What is the difference between Celiac Disease, Gluten Intolerance/Sensitivity and a Wheat Allergy?

Gluten is a combination of two proteins called gliadin and glutenin. Both are found in the endosperm of the wheat, barley and rye plants, and sometimes oats. Gluten is the protein that nourishes wheat during germination from seed to plant. The glutenin in wheat flour gives dough its elasticity and allows leavening; glutenin also contributes to the chewiness of baked goods. For many people, these proteins do not digest appropriately and the body reacts with a variety of symptoms.

One in 133 people suffer from a sensitivity to gluten. Gluten sensitivity is a term used to describe three very distinct wheat-related ailments:

  • Celiac disease
  • Gluten intolerance/sensitivity
  • Wheat allergy

Celiac disease, wheat allergy and gluten-intolerance are treated similarly as they have very similar signs, symptoms and treatment. However, there is a difference between these three medical problems. Celiac disease is an autoimmune condition, which puts people with celiac disease at risk for malabsorption of food, which causes nutritional deficiencies.

Celiac Disease is the most severe form or gluten intolerance/sensitivity. However, you can be gluten intolerant/sensitive and not have celiac disease. People with a wheat allergy or gluten-intolerance usually do not have such severe intestinal damage, nor are they at risk for developing other autoimmune conditions and nutritional deficiencies. Due to the risk factors involved with nutritional deficiencies and other autoimmune diseases, it is very important to be properly diagnosed.

This photo was taken from Gluten Free Society

Gluten intolerance is non immune mediated and is considered to be an inability to tolerate or digest gluten, while gluten sensitivity is an immune reaction and intolerance to the protein gluten. This means that a sensitivity to gluten can be linked to both and intolerance and an allergy to gluten proteins. People who are gluten sensitive (GS) cannot tolerate gluten and may develop gastrointestinal symptoms similar to those found in celiac disease, however these symptoms are generally less severe.

In a new study in the journal BMC Medicine, it shows that gluten can set off a distinct reaction in the intestines and the immune system, even in people who don’t have celiac disease. Gluten sensitivity and intolerance can be the cause of celiac disease and other medical conditions such as osteoporosis, thyroid disease, psychological disorders, rheumatoid arthritis, and over 200 more.

People may limit their diet down to only a few foods because they find themselves intolerant to so many things. The true cause may in fact be a leaky gut, and when that is healed, patients find that they can start to reintroduce foods that were problematic in the past. Gluten and dairy are typically the culprits and therefore cannot be reintroduced in any quantity, says Dr. Vikki Petersen.

There are speculations as to whether or not having a gluten sensitivity is a real medical condition. Apparently, researchers show that the condition’s existence hasn’t yet been proven definitively, and there is no explanation for how it might be related to celiac disease. I found this information in an article titled Gluten Sensitivity on about.com to be very informative and detailed.

According to the the Gluten Free Society website, most people with gluten sensitivity don’t have celiac disease, however they do have other diseases or symptoms. Which means that running tests to look for celiac disease also leads to a misdiagnosis. Below is a list of some of the common symptoms and diseases associated with gluten:

  • Asthma
  •  Autism
  •  Thyroid disease
  •  Rheumatoid arthritis and other autoimmune conditions that cause joint pain
  •  IBS (irritable bowel syndrome)
  •  Ulcerative Colitis
  •  Crohn’s Disease
  •  Migraine Headache
  •  Neuropathy
  •  Vertigo
  •  Schizophrenia
  •  Constipation, gas, bloating, and stomach pain
  •  Psoriasis
  •  Eczema
  •  Fatigue
  •  Hormone imbalance
  •  Infertility
  •  Unexplained weight loss
  •  Weight gain and obesity

For a proper diagnosis of gluten sensitivity, it is important that you specifically ask your doctor for the test HLA-DQ genotyping of both HLA-DQ a1 and b1 genes and that he/she look for all of the markers linked to gluten not just the HLA-DQ2 and DQ8 which is specifically linked to celiac disease.

Celiac Disease

Celiac disease is a manifestation of gluten sensitivity. At least 1 in 133 Americans suffers from Celiac Disease (CD), which can be defined as a permanent intolerance to wheat protein and related alcohol-soluble proteins (called prolamines) found in rye and barley. CD occurs in genetically predisposed individuals in which gluten causes an inflammatory reaction, often resulting in gastrointestinal distress, where the body’s immune system starts to attack normal tissue. Antibodies triggered by gluten flatten the villi (the tiny fingers-like projections present in the small intestine) needed to absorb nutrients from food.

If left untreated, CD can lead leaky gut syndrome. In this case, gluten causes intestinal damage which allows large undigested and partly digested proteins to leak into the bloodstream through the damaged intestinal wall. The immune system then produces antibodies to attack these foreign proteins. Our body then produces antibodies that attack both the foreign food proteins and similar amino acid sequences in our own tissues, which results in an autoimmune disease.

