Are you lactose intolerant? I am. And I know a lot of other lactose intolerant people. Ingestion of lactose by someone who is lactose intolerant is not deadly or debilitating. The most common symptoms are intestinal discomfort, flatulence, and sometimes stomach cramps and a bit of loose stool. While it can occasionally cause severe diarrhoea, that is rare enough that it’s quite common among a lot of lactose intolerant people to occasionally risk eating dairy products just for enjoyment, especially if it’s a small amount. The entire nations of Japan and China are largely lactose intolerant; however, pizza and ice cream have become incredibly popular there. They find ways to cope. Perhaps with lactase supplements, or perhaps often just by keeping an eye out for a toilet nearby in case things go down badly. In a highly industrialized and technologically sophisticated country like Japan, it’s not a disaster to occasionally risk even severe diarrhoea.
Anyway, my point is that there are plenty of lactose intolerant people out there who, while keeping an eye for obvious sources of lactose, aren’t too concerned about such unexpected, minor possible sources of lactose.
I’m lactose intolerant, too. Enough so that I’ve actually researched the subject. And that means I know that most popular statements on the subject are wrong.
Most, if not all, of the people who avoid all dairy products because they claim that even the tiniest amount of lactose hidden in another product will give them horrible symptoms are imagining it. There have been multiple medical studies of lactose tolerance. They find that even large amounts of lactose don’t reliably produce symptoms in people who self-identity as lactose intolerant. There is literally no medical evidence that a bit of lactose not extracted from casein can cause any symptoms at all.
As I keep saying, if you want to avoid all dairy for this reason, you can do so. But there is no reason to. And you’re probably eating some dairy and not even noticing it. That means you’re avoiding food that you might like and would be healthy for no reason. Not really a good thing.
Haven’t you been reading the thread? A person can be allergic to the casein proteins or the whey proteins or both. Someone not allergic at all to casein can still have a milk protein allergy because of the whey.
Nope, I missed that. I hadn’t realized the thread had moved that far along.
However, my answer was specifically to the issue of lactose intolerance vs allergy, so your addendum doesn’t really change my point. Lactose != milk allergy (regardless of what specific protein the allergy is to).
There’s a lot of noise in the autism world, about kids benefitting from removing casein and gluten from their diets.
I believe the theory is, that in some people, the proteins get into the bloodstream more or less intact, and this has an effect on brain function, somehow acting like opiates. No, I never entirely understood the “opiate” reference but am not making it up.
As a matter of fact, we had our son (mild autism) on a casein-free diet for a number of years. This happened sort of accidentally - we’d pooh-poohed the casein-free / gluten-free theory, but he had a stomach bug that gave him a nasty case of the runs, and every time we tried offering him milk for a week or so, the runs got worse. I guess his gut needed to recover more from the bug.
Anyway - we noticed a small but significant improvement in his speech and behavior - so we kept him off of dairy for a while. We would periodically offer him something with dairy and while he didn’t lose speech, his behavior seemed to be worse. Not Jekyll-Hyde worse, fortunately. So, this was enough to convince us that keeping him largely free of dairy (while making sure he got his calcium elsewhere) was worthwhile for a while and unlikely to harm him.
We never tried gluten free - too hard to avoid gluten without pretty major lifestyle changes, and he’d been wheat-free from an allergy challenge a year or so earlier - during which time his behavior was worse (poor kid could hardly have any food he liked, we were doing a challenge of multiple foods at once).
Interestingly, a lot of vegetarian “cheese substitutes” have… casien. Which has always baffled me. I gather it’s there to improve the meltability, but if you’re eating the stuff it’s either because you have a milk allergy, or are a vegan - and that additive would make the product unusable in either case.
That is how my kid started on the “GFCF” (gluten free casein free) diet. It really didn’t affect his autism - but it certainly affected his skin. He used to have eczema galore. If we keep him on GFCF diet, the eczema is gone. Any time he gets his hands on some bread, he gets a mild rash. Any time some milk is ingested, he gets serious skin problems. We tested him for celiac disease and the tests were negative, so it’s not that.
So - those reactions to milk - they are not lactose intolerance. What are they?
We had allergy testing. The tests came back positive for everything under the sun, including milk. The doc told me that when test results are like that, it doesn’t mean that he’s actually allergic. It was inconclusive.
While the blood tests can help doctors identify potentially risky foods, they aren’t always reliable. A 2007 issue of The Annals of Asthma, Allergy & Immunology reported on research at Johns Hopkins Children’s Center, finding that blood allergy tests could both under- and overestimate the body’s immune response. A 2003 report in Pediatrics said a positive result on a blood allergy test correlated with a real-world food allergy in fewer than half the cases.
“The only true test of whether you’re allergic to a food or not is whether you can eat it and not react to it,” said Dr. David Fleischer, an assistant professor of pediatrics at National Jewish Health. In one recent case there, doctors treated a young boy who had been given a feeding tube because blood tests indicated he was allergic to virtually every food. Food challenge testing allowed doctors to quickly reintroduce 20 foods into his diet, and they expect more to be added.
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The tests that we performed were blood tests. As I see from the article, they are basically worthless.
And this: “The only true test of whether you’re allergic to a food or not is whether you can eat it and not react to it.” You report your son has a consistent reaction to milk and nothing else. That’s normally significant. There are many allergy tests. It may be time for a new one.
To this crusty old primary care doc, the fact that he has a classic dairy protein skin rash when consuming dairy which goes away when he avoids dairy proteins and comes back when he consumes them again is pretty fair evidence in and of itself to make some educated choices on diet. Add into that the fact that one allergy test was positive for it (even though it was positive for other things) and it sounds like a pretty good argument for just avoiding dairy as much as possible.
Most patients lose their childhood dairy protein allergies by the time they get out of adolescence. So it may not be necessary to avoid dairy forever.
Just to pile on, allergy testing is good for some things, but it is not needed to tell you to avoid something when exposure causes problems, avoidance makes the problem go away, re-exposure causes it come back again, on multiple trials. Allergy tests are in particular very useless for deciding if a particular food triggers eczema, many many false positives and false negatives. Controlled elimination and challenge is the gold standard for food triggers of eczema.
There are different forms of casein proteins. The contention is that the types produced by Holsteins are chemically different from those of most other breeds (as well as those produced by camels and goats) and react in a different enough way as to cause some systemic problems. No idea how much that actually matters in the long term. The main source of most casein fright is probably the China Study, and Campbell’s “research” is a big ol’ pile of crap.
The casein and gluten molecules are chemically similar enough to cause some cross-reactions in sensitive individuals.
The idea that “casein is like heroin” is probably from the fact that casein breaks down to casomorphins in digestion, which are opaloids. Apparently there are some not-very-credible indications that they might worsen autism symptoms.
The easiest way to see if anything causes problems for a particular individual is to do an elimination trial. Stop eating the suspected problematic food for a few weeks, see if there’s an improvement. Check, if desired, by reintroducing it and see if the problem reoccurs. With a careful enough food diary you could probably even find the intake level that causes symptoms, if you don’t want to just eliminate it entirely.