Wheat Allergy: Symptoms, Testing, and Treatment

Wheat allergy is one of the nine most common food allergies and is often reported in young children. One study indicated that roughly two-thirds of children will outgrow their wheat allergy before their teenage years, although some people will remain allergic to wheat for their entire lives.

What is Wheat Allergy?

A wheat allergy, similar to other food allergies, occurs when your body tries to fight specific proteins that it considers to be a threat to the body.  The immune system reacts to the wheat proteins and releases IgE antibodies. As a result, individuals with a wheat allergy experience a variety of allergic reactions, with some occurring immediately and others occurring over a matter of hours or days after consuming wheat.  When multiple symptoms occur and impact at least two bodily systems – or one severe reaction occurs – a wheat allergy can be dangerous and even life-threatening. 

Wheat allergy is not an autoimmune disorder (like celiac disease, which is covered later in this article), though it does trigger an immune system response. 

Is Wheat a Common Food Allergy?

Wheat allergies are fairly common, with estimates ranging from 4 to 13 people out of 1000 having true wheat allergies. While two-thirds will outgrow their wheat allergy by the age of 12, some will continue to be allergic.

What are Wheat Allergy Symptoms?

Symptoms of a wheat allergy can include: 

    • Hives
    • Eczema
    • Hay fever
    • Tissue swelling 
    • Skin itching or irritation
    • Stomach cramps (and/or abdominal pain)
    • Swelling of the tongue and/or the lips or around the eyes
    • Nausea
    • Vomiting
    • Diarrhea
    • Nasal congestion

A severe wheat allergic reaction can trigger anaphylaxis, which can become life-threatening if not treated immediately. This occurs when the immune system sends a rush of chemicals to fight off invading proteins, causing anaphylactic shock. Signs of anaphylaxis include: 

    • Pale or bluish tint on the skin 
    • Throat constriction
    • Shortness of breath (and/or wheezing)
    • Difficulty breathing
    • Confusion and/or dizziness
    • Weak, rapid pulse

If an individual goes into anaphylaxis, epinephrine treatment must be sought immediately. If you have a diagnosed wheat allergy, consider using this downloadable form from FARE to create your own anaphylaxis emergency plan in case of accidental wheat ingestion.  

How to Test for a Wheat Allergy

Some allergic reactions to wheat overlap with symptoms of celiac disease or gluten intolerance/sensitivity, and thus can be frustrating and difficult to diagnose. Recent research even points to a possible link between wheat allergy and irritable bowel syndrome (IBS). What sets wheat allergy apart is that an allergic reaction can become severe, and may result in life-threatening anaphylactic shock. As a result, it is important to speak with an allergist to get a clinical diagnosis to avoid significant health and safety risks. 

The gold standard of food allergy testing encompasses three ways to clinically determine whether someone has a true wheat allergy or should be evaluated for celiac disease, or a gluten intolerance/sensitivity.

Skin Prick Test

A safe and low-risk test in which the skin is lightly pricked with a suspected allergen. This often results in hives or rashes, with more severe reactions pointing to a greater likelihood of a true wheat allergy.

Blood Test

Measures the amounts of IgE antibodies that the immune system has deployed as a response to wheat. The presence of IgE antibodies can help a clinician determine whether the immune system is responding to a wheat allergy.

Oral Food Challenge

A step-by-step process which involves consuming small amounts of a suspected allergen over 3 to 4 hours. Because severe allergic reactions can become life-threatening, this step is only performed under the supervision of a trained clinician, and only if they have previous determined that the patient is likely to safely pass the food challenge. If skin prick tests and blood tests are unclear, an oral food test can determine, with certainty, whether a suspected allergen may safely be consumed.

Foods to Avoid with a Wheat Allergy

Wheat is one of the most common grain products in the U.S. and wheat (and its byproducts) are found in a wide range of foods. Individuals with a wheat allergy must carefully examine all food labels, even if a certain food has been safely consumed in the past. The list is extensive, but some of the most common examples include:

    • Flour
    • Bread crumbs
    • Bread
    • Bulgur
    • Malt and malt extract
    • Triticale
    • Triticum
    • Cracker meal
    • Noodles and pasta
    • Glucose syrup
    • Soy sauce
    • Teriyaki sauce
    • Hydrolyzed vegetable protein
    • Vegetable gum

Is Wheat Allergy the Same as Gluten Allergy?

Gluten is a protein that is found in grains such as wheat, rye, and barley that can be present in a wide range of foods, from bread and crackers to salad dressings and artificial flavoring, but there is no such thing as a “gluten allergy.” The term “gluten allergy” often gets used erroneously to describe a wheat allergy or similar conditions like celiac disease. 

If you experience adverse reactions after eating wheat, it can be tempting to avoid gluten altogether – but trying to consume only gluten-free products is far from a cure-all for wheat-related conditions. It is most crucial to avoid wheat ingredients. In fact there is a deglutenized wheat starch product that is safe for celiacs, but may cause a reaction in someone with a wheat allergy.

