Wheat Allergy vs. Celiac Disease: How Are They Different?

Medically reviewed on Sept 20, 2023 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• Understanding Celiac Disease
• Understanding Wheat Allergies
• Take Control of Your Celiac Disease or Food Allergy With Everlywell
• Related Content

Celiac disease affects about 1% of the worldwide population, and the same can be said for wheat allergies. [1,2] However, they are not the same. The former is an autoimmune disease; it causes immune cells to attack the small intestine when you ingest gluten, limiting nutritional absorption and causing gastrointestinal issues. [1]

A wheat allergy, on the other hand, is a type of allergic reaction. It occurs when immunoglobulin E (IgE)-mediated antibodies recognize wheat protein as harmful to the body. As a result, people with wheat allergies can enter a state of anaphylaxis and/or gastrointestinal and respiratory distress if they consume wheat. [2]

Curious to know more about a wheat allergy vs. celiac disease? Let’s dig in.

Understanding Celiac Disease

Celiac disease is not characterized as a wheat intolerance or a gluten sensitivity. Rather, it’s a digestive and immune disorder. Accordingly, people with celiac disease will not typically experience symptoms common to allergies, such as hives or rashes. [1]

Instead, when people with celiac disease ingest gluten—which is found in wheat, barley, and rye—it makes its way to the small intestine and triggers immune cells that fight back against foreign invaders. [3]

Consequently, the immune system damages the lining of the small intestine, inhibiting its ability to effectively absorb nutrients into the bloodstream. This is what’s called ‘malabsorption’. [3]

In children, this condition can lead to stunted growth and development. For example, they may experience delayed puberty, have a shorter-than-average stature, or have learning disabilities. [3]

The intestinal damage caused by celiac disease can also lead to numerous gastrointestinal issues, such as [3]:

• Diarrhea
• Weight loss
• Bloating and gas
• Abdominal pain
• Nausea and vomiting
• Constipation

Adults may also experience symptoms completely unrelated to the digestive system, and even some hidden symptoms of celiac disease. Some people may experience extreme levels of fatigue, while others can develop anemia if they have deficient iron levels. Additional issues that may arise as a result of celiac disease include [3]:

• Osteoporosis
• Mouth ulcers
• Headaches
• Tingling extremities
• Cognitive impairment
• Joint pain
• Hyposplenism
• Increased liver enzymes

In some cases, celiac disease—or, more specifically, a gluten intolerance—can develop into a type of skin condition called ‘dermatitis herpetiformis’ in which a rash appears across the body, typically on the elbows, knees, torso, scalp, and/or buttocks. [3]

Celiac Disease Treatment

Although there’s no cure for celiac disease, people can manage their symptoms with a gluten-free celiac disease diet plan. While wheat, barley, and rye are off-limits in a gluten-free diet, people with celiac disease can still consume certain types of grains, like amaranth, sorghum, quinoa,, and more. They can also safely eat [4]:

• Fruits
• Vegetables
• Meat and poultry
• Fish and seafood
• Dairy
• Beans, legumes, and nuts

Celiac Disease Diagnosis

Most often, celiac disease is genetic. Likely, if you have celiac disease, someone in your family does, too. Researchers have also found that a large number of infections early in life—specifically those that disrupt the gut’s microbiome—can make a person more susceptible to the disorder. [5]

To diagnose celiac disease, healthcare providers will conduct a physical assessment, assess your symptoms, consider the possibility of silent celiac disease, and administer two types of blood tests [6]:

• Serology testing – This type of test identifies elevated levels of antibodies in your blood which can point to an immune response.
• Genetic testing – In this case, providers look to identify human leukocyte antigens, two genes that can identify celiac disease.

Understanding Wheat Allergies

Wheat allergies more commonly develop in infants and toddlers whose immune and digestive systems are still developing. In these cases, the immune system overreacts to wheat protein when it enters the body, believing it’s a threat. [7]

The immune response triggers an allergic reaction, which can be deadly, particularly in the case of anaphylaxis. In some cases, the reaction may arise within minutes. In other cases, a reaction can take up to two days to manifest. This largely depends on the type of wheat allergy you have [7]:

• IgE-mediated reaction – For these types of wheat allergies, the body responds to the “invader” by producing IgE antibodies, which trigger an immediate allergic reaction.
• Non-IgE-mediated reaction – In this case, the immune system still reacts to the ingested wheat, but much more slowly, without IgE antibodies. Within 48 hours, various conditions may develop, including inflammation of the esophagus or stomach lining.

A wheat allergy may manifest with any of the following symptoms, which can range from mild to severe [7]:

• Hives, swelling, and/or rash
• Stomach cramps
• Indigestion
• Nausea and vomiting
• Diarrhea
• Stuffy or running nose and/or sneezing
• Headache
• Wheezing
• Inflammation

Anaphylaxis is particularly dangerous, leading to [7]:

• Difficulty swallowing or breathing
• Tightness of the chest
• Feelings of doom
• Hypotension
• Confusion
• Increased heart rate
• Weakness or lightheadedness
• Hives and/or swelling of the face
• Abdominal pain
• Nausea and vomiting
• Diarrhea

In this case, it’s critical to contact a healthcare provider immediately to receive care.

