A lot of people say they are “allergic” to gluten or have a “gluten allergy.” But is a gluten allergy real? In this article, I’ll discuss why you can’t technically have a “gluten allergy” but why and how the term has become so widely used and understood. I’ll also discuss how you can tell if you have a gluten allergy (aka, gluten sensitivity). This post contains affiliate links. Please read my disclosures.
Before we talk about all things gluten, it’s important to know that there is no such thing as a gluten allergy.
No, my friends, you cannot be “allergic” to gluten.
In fact, the nearly three million people in the U.S. with celiac disease are not allergic to gluten, nor are the 18 million people in the U.S. diagnosed with gluten sensitivities or gluten intolerances allergic to gluten.
In fact, no one is “allergic” to gluten.
Gluten is a sticky protein found in wheat, barley, rye and sometimes oats and is not a recognized allergen.
That said, wheat, barley, rye and oats could be allergens, and wheat is considered one of the top eight allergens in the U.S.
Why Do People Say “Gluten Allergy”?
If a gluten allergy is not real, you may be wondering why people say they have a “gluten allergy”. How did this expression become part of our everyday vernacular?
I believe the reason the term “gluten allergy” has become so commonplace is that most people understand the word “allergy.” They know an allergy is a serious and life-threatening disorder. When someone says “I have a gluten allergy,” they’re taken seriously from the start.
On the other hand, if someone were to say, “I have an autoimmune disease,” people would be left scratching their heads. Few people know what an autoimmune disorder means.
Many people in the gluten-free community, therefore, resort to speaking the language widely recognized by others, including restaurant staff.
This is why they say, “I have a gluten allergy,” when placing their order at a restaurant. The staff immediately understands what the person is trying to communicate and the seriousness of the request.
If, however, you told the server working behind the register at Chick-fil-a, “I have autoimmune condition known as celiac disease that requires me to eat a strictly gluten-free diet,” he’d look at you like you had two heads!
On top of that, unfortunately, if you tell someone you have a gluten intolerance or sensitivity, you may not be taken as seriously as someone who says, “I have a gluten allergy.”
Even though gluten sensitivity is a very real and serious disorder, those who don’t suffer from it just don’t get it.
Editor Note: OK, before you send me hate mail, please note that I know and understand allergies are very serious conditions and the word “allergy” should not be thrown around lightly. Mind you, gluten sensitivities and autoimmune diseases are also very serious conditions that are less understood by the general public.
What is a Wheat Allergy?
While a gluten allergy is not a real condition, a wheat allergy, on the other hand, is a very real condition. Wheat allergies, however, impact far less people than celiac disease and gluten sensitivities. Approximately 0.1 to 0.3 percent of the U.S. population or 900,000 people have a wheat allergy according to Dr. Alessio Fasano in his book, Gluten Freedom.
Compared that to celiac disease, which afflicts about one percent of the population, and gluten sensitivity, which affects about six percent of the population or 18-20 million people in America alone.
Wheat, along with barley and rye, contain a protein called gluten. Someone who is allergic to wheat might still be able to eat barley, rye and other gluten-containing products. They only must avoid wheat. (Read: What is Gluten and Why is it Bad for Some People?)
What is an Allergy?
An allergic reaction occurs when the body’s immune system views a substance as harmful and therefore overreacts to it.
If you have an allergy to something in the environment or food supply, your immune system produces an antibody called immunoglobulin E (IgE).
Some allergies cause annoying but non-life threatening reactions such as watery eyes, itching, sneezing or hives. More serious and troublesome symptoms can be swelling in the mouth, trouble breathing and a life-threatening reaction called anaphylaxis.
Food allergies are very common and can trigger a harmful immune system response.
In fact, more than 170 foods have been known to trigger an allergic reaction in humans, and the eight most common food allergens are milk (dairy), egg, peanut, tree nuts, wheat, soy, fish and crustacean shellfish – these foods are responsible for most of the serious food allergy reactions in the United States.
