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Milk Allergy vs Lactose Intolerance

Last week I dragged myself into the allergist doctor. I’ve been delaying this appointment for years. Unfortunately I’ve become leery of specialist doctors. There are only so many misdiagnosis a girl can take though.

It all began with the rash on my scalp. When I was 15, the thing popped up almost overnight, covering the back of my scalp and a sliver of my neck. I can’t tell you how many topical creams, shampoos and oils I tried to get rid of the thing. And here I am at 29 with the same rash except now it’s traveled down my neck, to parts of my feet, my eyelids and my chest.

It’s a form of eczema. My sister has it as well. She saw a dermatologist last week for it, who prescribed a dandruff shampoo and a steroid topical cream. We’ve both tried this care method time and time again. The shampoo leaves my head itchy and dry while the steroid cream comes with a serious side effect. Prolonged use leads to adrenal gland suppression, which reduces the body’s ability to produce its own hormones. Not something I’m willing to risk.

I’m the person who thinks I can cure everything homeopathically and I only saw the doctor because I recently read a story about a women who treated a patch of dry skin with coconut oil and it turned out to be skin cancer. So I went.

The doctor entered the room and I launched into my allergy history. When I mentioned that my seasonal allergies have declined greatly since childhood, she explained that it can take up to three years for your body to adapt to new seasonal allergens after relocating to a new region. It’s very rare to grow out of seasonal allergies. Since high school, I have not lived in a specific region longer than five years. So my body just hasn’t had time to adapt. Give it time, my doctor said, those allergies will be back.

Then we got to the good stuff, food allergies. I’ve been tested for allergies and intolerances over the years but I never committed to the results. The last test I had five years ago showed I was intolerant to cow’s milk, sesame, sole fish, soy and cashews. I gave it a whirl for six months then went back to my old ways, which included a daily serving of greek yogurt. Yeah, not the best idea…

My doctor suggested the skin prick test (SPT). A SPT is used to measure the presence of IgE antibodies for a food. It’s performed by sightly scratching the skin and placing a drop of the food on that spot. After fifteen minutes, the skin will either become inflamed or remain neutral. Well I was 100% neutral except for cow’s milk, which blew up to a big, red bump.

So I am officially allergic to cow’s milk.

a1-a2-milk-dood-white-revolution

Milk Allergy vs. Lactose Intolerance

Allergies and intolerances are very different things. The way your body chemically reacts to the food is not the same. This was news to me. I always thought lactose intolerance and dairy allergy were somewhat interchangeable.

Food allergies cause an immune system response affecting multiple organs throughout the body. An allergy to cow’s milk is triggered by the milk proteins. When these proteins enter the body, your body goes into defense mode, fighting off the unwelcome protein. It can cause hives, diarrhoea, vomiting, eczema or even an anaphylaxis reaction, literally shocking your immune system. Which is why my doctor gave me an EpiPen.

After peanuts and tree nuts, milk is the most common allergen.

You can be allergic to one of more of the proteins in milk: albumin, casein or whey. These are found in various concentrations in different dairy products. When milk is coagulated, it separates into two forms, the curds and the whey. I always think of the nursery rhythm, Little Bo Peep lost her sheep… Anyway… The curds are the casein. Milk is composed of about 20% whey to 80% casein. You can make cheese from whey or casein and proportions vary.  Also, pasteurization breaks down whey protein so it’s possible that people with this allergy can tolerate pasteurized products.

Lactose intolerance is the decrease or lack of the lactase enzyme that is required to metabolize the milk sugar, lactose. Without this enzyme the milk sugar ferments in our guts, stirring around and causes distress. Unlike a dairy allergy,  it only affects the digestive system, leading to bloating, abdominal pain, gas and possible diarrhea and vomiting.

Those with an intolerance may be able to eat fermented dairy products, like yogurt, sour cream and buttermilk since they contain good bacteria that helps break down the lactose.

Can I still have Butter?

Butter is made of the fattiest part of dairy and contains very little milk protein. The higher the fat content of a dairy product, the lower its protein content. Clarified butter, or ghee, is butter that has had an even larger quantity of the milk protein removed. So those with a dairy intolerance can easily enjoy ghee. I can have butter or ghee occasionally without adverse symptoms.

How is Cow’s Milk Allergy linked to Skin health?

Eczema is commonly triggered by food allergies and often first occurs in infants. For years doctors thought that most babies would grow out of the allergy but a study by the American Academy of Allergy, Asthma & Immunology found this isn’t necessarily so. Children with more severe eczema are more likely to carry their allergy into adulthood. Sometimes eczema can be resolved just by removing that food from your diet. In my case, dairy is just one of the factors triggering my eczema. I still have more testing to do until it’s fully resolved.


Resources:

Diagnosis and management of food allergies: new and emerging options: a systematic review, http://www.ncbi.nlm.nih.gov/pubmed/25368525

Food Allergy, http://www.mayoclinic.org/diseases-conditions/food-allergy/expert-answers/food-allergy/faq-20058538

Milk Allergy, http://www.mayoclinic.org/diseases-conditions/milk-allergy/basics/symptoms/con-20032147

Ghee and Milk Protein, http://www.livestrong.com/article/523116-ghee-and-milk-protein/

Spotlight on Dairy Free, http://www.bbcgoodfood.com/howto/guide/spotlight-dairy-free

Natural course of cow’s milk allergy in childhood atopic eczema/dermatitis syndrome, http://www.ncbi.nlm.nih.gov/pubmed/12487205

Children with More Severe Eczema Less Likely to Outgrow Milk, Egg Allergy, http://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Media/Children-with-More-Severe-Eczema-Less-Likely-to-Outgrow-Milk,-Egg-Allergy.pdf

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