I know I’m preaching to the choir when I say that many celiacs and people with non-celiac gluten sensitivity struggle with a dairy sensitivity.
If you’re one of the lucky ones who is able to eat dairy, I’m happy for you (but I also secretly hate you just a tiny bit). I miss dairy terribly! But why do so many celiacs have a dairy sensitivity?
It’s probably best to begin by defining all the different ways you can “struggle” with dairy. It can be a tangled web of misued terms when you get into the specifics.
This is due in large part to the fact that people don’t always understand the difference between the terms intolerance, sensitivity, allergy, and autoimmune disease.
Intolerance – lacking an enzyme to digest a specific food, no immune response
Allergy – immune response in which IgE antibodies are formed (think: immediate physical response)
Imagine IgE antibodies as security guards. When they see a bad guy trying to sneak in (trigger food) they wake everybody up and tell your mast cells send out a swarm of cops to battle the the bad guy or trigger food.
The swarm of cops are the mediators that cause inflammation. So if mast cells in your lungs swarm the trigger substance, you may have difficulty breathing. If mast cells in your skin answer the IgE call, you may get hives.
Autoimmune Disease – when your immune system attacks your healthy body tissue
Sensitivity – when white blood cells respond to a substance/food and release mediators, no IgE antibodies involved (think: delayed physical response)
Let’s say you eat a food to which you’re sensitive. It goes through the digestive process and passes into your blood. Your white blood cells send out a swarm of cops (mediators) to battle the trigger food.
Since this is happening in your blood, symptoms can be wide ranging, from body aches, headaches, joing pain, to gut issues.
1. DAIRY INTOLERANCE (MILK SUGAR)
Lactose intolerance means your body cannot break down the lactose sugar in dairy. Our bodies use enzymes to break down food so we can access the nutrition inside it.
Lactase is the enzyme our body uses to break down lactose. If you’re lactose intolerant, you are lacking a sufficient amount of the lactase enzyme.
Enzymes are catalysts—they speed up chemical reactions. Almost all metabolic processes in your body’s cells need to be accelerated so the processes happen fast enough to sustain life.
Without any enzymes, we’d die—chemical reactions would take too long.
So enzymes are absolutely crucial to our health. Insufficient enzyme production is actually at the root of many health issues and chronic conditions.
In fact, a number of inherited diseases are due to a lack of a particular enzyme.
The lactase enzyme is made by the cells that line the small intestine and by the bacteria living in the small intestine.
Celiacs usually have quite a bit of damage to their small intestine (at least when they are first diagnosed and begin living gluten free).
So celiacs with intestinal damage will not be producing much lactase (if any) and will struggle to digest dairy.
Common symptoms inlcude digestive problems such as bloating, gas, constipation, or diarrhea.
Theoretically this should resolve as your gut heals, and after a couple years, you should be able to tolerate dairy again.
However, it has been my experience that some celiacs have a permanent sensitivity to dairy products.
LACTOSE INTOLERANCE AND GENETICS
Many people are lactose intolerant because they have a genetic predisposition that causes them to stop producing the lactase enzyme as they get older.
So if you are predisposed to reduced lactase production, and you have to stop consuming lactose for health reasons, you may not regain your previous lactase enzyme production levels.
Research has shown that almost all Native Americans and Asians become lactose intolerant. About 1/2 to 4/5 of Latinos and Blacks become lactose intolerant.
On the flip side, only about 1/10 of people hailing from northern Europe develop lactose intolerance.
Some scientists have actually stated that lactose persistence (the continued ability to digest dairy) is the strange phenomenon, and that losing the ability to digest dairy is normal.
2. DAIRY ALLERGY (MILK PROTEIN)
Food intolerances don’t involve the immune system, but allergies do. A dairy allergy is when your immune system treats the protein in milk like an enemy. So your body releases antibodies to neutralize the threat.
When you ingest milk again, IgE antibodies identify the milk proteins and tell your body to release substances which cause an allergic reaction.
A dairy allergy is one of the most common allergies in kids. Cow’s milk is typically the trigger for a milk allergy, but other animal milks (goat, buffalo, sheep, etc.) can trigger a reaction.
Milk has two main proteins, casein and whey, and a person can be allergiec to either or both.
Common sympoms include difficulty breathing or coughing, hives, swelling, itching, tingling, eyes watering, nose running, vomiting, and cramps.
A serious milk allergy can also give rise to anaphylaxis, a potentially fatal reaction that where the airways swell and a person may become uable to breathe.
Interestingly, peanuts are the #1 culprit for anaphylaxis, tree nuts holds the #2 position, and #3 is milk.
3. DAIRY INTOLERANCE (MILK PROTEIN)
While some people do have issues with whey, casein is normally the offending milk protein when it comes to intolerance. Casein accounts for more than 80% of the protein found in milk.
A casein intolerance is when you don’t have enough of the enzyme necessary to digest the milk protein.
