Do you suspect dairy intolerance?

A contentious issue in the nutrition community is whether dairy foods are good for us. As is sometimes found in nutrition, a food that works well and promotes health in one person may cause health issues in another.

Dairy products include milk, butter, cream, cheese, yoghurt, whey and ice cream. These foods are often used as ingredients in recipes and can appear in a variety of foods including soups, stock cubes, bread and also some medications. Dairy products can come from cow, sheep or goat’s milk with the majority of products in the UK made from cow’s milk.

As a food, dairy has a good nutritional profile providing some protein, carbohydrate and fat along with a range of micronutrients including calcium. For many people in the UK it is also an important source of iodine.

On the other hand, some people suffer and others are allergic to the proteins in dairy.  This article explores the reasons why some people may experience negative health symptoms as a result of consuming dairy products.

Skip to Key Takeaways

Lactose intolerance

Lactose is a naturally occurring sugar (disaccharide) found in milk. Normally the body produces the enzyme lactase, which breaks lactose down into glucose and galactose, which are then absorbed from the gut into the bloodstream. Lactase is a beta-galactosidase enzyme that can be found on the upper surface of the enterocytes (gut cells) on the microvilli of the small intestine.2

Some people are unable to digest lactose and this produces uncomfortable symptoms, which may include wind, diarrhoea, bloating, stomach cramps and pains, stomach rumbling and feeling sick.1 The severity of symptoms often relates to the amount of lactose consumed.

People with lactose intolerance do not produce enough of the enzyme lactase, so lactose stays in the gut where it is fermented by bacteria. The fermentation process produces various gases (a mixture of hydrogen, methane, and carbon dioxide) which contribute to the symptoms of lactose intolerance.3 The unabsorbed sugars and fermentation process raise the osmotic pressure of the colon, creating an increased flow of water to the bowels, which may lead to diarrhoea.

The degree of lactose intolerance will depend on how much lactase is present, the dose of lactose consumed, the composition of the gut microflora, gastrointestinal motility and sensitivity of the gastrointestinal tract in the generation of gas and other fermentation products of lactose digestion.4

Overall, lactose intolerance is a consequence of lactase deficiency, which may be:

Primary – genetic disorders. Primary hypolactasia only affects adults, and is caused by the absence of a lactase persistence allele which causes less lactase to be produced over time. Primary congenital alactasia is rare and affects lactase expression from birth, meaning that infants cannot tolerate lactose in breast milk or formula.5

Secondary – environmentally induced from damage to the small intestine that may cause a decrease in lactase activity. Damage may be due to gastrointestinal infections, inflammatory bowel disease, coeliac disease, severe malnutrition, some medications or abdominal surgery.2

There appears to be a genetic component to lactose intolerance, and in the UK it is more common in people of African-Caribbean or Asian descent. It can occur at any age, but commonly occurs in people between the ages of 20 and 40, however babies and young children can also be affected.3

Lactose intolerance may be tested by hydrogen breath testing, blood testing, stool acidity testing and intestinal biopsy.

If lactose intolerance is identified, then avoidance of lactose results in remission of symptoms. There are varying amounts of lactose in different dairy products so some people can manage small amounts of lactose containing dairy and others are very sensitive to even small quantities. There are now a variety of lactose-free dairy products available in supermarkets. Enzyme supplementation (giving lactase) may also help in the break down of lactose and provide symptom relief whilst consuming dairy products.

Lactose intolerance may also be part of a wider intolerance to FODMAP carbohydrates (fermentable oligo-, di-, monosaccharides and polyols). This is present in at least half of patients with irritable bowel syndrome (IBS) and these people require not only restriction of lactose intake but also a low FODMAP diet to improve gastrointestinal complaints.6 Intolerance to FODMAPs may suggest small intestinal bacterial overgrowth (SIBO) in the gut and addressing this may improve gut symptoms and tolerance to FODMAP foods, such as lactose.7

For some people, it has been suggested that regular consumption of dairy foods containing lactose may promote colonic bacteria adaptation, allowing people with primary lactase deficiency to reduce their intolerance and to consume more dairy foods.8 The way to induce tolerance is based on progressive exposure, consuming small amounts of lactose foods frequently, distributed throughout the day. 8