According to Food Allergy Research and Education (FARE), up to 32 million Americans have food allergies, including 5.9 million children under the age of 18.
This means one in 13 children, or roughly two children in every classroom, have a food allergy. About 30 percent of children with food allergies are allergic to more than one food.
Unfortunately, food allergies are on the rise.
According to the Centers for Disease Control & Prevention, the prevalence of food allergies in children increased by 50 percent between 1997 and 2011, and between 1997 and 2008, the prevalence of peanut or tree nut allergy is believed to have more than tripled in U.S. children.
Because wheat is one of the most common allergen foods in the U.S., it must be disclosed, as required by federal law, on packaged foods that contain wheat. You can learn more about gluten and allergen labeling in my article, Learn How to Decode Food Labels.
Gluten, however, is not considered an “allergen” (as discussed) so it does not have to be disclosed, by law, on food labels.
This means a portion of the food can be free from wheat but still contain gluten in the form of barley, rye or even oats. For example, Rice Krispies does not contain wheat, but it contains barley malt (aka, gluten).
On the other hand, while most granola bars contain oats, they don’t disclose that the oats likely contain wheat through cross contamination. (Read: Are Oats Gluten Free?) If you have a wheat allergy, you must also avoid oats unless labeled wheat-free or gluten-free.
What is an Autoimmune Disease [and Celiac Disease]?
I’ve written extensively about autoimmune disease in the past, particularly in my book, Dear Gluten, It’s Not Me, It’s You! and in my review of Dr. Tom O’Bryan’s book, The Autoimmune Fix.
Dr. O’Bryan says autoimmunity occurs when the body attacks itself and causes organ and tissue damage unto itself. Symptoms can begin early in life and are sometimes subtle – joint pain, weight gain, brain fog, gut imbalances, depression, mood disorders, and fatigue. These are just some of the symptoms that indicate autoimmune disease is either bubbling or fully present in one’s body.
Autoimmune disease affects eight percent of the U.S. population or 24 million people, 78 percent of which are women. However, the number of autoimmune sufferers is likely much higher due to the difficulties in diagnosing autoimmune disorders.
Celiac disease is classified as an autoimmune disease. When a person with celiac disease ingests gluten (the “trigger” food), his or her body becomes confused and initiates an immune system attack on the healthy tissue surrounding the small intestine. This results in intestinal damage and villous atrophy in someone with celiac disease.
The villi that line the small intestine serve an essential role in the digestive system as they soak up nutrients from food and deliver those nutrients where they need to be to keep you healthy.
The villi in someone with celiac disease are completely worn down and look more like a flat surface than a shag carpet.
When the villi are destroyed, the small intestine is no longer properly absorbing nutrients and this is why most people with celiac disease suffer from a slew of nutritional deficiencies or disorders related to nutritional deficiencies.
An autoimmune disease, while just as serious as an allergy in many ways, causes damage to the body over time and puts someone at risk for acquiring more serious diseases like cancer, diabetes, heart disease, Alzheimer’s and early death.
While an allergic reaction might be a more immediate life-threatening condition (and extremely concerning in cases of anaphylaxis), an autoimmune disease is a slower-to-react life-threatening condition, one that affects the quality of day-to-day life for those who bear the burden of autoimmune disease.
What is Gluten Sensitivity or Intolerance?
When someone is sensitive to gluten or gluten intolerant, it means they experience some sort of inflammatory response every time they consume the gluten protein.
Unlike people with celiac disease who have villous atrophy upon ingesting gluten, people with gluten sensitivity have more normal looking and functioning microvilli, albeit their intestines are often inflamed.
People with a gluten sensitivity also do not develop auto-antibodies whereas someone with celiac disease would test positive for tTg auto-antibodies via a blood test.
