“What to expect from Wheat allergy, Celiac, and NCGS: Wait! They’re not the same?” Disclaimer: None of the information provided in these posts should be taken as medical advice. Please consult with your doctor before trying recommendations or if you have concern
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Okay, I said last week that I was going to cover the elimination diet this week, but I’m still researching it. Which means I’m going to cover about a topic I don’t really have to research (much) to talk about.
Meet my nemesis, Gluten
As I have mentioned before, I have several food allergies, and one of them is wheat. It happens to be one of the top nine food allergies listed in the US, but it is similar to a couple of other gluten-based issues. So this week, I’m going to talk about the differences between a wheat allergy and both celiac disease (CD) and non-celiac gluten sensitivity (NCGS or GS). Because there is a lot of confusion surrounding these gluten-based irritants, let’s take a closer look at these conditions.
Wheat allergy
A wheat allergy, like all other allergies, is an immune response. The body creates immunoglobulin (IgE) antibodies to protect the body from the usually-innocuous protein in a food. In the case of a wheat allergy, that protein is gluten, which I’ll go into more detail on in a future post.
People can react differently to a wheat allergy. Some people only experience symptoms when they consume something that contains wheat. Others can react to simply breathing in wheat particles, even without eating them. Common wheat allergy symptoms include:
- Anaphylaxis
- Headache
- Hives or skin rash
- Nausea and vomiting
- Runny nose, congestion or sneezing
- Wheezing or asthma attack
Testing for a wheat allergy follows the usual allergy testing procedures, and doctors can choose from any of the common tests to help them make a diagnosis. Our next condition, however, requires a different approach.
Celiac disease
Celiac disease is an intolerance to the wheat protein gluten as well as gluten found in barley and rye. With celiac, the body develops an auto-immune response that attacks the small intestine and damages the villi, leading to a difficulty in absorbing nutrients. It is a genetic condition often triggered by stress, trauma, and other environmental factors.
Testing for CD usually involves several types of blood tests and possibly a biopsy of the small intestine. Your doctor can discuss with you what your best testing options are.
Common CD symptoms include:
- Bloating, gas, and constipation
- Brain fog, fatigue, and headaches
- Depression
- Diarrhea and nausea
- Joint pain
- Rash (dermatitis herpetiformis)
Ironically, some of these symptoms are similar to our last gluten condition, non-celiac gluten sensitivity.
Non-celiac gluten sensitivity
Symptoms in NCGS are usually more focused on digestion issue, such as bloating, constipation, diarrhea, and abdominal pain. This sensitivity is a little harder to define, largely because scientists haven’t quite figured out how it works. It isn’t an immune response (like the wheat allergy), but it also isn’t an auto-immune response (like celiac).
Some scientists think it could not be related to gluten at all. One study proposes that NCGS might be a sensitivity to another protein, amylase/trypsin-inhibitors (ATIs), found in wheat, barley, and rye.
Testing for it is challenging, because doctors must first rule out both a wheat allergy and celiac. If the patient tests negative for these two conditions but still reacts to gluten, the conclusion is NCGS.
Are you sure what you have isn’t celiac disease?
Short answer: maybe? The first test I had was a blood test, which isn’t as reliable as the scratch test I had two years later. The blood test checked for IgE antibodies and tissue transglutaminase IgA antibodies (tTG-IgA). All of these tests came to the same conclusion, though: I am definitely allergic to wheat.
I first found out about this allergy in 2008, right before I lost a contract job and was “unemployed” and freelancing for almost two years. Talk about a bad time to have to adjust to an expensive diet. And, trust me, eating gluten free isn’t cheap, though prices are getting a little better.
Life is never simple (for me, at least)
Thankfully, my symptoms don’t include anaphylaxis, but they do include inflammation, rashes (probably from the eczema), joint pain, and digestive upset, and some of these symptoms also occur in celiac disease. Also, I react negatively digestion-wise to barley, though I can’t say for sure with rye, because all of the rye products I’ve been exposed to also include wheat (which pretty much defeats the purpose of trying to determine a potential intolerance).
Since there is an allergy present, I don’t qualify for NCGS. And, though my tests don’t show it as a genetic marker, I still show some of the same symptoms as celiac.
Bodies are weird, as a friend of mine says. And none seem to be more so than mine. Ah, well. That’s life.
That’s all for this week. Next week I’m going to talk about what foods you can use to replace the wheat in your diet. Want to share a story about these conditions? Leave a comment below.
Be safe. Eat safe. And savor life!
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