Dairy Allergy vs. Intolerance, What is the Difference? Symptoms, Causes and Tips

Many people enjoy cheese, yogurt, milk, butter, and ice cream. But for others, there is a downside to dairy. Perhaps you’ve heard of dairy allergy and maybe you are even familiar with the term lactose intolerance, but do you know the difference between the two? 

Difference Between Dairy Allergy vs. Intolerance

Dairy products can be a delicious addition to meals, but they are also high in protein and contain important nutrients like calcium, phosphorus, iodine, vitamin B12, riboflavin, and potassium.¹ Dairy products such as cheese, yogurt, and milk also contain lactose, which is the most important source of energy required by infants, providing them with almost half of the total energy needed in the first year of development. ¹

Lactose is a sugar that requires an enzyme called lactase to digest it. When there is not enough lactase to digest lactose, the body can become intolerant which causes discomfort in the gastrointestinal (GI) tract.² Not being able to break down lactose is known as lactose intolerance. 

Dairy allergy can be confused with lactose intolerance because it results in the same type of GI discomfort but the two have very different causes. With a dairy allergy, particularly with milk, your immune system is reacting to the dairy, and not in a good way. Milk contains proteins like casein and whey and with a dairy allergy, the immune system overreacts by trying to neutralize those proteins.³ Soon after eating these proteins, the immune system responds by releasing chemicals known as IgEs, which then cause GI issues.³ Cow’s milk allergy is one of the most common food allergies in infants and young children and in about 60% of the cases, IgE is involved.⁴

As you can see, the difference between lactose intolerance and dairy allergy is significant with one involving an immune system reaction and the other involving a digestive enzyme. A dairy allergy is much more serious and requires immediate medical attention. That’s why addressing a dairy allergy versus intolerance is also different. 

Dairy Allergy vs. Intolerance Strategies

With both allergy and intolerance, dietary modifications are likely necessary. For example, in addition to obvious dairy foods such as milk, cream, cheese, butter, ice cream, and yogurt, dairy can be found in other “nondairy” products such as processed meats, breads, cereals, some soups, and sweets.⁵ Removing these foods from your diet is essential to avoid the associated gut issues.

Foods to avoid with lactose intolerance of course include foods that contain lactose such as milk, soft and processed cheese, buttermilk, cream, ice cream, sour cream, whey, butter, and margarine, and foods that contain butter or margarine.⁶ In addition to avoiding certain foods, lactose intolerance supplements that contain the lactase enzyme are often recommended as these help break down lactose in milk and milk-containing products, helping to ease digestive symptoms.6 Of course, lactose enzyme supplementation will not help if it’s a dairy allergy, so it’s important to talk to a health practitioner when experiencing symptoms of either a dairy allergy or dairy intolerance.

The first step in identifying a dairy allergy vs. intolerance is distinguishing between the two. From there, a combination of dietary modifications and possibly dietary supplements may help support GI function so your gut feels good and happy.

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References

1.  Silanikove N, Leitner G, Merin U. The Interrelationships between Lactose Intolerance and the Modern Dairy Industry: Global Perspectives in Evolutional and Historical Backgrounds. Nutrients. 2015;7(9):7312-7331. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4586535/?report=reader
2.  Walsh J, Meyer R, Shah N, Quekett J, Fox AT. Differentiating milk allergy (IgE and non-IgE mediated) from lactose intolerance: understanding the underlying mechanisms and presentations. Br J Gen Pract. 2016;66(649). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4979917/?report=reader
3.  Edwards CW, Younus MA. Cow milk allergy. StatPearls. 2023 Jan. https://www.ncbi.nlm.nih.gov/books/NBK542243/
4.  Flom JD, Sicherer SH. Epidemiology of Cow's Milk Allergy. Nutrients. 2019;11(5):1051. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6566637/?report=reader
5.  Johns Hopkins Medicine. Milk allergy diet. Accessed 2023, Aug 9. https://www.hopkinsmedicine.org/health/wellness-and-prevention/milk-allergy-diet
6.  Malik TF, Panuganti KK. Lactose intolerance. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK532285/