Lactose intolerance - symptoms, tests and dairy-free alternatives

What is lactose intolerance?

Lactose intolerance refers to the intolerance of milk sugar (lactose) due to an enzyme deficiency. More precisely, the small intestine produces too little of the enzyme lactase, which normally breaks down lactose into glucose and galactose. If the lactose remains undigested, it passes into the large intestine, where intestinal bacteria ferment it, producing gases and organic acids that can cause unpleasant symptoms. It is estimated that around 70% of adults worldwide are affected by lactose maldigestion【1】【8】. However, the frequency varies greatly: in northern Europe, only around 5-15% of the population is lactose intolerant, whereas in many Asian and African countries, 80-100% of adults are lactose intolerant【8】. This difference is related to the genetic make-up - in populations with a long dairy farming tradition (e.g. Northern Europe), gene variants that enable sustained lactase production (known as lactase persistence)【1】 are more common. Lactose intolerance is therefore not a disease, but rather the biological normality worldwide.

It is important to distinguish lactose intolerance from a cow's milk allergy. With a cow's milk protein allergy, the immune system reacts to even the smallest amounts of milk proteins - which can be life-threatening. Lactose intolerance, on the other hand, is a non-immunological food intolerance: the body lacks an enzyme, but the immune system is left out in the cold. People who are lactose intolerant can often tolerate small amounts of lactose without symptoms, whereas even traces are problematic in the case of an allergy【8】. The symptoms also occur differently (allergy often with skin rash or shortness of breath, intolerance mainly limited to the digestive tract). Both conditions can theoretically be present at the same time, but must be clearly distinguished from each other.

Medically, a distinction is made between different forms of lactose intolerance. The most common is primary lactose intolerance, also known as adult-type hypolactasia. It is genetically determined: In childhood, almost all people have sufficient lactase, but as people get older, enzyme production slowly decreases in many【1】. This natural decline typically begins after weaning and can become noticeable in adolescence or young adulthood. The enzyme activity drops to such an extent that the normal amount of lactose consumed can no longer be completely broken down. The second form is secondary lactose intolerance. Here, an intestinal disease or damage is the trigger: diseases such as coeliac disease, Crohn's disease, ulcerative colitis or even severe intestinal infections can damage the mucous membrane of the small intestine to such an extent that less lactase is temporarily produced【8】. After treatment of the underlying disease and healing of the intestinal mucosa, lactose tolerance can improve again. Finally, there is congenital lactose intolerance, an extremely rare genetic disorder. Affected babies do not produce any lactase from birth and develop severe diarrhea even with breast milk【8】. Without a special lactose-free diet from the first day of life, this condition would be life-threatening - fortunately, only a few dozen cases are known worldwide. So for the vast majority of people with lactose intolerance, it is the primary, acquired form, which is annoying but easily manageable.

Symptoms: How does lactose intolerance manifest itself?

The symptoms of lactose intolerance mainly affect the digestive tract. Typically, symptoms occur after lactose-containing foods have been consumed - often within 30 minutes to 2 hours afterwards, depending on the extent of the enzyme deficiency and the amount of lactose ingested【8】. Common signs are:

• Flatulence and bloating: the bacterial fermentation of lactose in the large intestine produces gases (mainly hydrogen, carbon dioxide and methane). This leads to a bloated stomach, intestinal noises and often cramp-like pain【1】.
• Abdominal cramps and pain: The stretching of the bowel and increased bowel movements can cause colic and abdominal pain. These usually occur in the lower abdomen and range from mild discomfort to severe cramps.
• Diarrhea or soft stools: The organic acids produced during fermentation draw water into the intestines. This often results in thin stools or diarrhea, often with a sour odor. Sometimes, instead of diarrhea, only mushy, frequent bowel movements occur.
• Nausea and rumbling: Some sufferers experience nausea, especially with higher amounts of lactose. Loud intestinal rumbling (the audible "gurgling" in the stomach) is also typical, as the gases and liquids move around.
• Flatulence: Increased gas formation not only leads to internal pressure, but also to increased discharge of wind. Many people find this uncomfortable or embarrassing, especially in social situations.

