Wheat-Dependent Exercise-Induced Anaphylaxis

by Allergy Guy

Wheat-dependent exercise induced anaphylaxis describes a condition where someone has an anaphylaxis after eating wheat, then experiencing physical exercise.

This is a specific case of the rare condition, called exercise-induced anaphylaxis, where exercise triggers anaphylaxis.  Food induced anaphylaxis is rarer still.  The gluten in wheat is a potent allergen, and ω-gliadins, a type of gliadin, seem to be the culprits in triggering this gluten allergy symptom.

Symptoms may start with flushing, wheezing, hives, nausea, diarrhea and cramping, and progress to more serious symptoms.

Usually, high exertion such as jogging trigger symptoms, but for some people walking or other low-level exercise may be enough.

The best way to reduce symptoms is to immediately reduce physical exertion.

Studies show that ω-5 gliadin is particularly good at passing through the gut-blood barrier.  It enters the blood stream undigested, and causes a range of health problems.  Different types of allergies can result, including wheat-dependent exercise induced anaphylaxis.

Allergy tests, unreliable at the best of times, seem particularly poor at revealing a gluten allergy because gluten is made up of several proteins, and unless these proteins are separated out, they may not indicate on an allergy test.  This makes a rare condition like WD exercise induced anaphylaxis particularly difficult to diagnose.

Ketotifen, an antihistamine, may prevent symptoms if taken before eating wheat.  I feel that this may simply mask symptoms and possibly allow other health problems to grow and would prefer to see more research on this approach, since avoiding wheat seems like a safer approach.  Since avoiding wheat is not always possible, it is good to have additional methods for fighting symptoms.  Work with a doctor if you are thinking of trying this.

While gluten allergies are relatively common, based on anecdotal evidence, wheat-dependent exercise induced anaphylaxis is rare but distressing and even life-threatening to those who experience it.

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{ 21 comments… read them below or add one }

1 Allergy Guy February 16, 2012 at 12:44

Has anyone experienced these symptoms and narrowed it down to wheat? Do you suspect this might be your problem?

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2 brianne April 5, 2013 at 21:55

Yes. I have had several severe reactions and determined them to be caused by wheat. I lost consciousness the most severe time. I can’t even go for a walk after consuming wheat without breaking out in hives. I’ve decided a gluten-free diet is the way to go.

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3 Allergy Guy April 9, 2013 at 22:30

Interesting. Thanks for sharing your experience.

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4 cibella January 25, 2013 at 23:52

yes I experience excercise induced allergies and have found that its wheat and eggs

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5 Juliane June 13, 2013 at 16:28

I experience this. I’ve just recently connected 2 and 2 together. I have an appointment with an allergist because I want to confirm this. I have been having these incidents for the last year or so and it has been a “mystery” for the doctors. I was told to avoid NSAID medications but the last time I had an incident I had no medication and all I did was go for a walk after eating pasta an hour prior. I was not told to stop exercise because I had anaphylaxis before without exercise so they didn’t think there was a link there. I will be discussing this further with the doctor when I go in.

I will add that I have hypothyroid and I was tested to see if I had Celiac or Hashimotos (one of the two, I can’t recall). It came back negative but one of the markers tested (IgG) came back weak positive. I was then told that I could be gluten sensitive and further testing should be done. I don’t know if this is related to WDEIA but it sounds to me like I should avoid gluten/wheat.

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6 Loretta January 22, 2014 at 20:05

My brother suffers from this condition and it now on a gluten free diet. I am now suffering fron Uticaria (hives) cause unknown. I am wodering if I am going to have the same problem. I do not do strenuous exercise like my brother does. Any ideas?

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7 Allergy Guy February 7, 2014 at 22:03

You could try cutting out gluten and see if that helps. Of course hives could be causes by all sorts of allergens, not just gluten. Don’t rule out non-food allergies such as mold, dust, pets etc.

Don’t worry about developing anaphylaxis. This is a rare condition and its just not worth worrying about something that might happen to you (but probably not)

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8 joe March 30, 2014 at 10:07

a friend talked me into going to a holistic clinical nutritionist about my sinus allergies and a small rash I had on my hand. we talked about the problems, he said that I was allergic to gluten. I had to go on a gluten free diet. he handed me a bottle of 7 wonder oil and told me to put a small amount on a spot of my rash and I did. within ten minutes I was having a severe allergy attack. I went to a pharmacy up the street and took some medicine for it. when I got back, he told me that it was the gluten that caused the attack. I went on the gluten free diet, and the rash has gotten worse, my health has gotten worse and I have had food allergy attacks, which I have never had food allergy before. I am going to go back to gluten, as soon as I figure how to start.

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9 Allergy Guy April 3, 2014 at 13:48

Sometimes, when you start on a gluten-free diet, things get worse before they get better. It takes time for the gluten to clear out of your system and unfortunately for some people this is not a comfortable experience, like kicking an addiction.