Wheat Allergy Treatment 

Recent studies have shown that wheat allergy can be successfully treated with oral immunotherapy (OIT) in patients of all ages. Not only is OIT safe, at Latitude Food Allergy Care, 92% of OIT patients are successfully desensitized to their allergens and reach maintenance

Oral immunotherapy works by routinely exposing the patient to increasing amounts of the foods they are allergic to. The goal of OIT is to gradually desensitize the body and protect against severe reactions due to accidental ingestion or exposure. 

At Latitude, our skilled clinical team will evaluate any existing conditions, gather a full medical history, and learn about your family’s lifestyle to determine if you are a good candidate for wheat allergy treatment through OIT. If clinically relevant, patients can choose to combine their oral immunotherapy with Xolair, an anti-IgE monoclonal antibody that helps inhibit allergic reactions.

The Difference Between Wheat Allergy, Celiac Disease, and Gluten Sensitivity

In addition to wheat allergies, there are two other primary wheat-related diseases: celiac disease and gluten sensitivity. As noted above, a misleading term that is commonly confused with these diagnoses is gluten allergy

Each diagnosis requires its own treatment plan, and consuming gluten-free products may only address some symptoms. Improperly addressing symptoms (or delaying adequate treatment) of a wheat-related disease can cause long-term or severe side effects, making accurate clinical diagnosis a crucial step.

What is Celiac Disease?

Celiac disease is an autoimmune disorder affecting approximately 1 in 100 people across the globe – whether they are aware they have it or not. In an autoimmune disorder, your immune system is unable to distinguish between your body’s normal cells and foreign, potentially harmful cells. 

When gluten is consumed, the immune system mistakenly attacks the villi within the small intestine. These small, fingerlike projections are designed to help with nutrient absorption and digestion.

What are the Symptoms of Celiac Disease?

Symptoms and health risks associated with celiac disease include: 

    • Fatigue
    • Vomiting
    • Diarrhea
    • Anemia
    • Bloating
    • Joint pain
    • Abdominal pain
    • Weight loss
    • Malabsorption 
    • Nutritional deficiencies 

How to Test for Celiac Disease 

Celiac disease can be difficult to diagnose. Along with a thorough medical history, there are two tests that can rule out whether a gluten hypersensitivity is linked to celiac disease. One option is to test your blood for antibodies that are produced during an autoimmune reaction. Individuals with celiac disease will have significantly higher levels of IgA or IgG antibodies. A second option is to take a small tissue sample of the small intestine. A lab will examine the biopsy and determine if the villi inside the small intestine are damaged due to this autoimmune disease.

Note that if you suspect that you have celiac disease, you should seek a diagnosis before pursuing a gluten-free diet. Removing gluten from your diet first could negatively impact the accuracy of tests that the gastroenterologist would run.

Celiac Disease Treatment

The only way to truly treat celiac disease is with strict avoidance of gluten. Gluten can be found in many foods beyond wheat, including barley, bulgur, and malt. While avoiding gluten can be challenging, for someone with celiac, it will help your body heal and reduce inflammation of your intestines.

What is Gluten Intolerance or Sensitivity?

What is often referred to as gluten intolerance is a digestive system reaction when your body is unable to effectively digest gluten.

Non-celiac gluten sensitivity (NCGS) is a newly recognized condition in which individuals experience adverse reactions after consuming wheat and other foods with gluten, but do not fall under a celiac disease or wheat allergy diagnosis. Recent research has shown that additional factors present in wheat may also play a role in non-celiac gluten sensitivity, making the term non-celiac wheat sensitivity (NGWS) more common. 

What are the Symptoms of Gluten Intolerance?

Individuals who are diagnosed with NGWS may be sensitive to small carbohydrates present in wheat. Because gluten-free products contain much lower levels of these carbohydrates (FODMAPs), consuming gluten-free products often brings significant improvement in symptoms. These symptoms may include: 

    • Fatigue
    • Headache
    • Skin irritation
    • Bloating
    • Digestive upset
    • Abdominal pain 

How to Test for Gluten Intolerance

Many symptoms of NGWS overlap with symptoms from celiac disease or wheat allergy, making it difficult to diagnose. The best way to determine if you are suffering from NGWS is to clinically test for – and exclude – celiac disease and wheat allergy. Once these wheat hypersensitivities are ruled out, individuals can work with a skilled clinician to begin eliminating wheat or gluten from their diet and note any positive changes.

How to Treat Gluten Intolerance

Eating a diet based on low-FODMAP foods can also be included as part of treatment. Although somewhat counterintuitive,  if celiac disease is suspected, it is important to continue including gluten in the diet for accurate testing. Consult an experienced clinician as soon as an issue is suspected.

Are you or someone you love impacted by a wheat allergy? Improve your quality of life and unlock a better future with Latitude Food Allergy Care. Latitude offers comprehensive food allergy care, including testing, treatment, and prevention, for babies, children, and adults. Contact us today to schedule a no-obligation conversation with one of our Patient Care Coordinators.

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