Can Celiacs Have Milk Products? A Guide to Dairy and Intestinal Health

October 27, 2025 •

4 min read

Nearly 70% of people with newly diagnosed celiac disease experience some form of lactose malabsorption. This common occurrence begs the important question: Can celiacs have milk products safely, or are dairy alternatives the only option moving forward?

Quick Summary

Plain dairy is naturally gluten-free, but many newly diagnosed celiacs experience temporary lactose intolerance due to intestinal damage. This typically improves as the gut heals on a strict gluten-free diet, and dairy can often be reintroduced gradually. Some individuals may require continued lactose management.

Key Points

Initial Intolerance is Common: Many newly diagnosed celiacs experience temporary lactose intolerance due to intestinal damage impacting the lactase enzyme.
Plain Dairy is Gluten-Free: Naturally, cow's milk and other plain dairy products are safe for celiacs, but vigilance is needed for processed, flavored, or added-ingredient versions.
Healing Restores Tolerance: Following a strict gluten-free diet allows the gut to heal, and for most, this restores the body's ability to produce lactase and digest dairy normally.
Manage Symptoms During Healing: During the initial recovery period, opting for lactose-free products, low-lactose cheeses and yogurts, or using lactase supplements can provide relief from digestive symptoms.
Address Nutrient Deficiencies: Celiacs are at risk for calcium and vitamin D deficiencies due to malabsorption; if dairy is avoided, seek out fortified alternatives or other non-dairy sources.
Read Labels Carefully: Always check labels on processed dairy products, as additives like thickeners or flavorings can sometimes contain hidden gluten.
Consult a Professional: Working with a dietitian is highly recommended to create a personalized plan for managing dairy intake and ensuring adequate nutrition during recovery.

The Link Between Celiac Disease and Lactose Intolerance

At its core, celiac disease is an autoimmune condition where gluten ingestion damages the villi lining the small intestine. This damage disrupts the body's ability to absorb nutrients properly. The same damage also impacts the production of lactase, the enzyme responsible for breaking down lactose, the sugar found in milk. When the body doesn't produce enough lactase, undigested lactose travels to the large intestine, where bacteria ferment it, leading to symptoms like bloating, gas, stomach pain, and diarrhea. This is known as secondary lactose intolerance, and it's a common complication of untreated celiac disease.

It is critical to distinguish this temporary lactose intolerance from a genuine milk protein allergy, which is a different immune response altogether. Unlike a lactose issue, a milk allergy requires complete avoidance. For celiacs, the lactose problem is a secondary effect of gluten-induced gut damage, and it often resolves over time once a gluten-free diet is strictly followed and the gut has had a chance to heal.

The Dairy Management Strategy: A Two-Phase Approach

Navigating dairy on a gluten-free diet typically involves two phases: managing symptoms during the initial healing period and gradually reintroducing products as your gut recovers. It is always wise to consult a healthcare professional or registered dietitian before making significant dietary changes, especially when dealing with a nutrient-dense food group like dairy.

Phase 1: During Intestinal Healing

For those with new or persistent celiac symptoms, it may be beneficial to temporarily reduce or eliminate high-lactose dairy products. A strict gluten-free diet is the cornerstone of healing, but limiting lactose can provide symptom relief while the intestines recover.

Choose Low-Lactose Options: Hard, aged cheeses (like cheddar, Swiss, and Parmesan) contain very little lactose. Yogurt and kefir also have reduced lactose content due to the fermentation process. Many individuals find they can tolerate these products even during the healing phase.
Opt for Lactose-Free Products: Fortunately, the market is saturated with lactose-free milk, yogurt, and other dairy items that provide all the nutrients without the lactose.
Consider Lactase Supplements: Oral lactase enzyme tablets can be taken with lactose-containing foods to help with digestion.
Explore Dairy Alternatives: Nut milks (almond, cashew), rice milk, and fortified soy milk are excellent sources of calcium and other nutrients, but always check labels to ensure they are gluten-free and adequately fortified.

Phase 2: Reintroducing Dairy

As your gut begins to heal, which can take weeks to several months, you can start to reintroduce dairy products gradually. This process helps you determine your new level of tolerance.

Start Small: Begin with a small amount of a high-lactose product, such as regular milk, and monitor your symptoms.
Keep a Food Diary: Documenting your intake and any associated symptoms will help you and your dietitian identify your personal tolerance threshold.
Work with a Dietitian: A registered dietitian can supervise the reintroduction process and ensure your diet remains nutritionally sound.

