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Differences and similarities between lactose and gluten intolerance

Verschillen en overeenkomsten tussen lactose- en glutenintolerantie

Lactose and gluten intolerance are two of the most common food sensitivities that affect millions of people worldwide. Understanding the similarities and differences between these conditions is crucial for people who want to manage their symptoms and live a healthy lifestyle. In this blog post we will explore the world of lactose and gluten intolerance, compare their symptoms and effects on the body, and provide practical tips for diagnosis and management.

Brief summary

  • Accurately identifying the cause of food sensitivities is essential to distinguishing between lactose and gluten intolerance.
  • Gluten intolerance can present with characteristic symptoms such as brain fog, rash and joint pain.
  • Managing both conditions requires a balanced diet that avoids triggering foods while using available alternatives for healthy eating.

Understanding lactose intolerance and gluten intolerance

Lactose intolerance and gluten intolerance are often confused because of their similar symptoms, including bloating, abdominal pain and digestive problems. However, these conditions have different causes and mechanisms in the body. Lactose intolerance occurs due to the body's inability to digest lactose, a sugar in dairy products, due to insufficient lactase enzyme production.

On the other hand, gluten intolerance, also known as non-celiac gluten sensitivity, results from an adverse reaction to gluten, a protein present in wheat, barley and rye. In some cases, individuals diagnosed with celiac disease who adopted a gluten-free diet were actually responding to symptoms caused by lactose intolerance rather than gluten sensitivity.

This highlights the importance of accurately identifying the cause of one's food sensitivities to ensure appropriate dietary adjustments.

What is lactose intolerance?

Lactose intolerance is a digestive condition that affects an individual's ability to digest or absorb lactose — a type of sugar found in milk and other dairy products. It can cause various gastrointestinal symptoms, as well as many other health problems. When someone with lactose intolerance consumes dairy, their body lacks enough lactase enzymes to break down the lactose. As a result, the undigested lactose travels to the colon, where it is fermented by bacteria, leading to common symptoms such as bloating, flatulence, diarrhea, nausea and stomach cramps. It is important to note that lactose intolerance is not an allergy, but rather a digestive problem.

Although lactose intolerance can cause discomfort and inconvenience, it is a manageable condition. By making informed food choices, people with lactose intolerance can avoid lactose-containing products and still maintain a balanced diet.

What is Gluten Intolerance?

Gluten intolerance, also called gluten sensitivity, is a disorder in which the body reacts negatively to the ingestion of gluten, a protein found in wheat, rye and barley grains. Possible symptoms may include bloating, abdominal discomfort, diarrhea, flatulence, fatigue, skin problems and more. Although the exact cause of the symptoms remains uncertain, it is believed that FODMAPs, a group of poorly digested carbohydrates, may be responsible.

Individuals with gluten intolerance should adhere to a gluten-free diet to avoid symptoms associated with the disorder. Fortunately, there are plenty of gluten-free food options available, making it easier for those affected to maintain a balanced and nutritious diet.

Comparison of Symptoms and Effects

Although both lactose and gluten intolerance share some common symptoms, such as abdominal pain and bloating, they also exhibit unique manifestations. Lactose intolerance usually presents with abdominal discomfort, flatulence, diarrhea, nausea and stomach cramps, while gluten intolerance can cause additional symptoms such as brain fog, rash and joint pain.

Recognizing these differences is essential to accurately identify and manage respective food sensitivities.

Common Symptoms

Abdominal pain and bloating are typically associated with both lactose and gluten intolerance. These symptoms can be quite uncomfortable and interfere with daily activities. In the case of lactose intolerance, the undigested lactose in the large intestine leads to increased gas production, which causes bloating and abdominal pain. For people with gluten intolerance, consuming gluten-containing foods can cause a similar reaction, resulting in abdominal discomfort and distension.

Although these common symptoms can make it difficult to distinguish between lactose and gluten intolerance, observing other unique symptoms can help identify the correct food sensitivity and ensure appropriate dietary adjustments.

