Gluten and Casein: Why Dairy Bothers Some With Celiac and What To Do

You’ve gone gluten-free, but something’s still not right.

You feel bloated much of the time and the bathroom situation is, well, messy…still.  Are you frustrated?  Of course you are, but you are not alone. 

The problem might be a milk protein called casein.

In this article, we’ll look at the connection between gluten and casein to help you understand why you are still having symptoms.  I'll share my own experience and help you sort out what you can eat comfortably on a gluten-free and casein-free diet.

What is Casein?

Casein is a protein in milk. It gives milk its white color and is the part that curdles to make cheese.

The other main protein in milk is whey.  It's the liquid part that's left behind in the cheese-making process.

Both casein and whey can cause intolerances, but casein is more common.¹

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Why Might Casein Be a Problem With Celiac Disease?

There are a few possible reasons for casein intolerance in people with celiac disease.

1. Increased Gut Permeability: Sometimes called "leaky gut," this happens when the gut is inflamed or still healing from celiac disease.  Food proteins like casein can slip through the gut barrier and irritate the immune system, causing a food intolerance.  As the gut heals, food intolerances should improve.²

2. Hard to Digest: Casein, like gluten, is high in proline and glutamine.  These peptides can be hard to digest and can cause symptoms like gas and bloating.²

3. Different Casein Subtypes: Cow's milk contains mostly A1 casein, which some studies have linked to inflammation. That's why milk from animals like goats and sheep which are higher in A2 casein are sometimes better tolerated.³

4. Immune Cross-Reactivity:  This is controversial and lacks good scientific evidence.  I'm including it here because you may have seen it in blogs or forums.  The idea is that the two proteins (in this case gluten and casein) are similar and the body mistakes one for the other, and causes a reaction.⁴⁵

5.  The Thyroid Connection: People with celiac disease often have other autoimmune diseases as well.  Hashimoto's disease is an autoimmune thyroid disease and has been linked to food intolerances including milk proteins.⁶ Many people with Hashimoto's must avoid gluten and casein.

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How to Tell if It’s Casein vs Lactose

You may have heard of lactose intolerance and you may have even heard that celiac disease and lactose intolerance often travel together.  So how can you tell if your dairy issue is caused by lactose or casein? Does it even matter?

Here are a few clues:

• If you've tried lactose free dairy products and still react, it may be casein.
• If you react to dairy products that are naturally low in lactose like yogurt and hard cheeses, it may be casein.
• If you can tolerate cheese made from goat or sheep's milk but not from cow's milk, it may be casein.
• If your dairy issues don't clear up after six months to a year on a gluten-free diet, it may be casein.

Celiac and Lactose Intolerance: Check out my complete guide to Celiac Disease and Lactose intolerance.  It will tell you why you might have lactose intolerance, what foods to avoid and lots of strategies for managing day to day.

Why Does it Matter?

Practically speaking, it doesn't matter a whole lot.  Avoiding dairy products is the solution either way.  Here are a few reasons why knowing if it's lactose or casein causing you trouble might matter:

• You like to know why foods affect you the way they do
• Knowing might steer you toward products you can tolerate.  For example:

      -Hard cheeses are low in lactose but high in casein.
      -Goat and sheep cheeses have A2 casein, which may be better tolerated. They are also slightly lower in lactose.
      -Lactose free dairy products or lactase enzymes are often helpful for people with lactose intolerance, but not for casein intolerance.

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What to Eat Instead / Practical Tips for a Gluten-Free & Casein-Free Diet

Eating a gluten-free, casein-free diet means choosing gluten-free foods AND eliminating dairy, or at least cow's milk dairy from your diet.

Avoiding both gluten and casein may seem overwhelming at first and you may feel like you've already given up so much by going gluten-free.  But don't despair.  There are lot's of rich and creamy gluten-free milk alternatives for your coffee, cereal, sauces, and baking.  You'll soon be a substitution pro and won't even miss the dairy. 

Here are a few quick ideas:

For your coffee: Coconut milk, soy milk and gluten-free oat milk* are similar in texture to cow's milk or cream and taste great in coffee or tea.  Look for dairy-free coffee creamers as another option.  (See the "Shop the Guide" section above)

To top your pizza or pasta: Try vegan cheese shreds or if you can tolerate goat and sheep cheese, try goat mozzarella or pecorino Romano.  Nutritional yeast has a cheesy flavor. Try a sprinkle on your pizza or pasta.

For baking: Canned coconut milk or plant-based yogurt substitutes nicely for cream or sour cream.  You can add a tablespoon of lemon juice to coconut milk if your recipe calls for sour milk.  There are also good vegan substitutes for cream cheese and sour cream.

In sauces: Canned coconut milk makes a beautiful creamy bechamel.  Add plant-based cheese or goat cheese and you'll have a mac 'n cheese sauce to die for.

Gluten-Free Milk Alternatives: For a complete guide to  milk replacements that behave well in coffee, cereal, sauces, baking and more see my Gluten-Free Milk Alternatives page.

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Recipes For Your Gluten-Free, Casein-Free Diet

I've curated this collection of recipes for you.  These are all recipes I make myself for my family.  All are gluten-free and dairy-free or have dairy-free options.  I hope you enjoy!

Quinoa & Butternut Squash Chili

Granola Bars

Garam Masala Chicken Curry

Maple Glazed Pork Tenderloin

Best Gluten-Free Meatloaf

Maple Curry Brined Chicken Breast

Rice Cakes (Dairy Free Options)

Festive Fried Rice

Flourless Cornbread

Ridiculously Easy Banana Bread

Potato Pizza Crust

Warm Cabbage Salad

Bean & Bacon Soup

Rice Pizza Crust

Gluten-Free Soups

Beef Hotpot with Chocolate and Cider

Grain Free Maple Nut Granola

Savory and Satisfying Slow Roasted Almonds with Olive Oil and Sea Salt

Love Nuts? Try Almond and Pecan Crusted Gluten Free Baked Haddock

Beef Stew with Red Wine and Chocolate

Beer Braised Sausages with Rich Onion Gravy

Easy Coconut Shrimp

Macaroni Casserole with Ham and Crispy Potato Chip Topping

Gluten Free Chicken Parm: Crispy, Delicious and Easy to Make

Oatmeal Chocolate Chip Cookies

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References

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