Dairy Intolerance

For the people that suffer from sensitivities to dairy, there is some good news. Many people only have trouble with one of two compounds found in dairy, lactose or casein. Fortunately, there are dairy products free from one or the other. Rejoice, for you may find there are still dairy products you can enjoy!

If you aren’t sure which is your problem, lactose or casein, there’s a pretty easy test. While otherwise staying dairy free, incorporate a small amount of aged cheese, such as cheddar, into your diet for two days. If you stay symptom free, add more back in to see how you feel after two weeks. If you have no issues, your problem is with lactose. If you react to the cheese, your problem is with casein.

It may seem a logical choice, but don’t use “lactose-free” milk to test for lactose intolerance. When I was severely sensitive to lactose I could not handle the milk, which still contains some lactose, but had no trouble with aged cheeses.


Lactose is a sugar only found in milk and other dairy products. It requires the enzyme lactase in order to be broken down and used by the human body. Most babies and children possess this enzyme. It’s necessary for the complete digestion of their mother’s milk. Many people lose the ability to produce lactase as they age. Lactose intolerance is the most common reason for people to react to milk.

When lactose isn’t broken down and digested by the human body, it is instead eaten by bacteria or yeast living in the gut. Lactose intolerance generally causes short-term symptoms like bloating, gas, or diarrhea, which can appear anywhere from 15 minutes to several hours after consumption. Longer term symptoms can include constipation and abdominal pain, presenting themselves 1-2 days after lactose is consumed.

Lactose content of dairy products

Fortunately, there are a variety of dairy products that contain little to no lactose! Aged cheeses contain no lactose because the bacteria used in the culturing process have already consumed it. Butter contains no lactose because all the liquid whey, where lactose is concentrated, has been removed during churning.

Raw dairy naturally contains the enzyme lactase. When dairy is pasteurized or otherwise cooked, all enzymes are destroyed. Fortunately, cultured dairy products both have their lactose reduced and lactase is re-added, all thanks to the culturing bacteria. Examples of cultured dairy products include yogurt, sour cream, and most cheeses. For many, the reduction of lactose plus the added lactase enzymes makes cultured dairy products easier to tolerate.

For me, both the lactose content and the cultured status matters. For example, I can handle yogurt, but not cream, even though they both contain similar amounts of lactose. I can’t tolerate much raw milk even though it contains lactase enzymes, because it still has such a high lactose content. By contrast, I can handle paneer pretty well due to its low lactose content, even though it’s not a cultured product.

Watch out for lactose being added back into dairy and other foods! Lowfat yogurt has more milk solids incorporated back into the product to help thicken it up, which means more lactose. Additionally, many manufactured foods contain whey, especially protein bars and shakes, so always read the ingredients!

With the following guidelines, you can trial adding dairy back into your diet based on how much lactose it contains and whether or not it’s cultured. Start with cultured low-lactose products and work your way up. You’ll soon figure out what you can handle!

Lactose content and cultured status of dairy

Name Grams lactose per 100g Grams lactose per serving Serving amount Cultured?
Ghee (clarified butter) 0 0 1 tbsp No
Aged cheeses (asiago, blue, brie, cheddar, colby, gorgonzola, gouda, gruyere, havarti, limburger, manchego, monterey jack, muenster, parmesan, romano, stilton, swiss) 0 0 1/2 cup Yes
Butter 0.06 0 1 pat No
Ricotta 0.31 0.38 1/2 cup No
Feta 0.4 0.3 1/2 cup Sometimes
Chevre 0.9 1.10 1/2 cup Yes
Paneer (Indian cheese) 1.33 1 1/2 cup No
Mozzarella cheese 1.45 0.62 1/2 cup Sometimes
American cheese 2.15 1.21 1/2 cup No
Cottage cheese 2.67 5.61 1 cup Yes
Cream 2.92 1.74 1/4 cup No
Sour cream 3.41 1.96 1/4 cup Yes
Kefir 3.70 8.99 1 cup Yes
Yogurt 3.74 9.16 1 cup Yes
Cream cheese 3.76 1.09 2 tbsp No
Buttermilk 3.9 9.6 1 cup Yes
Milk (goat) 4.45 10.86 1 cup No
Milk (cow) 5.05 12.32 1 cup No
Whey protein powder 5.13 2.00 2 scoops No
Velveeta cheese 8.10 9.07 1/2 cup No
Evaporated milk 10.04 12.65 1/2 cup No
Gjetost 42 30 1/2 cup No

Lactose hyper-sensitivity

If you find you can handle aged cheeses without issue, indicating you can handle casein, but have trouble even with small amounts of yogurt, you are hyper-sensitive to lactose. Even here, there is promising news. Cultured dairy like yogurt, sour cream, and cream cheese can be made at home with the lactose content vastly reduced compared to what you can buy in the store!

In essence, yogurt is made by incubating milk at 110-115°F with a yogurt culture, typically for 4-6 hours. At this point some, but not all, the lactose has been converted. However, if the yogurt is left to continue culturing for a total of 24 hours, almost no lactose will remain. Elaine Gottschall covers this process on her website and in her book. She is a biologist who advocates the benefits of lactose-free cultured dairy, full of probiotics, as a part of the healing diet she outlines to help those with severe digestive issues.

