It started with a chronic cough, burning in my chest, and a choking sensation… I saw my primary care doctor, an allergist, a gastroenterologist, an Ear Nose and Throat doctor. I tried every over-the-counter product possible. I drank gallons of milk trying to soothe the burn. I drank bottles of Mylanta, and always had antacids nearby. I tried Nexium, Prilosec, Aciphex, Pepcid, and even considered surgery.
But nothing could soothe my acid reflux.
For three years, I slept nearly upright. For three years, I avoided red wine, tomato sauce, oranges, and all of the other “acidic” foods I was told to avoid. The acid reflux continued. I tried the holistic route — adjustments from a chiropractor to push my “hiatal hernia” back in… yoga to relax more… ginger tea. I also cut out caffeine and took more magnesium.
And then, just when I nearly gave up, I made one change to my diet — and my symptoms were completely gone in 3 DAYS!
What was that change? I cut out dairy.
I had been eating it for years without any apparent problems, so I would have never suspected it would be the culprit of my digestive troubles. Since I cut out dairy, I haven’t experienced acid reflux. Second only to gluten, dairy is one of the most problematic foods for people with Hashimoto’s, and I have found that eliminating these two foods from one’s diet can have the most profound effect on bringing a thyroid condition into remission.
In this article, I’d like to explore:
- Why dairy is so problematic for human consumption
- The different types of dairy intolerances
- How consuming dairy impacts Hashimoto’s
- Thyroid-friendly alternatives to dairy
The Problem with Dairy
When I surveyed my readers with Hashimoto’s a few years ago, 40 percent of people reported already being dairy free, while 57 percent reported that they suspected they were sensitive to dairy.
The most common ways a dairy sensitivity may manifest are via gut reactions (like bloating, diarrhea, and acid reflux), as well as lung reactions (coughing, asthma, sinusitis, postnasal drip, and mucus) and skin reactions (eczema, rashes, and acne).
But what is it about dairy that makes it so problematic for people with Hashimoto’s?
Are You a Baby Cow?
Often, the argument against drinking dairy is overly simplified… “Humans are the only mammals that drink another mammal’s breast milk. Cow’s milk is only good for baby cows!”
This argument can be tough to counter, unless of course, you can think of examples of people who are perfectly healthy and drink lots of cow’s milk… and we all know those people.
Therefore, we need to dig deeper and find another explanation.
Cow’s milk contains proteins (primarily casein and whey) that are different from the proteins found in human milk. A person with intestinal permeability (which is always a precursor to autoimmune disease) is likely to recognize these proteins as a foreign invader and make antibodies to the proteins. While this may sound like a food allergy, it’s important to understand how the different parts of the immune system work, and how the body views and reacts to what it sees as invaders.
Food Allergies vs. Food Intolerances
Food allergies are mediated by the IgE part of the immune system, and take effect immediately.
An example of an IgE food allergy would be a person who eats peanuts and goes into anaphylactic shock (in which the airways narrow and breathing is blocked), requiring immediate medical intervention. These types of food reactions are often called a “true allergy” by medical professionals. However, this terminology is a misnomer, suggesting that only IgE allergic reactions exist and that reactions mediated by different parts of the immune system are non-existent.
In fact, there are at least two other parts of the immune system that react to foods: the IgA and IgG branches.
For lack of better terminology, IgA and IgG hypersensitivities have both been labeled as “food intolerances” or “food sensitivities” — however, they are much different in their mechanisms and propensity to cause harm in the body.
Dairy can be an IgA sensitivity, an IgG sensitivity, or both.
IgA Food Reactions
An IgA food intolerance is the more severe reaction and manifests primarily in the intestines. It is an abnormal response of the intestines to certain foods in genetically predisposed individuals. The intolerances may manifest themselves early in childhood, or later in life.