The intensity of the symptoms strongly depends on the amount of lactose consumed and the individual residual lactase activity. Some people with mild lactose intolerance can tolerate a shot of milk in their coffee or a small yoghurt without any problems, for example, but experience symptoms after a glass of pure milk. Others react significantly to even small amounts. The type of food also plays a role: fat or fiber in food can delay gastric emptying and thus release the lactose more slowly, which is often better tolerated【8】. On the other hand, a very hot drink or alcohol (such as in a cream liqueur) can impair the lactase enzyme effect. Typically, those affected experience symptoms above a certain threshold of undigested lactose - this individual tolerance threshold is between 5 and 12 grams of lactose per single dose for most people. According to the European Food Safety Authority (EFSA), the vast majority of lactose malabsorbers tolerate around 12 g of lactose at a time without developing severe symptoms【2】【7】. 12 g corresponds to around 250 ml of milk (a small glass). Higher amounts are more likely to cause symptoms unless they are spread throughout the day. However, these amounts are average values - there are a few sensitive people who react to less than 5 g and many who can tolerate significantly more.

Another indication of lactose intolerance is that the symptoms usually disappear if you avoid foods containing lactose. If you are unsure whether lactose is the trigger for your own gastrointestinal problems, you can observe this yourself: If the symptoms always occur after milk, yogurt, ice cream etc., it is reasonable to suspect this. However, self-assessment is often inaccurate - studies show that people sometimes overestimate their intolerance or overlook other food components as culprits【8】. It is therefore advisable to carry out a targeted test if you suspect an intolerance, instead of permanently eliminating foods at random.

Diagnosis: How is lactose intolerance diagnosed?

The medical standard for reliably detecting lactose intolerance is the hydrogen breath test (_H2 breath test). For this test, you drink a defined amount of lactose (usually 20-25 g dissolved in water)【8】 after a night without eating. The hydrogen content of the exhaled air is then measured at regular intervals for about 2-3 hours. Why hydrogen? Because it is only produced when undigested lactose is fermented by bacteria in the large intestine - the bacteria produce _H2, which enters the blood and finally the lungs and is exhaled. If the hydrogen content in the breath increases significantly (increases of ≥20 ppm above the baseline value are common), this is an indication that the lactose has not been completely broken down in the small intestine【2】【8】. The symptoms occurring during the test are also noted. The H2 _breath test is well tolerated by older children and adults, but cannot be used on babies (it would lead to diarrhea in infants, which is too risky)【8】. Alternatively, there is the lactose tolerance test, in which the blood sugar is measured several times over 2 hours: If the blood sugar barely rises after drinking the lactose solution, the lactose has not been utilized - an indirect indication of lactase deficiency【8】. This test is rarely carried out today, as it is more stressful due to the many blood samples and can be less reliable than the breath test.

Further tests may be useful in addition or for specific questions. If a secondary intolerance is suspected, the cause should be determined - such as a test for coeliac disease or a colonoscopy to rule out inflammation【8】. A genetic test is also possible: this involves looking for the most common gene mutation for lactase persistence (C/T-13910 polymorphism in the MCM6 gene). This test can indicate whether someone has a predisposition to tolerate lactose throughout their life. It can be helpful if the breath test result was unclear. However, the genetic test does not prove current intolerance - it only shows the predisposition. Theoretically, someone can be genetically lactase-resistant but still temporarily intolerant to lactose due to intestinal damage.

