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When it comes to the primary deficiency, Green sees a fundamental digestive issue at play: humans are the only mammals to continue to drink milk after they’re weaned. In Africa, Asia and the Middle East, he says, dairy products are not common to the diet so that when they are introduced into it, the body is not prepared.
As well, as people age, their digestive systems tend to become more sensitive in general, reacting to spicy foods or dairy products with some level of burping, bloating and discomfort.
Fortunately, replacing or reducing dairy has become easier these days and lactose intolerance seldom requires complete avoidance (as is the case with milk allergy). Dennis, who is co-author of the book Real Life with Celiac Disease: Troubleshooting and Thriving Gluten Free, says that if you need to replace cow’s milk, try a milk alternative made from almond or hemp. Some people will be able to tolerate whole (cow’s) milk.
Other foods rich in calcium include fish such as salmon and perch, leafy green vegetables like kale and spinach and sesame seeds, while vitamin D is found in fatty fish (think salmon again), beef liver and egg yolks. And don’t forget vitamin and calcium supplements.
“You need to make sure that you’re making up what you lack, especially when you’re talking about kids,” Dennis says. “While their guts will heal much faster than do those of adults, they’re also growing and need the protein, vitamin D, calcium, phosphorus and calories to thrive.”
“The good thing,” she continues, “is that we know so much more today. When I was diagnosed, I had a sharp learning curve to follow all on my own.”
Dairy: Not All or None
Many people who are lactose intolerant can to eat hard cheese and yogurt without symptoms. Others may have to take a lactase pill to aid digestion.
Consult with your doctor if you suffer with the following after eating dairy-based foods:
• abdominal pain
• bloating or nausea
A breath test, simple and non-invasive, may be recommended.
Case Study: Living with No Gluten, Little Dairy
When she was diagnosed with celiac disease 18 years ago, Lee Graham, the president of a Massachusetts celiac support group called Healthy Villi, did what she was supposed to: she cut gluten from her diet and waited to feel better. When she continued to have abdominal symptoms, she temporarily cut dairy out, too, waiting a good half year before testing what milk products she could, and could not, eat.
“I can have small amounts of yogurt, ice cream and milk with cereal, not every day, but every so often,” says Graham. “If I had something like yogurt every day, I’d have problems.”
Sherry Condo, a hospital clerk and fitness buff who makes her home in Kahnawake Mohawk Territory south of Montreal, already knew she was lactose intolerant when she was diagnosed six years ago with celiac disease. She has changed her diet, save for the few times a year she that she succumbs to the siren call of Peanut Butter Parfait from Dairy Queen despite the hot fudge sauce and the milk.
“I know I should never do it but sometimes, I have such a craving,” the 48-year-old admits. “It’s not something I do on the spur of the moment, like, ‘Let’s go to Dairy Queen and be bad.’ I have to plan it all out because I know that the next day I need to be safe in my house near a bathroom.”
Her gastroenterologist, whom she sees every six months for blood work and a colonoscopy, can tell when she has been cheating.
“He’ll put his hand on his hips, shake his head a few times and scold me. But I’m doing really well. I had to have iron transfusions three times in the month after I was diagnosed with celiac disease and I never want to be in that position again.”
And then, there is Margie Sweeney, an obstetrician/gynecologist just outside of Boston who suffered from severe fatigue, bloating, severe itching and joint swelling before she eliminated first gluten and then dairy from her diet. These days, she doesn’t touch either, for fear of reliving symptoms that once caused her to double over in pain.
“If I miss anything, it’s cheese. I would take eating cheese over gluten any day,” she says.
“But I don’t spend too much time thinking of the things I can’t eat and really try to focus on the things that I can and enjoy. I remind myself how much better I feel.”
Celiac Disease’s Toll on Your Teeth