Recently probiotics have been proposed to play a role in supporting the management of lactose intolerance – certain probiotic strains have shown beta-galactosidase activity and may help in digesting lactose.2 Both Lactobacillus acidophilus and Lactobacillus reuteri have been shown to be effective in clinical trials. 9–11

Cow’s milk protein allergy

Hypersensitivity to cow’s milk proteins is one of the main food allergies and affects mostly (but not exclusively) babies and young children, while it may also persist through adulthood and can be very severe. Between 5 and 15% of infants show symptoms that suggest milk protein allergy.12 Different clinical symptoms of milk allergy have been established and these include urticaria, vomiting, acute dermatitis, hives and swelling of the skin and mucus membranes e.g. lips, mouth. These symptoms usually occur within two hours of exposure to cow’s milk protein, whereas other symptoms like atopic dermatitis and gastrointestinal disturbances may occur later.13 Cow’s milk protein allergy can develop in exclusively and partially breast-fed babies, and when cow’s milk is introduced during weaning.12

Symptoms of cow’s milk protein allergy occur often, but not always, within the first weeks after the introduction of cow’s milk. Many children with milk protein allergy will develop symptoms in at least two of the following organ systems: gastrointestinal (50–60%), skin (50–60%) and respiratory tract (20–30%).12 The symptoms can range from mild to moderate to severe; symptoms may put the infant in immediate life-threatening danger (such as anaphylaxis) or may interfere with the child’s normal growth and development. The majority of children outgrow milk allergy, but for about 0.4% the condition persists into adulthood.1

The diagnosis of milk allergy differs widely due to the variety of symptoms, and can be achieved by skin or blood tests. Cow’s milk contains more than 20 proteins (allergens) that can cause allergic reactions. Casein fractions and beta-lactoglobulin (the main whey protein) are the most common cow’s milk allergens.14

Milk allergy can be either immunoglobulin E (IgE) or non-IgE mediated. IgE-mediated reactions typically occur immediately after ingestion whereas non-IgE mediated are delayed and take up to 48 hours to develop, but still involve the immune system.1

A1 beta-casein intolerance

Beta-casein proteins make up approximately 30% of the total protein of cow’s milk and may be present as one of two major genetic variants: A1 and A2. The latter (A2 beta-casein) is recognised as the original beta-casein variant because it existed before a mutation caused the appearance of A1 beta-casein in some European herds around 5000 years ago. Now the majority of our milk and milk products come from A1 beta-casein cows.

Once milk or milk products are consumed, the action of digestive enzymes in the gut on A1 beta-casein releases the bioactive opioid peptide BCM-7. In contrast, A2 beta-casein releases much less and probably minimal amounts of BCM-7 under normal gut conditions. There is now an increasing body of evidence that cow beta-caseomorphin-7 (BCM-7) is also an important contributor to milk intolerance syndrome.15

Therefore some people find that A2 milk is better tolerated. A2 milk is available more widely in Australia and the USA, but can be found in the UK specifically as gold-topped Jersey cow’s milk.

Different mammal milks

Some people report tolerating sheep or goat’s milk dairy products better than cow’s milk. This may be due to the casein and lactoglobulin types.

Caseins in milk of different species differ in fraction, number and amino acid composition. Beta-casein is the major fraction in goat casein, which is similar to human casein and different from cow casein.16 Hence for people who find they can tolerate goat’s milk better than cow’s milk it may be due to the different type of casein. Breast milk is free of beta-lactoglobulin, and is similar to camel milk.16

Allergies to milk proteins of non-bovine mammals have also been documented due to allergic cross reactivity between cow’s milk proteins and their counterpart in other species, and even between goat and sheep caseins.16 Individuals with reactions to specific allergens in food (or inhalants such as pollen) can be known to develop allergy to different foods (or substances) containing either the same allergen, or an allergen with a very similar protein structure (allergic cross-reactivity).17

Gluten cross reactivity

Certain amino acid sequences in dairy proteins share similarities with gluten. This can result in people who have coeliac disease, who are consuming dairy, continuing to show a gluten type reaction, even when gluten has been removed from the diet. Casein is similar to the gliadin protein found in gluten. In fact, at least half of those people who are gluten intolerant are also intolerant to dairy. This intolerance could be due to casein cross-reactivity or due to damage to the gastrointestinal tract resulting in low levels of lactase (i.e. lactose intolerance).