In practice, many doctors proceed as follows: First, a detailed medical history (what are the symptoms, what foods do they occur with, how long have they existed, are there any previous illnesses such as intestinal disorders?) An elimination trial is then often recommended - the patient strictly abstains from lactose-containing foods for 1-2 weeks and observes whether the symptoms disappear. This is often followed by a targeted stress test in everyday life, in which lactose is added again (e.g. a glass of milk) to see whether the symptoms reoccur. These self-tests provide clues. The final confirmation is then usually provided by the H2 _breath test at the doctor's surgery. With this combination of a consultation, omission diet and breath test, lactose intolerance can be reliably diagnosed and also differentiated from other causes (e.g. irritable bowel syndrome, fructose malabsorption, coeliac disease). It is worth making a clear diagnosis - only then can you take the right dietary measures without restricting yourself unnecessarily.

Treatment: How can lactose intolerance be managed?

The good news is that lactose intolerance can usually be managed well through dietary adjustments. The aim of treatment is not to exceed the individual lactose tolerance so that no symptoms occur - but at the same time to keep as many foods as possible in the diet in order to prevent nutrient deficiencies. It is often not necessary to completely avoid dairy products. The following strategies can help in everyday life:

Know and reduce sources of lactose

The first step is to know which foods contain significant amounts of lactose. The main sources are

• Milk and mixed milk drinks: cow's milk (approx. 4.5-5 g lactose per 100 ml), sheep's and goat's milk (similar), buttermilk, whey, milk shakes, cocoa drinks, etc.
• Fresh dairy products: Yoghurt (approx. 3-4 g/100 g, depending on the culture), kefir, soured milk, quark, cream cheese (cottage cheese, ricotta etc.), cream (contains less lactose, approx. 3 g/100 g, as higher fat content is diluted).
• Soft cheeses: Some types of cheese still contain noticeable lactose, especially young and soft cheeses (e.g. mozzarella ~2 g/100 g, cream cheese ~2-3 g, feta ~4 g). Very long matured hard cheeses, on the other hand, are almost lactose-free (Cheddar, Parmesan, Emmental & Co. contain <0.1 g).
• Ice cream and pudding: Depending on the recipe, dairy desserts contain a lot of lactose. Cream ice cream or milk pudding can easily contain 5-6 g of lactose per 100 g.
• Milk chocolate and sweets: Milk chocolate, milk caramel, milk sweets etc. also contain lactose (milk chocolate approx. 9 g/100 g). Dark chocolate, on the other hand, hardly contains any lactose.
• Hidden lactose: Some processed foods use lactose as an ingredient, e.g. certain types of bread (milk rolls), pastries, packet soups, sauces, sausage products (when mixed with milk powder) and even medicines (as a filler in tablets). These quantities are usually small and often do not cause any symptoms【2】 - but for people who are very sensitive to lactose, even these hidden sources can contribute.

If you know what contains lactose, you can adjust your diet accordingly. In most cases, you don't have to give up all of these things completely. Many lactose-intolerant people find that they tolerate small portions well, but not larger ones. This is where trial and error and portion adjustment can help: perhaps a few sips of milk in your coffee are fine, but a whole latte macchiato is not. Or half a cup of yoghurt is okay, but a whole one makes your stomach rumble. By consciously observing yourself, you can find out your personal tolerance limit. Use the rule of thumb: around 10-12 g of lactose at a time is often tolerated【2】【7】 - this corresponds to 1 glass of milk or 2 cups of yogurt, for example. Anything more than this can be divided into smaller portions (instead of one large milkshake, drink two small ones throughout the day) or combined with other foods. Lactose consumed with a meal often causes less discomfort than on an empty stomach because gastric emptying is delayed【8】.

In the case of secondary lactose intolerance (e.g. due to coeliac disease or intestinal inflammation), the focus is on treating the underlying disease. As soon as the intestinal mucosa recovers, lactase production usually improves again. In the meantime, you should of course still eat a low-lactose diet to avoid causing unnecessary discomfort.

