If you’ve walked down the supermarket aisle lately, it seems like a new, tasty, gluten-free food crops up every other week. But when you or your child has food allergies or a severe allergic reaction to gluten, like a rash, hives, or worse, this health “fad” (gastroenterologists have railed against gluten-free food for people who have no medical reason for it) is a true godsend.
People often get confused when we talk about gluten allergies. A lot of time, what is referred to as a gluten allergy is actually celiac disease — an issue for a GI doctor and not an allergist. When it comes to gluten — or rather, wheat allergy, there’s just a ton of misinformation on the internet (it’s the internet after all). “Foods can cause a lot of different types of reactions but you’re going to want to put those reactions into different types of bins and separate them,” Dr. Tricia Lee, an allergist working out of New York City, shared with Scary Mommy.
So we’re here to help you demystify the world of gluten and wheat allergies, with some help from an expert in the field.
Understanding Gluten and Wheat Allergies
What you think of as a gluten allergy is more accurately a wheat allergy, which results in a reaction that usually occurs when your blood makes an allergic antibody to the protein in wheat. A wheat allergy is an immediate and potentially life-threatening reaction to wheat. You can be tested for it with a skin and blood test, and people with a wheat allergy are usually treated by an allergist.
Gluten is a protein found in many different types of grain. People who are gluten-intolerant (more on that further down!) react to all grains of the Pooideae subfamily, including favorites like barley, oats, rye, and wheat. If you have a wheat allergy, you’re generally fine with other grains and only react to wheat.
What are the symptoms of a wheat allergy in children and adults?
There’s no difference between the wheat allergy symptoms experienced by kids and adults, but you should note that different people will have different symptoms. In very rare cases, a wheat allergy can lead to anaphylaxis. This is a medical emergency that involves impaired breathing and can lead to a person going into shock.
Chances are, if you’re an adult, you’re aware of your severe wheat allergy by now and have an Epinephrine pen for emergencies. But if you suspect your child could have a life-threatening reaction to wheat, you should discuss your suspicions with your pediatrician as soon as possible. If a severe allergy diagnosis is made, your doctor will likely prescribe your child an Epinephrine pen. Your child will need to carry at all times and follow strict dietary guidelines set forth by their doctor. If you, your child, or anyone else is experiencing signs of anaphylaxis (including a feeling of the throat or tongue swelling), call 911 immediately.
Luckily, anaphylaxis from a wheat allergy is very rare. The following symptoms are far more common:
- Hives or a rash
- Itchy, watery eyes
- Abdominal pain or nausea
- Stomach cramps
- Stuffy or runny nose and sneezing
- Weezing or asthma
- Blurred vision
If you’re dealing with any of these symptoms and suspect wheat is the culprit, your doctor can run tests to confirm or rule out a wheat allergy. At this time, doctors are still working on definitive tests that detect gluten and wheat sensitivity. But the truth is, it’s generally a trial and error process that will involve food elimination diets, blood tests, and skin tests. While it may be frustrating, all of the tests will be worth it if the end result is a better understanding of your health or the health of your child.
How common are wheat allergies? Can you outgrow them?
Although wheat is one of the top eight food allergens in the United States, around 65 percent of children outgrow their wheat allergy by the age of 12.
What ingredients should you avoid if you have a wheat allergy?
Oh, boy… wheat is in a lot of packaged foods. You pretty much need to become a food-label-reading ninja. Some ingredients that may trigger a wheat allergy include:
- Bread crumbs
- Cereals made from farina, wheat, or those with wheat products of malt added
- Cottage cheese with modified starch or other wheat-containing ingredients
- Cracker meal
- Durum/durum flours (a type of wheat)
- Einkorn (a type of wheat)
- Emmer (a type of farro)
- Flour (both enriched and not enriched, all-purpose, bread, cake, instant, pastry, self-rising, soft wheat, steel ground, whole wheat)
- Graham flour
- High gluten flour
- High protein flour
- Hydrolyzed wheat protein
- Malted milk or malted drinks
- Matzoh, matzoh meal
- Modified starch
- Salad dressing or gravy thickened with wheat flour or wheat products
- Semolina (a type of wheat)
- Spelt (a type of wheat)
- Triticale (a type of wheat)
- Vital gluten
- Wheat bran
- Wheat durum
- Wheat germ
- Wheat gluten
- Wheat grass
- Wheat malt
- Wheat protein isolate
- Wheat sprouts
- Wheat starch
- Whole wheat berries
Other possible sources of wheat or wheat products may include:
- Gelatinized starch
- Hydrolyzed vegetable protein
- Modified food starch
- Natural flavoring
- Soy sauce
- Textured vegetable protein
- Vegetable starch
Another note of warning? Play-Doh (and similar products) contain wheat. So, if your child is allergic to wheat, you should avoid the traditional version and opt for available wheat-free versions. Because, as parents know, Play-Doh has a way of sneaking into little ones’ mouths.