An IgA food intolerance results in irritation and inflammation of the intestinal tract every time that particular food is consumed. This results in damage to the intestines, with an eventual inability to absorb nutrients, and can increase the risk of autoimmune diseases and cancer, as well as accelerate aging through increased intestinal permeability.
IgA food intolerances may be asymptomatic, or they may present with the following symptoms: diarrhea, loose stools, constipation, acid reflux, malabsorption of nutrients from foods, and increased intestinal damage.
They may also cause IBS, gas, nausea, skin rashes (including eczema), acne, respiratory conditions such as asthma, nasal congestion, headaches, irritability, and vitamin/mineral deficiencies.
The most well-known IgA food reaction is called celiac disease, and it is an intolerance to gluten, the protein found in wheat. (Up to 15 percent of people with Hashimoto’s are estimated to also have celiac disease!) However, dairy protein, egg, and soy protein IgA intolerances are also extremely common in those with Hashimoto’s.
A more accurate description of an IgA food reaction may be Protein-Mediated Autoimmune Intestinal Inflammatory Reaction (PAIR).
IgG Food Reactions
As mentioned above, the proteins found in cow’s milk are different compared to those found in human milk. The body may recognize these dairy proteins as foreign invaders and produce antibodies to protect itself from what it perceives to be a threat. Sometimes, it’s the IgG branch of the immune system that reacts. A reaction of this kind is known as a Type IV Delayed Hypersensitivity reaction.
Guess what other kinds of antibodies are IgG mediated? Thyroid antibodies; more specifically, TPO and TG antibodies. In fact, Hashimoto’s is also considered a Type IV Delayed Hypersensitivity.
As far as I’m aware, the research doesn’t exist on this yet; however, experience shows that eating foods that stimulate the release of IgG antibodies and promote a Type IV Delayed Hypersensitivity response, will also increase thyroid antibodies.
Perhaps it’s a “turning on the faucet effect,” or perhaps dairy proteins cross-react with the thyroid gland. More research is needed to identify the exact reaction, but I can say that people who are dairy-sensitive and have Hashimoto’s, will have a reduction in thyroid symptoms and antibodies once they remove dairy from their diets.
Many people confuse a dairy intolerance with lactose intolerance, and will suggest taking a Lactaid pill so that you can eat your ice cream and go about your day.
However, lactose intolerance and dairy protein intolerance are two completely different reactions to dairy. Lactose is a milk sugar, and the ability to digest lactose depends on having the lactase enzyme necessary to break down the milk sugar lactose.
Although there are similarities in the symptoms caused by lactose intolerance and dairy protein sensitivity (bloating, diarrhea), the difference is that the latter response originates in the immune system. Additionally, lactose intolerance will not cause intestinal tissue inflammation or damage.
Dairy and Hashimoto’s
Limited studies are available on dairy proteins and Hashimoto’s. The only dairy-related study I’m aware of was one that showed lactose-sensitive individuals with Hashimoto’s as being better able to absorb medication after lactose restriction (hey, it’s a start, right?). But just because there aren’t studies yet, doesn’t mean you shouldn’t try this intervention that can be life-changing.
Some people with Hashimoto’s may present with an IgA (celiac-like) intolerance to milk proteins. Many of these cases are undiagnosed, and when people continue to eat these foods, they are damaging their intestines and robbing themselves of vital nutrients. It sounds surprising, but even people who are overweight may be completely malnourished and nutrient depleted because of the foods they eat.
Everyone with Hashimoto’s will have some degree of intestinal permeability, which makes one’s immune system more likely to recognize the whey and casein proteins as foreign invaders, and create IgG antibodies to protect itself.
Many people with Hashimoto’s could have both kinds of immune reactions (IgG and IgA) to dairy proteins, in addition to an intolerance of lactose.
Interestingly, a recent study showed that 76 percent of people with Hashimoto’s who were tested for lactose intolerance, tested positive. When they were placed on a lactose-free diet, their TSH levels dropped significantly, and they were found to absorb their thyroid medications (L-thyroxine) more effectively than when they were consuming lactose.