Use lactose-free and dairy-free alternatives

Fortunately, lactose intolerance is not a new phenomenon - the food industry and cuisines around the world have long since responded to this. Today, there is a wide range of lactose-free products and plant-based alternatives that mean you hardly have to miss anything. Here are a few examples:

• Lactose-free milk and dairy products: You can find "lactose-free milk" in many supermarkets. This is real cow's milk to which a lactase enzyme has been added. This breaks down the lactose into its individual components in the carton. As a result, the product tastes slightly sweeter (glucose is sweeter than lactose), but is well tolerated. Similarly, there are lactose-free quark, yoghurt, cream cheese and even cream. You can cook, bake and enjoy them normally without ingesting lactose. Note: According to EU labeling, "lactose-free" means less than 0.1 g of lactose per 100 g - this level is generally unproblematic.
• Plant-based drinks as a milk alternative: If you prefer to avoid cow's milk completely, there is now a large selection of plant-based milk alternatives. Whether soy drink, oat drink, almond drink, rice milk, coconut or pea protein drink - these 'plant milks' contain no lactose. Make sure you choose a calcium-fortified drink to ensure your calcium supply. Taste and use vary: Oat milk has a mild cereal taste and foams well in coffee, almond milk is slightly nutty, soy milk is more neutral and high in protein. It's worth trying out different varieties to find your favorite.
• Plant-based yogurt and cheese alternatives: Similar to milk, there are also soy, coconut or almond-based yogurts that have been fermented with lactic acid cultures - the taste is surprisingly close to real yogurt, but is lactose-free. For cheese lovers, there are vegan cheese alternatives (based on coconut oil, starch or nuts). Cream cheese alternatives based on almonds or cashews can be particularly tasty. Some mature cheese alternatives still have room for improvement in terms of taste, but the range is constantly growing.
• Sorbet and lactose-free sweets: Ice cream fans don't have to go hungry: Fruit sorbets do not require milk and therefore contain no lactose. There are also lactose-free ice creams (made with lactose-free milk) in some stores. Dark chocolate (high cocoa content) is usually lactose-free or low in lactose - to be on the safe side, look out for "May contain traces of milk" if you are very sensitive. Many gummy bears, sweets etc. are dairy-free anyway.
• Kitchen tricks: Many traditional recipes can be modified to be lactose-free. For example, you can use lactose-free milk when baking, replace cream with coconut milk, replace butter with lactose-free butter (yes, this is also available) or plant-based margarine. When thickening sauces, use lactose-free crème fraîche. This means you hardly have to miss out on any of your favorite dishes.

As you can see, "dairy-free" no longer means "indulgence-free". There are numerous dairy-free products that are in no way inferior to classic dairy products. Incidentally, many foods are naturally lactose-free - meat, fish, eggs, fruit, vegetables, cereals, nuts and oils do not contain lactose and can be eaten without hesitation. Even those who are very sensitive to lactose will therefore find enough choice for a balanced diet.

Tip: When shopping, look out for signs such as "lactose-free" or "dairy-free". In the list of ingredients, milk components are hidden behind terms such as "whey powder", "dried milk", "sweet whey" etc. - these indicate lactose. If you have to be very strict, a nutritionist can help you identify hidden sources of lactose. In many cases, however, this is not even necessary because tolerance to the smallest amounts is usually given【2】【7】.

Replace the lactase enzyme (lactase preparations)

Another helpful measure is the use of lactase preparations. These are freely available as tablets or drops. The idea behind them: You simply supply your body with the missing enzyme from outside so that lactose digestion still works. Lactase tablets are taken immediately before or with the first bite of a meal containing lactose. They contain the enzyme (usually obtained from special fungal cultures) in concentrated form. In the small intestine, the added lactase then breaks down the lactose from the food - and ideally you will not experience any symptoms at all. This approach has been well studied scientifically. The European Food Safety Authority (EFSA) has even approved an official health claim for it: "Lactase improves lactose digestion in people who have problems digesting lactose."【3】. This means that suppliers are allowed to advertise with this claim as long as each serving contains an effective enzyme dosage (at least 4500 FCC units of lactase). Studies have actually shown a significant improvement with lactase supplements: In a placebo-controlled crossover study with 47 adult sufferers, taking 9000 FCC units of lactase before a standardized 25 g lactose challenge test reduced both the typical increase in hydrogen in exhaled air by more than half and the symptom score significantly compared to placebo【5】. In other words, the test subjects had significantly fewer symptoms and less gas formation with enzyme tablets than without. Other studies also confirm that lactase preparations can be effective【7】.

