Casein Intolerance

Answered on August 19, 2014
Created May 12, 2010 at 1:43 PM

I was recently tested by Enterolab and was positive for casein intolerance. I've been a dairy eater for 44+ years, so this is quite new for me. I'm curious whether others who are casein intolerant by testing are able to tolerate cream and butter. To be honest, I really don't know what my symptoms are--I'm symptomatic with so many things right now (haven't eliminated all my suspected "problem" items yet) but perhaps I'll figure it out once I eliminate everything and try reintroducing them. I'd be interested in hearing others' experiences, though.

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3 Answers



on May 12, 2010
at 02:25 PM

Just speculating, but I think that a lab result that says you are casein intolerant will not automatically mean you can't tolerate cream or butter. It may depend on the quality/fat content of the cream/butter, how it was produced (grass-fed? raw?), and what other foods you eat and how long you've been eating them. I would bet money that if you haven't eliminated grains and vegetable oils and still have irritation in your gut lining, you will experience more problems.

What I mean by this is that I would not look at casein intolerance in a vacuum. Other foods you eat may have an influence. You may cut out casein altogether for 3 months and reintroduce and still have problems, whereas maybe if you cut out casein, grain, vegetable oils, legumes, nightshades for 6 months, and give your gut a good amount of time to fully heal, maybe you'll reintroduce high-quality high-fat cream and find that you do ok on it after all. You may find that you do ok on grass-fed, raw cream, but not grain-fed, pasteurized cream. Who knows?

No guarantees, and much speculation here. But, I would say that you need to experiment to find out for yourself, and also that you may get different results if you eliminate everything all at once, rather than eliminating one food at a time.

See also Dr. Harris's take on dairy, especially this comment:

Grass fed will have better n-3, more CLA and more VA.

A1 milk that is raw may have less antigenic casein -if you worry about that. It still has whey which can also be antigentic (just like beef protein and seafood and eggs, I always add)

The argument is that pasteurization may make a conformational change to the casein that makes it less susceptible to complete hydrolysis into individual amino acids - then incompletely hydrolysed peptide sequences can be antigenic if they cross a leaky gut (which 6 months after stopping wheat and excess LA n-6 yo hopefully don't have)

A2 is probably safer than A1 if you worry about that.. A2 milk has whey as well, of course.

Being grass fed and a2 is more important that being RAW, probably

Much of the raw enthusiasm may be political. If you are eating cream and butter I think it makes zero difference and is way less important than having the extra nutrients from being grass fed.

Before refrigeration, milk was boiled rather than pasteurized. Last I checked, 200 degrees is higher than 160.

The best and most natural way to drink milk is as something fermented, unless you are eating it as cream butter or cheese

Harris seems to think your gut can heal itself in six months if you stay away from wheat and vegetable oils (and to that I would add all grains and legumes in general), after which point even pasteurized casein is less likely to cause problems. This is most probably true for some people, but only you'll be able to figure out how you react to it.

Good luck, and I hope you get some good answers!



on May 13, 2010
at 02:20 AM

From what I have read, very few people have found Enterolab to have false positives. Enterolab is controversial enough that I think people would post if they found the results misleading. On the other hand, blood tests for food intolerances are notorious for false positives and an elimination diet/challenges are required to confirm the results.

I agree with the first answer that cleaning up your diet will give you the best chance to get good clear results from a food challenge several months down the road.

Digestive enzymes may be worth a try also. In general, sourcing high quality dairy is such a pain and so expensive that it is easier to go without.


on July 27, 2013
at 01:37 AM

I used Enterolab to test for gluten intolerance only and got a borderline test result. I took that for a positive and eliminated gluten for the past 4 years. I have fewer symptoms, but am anything but symptom free. I have recently embarked on an elimination diet. Essentially all foods that are known to be allergenic (or intolerant/sensitive). Food challenges begin after 3 weeks. I was feeling better before the first challenge, but was hesitant to start yet. I did anyway and started with nightshades followed by casein. What was I thinking!?! I've been sent into a tail spin! I have decided to stay on the basic elimination diet for several more weeks before doing the food challenges. BTW I have fibromyalgia and chronic plantar faciitis and other food pain along with chronic fatigue and digestive issues.

The elimination diet I'm following is from EliminationDietRD.com I did have to pay for it, but I think it has been well worth it. I have learned new ways of eating and considering how much better I began to feel before the first challenge, I am confident it will be worth it. I think nightshades and casein will likely go, but feeling better is so much better than the momentary enjoyment of a french fry or cheese. I've discovered so many tasty things I didn't know existed.

As for blood tests, I've found they don't give false positives, they give false negatives (take gluten intolerance for example). The problem is in the gut so test there, not the blood where the problem isn't.

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