Are You Allergic to Gluten or Intolerant?
Understanding the Difference Between Wheat Allergy, Coeliac Disease & Gluten Sensitivity
Many people struggle with uncomfortable symptoms after eating gluten-containing foods but aren’t sure if they’re dealing with a true allergy, an intolerance, or something more complex like coeliac disease. Understanding the differences is essential for finding the right diagnosis and the right path forward for your health.
What Is Gluten?
Gluten is a group of proteins found in wheat, rye, and barley. It gives bread and baked goods their structure and elasticity. While many tolerate gluten just fine, others experience a variety of reactions that may require eliminating gluten completely.
Wheat Allergy, Coeliac Disease & Gluten Intolerance: What’s the Difference?
1. Wheat Allergy (IgE-Mediated Allergy)
What it is: A true food allergy involving the immune system’s production of IgE antibodies to proteins in wheat (which may or may not include gluten).
Onset of symptoms: Immediate, usually within minutes to a few hours of eating wheat.
Symptoms: Hives, itching, swelling, difficulty breathing, wheezing, anaphylaxis in severe cases.
Testing: Skin prick testing or specific IgE blood testing through an allergist or immunologist.
Management: Complete avoidance of wheat. Some people with wheat allergy can still tolerate other gluten-containing grains like barley or rye, but this depends on the individual.
2. Coeliac Disease
What it is: An autoimmune condition where the ingestion of gluten triggers the immune system to attack the lining of the small intestine, causing damage to the villi (tiny projections that absorb nutrients).
Onset of symptoms: Can be delayed or silent for years; often chronic.
Symptoms: Digestive issues (bloating, diarrhoea, constipation), fatigue, nutrient deficiencies (especially iron, folate, B12), skin rashes (dermatitis herpetiformis), mood disorders, infertility, joint pain, and osteoporosis.
Testing:
Blood tests: Tissue transglutaminase antibodies (tTG-IgA) and total IgA.
Small bowel biopsy: Confirms intestinal damage.
Important: Testing must be done while consuming gluten to avoid false negatives.
Management: A strict, lifelong gluten-free diet. Even trace amounts can trigger damage.
3. Non-Coeliac Gluten Sensitivity (NCGS) / Gluten Intolerance
What it is: A sensitivity to gluten without the autoimmune damage of coeliac disease or the allergic response of a wheat allergy. The exact mechanism isn’t fully understood, but symptoms are real and can significantly impact quality of life.
Onset of symptoms: Hours to days after gluten ingestion.
Symptoms: Bloating, abdominal pain, brain fog, headaches, fatigue, joint pain, mood disturbances, and skin issues.
Testing: There is no definitive test for NCGS. It’s a diagnosis of exclusion, after ruling out coeliac disease and wheat allergy.
Management: A gluten-free diet, although some people tolerate small amounts without triggering symptoms.
How to Test & Diagnose Properly
Start with a consultation with a healthcare professional (GP, gastroenterologist, or naturopath).
Maintain your regular diet (including gluten) until testing is complete.
Tests to request:
Coeliac screening blood tests (tTG-IgA and total IgA).
IgE testing for wheat allergy.
Further testing, like a biopsy, may be recommended if coeliac antibodies are elevated.
If tests are negative but symptoms persist, trial a gluten-free diet under professional supervision. Keep a symptom diary.
How to Eliminate Gluten Safely
If gluten is contributing to your symptoms, an elimination protocol may help clarify your response. Here’s how to do it properly:
The Elimination Phase (6–12 weeks minimum)
Remove all gluten sources: wheat, barley, rye, triticale, spelt, kamut, malt, and oats (unless certified gluten-free).
Read labels carefully, gluten hides in sauces, marinades, processed meats, and even supplements.
Focus on whole, nutrient-dense foods to support gut healing:
Lean proteins (chicken, fish, eggs)
Vegetables and fruit
Gluten-free grains (rice, quinoa, buckwheat, millet)
Healthy fats (olive oil, avocado, nuts, seeds)
The Reintroduction Phase
Reintroduce gluten in a controlled way after the elimination period.
Track symptoms closely for 72 hours after reintroduction.
If symptoms return, you may need to continue avoiding gluten.
The Importance of Nutrient Density on a Gluten-Free Diet
Many gluten-free alternatives are heavily processed and lacking in nutrition. To support optimal health, hormone balance, and fertility:
Prioritise whole foods over gluten-free packaged foods.
Include gluten-free whole grains like quinoa, brown rice, buckwheat, and amaranth.
Ensure adequate fibre intake from vegetables, legumes (if tolerated), nuts, and seeds to support gut health.
Monitor key nutrients:
Iron (especially if you have coeliac disease)
B vitamins (found in leafy greens, legumes, seeds)
Zinc (pumpkin seeds, seafood)
Magnesium (dark leafy greens, nuts)
Final Thoughts
Wheat allergy, coeliac disease, and gluten sensitivity are often confused, but they require different approaches. Accurate testing and professional support make all the difference. Whether you’re navigating symptoms, planning for pregnancy, or managing an autoimmune condition, a personalised plan is key.
If you’re ready to explore how gluten might be affecting your health, or you need help with a nutrient-dense, balanced gluten-free diet, I’m here to help. I offer consultations in person at Ettalong Beach, New South Wales or via telehealth.
In best health,
Kirri Hickey
Naturopath & Nutritionist BHSc
Specialising in Hormonal Health & Fertility