Allergy to Wheat

Sensitization and allergy after consuming wheat or breathing wheat flour is considered as one of the food allergic diseases as well as respiratory diseases.
Studies show that the prevalence of wheat allergy has been increasing in recent decades! Wheat allergy is different from other food allergies in several ways.
First, wheat is the most consumed grain in Iran and the world.
Second, it is one of the most important sources of protein supply for humans.
Also, wheat is one of the foods that enter children’s diet at the beginning of life, i.e. from about 5 months of age, and can cause allergic reactions in susceptible children even through breastfeeding.

In general, cereals are the most important source of protein in the diet of people around the world.
Among them, the most consumed grain in Iran and the world is wheat.
All cereals botanically belong to the Poaceae family.
The wheat used to make bread with the scientific name of Triticum aestivum is widely planted in different regions of Iran and is compatible with different climates. Wheat has a high value among food items and it can be used to make various products such as bread, pasta, sweets, etc. 
Despite the high nutritional value of wheat and the great use of wheat flour in the food industry, reports of food and respiratory allergic reactions following the consumption of wheat or the inhalation of wheat flour are increasingly reported in Iran and other countries of the world.

Wheat allergy is more common in children than adults.  
In the world, research results indicate an increase in allergic reactions to wheat, especially in children.
In these studies, the prevalence of wheat allergy in children between 2 and 10 years old has been reported between 2 and 9 percent.

In general, proteins account for approximately 10-15% of the dry weight of wheat grain.
The major part of these proteins are gliadins and glutenins.
These proteins create more complex compounds such as gluten, which are abundant in wheat and some other grains.

Complications caused by consuming wheat or breathing wheat flour lead to various symptoms and clinical manifestations.

Food allergy caused by wheat consumption.
The most well-known allergic reaction to wheat is the complications caused by eating wheat. Wheat enters people’s diet for the first time at around 5 months of age. Allergy to wheat may also occur in children during breastfeeding.
In general, adults are less likely to have food allergies caused by wheat consumption than children. Symptoms of food allergy to wheat usually include hives, angioedema, shortness of breath, abdominal pain, nausea and vomiting, and in severe cases, anaphylactic shock.
Sometimes, late effects caused by wheat allergy are observed after about 24 hours in the form of gastrointestinal symptoms or exacerbation of allergic dermatitis (eczema) reactions.

Baker’s asthma
Baker’s asthma is a type of occupational allergy that often occurs in people working in wheat and grain mills, as well as bakeries and pastry shops.
Baker’s asthma is caused by inhaling cereal flour.
Respiratory symptoms in this disease may be accompanied by symptoms of allergic rhinitis, conjunctivitis and hives.
Most of the patients with baker’s asthma were able to eat wheat without suffering any special symptoms!

Wheat-related exercise-induced anaphylaxis
This type of complication caused by wheat consumption is unique and occurs when a person engages in sports activities after consuming wheat.
In this case, the side effects caused by the consumption of allergenic wheat proteins are local, such as hives, or widespread, i.e., in the form of hives in different parts of the body, angioedema, shortness of breath, low blood pressure, or shock.
The complication of anaphylaxis induced by exercise related to wheat cannot be easily predicted or diagnosed! Because the incidence and severity of this complication depends on the amount of wheat consumed and the intensity of sports activity.
In a study conducted on Finnish patients, the results showed that this complication appeared between 10 minutes and 4 hours after consuming wheat, and the duration of the sports activity that caused this complication was between 10 minutes and 60 minutes.

There are several differences between wheat allergy and celiac disease.
Wheat has different proteins that the human body sometimes reacts to some of these proteins.
Cells and substances causing complications in celiac disease and wheat allergy are completely different.
In food allergy to wheat or in baker’s asthma, a person has an allergic disease and its mechanism is the same as other allergic diseases, but celiac disease is a type of hereditary and autoimmune disease (deviation and reaction of a person’s immune system against certain substances and cells) his own body) in which the immune system causes damage to the intestinal tissue due to the reaction to the wheat gluten protein.
In this disease, intestinal villi are destroyed due to immune system invasion and inflammation.
This damage gradually causes disturbances in the absorption of food and mineral salts and eventually malnutrition in the person.

Diagnosis of wheat allergy is based on consultation with an asthma and allergy specialist and based on detailed knowledge of the patient’s history, symptoms caused by wheat consumption or wheat flour inhalation, as well as skin and blood tests. It is worth mentioning that some allergy proteins Wheat germ is similar to allergens found in some types of grasses or food, and this causes a cross reaction between these allergens.
In other words, sometimes people who are sensitive to the pollen of certain types of grasses or some special foods may experience allergic reactions if they consume wheat or inhale wheat flour.

As a general rule for allergic diseases, after proving the existence of an allergy to a substance such as proteins in wheat, avoiding contact with or consuming the allergenic substance can prevent the occurrence of allergic complications in the patient.
In cases where the allergic side effects are severe and there is a possibility of an anaphylaxis reaction, emergency care is needed, which is explained in the writing of emergency drugs for severe allergic reactions.

• In case of proof of allergy to wheat by an allergist, it is recommended to limit or stop the use of wheat and its products.
• Of course, avoiding the consumption of wheat due to its high nutritional value must be done at the discretion of the attending physician!
• Due to the high nutritional value of wheat in the human diet, wheat is often used in various products. Therefore, people with a severe allergy to wheat must pay attention to the ingredients of commercially purchased foods and read their labels carefully.
• People who are allergic to wheat should know the ingredients of the ordered food when they go to eat at restaurants. Small amounts of wheat sensitizing proteins in allergic people may cause an anaphylactic reaction in a person.
• A person who is sensitive to the pollen of some grasses or some foods such as sesame, grains and also some fruits such as kiwi should be careful in consuming wheat.
• For children and allergic children, the consumption of wheat and products derived from other grains, as well as milk powders containing wheat, should be done with caution! A specialist doctor should be consulted about how to use these food products.