If you want to try lactase tablets, keep a few things in mind: The dosage is crucial - depending on the product, one or two tablets correspond to around 5000 or 10,000 FCC units. This is roughly enough for 20-40 g of lactose (for comparison, a 250 ml glass of milk contains ~12 g, a plate of cheesecake can have 20+ g). You should take the enzyme tablet immediately before or with the first portion of the lactose-containing food, as it only works for a limited time. With very fatty meals, it may be that digestion takes longer than the enzyme effect lasts - in such cases, a subsequent dose may be useful. In everyday life, many sufferers use lactase mainly "on demand": for example, when they eat out, are invited out or want to treat themselves to something that normally causes problems. For daily use - e.g. muesli with normal milk every morning - it is usually easier to switch directly to lactose-free milk than to swallow tablets every day. Generally speaking, lactase supplements are a safe, simple option for enjoying occasional dairy products without having a stomach ache hours later【7】. However, they do not remove the cause of the intolerance - if you stop taking them, the symptoms will return as usual. They also cost money, of course: if taken regularly, they can add up to 10-20 € per month, depending on how often you take them. Side effects are rare, at most minimal gastrointestinal irritation. Conclusion: Lactase tablets are worth a try, especially to give you more flexibility. If in doubt, talk to your pharmacist or doctor about suitable products and dosages.

Support intestinal flora (probiotics)

An exciting approach that has been researched in recent years is the use of probiotics (beneficial intestinal bacteria) or prebiotics (dietary fibers that promote the growth of certain intestinal bacteria) to improve lactose tolerance. Background: Bacteria that can partially break down lactose live in the large intestine. If the composition of the intestinal flora is influenced, more lactose-degrading bacteria could theoretically be present, which would then "help" to digest the lactose before it causes discomfort【6】. In fact, there is evidence that regular consumption of fermented dairy products or special probiotics can increase the symptom threshold. For example, yoghurts contain live lactic acid bacteria(Lactobacillus delbrueckii subsp. bulgaricus and Streptococcus thermophilus), which already break down some of the lactose in yoghurt and can continue to produce lactase in the intestine - which is why yoghurt is often better tolerated than milk【8】. The EFSA has approved a health claim for this: "Live yogurt cultures improve the lactose digestion of the product in people who cannot tolerate lactose."【4】. This means that a yogurt with these cultures can advertise that it is more digestible for lactose intolerant people than other dairy products.

In addition, various probiotics have been tested in clinical studies - including strains such as Lactobacillus reuteri or Bifidobacterium species. A systematic review from 2020 summarized 15 randomized studies and found an overall positive trend: several probiotics were able to alleviate the typical symptoms of lactose intolerance and improve the H2 _breath test values【6】. However, the results varied depending on the bacterial strain and dosage, and not all studies showed significant effects. The authors emphasize that further clinical research is needed to derive clear recommendations. Similar findings emerged from a recent review from 2022, which suggests that certain probiotics (e.g. Lactobacillus acidophilus DDS-1 or L. reuteri DSM 17938) in sufficient quantities could help some sufferers【10】. However, probiotics are of course no substitute for a low-lactose diet - at best they should be seen as a supportive measure. So if you fancy giving it a try: There are special probiotic preparations for lactose intolerance on the market, or you can regularly integrate probiotic foods (such as yogurt, kefir, fermented vegetables) into your diet. It does no harm - whether it helps in individual cases has to be tested. However, such effects have not yet been confirmed by the EFSA; further studies are required. In other words, don't expect miracles, but a trial over a few weeks may be worthwhile to see if you personally feel an improvement.

