Dairy Intolerance: Causes, Symptoms, Solutions

By Kristi Kalinsky, RD, LD
April 4, 2024


Dairy intolerances, dairy sensitivities, and dairy allergies are all becoming more and more common these days. How would you know if you might have issues with dairy? Are there common dairy inflammation symptoms to look for? And if you find you might have a reaction to dairy, what do you do about it? 

When thinking of a typical dairy sensitivity or dairy intolerance, most of my clients assume that I’m referring to a “lactose intolerance” which encompasses unpleasant symptoms such as nausea, loose stools, bloating and/or gas after eating foods such as milk, cheese or yogurt. This type of lactose malabsorption is related to the inability to fully digest dairy, specifically the lactose, or milk sugar, in the dairy products. 

Dairy sensitivities and dairy allergy symptoms can also present in other ways, with other symptoms, which can be eye opening and make you stop and think. Let's take a look at the differences to see if your health problems and dairy allergy symptoms land in one of these categories. 

What's The Difference Between A Food Allergy, Food Sensitivity, And Food Intolerance? 

There are some differences between true food allergies, food sensitivities and food intolerances. 

Do You Have A Food Allergy? 

A food allergy, or allergic reaction, is defined as a severe immune system response after coming into contact with a certain food. The severe allergic reaction can be life threatening and can result in difficulty breathing, itching/hives, difficulty swallowing and/or swelling of the lips, tongue and/or throat. This usually occurs within a few minutes of ingesting the food. 

How To Test For A Food Allergy 

Food allergy testing is strongly recommended so offending foods can be avoided. Blood tests aren’t always accurate as they can provide false positive results, so the gold standard at this time is to do an oral food challenge under the supervision of a physician. The potentially offending foods are slowly consumed and in increasing amounts while monitoring for reactions from food allergies to occur. 

Do You Have A Food Sensitivity? 

A food sensitivity also involves the immune system, such as an allergy, but to a less severe degree. A dairy sensitivity is not life threatening and can include GI issues like constipation or loose stool, rashes, joint pain, fatigue, acne or other skin issues (eczema, rosacea, psoriasis), brain fog, difficulty breathing, etc. 

Do You Have A Food Intolerance? 

A food intolerance usually involves the GI tract and the inability to properly process and digest a food we have eaten leading to unpleasant digestive symptoms. As mentioned above, a dairy intolerance would include being lactose intolerant. 

The lactose, or dairy sugar, present in dairy products is unable to be digested or broken down properly in the small intestine. Individuals with this problem don’t have enough lactase, an enzyme, which is needed to break down lactose into a less complex form so it can be absorbed into the body. 

With low lactase production by the small intestine, milk sugar is undigested, which can wreak havoc on the digestive system. Water will draw into the bowels, leading to cramping, bloating, diarrhea and gas. The undigested milk sugar is also a fuel source for some of the bacteria in your gut, so as they feed on this, the by-product is gas and bloating. Individuals with lactose intolerance symptoms will notice problems anywhere from 30 minutes to 36 hours after ingesting a dairy product. 

How To Test For A Food Intolerance Or Food Sensitivity 

The gold standard to test for a food intolerance or a food sensitivity is an elimination diet. The offending food(s) are removed from the diet for 4-6 weeks. After this time, one food is introduced back into the diet, one at a time, and the individual monitors for the reoccurrence of signs and symptoms (GI distress, rashes, joint pain, brain fog, acne, asthma flares, skin conditions such as eczema or psoriasis, fatigue, etc.). Currently there aren’t any tests that are 100% accurate in diagnosing an intolerance or sensitivity. 


Ingredients In Milk That Can Create Intolerance Or Sensitivity 

Milk Proteins 

Cow's milk contains two different primary proteins, which are known as casein and whey. Casein and whey tend to contribute to more systemic inflammation in the body and appear to cause problems with the skin, lungs and sinus regions of the body but can also cause issues in the gut. 

Dairy Sugar 

The primary sugar found in milk is called lactose. As alluded to earlier, lactose primarily interferes with the GI or gut system in our bodies when not well tolerated because of the lack of the enzyme lactase. It is thought that approximately 75% of the world population is lactose intolerant to some degree. 

Symptoms of Lactose Intolerance or Sensitivities To Dairy Proteins 

1. How Dairy Products Affect Acne 

Simply put, acne is inflammation of the skin. It is a chronic inflammation condition that is defined as a disease of the sebaceous follicles of the skin. Dairy products have inflammatory components that are linked to an increased production of a hormone called Insulin-Like Growth Factor 1, which can lead to clogged pores that become inflamed and painful—both on the face and the body. 

The milk proteins, casein and whey, found in milk and dairy products can also cause an inflammatory response and acne. That means eating yogurt or cheese or drinking milk could cause some people to experience more breakouts. 

In addition, when combining both dairy and carbohydrate rich foods (like cereal or donuts), it overstimulates the sebaceous glands. So you can see that having a bowl of cereal and milk for breakfast is a recipe for more acne. Pizza is another food that could create acne for teens or adults. 

