All you need to know about wheat allergy and wheat intolerance

If you have wheat allergy, exposure to a wheat protein primes your immune system for an allergic reaction. 

Some people with wheat allergy develop symptoms only if they exercise within a few hours of eating wheat. Exercise-induced changes in your body either trigger an allergic reaction or worsen an immune system response to a wheat protein. This condition, called wheat-dependent exercise-induced anaphylaxis (WDEIA), usually results in life-threatening anaphylaxis. 

Another variant is related to so-called baker’s asthma, a serious occupational obstructive airway disease that affects between 4% and 25% of bakery workers worldwide. Wheat flour is the primary cereal used in bakery products and wheat flour allergy is the leading cause of baker’s asthma.  

Certain factors can lead to a greater risk of developing wheat allergy: 

• Family history. A person is at increased risk of allergy to wheat or other foods if their parents have food allergies or other allergies, such as asthma. 
• Age. Wheat allergy is most common in babies and toddlers, who have immature immune and digestive systems. But adults can also develop a wheat allergy. 

The primary symptoms of a wheat allergy manifest themselves on the skin and in the respiratory tract, often directly after meals. It may also cause indigestion, however, something which may occur after a delay.  

There are a large range of wheat allergy signs and symptoms, including: 

• Swelling, itching or irritation of the mouth or throat 
• Hives, itchy rash or swelling of the skin 
• Nasal congestion 
• Headache 
• Difficulty breathing 
• Cramps, nausea or vomiting 
• Diarrhoea  
• Anaphylaxis 

For some people, wheat allergy can cause a life-threatening reaction known as anaphylaxis, a condition that manifests itself in chest pain or tightness, swelling or tightness in the throat, severe breathing difficulty, trouble swallowing, skin paling to a blue tone, and dizziness or fainting.  

If someone shows signs of anaphylaxis, call the emergency services. Anaphylaxis is a medical emergency that requires immediate medical attention, and can result in death.  

If you suspect that you or your child is allergic to wheat, make an appointment to see your doctor.  

As with other allergies, the symptoms of wheat allergy should be recorded in a food and symptom diary. The next step involves a test for specific antibodies and a skin-prick test. If the symptoms are similar to the symptoms of coeliac disease, in other words, if symptoms such as abdominal cramping, diarrhoea or nausea occur after consuming wheat, it is important to exclude coeliac disease before proceeding further.  

Diagnosis of wheat allergy can be made through a skin-prick test or a blood test. 

In the skin-prick test, a small amount of a liquid containing wheat protein is placed on the back or forearm, which is then pricked with a small, sterile probe to allow the liquid to enter the skin. If a raised, reddish spot forms within 15 to 20 minutes, this can indicate an allergy. 

In the blood test, a blood sample is sent to a laboratory to test for the presence of immunoglobulin E antibodies to wheat protein.  

Around 0.3% of children under the age of five in Europe are allergic to wheat. Around two-thirds of children outgrow their wheat allergy by 16, but adults can also develop it, often as a cross-sensitivity to grass pollen. 

The main treatment for wheat allergy involves a change in diet. Once the allergy specialist has diagnosed wheat allergy, you must eliminate wheat and related types of cereals from your diet.  

Keep in mind that wheat may be used as an ingredient in many processed foods in which you would not suspect this is the case. For instance, rye bread can also contain wheat. Gluten free products are not the same as wheat-free products, because they may contain gluten free wheat starch, which is unsuitable for people with wheat allergy. It is important always to read the label before purchasing a product. 

As well as a lot of bread and bakery products, breakfast cereals, pasta, couscous, spelt and semolina, wheat proteins are often also present in crackers, hydrolysed vegetable protein (HVP) and other flavourings, soy sauce, processed meat such as hot dogs, some dairy products, modified food starch, gelatinised starch and vegetable gum.  

In order to ensure that your diet is balanced and to familiarise yourself with alternatives for cooking and baking, it is a good idea to get advice from a dietician and seek out tips for managing your wheat allergy. 

How long do wheat allergy symptoms last? 

There are no rules on how long an allergy will last. In most cases when a small child develops a wheat allergy, it will disappear at some stage. But this is not always the case. In general, the later in life a person develops a wheat allergy, the more likely it is to be a permanent condition.