Hi --

With respect to kosher markings: Generally speaking, some hechshers 
(kosher supervisors) are better than others. I go into this in some 
detail on my web site, but the rule of thumb is that a large hechsher 
(such as OU) combined with a large manufacturer (such as Kellogs) is a 
very good bet for safety, whereas a local hechsher vetting a small 
manufacturer, such as a local bakery, is less reliable from the allergy 
standpoint. However, I purchase baked goods from a local parve (no milk 
EVER) kosher baker in my area, and everything there is safe and 
delicious. That's because the baker NEVER uses milk products, so
cleaning between runs isn't an issue.

With respect to medications ... even pharma-grade lactose is rarely 
100% casein-free. Whether it's a problem for you depends upon your 
personal tolerance for casein. However, inhaled lactose (as in 
Singulair) should not be a problem for someone who is lactose 
intolerant (rather than any kind of milk-allergic). That's because 
lactose intolerance is a digestive issue. If the lactose isn't in the 
digestive system, there should be no issue. In the small quantity 
present in medications, the lactose should not be an issue for most 
people anyway, since most people who are lactose intolerant (not all, 
of course) still
have a little bit of the digestive enzyme lactase in their systems ... 
just not enough for most purposes. And a lactaid pill (whatever they're 
called?) should solve the problem for the rest of you.

My web site refers to one compounding pharmacy, but there are others. 
Sometimes your own neighborhood pharmacy may be able to recommend a 
local one.

I hope these thoughts help,
--Beth Kevles
 Eating without Casein webmaster
 http://web.mit.edu/kevles/www/nomilk.html
   I am not a doctor, so none of the preceding is medical advice. 
Consult with your own practitioner.


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