Wheat allergy refers to adverse reactions involving immunoglobulin E (IgE) antibodies to one or more proteins found in wheat, including albumin, globulin, gliadin and glutenin (gluten). (The majority of reactions involve albumin and globulin. Gliadin and gluten are more rare, and gluten allergy is often confused with Celiac disease or other digestive disorders.)
Allergic reactions to wheat may be caused by eating foods with wheat or even by inhaling flour containing wheat. Allergic reactions to wheat usually begin within minutes or a few hours after eating or inhaling wheat.
The most commonly reported symptoms seen with this kind of allergy include: atopic dermatitis (eczema), urticaria (hives), asthma, allergic rhinitis, anaphylactic shock and digestive symptoms.
Diagnosis may be easy if a person always has the same reaction after eating wheat food, but more often the diagnosis is difficult because wheat is a common food. Diagnosis usually entails a detailed patient evaluation with laboratory tests (RAST, skin prick-testing). Elimination-challenge testing remains the most reliable method of diagnosis.
Avoidance of wheat and wheat-containing foods is the first step in the treatment of wheat allergy. Wheat allergic patients who have sensitivity to gluten (or gliadin) should avoid other gluten containing cereals such as oats, rye and barley. However, because wheat is a common food product, wheat elimination diets can be difficult to maintain. Children on wheat-restricted diets are severely limited in their selection of foods. Alternatives may be found in special health and diet stores and restaurants.
Label items that indicate wheat proteins
- Bread crumbs
- Cereal extract
- Cracker meal
- Enriched flour
- High-gluten flour, high-protein flour
- Semolina wheat
- Vital gluten
- Wheat bran, wheat germ, wheat gluten, wheat malt, wheat starch
- Whole wheat flower
Labels that might indicate some wheat protein
- Gelatinized starch
- Hydrolyzed vegetable protein
- Modified food starch, modified starch
- Natural flavoring
- Soy sauce
- Vegetable gum, vegetable starch
As with most allergies, avoidance is key. Make sure to read all labels for foods, medicines, cosmetics, creams and ointments that may contain any type or amount of wheat. A history of allergic reactions shortly after exposure to wheat might suggest an allergy. However, this should be confirmed with a skin prick test or RAST. Talk to your doctor about a complete diagnosis.
SOURCE: This information should not substitute for seeking responsible, professional medical care. First created 1995; fully updated 1998; most recently updated 2005.
© Asthma and Allergy Foundation of America (AAFA) Editorial Board