Are lactose-intolerant people more likely to get osteoporosis?

January 5, 2026 •

4 min read

An estimated 30 to 50 million Americans are lactose intolerant, leading many to reduce or eliminate dairy, a primary calcium source. This avoidance raises a critical question: Are lactose-intolerant people more likely to get osteoporosis, a condition characterized by weakened, brittle bones?

Quick Summary

The relationship between lactose intolerance and osteoporosis is indirect. A higher risk may emerge from poor dietary management leading to insufficient calcium and vitamin D intake, rather than the intolerance itself.

Key Points

Indirect Link: Lactose intolerance does not directly cause osteoporosis, but the avoidance of dairy can lead to lower calcium intake, increasing risk.
Conflicting Research: Studies on the direct correlation between lactose intolerance and bone mineral density have produced conflicting results, highlighting the importance of managing dietary intake.
Critical Nutrients: Adequate intake of both calcium and vitamin D is essential for bone health, with vitamin D aiding in calcium absorption.
Diversify Sources: Lactose-intolerant individuals can obtain sufficient calcium from many non-dairy sources, including fortified plant milks, leafy greens, and canned fish with bones.
Lactose-Friendly Options: Hard cheeses and yogurt with active cultures are often tolerated by individuals with lactose intolerance and can be good calcium sources.
Supplements May Be Necessary: Calcium and vitamin D supplements can help ensure adequate intake, especially if dietary sources are insufficient.
Holistic Approach: Bone health is also influenced by lifestyle factors like weight-bearing exercise, not smoking, and limiting alcohol.

The Indirect Link Between Lactose Intolerance and Osteoporosis

Research has produced conflicting results regarding a direct link between lactose intolerance and bone mineral density (BMD). The primary concern is not the intolerance itself, but the behavioral change that often accompanies it: the avoidance of dairy products. Since dairy is a major source of calcium and vitamin D, eliminating it from the diet without proper substitution can lead to nutritional deficiencies over time.

Some studies show that individuals who report lactose intolerance and actively avoid dairy have lower calcium intake and, subsequently, poorer bone health. Other studies, however, find no significant difference in BMD between lactose-intolerant and non-lactose-intolerant individuals. This disparity suggests that the outcome is heavily influenced by how individuals manage their diet following a lactose intolerance diagnosis. Those who consciously replace dairy with other calcium-rich foods or fortified products can mitigate their risk, while those who simply cut out dairy are more susceptible to long-term bone health issues.

The Crucial Role of Calcium and Vitamin D

Bone mass is accrued rapidly during adolescence and peaks by age 30 before slowly declining. Adequate calcium intake throughout this lifecycle is paramount for building and maintaining strong bones. Vitamin D is equally important as it facilitates the body’s absorption of calcium. Without sufficient vitamin D, the body can only absorb a fraction of the calcium consumed, leading to the body drawing calcium from bones to support other functions, causing bone density to decrease.

Dairy products are well-known for their high calcium content, but the body can absorb calcium from many other sources. For lactose-intolerant individuals, diversifying their dietary intake is key to meeting daily requirements and minimizing osteoporosis risk.

Navigating Calcium Intake with Lactose Intolerance

Managing your diet strategically can ensure you get all the necessary nutrients for strong bones without relying on high-lactose dairy. Several effective approaches exist:

Choose Lactose-Friendly Dairy Products: Aged cheeses, like cheddar, Swiss, and parmesan, contain very little lactose and are well-tolerated by many. Yogurt with active, live cultures can also help with lactose digestion. Additionally, many grocery stores offer lactose-free milk and cottage cheese.
Incorporate Non-Dairy Calcium Sources: A wide variety of foods are naturally rich in calcium or are fortified with it.
- Leafy Greens: Bok choy, kale, and collard greens are excellent sources. Spinach contains calcium but also high levels of oxalates, which can hinder absorption.
- Fortified Foods: Many cereals, orange juices, and plant-based milks (soy, almond, oat) are fortified with calcium and vitamin D.
- Canned Fish: Canned salmon and sardines with the bones are rich in both calcium and vitamin D.
- Beans and Nuts: White beans, almonds, and figs contribute to your daily calcium intake.
Consider Supplements: If dietary intake is still inadequate, a calcium supplement can help, often combined with vitamin D. It's important to discuss this with a healthcare provider to determine the right dosage and monitor intake to avoid adverse effects.