This means that the consumption of dairy products can prevent thyroid hormones from working, while also causing an autoimmune attack on thyroid tissue.
Testing for Dairy Sensitivity
The problem with pinpointing a dairy reaction, like all delayed food reactions, is that it’s almost impossible to know if dairy is a trigger for you, unless you go off dairy for at least two to three weeks, then reattempt eating it.
When I was working as a pharmacist, we were always on the lookout for “true IgE-related allergies” to foods and medications. I learned about the reactions mediated by the other immune branches in immunology during my first year in pharmacy school, but somehow, calling the IgE-related reactions “true” led me to believe that the other types of reactions didn’t matter.
Unfortunately, most conventional medical professionals and insurance companies hold that same misconception, and food sensitivity tests are considered “experimental.” Fortunately, I don’t mind a little experimentation, and when I “experimented” with removing the foods that seemed to be reactive for me, I felt dramatically better!
The other challenge with food sensitivities is that when we eat the foods that our body is sensitive to on a daily basis, it is very difficult to connect the foods with the symptoms we are having. Every time we eat a food we are sensitive to, the body becomes depleted in its ability to protect itself from that food, and the reactions become less specific, and more chronic, over time.
However, the good news is that, once the sensitizing food is eliminated for a few days to a few weeks, most people find that they feel better with less bloating, less acid reflux, normal bowel movements, more energy, etc. If we then consume that same food, the body will actually produce a stronger, more specific reaction, allowing us to recognize which particular food is problematic.
This is known as an elimination diet and is the gold standard for food-sensitivity testing.
If you think dairy may be a problem for you, I recommend removing it from your diet for at least two to three weeks and noting which symptoms are relieved for you.
What About Raw, Goat’s and Sheep’s Milk?
Some raw milk advocates claim that only pasteurized milk is problematic, and that raw milk is the way to go. They believe that the pasteurization process can potentially denature dairy proteins, making them seem even more foreign to the body, and increasing the likelihood of an immune response. This could potentially be true if you spent your entire life drinking only raw milk. However, most of us have already been sensitized to the pasteurized cow’s milk proteins, and will likely react to the raw milk dairy proteins. The differences are simply not that great.
Goat’s milk and sheep’s milk proteins are also very similar to cow’s milk proteins and have about a 60-75 percent rate of cross-reactivity. This means that a significant percentage of people who are sensitive to cow casein will also react to goat and sheep casein. Once a person becomes sensitized to the casein protein, they may react to all forms of dairy across the board.
The one possible exception is camel milk. The camel is not a ruminant (the category that cattle, sheep, antelopes, deer, and giraffes belong to), but a tylopoda (camel and llama family), and has different proteins in its milk. One study found that, in those with an allergy to cow’s milk, only 18 percent also had camel milk cross-reactivity. Camel milk does not contain beta-lactalbumin (whey protein) and has a different structure of casein — the two most reactive parts in cow’s milk. Camel milk also has little fat (the lactose content is only 4.8 percent), making it easily tolerated by most people with lactose intolerance.
A physician in Israel reported healing cow’s milk sensitivities with camel milk in a subset of children. In my own case, I reduced my reaction to dairy from an 8+ to a 1 (on a scale of 1-10) over the course of four years, and I did drink camel milk for about two weeks as an intervention prior to this. It is possible that the camel’s milk helped, but I also made a lot of other interventions that are known to reduce food sensitivities: I started strict dairy restriction, eradicated gut infections, followed gut healing protocols, and took systemic enzymes.
For those interested in trying camel milk, I recommend the brand Desert Farms.
Living Dairy Free
For me, dairy was a more reactive food than gluten. Eating even tiny amounts of dairy resulted in coughing, bloating, acid reflux, joint pain, and diarrhea. I’ve been dairy free for several years now, and my food reactions have dramatically lessened. However, a small amount of dairy will still trigger a cough for me. (I once ate something that was marked “dairy-free” even though it had butter, and couldn’t figure out why I kept needing to clear my throat!)
