A lot of people say they are “allergic” to gluten or have a “gluten allergy.” While the meaning of this is known, the truth is you cannot technically be “allergic” to gluten because gluten is not a known allergen, rather, it’s a protein found in wheat, barley and rye. In this article, I discuss why you can’t technically have a “gluten allergy” but why and how the term has become so widely used and understood. This post contains affiliate links. Please read my disclosures.
OK, 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, people with celiac disease are not allergic to gluten, nor are people with diagnosed gluten sensitivities or a gluten intolerance. No one is “allergic” to gluten.
Gluten is a protein found in wheat, barley and rye (and derivatives of these cereal grains) and is not a recognized allergen. Wheat, however, is an allergen and considered one of the top eight allergens in the U.S.
Why Do People Say they Have a “Gluten Allergy”?
If a gluten allergy is not real, why do people constantly say they have a “gluten allergy,” and 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’m allergic to gluten,” they’re taken seriously from the start. On the other hand, if I were to say, “I have an autoimmune disease,” people would be left scratching their heads in wonder!
On the other hand, when I say, “I have a gluten allergy,” when placing my order at a restaurant, the staff immediately understands what I’m trying to communicate to them.
“I have a gluten allergy and need a gluten-free meal,” is very clear, right? Servers get it. Chefs get it. All the guests at your table get it. The wording makes sense to everyone and increases my chances of getting a truly gluten-free meal.
If, however, I told the kid 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 me like I have two heads!
On top of that, unfortunately, if you tell someone you have a “gluten sensitivity,” you may not be taken as seriously as you need to be, even though gluten sensitivity is a real and serious disorder – don’t let misinformed and/or ignorant people tell you otherwise.
Like I said (and it’s worth repeating), you cannot have a gluten allergy. Using the term is purely out of convenience.
Editor Note: OK, before you get upset with me and send me hate mail, please note that I know and understand allergies are very serious conditions. Mind you, gluten sensitivities and autoimmune diseases are also very serious conditions but 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 that affects approximately 0.1 to 0.3 percent of the U.S. population or 900,000 people according to Dr. Alessio Fasano in his book, Gluten Freedom.
Wheat allergies impact far less people than celiac disease and gluten sensitivities. Celiac disease afflicts about one percent of the population and a gluten sensitivity affects about six percent of the population or 20 million Americans.
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.
What Is an Allergy?
An allergic reaction occurs when the body’s immune system views a substance as harmful and then it overreacts to it. If you have a true 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 most common food allergens are noted as milk, 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, too.
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. Gluten, however, is not considered an “allergen” (as discussed) so it is not disclosed, by law, on packaged food labels. This means a food can be free from wheat but still contain gluten (Rice Krispies, for example, contains no wheat, yet it contains barley malt, which is gluten).
What is an Autoimmune Disease [and Celiac Disease]?
I have written extensively about autoimmune disease in the past (particularly in my review of The Autoimmune Fix book by Dr. Tom O’Bryan).
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.
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 disease.
Celiac disease is classified as an autoimmune disease. When a person with celiac disease ingests gluten (the “trigger” food), his or her body initiates an immune system attack.
A person’s white blood cells produce auto-antibodies (known as tissue transglutaminase or tTg auto-antibodies) that mistakenly attack the healthy tissue lining 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 our digestive system as they soak up nutrients from the food we eat and then help to deliver those nutrients where they need to be to keep one 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 some sort of nutritional deficiency or a disorder related to a nutritional deficiency.
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 and Alzheimer’s.
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 yet just as life-threatening condition, one that affects the quality of day-to-day life for those who bear the burden of autoimmune disease.
What is a 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 a 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 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 comes with a higher risk of premature death, than celiac disease. (Read my article Gluten Sensitivity vs. Celiac Disease for more information on this topic.)
Anyone telling you that gluten sensitivity isn’t a serious condition is truly misinformed. The research is there and should not be ignored!
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.
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 I was able to shed light on this important topic so you gain greater insight into how these gluten-spectrum disorders work and affect the human body.
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!