Is it a Wheat Allergy or a Gluten Disorder?
The two are often interchanged, but are actually two very different things
Though we closely relate wheat and gluten, the two are not interchangeable. In fact, wheat isn’t even the only gluten source out there, and a wheat-free diet can look very different from a gluten-free one. The distinction between a wheat allergy and a gluten-related disorder affects everything from symptom presentation to treatment.
If you believe you might have a gluten sensitivity or need to go on a gluten-free diet, be sure that what you have isn’t a wheat allergy.
A wheat allergy is when a person’s immune system becomes sensitized to and subsequently overreacts to something common in the environment, in this case, wheat. While most people have no issues coming in contact with wheat, those with a wheat allergy can experience symptoms from either ingesting, inhaling, or even touching wheat, depending on the reaction severity.
Wheat allergies are more common in children and are outgrown pretty often, though there are certainly adults with severe wheat allergy reactions. They are also more common in people who have parents with asthma, eczema, or other allergies. With a wheat allergy, exposure to wheat will generally lead to immediate or near-immediate (within a few hours) symptoms.
Typical symptoms of a wheat allergy are similar to seasonal pollen allergies (hay fever). They include a runny nose, red and itchy eyes, asthma, hives, sneezing, itchiness, headaches, or dizziness. Since wheat is also usually ingested, it can also cause nausea, vomiting, and diarrhea, which is where some confusion between a wheat allergy and gluten sensitivity can come in.
More serious allergic reactions to wheat can cause wheezing, swelling in the airways, and difficulty breathing—signs of anaphylactic shock that, left untreated, can be deadly. Any signs of anaphylaxis require immediate medical attention.
Patients suspected of a wheat allergy will go to an allergist for testing. The testing may include blood work or a skin prick test. Blood work requires drawing a blood sample and sending it to a lab to check for specific antibodies that indicate a reaction to wheat while a skin prick test involves putting some liquid that contains wheat onto the skin and then poking the skin with a needle. If the skin becomes red and raised within 15 to 20 minutes, the results are positive.
Once you receive a positive diagnosis for a wheat allergy, treatment will continue to be overseen by an allergist. Naturally, the easiest way to treat a wheat allergy is to avoid wheat in all of its forms, not only in food but also in items like Play-Doh, bath items, and even some cosmetics. Fortunately, wheat is an allergen ingredient that, in the United States, must be clearly labeled on products. One should also keep an eye out for descriptions that say “made in a facility that processes wheat” or similar disclaimers. While these labels are voluntary, contamination of items made in factories that also process wheat is a real possibility.
One great thing about the increase in attention to gluten-free diets for those with wheat allergies is that food labeled as gluten-free should also be safe for you. Since gluten is an inherent protein in wheat, it’s not really possible to make a gluten-free product that has wheat in it. A person with a wheat allergy shouldn’t feel like they have to restrict themselves only to gluten-free products (as they can eat items with rye or barley, both of which aren’t gluten-free), using gluten-free products is often convenient. Particularly when it comes to baking, one-to-one flour substitutes created for the gluten-free market will be a great substitute for wheat-free baking.
If a wheat allergy is triggered and isn’t too severe, it can generally be treated with OTC antihistamines, as described to you by your healthcare provider. A more severe reaction, such as one that reaches anaphylaxis levels, will need to be treated with epinephrine. In that case, your healthcare provider will talk to you about carrying and using an EpiPen.
Celiac & Gluten-Sensitivity
Celiac and gluten-sensitivity also involve an immune response, but not in the same way or to the same thing. In these disorders, the trigger is gluten.
Rather than creating an allergic response with sneezing or watery eyes like a wheat allergy, in celiac, the immune system responds to gluten by directly attacking the intestines. This damages the small intestine’s ability to absorb nutrients, leading to nutritional deficiencies alongside other symptoms of intestinal distress. In gluten sensitivity, the role the immune system plays isn’t as clear. However, symptoms after exposure to gluten tend to be similar to many of those experienced by patients with celiac.
Celiac or gluten-sensitivity diagnoses are usually given by a gastrointestinal specialist. Generally, a blood test is done first, though seeking a different antibody than is sought in a wheat allergy test, and then an endoscopy to confirm the diagnosis.
In both celiac disease and gluten sensitivity, symptoms tend to focus around the gut. Symptoms include diarrhea, nausea, vomiting, fatigue, weight loss, excessive gas, and abdominal cramping. Other non-digestive symptoms include iron deficiency, osteoporosis and osteomalacia, itchy and blistery skin rashes, joint pain, and even tingling and other signs of nerve damage.
Unlike a wheat allergy, symptoms don’t always appear immediately after consumption, as gluten tends to build up in the body and have a cumulative effect. That isn’t to say celiac and gluten intolerance sufferers don’t have immediate reactions; they can and do often become very ill after ingesting even tiny amounts of gluten. However, damage and symptoms tend to linger much longer than are typical in an allergic reaction.
As with a wheat allergy, the first treatment for celiac or gluten sensitivity is avoiding gluten, meaning any products derived from rye, wheat, or barley. Gluten-free products are essential for those who need to avoid gluten. Treating these disorders will also tend to include the need to take supplements, either to fix nutritional deficiencies or to prevent them from happening when the switch to a gluten-free diet is made.
Be Clear on What You Have
Wheat allergies and gluten-related disorders are two very different conditions, in presentation, diagnosis, and treatment. It’s important to be sure you’re clear on which condition you’re dealing with because then you can be sure you’re avoiding the right things! A gluten-free diet doesn’t require skipping a lotion made with wheat, for example, and a wheat allergy doesn’t necessarily mean you can’t have rye bread. Diagnostic clarity will help you to readily navigate the path ahead, and to seek and receive the help and support you truly need.