People with a wheat allergy have an abnormal immune system response to at least one of the proteins that exist in wheat.
A wheat allergy is one of the most common childhood food allergies, but it may affect adults as well. The person with a wheat allergy has developed a specific antibody to a wheat protein, and sometimes more than one.
Wheat allergy is not the same as celiac disease.
Contents of this article:
What is a wheat allergy?
A wheat allergy is a very common childhood allergy that may also affect adults.
An allergen is a substance that is harmless to most people, unless they have an allergy to it. An allergic reaction to wheat involves IgE (immunoglobulin) antibodies reacting to at least one of the following proteins found in wheat:
- Glutenin, or gluten.
Most allergic reactions involve albumin and globulin. Allergy to gliadin and gluten are less common. Gluten allergy is often confused with celiac disease and other digestive disorders.
Some people have an allergic reaction when they inhale wheat flour, while in others, eat it triggers symptoms. An allergic reaction can occur within minutes or sometimes hours of either consuming or inhaling wheat.
Signs and symptoms
The most common signs and symptoms of a wheat allergy include:
Eczema is one of the more common symptoms of wheat allergy.
- Allergic rhinitis, or nasal congestion
- Atopic dermatitis, known as eczema
- Urticaria, or hives, an itchy rash with possible swelling of the skin
- Nausea, diarrhea and vomiting
- Irritation and possible swelling of the mouth, throat, or both
- Watery, itchy eyes
- Bloated stomach.
Anaphylaxis may occur, leading to:
- Swelling and tightness in the throat and difficulty swallowing
- Tightness and pain in the chest and difficulty breathing
- Pale or bluish skin, weak pulse and a serious, possibly life-threatening, drop in blood pressure.
Anaphylaxis is a medical emergency.
Wheat allergies tend to develop in infancy, often accompanied by other food allergies. The allergy is normally resolved after the ages of 3 to 5 years.
Some adults have a wheat allergy, but it is far more common in children.
What causes a wheat allergy?
A wheat allergy is an immune system response.
The immune system exists to protect us from foreign bodies and pathogens, or things that cause disease. These include bacteria, viruses, and toxic substances.
When the immune system mistakes a normal or good substance for a pathogen and attacks it, this is an allergic reaction.
In the case of wheat allergy, the immune system attacks wheat proteins as if they were harmful substances, like bacteria.
Whenever the person with the allergy eats a protein contained in wheat, their immune system attacks it.
Some people are allergic to just one of the proteins in wheat, while others may be allergic to two or more.
Sources of wheat protein
The following foods are possible sources of wheat proteins:
- Most baked products, including cookies, cakes, donuts, muffins, crackers, pretzels, waffles, and bread
- Breakfast cereals
- Beer, ale, root beer
- Coffee substitutes, malted milk, and instant chocolate drink mixes
- Sauces, soy sauce, Worcestershire sauce, gravies, and condiments, such as ketchup
- Couscous, pasta, and noodles that are made with wheat or semolina
- Ice cream and ice cream cones
- Gelatinized starch and modified food starch
- Hydrolyzed vegetable protein
- Processed meats, such as hotdogs
- Meat, crab or shrimp substitutes
- Monosodium glutamate
- Natural flavorings
- Vegetable gum.
Barley, oats and rye also contain some of the proteins contained in wheat. A person with a wheat allergy may be allergic not just to wheat, but to rye, oats and barley too.
Conditions related to wheat allergy
Reactions triggered by wheat and exercise
Some people may have allergic symptoms if they exercise within a few hours of consuming wheat proteins.
Exercise, in some cases, may trigger the response. This type of allergic reactions often leads to life-threatening anaphylaxis.
Baker's asthma can affect people who work in bakeries or places where there is uncooked wheat flour. The allergy is caused by inhaling wheat flour, not by eating it. It tends to affect the breathing, and it may be caused by a wheat protein, or possibly a fungus.
Celiac disease is classed as an autoimmune food sensitivity, rather than an allergy. The immune system reacts to gluten, causing inflammation and damage in the small intestine. This leads to poor absorption of nutrients. Some people have both celiac disease and wheat allergy.
Risk factors for wheat allergy
The two main risk factors for wheat allergy are family history and age.
If a close relative has an allergy, including wheat allergy, hay fever, and asthma, there is a higher risk of developing wheat allergy.
Infants and young children are more likely to a have wheat allergy than older people, because their immune and digestive systems are still immature. Most children eventually outgrow the allergy.
Diagnosing a wheat allergy
A number of tests can reveal a wheat allergy.
The patient may be asked to keep a food diary, writing down everything they eat, and when, plus detailed notes on symptoms.
The best treatment is to avoid wheat proteins, but this can be difficult as many foods contain them.
The patient can eliminate all wheat product from their diet. After a few days, wheat will be reintroduced at intervals. With the help of the food diary, this can help to identify which foods cause problems. These foods can be replaced with others that do not cause a reaction. This must be done with a qualified health care professional.
Food challenge testing is normally done in a hospital or specialized allergy clinic. The patient eats capsules which contain suspected allergens. They start with small doses, gradually increasing over a period of hours or days, while the individual is monitored for signs and symptoms.
In a skin-prick test, drops of diluted foods are placed on the patient's arm or back. The skin is then pierced through the drop, introducing the food into the system. If there is itching, redness or swelling, the indication is most likely a positive reaction. However, the skin prick test is not definitive, so it is not used alone for diagnosis.
A blood test can detect antibodies for specific foods, and this indicates the likelihood of an allergy to those foods.
Treatment for a wheat allergy
The best treatment is to avoid wheat proteins, but this can be difficult, as so many foods contain wheat. It is important to check food labels.
Antihistamines lower the patient's immune system, eliminating or reducing the symptoms of allergy. These should be taken after exposure to wheat. Antihistamine should be used under the guidance of a physician.
Epinephrine, or adrenaline, is an emergency treatment for anaphylaxis. Patients at high risk of anaphylaxis should carry two injectable doses of epinephrine. The medication is administered as an auto-injector pen straight onto the skin.
One pen contains a single dose of adrenaline, which can be injected into the body through a concealed spring-loaded needle. Examples include the EpiPen and the Anapen. Adrenaline opens the airways, helping the patient to breathe more easily. It also helps to restore severely low blood pressure.