Lactose intolerance is a common symptom of ME chronic fatigue. Lactose intolerance means that the enzyme needed to process milk sugar, or lactose, is lacking. People who are lactose intolerant experience digestive problems, bloating, diarrhea, and skin problems after consuming milk.Foods that contain lactose which contain lactose include milk, cream, butter, cheese, fromage frais, ice cream, milk powder, condensed milk, buttermilk, custard, and most margarines. Some biscuits, cakes, breads sauces, soups, dressings, sausages, luncheon meats, tea/coffee whiteners, malt drinks, chocolate. Processed foods very often contain milk solids, skimmed milk, milk proteins, and non-fat milk that result in the symptom of lactose intolerance. Goat’s and sheep’s products contain lactose too.Some people with ME chronic fatigue have a milk allergy rather than lactose intolerance. A milk allergy does not mean that there is a missing digestive enzyme; it just means your immune system is not tolerant of certain proteins found in milk products. The most common allergen in milk is called casein. Common symptoms are digestive problems, catarrh, skin rashes, lethargy, irritability, blocked nose, sinus problems and excessive mucous production.There is a chance that people who have ME chronic fatigue and are lactose intolerant may be able to tolerate fermented cow dairy products such as yoghurt, cottage cheese or lassi (Indian yoghurt drink). This is because they contain ‘friendly’ bacteria which breakdown lactose. Some people may also be able to tolerate a small amount of organic butter.For those who have a milk allergy, all the foods classified as containing lactose above as well as all butter, yoghurt, cottage cheese, lassi, whey and whey related products must be avoided. Goat’s and sheep’s products however are OK as they contain only trace amounts of casein.Milk Alternatives• Non-genetically modified soya milk, yoghurt or cheese. Use sparingly as soya milk can cause other problems.• Rice milk or cheese• Oat milk• Almond milk• Coconut milk, may be diluted with water• Goat’s and sheep’s milk if milk allergy is the problem and not lactose intoleranceMeal Ideas for People with Me Chronic Fatigue who have Problems with Milk• Put milk alternatives on healthy cereals. Add cinnamon and a splash of apple juice to sweeten.• Hummus, mackerel pate, guacamole, tahini and nut butters such as almond or cashew are good alternatives to butter, cheese and cream.• Use olive oil, palm oil or coconut oil to cook with instead of butter?• Use coconut milk in a Thai green curry or as a sweet for m of milk.• Natural Soya yoghurt, blend with fruit• Fresh nuts and seeds, almonds, cashews, hazelnuts, pecans, sunflower and pumpkin seeds…• And of course, all fruit and vegetables are naturally dairy-free great snacks for people with ME chronic fatigue.