Dairy-free milks

Removing dairy from the diet is much easier than it used to be. There are now many plant-based milks, yoghurts and cheeses available and recent market research by Mintel found that a quarter of British people are now drinking non-dairy milks, with the biggest users being 16-24 year olds. Reasons for the switch include health and environmental impact. Nevertheless, dairy milk sales still account for 96% of the market with plant-based milks making up just 4%.20 Plant-based milks include soya, oat, almond, hemp, rice and coconut milk. There are some downsides to many of these milks – for example:

  • some contain added sugar
  • additives e.g. thickeners may be used
  • whilst fermented soy, as a food, has some benefits, there are concerns about consuming larger amounts (e.g. drinking soya milk)
  • concerns have been raised about low levels of arsenic in rice milk

Good choices of plant-based milks include coconut milk and almond milk (however, when choosing a brand check the ingredients list).

Non-dairy sources of calcium

One concern for people who exclude dairy is the amount of calcium in the diet. However there are plenty of non-dairy sources of calcium including dark green leafy vegetables (e.g. broccoli, pak choi and kale), almonds, sesame/chia and sunflower seeds, tinned sardines/salmon with the bones mashed in, white beans, black beans and dried figs. In addition, plant-based milks are available fortified with calcium (although they usually include poorly absorbed calcium carbonate or calcium phosphate).

Calcium from dairy is not well absorbed so, regardless of whether it is included or excluded in the diet, it is a good idea to include non-dairy sources as well.

Is calcium supplementation necessary on a dairy-free diet?

This will depend on the quality of the diet as well as the age and sex of the person. Children, pregnant, lactating and postmenopausal women have increased calcium needs so particular care in formulating appropriate diets is needed.

In our opinion people should not need to supplement with very high doses of calcium, if calcium supplementation is indicated then 200 to 400mg should be sufficient for most people. The form of calcium used is of key importance: Wholefood calcium from organic calcified seaweed has a porous and hydrolysed surface area because of years in the ocean and this helps it to be very soluble in the acid of the stomach permitting good uptake.

On the other hand excessive intakes of calcium (such as high dose calcium carbonate supplements) have been linked to increased incidence of heart, circulatory and other diseases. This is because, at high doses, calcium can be deposited in soft tissues, for example the arteries and kidneys, and contribute to arterial calcification and kidney stone formation.20 On the other hand, there has also been research showing that low calcium intake is associated with increased risk of cardiovascular disease.

Other considerations to support calcium absorption and utilisation in the body are vitamin D, vitamin K and magnesium. Vitamin D is needed for calcium absorption and vitamin K2, together with magnesium, regulate calcium deposition; they promote the calcification of bones rather than soft tissues.

Key Takeaways

  • Lactose is a naturally occurring sugar (disaccharide) found in milk. In some people the body is unable to digest lactose and this produces uncomfortable symptoms, which may include wind, diarrhoea, bloating, stomach cramps and pains, stomach rumbling and feeling sick.
  • Hypersensitivity to cow’s milk proteins is one of the main food allergies and can be life-threatening.
  • Cow’s milk contains more than 20 proteins (allergens) that can cause allergic reactions. Casein fractions and beta-lactoglobulin (the main whey protein) are the most common cow’s milk allergens.
  • Beta-casein proteins make up approximately 30% of the total protein of cow’s milk and may be present as one of two major genetic variants: A1 and A2. Now the majority of our milk and milk products come from A1 beta-casein cows. Some people find that A2 milk is better tolerated. A2 milk is available more widely in Australia and the USA, but can be found in the UK specifically as gold-topped Jersey cow’s milk.
  • Casein is similar to the gliadin protein found in gluten. At least half of those people who are gluten intolerant are also intolerant to dairy. This intolerance could be due to casein cross-reactivity or due to damage to the gastrointestinal tract resulting in low levels of lactase (i.e. lactose intolerance).
  • Good choices of plant-based milk alternatives include coconut milk and almond milk (however, when choosing a brand check the ingredients list for sugar and other additives).
  • Non-dairy sources of calcium include dark green leafy vegetables (e.g. broccoli, pak choi and kale), almonds, sesame/chia and sunflower seeds, tinned sardines/salmon with the bones mashed in, white beans, black beans and dried figs.
  • With a carefully planned diet, it is possible to obtain adequate calcium. Certain sectors of the population have increased calcium needs – these include children, pregnant and lactating, and post-menopausal women.
  • If supplementing with calcium 200 to 400mg per day of a well absorbed source, such as Wholefood calcium from calcified seaweed, should be sufficient for most people.