2. How Dairy Products Can Create Digestive Problems 

One of the most dramatic health changes I’ve witnessed in clinical practice was a young mom with a dairy sensitivity who was desperate for help with her digestion and gut health (she drove four hours to meet in person for her first appointment!). 

She was experiencing typical symptoms of lactose intolerance: gas, painful bloating, and intermittent bouts of fecal incontinence. It was getting to the point that she was fearful of riding in the car with her husband and being out in public with her kids because she was not sure if she would make it to the bathroom in time. 

During her initial consultation, we put together a dairy-free meal plan that helped get her symptoms and bowel movements under control in just three days. In our follow-up conversations, she said that any time she accidentally ate something with cheese or drank cow’s milk her symptoms would come roaring back for a few days. It was clear her body could not digest lactose! 

For clients with IBS (irritable bowel syndrome), the milk sugar (lactose) found in dairy can increase digestive problems like bloating and gas. According to the National Institutes of Health, “if individuals with lactose intolerance consume lactose-containing dairy products, they may experience abdominal pain, bloating, flatulence, nausea, and loose stool beginning 30 minutes to two hours later.” 

3. How Dairy Products Can Lead To Sinus Issues 

One of our nutritionists found that when she over-indulged in milk products like cheese or yogurt, her nose would start to drip, which often developed into a sinus headache. 

Dairy foods have also been shown to cause an increased mucus production, sinus and ear infections, and general congestion. Dr. Andrew Weil says, “casein, a protein found in dairy products, can increase mucus production and further irritate the immune system.”  Dr. Weil suggests taking a closer look at what you are eating to support your immune system. 

4. How Dairy Can Contribute To Autoimmune Diseases 

Dairy has been shown to contribute to asthma and psoriasis, which are both considered autoimmune diseases. The proteins, casein and whey, found in dairy products, can cause systemic inflammation throughout the body. This chronic inflammation tends to present itself with skin issues such as psoriasis and lung inflammation seen in asthma. 

Suspect You Might Have A Dairy Intolerance? 

Although dairy is cited as one of the top five inflammatory foods, we know each person responds differently to dairy - some have a severe reaction with milk consumption while others have a more subtle response. Sometimes symptoms of a dairy intolerance can show up a few days after you eat dairy! This is what makes food sensitivities and intolerances a bit of a challenge to figure out. 

If you experience any of the signs of dairy sensitivity mentioned above, I recommend that you avoid all dairy products for 4 to 6 weeks and see how your symptoms change. If you reintroduce cheese, yogurt, or other milk products only to feel your sinus symptoms, acne, digestive issues, asthma or breathing difficulties return, it may be time to follow a dairy-free nutrition plan. I created one below to help you get started. 

Foods To Avoid With Dairy Intolerance 

Here's a list of foods you'll likely need to avoid if you find you can't tolerate dairy: 

  • cow's milk 

  • cheese 

  • cottage cheese 

  • yogurt 

  • whey protein powder 

  • ice cream 

Dairy-Free Meal Plan


With a real, whole foods diet, there is still plenty of delicious foods you can eat for a dairy-free life. Many of our dietitians, nutrition educators, and staff are actually dairy-free, so we have lots of ideas. Here is an example meal plan of how a day of dairy-free eating might look: 

Breakfast:4 oz turkey breakfast sausage + 3/4 c. strawberries + 1 c. sugar snap peas + 1/2 avocado 

Mid-morning snack: NutriKey paleo protein powder + 1/2 banana + spinach + 1/3 cup full fat canned coconut milk blended together in a protein shake 

Lunch: Chicken Salad Supreme over mixed greens topped with 1/4 cup nuts or pumpkin seeds 

Snack: 2 hard-boiled eggs + sliced apple + 2 TBSP almond butter 

Dinner: Hamburger Soup + a side salad + 2-3 TBSP olive oil 

Bedtime snack: 1 cup carrot sticks + 1 mini cup guacamole 

What To Look For On The Label 

With the rise of dairy inflammation symptoms and lactose intolerance, there are a lot of new dairy-free or lactose-free products on the market. The trouble with many of these products lies in the ingredients. For example, non-dairy ice cream is still full of sugar. And many of the non-dairy milks and yogurts include gums that can cause gut upset. 

In addition, to make up for the lack of calcium in non-dairy alternatives, manufacturers add a cheap form of calcium, called calcium carbonate, into these products, which can actually line your blood vessels and cause hardening or calcification of the arteries, leading to cardiovascular disease. 

My advice is to stick with whole foods and check food labels to find products with no additives and minimal added sugar when looking for dressings, plant-based milks, or yogurts. Choose dairy-free products like non-dairy ice cream on special occasions. 

Often you can swap dairy products in recipes with a milk free alternative. 

Some Swaps To Try: 

  • Instead of milk or sour cream, use full fat canned coconut milk. 