A yogurt maker makes it easy to prepare your own yogurt. The typical yogurt cultures sold are 1-time use, as in they will make a batch of yogurt but aren’t robust enough for the yogurt to be used as a starter for a new batch. On the other hand, if you purchase an heirloom yogurt culture, you can forever use your yogurt as a starter to make more. In addition to yogurt, you can make cream cheese by draining this yogurt in a muslin cloth bag for 8-24 hours. Sour cream can be made the same way as yogurt, just substitute out the milk for cream. I spent a couple of years dealing with a severe sensitivity to lactose, so I can attest that these methods work!


Casein is a protein found in milk. It makes up about 80% of the total protein contained in dairy products. It’s very hard to avoid in dairy. Only ghee, clarified butter, is completely free.

Casein intolerance tends to manifest as immunological responses, so there are a wide range of possible symptoms which can include:

  • Throwing up, upset stomach, nausea, gassy
  • Migraines
  • Skin issues: Eczema or other rashes
  • Other immune related issues

Like other immune system based triggers, when the body is hypersensitive, it will overreact to even a tiny amount of casein! For those with a severe intolerance, symptoms often appear immediately and are extreme. For other individuals, the symptoms may be milder and build up over time. In this case, it’s generally easier to tolerate small amounts in the diet, but harder to pinpoint how much is too much before symptoms begin to manifest again.

Casein content of dairy

Some people who react to casein may find they can have a little bit. For the less sensitive, occasional butter or cream may be fine. For the hyper-sensitive, only ghee is tolerated.

Casein quantity in dairy

Name Grams casein per 100g Grams casein per serving Serving amount
Ghee (clarified butter) 0 0 1 tbsp
Butter 0.68 0.03 1 pat
Sour cream 1.52 0.87 1/4 cup
Cream 1.68 0.96 1/4 cup
Buttermilk 2.57 6.29 1 cup
Yogurt 2.78 6.8 1 cup
Milk 2.8 6.83 1 cup
Kefir 3.03 7.37 1 cup
Cream cheese 5.44 1.42 2 tbsp
Evaporated milk 5.45 6.86 1/2 cup
Gjetost 7.72 8.64 1/2 cup
Cottage cheese 8.36 18.90 1 cup
Ricotta 9.11 11.30 1/2 cup
Feta 11.37 8.53 1/2 cup
Velveeta cheese 13.04 14.60 1/2 cup
American cheese 13.36 14.96 1/2 cup
Chevre 14.82 18.38 1/2 cup
Paneer (Indian cheese) 17.14 12.86 1/2 cup
Mozzarella cheese 18.90 8.128 1/2 cup
Hard cheeses (asiago, blue, brie, cheddar, colby, gorgonzola, gouda, gruyere, havarti, limburger, manchego, monterey jack, muenster, parmesan, romano, stilton, swiss) 19.4 10.54 1/2 cup
Whey protein powder 53.34 20.80 2 scoops

Non-cow dairy

There is one spot of good news for those sensitive to casein. While all dairy, except ghee, contains casein, a number of people find they can tolerate the casein found in goat or sheep dairy better than cow dairy. The form of casein found in non-cow dairy is easier for the body to digest. Some people can eat as much non-cow dairy as they want. Others can tolerate it better than cow dairy, but need to watch their intake.

Almost any dairy product can come from an alternate source to cow. Today it is increasingly easy to find goat milk, and sometimes goat yogurt or kefir. It’s much more difficult to find non-cow cream and butter. The cream in goat and sheep milk does not separate easily the way cow milk does.

A number of cheeses such as chevre, feta, and manchego are typically made from goat or sheep milk. It’s not a guarantee, as these cheeses can be made from cow milk also, so read the labels. Conversely, some stores now sell goat milk cheddar and other goat/sheep versions of cheeses traditionally made with cow milk.

Dairy Alternatives

Dairy from healthy pastured animals is a good source of nutrition. So go ahead and enjoy what you can tolerate! Whether that means low-lactose, non-cow dairy, or at the very worst, ghee.

Plenty of of the dairy substitutes on the market are bad for you and should be outright avoided. Especially anything containing soy! Soy milk, soy cheese, soy yogurt; there are many options, and all of them are toxic. Traditionally made soy products undergo a long fermentation period to remove the toxins, which then makes these products safe to eat. Examples include naturally brewed soy sauce and miso. Conversely, the dairy-free soy alternatives do not undergo much, if any, fermentation.

The other problem with many dairy-free alternatives is the inclusion of fillers, added sugar, and other questionable ingredients. If you carefully read all the labels, you may be able to find decent replacements.

As someone who has dealt with wheat intolerance since grade-school, my advice is to make and eat foods that are naturally free from foods you can’t eat instead of attempting to replace them with some kind of fake alternative. Sometimes you’ll really crave a dish that’s more difficult with restricted dairy options, but be creative and you’ll come up with something! Some non-dairy milk/cream replacements I use when cooking are canned coconut milk (without thickeners), coconut cream, and chicken broth.


For both casein and lactose sensitivities, some people find that their gut heals after they remove the offending foods from their diet. They can then tolerate these once problematic foods again, though perhaps never to an extreme extent. Once you know the symptoms it’s much easier to spot when you’ve had too much. In addition, improving your overall lifestyle will help your body heal its digestive system faster and give your health a boost!

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