How to Cure Lactose Intolerance | Chris Kresser

How to Cure Lactose Intolerance

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Lactose intolerance is one of the most common food intolerances, affecting up to 65% 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)

Additionally, many adults who believe they have lactose intolerance are actually suffering from other gastrointestinal disorders such as SIBO, celiac disease, or IBS, and do not see significant benefit from eliminating dairy. Ultimately, there are many people who avoid dairy products without reason for doing so.

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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.

So what can you do if you believe you truly have lactose intolerance but want to begin eating dairy again? It may surprise you to learn that the quality and quantity of your gut bacteria can play an important role in your ability to tolerate dairy products.

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.

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)

Some feel this result suggests that while many people believe themselves to be lactose intolerant, there is only a small percentage of people who are truly lactose intolerant from a clinical perspective.

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!

Have any of you ever cured yourself of lactose intolerance? What method did you use? Let me know in the comments below!

463 Comments

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  1. I have been allergic to milk since birth .i have rashes on my skin when I cosume dairy products and I am 18 years old and still have the same issues with rashes on my skin when I consume any dairy products is there any way I can get a relief of this symptom ?

    • You may be getting dairy and not knowing it. I have to read labels like crazy. They sneak it into everything.
      Look for the words too. Whey, butter, non fat dry milk, sodium casinate is milk protein. Sodium or calcium proprianate is milk Salt.
      Creamed soups r made with milk. White sauce like fettuccini all milk and butter. Yum.
      If u get really strict about this those rashes will go away. For me it just took the teeniest bit to set me off.
      Just a 1/4 teaspoon of milk would make my tummy bloat. Look like o was 4 months preggers. Lol. It was awful.
      Start reading labels. U might be surprised where u getting milk. Also most NON DAIRY CREAMERS are NOT non dairy.
      They contain whey and casinate. ☹️

  2. I used to drink lots of milk with no issues. When I was 27 I started to react. If I had cereal in the morning I felt sick for a good hour. I could no longer handle milk, Greek yogurt, ice cream or whip cream. It went right through me and I had terrible cramps. I went off these thing for about 3 years. Occasionally I could have the odd bowl of cereal and be fine but I couldn’t and still can’t have it every day. I can usually handle Greek yogurt and whip cream now as well as a small amount of ice cream. For a few years I could handle steamed milk and then one day I reacted and now I stay away from it.

    What I now find confusing is that I don’t feel very good after eating cereal in the morning using lactose free milk but if I eat it in the evening I feel fine. It seems connected to an empty stomach and I don’t know why that is.

    • Ur body may be producing less lactase than it used too. Enough less, that its getting harder for i to break down.
      U maybe becoming reactive to other parts of the milk that u weren’t before.
      When the allergy started for me at 23, I was able to use non dairy creamers. I thot they really were non dairy. Cuz the label said so. But I’d never read the ingredient list.
      Some times I would eat a cookie that didn’t have milk but did have whey in it. I finally started seeing the pattern of when I would react I’d read the label and sure enuff it had whey in it. Within 2 yrs I was allergic to ALL dairy by products.
      Butter whey casein and proprianate. Maybe the cereal ur eating has some of those in it too. Also if your becoming allergic to the milk protein, lactase free milk won’t help u. Lactose free milk means it just doesn’t have lactose in it. But it’s still milk.
      I used a lot of mocha mix which is a TRUE and COMPLETELY non dairy creamer. It’s to replace hall and half like for ur coffee.
      But I used it in everything.
      Like making mashed potatoes for my family. Or gravy. Or when ever something I was making from scratch called for milk.
      It worked great. No one could ever tell.
      BUT. I could never make it work for making pudding or custards.
      I used it in my cereal but I added water to it.
      Because like I said early it was to replace cream. Or half abs half. So unless u add water to it it’s very high in calories. Just like half and half is. Lol
      I’ve even used it to make ice cream with a little ice cream maker. I’ve used it in baking goods too. U want to cook things just a bit less time tho. Mocha mix is made from soy beans and other things so it can dry out a cake. But u just have to learn how to bake using it and ull get it right!
      Ur lucky. Ur coming into a works that makes A LOT of non dairy choices.
      For me 40 yrs ago, just going in and ordering a pizza with NO CHEESE, they’d say they couldn’t do that. Lol. I’d say yes u can. Just don’t put cheese on it.
      Pizza is still very good with no cheese.
      My dairy allergy went away after 30 yrs or so.
      I don’t know how or why.
      But I still prefer my pizza with no cheese. I found the cheese kind of covered up the good flavors of the pizza.
      Also I never had to watch my weight when I was non dairy.
      Now I do. Lol.
      As far as going out to eat, don’t be afraid to bring ur own non dairy margarine ( butter replacent). Don’t be afraid to talk to the chef himself and tell him what non dairy means and what u can and can’t have. Don’t be afraid to ask to read the labels of what they are using. U can’t trust them to catch dairy. They don’t get it.
      YOU ARE THE ONE THAT WILL SUFFER.
      So do what u need to. It’s not worth being polite.
      Hope this info helps