This is different than lactose intolerance. Casein intolerance is the inability to digest milk protein and lactose intolerance is the inability to digest milk sugar.
4. DAIRY SENSITIVITY (MILK PROTEIN)
Dairy sensitivity/casein sensitivity is due to a couple of causes. Both causes are the result of a person being suceptible to casomorphin (a byproduct of digested A1 casein).
Some people are fine with casomorphin–their bodies quickly deactivate and eliminate it. But others of us are not so fortunate.
One cause is having a leaky gut that lets casomorphin enter your body during the digestive process.
Another cause is because you don’t have sufficient amounts of the enzyme needed to deactivate the casomorphin.
Let me break it down. Without additional information, that’s a little confusing.
A1 CASEIN VS A2 CASEIN
There are two types of casein – A1 and A2. A1 casein is digested differently than A2 casein, creating a protein fragment called beta-casomorphin-7 (BCM-7 or casomorphin).
Casomorphin can elicit an inflammatory immune response due your body’s subsequent release of histamine.
Casomorphin is basically an opiate. It attaches itself to the same brain receptors as morphine, heroin, and other drugs.
Have you ever had a really strong craving for cheese?? Now you know why! Cheese is a highly concentrated form of casein (it has like 7 times more than milk).
Some scientists think casein functions in this manner to make sure babies (human and animal) nurse a healthy amount.
But did you know you also have opiod receptors in your nervous system, immune system, endocrine system, and intestinal tract?
This study showed that drinking milk with A1 casein:
“…worsens gastrointestinal symptoms, increases gastrointestinal transit time, increases serum inflammation markers, lowers total fecal SCFA content, slows cognitive processing speed, and decreases processing accuracy compared with the baseline values. Consumption of milk containing only A2 β-casein did not adversely affect these variables, indicating that the changes observed with milk containing both β-casein types were attributable to the presence of A1 β-casein.”
The study also references research associating A1 casein with neurological problems, autism, schizophrenia, delayed motor develpment in infants, and a host of other issues.
There is also research that indicates A1 casein is a factor in type 1 diabetes, food allergies, circulatory issues, SIDS, and postpartum depression.
Again, some people produce enough of the enzyme that neutralizes casomorphin that they have no issue at all eating dairy.
But if you’re struggling with systemic inflammation or have health issues you’re trying to unravel, you may want to consider a dairy free diet for a few weeks and see how it impacts your health.
Since dairy sensitivity/casein sensitivity is not an allergy, you can’t detect it with an allergy test.
And casein can be a tricky ingredient to avoid because it’s used as a filler and binding agent in many processed foods labeled “milk free” or “dairy free.”
So casein sensitivity may be difficult to pinpoint since it may not correlate with dairy consumption. You may eat pancakes, a sandwich, cereal, gravy, or protein powder and have a reaction.
IgG and IgA antibodies are typically found in those with casein sensitivity, but their presence alone can’t be used for diagnosis so there’s no simple test to identify it.
However, if you had recurring ear, throat, or chest infections when you were a child, it is likely you have a sensitivity to A1 casein.
EATING CASEIN FREE
A1 casein is in the milk of Friesian and Holstein cows, the main types of cows in the US and Europe.
Jersey cows and cows in Asia and Africa provide milk that contains mainly A2 casein. Other mammals (such as goats) make milk exclusively with A2 casein.
If you want to try and go casein free to see how you feel, there’s a thorough list of ingredients to avoid here.
5. CELIAC DISEASE AND CASEIN
There are a number of studies showing a correlation between celiac disease and dairy intolerance/sensitivity–basically if you have one (celiac disease or an issue with dairy), you have a much higher chance of having the other.
This study shows that cow’s milk may:
“…contribute to persistent symptoms in coeliac patients who are on a gluten-free diet. The finding that casein induced an inflammatory response similar to that produced by cow’s milk identifies casein as one candidate behind the observed reaction to cow’s milk.”
They also state the relationship may simply be that “patients with CD are sensitized to a broad range of dietary proteins.”
Interestingly, the study cites research suggesting that casein is an “environmental trigger of other autoimmune disorders.”
If you’re celiac and you eat dairy and you’re struggling with inflammation, fatigue/exhaustion, brain fog, digestive distress, etc., you may want to eliminate dairy for a few weeks and see how you feel.
If you have a dairy sensitivity, you may need to remove dairy from your diet. But before you give everything up, try A2 casein products (like goat and sheep dairy) to see how you do with them.
If you feel your gut is in good shape and you want to try and reintroduce dairy to your diet, test the entire dairy spectrum to see what you can tolerate.
Try oranic, grass-fed, goat, sheep, camel, fermented (kefir), raw, aged or hard cheese, etc. You may find you have a dairy sensitivity to some things and not others.
If your issue is strictly lactose intolerance, digestive enzymes can be very helpful.
Disclaimer: This is not medical advice, nor is it intended to replace the advice or attention of heath-care professionals. This information is for educational purposes only. All information is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions.