Sunday, July 25, 2010

Wheat and lactase

While I'm trying to clear my desk top a little, with limited access to the net during an oncall weekend, I thought I might post this link as I'm thinking wheat at the moment.

I think I've discussed the role of gluten in trashing the brush border cells, again without need for any sort of immune system involvement. The present study did involve immune-injured people but I see no reason why exactly the same principle shouldn't apply to antibody negative "coeliacs" (suffering from "imagination" or even, gasp, orthorexia nervosa, another from Elizabeth. Apologies for the picture of the bowl of rabbit food).

Another aspect of normalising the brush border is that far less food is going to be left in the small intestine to feed a bacterial overgrowth. On a LC, low fibre diet there are likely to be massive changes in gut flora. I have an anecdote from several years ago given to me by a lady and her mother who had gone LC plus gluten free and, after quite some time, both suddenly became lactose intolerant. This is the last thing I would have expected.

Now, I'm no great enthusiast for pre- or pro-biotics, but I do eat a fair amount of cheese, soured cream and high fat yogurt. The last of those occasionally in large amounts. So eating real-food dairy accidentally includes plenty of germs. Germs to which we are well adapted. Gut bacteria are normal to humans and lactobacilli are amongst the first bacteria to colonise the gut of a healthy infant, presumably because its mother provides lactose (and pre-biotics too, hmmmm). For humans who are not genetically adapted to adult lactose intake, are we borrowing the gene for lactose tolerance from the microbiome in our gut? Is it possible to lose lactose tolerance if we lose lactobacilli during the major bacterial starve-out that LC probably produces?

Alternatively, as coeliac disease appear to require certain bacteria, does lactose intolerance REQUIRE certain non-lactobacilli bacteria? This would fit better with two people developing lactose intolerance at the same time in the same household, if they simultaneously picked up the same bacterial opportunist.

Answers on a postcard to........



david said...

../giddy he's the first to comment on a fresh post/...

I was thinking along the same line but on a slightly different subject and wondered who among our bacterial overlords did I upset/starved with my LC.

I noticed a rash/hives on the back of both my thighs since I started flirting with ketosis. The Intertubes seems to think it's either a yeast starvation (not aware we had yeast on our skin) or mast-cell degranulation (dunno what it means).

Can anyone offer a guess as to what caused it?

Peter said...

Hee hee, got to start somewhere! I never had any specific response to gluten with my skin until I went LC but not gluten free, it was just generally awful. Then I developed persistent localised lesions on my hands. Lutz suggest that marked LC can exacerbate immune mediated problems, possibly due to removing the effect of hyperglycaemia on the immune system, but that's a guess. It went with dropping the occasional beer...

The yeast issue is interesting as Weetabix sent me an abstract discussing whether a surface chemical on candida, which is a tissue transglutaminase substrate, might be intimately involved in the development of coeliac disease. You have to wonder whether candida might be a source of gliadinases too. Keeping Candida strictly in a science arena, nothing too alternative!


Anna said...

Hmmm, in my first few years of LC but not gluten-free eating (in fact earlier on, I was consuming nearly daily portions of LC pita bread with wheat gluten as a significant ingredient), I developed small patches of eczema on my lower legs, which later cleared up after I started taking thyroid hormone. I always assumed the eczema was due to the hypothyroidism, but now I've got to wonder.

Anyone else read Dr. Art Ayer's Cooling Inflammation blog? He has some very interesting thoughts on gut bacteria. He's not a fan of wheat, either.

Peter said...

Hi Anna,

Yes, I certainly follow it and the biofilm ideas and the gut in auto immunity are fascinating. Not quite the same point of view as Ebringer but looking at charge distributions on proteins is a similar approach... I like the ideas about signaling sequences of amino acids.


jon w said...

hmm I am working on mosquito/human parasite genomics for my MS but more and more wondering about a phd topic about various diets and the gut flora micro-biome. there has to be some major differences, the tools are readily available and it seems to be un-explored.

Peter said...

Hi Jon,

I love the gut microbiome. Have you browsed the Fiaf posts? They get a bit far out eventually but start technical. And maybe talk to Stephan at

He has switched from a neurophysiology PhD to nutrition post doc....


David said...

Tangentially, do the insulin spikes from all that dairy you consume concern you?

Susan said...

I went LC and gave up all grains right from the get go. A year and a half into the program, the only dairy I seem to tolerate at all, and still be socially acceptable, is butter and sour cream. I used to be able to eat most cheeses, but no more.

Peter said...

Hi Susan, noted for thinking about...

Dave, not at all. I still limit protein to 60-70g/d and while there may be some variation in insulogenic effect of casein vs other proteins the total insulin AUC is still not huge compared to 400g/d of carbohydrate. Protein is essential, I am quite willing to pay some insulin price for it.