Gluten sensitivity is a gluten spectrum disorder, but it is not considered an autoimmune disease at this time. What I have learned in my studies of gluten spectrum disorders is that unmanaged gluten sensitivity can be just as serious, and often comes with a higher risk of premature death than those with celiac disease.
Anyone telling you that gluten sensitivity isn’t a serious condition is truly misinformed. The research is growing and should not be ignored. (I highly recommend The Autoimmune Fix by Dr. Tom O’Bryan for more information on this topic.)
How Do You Know If You Have a Gluten Allergy?
While you now know you can’t technically have a gluten allergy, if you have an issue with gluten, chances are you have celiac disease or gluten sensitivity or intolerance instead. Please note the terms gluten sensitivity and intolerance can be used interchangeably.
Testing for Celiac Disease
The only way to know if you have celiac disease is to get tested. You can read more about the process of getting tested for celiac disease in this article.
I talk about getting tested for celiac disease at the doctor’s office, as well as the validity of at-home celiac tests like this one, which I highly recommend. You can read more about the reliability of at-home celiac testing in this article.
I also recommend getting tested for celiac disease before eliminating gluten from your diet. I explain why in this article, STOP! Don’t Go Gluten Free Until You Read This Article.
Testing for Gluten Sensitivity or Intolerance (often referred to as “gluten allergy”)
You can get tested for gluten sensitivity via a blood test, although please note some of the testing methods today are still fledging. Learn more about testing for gluten disorders in this article, Understanding and Testing for Gluten Sensitivity and Gluten Intolerance.
Sometimes gluten sensitivity testing is not necessary and you can simply see how you feel by eliminating gluten from your diet for 4-6 weeks, then reintroducing gluten slowly back into your diet.
If you choose to do an elimination diet to test for gluten sensitivity, I highly recommend working with a celiac disease or gluten-free practitioner to guide you through the process.
A Gluten Allergy Isn’t Real, but…
I hope from this article you now understand that a “gluten allergy” is not a real condition; however, the wording is used to help explain and express the seriousness of one’s gluten-free diet to a server or layman.
The truth is, no one can be allergic to gluten; rather, someone can be allergic to wheat, have celiac disease (an autoimmune condition), or have gluten sensitivity or intolerance.
All gluten spectrum disorders adversely impact someone’s life and strict adherence to a gluten-free diet (or wheat-free diet for someone with a wheat allergy) is required at all times. (Some wheat starch is considered gluten free, be careful with “gluten-free” labeled foods if you have a wheat allergy.)
A serious allergic reaction can be immediately life-threatening to someone with a wheat allergy, while someone with an autoimmune disease or gluten sensitivity will endure long-term damage that endangers the quality and length of their life over a period of years, even decades.
Despite the fact that a wheat allergy, celiac disease and gluten sensitivity are all serious disorders, each must be managed through diet.
I hope this article was able to shed light on this important topic so you gain greater insight into how these gluten-spectrum disorders work and affect your body.
- At-Home Celiac Test: Is It Reliable?
- How to Test for Celiac Disease
- Does Gluten Cause Inflammation in Everyone?
- Celiac Disease vs. Gluten Intolerance: What Do You Have?
- Understanding and Testing for Gluten Sensitivity and Gluten Intolerance
- Review: Everlywell Indoor Outdoor Allergy Test (Allergy Testing at Home!)
Thank you for sharing your story. Such an inspiration to any one with health challenges who might be contemplating changing their diets.
Thank you Jenny for this most informative material and all the research you have done. I have been dealing with gluten sensitivity for decades. After developing interstitial cystitis along with fibromyalgia and leaky gut I was working with a bladder specialist. After several procedures on my bladder that brought no relief this Dr wanted to take my bladder out and bag me. I chose to go to an alternative fully certified physician. Through the tests she gave me and an elimination diet I came to find that I was gluten intolerant. With adjustments and restrictions my health has turned around. That has been decades ago. So yes any of these gluten issues are very serious and can be life threatening. Thank you so much for sharing and giving me and others more understanding to get greater health with our food choices.
