Gluten-Related Disorders: The Difference Between Allergies, Autoimmune Reactions and Intolerances

Millions of people are affected by eating gluten, a protein found in wheat, barley and rye. Many of these people have celiac disease, a serious autoimmune disease that is triggered when gluten is consumed.

Those without celiac disease that also have a reaction to gluten may have non-celiac gluten sensitivity. Gluten sensitivity is a disorder in which a person cannot tolerate gluten and experiences symptoms similar to those with celiac disease yet lacks the antibodies and intestinal damage as seen in celiac disease. This disorder is often also referred to as gluten intolerance.

In a third category, some people may have an allergy to wheat.

Below, we’ll break down the difference between autoimmune reactions, intolerances, sensitivities and allergies as they relate to gluten and wheat.

Autoimmune Reaction to Gluten: Celiac Disease

Celiac disease is an autoimmune disease. When someone with celiac disease consumes food with gluten, the immune system reacts and attacks the villi of their intestines. These villi are little fingerlike projections in the intestinal lining that absorb nutrients and energy from the foods we eat.

Learn more about celiac disease.

Think you may have celiac disease? Complete our Celiac Disease Symptoms Checklist and share the results with your doctor.

Allergic Reaction to Wheat: Wheat Allergy

An allergy also affects the immune system. Allergic reactions are those that are triggered—often by certain foods or other foreign substances—that the body then reacts abnormally to.

A wheat allergy is an allergic reaction to foods containing wheat, and may include responses such as asthma, rashes and even anaphylaxis. A wheat allergy does not trigger the immune response to attack villi as a celiac disease autoimmune reaction does. An allergic reaction to wheat may be triggered by consuming or inhaling wheat or wheat particles. 

Symptoms of wheat allergy:

• swelling and/or itching of the mouth or throat
• Hives and/or rashes
• Headaches
• Congestion
• GI issues
• Anaphylactic shock

Allergies, including those to wheat, are associated with positive IgE assays. Diagnosis is made through skin prick tests, wheat-specific IgE blood testing and a food challenge.

Individuals who have gluten-related symptoms but test negative for a wheat allergy or celiac disease may have non-celiac gluten sensitivity.

Food Sensitivity: Non-Celiac Gluten Sensitivity/Gluten Intolerance 

When someone is intolerant to a certain food, it means their body has difficulty digesting it. The most common food intolerance is lactose intolerance. Lactose intolerance is caused by a deficiency of the enzyme lactase, which digests lactose.

Non-celiac gluten sensitivity is sometimes referred to as gluten intolerance. Researchers determined that gluten sensitivity, instead of gluten intolerance, is the most accurate way to describe the condition, however many people (and even some doctors) continue to refer to it as gluten intolerance. 

Non-celiac gluten sensitivity is a condition that occurs in individuals who are unable to tolerate gluten and experience symptoms similar to those associated with celiac disease without autoimmune damage in the intestines.

Learn more about non-celiac gluten sensitivity.

A diagnosis distinguishing between celiac disease, a wheat allergy and gluten sensitivity is important. Talk to your doctor if you believe you may have one of these conditions.