I was taking and was surprised to find that I didn’t need any. Maybe the antibiotic killed the bad bacteria making it easier for good bacteria to thrive. Not sure if the “cure ” is permanent, but it’s over a year. I still don’t have symptoms, but I do try to avoid ultra pasteurized, powdered and canned milk.
Keep trying to find a solution to your problem. Good luck.
Hello, thanks for the great article. Can someone please throw some light on why the “full-fat” version of yogurt or cheese is recommended when slowly reintroducing dairy into one’s diet along with probiotics?
because fat slows the lactose through your gut and therefore the lactose can have a better chase of being digested
Ah, I see. Thanks, that helps a lot.
Check out this web site
https://www.stevecarper.com/li/list_of_lactose_percentages.htm
Full-fat versions have less sugar, including lactose. Low-fat and fat-free versions are loaded with sugars and lactose.
I’ve been told drinking buttermilk can help reverse lactose intolerance. So I’m doing that right now, I also take some probiotics.
This is the first time I am hearing that buttermilk can help. Can you please let me know your source of information?
I haven’t been able to tolerate milk since I was an infant. Pretty sure I’m in the ‘true lactose intolerance’ camp 😉 Even the slightest little bit takes its toll on me.
my daughter loves milk and milkshakes and had them every here and there but throws up after eating and has stomach aches. when she eats ice cream and food like that she passes gas and burps. is there anything to take to prevent/help? thanks.
Yes, get onto amazon and buy some lactase pills, they provide you with the lactase enzyme which helps break down the lactose protein in dairy, i take 2 before a large bowl of ice cream and have virtually no symptoms at all, take 3 i have none, let me know how your daughter gets on
Lactose is a polysaccharide sugar, NOT a protein. 😉
Look at Norm Robillard’s diet: Fast Track Digestion: Heartburn and Fast Track Digestion, IBS. It will help you understand your daughter’s symptoms and help you make safer food choices for her.
what about butter? I don’t ever want to drink milk, I would drink skim milk as a kid because we had to drink milk and my brother and I both preferred the skim milk. Our Mom never bought butter but my grandmothers did. I love butter. I cook with it and only eat toast to eat butter. I thought butter might not have the stuff that doesn’t agree with my stomach. is this true?
Butter is just the fat from the milk, it doesn’t contain lactose. Butter should be no problem 🙂
Butter is processed milk – clarified butter has no lactose in it because it is just the oil.
I have a problem with butter every since I became lactose intolerant. Even the small amount used in some cooking bothers me.
Butter still has other dairy products in it.
Ur the only one that can tell for sure if butter bothers u.
Sounds like u can eat it tho.
Butter is mostly fat, which digest slower. Might be part of the reason u candle it. Plus ur not drinking a glass of butter.
I would if I could. Lol. With some brown sugar and Oates stirred into it. Lotsa sugar. Lol.
At most ur prob only using a tablespoon or 2. I how ever couldn’t do it either when I was allergic. My dairy allergy went away after 30 yrs.
sure wish they had internet back when mine dairy allergy started. I didn’t KNOW WTF was going on with my tummy and my head. Turns out dairy also gave me vertigo. And made my ears ring really loud.
I got diagnosed with IBS and TINNITUS ( ringing ears).
Turned out it was all dairy.
Just now doctors r FINALLY starting to talk OUT LOUD about dairy and tinnitus. It’s just been the last few years I’m reading about drs telling tinnitus patients to go off dairy.
Dairy creates mucus. That’s mucus flows or sits clogged up in ur eustia tubes. The tubes in ur ears. As a kid I never got sick. Then I was getting colds and bronciatus ALL THE TIME!!
It was all dairy related. No kidding.
A lot of unproven facts and advice that doesn’t relate to lactose intolerance.
If you DO have lactose intolerance, you will not cure it with yogurt or probiotics!!!
You can only cure it with lactase tablets that contain it. THAT IS IT!!!
I feel this article can give wrong hope to people suffering from it as there are too many claims here and online that are nothing more than guesses, with absolutely no research done behind it. Take it from someone who spent years researching it,after being hit with this at the tender age of 24 🙂
PLEASE PLEASE PLEASE people, do not think you can cure lactose with probiotics. This has NEVER been proven to work for those suffering from lactose intolarance. Maybe it works for some kind of allergies of some sort,but it does NOT work for lactose issues.
