Wheat allergies are immune system reactions to the proteins found in wheat, including albumin, globulin, gliadin and glutenin (gluten). Most often, the source of symptoms is wheat consumed in food. However, inhalation of flour containing wheat can also cause reactions (a condition known as baker’s asthma).

In people with wheat allergies, the immune system mistakes wheat protein for a harmful substance and releases antibodies called immunoglobulin E (IgE). As a defense against the invader, the IgE antibodies cause certain histamines to be released into the blood stream. These histamines result in the unpleasant allergic symptoms most people associate with wheat allergies.

Wheat allergy tends to affect people from families with a history of allergies such as allergic rhinitis.  It is most common in infants, who often outgrow symptoms within the first few years of life. Symptoms of wheat allergy may be mild and mimic those of allergic rhinitis. However, in some cases they can be more serious, manifesting as anaphylaxis. 

The only effective treatment for wheat allergies is to completely remove wheat products from the diet. By practicing diligent avoidance, an individual can successfully remove the threat of a wheat–related allergic reaction.

Because wheat is so prevalent in food products, it can be difficult to avoid. Dietitians can help patients plan meal menus that are safe. In addition, patients must be vigilant in reading ingredient lists while shopping, and ask restaurants about food preparation techniques and ingredients.

Alternatives to wheat also are available. They include:

• Flours made of corn, potato, barley, rye, oat, soy or rice
• Rye meal
• Rolled oats
• Potato starch
• Sago
• Arrowroot starches

Cross-reactions may occur in some patients with wheat allergy. Wheat is a member of a very large plant family (Gramineae) that includes grasses and most grains. Some people with wheat allergies may not be able to consume other grain–based foods from this family because of an allergic reaction to the shared protein. Grains that are common alternatives to wheat but may cause cross-reactions include barley, rye and oats.