Plus both soured cream and my high fat yogurt (when I make it) are quite low in protein anyway.


AJW said...

Coeliac from birth and diagnosed at 4 months, since dispensing with the prescribed crap that passes as wheat and gluten free prescription food and going "primal/paleo/LC/Real food" about two years ago I've noticed significant changes in what I can and can't tolerate. I used to eat cheese and yoghurt by the bucket load but suffered with terrible skin problems when I did. Since removing it from my diet and substituting with coconut milk I've finally got a grip on my health (and dropped five stone in the process - it was needed). However, if I have cheese it feels like food poisoning and can last for days. Personally, there's a definite link between lactose and wheat intolerance / tolerance. Interesting post.

Paul Jaminet said...

david -

Yeast/fungi can definitely do that. I had that experience when I first went low-carb, except on my ear. Try an over-the-counter antifungal on it, if it's yeast that will work.

The basic issue is that the immune response to fungi relies entirely on respiratory bursts which use a lot of glycogen. Especially when you first switch to low-carb, immune cells are likely to be deficient in glycogen and not be fighting yeast very effectively.

If it is fungal, eat at least 200 calories per day starch (you want glucose not fructose - rice, sweet potatoes, taro are good sources). Also, supplement iodine - this is also needed to fight yeast.

Stan Bleszynski said...

Hi Peter,

Just slightly off topic:


Another clue that vitamin D likely caused the increase in PD risk among men drinking more milk in the Honolulu study was that consumption of cheese and ice-cream did not affect PD risk. The explanation? Although these products are made from milk, they are generally made from milk before it has been fortified with vitamin D.

That Park and team did not even consider the vitamin D in milk as a possible cause for the increase PD among men consuming more of the substance speaks to the incredible strength of the current consensus that fails to recognize the immunosuppresive properties of vitamin D. This is bound to hange, but in the meantime, vitamin D fortified milk should at least come with the message, “Immunosuppressive steroid included at no extra charge!!”

It doesn't make a sense to me for 2 reasons: 1 because parkinson's patients tend to have too low vitamin D levels, and 2 - the lack of D is associated with immune dysfunction not an excess of D. Howver I am not 100% sure and I am curious if there is some mundane interpretation of that milk study. What do you think about it?


Peter said...

Hi Stan and Paul, the world is full of U curves.... From acute glucose levels through to chronic fasting insulin level. Cortisol too. Addisons vs Cushings, both bad. On the D front we're still waiting for informtion and when there is insufficient information then beliefs seem to get pretty entrenched. I think there's probably a U curve.

I see PD, ALS and alzheimers as esentially the same disease, driven by energy consuption beyond supply ability. I know Paul has interesting ideas on how microbes might trigger acute energy deficiency in neurons but I think you have to explain the localisation of the lesions and I'm personally over-enthused with metabolic problems which also predispose to infection rather than the other way round. But that's just my bias. I have to be willing to change that view if data tell me to!

About yeasts: I also have a paper on my hard drive (off line) with a group of case reports suggesting Meniere's syndrome responds to nystatin, an anifungal with minimal systemic uptake in most people. It's from Pubmed but seems to have disappeared. Then we're back to gut microbes and auto immunity.

AJW, caseine undoubtedly does the job of gluten if you can get it past the stomach's acid/pepsin environment. It doesn't matter how you open the tight junctions. Most of us are OK in terms of degrading caseine to non active peptides but clearly not all of us manage it.


Peter said...

Oh, Re milk and PD, what sort of adult American drinks most milk? I doubt there is any way they could account for all of the potential confounders likely to be going on here.


Paul Jaminet said...

Hi Peter,

Agreed on the U-curves.

Re explaining the location of lesions, I see locational differences of infections as accounting in part for the diversity of diseases and symptoms.

C. pneumoniae tends to infect monocytes/macrophages first and then spreads to wherever the macrophages take them. Once in a cell, they proliferate there within endosomes. When the bacterial population becomes so large and the cell so damaged that it is no longer an adequate host, the bacteria lyse the cell and release themselves into the extracellular medium. Here they can neither reproduced nor manufacture proteins, so they must quickly find and enter a new cellular host. They tend to spread locally.

My guess is that MS results from an early localized infection in the brain, and the infection radiates from this central focus. Fibromyalgia seems to involve infection of peripheral nerves. Atherosclerosis involves infection of vascular endothelial and mural cells (but this is a diet dependent infection, not much bacteria food in these cells on a low-carb diet). Alzheimer's probably results from a more diffuse infection of the brain, probably following some breakdown of the blood-brain barrier due to other causes - possibly including atherosclerosis/chlamydial infection of the microvessels.