Thank you again, Jenny, your answer is greatly appreciated. Yes! Let’s hope and work hard, together, celiac and gluten-sensitive/allergic people!
All the best!!!
Thank you for taking the time to write such a thoughtful comment. I can imagine there are different viewpoints on this and while I don’t know for sure, I do know that there is so much effort right now to research gluten disorders… so my hope for us all is that we can figure out more about gluten sensitivities and what it is about gluten that seems to get so many people without celiac disease. Fingers crossed that we will have a broader understanding in the coming years so we can better treat and help people who struggle with gluten but do not have celiac disease. I definitely feel for my gluten sensitive friends who know gluten bothers them, but don’t quite understand why and are not quite taken as serious as someone with celiac disease. Thank you again for your comment Nicola!
Hi Jenny, thanks for everything you do. I’m an Instagram follower, ex-sufferer for 16 years now pain free thanks to goodbye gluten (also non-wheat gluten sources), registered dietitian (in Italy), and food technologist & scientist (in Canada). I enjoy your articles a lot!
In this case, I must disagree about a subtle detail: when you say:
“People with a gluten sensitivity also do not develop auto-antibodies whereas someone with celiac disease would test positive for tTg auto-antibodies via a blood test”
Actually it seems to me it’s different. People with gluten sensitivity do not develop THE USUAL/KNOWN auto-antibodies that have been discovered in celiac disease. Sorry for the capital addition (I don’t know how to add italic style to online comments). As in the past we didn’t know about the celiac-related auto-antibodies and now we do, hopefully we’ll find something for non-celiac gluten sensitivity.
What makes me so sure that we’ve got to have some auto-antibodies too? Well, if you eat gluten and, besides GI symptoms, you get systemic symptoms, or neurological ones, or eczema on your legs, or thyroid issues, tissues and organs that don’t even touch gluten itself, than it can’t be an “intolerance/sensitivity/digestion” problem with gluten, it must be something systemic affecting the body as a whole.
And, if gluten doesn’t “touch” a given organ or tissue, but this organ or tissue gets sickened when eating gluten, what does/can touch it? Our immune system, thus, auto-antibodies. It’s the only way.
Indeed, I don’t like the way non-celiac gluten sensitivity is called, using the word “sensitivity”. It’s a real allergy actually! (Sorry for your post though. You’re right, I’m just stating my personal opinion). Since the reactions are obviously immune-mediated, it should be called non-celiac gluten allergy in my opinion.
It’s not like lactose, which mere physical presence bothers the gut, but doesn’t trigger any immune-mediated reaction somewhere else in the body. Gluten is a protein, thus it’s an antigen → allergy should be the most appropriate word. Unless, of course, there is somebody who has exclusively GI symptoms after eating gluten. But again, how can be sure it’s only GI and it’s not also damaging something else, just without manifesting symptoms (yet)? So, even that hypothetical person might still be allergic.
Another sign that, in my opinion, confirms “allergy” rather than “intolerance/sensitivity”? The relatively quantity-independent intensity of the symptoms.
If you eat grams or dozens of grams of gluten, and you get sick. But you get equally (or very similarly) sick by eating milligrams or less, just molecular traces of gluten (then you call the manufacturer of the product you ate and they admit there might be some tiny traces or cross-contacts with gluten!), how can it be an intolerance/sensitivity/indigestion? If something bothers my gut because I can’t digest it, the symptoms are proportioned to the quantity: the more “stuff” is there and can’t be digested, the more I suffer.
But if pain and symptoms are equal with both plates or microscopic traces, then, again, gluten is just the trigger (antigen), which turns on an anomalous reaction of the immune system, which is then the culprit of the powerful symptoms body-wide: again, allergy would be the most appropriate word.
I’d love to hear your opinion about this, after considering the above perspective.
Thanks so much and all the best!