What is wheat allergy? What are the symptoms of wheat allergy? And how is a wheat allergy different from a gluten intolerance? We'll answer these questions and more in this parent's guide to wheat allergy.
Wheat allergy is one of the top 8 food allergies in the United States. It affects around 0.4% of children. Today, we'll break down what parents need to know about wheat allergies, including the difference between a wheat allergy and a gluten intolerance. We'll also list out many of the hidden sources of wheat that people with wheat allergies need to avoid.
What is a Wheat Allergy?
Our immune systems normally defend and protect us from viruses, bacteria, and other harmful foreign invaders. But when someone has a wheat allergy, their immune system mistakenly over-defends the body against wheat proteins. It treats the specific proteins in wheat, a normally harmless food, as foreign invaders. The immune system causes the body to develop an allergic reaction whenever the person eats a food that contains wheat.
Most wheat allergies involve IgE antibodies that develop to respond to specific wheat proteins. These are called IgE-mediated wheat allergies.
When someone has this traditional type of wheat allergy, their immune system makes special allergy antibodies called IgE antibodies to wheat proteins to help fight them off. These IgE antibodies trigger symptoms of an allergic reaction seconds to hours after the person eats a food containing wheat.
But some wheat allergies don't involve IgE antibodies, and cause a more delayed reaction to wheat. These types of wheat allergies are called non-IgE-mediated wheat allergies, or delayed-type wheat allergies. They cause GI symptoms hours to days after someone consumes wheat. For example, EoE (an allergic condition involving the esophagus) sometimes develops to defend against wheat---if it does, it counts as a delayed type of wheat allergy.
Learn more about wheat allergy from Food Allergy Research & Education (FARE):
Wheat Allergy Vs. Gluten Intolerance
What is the difference between a wheat allergy and a gluten intolerance?
Like all allergies, wheat allergies always involve an immune system response to specific food proteins.
But gluten intolerances are not allergies. There is no such thing as an allergy to gluten, and an allergy to wheat is completely different from a gluten intolerance.
Gluten intolerances are not allergies.
A wheat allergy causes an allergic immune response to a protein specifically found in wheat.
Meanwhile, gluten intolerances are immune responses to gluten, a protein that can be found in many grains.
Even though gluten is present in wheat, it is also present in multiple other grains, including rye and barley. So, it isn't a specific food protein.
The mechanisms of gluten intolerance aren't well understood. But if someone's body reacts to gluten, this is because of a gluten intolerance.
Celiac disease is a serious form of gluten intolerance. It is a gluten-related autoimmune disease that affects the intestines. If someone with celiac disease consumes gluten, it damages their small intestine.
Wheat allergy is more common in children than gluten intolerance, and many children outgrow their wheat allergy eventually. But a gluten intolerance tends to persist in adulthood.
Board Certified Allergist, Dr. Katie Marks-Cogan, shares more information on gluten intolerances:
Symptoms of Wheat Allergies
Symptoms of an IgE-mediated wheat allergy can include:
- Hives (red raised bumps)
- Vomiting
- Skin redness
- Itching
- Itchy, watery eyes
- Swelling of the face, lips, eyes, tongue, or throat
- Runny nose
- Congestion
- Wheezing
- Difficulty swallowing
- Difficulty breathing
- Nausea
- Diarrhea
- Abdominal pain
- Dizziness
- Fainting
Symptoms of an IgE-mediated wheat allergy usually develop seconds to minutes after eating wheat, and almost always within 2 hours.
(For the symptoms of non-IgE mediated wheat allergies, also called delayed-type wheat allergies, please read this article.)
Wheat allergic reactions can range from mild to severe. When the symptoms of a wheat allergic reaction are severe, and involve more than one organ system, the reaction is classified as anaphylaxis. And anaphylaxis can be life-threatening.
Anaphylaxis can be life-threatening.
Swelling of the face, tongue or throat, wheezing, breathing difficulty, and significant cardiovascular symptoms may be signs of an anaphylactic reaction. If your child shows signs of anaphylaxis, give epinephrine (use an Epi-Pen) immediately, and call 911.