Differences in pathogens also may account for disease differences. Nocardia infections can induce a Parkinson's mimic in mice (; see also, but it hasn't been confirmed that they do so in humans. I haven't looked into ALS.

Lee said...

Hi Peter

Interesting what Susan said. I also have the impression that I tolerate dairy better if eating higher carbs, including gluten. I had bad halitosis during a high cream phase. I put it down to the cow's milk, but I am not absolutely sure.

JK does not mention food intolerance much, assuming they all disappear with the OD. Rereading Optimal Nutrition, and comparing my diet with the sample menu, I do not find great similarity. The main difference: the OD menu contains much more offal, especially gelatinous products. So tonight then, I think I'll have pig trotters followed by buttery fruit jelly (p139) (:-0).



Anonymous said...


Regarding digestion of lactose, Dr. Natasha Campbell-McBride, in "Gut and Psychology Syndrome" states:

"If we are not meant to digest lactose, why do some people seem to manage perfectly well? The answer is that these people have the right bacteria in their gut. One of the major Lactose digesting bacteria in the human gut is E.Coli. It comes as a surprise t many people that physiological strains of E.coli are essential inhabitants of a healthy digestive tract. They appear in the gut of a healthy baby from the first few days after birth in huge numbers and stay in these same numbers throughout life providing that they do not get destroyed by antibiotics or other environmental influences."

Peter said...

Hi Jack,

I like the idea, does she have any sort of ref tying E coli to lactose digestion? E coli are a massive family of bacteria from normal and probably beneficial commensal through to O157 of the Lanarkshire outbreak.... But it could be that simple.


Anonymous said...


I could not identify the reference regarding the breakdown of lactose by E.coli in the book "Gut and Psychology Syndrome" because references given are not related to the narrative, but I found the same statement about E.coli digesting lactose in the article on "Food Allergies", also by Natasha Campbell-McBride, in the latest WAPF journal, and a reference is given.

You will find the discussion of E.coli beginning with the 7th paragraph under the topic "Malnutrition", and the reference regarding lactose digestion is #10.

Regarding the ladies who developed "lactose intolerance" after being on a low carb diet, it seems quite likely that the problem could be other than lactose intolerance.

Did the ladies change their source of milk? Some people are intolerant of casein from A1 cows but can drink milk from A2 cows or goats milk, which is A2 milk and has more casein than cows milk, with no problem.

If the ladies changed from drinking "regular pasteurized" milk to ultra pasteurized milk, it could possibly cause problems, including increased release of the peptide beta-casomorphin 7 (BCM7) which seems to cause many problems.

Jack C.

zach said...

I get around 60% of my calories from unprocessed milk, butter, cream, cheese, yogurt, etc and have been wheat, vegetable oil, and white sugar free for over a year. I'm much healthier now for sure, but on the rare occasions when I do eat wheat, I get a terrible pain behind my right eye! Weird huh? What do you make of that. I've repeated this experiment 4 times, with 4 different wheaty foods, same result. When I ate wheat all the time I never had any pain.

Richard said...

Well, this is interesting. I have been on my version of the PaNu diet for about six months. I have lost about 10 pounds, a lot for me, as I was not noticeably overweight to start with, and I realized I do have real issues with wheat. No more wheat.

But now I have a persistent itchy rash on my chest. I have been drinking UHT cream, and some coconut oil, with some cream in a can from Nestle.

Just to explain, where I live, in Cebu, Philippines, it is very difficult to get fresh cream. Or yogurt, or beef, for that matter. But I can get decent cheeses.

Is this a candida reaction? Lactose reaction?

I have to eat wheat to fix it?

How very strange. Maybe I need to stay with the more pure non UHT cream? Butter instead? But the low carb I thought would help get rid of the candida? Very itchy.

Paul Jaminet said...


Low-carb doesn't get rid of Candida. It usually exacerbates it due to reduced immune function from glycogen-deprived white blood cells.

Don't add wheat, rather add rice or sweet potatoes or taro.

Also, if it is Candida, you need selenium, iodine, vitamin D, vitamin C, glutathione, and probiotics (ThreeLac is good). There are various herb and oil remedies which help as well, but immune function is the key. If you can work up to high-dose iodine of 50 mg/day, that will make a big difference.

Peter said...

Hi Jack, thanks for the link, not had time to follow it yet but I will.

Hi Zach, reactions can be very localised. My persistent one was lateral side of digit 5 of my right hand. It has shown occasionally else where. Exactly what determines location seems random. Possibly sugar moieties of cell surface glycoproteins????

Richard, whatever else you do, opt for real food and see what happens. Obviously wheat does not come in that category! UHT cream doesn't either as far as I can see.....


Peter said...

Hi Jack,

Followed the link, she talks a lot of sense. The E coli ref is a textbook citation but I see no reason to doubt it says what she says... An interesting person.