      • I have been becoming intolerant to dairy over time and this last leap seems like it was overnight. It started with I couldn’t do liquid diary – mostly bc it made me congested, but I could eat cheeses. I could do goat cheese and milk ok. Then it got to where I could not tolerate soft cheeses. Each level of intolerance came with a higher level of reaction and severe gi suffering. To my current state – can’t tolerate even small amounts of cheese of any kind nor even butter. I believe it is a allergy to proteins in the milk as lactase enzymes helped for a short period of time, but not at all now and not to mention the hard cheeses I tried last don’t have lactose in them any longer. The progression has been ongoing over the last couple of years, but the abrupt COMPLETE INTOLERANCE (and I mean with a complete vengeance) seems like it was overnight. It bums me out as I already have gluten allergy which I have adapted to, but dairy is making me sad. I feel like i have to mourn the loss of my beloved dairy LOL. I also am fearful of eating out and getting contaminated.

  3. I think I may be lactose intolerant I haven’t had it checked out yet but I’ve noticed the constant symptoms when I’ve eaten a dairy product but for some reason they still happen when I don’t eat dairy products also so I’m confused

    • I would not bother with an unreliable test. Plus sometimes they only check for lactose allergy. Not milk protein
      ( casinate )
      Or proprianate.
      Just do it yourself. Read labels. Stay off it COMPLETELY FOR A WEEK or two. Then start introducing dairy. Their is no better test. Abs it’s free!

  4. I get itchy from dairy and get a runny nose. I also get traditional digestive issues. Is this intolerance or allergy? I’m autoimmune paleo right now, with a couple of exceptions such as rice because after two years I am certain that is not a trigger. I would like to beat my lactose problem since all of the medications I’m on for bipolar disorder have lactose in them. But if I’m allergic, then it’s a moot point.
    I don’t think anyone replies to these comments, but just in case. Thanks!

    • It seems to me like you have an A1 milk protein allergy and not Lactose intolerance the only way yo tell is to get some A2 milk and give it a try 🙂

    • I’m replying. Lol. U medicine may or may not have enuff dairy to affect u.
      For me it did.
      So o would ask to see other brands and read labels. I usually found another brand I could take. It’s not a moot point. If u arebt digesting it. Stay away from as much as u can.
      It’s not fun walking around with a bloated belly. Lol. Waist band so tight I cut it up with scissors. Lol. Yep. I did. For me it also affected my thinking. When I’d get dairy I’d also get kind of spacey. Lol. No memory. It also gave me sniffles. Sometimes my ears would feel wet on the inside. Sort of cold and wet. Like I got a bit of water in them. But I hadn’t.
      I also got vertigo when I’d lie down or turn my head a certain way.
      Dairy creates mucus. I’ve actually walked up to strangers that r sniffling a bit and asked if they just ate something with milk or cheese. Of course they thot I was crazy.
      But guess what? I was correct.
      I also got them thinking about food differently.
      I’m a busy body I guess.
      Really I just wish I’d had someone helping me figure out what was going on with my body. It took me 2 yrs to figure it out completely, and learn what all is from dairy. It’s more than cheese and milk. There r dairy by products used in premade foods. So got to read labels.
      Take care

  5. I’ve been drinking milk, eating cheese, and consuming a lot of other dairy products all my life and then out of nowhere I woke up one day I had cereal and about five to ten minutes later I had a pretty bad stomach ache. If anyone could tell me what happened that would be great.

  6. So I got home from Taco Bell. I ate a burrito with cheese in it. A lot of cheese. About an half and hour later my stomach started gargling and rumbling. I ran to the bathroom and it gave me diarrhea. (Explosive ?) I’ve been eating and drinking dairy products for a while. I love them. But from now on my stomach does this. Someone help

  7. I have been hand milking 2 dairy goats for 8 years now. I make all of our cheeses, yogurt and ice cream. My problem began about a year ago when having a glass of milk with supper suddenly began to leave me bloated and with diarrhea. I cut back and things improved. (aside: I went gluten free 3 years ago) After a bit I began to get the same symptoms after morning coffee that I put warm milk in. I wasn’t so inclined to give up morning coffee so I purchased some dairy-ease to help. That worked for a couple months and then the symptoms were back. So, I had to give up milk in coffee… but cheeses still seemed okay. Now, I can no longer eat soft goat cheeses. I am very discouraged that I can no longer enjoy what I work so hard at. Do I get rid of goats and give up on dairy completely? What is causing this??