Although I did not work for me, some people do say positive things about Digestive Advantage Lactose Defense. Apparently you just take 1-3 pills(they contain lactase) in the morning and eat all the dairy you want. It didn’t work for me,but I noticed some improvements in general digestion so it still may be of benefit. I also noticed that if you take it for more than a few months, your body starts to act strange so stopping for a week or two is beneficial. Whatever bacteria it introduces to your gut(perhaps) grows too much of it and your body starts to act up.
In Canada stores charge you up to $1 per lactose pill as Lactaid tablets are VERY VERY expensive at drug stores and most only contain 4500 lactaid.
My suggestion to look online for Kirkland lactose pills. Those are 9000 (and I still have to take 2 or at certain meals 3). Price per 180 tabs is around $18-25. Same amount and strengh from lactaid would be around $120-240(!!!)
I also noticed that I can tolerate lactose better in the morning. Not sure if it’s the same with other people,but it’s a strange observation.
OLD(aged) cheeses do NOT have any lactose and this is why most can tolerate it. These days a lot of brands even say that on the packaging.
Despite some claims, goat cheese DOES have a lot of lactose. If you can eat that but not cow milk,maybe you have some allergy and it has nothing to do with lactose.
The only mammal that produces milk with no lactose is camel…tried it. It was awful,but it had no lactose…
A lot of stores these days in Canada(Toronto) have lactose free milk, cheese, sour cream, cream cheese, ice cream,pizza. Life is easier than even 6-8 years ago when we only had milk.
I know what you mean: there are people out there who are lactose intolerant and nothing will change that. But I think this article is more aimed at people who, like me, grew up having tons of milk and had no problem and maybe even don’t have a family history of lactose intolerance… Anyway, they start feeling discomfort after a glass of milk or two, and very quickly jump into the conclussion that the MUST BE LACTOSE INTOLERANT.
I am European and Caucasian, so chances are I am not lactose intolerant. I grew up drinking 2-3 glasses of milk a day + yogurt + cheese… You get the idea.
I’m 30 and I have lived in Asia for last 5 years… Living in college and milk being much more expensive here, I simply stopped having it and you know what? Every time I occasionally drink more than a cup of yogurt (say, a large porcion of ice cream or a milkshake) I become gassy and have cramps.
To sum up, I think the ideas in this article may not work for true lactose intolerant people but those are very few… Instead of giving myself a self diagnose, I’m going to give this a try, and hope that my belly is now simply not used to milk, but can get used to it again
Nope. Depends on what part of the milk u are allergic too.
There is more than just lactose allergy. There’s the milk protein and milk salt allergy too.
But I agree I think the artical is directed towards people developing allergy to dairy after never having had it.
I never found the pills to work for me EXCEPT, if I accidently ate dairy ( the only way o ate it) the next morning I would still feel awful. Almost like a hangover. Then I’d take about 8 lactase pills and it would ” help” the left over gas and bloat dissipate faster.
I don’t reccomend taking more than prescribed on back of lactase bottle.
However I never had anything bad happen when I did. But it was very rare that I accidentally consumed dairy.
It would only happen if I went out to eat or friend cooked for me. Otherwise accident just didn’t happen. Made me to miserable to ever eat it on purpose.
At last a sensible post, have been taking lactase pills for the last 7 months they work fine, all this other nonsense is just a load of baloney!
This is very interesting. I am LI and cannot eat any dairy products that have lactose. I take lactase tablets between 1-3 and find that although i dont get the normal symptom my body gut feels heavy. I was in Toronto recenty and i was so excited that this condition is recognised and yes lactase was seriously expensive.
Btw when i consume dairy i develope blisters.
