Positions on dairy in a "paleo" diet aside...
I am lactose intolerant, which I started noticing when I was in high school and my daily carton of milk gave me digestive upset (well, I was sure this was it - could have been my sandwich bread, too). There had been a lull between that and my elementary, when I drank lots and lots of milk every day (it was not "cool" in middle school to buy milk!). So at 16, I stopped drinking milk, but kept eating ice cream, yogurt, cheese, etc. and suffered from mild to moderate bloating when I did. I ended up wising up and purchasing lactase enzyme supplements at some point in college, and took a few whenever I ate ice cream, but when I started getting very worried about symptoms, particularly in social situations, I would take enzymes for ANY dairy, including hard cheese and yogurt. My punishment seems to be that I had a dish of ice cream a month ago, with no enzymes, and suffered such severe GI distress that I could only eat "gentle" foods (broth, eggs, etc.) for a few days. A few years ago in college, I probably would have only had a bit of bloating and a little gas.
If I drink pasteurized cow's milk (or ice cream, milkshakes, etc.), it seems that no amount of enzymes will keep my gut from rebelling, badly. Raw milk produces a few rumbles, but nothing really awful - without supplementing enzymes. I have been popping a cautionary lactase supplement whenever I eat hard cheese, but perhaps I am doing myself a disservice here since a couple of years ago I doubt it would have bothered me without the lactase.
So I guess my questions are - can supplementation make intolerance worse, and is it possible to reverse this course? I have heard the latter suggestion bandied around, but never encountered any solid anecdotes or research on the subject. I do love my aged cheeses and heavy cream - it doesn't give me acne; my blood lipid profile is excellent; and I am not at all overweight.