  8. I have (had) been lactose intolerant for years. I used to get terrible bloating and pain. At a friend’s recommendation, I started eating goat yogurt without any problems and while tasty, I missed regular yogurt. I have been taking probiotics for about a year for general GI health and started experimenting with regular yogurt again as my husband likes it. It seems I can eat it again and have had no issues. Another thing is that the higher the fat content in the yogurt, the fewer GI symptoms it seems.

  9. Cortisone has destroyed all the bacteria in my system that takes care of lactose. I can tolerate 0 amounts. I eat yogurt and am now using lactaid tablets. Even the smallest amount of “milk” in a product sets me off. What can I do????

  10. I have suffered from lactose intolerance for a decade. I always had to have lactaid pills in my bag or pocket just in case I might eat something with dairy. I wanted to share a probiotic that I found that has taken away almost all of my symptoms… It’s called LactoFreedom. Fellow sufferers, look it up!!!

  11. I have been Lactose Intolerant for many years. It was a result of taking large amounts of antibiotics before going to the dentist. That used to be protocol if one had a heart murmur. I had both that and lousy teeth, so many trips to the dentist and therefore many antibiotics. Antibiotics kill bacteria, but do not distinguish between good and/or bad bacteria, therefore they kill the good bacteria in your stomach that you need to digest dairy products. The sugar called lactose is the culprit. There are solutions. There are dairy products that are lactose free, they have added the enzyme lactase, which breaks lactose down into 2 digestible sugars and makes the dairy product easily digestible for those with the problem.The real problem here is the poor or limited distribution of these products and the limited types available. The LACTAID Company makes whole,2%, 1%, skim or fat free and chocolate milk, as well as cottage cheese and ice cream. I use all these products and they are very good. I used to be able to take lactaid pills before eating other kinds of dairy products and it usually worked, however a few months ago that stopped working for me and now I only have the lactose free products. I have found other companies that make other products, such as Lactose Free butter, cream cheese, sour cream, yogurt and kefir. However distribution is very limited and hard to find. Finlandia has a Yarlsburg cheese that is lactose free. Hard cheeses that are lactose free are usually ripened, but I only will try those that plainly say “Lactose Free”. I am very seriously thinking about starting a company that will make every kind of dairy product Lactose Free., and even making foods from the lactose free dairy products, such as Cheesecake, puddings, rice pudding, cheese blintzes, and cakes and cookies and on and on.
    I would then like to distribute them everywhere and have a unique marketing plan that will make it easy for people to find the products.
    Firstly, I would like to know how many people who are lactose intolerant would like to see these products in their local supermarkets and groceries, at reasonable prices and readily available.
    Secondly, are there any of you out there who would be interested in starting this kind of business with me?
    Thirdly, any one out there who has any kind of knowledge or expertise in the dairy, supermarket. dairy distribution or any related industry and could be of real use/help in this kind of business?
    Fourth, are there any out there who would be interested in investing in such a company?

    • Hello, my name is Tommy.
      Why did Lactase tablets stopped working for you?
      I’ve never taken these pills before but now I want to try. Ive been Lactose intolerant since birth.
      Regards
      Tommy

      • Lactaid makes four different flavors of ice cream, and Breyers makes one. Lactaid also makes milk in three or four %’s of fat. But, the interesting news here is that Boar’s Head makes two cheeses that are lactose free! One is a Swiss Cheese and the other is a Cheddar. If you have a store that sells Boar’s Head, have them look up which ones they are. The Swiss is from “Switzerland” and the Cheddar is from Wisconsin. It is outlined in their most recent brochure. Most of the deli counter people don’t even know it as it is not marked on their packaging. At least you can’t see it from in front of the counter. And, they are delicious!

        On another note, I think I have cured my lactose intolerance with the addition of Kefir and Coconut Oil to my diet. I ingest about 2 T. of Organic, Virgin Coconut oil a day and about 1/4 C. of Kefir. I know the Kefir has probiotics in it, but I think the Coconut Oil helps, too. I can’t explain it.

    • I REALLY WISH I could help with investment or partner with u on this greatly needed product line I will definitely be a CUSTOMER though!! Best of luck to you in ur venture. Please make sure that you distribute to SE AL!!

  12. Hello LI people
    I sufferd from severe li for more than 30 years
    Now I can drink milk as much as I like .

  13. I became lactose intolerant after I had a stomach bug from travelling to Mexico. I was super sensitive to any lactose (bloating) I have had it for 3 years. (I am 54) After reading this website, I decided to try slowly adding in dairy again. I now daily eat many cheeses, lactose free yogurt, lactose free kefir, Horizon LF milk, Ghee. No problems. I am just doing it slowly, but I also try to eat many fermented foods. (kimchi, miso, soy sauce, wine, sauerkraut, vinegar, salami, etc.) I can go out to eat or sample at Costco with no stomach problems. I am not pushing it with cream sauce…but I can live with this! So much better! I really think it is getting the gut healthier that helped me.