Sounds like you may have a milk allergy, too. 🙁
My 5year old son became lactose intolerant after a gastroenteritis. Took us a while to figure out that the milk was the culprit for persistent diarrhea. One lactaid 9k unit before each meal that contains dairy takes care of his symptoms. Generic ones may work for some people as suggested above. We tested that and to my surprise they did not work at all. I guess we’ll try another generic in a while and see if it makes a difference, because indeed they are expensive (certainly not $1/pill here in US, more like ¢20-30)
I am very lactose intolerant. I say very because of the severity of the symptoms. Waves of severe lower abdominal cramping occurring at first every few minutes, then becoming farther apart. This is accompanied by vomiting. These “attacks” can last for 4 or 5 hours, leaving me wiped out. I have learned to be VERY careful about what I eat and keep a ready supply of lactaid on hand. I would love to try to “cure” myself, but I am afraid of trying anything new. I also have IBS which causes identical symptoms, even if I eat no dairy. I have found that a good probiotic and digestive enzyme supplements help significantly.
Hello..i am a 23 year old girl experiencing problem in digesting milk from last 4 years..however i cn digest other dairy products such ss cheese, curd and icecreams very well..but as soon as i drnk milk,within an hour my stomach gets bloated nd diarrohea is d consequence..i also suffer from dis heaviness feeling in stomach even widout drinking milk…dis happens with me in mornings usually..after passing stool once in.d moring..stomach gets heavy and jst after having breakfast i hv to pass loose stools..as dis problm is becoming chronic..my weight is reducing gradually..wat shud i do cure dis problm…no medication has long lasting effect..i also suffer from urticaria..nd i used levo cetrizene continously for 4 yrs for dis but nw m taking homeopathic medication for dis urticaria…please do reply wid sum workable solutions.thanku
Stop milk completely.
do some research yourself
Stick to high-fat dairy products and take a lactase supplement with the first bite/sip.
No solutions. I know ur post is old. Getting off dairy should help with uticaria. The heaviness u talked about, u maybe be still eating dairy and not know it. U have to read the ingredient label. For some people the tiny amount of non fat dry milk used to make most store bought bread is also enuff to make them feel heavy and icky. Or maybe u r using a butter substitute that still has dairy in it. Dairy by products has go by other names besides milk. Hope u figured it out tho. If so what was it?
Just drink a ton of milk til that goddamn body of mine makes the damn enzyme i need to take a solid crap while aboard the milktrain
Hi Chris , my 2.9 year old is lactose intolerant after a high dose of antibiotics … It’s been over 4 months .. He can’t tolerant milk , yogurt or any such dairy products.. I have started with a probiotic Yakult which has live bacteria … Can you please suggest something, thanks mommy
Makes the probiotics u but are grown from a non dairy source. Like carrots or yams.
Years ago when there was NO ONE making dairy free yogurt, one company did. I ate it. Got dairy sick. I thought about it and called the company and asked what the yogurt culture was made out of.
DAIRY!!!! But this was years ago. Things r changing. Retailers listen to us consumers.
Now if we could just get doctors to LISTEN. So that when we leave their office we feel HEARD!
I’ve been recently trying to re-introduce some goat dairy back into my diet after finally (took over a year) successfully re-introducing eggs. I tried just what you suggested….epic fail. It seems the only dairy I can tolerate is LOW FAT soft goat cheese (under 10%). As soon as I try whole goat yogurt, I get symptomatic. When I try full fat hard cheese, symptomatic. Any idea why this may be? I don’t get the usual lactose symptoms but instead get a 12-24hr reaction of painful lower GI symptoms and a feeling of ‘swelling’ from my stomach to my end bits…then constipation for a few days and general fatigue. Strange…my brother gets the same thing!
You may have an allergy to milk instead, which is much more serious than lactose-intolerance! 🙁
I am confused about casein and yogurt on the GAPS diet. If a person has an IgG allergy to casein, should they still try to add fermented dairy? I know the process removes the lactose, but does it remove the casein too?
Thanks!
dont really know how, but I was diagnosed 14 years ago (I am no 41 years old). I never had a problem before then…I used to eat all types of cheese, drink milk, I loved icecream, etc. Then it just kind of hit me. I have been taking Digestive Advantage for about the last 10 years or so. About 2 months ago, I started getting ver constipated…I stopped taking the Digestive Advantage and started drinking lots of milk, eating cheese, etc. to “naturally” flush me. Well, after several days of laxitives and softeners…I am back to “normal” and for the last 6 weeks I have not had any problems with dairy… Strange, very strange, but I think God that I no longer have the problem!!!
