Milk Allergies vs. Lactose Intolerance; Get Answers and Relief with PAT

Milk and dairy products are so ingrained in our modern diets, yet so are the prevalence of milk allergies vs. lactose intolerance! There are actually various types of reactions we can have to milk (IgE or non-IgE), to the various proteins, as well as lactose.

So if you suspect you’re having issues with milk or dairy products, we’ll help you decipher the different types of reactions you could be having to milk, and how you may be able to get relief from your symptoms with Positive Association Technique (PAT).

Milk Allergies

There are different types of reactions to milk, but only two types of dairy allergy, Immunoglobulin E (IgE)-mediated and non-IgE-mediated. They are a result of your immune system overreacting to one or more of the proteins in milk you’ve eaten or drunk. 

Cow’s milk is the most common cause of a milk allergy. However, other types of animal milk, including goat’s milk and sheep’s milk may cause your immune system to react. 

It can affect anyone of any age but it is more common in infants and children under 16 years old. Reactions to milk can also develop in formula fed and breastfed babies as the milk proteins can pass through into the mothers breast milk.

IgE Mediated Milk Allergy

A ‘true’ milk allergy causes an allergic reaction by creating immunoglobulin E (IgE) after exposure to milk, which is made by your immune system. The immune system mistakenly determines that the dairy proteins are harmful and responds by releasing chemicals such as histamine. 

These IgE are antibodies that bind to mast cells (allergy cells) in your skin, respiratory tract and cardiovascular system which release histamine causing you multiple body system symptoms. This triggers a very quick reaction following consumption.

The severity of the symptoms can vary between people, mild symptoms include hives, nausea or vomiting, abdominal pain, diarrhoea, rash, itching, tingling or swelling of your lips, tongue or throat.  

Severe symptoms may include chest tightness, shortness of breath, difficulty swallowing, wheezing, dizziness, drop in blood pressure, loss of consciousness and even anaphylaxis. 

If you have a milk allergy you are reacting to one or both of the proteins in milk which are casein and whey.

• Casein is a byproduct of milk when it spoils and turns solid (curdles).  It is also found in cheese and yogurt and accounts for 80% of the protein in milk and gives milk its white colour.  This is the most common reaction out of the two.
• Whey is a byproduct of the liquid part of milk when it curdles which accounts for the other 20% of protein in milk. 

If you have a milk allergy, you react to all milk and its byproducts, and this is where people often trip up as not everyone associates milk with other dairy products. This includes milk in all its forms, including condensed, dry, evaporated and powdered milk, as well as all dairy based products like yogurt and cheese.

Non-IgE Mediated Milk Reaction

An IgE-mediated response typically occurs immediately where a non-IgE mediated response involves other components of the immune system, so can take up to 48 hours to trigger symptoms. It is also usually the cause of gastrointestinal symptoms such as vomiting, bloating and diarrhoea.

This is often why people may confuse a non-IgE mediated dairy allergy with lactose intolerance. 

This also means that non-IgE mediated reactions won’t show up on medical allergy tests, which can cause confusion for people when they’re trying to work out what they’re reacting to. 

Cows Milk Protein Allergy (CMPA)

CMPA can affect between 2 and 7.5% of formula feed and 0.5% exclusively breastfed babies. With exclusively breastfed babies developing CMPA it is a result of milk proteins from products the mother has eaten transferring through breastmilk. CMPA can either be IgE mediated, or non-IgE mediated.

With the immediate type (IgE mediated) signs and symptoms occur within a few hours. They may have skin reactions, itching, swelling of lips, face, eyes, breathing issues, abdominal pain, vomiting, diarrhoea, sneezing, itching, runny or blocked nose.

The non-IgE mediated reaction causes the delayed reaction where symptoms can take days if not weeks to present. They include reflux, colic, eczema, sore red bottom, abdominal pain, constipation. loose or frequent stools, blood and /or mucus in stools, as well as a faltering growth in some children.

The non-IgE mediated CMPA is usually associated with intense pain. In these children the cause of the pain is still uncertain. Reflux is one factor, but there is also painful passage of wind, straining with stools, abdominal crunching and back arching. 

One theory is there is a close proximity of the immune system (your gut is your biggest immune organ in your body) with gut pain fibers (your gut is the second biggest nervous system) that communicate with each other, and this interaction can lead to the intense pain in CMPA. 

A lot of symptoms can occur at night and it’s not completely understood why, it may be related to the transit of digested foods to the lower intestine (painful wind is common) This is one of the most disturbing and exhausting symptoms for families! Eczema is also commonly associated with CMPA too.

Most children will grow out of CMPA but it is usually longer than the supposed 1 year. Paediatric gastroenterologist specialist Professor Shah says in reality, most children do grow out of their cows’ milk allergy but between the ages of 2-3 years. 

In her experience, many infants do begin to acquire some tolerance to milk before a year, and can tolerate it in baked or heated forms, but not raw. Tolerance to raw milk is often seen much later, around 2-3 years, so cows’ milk allergy is longer lived than most people think.

Because CMPA can present with multiple symptoms, getting a correct diagnosis is important so it’s best to talk to your health care provider about it. 

Factors that can contribute to the development of CMPA

For breastfed children, the level of cow’s milk protein present in breast milk is 100,000 times lower than that in cows milk, and the symptoms are often not as severe.

It is thought that immunomodulators present in breast milk and differences in the gut flora of breast fed and formula babies may contribute to this.

There is a secretory immunoglobulin A in breastmilk that ‘paints’ a protective coating on the inside of a babies intestines to prevent penetration by potential allergens, like foreign proteins.