What can you eat if you’re allergic to wheat?
There’s still plenty of other grains that wheat allergic patients can usually eat, such as:
- Non-cereal grain
How do I treat a wheat allergy?
So far, there is no FDA-approved way to treat food allergies aside from strict avoidance. So yeah, the way to treat a wheat allergy is to take wheat off the menu. The good news is that you can make grilled cheese with gluten-free bread and that there’s gluten-free mac and cheese. The food options are so much more varied than they were even a decade ago.
Understanding Gluten Sensitivity
Gluten sensitivity is a wide cast term used to describe adverse but non-life-threatening reactions people have to food. There is no FDA-approved way to test for gluten sensitivity, but an allergist could help you deal with gluten sensitivity with a specially tailored plan.
What are the symptoms of food sensitivity?
Here’s where things get a little hairy, as symptoms of food sensitivity differ from patient to patient. “The concept of food sensitivity is a little bit of a catch-all statement,” said Dr. Lee. “In the sense of in a week’s time in my office, I will have a patient come in saying wheat causes them to bloat, one will say wheat causes them to have acne.” She explains experts have no way of testing for gluten or wheat sensitivity.
Lee knows these symptoms cause her patients discomfort and pain and aims to manage them. However, unlike with allergy or celiac disease, “I don’t know that it is causing any long term harm or concerns and certainly, there is not that acute concern with those who have an immediate life-threatening reaction.”
What foods should you avoid on a gluten-free diet?
All wheat products should be avoided, same for rye and barley. “Barley and rye are very much associated with wheat, and in fact, it’s often really hard to get barley and rye products that haven’t touched wheat products so cross-contact is a concern,” Lee explains. Your allergist should also give you a list of foods to avoid.
Here’s a list of foods to avoid, courtesy of the Mayo Clinic:
- Beer, ale, porter, stout (usually contain barley)
- Bulgur wheat
- Cake, cupcakes, pies
- Communion wafers
- Cookies and crackers
- French fries
- Imitation meat or seafood such as imitation crab
- Malt, malt flavoring, and other malt products (barley)
- Hot dogs and processed lunchmeats
- Salad dressings
- Sauces, including soy sauce
- Seasoned rice blends
- Seasoned snack foods, such as potato and tortilla chips
- Self-basting poultry
- Soups, bouillon, or soup mixes
- Vegetables in sauce
Thanks to FDA rules, you can be pretty confident when buying food items labeled as gluten-free, which you can thankfully find in almost every grocery store nowadays.
Can you test for gluten sensitivity?
Unfortunately, there’s currently no FDA-approved test for food sensitivity. While you may come across test kits promising answers in your search queries, keep in mind that they have not gone through rigorous research or been confirmed by doctors or the FDA to work.
Why is it so hard to test for food sensitivity? Well, as Lee explains, while a food allergy test answers the question, “do you make an allergic antibody in the protein of the food?” a food sensitivity test is much more complicated as patients have a broad spectrum of effects. While one person might experience bloating, another might complain of acne. “There are probably different cells in the body that are causing these issues. So even if we do ever have a test to predict those things they will be different tests,” Lee explained.
What are other negative reactions to gluten/wheat?