Unique Symptoms

Although the common symptoms of lactose and gluten intolerance can be quite similar, there are some unique manifestations that can help distinguish between the two conditions. In the case of lactose intolerance, there are no exclusive symptoms that can be attributed to lactose intolerance alone and are not present in other types of food intolerance.

On the other hand, gluten intolerance can present with distinctive symptoms such as brain fog, rash and joint pain. Recognizing these unique symptoms can be crucial in accurately diagnosing and managing the respective food sensitivities.

Long-term health consequences

Untreated lactose and gluten intolerance can cause long-term health problems. In the case of lactose intolerance, reducing dairy intake or avoiding dairy can lead to reduced bone density, brittle fractures, malnutrition and osteoporosis. For people with celiac disease who continue to consume gluten, continued gluten ingestion can lead to long-term complications such as nervous system problems, malnutrition, and mental health problems such as depression and anxiety.

It is crucial to consult a health professional and seek appropriate diagnosis and treatment for lactose and gluten intolerance to avoid these potentially serious long-term health consequences. Proper management of these food sensitivities, through dietary adjustments and medical advice, can help reduce the risk of complications and improve overall health.

Diagnosis of Lactose and Gluten Intolerance

Diagnosing lactose and gluten intolerance can be a complex process, as their symptoms often overlap with those of other food sensitivities. To accurately identify the cause of a person's symptoms, a combination of diagnostic tests and elimination diets may be necessary.

Consulting with a health professional and maintaining a regular diet for two weeks, along with keeping a food/symptom diary, can help determine what type of sensitivity one has to certain foods.

Lactose hydrogen test

The lactose hydrogen test is a diagnostic procedure used to diagnose lactose intolerance. It measures the amount of hydrogen gas in a person's breath at regular intervals after ingesting lactose. The test is usually performed in two parts. During the first part, the person provides a basic breath sample. They then drink a drink containing lactose and take breath samples at regular intervals over the next two hours.

An increase in hydrogen level of 20 ppm compared to the pre-test level is considered a positive test, indicating lactose intolerance. This test can provide valuable information for people experiencing symptoms consistent with lactose intolerance, helping them make informed dietary choices and better manage their condition.

Blood Tests and Elimination Diets for Gluten Intolerance

Diagnosing gluten intolerance can be challenging because there are no reliable tests that can accurately diagnose gluten intolerance. Serological tests that check for antibodies, such as the tTG-IgA test, are used to diagnose gluten intolerance, but they do not directly assess gluten hypersensitivity. Alternatively, elimination diets can be used to identify foods that may be causing symptoms of gluten intolerance. This requires removing all sources of gluten from the diet for a period of time and then reintroducing them one at a time to determine which foods are responsible for the symptoms.

Although blood tests and elimination diets can be labor-intensive and difficult to follow, they can help identify the source of symptoms and provide a method to manage them. An accurate diagnosis allows people with gluten intolerance to make appropriate dietary adjustments and improve their overall well-being.

Management of Lactose and Gluten Intolerance

Management of lactose and gluten intolerance mainly revolves around dietary changes and substitutions. By avoiding products that contain lactose and foods that contain gluten, people can relieve their symptoms and maintain a balanced diet.

There are numerous lactose-free and gluten-free food options available, which can make it easier for those affected to adhere to necessary dietary restrictions.

Gluten Free Foods

For people with gluten intolerance, there are plenty of gluten-free food options available. Fruits, vegetables, meat, poultry, fish, dairy products, beans, legumes, nuts and certain whole grains are all suitable for a gluten-free diet. Many whole foods are naturally gluten-free, making them a safe choice for people with gluten sensitivity.

On the other hand, processed foods such as bread, pasta, cereal, cookies or crackers, cakes and pastries, pies, gravies and sauces often contain gluten and should be avoided. To maintain a balanced and nutritious diet, it is essential to consume a variety of gluten-free foods, limit processed foods and examine food labels to detect hidden sources of gluten.

By doing this, people with gluten intolerance can effectively manage their symptoms and live a healthy lifestyle.

Lactose-free Dairy Products

For people with lactose intolerance, lactose-free dairy products and alternatives are available. These products include milk, cream cheese, sour cream, yogurt, kefir and butter. Low lactose cheeses include Parmesan, Swiss cheese and cheddar.

