The RPAH advise that individuals who have done a month’s trial of the failsafe diet but continue to have some problems should try cutting out gluten and casein for at least two weeks.
Gluten and casein intolerances often occur together because they seem to be caused by a sensitivity to opioid-like peptides. Though there are a number of reasons why gluten and casein may affect people (such as insulin-like lectins and lactose intolerance), opioid-like peptides, along with genuine food allergies, appear to be a common issue. There is no scientific evidence that this is caused by “incomplete digestion” or “IgG allergy” as has been put forward by some alternative theorists. Incomplete digestion of opioid-like peptides is actually normal. Rather this sensitivity appears to be related to the body’s natural endorphin levels. Opioid-like peptides act on endorphin receptors throughout the body and can cause problems such as aches and pains, headaches, lowered pain threshold, digestive problems, nausea, abnormal hunger, motivational problems, mental/behavioural problems, brain fog, irritability, weight problems, cravings, and histamine release. Opioid-like substances that trigger endorphin receptors automatically impact on dopamine function, releasing a surge of dopamine which is then followed by a withdrawal reaction.
What appears to happen is that gluten and casein have the strongest effects in individuals who have naturally low levels of endorphins or who are ‘resistant’ to endorphins due to endorphin receptor polymorphisms. They act as natural analgesics and provide a mild sense of relief and demotivation in the short term, but during withdrawal cause increased pain, anxiety, and negative symptoms. Gluten and casein also cause non-allergy mediated histamine release, and are problematic for those who are sensitive to histamine.
There is some indication that people with pale skin, red hair and/or freckles appear to be more likely to be affected by gluten and casein. This may be because the genes that cause red hair and freckles (such as MC1R and POMC variants) affect the proopiomelanocortin/endorphin production/receptor system. Individuals with red hair tend to require larger quantities of anaesthesia (around 20% more), but experience increased analgesia to morphine-6-glucuronide. They tend to experience heightened thermal pain but less pain from electrical stimuli. These differences may affect tolerance levels to the opioid-like peptides in gluten and casein.
It is not necessary for most people to cut out all gluten and casein. Because gluten and casein intolerance is not an allergy, just as with salicylates, amines and glutamates, limited quantities may be tolerable to less sensitive individuals.
It is important to distinguish between different types of casein. Most farmed cows such as holstein and friesian produce milk with a fragment of protein called A1 beta-casein. It is this A1 fragment that produces an opioid-like reaction in the body. Originally cows produced milk with a fragment of protein called A2 beta-casein. A2 beta-casein does not cause the same opioid-like reaction as A1 beta-casein. All ancient breeds of cattle such as zebu cattle produce A2 milk, along with buffalo, yak, goat and sheep. Guernsey cows produce milk with around 90% A2 content, and Jersey cows produce a moderate amount more A2 content than regular farmed cows. For more information on the science of A2 milk, visit the A2 corporation website, the A2 science website, and betacasein.org. Milk may contain some other much milder, weaker opioid-like peptides to which the most sensitive individuals may react, so A2 milk is not 100% safe, however, many individuals who do not tolerate cow’s milk may tolerate goat’s or sheep’s milk very well.
A note on spinach. Spinach is not a failsafe food, however, it also contains opioid-like peptides in the form of rubiscolin. Individuals who are sensitive to the opioid-like peptides in gluten and casein are also sensitive to spinach in the same way. If you discover you can tolerate salicylates but are unable to tolerate gluten and casein, it would be wise to do a spinach trial.