Some people believe that they’re lactose intolerant when what they really have is a true milk allergy. “There’s actually a pretty big difference,” Ansel says. “Lactose intolerance has to do with an inability to metabolize or break down lactose. That’s a metabolic issue.”
In contrast, “An allergy to milk has to do with your immune system. When you drink milk, your body perceives one of the proteins in milk as a foreign invader. Your body responds by producing antibodies to fight that protein. When those antibodies are released, it causes the symptoms of an allergic reaction.” True milk allergies are far less common than lactose intolerance.
Milk allergy symptoms can include itching, swelling, hives, runny nose, or difficulty breathing Ansel says, “You could also have digestive symptoms. That’s why a lot of times, people confuse milk allergy with lactose intolerance. They do sometimes have overlapping symptoms.”
“Allergy can be a dangerous thing,” she adds. If you suspect that you might be allergic to milk, ask your doctor about allergy testing. “You really shouldn’t try to diagnose it yourself.”
If you learn you do have a milk allergy, buying lactose-free milk products will still cause symptoms. Talk with your doctor about the nondairy, plant milks, from almond to soy that might be right for you.
Nondairy Alternatives for Vegans
Nondairy beverages, or plant-based "milks," appeal to vegans and some vegetarians.
“There’s a lot of variety, which is great,” Ansel says.
Hemp, multigrain, oat, and potato milk are on the market. But the old standbys -- almond, rice, and soy milk -- are by far the most common for drinking and cooking, says Suzanne Havala Hobbs, DrPH, MS, RD, author of Living Dairy-Free for Dummies.
Nondairy milks vary in taste and consistency. For example, soy milk has a thicker consistency than cow’s milk, while rice milk is thinner. Rice milk is a popular choice, Hobbs says, because it “looks bright white, just like cow’s milk.” Almond and soy milk have a slightly beige color. Almond milk also has a faint almond taste.
When choosing a beverage, be aware that the various types of dairy and nondairy options differ in key areas of nutrition.
Lactose-free cow’s milk is high in calcium and other nutrients and is often fortified with vitamin D like regular cow's milk.
Nondairy alternatives can vary in their nutritional values. It’s smart to compare the label to cow’s milk to make sure that you’re getting similar levels of fortification, nutrients, and protein. “If you’re not able to drink milk, these are a good way -- as long as they’re fortified -- to get calcium and vitamin D,” Ansel says.