Wheat Allergy Testing
IgE-mediated wheat allergies can be diagnosed through:
- A skin prick test: your child's forearm is pricked with a needle containing specific wheat protein, then monitored to see if an allergic reaction develops around the area where their skin was pricked
- A blood test: your child's blood is checked for IgE antibodies that respond to specific wheat proteins
- An oral food challenge: your child will eat small amounts of wheat at a time, and an allergist will closely watch to see if your child develops an allergic reaction. This is the most accurate way to diagnose a wheat allergy.
These tests rely on the presence of IgE antibodies or an immediate allergic reaction to wheat. So, these tests can only diagnose IgE-mediated wheat allergies. They can't accurately diagnose a delayed wheat allergy.
Wheat Allergy Trends
Wheat allergy is one of the top 8 food allergies in the United States. It affects around 0.4% of children.
Wheat allergy is one of the top 8 food allergies in the United States.
Fortunately, though, wheat allergies are often outgrown. One study indicates that around 84% of children with wheat allergies outgrow their allergy by age 10. Another study showed that children who outgrow their wheat allergy do so at 6 ½ years of age on average, but that 35% of children still had a wheat allergy in their teens.
Even though most people outgrow their wheat allergy well before adulthood, some people end up with persistent, lifelong wheat allergies.
Since wheat allergy is one of the top 8 food allergens in the United States, federal law requires manufacturers of all food products with wheat ingredients to clearly state that a product contains wheat on the label.
Manufacturers must mark wheat products with "contains wheat," and clearly list the wheat ingredient.
Wheat Allergy Management
Any amount of wheat could cause someone with wheat allergy to develop an allergic reaction. And any allergic reaction could develop into life-threatening anaphylaxis. So, it's vital that children with wheat allergies avoid all wheat and wheat products.
Stay away from all products with "wheat" in their names, including wheat flour, wheat berries, wheat bran, whole wheat, wheat germ, wheat germ oil, wheat protein isolate, wheatgrass, wheat starch, wheat sprouts, and sprouted wheat.
Wheat sometimes appears in products under these "hidden" names as well.
- Bulgur
- Malt
- Seitan
- Couscous
- Cereal extract
- Einkorn
- Farro
- Durum
- Freekeh
- Emmer
- Farina
- Kamut
- Semolina
- Spelt
- Tabbouleh
- Triticale
- Triticum
- Wheatgrass
Carefully read all labels to keep your child safe!
Wheat is usually found in the following products:
- Bread
- Bread crumbs
- Baked goods, like muffins, cookies, cupcakes, pies, pastries, and cakes
- Flour, including all-purpose, bread, whole-wheat, cake, enriched, pastry, instant, graham, high-gluten, high-protein, self-rising, soft wheat, steel ground, stone ground, and durum flours
- Cereals
- Pasta/noodles
- Crackers
- Matzoh/matzo/matza
Wheat is also sometimes found in these products, so read the labels carefully:
- Hot dogs
- Sauces
- Food starch
- Breaded meats, like chicken nuggets
- Other breaded fried foods
- Ice cream
- Caramel coloring
- Glucose syrup (similar to corn syrup)
- Vegetable proteins (including vegan meat alternatives)
- Surimi
- Natural and artificial flavors
- Oats/oatmeal (yes, wheat is sometimes added to oats!)
If your child has a wheat allergy, you'll also need to read cosmetic and bath product labels carefully. Many cosmetic products also contain wheat, but cosmetics products don't have to state "contains wheat" on the label. Avoid using any cosmetic products with wheat on your child's lips---your child could ingest the wheat and develop an allergic reaction. Also avoid using wheat products in the bath, in case your child would accidentally swallow water with some of the wheat product in it.
In addition, you'll need to watch out for cross-contamination, or the accidental mixing of a food with wheat into a food without wheat. At restaurants, and anywhere else food is served outside the home, always alert the person preparing the food that your child has a wheat allergy. This will help prevent cross-contamination.
At stores, also avoid products that say "may contain wheat," "made on shared equipment with wheat products," or "manufactured on equipment that also processes wheat." This is a sign that cross-contamination may have happened in the plant where the products were produced. So, there could accidentally be traces of wheat in these products.
People with wheat allergies (NOT gluten intolerances) can often have other grains that are not wheat, like rye, rice, corn, barley, and wheat-free oats. So, you may be able to use types of flour that don't contain wheat to bake for your child. Check with your allergist to make sure.
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