That was the line I read in a comment on a web discussion by someone who was diabetic and had just found out they were also lactose intolerant. It was, in a way, the impetus for this blog. I knew the feeling. By the time I figured out that I was lactose intolerant, I was very used to being diabetic. I had gotten used to a low carb, low sugar diet. I was used to being on insulin, detecting the symptoms of lows and staying away from the things that caused my blood sugar from getting too high. I was consistently getting A1C test results below 7 and even below 6.5. It had become a way of life for me. While some might be shocked to hear that I was used to taking three shots of insulin a day, I really am.
But cutting out sugar was not that hard for me. Sure I missed chocolate chip cookies and certain sweets, but on insulin I could still have an occasional cookie and that seemed to be enough for me. I never really had a sweet tooth. I found that I was ok with a single bite of something sweet after dinner and a square of dark chocolate or a piece of fruit was enough to satisfy that urge. But give up cheese???? Stop eating pizza???? I didn’t think that was going to work.
My doctors told me that everyone has a different tolerance for lactose and that I had to find my level. They also told me that the pills that were supposed to help this worked for some people and not for others and that I had to experiment with the pills to figure out what dosage worked for me. I was hopeful that if I just popped a couple of pills before sitting down to a Caprese salad everything would be fine.
The package on the “Dairy Relief” pills suggested 2-3 pills before a meal containing dairy so I started with two. Then 3. I tried 4, 5, 6. I think there may have been some benefit but not much really. Certainly not enough to enjoy a Caprese salad. At this point I don’t even bother with the pills. I have just concentrated on figuring out what level of dairy in my meal I can and can’t tolerate. And it’s not much. Often, I can get by ok with small amounts of butter in cooking. But pretty much anything else causes uncomfortable digestive symptoms. I know other people for whom it’s a question of amount. They can have a little dairy but not a lot. Or for others, the pills allow them to have butter or at least some cooked dairy.
The fact is that every person is different and will have different levels of tolerance. There are no tests to help you figure it out and the only way to do so is by trial and error. You need to pay attention to: (1) ingredients, (2) amounts, (3) means of preparation, and (4) your own tolerance for the symptoms that result. It’s not a bad idea to keep a food diary and a diary of how different foods affect you at least at the beginning. That will help you map out the quantities and parameters of what you can eat.
With respect to ingredients, look for hidden forms of dairy. There have been many times I thought I ate a meal that did not have dairy and then I subsequently had digestive issues. I was convinced I had some other form of food intolerance until I learned that something in that meal had dairy hidden within. For example, some brands of cold cuts have dairy in them. I had no idea and thought I had some sort of intolerance to nitrates or some types of ham until I did some research and realized that it was hidden lactose.
Quantities and preparation are also important factors. For me, most baked goods are fine. I can even eat a croissant. I have seen how they are made. I know that they are filled with layers and layers of butter. But for some reason they do not affect me. I also know that I can tolerate a meal when a little bit of butter was used when cooking it. But I can’t have something cooked in “butter sauce” and I would never eat a buttered roll.
I only know these things because of trial and unfortunate error. As I said, everyone is different and there is no other way that I know of to map out your particular level of tolerance. You need to understand both the timing and severity of the likely symptoms if your meal results in the “error” part of trial and error. This can be very helpful in deciding whether a particular meal is a good time to take a risk (given who you are with, what you have to do, ability to get to a bathroom etc.). If a meal is good enough, a little discomfort might be worth it. But if you’ve got a big presentation later that day or you are on a first date, maybe not.
A couple of important things to remember and myths to bust:
- Mayonnaise is not dairy – it is made from eggs and oil.
- Sorbet does not have dairy – although it does have sugar!
- Yogurt is dairy but there are now many forms of non-dairy yogurt. You just have to be careful about sugar content. More on this to come.
The most important thing is to read labels and ask questions. The more you know, the better choices you can make to eat food that makes you feel good. If you are in a restaurant, don’t be afraid to ask questions. Understanding what you are eating and how it is affecting you is the only way you are going to get a handle on this. You will get better and better at it as you go along, and you will feel better and better as a result. Most restaurants are very accommodating about your questions and there are usually at least a few things on the menu that will be fine. If someone gives you attitude, don’t go back. No one should make you feel bad about asking about what you are about to eat. Remember, a good restaurant wants you to enjoy your meal. So don’t feel bad about asking the questions you need to ask in order to make that happen.