DAIRY ALLERGY SURVIVAL GUIDE a sensationalist information document on casein sensitivity by Tatterdemalion, Not A Doctor copyleft 2004-5, share freely. When I met my partner, he had some mysterious vitamin deficiencies and he had digestive trouble triggered by a host of foods that should have been fine for him to eat. He hadn't been able to eat chocolate, tomatoes, spicy foods, citrus fruits, or various other acidic foods for several years. Only less than two years ago, he'd noticed that dairy foods set him off, and so he'd started avoiding milk and cheese -- but still had the rest of his troubles. I had a hunch that dairy might be responsible for all of his problems, and told him so. What's more, I introduced him to the concept of hidden dairy products. Yes -- milk lurks everywhere! It tiptoe-sloshes through the grocery store at night and infests the aisles, hiding behind fake names like "casein" and "hydrolyzed whey protein". This fine document will tell you how to evade the lurking white menace (!), and furthermore will help you figure out whether or not you need to. My own background? I am an ovo-lacto vegetarian who reads labels constantly and eats fish on days beginning with a "Q". I'm not a doctor, and I don't have any political motivations, or anything to sell you (unless you'd like to buy some original art . . .) I simply want to spread my knowledge of hidden protein allergies, which can cause a lot of mysterious grief, and share the tips and tricks that've helped us. HOW DO I KNOW IF DAIRY IS THE PROBLEM? First of all, let's back up a little to protein intolerance or hypersensitivity in general. Also, I'll give you a disclaimer: I'm not a doctor, and this is just a summary of the data I've pieced together from various information sources and personal experience. Probably the best way of finding out more information is reading about celiac disease, which is a wheat gluten sensitivity that seems to operate in much the way my sweetie's dairy intolerance does. There are various types of allergies and sensitivities, and the stuff I'm describing here is not technically an allergy -- there is no life-threatening IGE antibody reaction. But it can be fairly devastating in the long term. In these conditions, the body simply can't digest wheat or milk protein, and (a) having these indigestible proteins around messes with the intestinal lining, leading to vitamin deficiencies and bowel problems. If you don't digest your food right, you lose the nutrients you need to keep going. (b) furthermore, with the intestinal lining messed up, protein goes into the bloodstream -- causing, in some cases, autoimmune conditions and mysterious systemic symptoms as the immune system attacks the protein. This is called "leaky gut syndrome." My partner wasn't having weird autoimmune symptoms. I'm not sure this says anything; he's a freak who only sniffles for two days when he catches the flu. But when he went to the doctor about all this, years ago, the doctor noted a high protein level in his bloodstream, though they had no clue what it meant. Another of our friends has a gluten sensitivity, and had just the weird autoimmune symptoms, no obvious digestive problems. SO -- it can vary from person to person. Dairy and wheat sensitivities have been implicated in Chronic Fatigue Syndrome, Systemic Lupus, and other nasty mysterious syndromes such as Irritable Bowel Syndrome. B Vitamin deficiency (symptoms here) is a particularly common warning sign that protein sensitivities may be responsible. It's worth trying . . . HOW FAST WILL I GET BETTER? My partner had almost started to lose heart by the time he finally noticed an improvement. It was two months for him from the last time he ingested a dairy product by accident to when he was finally able to eat most acidic foods without trouble, and things continued to improve over the month after that, indicating the process wasn't finished yet. He's had long periods without trouble now, and only has mild problems when he accidentally swallows something unidentified, since his system isn't being bombarded with the stuff regularly. But now he can eat spicy foods, chocolate, and whatever else he pleases as long as it doesn't contain any milk extractives! It might take even longer for you. Give at least three months' trial to the elimination of whatever proteins you think are troubling you (which, if you're reading this document, probably includes the dairy proteins. What are they called? Casein, sodium or potassium caseinate, whey or whey protein (in any form), lactalbumin, and lactoglobulin, mainly.) Don't get discouraged too easily. HOW DO I AVOID DAIRY? Ingredients to look out for This is a more complicated question than it sounds! Don't think you can get away with merely refusing glasses of milk. The cow creeps in under the door, I tell you. The cows . . . (low paranoid voice) . . . are everywhere. Here is a list of ingredients to avoid: Obvious -- milk, anything with "milk" in the name or that says "milk derivative", cheese, anything with "cheese" in the name, cream, cream curds, curds, whey, anything with "whey" in the name -- demineralized, delactosed, whatever; butter, buttermilk, anything with "butter" in the name INCLUDING artificial butter flavor; half-and-half, sour cream, yogurt. Less obvious but equally important -- casein, anything with "caseinate" in the name, lactalbumin, anything with "lactalbumin" in the name, caramel color, caramel flavoring, ghee, custard, hydrolysates, hydrolyzed milk protein, high protein flour, lactoferrin, lactoglobulin, lactose, lactulose, margarine, rennet, protein, Simplesse, nougat. You'll only find this on some bakery and foreign products, but avoid anything that says "margarine", unless you have the margarine tub in front of you and can read the ingredients right then and there. 