    • Dairy is not good for you. In fact, you lose more calcium drinking milk, due to the acidic nature it has on your bones. Don’t believe me, just research it yourself.

        • Milk is the best food for humans young and old, it contains protein, vitamins and minerals (except iron) drinking milk daily builds strong bodies, but it causes digestive upset to some people due to the inability of the intestines to digest lactose the sugar found in milk , it is possible to resolve this problem . I suffered from lactose intolerance since childhood to the extent that a teaspoon of lactose could kill me, but now I can drink milk, eat yogurt, ice cream and cheeses without any discomfort just a little bloating . And that because I’m still in the process of therapy that I kept doing it almost two years.

      • My daughter is vegan, how do you get calcium if you are vegan? I am worried for her. Should I be worried or not?

        • There are many leafy greens that provide more calcium per serving that milk, such as arugula, watercress, broccoli, and spinach.

  14. The problem is from what I’ve found thought diet and research is that yes many of us CAN eat small amounts of dairy a day however, that leads to constipation and even further discomfort down the line. My children haven’t been able to digest dairy since birth, I was “colicky” and sick with ear infections and severe constipation since birth, when I removed dairy from my diet I became regular, and very happy in my tummy! Now if I use even a tbs of raita with my dinner I’ll have to run to the restroom. My son if exposed to any amount of dairy at school, literally can’t control his bowels. I’m very interested in this method but I think I’ll start with rx probiotics and see what happens!

  15. I only have a reaction to dairy and dairy products in the US. Born/raised in the US and developed an allergy as an infant, outgrew it and then redeveloped an allergy/reaction after turning 30. The only time I can consume dairy and not have any sort of negative reaction is when I have it abroad (so far Europe and South America). Same goes for bread and pasta-zero reaction outside of the US. Makes me really wonder what the US is doing to our food.

    • You’re hitting it on the bail here. Have you noticed that ppl outside of the USA are far less sensitive to food than Americans. Our food chain is disrupted in the USA and not enoeugh is being done about it. That’s why this blog and your post is important!

      • Interesting… I have an unusual problem when I consume lactose – it gets difficult to breathe, but while I was in Ireland last fall, I didn’t have any problems. I tried to avoid milk products but eating out on vacation that was pretty hard and I did have some breads and sauces that surely had milk in them and no problems. Your comment has me quite curious. I get my milk from a local farm it’s actually A-2 milk and I make my own Kefir with it, and don’t have any problems consuming it (but the kefir grains eat up the sugar – lactose), I haven’t had the “guts” to try to drink it straight…but I have been taking probiotics quite regularly maybe I should give it a try, or make my own yogurt and start consuming that. Thank you for the article and the posts.

      • Part of the reason you might not have a problem in Europe is because they banned GMO foods. I don’t think they use Round-up, either. Plus, their dairy is pasture raised and not full of antibiotics. I only use Kerry Gold Butter, from Ireland, that is raised the way nature intended and in the correct climate for cows. Cows don’t like the heat or the desert. Probably the best climate in this country for cows would be Wisconsin, Minnesota, etc. and in the west, Idaho. Cooler temperatures and more humidity. Happy cows.

  16. Hi I am 36 years old I notice I couldn’t digest dairy about 15 years ago. But at the age of 30 I also notice when I ate a small meal first I could eat an egg, a few slices of cheese or a small bowl of icecream without any discomfort. Now if I didn’t consume something before eating any dairy I would have discomfort all night long. This method works really well for me.

  17. I found the cheese is tolerable. I missed ice cream so much! But Lactaid’s version of ice cream is pretty good, but don’t binge on it – they get new flavors all the time.

  18. My baby does not want to eat milk. Mandatorily, which is feed, he vomits. What’s the treatment for it?

          • That was a bit unnecessary…
            How old is your baby? They should be introduced to cow’s milk after 1 year old, but if he/she can’t tolerate it, maybe try goat’s milk. My brother in law was lactose intolerant as a baby, but was able to tolerate goat’s milk just fine.

    • There isn’t a treatment. U have find another baby formula that is COMPLETLY DAIRY FREE. No whey. No casein or casinate. This usually means a soy base.
      But some babies r allergic to soy too. If ur baby reacts to milk don’t force it on them.
      They know that when they eat that they don’t feel well. But don’t have the ability to tell us that. So we have to interpret for them. This can be very painful for some adults when they eat dairy, so baby could be on horrible pain. Also if ur children keep getting ear infections. That’s from dairy.

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