Updated 14 May 2014

Allergic to wheat?

Does your nose drip and your stomach growl with cramps? Do you itch all over or suffer from constant nausea? Any one of these unpleasant symptoms, can be caused by a wheat allergy.

Does your nose drip and your stomach growl with cramps? Do you itch all over or suffer from constant nausea? Any one of these unpleasant symptoms, or all of them, can be caused by a wheat allergy. Although diagnosis of wheat allergy is relatively uncommon, many people probably suffer from this allergy without being aware of it.

Why do people react to wheat?
Although wheat is a grain and a rich source of carbohydrates, it also contains some protein. The protein in wheat, like all proteins, is made up of building blocks called amino acids. The major amino acids in wheat are called albumin, globulin, gliadin and glutelin (gluten).

Wheat allergy is usually linked to the albumin and globulin amino acids in wheat. When these amino acids enter the body through the digestive system or the lungs, the immune system reacts by making so-called immunoglobulin E antibodies. These antibodies then cause the actual symptoms of runny nose, wheezing, skin reactions, nausea and diarrhoea.

What’s the difference between wheat allergy and coeliac disease?
It is important to remember that wheat allergy differs from the condition called coeliac disease, which is a hereditary illness. People who are allergic to wheat develop symptoms after eating products that contain wheat or if they inhale wheat flour (baker’s asthma). While patients with coeliac disease are sensitive to wheat from birth, wheat allergy can develop at any stage of life.

Why am I suddenly allergic to bread?
Some people can eat a food like bread for years without any ill effects and then suddenly one day develop the symptoms of wheat allergy. This is not due to an overnight change, but a gradual build-up of wheat antibodies over time. When the level of wheat antibodies reaches a critical level in the body of wheat-sensitive individuals they start to develop respiratory, gastrointestinal, or skin reactions.

Is wheat allergy common?
According to statistics, wheat allergy is supposed to be relatively uncommon, but there may be many more sufferers out there who are not even aware of the fact that they are allergic to wheat.

In the baking industry where people are constantly exposed to fine wheat particles in the air, wheat allergy can affect up to 30% of workers. These patients usually develop respiratory symptoms or baker’s asthma.

What symptoms should I look out for?

The main symptoms of wheat allergy are:

  • skin reactions - eczema, itchy skin, and hives
  • digestive reactions - abdominal cramps, bloating, nausea and in severe cases, vomiting
  • respiratory tract - asthma, runny or blocked nose, post-nasal drip, cough, wheezy chest

Dietary treatment of wheat allergy
If you suffer from confirmed wheat allergy, the most important thing you can do is of course to avoid foods that contain wheat. This is easier said than done.

Because wheat is one of mankind’s staple foods that humans have been eating for millennia, it is particularly difficult to avoid all wheat-containing foods. In addition, modern food processing methods use various forms of wheat in hundreds, if not thousands, of foods (see List of Label Ingredients below).

A wheat-free diet is very restricted and individuals who are highly allergic can basically eat only unprocessed fruit, vegetables, meat, poultry, fish, eggs, milk and dairy products, nuts, fats and oils.

Unless you suffer from so-called "cross-reactivity", which means that you also react to other cereals, you should at least be able to eat rye bread, breakfast cereals made from oats or maize, and barley. Other cereals which are safe, include rice, and maize, and products made from rice and maize like rice cakes, rice flour, maize meal, samp, crushed maize and maize porridge.

How to avoid wheat-containing foods
In the modern world, wheat and ingredients derived from wheat are used in practically every kind of processed food. For example, soup power is usually thickened with wheat flour, and commercial sauces contain vegetable gum that may, or may not, be derived from wheat.

To be safe, it’s best to read the labels of each and every processed food you purchase. Be on the lookout for the following ingredients that indicate that the food contains wheat:

List of wheat-containing label ingredients

  • Bread crumbs
  • Bran or whole-wheat flour, wheat bran, wheat germ, wheat gluten, wheat malt or wheat starch
  • Cereal extract
  • Couscous
  • Cracker meal
  • Semolina
  • Flour and enriched flour, high-protein flour
  • Gluten, high-gluten flour and vital gluten

The following ingredients can also be derived from wheat flour and may thus contain wheat proteins, which could cause an allergic reaction: Gelatinised starch, hydrolysed vegetable protein, modified food starch, modified starch, natural flavouring, soya sauce, starch, vegetable gum or starch.

Will I get a vitamin deficiency?
Cereals and bread are important sources of dietary fibre, vitamins, especially the B vitamins and minerals. To make sure that you or your child, do not develop deficiencies if you have to cut all wheat-containing foods out your diet, it is advisable to consult a clinical dietician to work out a wheat-free diet for you.

Dieticians are listed in the telephone directory or get your doctor, clinic or hospital to refer you. In some cases it may also be necessary to take B complex supplements to make up for the lack of B vitamins in a wheat-free diet.

Living with an allergy to wheat is not easy, but by taking basic precautions you should be able to avoid the unpleasant symptoms of this food-linked condition. - (Dr I.V. van Heerden, DietDoc)

Any questions? Ask DietDoc


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Allergy expert

Dr Morris is the Principal Allergist at the Cape Town and Johannesburg Allergy Clinics with postgraduate diplomas in Allergology, Dermatology, Paediatrics and Family Medicine dealing with both adult and childhood allergies. obesity and diabetes societies and runs a trial centre for new drugs.

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