If you have questions regarding the topics that have been raised, or any other health matters, please do contact me (Clare) by phone or email at any time.

clare@cytoplan.co.uk, 01684 310099

Clare Daley and the Cytoplan Editorial Team


Relevant Cytoplan Products

Cyto Gold – A one-a-day Food State  multivitamin and mineral which includes Wholefood calcium from calcified seaweed.

Wholefood Calcium – A natural multimineral seaweed product harvested off Ireland’s southwest coast. It is an organic wholefood supplement which yields 200mg of elemenal organic calcium per capsule and contains no additives.

Bone Support – A multi-nutrient formulation specifically tailored for those who are concerned about bone health and bone mineral density. Provides calcium along with nutrients important for bone health including magnesium, boron, vitamin D3 & K2.

Vitamin D3 & K2 – Contains 100ug of vitamin D3 as cholecalciferol from a vegetarian source and 100ug of vitamin K2(MK-7), and is designed to support levels of vitamin D and K2.

Cytobiotic Active Powder – A dairy-free probiotic powder containing eight live native bacterial strains, plus a small amount of inulin and fructooligosaccharides.


References

  1. 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):e609-11. doi:10.3399/bjgp16X686521.
  2. Fassio F, Facioni MS, Guagnini F. Lactose Maldigestion, Malabsorption, and Intolerance: A Comprehensive Review with a Focus on Current Management and Future Perspectives. Nutrients. 2018;10(11). doi:10.3390/nu10111599.
  3. Deng Y, Misselwitz B, Dai N, Fox M. Lactose Intolerance in Adults: Biological Mechanism and Dietary Management. Nutrients. 2015;7(9):8020-8035. doi:10.3390/nu7095380.
  4. He T, Venema K, Priebe MG, Welling GW, Brummer R-JM, Vonk RJ. The role of colonic metabolism in lactose intolerance. Eur J Clin Invest. 2008;38(8):541-547. doi:10.1111/j.1365-2362.2008.01966.x.
  5. Ingram CJE, Mulcare CA, Itan Y, Thomas MG, Swallow DM. Lactose digestion and the evolutionary genetics of lactase persistence. Hum Genet. 2009;124(6):579-591. doi:10.1007/s00439-008-0593-6.
  6. Altobelli E, Del Negro V, Angeletti PM, Latella G. Low-FODMAP Diet Improves Irritable Bowel Syndrome Symptoms: A Meta-Analysis. Nutrients. 2017;9(9). doi:10.3390/nu9090940.
  7. Ghoshal UC, Shukla R, Ghoshal U. Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy. Gut Liver. 2017;11(2):196-208. doi:10.5009/gnl16126.
  8. Szilagyi A. Adaptation to Lactose in Lactase Non Persistent People: Effects on Intolerance and the Relationship between Dairy Food Consumption and Evalution of Diseases. Nutrients. 2015;7(8):6751-6779. doi:10.3390/nu7085309.
  9. Almeida CC, Lorena SLS, Pavan CR, Akasaka HMI, Mesquita MA. Beneficial Effects of Long-Term Consumption of a Probiotic Combination of Lactobacillus casei Shirota and Bifidobacterium breve Yakult May Persist After Suspension of Therapy in Lactose-Intolerant Patients. Nutr Clin Pract. 2012;27(2):247-251. doi:10.1177/0884533612440289.
  10. Ojetti V, Gigante G, Gabrielli M, et al. The effect of oral supplementation with Lactobacillus reuteri or tilactase in lactose intolerant patients: randomized trial. Eur Rev Med Pharmacol Sci. 2010;14(3):163-170. http://www.ncbi.nlm.nih.gov/pubmed/20391953. Accessed December 12, 2018.
