Image by Sornram Srithong from Pixabay

Let me start with a disclaimer: I’m not 100% against gluten and dairy. I don’t believe that everyone should categorically avoid either or both. 

That said, there are many different potential reasons for going gluten and dairy free. 

Reasons Why You Might Want to Avoid Gluten and Dairy

If you have Celiac Disease, of course, strict gluten free is a must, and avoidance of casein (a cross-reactive protein in dairy) is advisable as well. 

You might have a gluten or dairy IgE allergy or IgG sensitivity, which you can determine on lab testing.

You might have Hashimoto’s Thyroiditis, in which case gluten and casein act like molecular mimics and perpetuate antibody production. For these people, it’s a good idea to avoid gluten and dairy at least until Hashimoto’s antibody production has normalized. 

All of us should want to avoid non-organic, GMO gluten to avoid glyphosate exposure, and non-organic dairy to avoid all the hormones and antibiotics given to the cows. The way the bread is prepared and the breed of the cows milked can also make a significant difference in sensitivity and tolerance levels. 

But if you find you (or your kids) crave bread and dairy products and can’t get enough of them, there might be something else going on too. 

Food Opiates: Casomorphin and Gliadorphins (aka Gluteomorphins)

Casomorphin and gliadorphin are opiate-like compounds produced in the gut during the breakdown process of casein and gluten. They’re not a problem, under the right conditions. 

First, the body has to be able to break them down adequately in the gut. Every protein has a respective enzyme that helps the body to chop it into its component amino acids. Casomorphin and gliadorphin happen to share one: it’s called dipeptidyl peptidase (DPP-IV).

For those with plenty of DPP-IV, this isn’t an issue. However, some people don’t produce enough DPP-IV. Others may consume gluten and dairy at such a quantity that even normal enzyme production levels are insufficient for the task.

A class of secondary medications for Type 2 Diabetes, the -gliptins (sitagliptin or Januvia,  saxagliptin, and vildagliptin), also block DPP-IV. I speculate that anyone on these medications may be more susceptible to increased circulating levels of casomorphins and gliadorphins, though I wasn’t able to find any papers alluding to this. 

The second situation that might pose a problem for food opiate breakdown is increased intestinal permeability. Even if DPP-IV levels are fine, if you have leaky gut syndrome, these compounds can “leak” out into the bloodstream before they’ve been rendered harmless. This has been reported particularly in autism and schizophrenia. 

Once outside the gut, these compounds can stimulate opiate receptors, leading to symptoms similar to those produced by opiate medications. 

Symptoms of Casomorphin or Gliadorphin

Opiates are recognized as some of the most powerfully addictive drugs out there, so it’s no surprise that those suffering from circulating casomorphin or gliadorphin would struggle with strong cravings for products containing gluten and casein. 

Other common symptoms of course involve GI distress and inflammation, particularly constipation and abdominal pain.

Opiates and food opiates alike are also associated with mental disorders, including trouble focusing, confusion, nervousness, dysphoria and euphoria (or mood swings). 

There is even speculation that increased casomorphin or gliadorphin can later cause Celiac Disease. 

Testing for Casomorphin and Gliadorphin

Specialty labs will test the urine for casomorphin and gliadorphin. High levels are consistent with food addiction, either from decreased DPP-IV relative to demand, leaky gut, or both. 

If present, it is certainly advisable to cut out gluten and dairy entirely while sorting out the cause— just be prepared for withdrawals. You may need to wean off slowly so that the process is tolerable, just as you would with medication. 

Meanwhile, test for leaky gut syndrome and make sure you rule out Celiac Disease while you’re at it. 

If leaky gut is present and Celiac is negative, go through your history and see if you can identify the trigger for leaky gut, as intestinal permeability doesn’t just “happen”; there’s always a cause. Further testing may be warranted at this step, unless it seems clear from your story that the initial insult is long gone, and all that’s left is “clean-up.” 

Treatment Approaches

If you do have increased intestinal permeability, then you’ll need to find and remove the obstacle to cure if there still is one, and supplement to heal up the gut lining. One important step here is certainly probiotics. This study demonstrates that certain bifidobacillus strains are helpful in breaking down casomorphin and gliadorphin. This isn’t too surprising, since one of the jobs of our microbiome is to help us digest our food. 

If you and your doctor ever decide it’s worth it to try reintroducing (high quality, non-GMO, organic) gluten and dairy after you’ve cleaned up your gut, you might want to try a digestive enzyme containing DPP-IV. This is especially true if you never did have leaky gut, in which case you might just produce less DPP-IV than you need. There are many enzymes out there that contain DPP-IV, but here is one option.