<<Disclaimer: Verify this information before applying it to your situation.>> Original question: "Can someone explain if there is a difference in "cows milk protein intolerance" and "lactose intolerance?" Because so many of you requested that I forward all my responses to you, I am summarizing at length the replies. Hope they are helpful as they were to me. Thank you all for your help. Almost everyone stated that there is a distinct difference between cows milk protein intolerance and lactose intolerance. However, there were a few that felt they are the same. My doctor explained that with cows milk proteing intolerance the body actually creates antibodies to fight the protein (just like gluten). Here's the responses from the Listserv. Thanks to all, Jill in Texas (newly diagnosed gluten intolerance, milk, egg, yeast ) "Casein intolerance is quite common in celiacs as casein is very like gluten at the molecular level ( looks alike to the immune system). This is not the same as lactose intolerance which may subside after the villi return to normal.." "No, unfortunately, it's not the same. Lactose intolerance is due to the lack of enzyme lactase. Lactase is naturally made on the tips of the villi -- the area damaged by Celiac. Once the intestine heals, the tips heal and begin to produce the lactase again (usually).Milk protein intolerance is something like gluten intolerance. Both casein and gluten are proteins that triggers an autoimmune reaction." ALLERGY TO CASEIN OR WHEY http://www.parentsofallergicchildren.org/allergy_to_casein_or_whey.htm "Allergic reactions to casein and/or whey protein are caused by an immunological sensitivity to milk protein - rather than the sugar. A reaction to casein or whey can cause breathing problems, hives and rashes, abdominal pain, and possibly serious weight loss. While there are at least 30 types of potentially allergy-causing proteins in milk, casein is the most prevalent. The proteins lactalbumin and lactoglobulin, which comprise the whey proteins, are also known to cause problems.Because whey proteins are changed by high heat, those sensitive to why can sometimes tolerate evaporated, boiled, or sterilized milk and milk powder. That other 80% of milk, the casein, is unfortunately for sensitive folks, heat stable. It's also the most common allergen in cheese, which seems to be particularly craved by those who can't have it. The harder the chees, the more casein it contains.And because milk proteins are not altered sufficiently when milk is converted to other dairy products like cheese or yogurt, the only way to avoid reactions is to avoid milk in all its forms.Interestingly, too, the molecular structure of casein is similar to that of gluten, and those with celiac disease may also suffer from casein intolerance." "One and the same, why would you want to add back milk? there are better substitutes." "No, it is two different things. I have a milk protein intolerance and can never drink milk. When I have to slightest hidden amount, I react. I am taking a drug 4x a day with lactose in it and it hasn't bothered me the way I thought it would. I thought I would get a milk reaction, and I haven't. If I were you, I wouldn't add it back, but if you do, and you are truly allergic, you will find out soon enough." "As far as I know they are the same. If you problem was really bad with milk I would wait a little longer to make sure your villi are really healed. I added hard cheeses first and went slowly at first with yougart and milk." "I would think the test is saying they only know you are allergic to cow's milk, vs goat, sheep, etc. Cow's milk is the most common at least in this country, so that's probably all they were concerned about in the test, which generally also means lactose intolerant.I know I was lactose intolerant for at least 12 years, but after being diagnosed with CD, then continuing lactose and gluten free diet for another year, I was able to slowly reintroduce milk back into my diet. I can now ingest approx 1 cup of milk product without getting sick." "Lactose is the sugar in milk, not the protein. The enzyme to digest this sugar is called lactase and is manufactured by cells at the tip of the villi in the small intestine. The reason most people can eat dairy products again after a year +/- is that the villi tend to "regrow" from base to tip. However, it is a demand system. If you don't *use* it, you can permanently lose the ability to manufacture it. That's why people who quit drinking milk in their teens can't suddenly start again when they fear osteoporosis. They can no longer make the enzyme. Lactaid brand enzyme can be added to milk before drinking to make it easier to digest (tablets are GF, not the liquid-last time I checked). Some foods have less lactose than others-butter, hard aged cheeses, ice cream and sour cream are lower in lactose than milk and fresh cheeses. These foods are sometimes easier to eat sooner."