  11. Pakdaman MN, Udani JK, Molina JP, Shahani M. The effects of the DDS-1 strain of lactobacillus on symptomatic relief for lactose intolerance – a randomized, double-blind, placebo-controlled, crossover clinical trial. Nutr J. 2015;15(1):56. doi:10.1186/s12937-016-0172-y.
  12. Høst A. Frequency of cow’s milk allergy in childhood. Ann Allergy Asthma Immunol. 2002;89(6 Suppl 1):33-37. http://www.ncbi.nlm.nih.gov/pubmed/12487202. Accessed December 12, 2018.
  13. Vandenplas Y, Koletzko S, Isolauri E, et al. Guidelines for the diagnosis and management of cow’s milk protein allergy in infants. Arch Dis Child. 2007;92(10):902-908. doi:10.1136/adc.2006.110999.
  14. Sélo I, Clément G, Bernard H, et al. Allergy to bovine beta-lactoglobulin: specificity of human IgE to tryptic peptides. Clin Exp Allergy. 1999;29(8):1055-1063. http://www.ncbi.nlm.nih.gov/pubmed/10457108. Accessed December 11, 2018.
  15. Pal S, Woodford K, Kukuljan S, Ho S. Milk Intolerance, Beta-Casein and Lactose. Nutrients. 2015;7(9):7285-7297. doi:10.3390/nu7095339.
  16. El-Agamy EI. The challenge of cow milk protein allergy. Small Rumin Res. 2007;68(1-2):64-72. doi:10.1016/J.SMALLRUMRES.2006.09.016.
  17. Bonds RS, Midoro-Horiuti T, Goldblum R. A structural basis for food allergy: the role of cross-reactivity. Curr Opin Allergy Clin Immunol. 2008;8(1):82-86. doi:10.1097/ACI.0b013e3282f4177e.
  18. Månsson HL. Fatty acids in bovine milk fat. Food Nutr Res. 2008;52. doi:10.3402/fnr.v52i0.1821.
  19. Food Composition Databases Show Foods — Butter, without salt. https://ndb.nal.usda.gov/ndb/foods/show/132. Accessed December 10, 2018.

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19 thoughts on “Do you suspect dairy intolerance?

  1. A very good and balanced blog. Those working in Functional Medicine often take the view that milk is for cows not humans – even cows don’t drink mothers milk for life. The idea that you must drink milk to get your calcium has been a myth promoted by the milk industry for years and they have done a good job at this. I was interested to note that calcium in milk is not easily absorbed by humans and most people don’t realise that eating a portion of Kale has more calcium than a glass of milk. A high plant based diet has many great health benefits as well as environmental benefits as cows are a major source of greenhouse gases. Animals for food and milk also use a great deal of farm land leading to the UK having to import a lot of food to feed the population.

  2. A reallt useful summary speaking to the growing numbers of people and children with dairy intolerances.

    No mention, however, that unpasteurised milk retains the enzyme lactase which is naturally present in raw milk and which is destroyed by heating?

    Certified, pro-biotic rich, unpasteurised raw milk is a nutrient dense, energy rich food with long history of use as medicine and an exemplary safety record. It is available online in the UK from certified producers.

    Many, if not most of their customers are individuals and/or parents of children with conventional milk-related intolerances (asthma, eczema, skin conditions, digestive distress) which go
    away with natural unpasteurised milk.

    1. Hi Izabella,

      Thank you for your comment on our blog and the useful information about raw milk being available online from certified producers, which may be of interest to people with lactose intolerance.