There are other negative reactions you or your child could have to gluten or wheat. Lee says wheat is one of the top three foods to exacerbate eczema, along with milk and eggs. However, again, there’s no way of testing for a sensitivity right now. Gluten can also cause food protein-induced enterocolitis, also known as FPIES. FPIES leads to delayed vomiting or diarrhea around two hours after you’ve consumed wheat. It can also cause eosinophilic esophagitis — EOE, which would lead to reflux-like symptoms. With “immediate life-threatening reaction [like] FPIES and EOE, we are strictly avoiding the food,” says Lee.
Is there a gluten-intolerance symptoms checklist?
Gluten intolerance can present itself in various ways, some of which you wouldn’t intuitively connect with a gluten sensitivity. As a result, it may be beneficial to look at a gluten intolerance symptom checklist before presenting your concerns to your doctor. Just remember, you don’t have to experience all of these symptoms to have an intolerance — any combination of them may signal that gluten is the culprit behind your fatigue and stomach issues, among other problems. Your doctor will run tests based on your symptoms, so it’s always a good idea to know what you should be looking out for.
All of the following symptoms have been connected to gluten intolerance:
- Diarrhea and constipation
- Skin conditions like psoriasis and alopecia
- Brain fog
- Unexplained weight loss
- Iron deficiency
- Anxiety and depression
- Autoimmune disorders
If you’re experiencing any combination of these symptoms, particularly after consuming foods containing gluten, it might be a good idea to make an appointment with your doctor.
Can you suddenly become gluten intolerant?
For some people, gluten intolerance presents at a very young age. In fact, in some cases, parents may know whether or not their child will have to be gluten-free when they’re still an infant. But for others, the intolerance develops over time. So in that sense, yes, you can develop an intolerance to gluten at any period in your life, including late adulthood. While doctors are still split on the exact cause of the condition, the general thinking is that genetics and environmental factors both play a role in triggering gluten intolerance in children and adults.
Making things even more complicated, some people experience a delayed reaction before symptoms present. That means you may not intuitively connect your health issues to gluten consumption (especially if you have symptoms), as it’s been a few days since you ate anything that includes gluten. It can definitely be a confusing process! Be aware that gluten intolerance and celiac disease can occur anytime, so just because you didn’t have gluten issues as a child doesn’t mean you won’t have problems as an adult.
Additionally, certain events can prompt a gluten intolerance or celiac disease to present itself. According to LiveStrong, these events include:
- Viral infections
If you suspect that you’ve developed an intolerance to gluten or may have celiac disease, speak to your doctor before eliminating gluten from your diet. Your doctor will need to perform tests to determine whether or not you’re dealing with an intolerance or something else entirely, and those tests won’t be accurate if there’s no gluten whatsoever in your system.
What should you do if you have a gluten attack?
OK, so you know you’re gluten-sensitive, now what? Even though the market for gluten-free products is growing, there’s a good chance that, at some point, you’ll accidentally consume gluten. This situation is known as a “gluten attack.” It sounds frightening, but it basically means you’ve come into contact with gluten, and you’re not going to feel great until it leaves your system.
Since everyone experiences different gluten intolerance symptoms, your experience is likely to be unique to you. But some examples of a gluten attack include stomach upset, mood swings, brain fog, feelings of fatigue, bloating, or vomiting. The only thing you can really do is ride out the symptoms and try to pinpoint which food caused the attack to avoid it in the future.
Understanding Celiac Disease
Celiac disease is an auto-immune disease that causes your immune system to attack your small intestine. You test for it with a blood test and a scope. The scope and treatments of celiac disease are managed by a gastroenterologist.
Can you grow out of celiac disease?
No. Unfortunately, since celiac disease is not an allergy, it is impossible to outgrow.
How do you treat celiac disease?
The way to treat celiac is first and foremost with strict avoidance of all wheat products. But you should always confer with your doctor for a treatment plan that is tailored to your needs.
What are the symptoms of celiac disease in adults?
To manage celiac disease, the first step is being able to identify it. The symptoms can be uncomfortable, so here are several things to look out for to help you keep it under control.
- Loose bowels (diarrhea)
- Stomach pain/gas
- Watery stool
- Hair loss
- Weight loss/weight gain
- Foul-smelling stool
- Frothy and greasy-looking stool