not all need to be refridgerated. I bought align and took 3 pills and got really sick...so I am really interested in how it will be for you. I realize we are all different though. Secondly, lactose intolerant people usually can handle some amount of lactose so it depends on how severe it is for you. I don't think milk protein and lactose are the same thing though... I believe lactose is a sugar !! if it does contain lactose I wonder if lactaid would help !!! good luck anyways.