Lactose Intolerance In America’s Dairyland

(Just a quick CW for mentions of lactose intolerance, dairy, and being sick when those two things come together. No gross details.)

As a US citizen who has always had decent health insurance but not enough spare money to pursue all of my minor ailments to full comprehension, I’ve gotten pretty good at finding ways to deal with minor day-to-day health issues. Now, this practice is no replacement for actual medical aid, nor are my actions entirely without negative consequence (the thing about trial and error is that you get a lot of errors before you find out what works, generally speaking), but as a person living in an imperfect system who is methodical in almost everything they do, I’ve managed to mostly resolve a few minor problems that come up for me. I keep a close watch on them, of course, making sure I’m not ramping up my mitigations without realizing it to account for worsening symptoms because I know there’s a chance that they’ll graduate from minor problems to major problems, but so far this strategy has paid off pretty well for me, all things considered.

The best example, and the one I’m going to focus on, involves my lifelong issues around digesting dairy. I’ve never been terribly good at it, and was diagnosed around five or six with lactose intolerance. It’s not a terribly helpful diagnosis, since it seems to have been more of an observation than a diagnosis that helped me to work around the problem or mitigate the symptoms, but it was enough for my parents to invest in a lot of dairy alternatives in the mid-nineties. I drank a lot of rice milk as a child, along with frequent changes to soy milk and the occasional almond milk. I say “drank,” but I really only consumed milk in cereal. Since I’d always gotten sick after drinking milk, eating cheese, or having ice cream, I grew up without developing much of a taste for any of them, but cereal was a frequent staple of my childhood breakfasts so my milk substitutes were primarily for that purpose.

A few years in, I started using lactaid tablets to help me deal with my dairy inability, but had mixed results with them. I felt better than if I’d done nothing, of course, but I still didn’t feel good. By around eight or nine, the only dairy I consumed was in the form of cheese on pizza, which didn’t seem to bother me as much, between the lower ratio of dairy to other types of food and the small benefit I got from lactaid tablets. Until my senior year of college (over a decade later), I lived a primarily dairy-free existence. The only reason I returned to dairy was because I was broke, cereal was cheap, and I was in Wisconsin (the so-called “Dairy State”). It had become difficult to avoid.

What I learned that year was the threshold. Apparently, I could eat a certain amount of dairy without a problem. It seemed to fluctuate a bit, based on factors I failed to nail down, but I knew I was fine with one serving a day of most dairy. If I wound up picking some kind of heavier cream product, I had to do a half or a quarter serving or else I’d get sick. Since then, I’ve tried to figure out what causes this to fluctuation and while I haven’t figured everything out (I think some part of it has to do with total dairy in my system and how frequently I’ve been eating dairy, but that’s difficult to quantify given that it involves constantly exposing myself to something that makes me feel awful), I have learned a few interesting lessons.

The most basic of them (and perhaps the most obvious), is that I have an easier time with dairy products if I’ve also eaten something acidic in the hour before the dairy. A nice tall glass of sour lemonade or a cup of grapefruit juice does the job, as does tomato sauce or an orange. Which is why most of the ice cream I’ve eaten in my adult life was proceeded by a good spaghetti dinner. And this is also why I keep grapefruit juice in my fridge at all times. Another one I discovered entirely by accident after getting a wisdom tooth removed is yogurt. If I have some yogurt, I’m usually fine with a moderate amount of dairy for the rest of the day, more so even than when I’ve had something acidic.

I could speculate about why these things allow me to digest dairy more easily than I normally can, but I don’t really know for sure and I’d like to avoid spreading misinformation. There’s plenty of research out there about stomach acid acidity levels and the probiotic benefits of yogurt, but not a lot that connects either one of those to allowing people to digest dairy better. I’ve thought about trying to chase this down with a doctor since I’ve discovered in recent years that lactaid tablets don’t work at all anymore, but that’s a decent amount of money, a great deal of risk during this pandemic, and an untold number of doctor’s visits, all without any guarantee of a solution or even more accurate speculation than I’m doing right now. Maybe someday, if it becomes less risky to go to the doctor’s office again (if my area starts taking masking more seriously, maybe), but for now I’m just gonna stick to my grapefruit juice and yogurt.

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