Table of ContentsView AllTable of ContentsCeliac DiseaseGluten SensitivityWheat AllergyDermatitis HerpetiformitisGluten AtaxiaWhich Do You Have?
Table of ContentsView All
View All
Table of Contents
Celiac Disease
Gluten Sensitivity
Wheat Allergy
Dermatitis Herpetiformitis
Gluten Ataxia
Which Do You Have?
“Gluten allergy” is not a real medical term. Rather, when people use the term gluten allergy, it’s likely they meanone of five different conditions: celiac disease, non-celiac gluten sensitivity,dermatitis herpetiformis, gluten ataxia, orwheat allergy.
This article explains the different sets of symptoms and related issues that are commonly referred to as gluten allergies, along with how to tell them apart.
When your healthcare provider hears you say “gluten allergy,” they are likely to think first of the autoimmune conditionceliac disease.
In celiac disease, the immune system mounts an attack on the small intestine in response to the ingestion of gluten-containing foods.
Untreated celiac disease can lead tovillous atrophy, in which the tiny bumps lining your small intestine that absorb dietary nutrients, known asvilli, become inflamed. Eventually, the inflamed villi can flatten and even disappear.
When this happens, your body’s ability to absorb nutrients from your foods becomes partially or totally impaired—a condition known as malabsorption that results in severe nutrient deficiencies.
Malabsorption is associated with numerous complications, including osteoporosis and fractures resulting from brittle, nutrient-deficient bones. Villous atrophy is also linked to an increased risk of lymphoproliferative disorders, such as lymphoma and leukemia.
Tim Liedtke / Verywell
Celiac disease affects about one in every 133 Americans.
The absence of these symptoms doesn’t necessarily mean you can rule out celiac disease. And other people mainly experience neurological symptoms, such as migraines and tingling in their arms and legs.
Can Celiac Disease Develop Suddenly?In many cases, people with celiac disease are able to digest gluten for years before suddenly developing symptoms. Celiac disease is best known for causing gastrointestinal symptoms. It can fly under the radar when it causes systemic (affecting multiple body systems) issues, like brain fog, fatigue, anemia, and joint pain.
Can Celiac Disease Develop Suddenly?
In many cases, people with celiac disease are able to digest gluten for years before suddenly developing symptoms. Celiac disease is best known for causing gastrointestinal symptoms. It can fly under the radar when it causes systemic (affecting multiple body systems) issues, like brain fog, fatigue, anemia, and joint pain.
Non-Celiac Gluten Sensitivity
Symptoms you may experience with non-celiac gluten sensitivity include:
Like those with celiac disease, people with non-celiac gluten sensitivity also report joint pain, anxiety and/or depression, and even numbness in their arms and legs.
People who have a true allergy to wheat sometimes also experience gastrointestinal symptoms and rashes. However, wheat allergy symptoms are often more “typical” allergy symptoms, such as a runny nose.
Although people occasionally refer to a wheat allergy as a gluten allergy, a true wheat allergy doesn’t necessarily involve gluten. It’s possible to be allergic to multiple proteins in the wheat plant, and gluten may or may not be one of them.
Symptoms of true wheat allergy include:
In some people with wheat allergy, exposure to wheat may triggeranaphylaxis, a potentially life-threatening, systemic allergic reaction. Symptoms of anaphylaxis include coughing, wheezing, rapid or irregular heartbeat, difficulty swallowing, or a large drop in blood pressure. Anaphylaxis is a medical emergency, so if you experience these symptoms, call 911 immediately.
Dermatitis Herpetiformis
It’s not unusual for a true allergic reaction to result in a skin rash. As such, it would make sense to calldermatitis herpetiformisa gluten allergy since it causes a remarkably itchy, persistent rash.
But a dermatitis herpetiformis rash is not the result of a true allergy. Dermatitis herpetiformis, also called Duhring disease, is an autoimmune skin condition in which exposure to gluten causes the body to produce antibodies that mistakenly attack skin tissues.
