The short answer is “Likely, no.” In untreated celiac disease, the lining of the small intestine (microvilli) is damaged by the ingestion of gluten. The enzymes (lactase) on the tips of the villi are responsible for absorbing milk sugar (lactose). Until they heal, the enzymes are temporarily unable to do their job which can lead to symptoms of lactose intolerance, such as gas, bloating, loose stool or diarrhea, and sometimes constipation.

This is a very common occurrence in patients with newly treated celiac disease. At BIDMC’s Celiac Center, if we suspect this is an issue, we will recommend a few months of a lactose-free or lactose reduced trial. In the meantime, substitutions can be lactose free milk or yogurt, hard and aged cheeses (edam, parmesan, romano, cheddar) or non -dairy beverages such as almond, coconut or rice milk (note: these typically have no protein) or soy milk. All must be labeled gluten-free. This trial period is then followed by a gradual rechallenge of the lactose-containing foods, as tolerated.

Some patients find that they cannot tolerate milk at all. They might:
A. Be highly sensitive to lactose, even in small amounts

B. Be unable to tolerate milk proteins (whey and, more often, casein)

C. Have a true food allergy to milk

D. Have chosen to avoid animal products for ethical, environmental or other health reasons.

In all cases, they can work with a dietitian to ensure they are getting adequate calcium, vitamin D, and other nutrients in their diet. Fortunately, there are many, many non-dairy sources of calcium in our food chain. If necessary, nutrient needs can be met through gluten-free supplements.

Celiac Center, Beth Israel Deaconess Medical Center. Lactose Intolerance. https://www.bidmc.org/centers-and-departments/digestive-disease-center/services-and-programs/celiac-center/celiacnow/nutrition-and-the-gluten-free-diet/lactose-intolerance/level-3.

Reviewed and updated October 4, 2022.