      Thanks,
      Clare

    1. Hi Pat,

      Thank you for the question on our blog. Firstly, it is important that you visit your G.P. to explain your symptoms so she/he can investigate further if necessary. Bloating can be an indication of digestion dysfunction but it could also be gynaecological and your G.P. will be able to evaluate the cause.

      It would be useful to have a little more information about how long you have had these symptoms? When the symptoms started was it following a particular event, stress or illness? When does the bloating occur? Is it after every meal or just your main meal or at other times? Any other symptoms? How old are you? Are you female or male? etc. If you would like to email me directly with more information I may be able to help more specifically – clare@cytoplan.co.uk.

      In the meantime, in terms of evaluating whether there are dietary factors that are contributing to the bloating, you could consider a trial elimination of certain foods, along with some digestive enzymes with meals and a live bacteria supplement. So you could try

      – Eliminating all foods containing gluten (wheat, barley and rye) and dairy for a period of one month and note how the bloating is during this time. Then also note how your symptoms are when you reintroduce bread or dairy (introduce them on different days)
      – Take a digestive enzyme with meals – Cytozyme – 1 at the start of each meal (this is not suitable if you have had a history of gastritis)
      – Take a live bacteria supplement – Acidophilus Plus – take 1 per day on an empty stomach, eg at bedtime

      Gluten-free foods unfortunately are highly processed, high in sugar, undesirable fats and lower in fibre than wheat. So avoid eating too many of these during a gluten elimination. Also be aware that wheat provides a significant amount of fibre in the UK diet, so if you remove it from your diet you need to find alternative sources of fibre – vegetables, fruit, nuts and seeds all provide fibre.

      In the Appendix of our booklet – Your Guide to Eating Well – there is some further guidance on how to carry out a trial elimination diet. You can download this booklet here.

      Finally for a more in-depth evaluation, we do offer a free health questionnaire service. If you complete and return a health questionnaire, it will be evaluated by a nutritional therapist and we will send you some written diet and supplement recommendations.

      I hope this helps.

      Best wishes
      Clare

  3. Hi, great article. I recently gave up all dairy, but slightly worried now that I am not getting enough iodine. I am also now on thyroid tabs, levothyroxine, and my inner sense tells me i should be able to eat seaweed etc even though medics warn against it – surely my body still needs it so what can I do about the defecit? thank you xx

    1. Hi Betty,

      Thank you for your comment. There is concern about high iodine intake with hypothyroidism – may be because in the past some people have supplemented with very high doses. I would suggest you consider an all round multivitamin and mineral – e.g. we have multis with 75mcg per 2 tablet dose. Up to 200mcg per day would be fine. If you are eating a lot of seaweed it would be worth doing some research on the particular type you are eating – iodine levels in seaweed vary significantly depending on the species etc and can range from quite low to very high. If you have recently been diagnosed there is lots of useful information on the Thyroid UK website – http://www.thyroiduk.org. You might also be interested in our free health questionnaire service. If you complete and return a health questionnaire we will send you some written diet and supplement recommendations. I hope this helps.

      Thanks,
      Clare.

  4. Great article.

    I agree with Izabella – I am lactose intolerant but tolerate raw dairy. I also believe that unpasteurized dairy has significantly greater bioavailability of it’s minerals as the transport proteins are intact.

  5. I do not have digestive issues with dairy but suffer from excess mucous caused by eating dairy which blocks my sinuses and makes me cough. What research has been done on this please?

    1. Hi Sue,

      Thank you for your question on our blog.

      This is a 2019 review article in the BMJ on the topic of dairy causing mucus and it does explain a couple of the potential mechanisms. On the other hand it dismisses the concept of dairy causing mucus as a ‘myth’. https://adc.bmj.com/content/104/1/91.long. There does not appear to have been much solid research on this area.

      However, an interesting paragraph in this paper says:

      “β-casomorphin-7 (β-CM-7) is a protein that is derived from the breakdown of certain types of milk, and this is known to upregulate MUC5AC gene expression and increase mucus secretion.14 However, this is in the colon, so can only lead to more mucus in the respiratory tract if intestinal permeability is increased during inflammatory states, thus allowing milk proteins to enter the systemic circulation.”