Comparison: Dairy vs. Non-Dairy Calcium Sources


Feature	Dairy Milk (e.g., Cow's Milk)	Fortified Plant-Based Milk (e.g., Almond, Soy)	Leafy Greens (e.g., Kale, Bok Choy)
Calcium Content	High; approx. 300mg per 8 oz glass.	Fortified to be similar to cow's milk.	Variable; depends on type and serving size.
Vitamin D	Often fortified with vitamin D.	Often fortified with vitamin D.	Generally not a significant source.
Lactose Content	High in regular versions. Lactose-free versions available.	Lactose-free.	Lactose-free.
Absorption	Generally good, especially when fortified with vitamin D.	Can be hindered by natural compounds like phytates.	Bioavailability can be excellent, but some types (like spinach) have inhibitory factors.
Other Nutrients	Excellent source of protein, potassium, and other vitamins.	Varies by product; often high in other vitamins/minerals.	Rich in fiber, antioxidants, and other vitamins.

Lifestyle Factors for Stronger Bones

Beyond diet, several lifestyle choices significantly impact bone health:

Weight-Bearing Exercise: Activities that force your body to work against gravity, such as walking, jogging, dancing, and weight training, stimulate bone growth and increase density.
Avoid Smoking: Smoking is known to harm bone health and can trigger earlier menopause in women, leading to accelerated bone loss.
Limit Alcohol: Excessive alcohol consumption can interfere with calcium absorption and increase fracture risk due to poorer nutrition and a higher risk of falls.
Sunlight Exposure: While caution is necessary, getting some sun exposure helps your body produce vitamin D naturally. This is an important consideration for overall vitamin D levels, especially for those who spend limited time outdoors.

Conclusion

While lactose intolerance itself does not directly cause osteoporosis, the risk is elevated for individuals who inadequately compensate for the loss of calcium and vitamin D from avoiding dairy. It is not a foregone conclusion, but a matter of proactive dietary management. By consciously incorporating a variety of alternative calcium sources, including fortified foods, leafy greens, and specific dairy products, lactose-intolerant individuals can maintain robust bone health. Combined with a healthy, active lifestyle, they can significantly lower their risk of developing osteoporosis. Consulting with a healthcare professional or registered dietitian is highly recommended to create a personalized plan and consider supplementation when necessary.

For more information on bone health, consult the National Institutes of Health Osteoporosis and Related Bone Diseases ~ National Resource Center.

Frequently Asked Questions

No, lactose intolerance itself does not weaken bones. The risk of developing osteoporosis comes from the dietary choices made in response to the intolerance, specifically the potential for inadequate calcium and vitamin D intake from avoiding dairy.

Excellent non-dairy calcium sources include fortified plant-based milks and juices, tofu made with calcium sulfate, leafy greens like kale and bok choy, and canned fish with bones, such as salmon and sardines.

Vitamin D is crucial because it helps your body absorb the calcium you consume. Without enough vitamin D, your body cannot effectively use calcium, which can lead to low bone density and increased osteoporosis risk.

Yes, many people with lactose intolerance can tolerate certain dairy products. Hard cheeses and yogurts with active cultures generally contain less lactose and are often well-tolerated. Gradual reintroduction of small amounts can also improve tolerance.

While generally safe, calcium supplements can cause side effects like gastrointestinal issues for some people. Excessive intake can increase the risk of other health issues, so it is important to consult a healthcare provider for appropriate dosage.

Yes, exercise is vital for bone health. Weight-bearing and resistance exercises, like walking, jogging, and lifting weights, stimulate bone growth and help maintain bone density, which is not achieved through diet alone.

Symptoms of low calcium intake can be subtle. Over time, inadequate intake can contribute to low bone density, which is often called a 'silent disease' because it has no obvious symptoms until a fracture occurs. A doctor can use a bone density test to assess your bone health.

Lactose intolerance is a digestive issue caused by an inability to break down lactose, a milk sugar. A milk allergy is an immune system reaction to the protein in milk. The symptoms and management strategies are different, and a proper diagnosis is important.