Symptoms of dermatitis herpetiformis include:
Dermatitis herpetiformis can occur anywhere on your body, but the most common locations for this rash are your buttocks, elbows, knees, and on the back of your neck. Also, most people who have dermatitis herpetiformis have celiac disease as well.
What Is the Difference Between Autoimmunity and Allergy?An allergy occurs when the immune system overreacts to an allergen and attempts to expel it from the body. Autoimmunity occurs when the immune system creates antibodies that mistakenly attack the body’s own tissues or organs.
What Is the Difference Between Autoimmunity and Allergy?
An allergy occurs when the immune system overreacts to an allergen and attempts to expel it from the body. Autoimmunity occurs when the immune system creates antibodies that mistakenly attack the body’s own tissues or organs.
The last of the potential “gluten allergy” conditions is also the most uncommon: abrain disorder called gluten ataxia.
With gluten ataxia, gluten consumption actually causes your immune system to attack the part of your brain called the cerebellum, eventually resulting in irreversible damage.
Fewer than 10% of people with gluten ataxia have gastrointestinal symptoms.More common symptoms of gluten ataxia include:
Gluten ataxia is progressive. People with this condition may start out with what may seem like a minor balance problem, but can ultimately wind up with significant disability.
How to Tell the Difference
It’s clear you can’t tell from symptoms alone. You’ll need to see your healthcare provider and have some medical testing to determine which of these gluten-related conditions—if any—you might actually have.
If you have gastrointestinal symptoms that may point toceliac disease, you’ll likely start withceliac blood tests. If those are positive, your healthcare provider will likely recommend you undergo anendoscopy, a procedure that enables them to look directly at your small intestine and take samples for laboratory examination.
If, on the other hand, your celiac blood tests are negative, then your healthcare provider may consider the possibility ofnon-celiac gluten sensitivityor another condition such as irritable bowel syndrome, and may recommendtests for gluten sensitivity.
Wheat allergyis usually diagnosed with skin prick tests, although your healthcare provider may also use a blood test that looks for specific antibodies to wheat proteins.
For people with rashes they believe may bedermatitis herpetiformis, the first step is likely a visit to a dermatologist, who may recommend askin biopsythat checks for deposits of specific antibodies in your rash area.
And finally, if your symptoms are indicative ofgluten ataxia, thepath to diagnosisunfortunately isn’t straightforward, although there are several tests your neurologist may want to perform.
Regardless of which of these “gluten allergies” you think you have, your first step should be an appointment with your healthcare provider. They can help you determine what medical testing, if any, you may need.
Is Gluten Bad for You?
Summary
“Gluten allergy” is an inexact term commonly used when referring to celiac disease, non-celiac gluten sensitivity, dermatitis herpetiformis, gluten ataxia, or wheat allergy. Some of these conditions, like celiac disease and dermatitis herpetiformis, are closely related. But only one of them—wheat allergy—is a true allergy. Although wheat contains gluten, you can have a wheat allergy without any clinical gluten sensitivity.
If you experience unusual symptoms after consuming gluten, contact your healthcare provider for a diagnosis. You may need special testing to determine the underlying cause.
