What Is a Wheat Allergy?

If you have a wheat allergy, you'll likely come down with symptoms just minutes—or sometimes hours—after you eat something that contains wheat. In some cases, this reaction can be deadly, so it's important to know what to watch for and how to respond. The best treatment, though, is prevention, which means learning what you (or your child) can and can't eat.

A wheat allergy is a common food allergy, affecting approximately 2 million adults in the United States.

Types of Wheat Allergy

A wheat allergy isn't the same thing as a "gluten allergy." While there's not a true allergy to gluten, people sometimes use the term when referring to celiac disease or gluten sensitivity/intolerance, neither of which involves an allergic reaction.

True wheat allergies come in a few different types, depending on what effect wheat has on your immune system:

• A traditional food allergy
• A respiratory allergy
• Eosinophilic esophagitis or gastritis

Food Allergy

The traditional food allergy is an abnormal immune response that involves immunoglobulin E (IgE), a protein in the immune system that functions as an antibody. Basically, your immune system mistakenly identifies wheat (or another food) as a threat and tries to get it out of your body.

When you eat something you're allergic to, IgE goes to work, kicking off a complex chain reaction that leads to allergy symptoms. Your immune system tries to empty your digestive system, flush out your respiratory tract, and do anything else it can to rid your body of the "problem" food. It's not really the food that the problem, though, it's your immune system.

These symptoms come on fast and can hit hard, even triggering a life-threatening reaction.

Respiratory Allergy

Often called baker's asthma or baker's rhinitis, a respiratory allergy to wheat is often an occupational disease caused by frequently inhaling wheat—usually in the form of flour. This is more likely to develop in people who had other allergies before being regularly exposed to wheat in an inhalable form.

This form of wheat allergy also involves IgE. Once IgE's response to the presence of wheat kicks in, it proceeds much the same as a traditional food allergy.

Eosinophilic Esophagitis/Gastritis

Eosinophilic esophagitis (EoE) and eosinophilic gastritis (EG) are systemic diseases involving chronic inflammation of the esophagus (EoE) or stomach (EG). The inflammation stems from the wheat-triggered activity of a type of white blood cell called an eosinophil.

This is an entirely different process than the IgE-mediated response of traditional or respiratory wheat allergies and it takes longer for symptoms to manifest.

Wheat Allergy Symptoms

Symptoms of a traditional wheat allergy can vary in severity from a mild, flu-like condition to a life-threatening, all-body reaction known as anaphylaxis.

How fast symptoms develop can also vary. With an IgE-mediated reaction, the symptoms can occur within minutes of eating wheat, or as long as a few hours afterward. A traditional wheat allergy can affect one or several organ systems at once and may include:

• Digestive symptoms: Abdominal pain, bloating, nausea, diarrhea, and vomiting
• Respiratory symptoms: Rhinitis (inflammation of the nasal passages), asthma, wheezing, and respiratory distress
• Dermatologic symptoms: Eczema, hives, blisters, and the swelling of the hands and face
• Oropharyngeal symptoms: Mouth and throat itchiness, coughing, and a swollen tongue and throat
• Neurological symptoms: Headaches, dizziness, blurred vision, confusion, and seizures

In more severe forms of anaphylaxis, people will commonly describe a "feeling of impending doom" in relation to their deteriorating state.

Respiratory Allergy Symptoms

A respiratory wheat allergy has two different sets of symptoms. Baker's rhinitis involves a response that's similar to what people with seasonal allergies (hay fever) experience:

• Nasal congestion
• Itchy nasal passages
• Sneezing
• Watery eyes

Baker's rhinitis can eventually lead to baker's asthma, which, as the informal name suggests, primarily involves asthma attacks:

• Coughing
• Wheezing
• Shortness of breath
• Chest tightness

Eosinophilic Allergy Symptoms

With a non-IgE-mediated reaction (EoE or EG), symptoms may not appear until a day or two later as a result of the different immune system activity.​ Symptoms typically include:

• Abdominal pain
• Bloating
• Cramping
• Feeling full after eating a small amount
• Nausea
• Vomiting
• Diarrhea