90% of margarines have whey or casein added to give it that yummy milk protein flavor -- and frustrate allergic consumers. Avoiding "natural flavors" or "flavoring" is almost pointlessly difficult unless you happen to get life-endangering reactions. My sweetie can be set off by a teaspoon of margarine with whey protein in it, but he's never fallen victim to "natural flavors". We've also not been cautious about "caramel color". This one is a lactose derivative, and we suspect he's only sensitive to the proteins. Nor have we been careful about things that don't have any dairy ingredients, but have the dairy kosher symbol or say "may contain", which usually means that they're prepared with the same equipment -- something which is significant to people with severe immediate allergies, but not as much to long-term sensitivities. Your mileage may vary. The idea that lactic acid should be on this list is silly. It doesn't even necessarily come from milk (it's also found in various veggies) and even if it does, it's presumably extracted in a laboratory to be identical to all other lactic acid. It's even meat-kosher. The same is true for "potassium lactate" (an ingredient which, when I spied it on a label of a food product the sweetie was eating, nearly gave me a heart attack -- then I read up on it) or anything lactate or lactylate; these are all lactic acid compounds. THE SECRETS OF THE COW CONQUERERS: more hints on hidden dairy NON-DAIRY doesn't mean anything! It's a lie! A holdover from the days in which "dairy" just meant whole milk, this label is usually inaccurate. Read the ingredients. DAIRY FREE and VEGAN are usually more reliable labels, but as far as I know there's no law. Read the ingredients. TWO IMPORTANT RULES: 1. You can always find a dairy-free version of ANYTHING somewhere. So don't despair. 2. You can always find a version of anything WITH dairy in it somewhere. So don't assume. We even found fortune cookies with whey in them the other day. Bad orange fortune cookies. Be especially careful with these food items: Bread and pastries -- in restaurants, ask to see packaging or find someone who knows the ingredients. Pastries almost always have butter, but if you go to your local college coffee hangout they might be able to get you a vegan one. Margarine -- a little margarine on an egg recently gave my sweetie a two-week spell of symptoms. No kidding. This stuff usually has whey in it. Mind you, there IS safe margarine out there; they just don't use it in restaurants. See the later part of the guide. Fake Cheese -- Yes. Cheese substitutes have casein in them nine times out of ten. I suppose they're for lactose intolerant people. But really. What a death trap! Look for the ones labeled "VEGAN". Non-dairy creamer -- I'm sorry, Virginia, there ain't no Santa Claus, and something you've believed all your life has just been torn down. Non-dairy creamer has casein all the whey (heh heh) and I've never seen one without it, except for the refrigerated kind produced by soymilk companies. Meat -- hot dogs, sausages and luncheon meat can have dairy in them. Candy -- dairy is in some weeeiiiirrd things out there. Dark chocolate's one that often has milk in it when you wouldn't expect. Dressings and sauces -- especially in restaurants, always ask. Check everything! We've found dairy in salad dressings and sandwich fixings; we've found "Extra Butter Flavor" microwave popcorn that doesn't contain a drop of the stuff. We've found stuffing that comes in exactly the same package, except that some of the packages include 'whey' in the ingredients and some don't. (Oreos are similarly confusing.) You'll be surprised by good fortune as often as disappointed. IN RESTAURANTS -- ASK. What are you paying those inflated meal prices for if not to get a good meal? And a meal that hurts you is not a good meal. If you tell them you have a dairy allergy, they should be careful to avoid getting dairy in your food, and solicitious to make certain you know what is there. Eating bugs won't hurt most people, but restaurants get sued when bugs wind up in the food, right? So if something that will hurt you winds up in yours, don't hesitate to ask for a new plate. The same goes for any other allergies you might have. REPLACING THE COW Westsoy and Trader Joe's Brand unsweetened soymilk give you the most bang for your buck. Unsweetened because you want to cook with that sometimes, right? You can always put sugar in, but you can't take sugar out. It doesn't actually matter all that much what milk substitute you use. They're mostly pretty good for things like cereal and coffee creamer. We use soy because it's thicker than the others and creamy, not grainy. Almond milk is thin and rather grainy, but has a wonderful flavor. Rice milk is thin but not grainy; think nonfat milk. Oat milk is thick and grainy, but it cooks in some applications at a better consistency. And, as always, check the labels. I haven't found a soymilk with dairy in it yet, but I HAVE seen soymilk powder with milk ingredients. How useless -- like instant water. Earth Balance margarine is, unlike most other margarine, dairy-free AND not disgusting! No hydrogenated oils, and best of all, it tastes just like butter -- not that nasty fake taste. I even make sauces out of it. If you can't find this, look for anything that says "Parve"; that's the kosher label for 'neither meat nor milk'. DO NOT confuse it with "Smart Balance", which is a copycat brand with whey in it! For ice cream, around here, we enjoy Soy Delicious, Tofutti and the Double Rainbow brand (be careful with this, as they also put out milk ice creams which are often right near their soy versions.) "Soy Dream" isn't quite as good, IMHO. For cheese, we use Vegan Gourmet Cheese Alternative by Follow Your Heart. If you can't get it locally, for it's fairly rare, it's available online at www.followyourheart.com. Tofutti makes good cream cheese and sour cream substitutes. The ones available in most stores have nasty hydrogenated oils; try a Wild Oats/Nature's grocery store location for ones that don't. Trader Joe's also makes a sour cream substitute. We recommend the cookbook Dairy-Free and Delicious by Brenda Davis, Bryanna Clark Grogan, and Joanne Stepaniak. It contains various cheese replacements (sweetie doesn't like the hard cheeses, but likes the sauces; I like the hard cheeses just fine, so it's your call, I guess) and substitutes for various ingredients, so you can make pies with sweetened condensed soymilk, for example. SEARCH LOCALLY! You may live in a barren wasteland like the Midwest -- but if you're in a major East or West Coast city or a hippieish one, chances are that some local weirdos are putting out something unique, yummy and dairy-free. In Portland, we found soy soft-serve ice cream at Scooters on SE 33rd and Belmont, to say nothing of the vegan pastries available in almost every coffeehouse. You may not be so fortunate, but look around.