Wheat Allergy: Symptoms, Triggers, And Tips

Wheat is one of the eight major allergens that must appear on food labels according to the Food and Drug Administration (FDA). But how does a person know if they have a wheat allergy? It has many of the same symptoms as celiac disease, but that is a different condition with different treatment strategies, according to the American College of Allergy, Asthma, & Immunology (ACAAI). 

While a wheat allergy is most often seen in children, who may outgrow it, adults live with it as well (via Wheat Allergy). Those with this allergy can manage it by receiving an accurate diagnosis, so they know exactly what to avoid. Reading food labels is essential, but that isn't as simple as it may seem. FDA-mandated food labels may not disclose potential cross-contamination in production facilities (per FDA). There is also no rule about disclosing the presence of wheat in non-food products, leaving people with wheat allergy vulnerable to coming into contact with an item that may cause a mild or even life-threatening reaction (via ACAAI). However, learning more about wheat allergy is the first step to effective management. 

Many people think of one food when they consider wheat allergy: bread. That's a smart intuition, as many breads contain wheat (via Healthline). Many, however, are actually made with wheat alternatives and may be safe for people with a wheat allergy (via Medical News Today). 

Aside from bread, some surprising food and non-food items may contain wheat, and therefore are not safe for people with a wheat allergy. According to the Asthma and Allergy Foundation of America, wheat may be present in tabbouleh, seitan, farro, matzo, and spelt. Some of the less obvious sources of wheat are some food additives. Glucose syrup, soy sauce, textured vegetable protein, and monosodium glutamate (MSG) may all cause a reaction in people with wheat allergy. Even if wheat is not a food ingredient, people may have wheat exposure due to cross-contamination during manufacturing (via Cleveland Clinic). That's when the equipment used to make a food or non-food product is contaminated with wheat proteins, possibly transferring those proteins to other products that don't themselves contain wheat. 

Non-food items can also contain wheat. Play-Doh, the children's craft item, contains wheat and can be dangerous for kids and adults that have wheat allergy. Some types of makeup can also have wheat. Since these products are not food, manufacturers don't have to declare the presence of wheat and other allergens on the labels. For this reason, people with a wheat allergy may have to be extra vigilant, as they may experience a reaction not just from eating wheat but inhaling or touching wheat products. 

People often confuse wheat allergy with gluten intolerance or celiac disease. These are all different conditions. According to the ACAAI, people often use the phrase "gluten allergy," but this is misleading. Celiac disease is not an allergy, and there is no such thing as a gluten allergy. 

Gluten intolerance can cause symptoms like diarrhea, constipation, bloating, and abdominal pain after eating gluten. Unlike celiac disease, the condition does not damage the gastrointestinal tract. The symptoms of gluten intolerance are less severe than for celiac disease (via Medical News Today). Someone with a wheat allergy can usually eat foods that do not contain wheat but may contain gluten. This is true for most people with wheat allergy, but the ACAAI recommends speaking with an allergist to see if you need only to avoid wheat or if you must stay away from other grains as well.

In contrast, someone with celiac disease has to avoid all sources of gluten, which, according to the National Institute of Diabetes and Digestive and Kidney Diseases, includes other grains such as barley and rye. Symptoms of celiac disease can include severe diarrhea, rash, severe weight loss, and abdominal pain (via ACAAI). Some people may have gluten intolerance and have to be tested for celiac disease. According to ACAAI, few people with gluten intolerance actually have celiac disease, and having gluten intolerance is not the same as having an allergy.

According to Stanford Medicine, wheat allergy is caused by an immune system reaction. Unlike celiac disease, however, it is not an autoimmune disorder and does not cause damage to the cells of the intestine. A wheat allergy is comparable to a peanut allergy, as the biological mechanisms for both are similar. In general, an allergic reaction happens when the body encounters an allergen (via MedlinePlus). An allergen is something the body recognizes as dangerous. The immune system creates antibodies to fight the allergen, and these antibodies lead to allergy symptoms. 

People with wheat allergy may have developed an allergy to one or more of the proteins found in wheat. These proteins are albumin, globulin, gliadin and gluten (via Mayo Clinic). When a person is exposed to any of the proteins they are allergic to, their body responds with an allergic reaction. 

Surprisingly, some people develop a wheat allergy after repeated exposure to wheat proteins. Stanford Medicine calls this "baker's asthma," a condition experienced by approximately 4-25% of bakery workers. This happens after continued inhalation of wheat proteins and ongoing skin contact with these allergens. 

An allergist can diagnose a wheat allergy using one of several tests (via Mayo Clinic). Typically, a doctor will start by taking a detailed medical history, including prior reactions to food. They may ask the person with the suspected wheat allergy to keep a food diary where they document exactly what they eat and what symptoms they experience. Another option for food allergy testing is the food elimination method, where foods are taken out of the diet and gradually re-introduced. As the person begins to eat certain foods again, they will note if symptoms come back.

In addition to these techniques, an allergist can perform specific tests to diagnose an allergy to wheat or another substance (via Children's Hospital of Philadelphia). Allergy skin testing is when a small sample of the allergen, such as wheat, is placed on the skin. The doctor monitors for any reaction. Allergy blood testing is when blood is drawn and screened for specific antibodies that may be produced because of a food allergy. Food challenge testing is when the person eats a small amount of the food under medical supervision, and the professional team monitors for and records any reaction.

Receiving the correct diagnosis of wheat allergy is important to distinguish symptoms caused by other conditions, such as celiac disease or gluten sensitivity.

Even the most diligent of people with a wheat allergy may sometimes come into contact with wheat. There are a number of ways to treat the allergic reaction to wheat, depending on the severity of symptoms. Mild symptoms are often managed with antihistamines or corticosteroids (via Cleveland Clinic).

For those who might experience anaphylaxis, it is critical to have quick and easy access to epinephrine (via Stanford Medicine). This is most commonly available by prescription in an auto-injector form. People who have an epinephrine auto-injector and their caregivers should know where it is kept at all times and instructions for proper use in the case of a severe allergic reaction.

There are promising new therapies that may offer new ways of treating, and perhaps eliminating, wheat allergies. Immunotherapy is one technique currently under study for the treatment of wheat allergies, although it is still experimental and not FDA-approved. Some research has shown that immunotherapy, where a person is given small amounts of an allergen in a controlled setting over time, can help reduce or eliminate wheat allergy (via American Academy of Allergy, Asthma, & Immunology (AAAAI)).