In addition to these lactose-free dairy products, non-dairy alternatives such as almond milk, coconut milk and soy milk can be used. Including these lactose-free dairy products and alternatives in the diet can help people with lactose intolerance avoid their symptoms while still getting essential nutrients. This allows them to maintain a balanced and nutritious diet without compromising their well-being.

Tips for a Balanced Diet

When managing lactose and gluten intolerance, it is essential to maintain a balanced diet that provides essential nutrients. For people with lactose intolerance, alternative sources of calcium should be considered, such as soft-boned fish, leafy vegetables and calcium-fortified products such as breakfast cereals and juices.

Those with gluten intolerance, on the other hand, should focus on consuming a variety of naturally gluten-free whole foods, including fruits, vegetables, meat, poultry, fish, dairy, beans, legumes and nuts. By including a wide variety of nutrient-dense foods and avoiding processed foods that may contain hidden sources of lactose or gluten, people can effectively manage their food sensitivities while maintaining a balanced and healthy diet.

Secondary Lactose Intolerance and Celiac Disease

There is a link between secondary lactose intolerance and celiac disease, because people with celiac disease can also develop lactose intolerance. The damage to the small intestine caused by celiac disease can hinder the ability to adequately break down lactose, resulting in symptoms of lactose intolerance. Interestingly, following a gluten-free diet can improve symptoms of lactose intolerance in certain cases, as healing the small intestine can restore production of the lactase enzyme.

One study found that cow's milk protein allergy may be the underlying factor when some children do not respond to a gluten-free diet. Allergy to milk proteins may be the cause of their persistent symptoms. Withholding cow's milk resulted in a rapid return to normal in asymptomatic children whose blood test and biopsy results had previously indicated continuous damage from celiac disease. This highlights the importance of an accurate diagnosis and appropriate dietary adjustments to manage both lactose and gluten intolerance.


In conclusion, understanding the similarities and differences between lactose and gluten intolerance is essential for people who want to manage their symptoms and live a healthy lifestyle. An accurate diagnosis through various tests and elimination diets can help determine the cause of a person's food sensitivities, allowing for appropriate dietary adjustments. By avoiding products containing lactose and foods containing gluten, individuals can relieve their symptoms and maintain a balanced diet. Furthermore, understanding the relationship between secondary lactose intolerance and celiac disease can provide valuable insights into the complex relationship between these conditions and aid in the development of effective management strategies.

Frequently Asked Questions

Can you have lactose and gluten intolerance?

Yes, it is possible to have both lactose intolerance and gluten intolerance. Many experts recommend being evaluated for celiac disease before starting a gluten-free diet.

How do you test for gluten and lactose intolerance?

To test for gluten and lactose intolerance, your doctor may perform a hydrogen breath test to measure the amount of lactose in your system after drinking a liquid with high levels, as well as blood tests to measure specific antibodies, skin tests to diagnose milk protein allergies, and tests for celiac disease such as biopsies, tTG IgA tests, EMA tests, total serum IgA tests, DGP tests, genetic tests, and home tests.

These tests can help diagnose the condition and determine the best treatment. Depending on the results, your doctor may recommend dietary changes, medications, or other treatments.

What Can Mimic Gluten Intolerance?

It is important to be aware that the symptoms of gluten intolerance can mimic those of a wheat allergy or intestinal disorders such as irritable bowel syndrome (IBS). Estimates suggest that 10-15% of American adults have IBS-like symptoms, so it's worth being aware of alternative potential causes of perceived digestive distress.

It is important to consider other possible causes of digestive problems, as gluten intolerance may not be the only cause. Taking the time to investigate other possible causes can help ensure that the correct diagnosis is made and the best treatment plan is developed.

Is milk gluten-free?

In conclusion, milk and most dairy products are naturally gluten-free and a safe option for those following a gluten-free diet.

It is important to always check the labels of flavored yoghurts, cottage cheese and puddings for the presence of gluten.

Check if any food or ingredient has gluten

Check any ingredient like white bread to read more about its likely gluten content.

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What is Tolerase® G?

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