Hi Aaron, can you please give an update of your conditions now? Your post was in April. Do you continue to have no symptoms with dairy even now? I started taking the Digestive Advantage Lactose Defense supplement just over 2 months ago, so i still have a long way to go. But I’m just curious to hear you updates, since I was given to understand that I’d need to take the supplements for the rest of my life.
Hi Chris,
I wonder if it will help to eat the probiotic yogurt without the extra pro and prebiotics. I only ask due to budget and availability restrictions where we live.
I don’t even know if I have a lactose problem, but am suspecting (after a Whole30) that I might. My only obvious symptom seems to be constipation caused by dairy, maybe some bloating as well, but no real strong gut pains. Could this be due to lactose?
I have a quick question. So I don’t have any real food intolerance. Never had any issues with dairy. Recently I accidentally purchased some “lactose free” ice cream. I figured, oh well, so it tastes faintly of cardboard. Didn’t want to throw it away, so I’ve tried it several times. Every time – after just a spoonful or so, I have intense cramps. Shortly after I just feel extra tired and bleh. I find this ironic. Been googling for any info on it, but nothing has turned up. No matter how I phrase it, Google just shows me a bunch of anti-dairy stuff. Anyone else experienced this or know about it?
As an aside – Again, I’ve no food intolerances or allergies. What I have noticed is that I am intolerant of NON foods – heavily processed, preservative laden, shiny-packaged anything. When I eat these I break out, have less energy, sleep poorly, and feel generally yucky, weak and cranky. Nearly every person I know who loves their special diet have all one thing in common – it’s all FOOD. One says they feel so good because they are eating meat and avoiding wheat. Another says they feel so good because they are avoiding meat and eating veggies. They all look and feel great. And they thing they have in common is it’s all REAL FOOD.
As a person from Finland where lactose intolerance is REALLY common and almost every dairy product has a lactose free/low-lactose version, this sounds a lot like bullsh…t.
I have suffered from lactose-tolerance since I was a kid and I can name at least 40 people who have it also. And fuck no, we can’t eat mozzarella or feta (as someone before me mentioned) unless the package says “lactose free”. Hard, long ripened cheeses I can tolerate – they naturally don’t contain any lactose. That’s a well-known fact over here. So people saying they can eat hard cheeses nowadays – NO SH…T!
BUT. We do have these lactose enzyme pills at the pharmacy and they DO work if used properly – you have to know the amount of lactose in your food to take enough of those enzyme pills. So there is basically a ‘cure’ or ‘medicine’ for it – if you happen to have enough euros to buy those expensive things.
If you have digestion troubles with dairy my own experience is that the culprit is often the hard cheese. Old ripe hard cheese contains large quantities of *histamine*, and many people don’t tolerate a histamin-rich diet.
Personally, I am happy milk drinker, and I eat all type of fresh cheese, including mozarella and feta. But cheese like gouda, cheddar, parmesan etc I completely avoid
I have been diagnosed as lactose intolerant, and have suffered for 8 years now, I have done the Breath Hydrogen Test which also indicated that I am lactose intolerant, and for the past 8 years even a smallest amount of dairy ingested has bothered me intensely. Here is the funny thing, since October 2013, I am feeling better , I can eat cheese, milk in coffee, yogurt etc, though I am still afraid to try a whole glass of milk, small amounts are fine. I am just intrigued how did I go from being extremely sensitive to dairy products to a whole lot better where I don’t have to carry my lactase pills. My diet has not changed, my life style has not changed so I ask myself how did it happen. The only thing that I can think of is that my friend gave me powered mixture of ground Senna leafs, almonds and sugar, she claims it a good body cleanse, we all know Senna leaves are a natural laxative, I did take this thinking it can do any harm, and I only took it twice. Because I starting feeling better about the same time I took this, I don’t know if I can attribute my wellness to the Senna mixture. Anyway just sharing, not even certain about anything else but the fact that I feel better.
Mr. Kresser,
THANK YOU SO MUCH for this article. You’ve changed my life.
I did a slow transition, starting with probiotics, then fage full fat greek yogurt and sauerkraut daily, and now I am able to eat hard cheeses and this local DELICIOUS cream from my co-op!
I cannot thank you enough. I no longer get scared about dairy being in my food in restaurants because I know I’ll be okay. You’re the best.