I can tell you exactly where I was when the field of allergy and immunology first stole my heart. I was in my first year of medical school sitting in an overly cool classroom taking notes as fast as any human hand could. My pathology lecture was just ending and immunology was up next. I rubbed my sore fingers and prepared to write down, verbatim, the next lecture.

But shortly after my professor started to speak, I realized that I had completely stopped taking notes. I had allowed myself to be drawn into the story that she was weaving, a story of T cells and B cells and their physical and chemical conversations with each other. It was amazing.

Little did I know that she was introducing me to a cast of cellular characters that would soon become not only important for me to pass my next immunology test, but also to complete my subsequent fellowship training and to my understanding of the mechanism of food allergy, an immunological disease that would affect three of my four children.

In 2005, after completing a pediatric residency, I started my fellowship in the field of allergy and immunology at the Children’s Memorial Hospital in Chicago. I had a 7-week-old baby boy at home so I was knee-deep in motherhood, but I was ready. I was excited to finally be seeing patients with the allergic and immunological disorders that I had been so interested in during medical school.

These diseases, including chronic sinusitis, seasonal allergies, and immune deficiencies, were all challenging and interesting, but what drew me in the most was food allergy. There was something so cruel and senseless about a disease that denies a child a bakery cookie – it made me want to break its code.

Patient Emotions
As fellows, we were taught to take a detailed history of the allergic reaction from the patient and the parent, paying exquisite attention to what food was ingested, the timing of the ingestion in relationship to the symptoms and what symptoms occurred.

Patient histories would often become complicated, a fusion of facts and feelings. We would then perform skin-prick testing with the suspected food protein and draw blood for the same allergen. Combining the history and the results of the testing, a diagnosis was made.

We would review an allergen avoidance sheet with the family, explaining the importance of reading food labels, and discuss an emergency health-care plan, teaching the families how to recognize and treat an allergic reaction. We provided them with a short list of support services and asked them to follow up in one year. It was a good system, at least as far as I knew.

By the end of my first year of fellowship, we had twin boys (yes, we had three boys in 13 months!) and one of them, Gino, literally had hives on his skin only a few days after he was born. He would soon be covered in itchy, bleeding eczema and more often than not, vomit, so I made an appointment with an allergist.

Next page: The diagnosis: a powerful blow

When you have wheat allergy, your immune system sees it as a dangerous foreign substance and takes action, fighting back with antibodies known as Immunoglobulin E, or IgE. This results in histamine and other chemicals being released into your bloodstream, an action that begins the allergic reaction, with symptoms that range from mild to life-threatening, from runny noses to drops in blood pressure and breathing difficulties.

There have been no recent studies on the prevalence of wheat allergy in North America because it is not as common as those to peanuts, tree nuts, sesame, shellfish and fish. But that does not mean it is less dangerous.

If you are diagnosed with a wheat allergy, you must eliminate wheat from your diet, period. And while wheat allergies occur most often in children, the good news is that many of them will outgrow it by the time they reach adulthood.

What are the symptoms?

Wheat allergy’s symptoms are many and varied. You could have a bloated stomach and diarrhea, or you could suffer from joint pain, nausea, skin rashes and that darned runny nose. You could have psoriasis, sneezing, watery and itchy eyes, mood swings, or your throat could feel swollen.

You may be tired or have a cough, heart palpitations, eczema and chest palpitations. You may suffer from just one of these symptoms, a few or all of the above. What you must do is to consult a doctor because some of these same symptoms could indicate other medical conditions, including celiac disease, an autoimmune condition in which the body cannot tolerate gluten, a protein found in wheat, barley and rye. But where you may outgrow your wheat allergy, celiac disease is permanent. Once you have it, it’s there for life and right now, the only cure is to eliminate all gluten from your diet. With a wheat allergy, your immune system reacts specifically to the wheat protein and you may eat products that contain the two other grains with no ill effect.

Next: Eliminating Wheat from Your Diet

Does your child refuse to eat a certain food, or complain that it makes his “tongue hurt”? These could be signs of a food allergy, and should be taken seriously.

It is common for the symptoms of food allergy to vary by individual – and from reaction to reaction in the same person. Not everyone will get all the symptoms, which range greatly in severity from mild to severe (and even fatal): your throat may feel tight on one exposure to your allergen or you may get itchy hives on your skin and vomiting with the next.

The Range of Symptoms

-Tingling in the mouth
-Swelling of the tongue and throat / feeling of throat tightness
-Itchy skin, hives or skin redness
-Abdominal cramps
-Vomiting or diarrhea
-Breathing difficulty, wheezing
-Faintness due to a sudden drop in blood pressure

Anaphylaxis

Anaphylaxis is the severe form of allergic reaction. It involves one or more of the body’s symptoms; for example, the gastrointestinal tract, the respiratory tract, the skin and the cardiovascular system. A person experiencing anaphylaxis often has difficulty breathing, and the person could lose consciousness. Anaphylaxis puts a person at risk of death.

Anaphylactic reactions can come on quickly, and it’s impossible to know when a reaction will become severe. It’s important that people with food allergies are prepared for a reaction by always carrying an epinephrine auto-injector (either EpiPen or Twinject).

Experts recommend using epinephrine early if a person known to be at risk of anaphylaxis begins to show signs of allergy symptoms – don’t wait until the symptoms worsen, as it may become to difficult put a halt to the reaction once it’s in progress.

Symptoms reviewed by Dr. Susan Waserman