Wheat Allergen Facts, Symptoms, and Treatment
Learn more about common allergic diseases, symptoms, management paradigms, and testing considerations.
Is your patient a candidate for specific IgE testing?
Get detailed information on whole allergens and allergen components.
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Learn more about common allergic diseases, symptoms, management paradigms, and testing considerations.
Is your patient a candidate for specific IgE testing?
Get detailed information on whole allergens and allergen components.
Ready to test a patient?
Access videos and webinars delivered by key experts in the field of allergy.
Wheat is a cereal grass whose processed grains are considered by some to be the most important source of food globally.1,2 In fact, wheat is used in a multitude of foods and nonfood items, including some you might not suspect. Although this list includes more obvious items such as cakes, crackers, and cereals, it also incorporates things such as ice cream, hot dogs, cosmetics, and play dough.3 On average, unprocessed wheat grains contain severl nutrients and are 70 percent carbohydrates, 12 percent protein, and 2 percent fat. However, the milling process involved in creating flour eliminates considerable nutritional value.1
Wheat allergy is self reported in an estimated 3.6 percent of Europe's population, it's one of the eight major food allergens in the United States, and it's the third most common food allergy (after milk and egg) in Germany, Finland, and Japan.2,4,5 Children have a higher prevalence of wheat allergy compared to adults, but most outgrow the allergy by the age of 16.6 Note that wheat allergy shouldn't be confused with celiac disease. The former is a food allergy that some people can grow out of, and the latter is a lifelong autoimmune condition triggered by gluten, which can be found in wheat, rye, and barley.7
Wheat can be found in a host of food products including:5 baked goods, baking mixes, bread, bread crumbs, breaded food, breakfast cereal, bulgur, couscous, cracker meal, durum, einkorn, emmer, farina, farro, flour (multiple varieties), matzoh, pasta, seitan, semolina, spelt, triticale, and wheat germ oil.
Additional potential sources of wheat include:2,3,5,7 Asian dishes with wheat flour shaped like animal proteins, batter-fried foods, beer, candy, dairy products such as ice cream, glucose syrup, hydrolyzed vegetable and wheat protein (HVP), imitation crab meat, marinara sauce, meat products such as hot dogs, modified starch and raising agents such as baking powder, natural flavorings, oats, potato chips (crisps), salad dressings, sauces, soy sauce, turkey patties, and vegetable gum.
In some allergic individuals, inhaling wheat flour can also cause a condition that's sometimes called baker's asthma and elicits symptoms of allergic rhinitis (aka hay fever).2,6 The condition's name is derived from the fact that it's a common occupational issue with bakers and those with repeated contact with wheat flour.6
Those with a wheat allergy may also develop allergic urticaria (aka hives) after coming in contact with cosmetics that contain wheat.2 Nonfood items including play dough, bath products, and cosmetics may contain wheat.2,3,5,7
Note that a gluten-free product isn't necessarily wheat free. Rather, the labeling indicates that the item contains a safe level of gluten for those with celiac disease. Since some wheat allergic individuals react to less than 20 parts per million, gluten-free foods aren't considered safe for those with a wheat allergy.7 Buckwheat, however, isn't related to wheat and may be tolerated by wheat-allergic individuals.5
Some people with wheat allergy may also experience symptoms when eating or being exposed to other seemingly unrelated allergens. This is called cross-reactivity and occurs when your body's immune system identifies the proteins, or components, in different substances as being structurally similar or biologically related, thus triggering a response. The most common cross-reactivities with wheat are other cereals (e.g., rye and barley), rice, maize, and grass pollens.2
Wheat consists of different types of proteins that all have different characteristics that may be associated with varying risk of causing severe allergic reactions.2 Knowing the proteins, or components, within each allergen that are triggering your symptoms can help guide your management plan. With that in mind, and based on your symptom history, your healthcare provider may suggest something called a specific IgE component test, which can help reveal your specific risk profile.2
Already have your specific IgE component test results?
Your component test results will include the name of the components (a series of letters and numbers and/or name). Your healthcare provider will likely review the results with you, but here you'll find an at-a-glance breakdown you can use as a reference. Simply match the component names to the list below to see what they mean in terms of symptom management.2
rTri a 14
rTri a 19 (Omega-5-gliadin)
Gliadin
rPhl p 12
MUXF3 (CCD)
Test results should be interpreted by your healthcare provider in the context of your clinical history. Final diagnosis and decision on further management is made by your healthcare provider.
*These products may not be approved for clinical use in your country. Please work with your healthcare provider to understand availability.
Because there is no cure for food allergies, your healthcare provider may recommend a plan that includes the following.12-15
Your healthcare provider may direct you to take one of the following medications:
If you're with someone who's having an allergic reaction and shows signs of shock, act fast. Look for pale, cool, and clammy skin; a weak, rapid pulse; trouble breathing; confusion; and loss of consciousness. Do the following immediately:
Wheat allergy can range from mild to severe and may vary over time, resulting in mild symptoms during one episode and severe symptoms in another. Although food allergy symptoms can start a few minutes to several hours after ingestion, most begin within two hours.8 Symptoms may involve the skin, gastrointestinal tract, cardiovascular system, and respiratory tract, and may include one or more of the following:8,9
Wheat allergy can also result in exercise-induced anaphylaxis, a rare reaction that occurs when the allergen is eaten before exercise. Here symptoms vary from allergic urticaria (aka hives) to anaphylaxis.2
Together with your symptom history, skin-prick testing or specific IgE blood testing can help determine if you are allergic to a particular allergen. If you are diagnosed with an allergy, your healthcare provider will work with you to create a management plan.
It's important to note that some children with wheat allergy may outgrow their allergy, and food can be reintroduced. Therefore, periodic retesting and oral food challenges are recommended to track any progress toward outgrowing wheat allergy.11
*These products may not be approved for clinical use in your country. Please work with your healthcare provider to understand availability.
Because food allergic reactions are unpredictable and symptoms range from local to systemic, it is recommended that an epinephrine prescription be considered for any patient with an IgE-mediated food allergy.12
If you have asthma, you may face a higher risk of severe wheat reactions, particularly if your asthma is poorly controlled.7