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Johns Hopkins Medicine.Celiac disease.Schiepatti A, Maimaris S, Raju S, et al.Persistent villous atrophy predicts development of complications and mortality in adult patients with coeliac disease: a multicentre longitudinal cohort study and development of a score to identify high-risk patients.Gut. 2023 Jun;2023(0):1-8. doi:10.1136/gutjnl-2023-329751Volta U, Caio G, Manfredini R, De Giorgio R.Detection of asymptomatic celiac disease in two siblings from a mother with non-celiac gluten sensitivity.Gastroenterol Hepatol Bed Bench. 2018;11(3):269-272.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of celiac disease.Mansueto P, Seidita A, D’alcamo A, Carroccio A.Non-celiac gluten sensitivity: literature review.J Am Coll Nutr. 2014;33(1):39-54. doi:10.1080/07315724.2014.869996Czaja-bulsa G.Non coeliac gluten sensitivity - A new disease with gluten intolerance.Clin Nutr. 2015;34(2):189-94. doi:10.1016/j.clnu.2014.08.012Bieskiekierski J, Iven J.Non-coeliac gluten sensitivity: piecing the puzzle together.United Euro Gastroenterol J. 2015 Apr;3(2):160-165. doi:10.1177/2050640615578388Cianferoni A.Wheat allergy: diagnosis and management.J Asthma Allergy. 2016;9:13-25. doi:10.2147/JAA.S81550Yale Medicine.Dermatitis herpetiformis.Antiga E, Maglie R, Quintarelli L, et al.Dermatitis herpetiformis: novel perspectives.Front Immunol. 2019;10:1290. doi:10.3389/fimmu.2019.01290Giuffrè M, Gazzin S, Zoratti C, et al.Celiac disease and neurological manifestations: from gluten to neuroinflammation.Int J Mol Sci. 2022 Dec;23(24):155564. doi: 10.3390/ijms232415564Zis P, Hadjivassiliou M.Treatment of neurological manifestations of gluten sensitivity and coeliac disease.Curr Treat Options Neurol. 2019;21(3):10. doi:10.1007/s11940-019-0552-7
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Johns Hopkins Medicine.Celiac disease.Schiepatti A, Maimaris S, Raju S, et al.Persistent villous atrophy predicts development of complications and mortality in adult patients with coeliac disease: a multicentre longitudinal cohort study and development of a score to identify high-risk patients.Gut. 2023 Jun;2023(0):1-8. doi:10.1136/gutjnl-2023-329751Volta U, Caio G, Manfredini R, De Giorgio R.Detection of asymptomatic celiac disease in two siblings from a mother with non-celiac gluten sensitivity.Gastroenterol Hepatol Bed Bench. 2018;11(3):269-272.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of celiac disease.Mansueto P, Seidita A, D’alcamo A, Carroccio A.Non-celiac gluten sensitivity: literature review.J Am Coll Nutr. 2014;33(1):39-54. doi:10.1080/07315724.2014.869996Czaja-bulsa G.Non coeliac gluten sensitivity - A new disease with gluten intolerance.Clin Nutr. 2015;34(2):189-94. doi:10.1016/j.clnu.2014.08.012Bieskiekierski J, Iven J.Non-coeliac gluten sensitivity: piecing the puzzle together.United Euro Gastroenterol J. 2015 Apr;3(2):160-165. doi:10.1177/2050640615578388Cianferoni A.Wheat allergy: diagnosis and management.J Asthma Allergy. 2016;9:13-25. doi:10.2147/JAA.S81550Yale Medicine.Dermatitis herpetiformis.Antiga E, Maglie R, Quintarelli L, et al.Dermatitis herpetiformis: novel perspectives.Front Immunol. 2019;10:1290. doi:10.3389/fimmu.2019.01290Giuffrè M, Gazzin S, Zoratti C, et al.Celiac disease and neurological manifestations: from gluten to neuroinflammation.Int J Mol Sci. 2022 Dec;23(24):155564. doi: 10.3390/ijms232415564Zis P, Hadjivassiliou M.Treatment of neurological manifestations of gluten sensitivity and coeliac disease.Curr Treat Options Neurol. 2019;21(3):10. doi:10.1007/s11940-019-0552-7
