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What's the difference between a wheat allergy and a gluten allergy?

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Updated February 28, 2013

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What's the difference between a wheat allergy and a gluten allergy? Getty Images/Anne Rippy
Question: What's the difference between a wheat allergy and a gluten allergy?
Answer:

A wheat allergy and a gluten allergy are actually two very different things. One is a diagnosable medical problem, while the other is non-medical shorthand for several different possible conditions. And beware: foods that might be okay if you have a wheat allergy may not be okay if you have a "gluten allergy," (and vice versa).

Confused? Here's how to sort it all out.

Wheat Allergy: Not Just Gluten

A wheat allergy is an allergic reaction to wheat, which, as we know, is a grain used to make a wide variety of different foods. Wheat has many different components, including starches, proteins and even a little bit of fat.

Not everyone with a true wheat allergy is reacting to the same part of the wheat plant: researchers have actually identified 27 different potential wheat allergens. The notorious protein gluten is one potential allergen, but there are more than two dozen others.

When you have a true wheat allergy, you suffer near-immediate or slightly delayed (by no more than a few hours) symptoms following a meal that includes wheat products. Symptoms are often respiratory in nature (stuffy nose, wheezing, watery eyes) but in the most serious cases can include difficulty breathing and shock. Learn more:

People who've been diagnosed with wheat allergy need to avoid foods that contain wheat ingredients. Note that not all gluten-free foods are actually wheat-free: some contain ingredients that are originally derived from wheat but are considered to be free of the protein gluten. This is especially true in the United Kingdom and Europe, where gluten-free-labeled breads and other products can contain wheat starch that's been processed to remove the gluten protein.

In the United States, food allergen labeling laws require disclosure of any ingredients that are derived from wheat. (Learn more: Do food labeling laws require manufacturers to disclose gluten?). That's because wheat — not just gluten, but the whole wheat plant, stalk, grains and all — is considered one of the top eight allergens in the food supply.

'Gluten Allergy' Not Really An Allergy

A "gluten allergy," on the other hand, is not really an allergy, nor is it an accepted medical condition.

When people say they have a "gluten allergy," they're generally using the term as shorthand for one of four gluten-related disorders: celiac disease, non-celiac gluten sensitivity, dermatitis herpetiformis or gluten ataxia. They may also mean that they've been diagnosed with a true wheat allergy, but that's a bit more unusual.

Even though the term "gluten allergy" isn't accepted by doctors, people use it because it gets the point across: they need to stay away from gluten. Learn more:

Just as foods that are labeled "gluten-free" aren't always suitable for someone who needs to be completely wheat-free, foods that are labeled "wheat-free" may or may not be suitable for someone who follows a gluten-free diet. The gluten protein occurs in wheat, but also in barley and rye. And in the U.S., at least, manufacturers do not need to disclose barley or rye ingredients. (For more on this, see: Does Wheat-Free Equal Gluten-Free?)

The bottom line is that wheat allergy and gluten allergy are two completely different problems with similar, but not identical, treatments. Talk to your doctor if you're not sure which condition you have, since your diagnosis makes a major difference in what you can (and can't) eat.

Sources:

Ludvigsson J. et al. The Oslo definitions for coeliac disease and related terms. Gut. 2013 Jan;62(1):43-52. doi: 10.1136/gutjnl-2011-301346. Epub 2012 Feb 16.

Sotkovský P. et al. A new approach to the isolation and characterization of wheat flour allergens. Clinical and Experimental Allergy. 2011 Jul;41(7):1031-43. doi: 10.1111/j.1365-2222.2011.03766.x. Epub 2011 May 31.

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