Some patients require major detective work, but Christina's problems didn't take long to pinpoint. Her complaints during our initial consultation of alternating constipation and diarrhea, a stuffy nose, and brain fog—coupled with a brief glance at her food journal—pointed to one major culprit: dairy.
This 34-year-old patient started her day with skim milk in granola, frequently drank lattes, and had an 11 p.m. weakness for butter pecan ice cream. And as a medical doctor who specializes in gut issues, I find that lactose is one of numerous factors that contribute to dairy intolerance, leaky gut, and digestive issues.
The real problem with milk and dairy might not be lactose.
The milk we drink today isn't the stuff our great-grandparents consumed. Cows are fed grains (not their natural diet) and pumped with hormones and antibiotics to speed growth and milk production. Conventional milk is also pasteurized and homogenized, killing bad bacteria but also good bacteria while lowering nutrient content. About 80 percent of the protein in dairy is casein and about 20 percent is whey. Of that casein, about 30 percent is beta-casein.
Beta-casein has two subtypes: A1 and A2. In conventional milk, the A1 subtype is more prevalent because most American cows retain genetic casein mutations that occurred thousands of years ago. And while the A1 and A2 beta-casein proteins differ by just one amino acid, their differing impact on your gut and health is quite dramatic, which has led many scientists to suspect that milk with just the A2 beta-casein could be far healthier, and maybe even digestible by people with lactose intolerance.
A1 milk versus A2 milk.
The developing benefits of A2 milk—and drawbacks of A1 milk—have led one company, a2 Milk® to produce milk that is naturally easier-to-digest exclusively by identifying and differentiating only A2 milk producing cows through genetic DNA testing. It's a trend that got started in Australia and New Zealand and quickly spread to Europe, China, and is currently launching in the U.S. markets.
So what's the real difference between A1 and A2? Well, when we compare A1 and A2 milk, we start with the fact that our body breaks down A1 beta-casein into a peptide called beta-casomorphin-7 (BCM-7). Studies show A1 produces four times as much BCM-7 compared to A2. The issue here is that BCM-7 peptide can trigger or worsen neurological and gastrointestinal disorders as well as inflammation. One study that looked at 20 countries found higher heart disease rates in A1 milk drinkers, while those who drank A2 milk had fewer cardiovascular issues and a lower risk of diabetes. In addition, A2-rich milk contains more vitamin E, carotenoids, and minerals like zinc than the alternative.
Simply put: the A1 beta-casein might be one reason you're dairy intolerant. For many patients like Christina, I've seen how A1 milk can create or exacerbate leaky gut and other problems, and studies show A1 (but not A2) triggers abdominal pain and constipation. Even organic, grass-fed, and raw dairy can contain some A1 casein, creating the BCM-7 peptide and all the undesirable symptoms that come with it.
Here's what you need to know about going dairy-free.
Although many of us want to believe that A2 milk is a miracle cure for our dairy problems, it's important to know that there are other dairy components—besides the A1 beta-casein protein—that cause problems. With conventional dairy, we also see increased use of antibiotics, growth hormone, a greater proportion of inflammatory omega-6 fatty acids, and genetically modified (GMO) feed. All these things can contribute to chronic inflammation and dairy intolerances that might not be completely resolved by just switching to A2 milk. And while science isn't conclusive about the A1 versus A2 debate, in my practice I find that patients with gut issues do better by either going dairy-free or using exclusively A2 milk—which can be found at many farmers markets.
For Christina, avoiding certain forms of dairy eliminated many of her health issues. She found sheep and goat milks to be less problematic since they contain smaller, more easily digestible fat globules and less lactose than cow's milk. She also tried dairy alternatives like coconut, almond, and cashew nut milks. She traded her lattes for coconut creamer in black coffee sweetened with stevia, and found a no-sugar-added coconut milk "ice cream" that satisfied her late-night dairy craving. Altogether, she decided cow's milk wasn't for her, but if you do drink cow's milk, ideally buy it raw if your state allows it. Otherwise, A2 milk from grass-fed cows is best and organic is better than conventional.
I'd love to provide you with more strategies to heal your gut and reclaim your health. A few simple changes, and you could be on your way to better gut health. To learn more, get my free Quick Start Guide to a Happy Gut.