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Johns Hopkins Medicine.Celiac disease.Schiepatti A, Maimaris S, Raju S, et al.Persistent villous atrophy predicts development of complications and mortality in adult patients with coeliac disease: a multicentre longitudinal cohort study and development of a score to identify high-risk patients.Gut. 2023 Jun;2023(0):1-8. doi:10.1136/gutjnl-2023-329751Volta U, Caio G, Manfredini R, De Giorgio R.Detection of asymptomatic celiac disease in two siblings from a mother with non-celiac gluten sensitivity.Gastroenterol Hepatol Bed Bench. 2018;11(3):269-272.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of celiac disease.Mansueto P, Seidita A, D’alcamo A, Carroccio A.Non-celiac gluten sensitivity: literature review.J Am Coll Nutr. 2014;33(1):39-54. doi:10.1080/07315724.2014.869996Czaja-bulsa G.Non coeliac gluten sensitivity - A new disease with gluten intolerance.Clin Nutr. 2015;34(2):189-94. doi:10.1016/j.clnu.2014.08.012Bieskiekierski J, Iven J.Non-coeliac gluten sensitivity: piecing the puzzle together.United Euro Gastroenterol J. 2015 Apr;3(2):160-165. doi:10.1177/2050640615578388Cianferoni A.Wheat allergy: diagnosis and management.J Asthma Allergy. 2016;9:13-25. doi:10.2147/JAA.S81550Yale Medicine.Dermatitis herpetiformis.Antiga E, Maglie R, Quintarelli L, et al.Dermatitis herpetiformis: novel perspectives.Front Immunol. 2019;10:1290. doi:10.3389/fimmu.2019.01290Giuffrè M, Gazzin S, Zoratti C, et al.Celiac disease and neurological manifestations: from gluten to neuroinflammation.Int J Mol Sci. 2022 Dec;23(24):155564. doi: 10.3390/ijms232415564Zis P, Hadjivassiliou M.Treatment of neurological manifestations of gluten sensitivity and coeliac disease.Curr Treat Options Neurol. 2019;21(3):10. doi:10.1007/s11940-019-0552-7
Johns Hopkins Medicine.Celiac disease.
Schiepatti A, Maimaris S, Raju S, et al.Persistent villous atrophy predicts development of complications and mortality in adult patients with coeliac disease: a multicentre longitudinal cohort study and development of a score to identify high-risk patients.Gut. 2023 Jun;2023(0):1-8. doi:10.1136/gutjnl-2023-329751
Volta U, Caio G, Manfredini R, De Giorgio R.Detection of asymptomatic celiac disease in two siblings from a mother with non-celiac gluten sensitivity.Gastroenterol Hepatol Bed Bench. 2018;11(3):269-272.
National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of celiac disease.
Mansueto P, Seidita A, D’alcamo A, Carroccio A.Non-celiac gluten sensitivity: literature review.J Am Coll Nutr. 2014;33(1):39-54. doi:10.1080/07315724.2014.869996
Czaja-bulsa G.Non coeliac gluten sensitivity - A new disease with gluten intolerance.Clin Nutr. 2015;34(2):189-94. doi:10.1016/j.clnu.2014.08.012
Bieskiekierski J, Iven J.Non-coeliac gluten sensitivity: piecing the puzzle together.United Euro Gastroenterol J. 2015 Apr;3(2):160-165. doi:10.1177/2050640615578388
Cianferoni A.Wheat allergy: diagnosis and management.J Asthma Allergy. 2016;9:13-25. doi:10.2147/JAA.S81550
Yale Medicine.Dermatitis herpetiformis.
Antiga E, Maglie R, Quintarelli L, et al.Dermatitis herpetiformis: novel perspectives.Front Immunol. 2019;10:1290. doi:10.3389/fimmu.2019.01290
Giuffrè M, Gazzin S, Zoratti C, et al.Celiac disease and neurological manifestations: from gluten to neuroinflammation.Int J Mol Sci. 2022 Dec;23(24):155564. doi: 10.3390/ijms232415564
Zis P, Hadjivassiliou M.Treatment of neurological manifestations of gluten sensitivity and coeliac disease.Curr Treat Options Neurol. 2019;21(3):10. doi:10.1007/s11940-019-0552-7
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