Ensure nutrient supply

One thing must not be forgotten when dealing with lactose intolerance: Anyone who severely restricts or eliminates milk and dairy products should make sure they have an adequate supply of certain nutrients - first and foremost calcium. Milk and cheese are important sources of calcium in this country. In turn, our body needs calcium for bones and teeth, but also for muscle function and much more. The recommended daily intake for adults is around 1000 mg of calcium. Fortunately, there are many alternative sources of calcium: green vegetables (e.g. broccoli, kale, rocket) contain significant amounts of calcium, as do nuts and seeds (almonds, sesame seeds) and calcium-rich mineral water. The fortified plant drinks already mentioned often also provide 120 mg per 100 ml (comparable to cow's milk). Hard cheese is rich in calcium despite being low in lactose - 30 g of Emmental cheese has ~250 mg, and most intolerant people tolerate it without any problems because it is practically lactose-free. You should also make sure you get enough vitamin D (promotes calcium absorption and bone health). Dairy products also provide protein, vitamin B2 and B12 - but all of this can be balanced out with a balanced diet of meat, fish, eggs, pulses and vegetables. The bottom line: a low-lactose diet can be complete and nutrient-dense as long as you consciously make substitutions. This aspect is particularly important for children with lactose intolerance, as they are still growing - a nutritionist may need to be consulted to prevent deficiencies. In many cases, however, it is sufficient to use lactose-free dairy products, which results in hardly any loss of nutrients.

Lactose intolerance and other intolerances

Sometimes there is uncertainty as to whether your symptoms are really caused by lactose or whether there is something else behind it. In fact, there are several food intolerances that can cause similar symptoms. So here is a brief look at the differences and correlations:

Cow's milk allergy vs. lactose intolerance: as mentioned above, allergy and intolerance are fundamentally different. In the case of recurring symptoms after milk, it should be clarified whether a genuine milk protein allergy is present - this usually begins in infancy and can affect the respiratory tract, skin and circulation, whereas lactose intolerance typically only occurs later and "only" causes abdominal symptoms. An allergist can use specific tests (prick test, IgE antibody determination) to determine whether a milk allergy is present. Incidentally, both conditions can overlap: An allergic person can also be lactose intolerant, but this is rare.

Fructose malabsorption: An intolerance to fruit sugar (fructose) also manifests itself in flatulence, abdominal pain and diarrhea if too much fructose is eaten at once. The mechanisms are similar - a transporter in the intestine does not work efficiently, fructose reaches the large intestine and is fermented there. Anyone who has problems after fruit, sweets or soft drinks, for example, should keep this in mind. An _H2 breath test with fructose can provide information. Fructose malabsorption is also common, but has nothing to do with lactose intolerance per se (different substance, different enzyme).

Histamine intolerance: Some people react to the consumption of histamine-rich foods (such as mature cheese, red wine, salami, sauerkraut) with symptoms that sometimes go beyond the intestines - such as headaches, reddening of the skin, palpitations, in addition to abdominal pain and diarrhea. Histamine intolerance is caused by an imbalance between the histamine intake and the degradation capacity of the enzyme DAO (diamine oxidase)【9】. If too little DAO is present, histamine accumulates in the body and causes symptoms. This intolerance is more difficult to diagnose and is often diagnosed by ruling out other causes. If you observe such systemic reactions in addition to digestive symptoms, it may be worth taking a look at the topic of histamine intolerance. You can find out more about the causes, symptoms and a low-histamine diet in our detailed article. Special enzyme supplements are also available to help: the enzyme DAO can be taken as a capsule to break down histamine in the intestine while eating. Such a supplement (e.g. DAO diamine oxidase) can bring individual benefits. However, the correlation between the intake of diamine oxidase and the alleviation of histamine intolerance symptoms has not yet been confirmed by the EFSA; further studies are required as an official health claim for DAO in histamine intolerance does not yet exist. Anyone who suspects histamine intolerance should consult an experienced allergist or gastroenterologist for clarification and care, as treatment can be more complex than for lactose.

