Is your stomach upset after you eat ice cream? Do you have to run to the bathroom after you drink milk? Patients often wonder if they have a new onset milk allergy. What is the difference between milk allergy and lactose intolerance?

Dairy is a common allergy in the United States, especially in children and the Salt Lake valley is no exception. Most children will outgrow dairy allergy over time. Food allergies are an immunological response and are caused by the immune system overreacting to the proteins found in milk. The two main proteins are casein and whey. Dairy allergy symptoms can range in severity and can include hives, rashes, immediate vomiting, wheezing, coughing, difficulty breathing and anaphylaxis. These can be life-threatening. These symptoms typically occur within a few minutes to an hour of ingestion. Allergy testing can help confirm this diagnosis. Dairy avoidance is necessary, although some patients can tolerate milk in a baked form. You must see an allergist before trying this at home. Patients should carry an epinephrine device with them at all times. 

Interestingly, about 92% of cow’s milk individuals will also be allergic to goat milk. Cow’s milk has significant cross reactivity with goat, sheep, ewe, and buffalo milk. Surprisingly, there is low cross reactivity to mare and camel milk, although these are not widely available commercially. About 10% of cow’s milk allergic patients will also be allergic to beef. Heating or cooking can reduce the allergenicity of beef, so well-cooked beef is less likely to cause a reaction in cow’s milk allergic individuals.

Lactose intolerance is a deficiency in the lactase enzyme. Lactase breaks down lactose, the sugar found in dairy. Therefore, a deficiency can cause digestive issues including abdominal pain, cramping, diarrhea, bloating, or other gastrointestinal symptoms. Intolerances do not involve the immune system. Most people can eat a certain amount of lactose without having symptoms; however, that amount varies from person to person. Lactose intolerance can be managed with dietary modifications or possible lactase supplementation. Some forms of dairy, like hard cheeses are better tolerated because they contain little lactose.

Are you or your family members worried about food allergies? Allergy Associates of Utah is an allergy, asthma, and immunology specialty clinic serving the greater Salt Lake City, Utah area with 2 convenient locations in Murray and West Jordan. Led by specialists Andrew Smith, MD, MS, and Tara Sarin, MD, the practice strives to help people of all ages and background achieve success. Request an appointment by phone or online at either Allergy Associates of Utah location for expert allergy and immunology care today.