Causes

While the underlying immune system mechanisms of allergies have become better understood, doctors still don't know why some people develop allergies to begin with. Some suspected causes or risk factors include immune system irregularities due to:

• Genetic predisposition
• Excessive hygiene during early life
• The trend away from breastfeeding
• Consumption of additives in food
• Societal changes in eating habits
• High levels of wheat exposure (dietary or occupational)

Triggers

Wheat is in a lot of packaged foods, including some you may not expect. When dealing with any food allergy, it's important that you become familiar with potentially problematic ingredients and read labels religiously. Foods that may trigger a wheat allergy include:

• Bran
• Couscous
• Durum
• Einkorn
• Emmer
• Farina
• Farro
• Flour (enriched and not enriched)
• Fu
• Kamut
• Modified starch
• Seitan
• Spelt
• Triticale
• Semolina
• Wheat germ

You'll find these ingredients in all kinds of foods, including cereal, pasta, bread, soup, baked goods, and mixes for cooking and baking.

On ingredient lists, manufacturers will also use the phrase "may contain wheat," or "made in a facility that processes wheat." If your reaction to wheat has been severe enough to require emergency care or hospitalization, you will likely want to steer clear of these products just to be safe.

The same applies to certain cosmetics, hair care products, vitamins, and pet foods which may contain trace amounts of wheat and accidentally contaminate your hands or cooking surfaces.

Diagnosis

If your doctor suspects a wheat allergy, they'll consider your symptoms, personal and family history of allergies or allergy-related diseases (such as asthma or eczema). Then they can perform some tests to confirm an allergy.

• Skin prick test: A drop of liquid containing wheat protein is placed on your skin, which is then pricked to allow the liquid into your skin. A reddish raised spot will form within 20 minutes if you're allergic to wheat.
• Blood test: Your blood sample may be tested for IgE antibodies to wheat protein. If celiac disease is a possibility, the lab may look for other antibodies as well.
• Oral food challenge: If those tests don't give a clear answer, you may be given small amounts of wheat—while under close medical supervision—to see if you have a reaction.

Treatment

As with all food allergies, the management of a wheat allergy involves completely avoiding wheat in any form. This can be difficult since wheat is found in a plethora of everyday products.

Around 75% of all grain products in the U.S. contain wheat, making this a particularly tough allergy to manage.​​ To address the growing concern, the Food and Drug Administration requires all wheat-containing food products to be clearly labeled.

It is also important to note that the majority of gluten-free foods are also wheat-free, but not all of them are. Always check the food label and avoid the mistake of thinking that "gluten-free" and "wheat-free" are the same thing.

Treating Emergency Symptoms

Your doctor may recommend that you carry a rescue asthma inhaler and/or an epinephrine auto-injector (like an EpiPen) in case you have a severe reaction to wheat. Even people who've only had mild food allergy symptoms before can suddenly have a life-threatening reaction.

• Be sure you and people frequently with you know how to use the auto-injector. If the allergy is in a child, all caretakers should have access to it and know how to use it. Older children should know when and how to use it as well.
• Use the EpiPen as soon as you or the allergic person realizes they've eaten a problem food, or as soon as symptoms become apparent. It's better to use it when it's not necessary than not to use it when you do need it.
• Call 911 right after using the EpiPen.

If an EpiPen isn't available, call 911 immediately.

Prognosis

Wheat allergies most often develop during childhood, but most children outgrow the allergy by the time they're 16.

While it's less common to become allergic to wheat during your adult years, symptoms can manifest at any stage of life, especially if they're related to your occupation (such as with baker's asthma). The later in life you develop a wheat allergy, the more likely it is to be a permanent condition.

A Word From Verywell

A wheat allergy certainly complicates your life and adds a layer of stress and worry—especially if your child has a wheat allergy. However, once you have a proper diagnosis, you can learn to avoid wheat, manage your allergy, and treat emergency symptoms if they should arise. Fortunately, labeling of allergen-containing foods is much better than it used to be and more safe alternative foods are now available, so you don't have to give up the foods you enjoy.