The Dairy Withdrawal
If you’re someone who is craving dairy, you should know that it’s not just in your head. The dairy protein casein, when broken down, can bind our endorphin (“feel good”) receptors in the body.
Preliminary research in animals shows that casomorphins (from casein), as well as gliadorphin (from gluten), may have behavioral effects.
There are those that claim that dairy is as addictive as heroin (which is a strong stimulator of our endorphin receptors). It has been hypothesized that when dairy is digested, opioid peptides called casomorphins are released into the gastrointestinal tract and taken up into the bloodstream. These opioid peptides are considered exorphins, as they have morphine-like effects on the brain. In other words, they can have “addictive” properties, so suddenly cutting dairy out of our diet can cause strong withdrawal symptoms. (A similar thing can happen when we withdraw from gluten!)
In my own case, I did find that I had slight withdrawal symptoms when I went dairy and gluten free. I felt a little spacey and dazed for a few days… so while I don’t have personal experience with heroin withdrawal that I can compare this to, I think the “as addictive as heroin” assertion may be a bit of a stretch, so don’t let that scare you from going dairy free!
Additionally, something else happened while I went dairy and gluten free: my bloating and acid reflux went away, while my joint pains began to diminish. (If you are already dairy free and still have acid reflux, check out the video I made about the root causes of Hashimoto’s and acid reflux.)
Can I Ever Have Ice Cream and Pizza Again if I Go Dairy Free?
Giving up dairy can be very scary, as dairy is a common staple in the standard Western diet, and a base for many rich, nourishing foods. However, giving up dairy may just be the one change that makes the greatest difference to your health.
People with Hashimoto’s who have a sensitivity to casein and whey proteins (the two proteins found in dairy products) will need to eliminate all dairy, including milk, cheese, yogurt, ice cream, butter, and certain protein powders. Some people have a primary sensitivity to dairy, while others have a secondary sensitivity, meaning that the reaction to dairy proteins is a result of gluten-induced damage to the gut. People in this latter group may be able to tolerate dairy again after intestinal permeability has been repaired, or after approximately six months of gluten and dairy avoidance.
However, I have found that most people with Hashimoto’s do much better on a gluten and dairy-free diet, and I recommend staying off both of these foods for most of the people that I work with.
If you do find yourself accidentally exposed to dairy while eating out at restaurants, it can be a good idea to have a bottle of Pure Encapsulations Gluten/Dairy Digest on hand. Though not a long-term solution, this product can help mitigate the effects of accidental dairy (and gluten) exposure if taken right away.
The good news is that there is no shortage of tasty, dairy-free alternatives that are easy to find at your local supermarket, or online. These days, it is easier than ever to live dairy free, and still enjoy your meals.
Please note: all of the suggested brands below are dairy, gluten and soy-free. Some of them are Paleo as well as Autoimmune Paleo-friendly, but others may have additives that are not considered Paleo/Autoimmune Paleo-friendly.
Milk – Milk is a combination of fat, protein, and carbohydrates.
- Coconut milk is my top choice, though it doesn’t contain protein.
- Almond milk is my second choice, but some people may react to nuts.
- Rice milk is an option, but it often contains large amounts of sugar and no fat, and some people may be sensitive to grains.
I recommend avoiding soy milk. While it does contain fat, carbohydrates, and protein, soy is the third most common reactive food for those with Hashimoto’s, and we don’t want to replace one reactive food with another reactive one!
- To make cream cheese, soak 1 cup of cashews in water overnight, then blend them with ¼ cup of water, and 1 tablespoon of lemon juice in a blender, such as the Vitamix.
- For shredded cheese, the Daiya brand makes a gluten, dairy and soy-free “cheese” that can be used in place of cheddar, mozzarella, and Pepperjack cheese on pizzas, casseroles and the like. They also have a cheesecake, made with a gluten-free crust.