Another factor to consider is c-section babies.  Studies have shown that they face twice the risk of developing an allergy or intolerance to cow’s milk than other children, according to a report in the medical journal Allergy.

The difference is that compared to infants born vaginally, children delivered by c-section are exposed less to maternal bacteria and their digestive tracts are consequently not colonized in the normal way. They are also potentially exposed to antibiotics and opportunistic pathogens associated with the hospital environment.  

Intestinal microbiome has an important role in signalling the developing mucosal immune system and making it strong. In c-section babies their immune system can overreact to allergenic substances so it is best to give them baby probiotics especially designed with the correct species for colonisation of their gut.

You can learn more in our other recent blog/podcast “The Gut Microbiome and Allergies“.

Lactose Intolerance

Lactose intolerance is a reaction in your digestive system to milk sugar. Lactose intolerance isn’t an allergy, it’s because you lack an enzyme called lactase and you can’t digest the sugars present in milk. 

For lactose to be absorbed it needs to be hydrolyzed in the intestine by a β-galactosidase enzyme, called lactase-phlorizin hydrolase, which we generally call lactase. This enzyme hydrolyzes lactose into the simpler sugars so we can digest and absorb the sugars.

In adults with lactase deficiency, lactose is not digested in the upper bowel and reaches the lower bowel, where it is fermented by gut microorganisms, which produce hydrogen, carbon dioxide, and methane gases which can cause abdominal pain, bloating, and flatulence. Undigested lactose also draws water into the intestinal lumen through its osmotic effect, which can cause diarrhoea.

What causes lactose intolerance?

When we are babies our bodies makes lactase so we can digest the lactose in breastmilk. After babies are weaned this enzyme in some people stops being made, so we can’t properly digest the lactose in milk which can result in the symptoms of lactose intolerance.

In some people the lactase enzyme stays switched on and to better understand this we need to look at human history with milk and our evolution. Humans as a species began developing 300 thousand years ago but didn’t start drinking cow’s milk until about 10 thousand years ago. 

The first people to drink milk were the early farmers in western Europe who began domesticating and living with animals including cows. They would most likely have had reactions to the milk originally but they evolved the ability to keep their lactase enzymes through into adulthood from a result of mutations in a section of DNA that controls the activity of the lactase gene. This has been termed ‘Lactase persistence’ and allowed them to drink milk without side effects.

Fast forward now and it’s actually more common to have lactose intolerance than ‘lactase persistence’. Experts estimate that about 68% of the world’s population now has some level of lactose malabsorption!

You can also develop lactose intolerance when your small intestine decreases lactase production after an illness, injury or surgery involving your small intestine. Diseases also associated with secondary lactose intolerance include intestinal infection, coeliac disease, bacterial overgrowth and Crohn’s disease.

A1 vs. A2 Milk

Basically, (and there is SO much I could go into here!) there is a protein in milk called beta-casein. This protein originally came in the form of A2 beta-casein, which is the same primary protein found in breast milk, so it is easier for the body to absorb. 

At some point in the cows evolution there was a genetic mutation that created a A1 Beta casein variant, which has resulted in most commercially available cows milk producing a mixture of A1 and A2 beta-casein.  

The problem is that this new variant A1, forms an inflammatory peptide called beta-casomorphin-7 (BCM-7) in some people. This can cause digestive symptoms such as diarrhoea and or recurrent infections, (recurrent tonsillitis as teenager is a classic sign of A1 casein sensitivity), inflammation, type one diabetes, heart disease, behavioural problems, food intolerance, allergies, premenstrual mood symptoms, period pain, and autoimmune conditions, among many more.  

Another part of the problem for A1 cows is they contain a histidine residue in the beta casein protein in their amino acid structure.  Histidine is a precursor to histamine, so when drinking A1 milk you are more likely to have allergic symptoms.  A2 does not contain this, rather a proline residue. 

Symptoms can be resolved when people switch to A2 milk and other dairy products; butter, cream, ricotta and whey protein powder or cows that have only the A2 casein. Goat and sheep naturally don’t contain A1 casein, like all other milk products do.

Managing Reactions to Milk and Dairy Products

Once you have learned what components of milk or dairy products are causing the issue for you, you’re one step closer to learning how to manage your symptoms.

If you have some degree lactose intolerance, you may be able to determine with some trial and error how much lactose you can consume. You can also still consume some dairy products like aged cheese, where the lactose decreases during the manufacturing process.

When it comes to dairy allergies, unfortunately this causes issues with all milk/dairy based products. Although, this is a difficult elimination diet to follow, especially for breastfeeding babies and children.

If you want to explore a natural way to help relieve the symptoms of your reaction to milk, so you can consume it occasionally without the uncomfortable issues, Positive Association Technique (PAT) may be beneficial for you.

Positive Association Technique (PAT)

At Health & Wellness Australia & Auckland (HWA), we use a technique called muscle testing (or kinesiology) to help identify the reactions to food and environmental substances that may be triggering or exacerbating your symptoms.

Following testing, you can work with your qualified Naturopath to address the reactions to these milk proteins and lactose using a natural allergy treatment called Positive Association Technique (PAT).

Please note that PAT can not be used for milk reactions that trigger an anaphylactic reaction, or for lactose intolerance caused by an enzyme deficiency.

You can learn more about PAT, and find out if it’s right for you by;

• Calling us on 1300 853 023 / 09 479 5997 (NZ) to chat to our friendly staff
• Send us your question HERE
• Request a Free PAT Information E-PACK HERE

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Please note that this blog post contains general information only. Always consult your health care professional before changing your diet, starting new supplements or regarding any medical condition.