Irritable bowel syndrome: Finally, it should be mentioned that some people have irritable bowel syndrome (IBS), in which various foods - often including dairy products - trigger symptoms without there being a clear intolerance. It is not uncommon for a placebo effect or expectation effect to play a role in irritable bowel syndrome patients: If you firmly believe that you cannot tolerate milk, your gut may react with discomfort【8】 simply due to nervousness. A thorough diagnosis helps to clarify the situation. Interestingly, some irritable bowel syndrome patients report that they experience an improvement with a lactose-free diet, although objectively there is no lactose malabsorption. This shows how individually the digestive system can react - so it is all the more important to test your own tolerance and not ban everything across the board.

Tips for everyday life and conclusion

Lactose intolerance ultimately requires conscious dietary behavior, but is easy to manage. Many sufferers emphasize that after a short adjustment phase, they hardly feel any restrictions in everyday life. Here are some practical tips that can help you stay symptom-free and still enjoy yourself:

• Know your tolerance limit: test what you can tolerate in quiet moments at home. For example, try 100 ml of pure milk and see if symptoms occur. If not, increase to 150 ml and so on. This way you will find out how far you can go. You can safely consume anything less than this outside the home.
• Combine dairy products cleverly: It is best to eat things containing lactose as part of a larger meal. Example: A piece of cheesecake as a dessert after a full lunch causes fewer problems than if you eat the cake alone on an empty stomach. Other foods slow down digestion and "buffer" the lactose.
• Always have lactase with you: It doesn't hurt to carry a few lactase tablets in your bag or car in case you spontaneously want to eat something containing milk. This gives you flexibility if, for example, ice cream is unexpectedly served at a party. Make sure you dose the preparation correctly (it is better to take enough than too little).
• Give preference to fermented milk products: yogurt, kefir and hard cheese are usually better tolerated than milk. Use these products regularly to cover your calcium balance. It often helps to eat a cup of yogurt instead of a glass of milk - the bacteria it contains do some of the work and provide probiotic benefits.
• Read labels: With new foods, it's worth taking a quick look at the ingredients list. If you see words like "skimmed milk powder", "whey powder" or "lactose", you know what's what. This can be particularly relevant for ready-made products. However, the quantities are often small enough that they don't bother you - this varies from person to person.
• Don't panic and find a balance: Lactose intolerance is unpleasant, but not dangerous. Try to be relaxed about it. If you accidentally ingest some lactose, it's no big deal - the symptoms usually subside within hours and don't cause any damage. Treat yourself to some quiet time, warmth for your stomach (e.g. a hot water bottle) and a cup of peppermint or caraway tea - many sufferers swear by these for flatulence. Over time, most people develop a good body awareness and know exactly when it's better to do without and when they can take it easy.

To summarize: lactose intolerance is easily manageable. You don't have to give up indulgence or necessarily live completely dairy-free. You can achieve natural relief for your gut by adjusting your portions, using lactose-free products and optionally taking lactase supplements. Scientific studies show that most people with lactose malabsorption can tolerate small amounts (approx. 12 g at a time) without any problems【2】【7】 - so it's all about finding the right balance. Certain plant substances and probiotic helpers can possibly provide additional relief, but the individual differences here are large and have not yet been definitively confirmed by the EFSA. Above all, it is important to ensure a balanced diet despite intolerance: Milk provides many nutrients, but you can also get these from other sources if you are informed. Don't be afraid to seek expert advice - doctors and nutritionists can support you, especially if you are unsure. Ultimately, you should feel good and be able to eat without complaints. With the knowledge from this article and a little trial and error, you will find your own personal way to make your liver - sorry, your digestion - happy (a little joke on the side for the loyal XTRAFUEL readers who still have the liver detox topic on their minds!) With this in mind, stay healthy and enjoy your (lactose-free) milk!