Comparison Table: Dairy Tolerance Considerations for Celiacs


Feature	Newly Diagnosed Celiac	Celiac in Remission (Healed Gut)
Lactase Levels	Often reduced due to intestinal damage.	Usually returns to normal as the gut heals.
Symptom Risk	High risk of lactose intolerance symptoms (bloating, gas, diarrhea) from dairy.	Lower risk of lactose intolerance, can often consume dairy without issues.
Recommended Dairy Approach	Consider temporary reduction of high-lactose dairy; prioritize lactose-free, low-lactose, or alternative options.	Can often reintroduce dairy, starting with small amounts to test tolerance.
Risk of Malnutrition	High risk of nutrient deficiencies (like calcium and vitamin D) if dairy is avoided without proper replacement.	Lower risk, but still requires monitoring to ensure adequate nutrient intake.

Potential Nutritional Deficiencies and Sources

Untreated celiac disease often leads to malabsorption, which can cause deficiencies in vital nutrients like calcium and vitamin D. Since dairy is a primary source of these, managing intake is crucial. If you are temporarily avoiding dairy, it's essential to compensate for these nutrients to prevent complications such as osteoporosis.

Sources of Calcium and Vitamin D

Lactose-Free Dairy: As mentioned, lactose-free products contain the same amount of calcium and vitamin D as their regular counterparts.
Fortified Plant-Based Milks: Choose plant-based alternatives (like soy, almond, or rice milk) that are explicitly fortified with calcium and vitamin D.
Fish: Canned salmon (with bones) and sardines are excellent sources of calcium.
Leafy Greens: Dark, leafy greens such as broccoli, kale, and spinach provide calcium.
Supplements: In cases where dietary intake is insufficient, a healthcare provider may recommend calcium and vitamin D supplements.

Gluten Contamination in Processed Dairy Products

While plain dairy is safe, processed dairy products can pose a risk of cross-contamination or hidden gluten-containing ingredients. It is vital to read all labels carefully.

Common Sources of Hidden Gluten in Dairy:

Flavored Milks and Yogurts: Thickening agents or flavorings may contain gluten.
Processed Cheese Products: Some processed cheeses or cheese spreads use gluten-based additives.
Malted Milk: Malted beverages contain barley and are not gluten-free.
Additives: Watch out for ingredients like modified food starch, malt, and certain thickeners unless specifically certified gluten-free.

For more information on living gluten-free, consult reputable resources like the National Celiac Association.

Conclusion: Dairy Isn't Necessarily a Permanent Foe

In summary, the answer to "Can celiacs have milk products?" is nuanced. Plain dairy is naturally gluten-free and safe for celiacs. The temporary issue of secondary lactose intolerance, often experienced during the healing phase, is a result of intestinal damage caused by gluten. As the small intestine recovers on a strict gluten-free diet, most individuals will find that their ability to digest lactose returns. Managing dairy intake, whether through lactose-free products, low-lactose items, or supplements, is a manageable part of recovery. By following a personalized plan with professional guidance and being vigilant about label-checking for hidden gluten, celiacs can successfully incorporate dairy back into their diet without compromising their health or intestinal healing.

Frequently Asked Questions

Celiac disease causes damage to the villi in the small intestine, which are responsible for producing the lactase enzyme needed to digest lactose. This damage leads to a temporary deficiency of lactase, resulting in secondary lactose intolerance.

For most celiac patients, lactose intolerance is temporary. As the small intestine heals on a strict gluten-free diet, lactase production typically returns to normal, and dairy can be tolerated again.

Hard, aged cheeses like Parmesan, Swiss, and cheddar contain very low levels of lactose. Some fermented products like Greek yogurt and kefir are also often well-tolerated due to the breakdown of lactose during processing.

There are many non-dairy sources of calcium, including fortified plant-based milks, leafy greens (like kale and broccoli), and canned fish with bones. Supplements may also be necessary if dietary intake is insufficient.

Lactose intolerance is a digestive issue caused by an inability to break down lactose, leading to bloating, gas, and diarrhea. A milk allergy is an immune system response to milk proteins, which can cause hives, swelling, or even anaphylaxis, and does not damage the intestine.

Yes, some processed dairy products like flavored yogurts, sauces, and spreads can contain hidden gluten from thickeners, modified starches, or flavorings. It is crucial to always read the ingredient labels carefully.

The healing time varies for each individual, but for many, it can take anywhere from a few weeks to several months for the small intestine to recover and lactase production to normalize.