It’s believed that about 66% of children with wheat allergies do outgrow them. However, it’s also possible for adults to develop a cross-reactive allergy to wheat. Essentially, if you’re allergic to grass pollen, your body can wrongly interpret wheat protein (albumin, gliadin, globulin, or glutenas) as the pollen found in grass and initiate an immune response. [8]

Wheat Allergy Treatment

While some children may outgrow their wheat allergies, there’s no direct way to eradicate the allergy completely. Instead, it’s best practice to avoid products that contain wheat entirely. In terms of food, these can include avoiding [7]:

• Baked goods
• Bread
• Breakfast cereals
• Couscous
• Hot dogs
• Malted drinks
• Pastas
• Pizza dough
• Seitan
• Wheat-based beer
• Wheat flours

It’s also important to note that some non-food items can also contain wheat, particularly if they’re manufactured in the same factory as wheat-based products. Such items include Play-Doh, makeup, and toiletry items. Fortunately, in most cases, you can find this information on the product label. [7]

Unlike celiac disease, there are certain medications that can help treat and manage wheat allergies, including:

• Antihistamine medications – The immune system produces chemicals called ‘histamines’ that are responsible for the immune “overreaction” to wheat. Antihistamines are prescription medications that block histamines, halting an allergic reaction. They typically work within 30 minutes of taking them. [9]
• Corticosteroids – As a type of anti-inflammatory drug, corticosteroids slow down the immune system and decrease inflammation throughout the body to ease wheat allergy symptoms. They’ll typically start to work within an hour. [10]
• Epinephrine injections – You may recognize several epinephrine brands, such as EpiPen, Adrenaclick, and Auvi-Q. These injectables reverse anaphylaxis, easing symptoms related to breathing and swelling immediately following injection. Side effects may include dizziness, dry mouth, headache, nausea, and an increased heart rate, among others. [11]

Wheat Allergy Diagnosis

Similarly to celiac disease, your healthcare provider may choose to administer a blood test to diagnose a wheat allergy. However, there are also several alternative avenues of diagnosis including a [7]:

• Skin prick test – For this type of test, you’ll visit an allergist. After cleaning your forearm or upper back, they’ll expose the area to various wheat proteins to see if your body reacts. To do this, they’ll prick your skin with a small, wheat-exposed needle. While you may feel a pinch, you won’t bleed. However, some allergists may choose to forgo the prick entirely. Rather, they’ll simply scratch your skin with the needle, allowing the liquid wheat to seep into your skin. After about 15 minutes, they’ll assess your skin. If you experience discolored or raised skin, it’s likely that you have a wheat allergy.
• Graded oral challenge – Healthcare providers typically order a graded oral challenge if your blood test and/or skin prick test both come back as inconclusive. However, this test is more risky. Under the supervision of your healthcare provider, you’ll be asked to eat a small amount of wheat. Your healthcare provider will then monitor you for signs of an allergic reaction for up to four hours. While this is a riskier option, it’s typically only administered to patients with a low or moderate risk of a severe reaction, such as anaphylaxis.
• IgE blood test – In this case, your healthcare provider will order a blood test, in which the lab technician will use a needle to withdraw blood from your arm. For this type of test, you will not need to expose yourself to wheat. Rather, within the lab, staff will add wheat protein to your blood sample and identify the number of IgE antibodies present.

Take Control of Your Celiac Disease or Food Allergy With Everlywell

Celiac disease and wheat allergies both involve a reaction to gluten. That said, celiac disease is an autoimmune response that can destroy the lining of the small intestine. Thus, the most predominant symptoms of celiac disease include gastrointestinal issues.

Wheat allergies, on the other hand, manifest when the immune system perceives wheat as a harmful invader. Accordingly, it’ll trigger an immune response that causes inflammation throughout the body and, in severe cases, anaphylaxis.

To assess your risk for either condition, adopt the help of Everlywell. Our At-Home Celiac Disease Test screens for 3 key antibodies that may indicate celiac disease, while our At-Home Food Allergy Test measures 9 IgE antibodies linked to certain food allergies. Plus, taking both tests is easy. You’ll simply finger prick at home, then send your sample to one of our CLIA-certified labs. Within days, you’ll receive your results, as well as advice from a licensed healthcare provider regarding next steps.

If you have questions about celiac disease and allergies, trust Everlywell to provide answers.

Related Content

Celiac Diet Plan: Benefits and How To Create One

Can Celiac Disease Go Away?

Hidden Symptoms of Celiac Disease

Silent Celiac Disease: Symptoms & Causes

Understanding Refractory Celiac Disease

References

1. Definition & Facts for Celiac Disease. NIH. Published October 2020. URL. Accessed September 14, 2023.
2. Wheat Allergy. FARE. URL. Accessed September 14, 2023.
3. Mayo Clinic. URL. Accessed September 14, 2023.
4. Gluten-Free Foods. Celiac Disease Foundation. URL. Accessed September 14, 2023.
5. Symptoms & Causes of Celiac Disease. NIH. Published October 2020. URL. Accessed September 14, 2023.
6. Celiac Disease. Mayo Clinic. URL. Accessed September 14, 2023.
7. Wheat Allergy. Cleveland Clinic. Published September 5, 20220. URL. Accessed September 14, 2023.
8. Grass Allergy. Allergy & Asthma Network. URL. Accessed September 14, 2023.
9. Antihistamines. Cleveland Clinic. Published July 13, 2020. URL. Accessed September 14, 2023.
10. Corticosteroids. Cleveland Clinic. Published January 20, 2020. URL. Accessed September 14, 2023.
11. Epinephrine Auto-Injector. Cleveland Clinic. URL. Accessed September 14, 2023.