Wheat Allergy

What is a wheat allergy?

A wheat allergy is one of the most common types of food allergies. Your immune system overreacts to wheat you’ve ingested (eaten or drunk) or inhaled (breathed in). For many people, ingesting wheat is harmless. However, if you have a wheat allergy, your immune system views wheat as a harmful “invader,” like a bacterium or virus.

A wheat allergy can be deadly. If you have severe allergic reaction symptoms, such as swelling in your throat, call 911 or go to your nearest emergency room (ER) immediately.

Who does a wheat allergy affect?

Anybody can have a wheat allergy. You’re more likely to develop an allergy if there are allergies in the family.

How common is a wheat allergy?

Studies suggest that between 0.2% and 1.3% of the world population has a wheat allergy.

About 0.4% of children in the U.S. have a wheat allergy.

How does a wheat allergy affect my body?

A wheat allergy causes an allergic reaction in your body. An allergic reaction is your body’s response to an allergen. If you have a wheat allergy, your body may have two different types of reactions:

Immunoglobulin E mediated reaction

If you have a wheat allergy, your body responds by creating immunoglobulin E (IgE) when you eat wheat. IgE is an antibody that your immune system makes. Your body makes many different types of IgE, which are sensitive to specific kinds of allergens.

IgE reactions happen quickly after ingesting or inhaling wheat. They usually occur within minutes, but they may occur up to four hours later. Reactions may include anaphylaxis, which is a severe allergic reaction that may cause death.

Non-immunoglobulin E mediated reaction

Non-IgE reactions involve your immune system, but not your IgE antibodies. Your allergic reaction to wheat is slower than an IgE-mediated reaction. It may take up to 48 hours to develop.

Reactions may include eosinophilic esophagitis (EoE) or eosinophilic gastritis (EG). EoE causes inflammation in your esophagus, which is the tube that connects your mouth to your stomach. EG causes inflammation in your stomach lining.

What are the symptoms of a wheat allergy?

Wheat allergy symptoms include:

• Hives and swelling.
• Rash.
• Stomach cramps.
• Indigestion.
• Nausea and vomiting.
• Diarrhea.
• Stuffy nose.
• Runny nose.
• Sneezing.
• Headache.
• Wheezing.
• Anaphylaxis.
• Inflammation.

Wheat allergy symptoms vary from person to person. They may be mild or severe.

What are the symptoms of anaphylaxis?

If you have any symptoms of anaphylaxis, contact your healthcare provider immediately.

Severe anaphylaxis symptoms include:

• Shortness of breath (dyspnea).
• Difficulty swallowing (dysphagia).
• Chest tightness.
• Feeling of doom or dread.
• Drop in blood pressure (hypotension), with a weak pulse or confusion.
• Increased heart rate.
• Shock.
• Sudden weakness.
• Lightheadedness or passing out (syncope).
• Hives or swelling of your face, tongue and/or throat.
• Wheezing.
• Coughing.
• Abdominal pain.
• Nausea and vomiting.
• Diarrhea.

How long after eating wheat do symptoms appear?

It depends on the severity of your wheat allergy.

They may appear within minutes after ingesting wheat or take up to 48 hours to appear.

What causes a wheat allergy?

Proteins in wheat cause your immune system to overreact. There are four types of wheat protein that you may be allergic to:

• Albumin.
• Gliadin.
• Globulin.
• Gluten.

Can you suddenly become allergic to wheat?

People can develop IgE-mediated reactions as infants, which may seem sudden. Non-IgE-mediated reactions may feel like they slowly develop over time, especially until diagnosis in most people.

Is a wheat allergy contagious?

No, a wheat allergy isn’t contagious. You can’t spread a wheat allergy to another person.

How is a wheat allergy diagnosed?

An allergist is a healthcare provider who specializes in allergies. They can help you diagnose your wheat allergy through tests — especially if they’re due to an IgE-mediated reaction.

Before conducting wheat allergy tests, they may ask you questions, including:

• Do you have a family history of wheat allergies?
• Have you ever been diagnosed with other food allergies?
• What are your symptoms?
• Do you take any over-the-counter (OTC) medications to treat your symptoms?
• When do you notice your symptoms start to appear?
• Do you keep a food journal?

What tests will be done to diagnose a wheat allergy?

Your allergist may use different allergy tests to help diagnose your wheat allergy based on your symptoms. These tests may include:

Skin prick (scratch) test

This test exposes your body to small amounts of wheat proteins.

Your allergist will first clean a test area of your skin with iodine or alcohol. The test area is usually on your forearm or upper back.

Your allergist will use a thin needle (lancet) to prick your skin with a small amount of liquid containing wheat proteins. The lancet won’t go deep into your skin. You’ll only feel a tiny pinch, and you won’t bleed.

Some allergists may place a droplet of liquid wheat proteins on your skin. They then use a lancet to scratch your skin lightly. The droplets will enter your skin through the scratch. You’ll only feel slight discomfort, and you won’t bleed.

Wheat allergy reactions typically occur within 15 minutes of exposure. Reactions usually include round, discolored, raised spots (wheals) that look like bug bites.

Your allergist will then measure the size of your wheal.

Blood (IgE) test

During a blood test, a laboratory technologist will use a thin needle to withdraw a small amount of blood from a vein in your arm. The blood sample goes to a laboratory. The lab adds wheat proteins to your blood sample and measures the levels of IgE antibodies in it.

It may take a week to get the results from a blood test sent to a lab.

Graded oral challenge

If you don’t get conclusive results from a skin prick test or a blood test, your allergist may order a graded oral challenge.

