- Lactose intolerance symptoms include bloat, diarrhea, and gas shortly after eating dairy products.
- If you have a hard time digesting lactose, try an enzyme supplement like Lactaid before eating dairy.
- You can also combat lactose intolerance with dairy-free alternatives like oat milk and cashew cheese.
- Visit Insider's Health Reference library for more advice.
About 36% of Americans have some degree of lactose intolerance — a digestive disorder that occurs when the small intestine does not produce enough of the enzyme lactase necessary for breaking down the natural sugar (lactose) in milk.
Many people with lactose intolerance can still consume low to moderate portions of lactose, but some individuals may need to eliminate it from their diet completely to avoid experiencing symptoms like bloating and gas.
"The amount of lactose that causes symptoms in someone who is lactose intolerant is variable," says Anna Maria Bittoni, RD, a registered dietitian at The Ohio State University Wexner Medical Center. "It depends on many factors, including how much lactase your body produces, how quickly food moves through the gastrointestinal tract, and the bacterial makeup of your intestines."
Here are the symptoms of lactose intolerance and how you can avoid them by making some simple dietary changes.
Symptoms of lactose intolerance
People with lactose intolerance may experience the following symptoms about 30 minutes to two hours after consuming food or drinks containing lactose:
- Bloating
- Diarrhea
- Stomach cramps
- Nausea
- Vomiting
- Gas
- Stomach growling or rumbling
The symptoms of lactose intolerance can be similar to other digestive disorders such as inflammatory bowel disease (IBD) or irritable bowel syndrome (IBS). It is important to distinguish between these conditions for proper treatment.
One way to tell if it's lactose intolerance or something else, like IBS, is that symptoms of lactose intolerance are triggered only by dairy products whereas IBS can be triggered by many different foods or stress.
See your healthcare provider if you experience symptoms of these conditions, particularly if they are persistent, severe, or there is blood in your stool as it may be a sign of IBD or another serious condition.
How to combat lactose intolerance with dairy-free replacements
Although lactose is found in foods that we consume on a daily basis, such as milk and other dairy products, there are plenty of lactose-free alternatives you can try in order to avoid the symptoms of lactose intolerance.
You can also try supplements that contain lactase — the enzyme that helps break down lactose. Brands like Lactaid and Colief have a series of chewables and pills you can take at the start of your meal to help you digest dairy and reduce, or prevent, symptoms.
Milk
"Studies suggest that most adults [with lactose intolerance] can tolerate up to 12 grams of lactose — approximately the amount in 1 cup of cow's milk — without symptoms," says Bittoni.
However, if you can't tolerate any amount of lactose at all, you can try other non-dairy milk alternatives, such as:
- Cashew milk
- Soy milk
- Oat milk
- Rice milk
- Almond milk
There's also Lactaid milk, which is made from cow's milk. The difference is that a synthetic form of the lactase enzyme has been added to the milk to break down all of its lactose, so there's none left to cause any gastrointestinal comfort. As a result, the milk may taste slightly sweeter than regular cow's milk, according to the manufacturer.
Cheese
"Go for more aged cheeses as they have low lactose," says Kalyani Meduri, MD, a gastroenterologist at AdventHealth Zephyrhills.
Natural bacteria break down the lactose as cheese ages during the process of fermentation, that's why fresh cheeses have higher lactose content.
For instance, 100 grams of ricotta cheese has 4 grams of lactose, while Parmigiano Reggiano has virtually none. Hard cheeses like cheddar and Swiss cheese also contain very little to no amount of lactose.
You can also opt for the following dairy-free alternatives to everyday cheese products, most of which you should be able to find in your local grocery:
- Egg whites or tofu are often used to replace cottage cheese.
- Almond or cashew cheese can replace feta cheese in common dishes.
- Soy and nut-based cream cheeses are great alternatives to regular cream cheese.
- Vegan cheese spreads work just as well with bread as dairy cheese spreads do.
Yogurt
A hundred grams of yogurt contains about 3.2 grams of lactose. Greek yogurt — where yogurt is strained to remove whey — contains only 2.6 grams of lactose per 100 grams.
People with lactose intolerance can usually tolerate yogurt with live cultures because the bacteria assist in digesting lactose, which makes symptoms less likely. However, you may still prefer dairy-free alternatives such as:
- Dairy-free yogurt
- Soy yogurt
- Coconut yogurt
- Almond yogurt
- Cashew yogurt
Ice cream
The lactose content in ice cream generally varies per brand and recipe, but a cup of regular vanilla ice cream is estimated to contain about 9 to 10 grams of lactose.
If you have lactose intolerance, try the following alternatives instead:
- Lactose-free ice cream from brands like Lactaid and Breyers
- Vegan ice cream from brands like Daily Harvest and Oatly
- Sorbets
- Frozen fruit bar
- Lactose-free gelato or pudding
Butter
Unlike most dairy products, butter contains very little lactose. There are about 0.58 grams of lactose in 100 grams of butter, so people who can tolerate small amounts of lactose are likely to consume butter with no problem.
However, if you're looking for alternatives, here are several options you can explore:
- Ghee is a type of clarified butter but is usually tolerated better by people with lactose intolerance because it contains little to no lactose, generally lower than butter.
- Vegan butter is a plant-based substitute specifically made to taste like regular dairy butter. Brands like Milkadamia and Earth Balance make it.
- Coconut oil is naturally lactose-free and you can use it in cooking, baking, or even spread it on your toast.
- Unsweetened applesauce can be a viable substitute for butter in baked goods.
Getting enough calcium
Individuals with lactose intolerance may be susceptible to a calcium deficiency since Americans typically get about 72% of their calcium from dairy products.
Adults aged 19 to 50 typically need about 1,000 mg of calcium per day to meet nutrient requirements. Adolescents and older adults usually require more, approximately 1,000 to 1,300 mg per day.
Here are several dairy-free sources of calcium:
- A cup of calcium-fortified orange juice: 349 mg of calcium (25% Daily Value)
- 3 ounces of sardines canned in oil: 325 mg (25% DV)
- 3 ounces of canned pink salmon: 181 mg (14% DV)
- 1/2 cup of cooked soybeans: 131 mg (10% DV)
- 1/2 cup of boiled and drained spinach: 123 mg (9% DV)
Milk and other dairy products are also a good source of vitamin D, which helps the body absorb and use calcium. If you avoid consuming dairy due to lactose intolerance, you may not get enough of the calcium and vitamin D that you need.
"People who avoid dairy products should check with their doctor if they need to take a calcium or vitamin D supplement," says Bittoni. "A registered dietitian nutritionist can help create an individualized plan to best control your symptoms while making sure that you are still meeting 100% of your protein, vitamin, and mineral needs."
Insider's takeaway
People with lactose intolerance tend to experience diarrhea, bloating, gas, and stomach cramps after eating foods with lactose, such as cheese, milk, and ice cream.
Although the digestive disorder comes with a lot of dietary restrictions, many dairy-free alternatives are easily available.
"A diagnosis of lactose intolerance is not the end of the world," says Meduri. "You can still enjoy your favorite foods with the right strategies."