Celiac disease and dairy proteins – summarization of articles

I want to address the issue of whether dairy could be an issue for those with celiac disease. I don’t think that I will be able to arrive at an exact answer with this post, but I do wish to summarize existing articles and evidence on this topic. From my personal experience, I get all the same symptoms from dairy products as from foods containing gluten. The symptoms include pains in the lower abdomen, bloating, constipation, fatigue, inflammation of the eyelids, as well as psychiatric symptoms including panic attacks, anxiety, and depression. Gathering anecdotal evidence by speaking to reddit users in the gluten-free subreddit, multiple individuals have also expressed the same experience with dairy causing similar symptoms to gluten. Also these individuals noticed that the same symptoms were caused by lactose-free products, therefore likely the culprit is not the sugar (lactose), but the proteins in dairy (casein). Below I will summarize several articles addressing the consumption of casein by individuals with celiac disease.

The first study that I found looking at the correlation between gluten and casein is from 2007, Mucosal reactivity to cow’s milk protein in coeliac disease. This article discusses the fact that some celiac patients on a gluten-free diet still experience gastrointestinal symptoms. The authors then examine whether these patients have an inflammatory immune response to the protein in cow’s milk. The results of this study indicated that in fact in a fraction of celiac patients did experience a similar reaction to the milk protein as to gluten. As usual, I used python to create article summaries, including this one.

Summary:
On clinical grounds cow’s milk (CM) protein sensitivity may be suspected. Here, using rectal protein challenge, we investigated the local inflammatory reaction to gluten and CM protein in adult patients with CD in remission.
In 18 of 20 patients gluten challenge induced neutrophil activation defined as increased MPO release and increased NO synthesis.
A mucosal inflammatory response similar to that elicited by gluten was produced by CM protein in about 50% of the patients with coeliac disease.

Summary using LexRank (graph-based method for computing relative importance of sentences):

Mean rectal ΔMPO was 303 ± 27 µg/l after casein challenge and 16 ± 27 µg/l after challenge with α-lactalbumin.
Compared to healthy controls, patients with CD showed significant increases in rectal NO and MPO concentrations measured 15 h after challenge with both CM and gluten (P < 0·001), while ECP was increased to a similar extent in the two groups ( ).
The major finding in this study is that rectal challenge with CM protein frequently induced a local inflammatory mucosal reaction in patients with CD but not in healthy controls.
Our patients with CD had normal serum levels of IgA, IgG and IgE against casein and α-lactalbumin, which might be explained by the fact that they were on a gluten-free diet and therefore had improved the mucosal integrity.
Our finding that, in a fraction of coeliac patients, CM protein challenge may induce an inflammatory reaction of the same magnitude, as did gluten challenge, may also suggest an innate as well as adaptive immune response to CM, and casein in particular.

There were several other studies on the topic of gluten-free and casein-diet, but they all investigated whether this diet would help patients on the autism spectrum, which is not the topic of my post. I did find another short article on gluten-free and casein-free diet helping with psychotic symptoms. Personally I have a similar experience, as consuming any gluten or dairy increases my paranoia, panic attacks, and intrusive thoughts. The authors claim that there is a following mechanism for psychosis:

“In autism and schizophrenia, incomplete digestion of certain proteins, gluten and casein, cause an autoimmune response as indicated by elevated levels of IgA and IgG antibodies. This intestinal malabsorption also causes pathogenic elements (peptide fractions), which bind to opioid receptors by crossing the blood-brain barrier. This releases exorphins (opiate-like substances, similar to certain drugs) that cause psychotic symptoms.”

Evidence-Based Practice: Introduction of a Gluten-Free and Casein-Free Diet to Alleviate Psychotic Symptoms
A case review of a young boy yielded an unexpected resolution of psychotic symptoms after the introduction of a gluten-free, casein-free (GFCF) diet.
The purpose of this paper is to show that health care professionals may use a gluten-free and casein-free diet (GFCF) as an additional element to standard treatment methods, to alleviate psychotic symptoms.
Additionally noted were similarities between autism and schizophrenia.
Introduction of a GFCF diet helps reduce psychotic symptoms, and gives another option for patients resistant to traditional treatment methods, especially adolescents and young adults.
Keywords: autism, gluten-free, casein-free diet (GFCF), psychosis, schizophrenia