Wheat allergy

What it is

A wheat allergy is an immune reaction to proteins in wheat.¹ It is most often reported in young children and may affect up to 1% of children in the US.¹ Many outgrow it: about 65 percent of children with a wheat allergy outgrow it by the time they are 12.² Some people stay allergic to wheat throughout their lives.¹

A wheat allergy is not celiac disease. Both are reactions to food, but their underlying causes are very different.¹ Celiac disease is an autoimmune disorder in which the immune system is abnormally sensitive to gluten, a protein found in wheat, rye and barley. The resulting inflammation damages the villi, the small, finger-like projections that line the small intestine.⁵ NIDDK describes it as a chronic digestive and immune disorder.⁶ A wheat allergy, by contrast, is an IgE-mediated reaction to wheat proteins, and in some people it can include anaphylaxis.¹ ACAAI says a diagnosis of celiac disease must be made by a board-certified gastroenterologist.²

“Gluten allergy” is a misleading term, according to ACAAI, and is often confused with wheat allergy or celiac disease. Gluten intolerance is not an allergy, and there are currently no tests that accurately diagnose it.²

Symptoms it causes

Symptoms of a wheat allergy can include hives or a skin rash; nausea, stomach cramps, indigestion, vomiting or diarrhea; a stuffy or runny nose; sneezing; headaches; and asthma.² Reactions can involve the skin, the digestive tract and the airways, and even very small amounts of wheat can cause one.¹

Anaphylaxis is less common.² It is a life-threatening reaction that affects the whole body and can impair breathing.³ In the US, food allergy is the leading cause of anaphylaxis outside the hospital.² An allergist can test for a wheat allergy.⁴

Reading food labels

Wheat is a major food allergen under US law. The Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA) named eight major food allergens, wheat among them, and the FASTER Act made sesame the ninth, effective January 1, 2023.⁷

A packaged food that contains wheat must name it in one of two ways: in parentheses after an ingredient, as in “flour (wheat),” or in a “Contains” statement next to or right after the ingredient list.⁷ Not every product that contains an allergen has a “Contains” statement, so FDA points readers to the whole ingredient list.⁸

For labeling, FDA defines wheat as any species in the genus Triticum. Its guidance names common wheat, durum, club wheat, spelt, semolina, einkorn, emmer, Khorasan and triticale.⁹

Phrases such as “may contain wheat” or “produced in a facility that also uses wheat” are advisory statements. FDA says they are not required by law. Manufacturers can use them for cross-contact that cannot be avoided, but only if they follow good manufacturing processes and have taken every precaution to avoid it, and the statements must be truthful and not misleading.⁷ FDA calls the “may contain” statement voluntary, and not all manufacturers use it.⁸

Wheat is in many foods, including cereals, pastas and crackers, and even some hot dogs, sauces and ice cream. It also turns up in nonfood items such as Play-Doh and some cosmetic and bath products, and FALCPA’s labeling rules do not apply to nonfood items.² FARE says wheat is sometimes found in glucose syrup, soy sauce, some starches including modified food starch, surimi and plant-based meat alternatives.¹ Its list of ingredient names that point to wheat includes bulgur, couscous, farina, farro, freekeh, matzoh, seitan, semolina, spelt and vital wheat gluten.¹