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10 ellen August 16, 2014 at 12:37

For a bit over 20 years now, if I eat wheat in the 36 hours before exercise (including a leisurely stroll), I will have trouble breathing. It took me 10 years to figure it out, because it looked just like a mild case of exercise induced asthma. In the past few years, it has gotten worse, and now includes rye and barley. By gotten worse, I mean that it now includes either a nausea component, full body hives, full body itching, or facial swelling, in addition to the wheezing and breathing through a straw. There’s a brochure out there called “when anaphylaxis looks like asthma” that I’m sure applies. Of course, I still don’t have a diagnosis, or an epipen, due to a negative skin prick test. If I could get around to having full blown anaphylaxis and get sent to a hospital once, then I might be taken seriously. However, I’ll stick with my “mild” allergy, avoid eating any wheat, rye, or barley, and carry the rescue inhaler to keep breathing when I do accidentally eat some before exercise, or aspirin ingestion.

I wish I could be tested properly. Having an official diagnosis and being able to carry epi-pens while exercising would help.

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11 Allergy Guy August 18, 2014 at 07:52

Sorry to hear about your exercise induced asthma, but glad you’ve figured out the cause.

Since your symptoms are mild so far, I suggest you try Benadryl or equivalent to control symptoms, but stick to diligently avoiding gluten-=containing foods.

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12 Bodo October 12, 2014 at 09:12

I was tested positiv of WDEIA after an anaphylactic shock 18 months ago. I have to avoid Omega 5 gliadin if I want to do any exercise.
So, I just eat rye bread, for example, before the excercise and nothing happens. I have never had this anaphylactic shock again.
Now, I am trying to find answers for two sorts of questions:
1.) Do other types of Wheat (kamuth, spelt, “Einkorn” wheat, …) or include Omega 5 gliadin? Where can I find out the protein components (-> gliadin) of the various plants?
2.) How does it work that this kind of allergy gets worse and if possible how can I avoid this?

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13 Chritine October 17, 2014 at 16:20

Is there a specific test for this? I just stumbled across this site after searching for days for help with my son. so far the treatments given by his doctor have only helped inconsistently, pretty much just treating him as an allergy asthmatic. He started with what looked like typical outdoor allergies 1 year ago. Stuffy nose, globs of mucus, hives and facial angioedema with exercise/playing outside(he is 10 and very athletic, plays competitive soccer). Then he started wheezing and now he is getting angioedema in his throat and possibly his stomach because he complains of cramps. He is now experiencing anaphylaxis with exercise almost weekly and passed out at school last week. We were blaming oak trees despite negative blood test and his blood test were only done on outdoor allergens because his symptoms are almost exclusively outdoors. I’m going to cut wheat out of his diet immediately, worth a try anyway- got nothing to lose.

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14 Allergy Guy October 20, 2014 at 10:05

As far as I know, the only truly reliable test is to do just what you suggest: cut out wheat for a few weeks and see if there is an improvement. You may even want to stick with a wheat-free or better yet gluten-free diet for up to two months before deciding. Read through the other comments on the Wheat, Gluten and Asthma thread. While not the same thing you may get insight from that thread as it is related.

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15 Brianne October 20, 2014 at 12:13

A skin prick test for wheat confirmed it for me, although eating wheat without exercise afterward doesn’t result in any issues. You might be interested to know the first time I recall having any issues with this type of thing was in middle school. Perhaps the onset of puberty triggered it.

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16 Brianne October 20, 2014 at 12:19

Does your son have an epipen? If not, I highly suggest asking his pediatrician for one immediately, especially if he’s experiencing such severe symptoms. Anaphylaxis is no joke – it’s terrifying and life threatening within minutes. I know – it’s happened to me. I passed out, and was going into shock by the time the paramedics arrived. It took two doses to stop mine. I’m not trying to scare you but he needs to carry an epipen.

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17 Allergy Guy October 20, 2014 at 18:52

And Benedryl. Epipens are only half of what you need to manage an allergic reaction

18 Cristine October 21, 2014 at 10:36

Thank you all for your replies. Since this happened, I have been freaking out. He has been on Benedryl and Zyrtec and has a rescue inhaler. He doesn’t have an epipen yet, but he is going to go to an allergy/immunologist and I’ll get a script from them. I took wheat out of his diet Fri. evening after I read this. I hope this is a food dependent allergy because if it is outdoor/oak or grass then I don’t know what we will do.

19 Bodo November 16, 2014 at 06:01

The test which was done to find out my allergy type is called:
“ImmunoCAP Specific IgE 0-100”
My printout of the result states:
Testcode: “f416” (Omega-5 gliadin)
Testname: “rTri a 19”
The Company which conducted the test is:
Phadia GmbH, Freiburg (Germany)
I hope this helps already – let me know if not.

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20 John August 25, 2015 at 07:14

I also have the exercised induced wheat allergy which has resulted in anaphylaxsis passing out hives etc. I have been admitted to hospital on several occassions because of it. I had several tests with immunology specialists none of the prick tests found anything so had to have the blood tests which discovered the wheat allergy. I have been prescribed with epi pens and loretadine antihistamines to take every day.
I have always eaten wheat and always played rugby, done running and been to the gym. My allergy started at the age of 30 after I had and operation where i had been put under anaesthetic so it was like my immune system had restarted itself. Anyone experienced this. Will it go away again as it is making my life hell.

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21 Allergy Guy October 21, 2014 at 10:49

Sounds very distressing. I’m with you on food allergies vs. airborne, good luck!

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