- So Delicious Dairy Free makes a coconut milk-based ice cream in a variety of flavors.
- You can also try Yonanas, which is an awesome machine that turns frozen bananas into ice cream.
- Coconut oil works very well as a butter substitute for most purposes.
- Duck fat is another tasty alternative.
- Daiya and So Delicious Dairy Free make tasty coconut-based yogurts.
- Daiya brand makes a tasty gluten, dairy, and soy-free pizza.
Protein for Shakes
- You can make a purée of cashews and lemon juice, or use a coconut milk with a high-fat content, such as coconut cream.
Additionally, there are many online recipes and cookbooks that are full of ideas for crafting delicious, dairy-free meals. I also released my own cookbook, Hashimoto’s Food Pharmacology: Nutrition Protocols and Healing Recipes to Take Charge of Your Thyroid Health, which contains 125 recipes that are all dairy free! My hope is to inspire people to create their own meals that are nourishing to their thyroid health, while still tasty and fulfilling.
Time and time again, I have seen people with Hashimoto’s shed their symptoms and feel better after giving up dairy. For me, getting off dairy meant no more irritable bowel syndrome, bloating, acid reflux, or carpal tunnel. For one reader, Crystal, getting off dairy meant getting her Hashimoto’s into remission. (Read Crystal’s Hashimoto’s success story here.)
If you have given up gluten, but are still struggling with digestive or respiratory symptoms, I encourage you to try eliminating dairy for a period of at least three weeks, and take note of how you feel. You may even want to get a journal and keep track of your symptoms. You may just find that they disappear altogether!
I hope this information helps you on your journey to better health!
P.S. Be sure to join my email list to get a free chapter of my first book, recipes a, Thyroid Diet start guide, notifications about upcoming events, and my weekly newsletter.
- Fasano A. Leaky gut and autoimmune disease. Clin Rev Allergy Immunol. 2012;42(1):71-78.
- Luiz, HV. IgG4-related Hashimoto’s thyroiditis – a new variant of a well-known disease. Arq Bras Endocrinol Metab. 2014;58(8):862-868.
- Ruchala M, et. al. The influence of lactose intolerance and other gastro-intestinal tract disorders on L-thyroxine absorption. Endokrynol Pol. 2012;63(4):318-23.
- Asik M, Gunes F, Binnetoglu E, Eroglu M, Bozkurt N, Sen H, Akbal E, Bakar C, Beyazit Y, Ukinc K.Decrease in TSH levels after lactose restriction in Hashimoto’s thyroiditis patients with lactose intolerance. Endocrine. 2014 Jun;46(2):279-84.
- Cellini M1, Santaguida MG, Gatto I, Virili C, Del Duca SC, Brusca N, Capriello S, Gargano L, Centanni M.Systematic appraisal of lactose intolerance as cause of increased need for oral thyroxine. J Clin Endocrinol Metab. 2014 Aug;99(8): E1454-8. doi: 10.1210/jc.2014-1217. Epub 2014 May 5. PMID: 24796930.
- Muñoz-Torres M1, Varsavsky M, Alonso G. Lactose intolerance revealed by severe resistance to treatment with levothyroxine. Thyroid. 2006 Nov;16(11):1171-3.
- Shabo, Y. et. al. Camel Milk for Food Allergies in Children. Immunology and Allergies. IMAJ 2005; 7:796-798.
- Lister J, et. al. Behavioral effects of food-derived opioid-like peptides in rodents: Implications for schizophrenia? Pharmacol Biochem Behav. 2015 Jul;134:70-8.
- Asik M, Gunes F, Binnetoglu E, Eroglu M, Bozkurt N, Sen H, et al. Decrease in TSH levels after lactose restriction in Hashimoto’s thyroiditis patients with lactose intolerance. Endocrine. 2014 Jun;46(2):279-84.
Note: Originally published in 2015, this article has been revised and updated for accuracy and thoroughness.