During a graded oral challenge, you’ll eat a small amount of wheat in your allergist’s office. Your allergist will observe you to see if a reaction develops. You may gradually eat more wheat to see how your body responds.

Your allergist will only order a graded oral challenge if you have a low or moderate risk for a severe allergic reaction.

A graded oral challenge may take up to four hours.

Can you get rid of a wheat allergy?

No, you can’t get rid of a wheat allergy. However, about 66% of children outgrow it.

The best way to manage your wheat allergy is to avoid it. By law, manufacturers must include wheat on the ingredients label of packaged foods sold in the U.S.

If you have a wheat allergy, you must consider other possible exposures, including:

• Nonfood items. Certain nonfood items contain wheat, including Play-Doh® and certain makeup and toiletry items. However, the labeling law doesn’t apply to nonfood items. If you’re not sure of the ingredients in a nonfood item, go to the manufacturer’s website or call their customer service number to get the complete list of product ingredients.
• Shared equipment. During the manufacturing process, some items share equipment or surfaces with wheat. Look for labels that say: “Made on equipment shared with wheat.”

What foods should I avoid if I have a wheat allergy?

Many different foods and drinks contain wheat or wheat proteins. These include:

• Baked goods, including cakes, cookies and muffins.
• Bread.
• Breakfast cereals.
• Couscous.
• Hot dogs.
• Malted drinks.
• Pasta.
• Pizza dough.
• Seitan.
• Wheat beer.
• Wheat flours (all-purpose, enriched, pastry, steel ground, stone ground and so on).

What medications are used to treat a wheat allergy?

If you have a mild or moderate wheat allergy, your healthcare provider may prescribe antihistamine medications or corticosteroids to help relieve your symptoms.

If you have a severe wheat allergy, your healthcare provider may prescribe you an epinephrine injection (EpiPen®, Adrenaclick®, Auvi-Q® and SYMJEPI®). Epinephrine quickly reverses the symptoms of anaphylaxis. The injector is about the size of a large marker. If you accidentally ingest wheat, you’ll inject yourself with the medicine, usually in your outer thigh. You should keep two epinephrine injectors with you at all times.

What are the side effects of epinephrine injections?

Epinephrine injection side effects may include:

• Anxiety.
• Dizziness.
• Dry mouth.
• Headache.
• Increased sweating.
• Nausea.
• Racing heart rate.

However, if you’re having an allergic reaction, epinephrine usually makes you feel better immediately.

How soon after treatment will I feel better?

Antihistamines start to work about 30 minutes after you take them. They’re most effective within the first few hours.

Corticosteroids usually start to work in about an hour.

An epinephrine injection starts to work immediately after you’ve injected yourself.

How can I prevent a wheat allergy?

The best way to prevent an allergic reaction to wheat is to strictly avoid wheat ingredients in foods and other nonfood products.

Check the ingredient labels on all packaged foods. If you’re not sure if a product contains wheat, avoid it until you can confirm with the manufacturer.

What can I expect if I have a wheat allergy?

Living with a wheat allergy can be challenging. Symptoms can range from mild to severe, and there’s no way to predict how your body will react. However, with caution, you can live a fulfilling life. Your healthcare provider can recommend resources, support groups and dietitians to help you with your day-to-day meals.

Children are more likely to have wheat allergies than adults. Around 80% of children outgrow their wheat allergies by around age 16.

When should I see my healthcare provider?

See your healthcare provider if you regularly have wheat allergy symptoms or if you notice that your symptoms develop after eating wheat.

When should I go to the ER?

Go to the ER or call 911 if you start showing symptoms of anaphylaxis.

What questions should I ask my healthcare provider?

• How can you tell that I have a wheat allergy?
• Do I have a mild, moderate or severe wheat allergy?
• What medications do you recommend?
• What’s the complete list of side effects of your recommended allergy medication?
• Are there any support groups for people or parents of children who have a wheat allergy?
• Can you recommend a dietitian?

Is a wheat allergy the same as a gluten allergy?

No, a wheat allergy isn’t the same as a gluten allergy. There’s no such thing as a gluten allergy.

More accurately, what some people refer to as a gluten allergy is celiac disease. Celiac disease is a condition in which your immune system damages your small bowel after you eat gluten. Gluten is a protein in some grains, including wheat, barley and rye.

What is the difference between a wheat allergy and a gluten intolerance?

A wheat allergy causes your immune system to overreact after you eat wheat.

A gluten intolerance is a digestive system response. Your body is unable to properly digest gluten, which causes sickness. If you have a gluten intolerance, you may feel tired, nauseous or bloated.

What is the difference between a wheat allergy and celiac disease?

A wheat allergy and celiac disease are sometimes confused for each other. However, they’re different.

A wheat allergy causes your immune system to respond with IgE-mediated reactions or non-IgE-mediated reactions.

If you have celiac disease, your immune system overreacts specifically to gluten. Wheat and other grains contain gluten. Your immune system responds by attacking the lining of your intestine. It causes inflammation and damages the hair-like structures that line your small intestine (villi). The villi help absorb nutrients in food. Damaged villi can’t absorb nutrients. This eventually causes malnourishment, no matter how much food you eat.

A note from Cleveland Clinic

A wheat allergy is a type of food allergy that occurs when your immune system mistakenly triggers a defensive response to wheat. This response — or allergic reaction — can cause various symptoms, including hives, stomach cramps, indigestion, diarrhea and, in severe cases, anaphylaxis. You may feel frustrated not knowing what’s causing your symptoms, but your healthcare provider can help. They can conduct tests to confirm a wheat allergy and prescribe medications. They can also refer you to a dietitian who can help you learn what’s best for you to eat and drink.