      So this is suggesting that it might only be the case if there is increased intestinal permeability (of course dairy may also contribute to increased intestinal permeability in some people).

      Also probably most Nutritional Therapists and perhaps also other complementary health practitioners will be able to give ‘anecdotal’ examples of clients whose sinus or other ‘mucus’ issues have improved with elimination of dairy. It may not work for everyone, but certainly people who have blocked sinuses, glue ear, catarrh in throat etc – it is definitely worth a trial elimination for at least one month to see if symptoms improve. The gold standard in knowing if a food is causing a symptom is an elimination diet (more reliable than intolerance testing etc).

      I hope this helps.

      Best wishes, Clare

      1. I agree – my sinus issues hugely better with a reduction in sugar and dairy. Elimination of gluten significantly helped as well, although I allow myself organic long fermented gluten in the form of sourdough bread.

  6. Great blog, with a very balanced approach. Unbeknown to me at the time (37 years ago) I was lactose intolerant and had been since childhood and so it seemed was my baby son who couldn’t tolerate my breast milk. Now if I’m unable to avoid lactose I take lactase tablets. If only I had had access to this knowledge years ago it would have avoided a great deal of heartache. Thank you

  7. I have been a diagnosed Coeliac for 20 years and now have IBS. I find taking probiotics helpful. I suspect I could be dairy intolerant so find your blog and comments v helpful. Should I cut out dairy for a while and see what happens? I feel bloated all the time. I drink Lacto free milk. Please help! Thanks for any feedback!

    1. Hi Allie,

      Thank you for your comment.

      Yes I would definitely suggest eliminating dairy from your diet for three months and seeing how your symptoms are. It might also be a good idea to have a look and see if there are other factors that could be contributing to your symptoms. The 5R Programme is used by functional medicine practitioners to support gut health – Remove, Replace, Reinoculate, Repair and Rebalance and there may be elements in this programme that would be useful for you. For example, in terms of the bloating, you may benefit from a digestive enzyme for a period of time. If you would like more specific advice on this, we do offer a free health questionnaire service. If you complete and return a health questionnaire we will send you some written diet and supplement recommendations. You can download a questionnaire here.

      I hope this helps.

      Best wishes, Clare

  8. I have been drinking coconut milk for a long time!. I will never go back to cows milk. We don’t need cows milk, coconut milk can do it all!.

  9. Hi Clare
    Thanks for a very balanced article. I am osteopenic and on oestrogen suppressing tablet related to having breast cancer for a second time. I was put on standard Calcium Gluconate supplementation. I replaced this with an equivalent dose of Cytoplan whole food calcium which equates to three a day and am also taking Cytoplan magnesium citrate 2 a day and vit d3 and K2. From what you say I could reduce this dose? Another not on your foodstate Calcium it does not cause constipation as Calcium Carbonate does.

    1. Dear Fiona

      Thanks for your question. In terms of an appropriate dose for our Wholefood Calcium, I would usually recommend 2 capsules for someone with osteopenia (providing a total of 400mg og calcium). It is good that you are also taking magnesium, vitamin D3 and vitamin K2. Hopefully you are also taking an all-round multivitamin and mineral.

      We do have another product that might be of interest to you – Bone Support – this includes calcium, magnesium, boron, vitamin K2 and vitamin D3. If taking this one, I would suggest 2 capsules of Bone Support plus one of Wholefood Calcium. You would then not need the vitamin D3/K2. You don’t mention the dose of vitamin D3 you are taking. Do check the dose from all sources and that it is not above 5000iu (125mcg) per day. A high dose is ok for short-term use if levels are low, however if taken long-term then the dose should be reduced (there are also home blood tests that can be used to check the level – http://www.vitamindtest.org.uk – if you do get a test done, I would be happy to advise on an appropriate level of supplementation once you have the result – you can email me at clare@cytoplan.co.uk).

      Best wishes, Clare

  10. Thanks for this article . Sara Flowers a nutritionist recently diagnosed me with a milk intolerance. At the age of 62 I was in denial having been diagnosed previously . It has been very hard to give up milk But I have made it . Am now also,on gluten free bread . Your article,pointed out a link.

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