  • Rather than topping your chili or tacos with sour cream or shredded cheese, try avocado slices. 

  • As a substitute for milk or cream in your coffee, find a plant-based milk like full fat canned coconut milk or almond milk with few ingredients. 

  • Instead of whipped cream, use chilled, whipped coconut milk. 

  • Skip the traditional ice cream and try "nice cream", like this Mango-Lime Dole Whip. 

  • Swap dairy-based dips for hummus with all the mix-ins or guacamole. 

Many of the recipes on our website or in our Weight & Wellness Way Cookbook are made without dairy or offer suggestions on how to make dishes dairy-free. 

A good dairy free option for protein powder is our sister company NutriKey's Vanilla or Chocolate Paleo Protein Powder. Paleo protein powders do not contain whey (the dairy protein) found in other protein powders. 

How To Live Free Of Lactose Intolerance Symptoms 

As you can see, dairy can create unwelcome symptoms and increased inflammation levels for many reasons, which could be a response to the proteins casein or whey and/or to the milk sugar lactose. If you are lactose intolerant, you might be able to eat butter, heavy cream, or other high-fat dairy sources from grass fed cows that naturally have very little lactose. 

Remember that your symptoms—like acne, bloating and gas, skin, and sinus problems—are a way that your body communicates with you. Listen to your body; don’t let a whisper become a scream for change. If you suspect you have a dairy intolerance and are not sure where to start, I would encourage you to set up an individual consultation with one of our nutritionists. 


Dairy or Milk Intolerance? Here are our favorite dairy-free recipes: 

Dairy-Free Recipes 


For more information on food sensitivities, check out these resources: 


LISTEN: Nutritional Yeast and Protein Portions - Ask a Nutritionist - Learn about nutritional yeast - a versatile superfood that can transform your meals and your health, especially if you're exploring dairy-free alternatives. 

LISTEN: How to Determine Food Triggers for Digestive Issues - Ask a Nutritionist-The only thing less fun than digestive issues is tracking down what triggers the issue in the first place. Two of the most common triggers for digestive issues are gluten and dairy. Listen for potential triggers as well as potential solutions to food based digestive issues.  

READ: Healthy Coffee Creamer Alternatives for ideas on how to make your coffee creamy and delicious without and the dairy. 

NutriKey Products Mentioned: 

Paleo Protein Chocolate and Paleo Protein Vanilla are two great-tasting beef protein powder that are rich in essential amino acids and contain absolutely no lactose/dairy. 

Weight & Wellness Way Cookbook & Nutrition Guide provides a balanced eating plan, over 110 delicious recipes, and tips and techniques for your success as a home cook. Follow this plan for six weeks and experience life-changing nutrition for yourself. 


  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3481796/                                                      

  1. Suuberg, Alessandra, Increasing Support for a Dairy-Acne Link: IGF-1, mTORC1, FoxO1, and Dietary Aggravation of Acne Vulgaris (June 16, 2017). Available at SSRN:https://ssrn.com/abstract=2987864 or http://dx.doi.org/10.2139/ssrn.2987864 

About the author

Kristi approaches her work with clients with a great deal of empathy and understanding. She knows people are very busy, so she coaches them by breaking down goals into small steps, so they are more easily achievable. “Change won’t happen overnight. It is a journey. We’ll make it doable. When goals are attainable, it is easier to feel and be successful when actively working towards health goals.” 

View all posts by Kristi Kalinsky, RD, LD


Are any of these symptoms the same in toddlers? :)
October 10, 2019 at 9:18 am


Yes these symptoms would be the same for a toddler, a dairy sensitivity can show up many different ways for different people and children. As for acne, especially for young children, dairy sensitivity can show up as lots of different types of skin issues as well.

I checked about all of these symptoms, which is why I need to avoid dairy now, which sucks. I know there are alternatives, but I do love my ice cream with milk. This article, https://www.ez.insure/landing/2020/06/is-dairy-free-the-way-to-be/ provided some great info and alternatives which makes it not seem so bad. It's a great read. Thoughts? What is your fave non-dairy icecream?
January 24, 2021 at 3:56 pm


Removing dairy from the diet can help relieve many common symptoms related to digestion, sinuses, skin problems, and more! So many people feel better by avoiding dairy that non-dairy alternatives are huge on the market these days! The trouble with many of these products lies in the ingredients. For example, non-dairy ice cream is still full of sugar. And many of the non-dairy milks and yogurts include gums for an appealing consistency, but also may cause digestive upset.

My advice is to stick with whole foods by making your own nut milk, for example, with no additives, and choosing these dairy-free products on special occasions.

Jeannine napuunoa
Every morning I cough and bring up mucus. Now I am having sinus pain
February 20, 2024 at 12:39 pm


This could definitely be a sign of a dairy sensitivity. We'd recommend avoiding all dairy products for 1-2 weeks and see how your symptoms change. A follow-up with a nutritionist would also be a great option to customize an eating plan specific to your needs.

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