Transglutaminase is an enzyme used in the food industry to tenderize poor quality meat for cheap or fast foods. It is not typically found in meats in grocery store meats departments or normal steakhouses. The food industry also uses transglutaminase to form meat into perfect shapes. Have you ever seen chicken nuggets that all look the same? If so, they probably used transglutaminase. If you have an immune response to transglutaminase, you may have an immune cross-reactive response to food industry transglutaminase and notice symptoms of inflammation if you eat it. Going gluten free can be as simple as avoiding processed and fast foods, eating a diet of meats, vegetables, fruits and using gluten-free condiments. This also means that when you eat out, you cannot always trust the chef or server and you must stick to meat and vegetable dishes without heavy or processed sauces. Most people who react to gluten notice a change in their wellbeing within a week of adopting a gluten-free diet, though some will take longer. It may take several weeks or even months for the immune response to calm down, which is why cheating or small exposure can sabotage the entire program. “Just a bite” can trigger a domino-effect immune response that can last for long periods of time, so it is important to be consistent.

Unfortunately, going gluten free alone may not be enough to manage declining brain function, autoimmunity, or inflammation. This is because proteins in other foods can cross-react with gluten. Cross- reactivity means the proteins in certain foods are similar enough to those in gluten to trigger a reaction. Foods known to commonly cross-react with gluten and casein (dairy protein) are yeast, oats, sesame and some brands of instant coffee.

The food that most commonly cross-reacts with gluten is casein. This is not to be confused with lactose in tolerance. Lactose is the sugar portion of milk whereas casein is the protein. Lactose intolerance is a condition in which some people lack the enzyme to digest milk sugars. It is not the same as an immune response to casein.

One study found 50% of patients with gluten sensitivity experienced only partial remission of symptoms on a gluten-free diet because they had a cross-reactivity to milk. It’s also important to test for different antibodies to milk protein or you may miss a dairy sensitivity. These include alpha-casien, beta-casein, csomorphin, and milk butyrophilin.

The other common cross-reactive foods – oats, yeast, sesame, and some brands of instant coffee – can also be an issue. If you symptoms are not improving on a gluten-free diet you may need to get tested for these cross-reactive foods or simply avoid them completely.