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Lactose: How Much Can You Take?

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WebMD Feature

If your doctor just broke the news that you're lactose intolerant, don't assume that you'll never be able to savor another bite of ice cream.

At first, many people fear they'll have to give up all dairy products, says Dee Sandquist, MS, RD, a dietitian in Fairfield, Iowa. But with some experimentation, most people with lactose intolerance discover that they can still eat small amounts of dairy without triggering symptoms, such as bloating, gas, abdominal discomfort, diarrhea, or nausea. Dairy foods are important to the health of your bones because they are a large source of calcium and vitamin D, so you need to be mindful of how much of these bone-preserving nutrients you're getting.

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"Listen to your body and your symptoms," says Sandquist, who's also a spokesperson for the Academy of Nutrition and Dietetics.

Degrees of Severity

How much dairy you can eat depends on how much lactase enzyme your body makes, says Yuri A. Saito-Loftus, MD, MPH, an assistant professor in the Mayo Clinic's division of gastroenterology and hepatology. "That does vary a little bit from individual to individual. We don't know 100% what controls that. Presumably, it's genetically determined."

Some people with lactose intolerance can adapt. You may be able to add small amounts of lactose-containing products to your diet gradually and have fewer symptoms. "If you keep eating dairy, you can stimulate some lactase production," says Saito-Loftus. "That may help you better tolerate dairy products."

If your symptoms are so severe that you can't handle lactose in foods, talk to your doctor about how to ensure you are getting enough calcium and vitamin D.

What Foods You Can Eat -- and How Much

"Many people know their symptoms pretty well so they know if they can handle just a little bit or not. They have already experimented with it," Sandquist says. Those people may be able to keep a mental tally of foods or amounts to avoid. Other people gain a better understanding by jotting down notes. “A diary is extremely helpful because then you can log what symptoms you have, what you've eaten,” Sandquist says. “You can look back and see if there’s a pattern.”

Determine foods you can eat. If you're not sure which lactose-containing foods you can handle, experiment with one dairy food at a time, Sandquist says. You should be able to tell whether a dairy food bothers you within 30 minutes to two hours after eating it, because that's typically when any discomfort from lactose intolerance will set in. For example, drink a half-cup of dairy milk and see how well you tolerate it.

See how much you can eat. If you don't have symptoms from the food and amount you try, slowly keep increasing the amount to see at what point you do have symptoms. For instance, you may find you don't have symptoms with a cup of milk, but you do with one and a fourth cups of milk. So your tolerance level is one cup.

If you do have symptoms, try cutting back on the amount to see if you can handle a smaller portion. 

Once you've found how much of one food you can tolerate, start testing another food.

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