This not only results in partially digested gluten leaving the small intestine but it also allows a host of other partially digested foods to leave through the overly permeable small intestine and enter the bloodstream that wouldn’t normally be present, which may result in the development of other intolerances.

The gluten also causes inflammation and atrophy of the intestinal villi (small, finger-like projections in the small intestine) which results in the malabsorption of essential vitamins, minerals, and calories. Celiac disease can present itself at any age, and symptoms range from mild to severe depending on the individual.  Symptoms of CD typically include diarrhea, iron-deficiency anemia and lactose intolerance.

However, there are also other symptoms associated with CD such as abdominal pain, irritable bowel, vomiting, blurred vision, shortness of breath, and more. One of the most profound symptoms of CD is Dermatitis Herpetiformis, which is the skin manifestation of celiac disease. It is an extremely itchy, watery blister or rash. The blisters reoccur in the same areas, and are often mistaken for and treated as other skin conditions including psoriasis, infected mosquito bites, contact dermatitis, allergies or herpes. Click to read more about celiac disease symptoms.

Wheat Allergy

A wheat allergy may sometimes be confused with celiac disease, but these conditions are different. A wheat allergy is an immune mediated response which generates an allergy-causing antibody to proteins found in wheat. This means that your immune system reacts to the gluten proteins. The allergic reaction involves at least one of the following proteins found in wheat: albumin, globulin, gliadin, and glutenin.

According to the Health Now website, “One develops allergic symptoms due to the immune system “labeling” something as a toxin or foreign invader. In a classic allergic response the reaction is often immediate and dramatic -those suffering with peanut allergies are a perfect example. This reaction is created by a specific immunoglobulin (a protein designed to fight toxic or foreign substances) named immunoglobulin E or IgE for short. This is the type of allergic reactions that a scratch test would identify.”

This is different than an auto-immune reaction which means the body attacks its own cells. The immune system mistakes some part of the body as a pathogen (infectious agent) and attacks it’s own healthy tissue. People who are allergic to wheat have an IgE-mediated response to wheat protein and may tolerate other grains, as opposed to those who suffer with celiac disease which creates a permanent adverse reaction to gluten found in wheat, rye, barley, and sometimes oats.

Symptoms of a wheat allergy are commonly found in less than 1% of children, but may affect adults as well, and is one of the top 8 food allergies in the United States. According to foodallergy.org, most wheat-allergic children outgrow the allergy. Possible signs and symptoms of a wheat allergy include breathing difficulties, nausea, hives, bloated stomach and an inability to focus.

Some patients who consume wheat may experience anaphylaxis, which is a life-threatening allergic response. The most common signs and symptoms of a wheat allergy include nasal congestion, difficulty breathing, eczema, diarrhea, mouth , eye and throat irritation, nausea, swelling, itchy rash, vomiting, and bloating.

The easiest way to diagnose a wheat allergy is to eliminate foods containing wheat. After a few days wheat is then reintroduced in intervals. Carefully keeping track of each item consumed and the symptoms felt, a patient can then identify which particular foods are causing problems. It is important to seek help with a health care professional. It may also be helpful to start an elimination diet.

Wheat Products Wheat-Containing Ingredients Wheat-Containing Food
Whole wheat or enriched flourHigh gluten flourHigh protein flourBranFarinaGraham flourBulgurDurumSemolinaWheat maltWheat starchModified starchStarch GlutenGelatinized starchHydrolyzed vegetable proteinVital glutenWheat branWheat germWheat glutenVegetable gumVegetable starch Many breads, cookies, cakes, and other baked goodsBread crumbsCrackersMany cerealsAcker mealCouscousCracker mealPastaSpelt

The article written by Dr Vikki Petersen, DC, CCN (Founder of HealthNOW Medical Center and co-author of “The Gluten Effect“) continued to explain that “celiac disease and gluten sensitivity are not moderated by IgE, they are not the same as having a wheat allergy and will not show positive on a scratch test.

This can be a source of confusion when a patient wants to be tested for gluten intolerance but instead asks their doctor for a wheat allergy test. They are not remotely the same thing. Those suffering with IgE initiated food allergies tend to know it because they react rather dramatically and quickly to the offending food.

Celiac and gluten sensitivity are mediated by the immunoglobulins A and G, and those are measured in lab tests for both conditions. These types of reactions can vary dramatically in their time frame of reaction – from several hours to several days after ingestion of the offending food.”

Further information about testing can be found by reading the article “Challenging the Gluten Challenge” By Dr. Ron Hoggan, Ed.D.

I hope this information is helpful to you and figuring out what ails your own system. I have had a lot of fun researching all of this information, and I am so happy to share it with you. Thank you to all of those doctors and writers out there for providing so much research!


HealthNow Medical
The Mayo Clinic
The American Celiac Disease Alliance
The Celiac Disease Foundation
Medical News Today
The Wall Street Journal -Health Journal

4 thoughts on “What is the difference between Celiac Disease, Gluten Intolerance/Sensitivity and a Wheat Allergy?

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