What are the symptoms of having a wheat allergy
It is here where the trouble begins. There’s something intensely disturbing about the notion that we can make ourselves ill. Belief, not physiology, becomes the causal agent, displacing MSG or gluten as the source of blame for someone’s suffering. This can make us feel vulnerable, stupid and feeble, as though we own the choice to be better but lack the mental acuity to manage it. Not only that, it’s hard not to feel love a psychological explanation trivialises one’s condition – hence the expression “It’s only in your head.” But things that are in our heads aren’t fake or unimportant (OCD?
anorexia?), and susceptibility to a nocebo effect isn’t a sign of weakness. Anyone can unknowingly invent a untrue memory or react to a substance that is actually benign.
Accepting a psychological explanation of gluten intolerance is especially hard because food aversions often turn into a way of life.
Love religion, avoiding gluten requires personal sacrifice. Gluten intolerance creates communities, which, love religious communities, share stories of suffering and redemption, and share meals made special by the presence of a food taboo. It’s no wonder people take offence at the suggestion that gluten intolerance could be psychological – after every, who wants to own built their way of life on a “mere” trick of the mind?
Thinking that way is a error. Reductionist psychological explanations of religious beliefs can be offensive because they deny fundamental religious truths: “You believe in heaven to stave off your fear of death, not because it really exists.” Legitimate psychological explanations of medical conditions, on the other hand, deny no such truths.
The question of whether and to what extent MSG and gluten cause physiological reactions is scientific, not religious. When one’s explanation of a medical condition becomes an unquestionable truth, the explanation is no longer scientific.
Many basic claims of nutrition science are unintuitive and sometimes don’t stand up to repeated research. (Salt? Cholesterol? Vitamins?Alcohol?Coffee?) At this point, scientists simply don’t own a excellent explanation for the mechanism and prevalence of gluten intolerance – hence the need for studies about whether it exists at all.
Maybe people own always been gluten intolerant and were going undiagnosed – as is true with coeliac disease.
Maybe our guts haven’t evolved to process gluten – as some advocates of the Palaeolithic diet claim. Maybe it’s Monsanto (conspiracy theorists rejoice!). Maybe gluten intolerance isn’t really caused by gluten, and we should actually be blaming a family of proteins in wheat called amylase trypsin inhibitors.
None of these explanations is “only” in our heads, which makes them feel more acceptable. But to deny the distinct possibility that gluten could be another MSG, at least for some people, is to deny what science has confirmed, again and again, about our nature as human beings.
So when some annoying friend implies that your gluten intolerance is psychological, go correct ahead and be offended.
But when science suggests it? Best to hear up, question your self-diagnosis, and remind yourself that nocebo effects are nothing to be ashamed of.
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Managing a wheat allergy — your own or someone else’s — includes strict avoidance of wheat ingredients in both food and nonfood products.
Wheat is one of eight allergens with specific labeling requirements under the Food Allergen Labeling and Consumer Protection Act (FALCPA) of 2004. Under that law, manufacturers of packaged food products sold in the U.S.
and containing wheat as an ingredient must include the presence of wheat, in clear language, on the ingredient label.
The grain is found in a myriad of foods — cereals, pastas, crackers and even some boiling dogs, sauces and ice cream.
It is also found in nonfood items such as Play-Doh, as well as in cosmetic and bath products. Note that the FALCPA labeling rules do not apply to nonfood items; if you own questions about ingredients in those products, check the manufacturer’s website or contact the company.
Foods that don’t contain wheat as an ingredient can be contaminated by wheat in the manufacturing process or during food preparation. As a result, people with a wheat allergy should also avoid products that bear precautionary statements on the label, such as “made on shared equipment with wheat,” “packaged in a plant that also processes wheat” or similar language.
The use of those advisory labels is voluntary, and not every manufacturers do so.
A challenging aspect of managing a wheat allergy is baking. While there’s no simple substitution for wheat as an ingredient, baked goods such as breads, muffins and cakes may be made using a combination of non-wheat flours, such as those made from rice, corn, sorghum, soy, tapioca or potato starch. Your allergist can provide you with guidance on which grains are safe for you.
Options for wheat-free grocery shopping include foods made from other grains such as corn, rice, quinoa, oats, rye and barley.
The recent growth in gluten-free products is making it easier to manage a wheat allergy.
Gluten is a protein found in wheat, barley and rye.
A gluten-free product may be safe for those who are allergic to wheat because the product should not contain wheat ingredients. However, because a product marketed as “gluten-free” must also be free of rye and barley in addition to wheat, those who must avoid only wheat may be limiting themselves. Anyone managing a food allergy shouldn’t rely on a “free from” label as a substitute for thoroughly reading the finish ingredient label.
People with any helpful of food allergy must make some changes in the foods they eat.
Allergists are specially trained to direct you to helpful resources, such as special cookbooks, patient support groups and registered dietitians, who can assist you plan your meals.
Managing a severe food reaction with epinephrine
A wheat allergy reaction can cause symptoms that range from mild to life-threatening; the severity of each reaction is unpredictable. People who own previously experienced only mild symptoms may suddenly experience a life-threatening reaction known as anaphylaxis. In the U.S., food allergy is the leading cause of anaphylaxis exterior the hospital setting.
Epinephrine (adrenaline) is the first-line treatment for anaphylaxis, which can happen within seconds or minutes, can worsen quickly and can be deadly.
In this type of allergic reaction, exposure to the allergen causes the whole-body release of a flood of chemicals that can lead to lowered blood pressure and narrowed airways, among other serious symptoms.
Once you’re diagnosed with a food allergy, your allergist will likely prescribe an epinephrine auto-injector and teach you how to use it. Check the expiration date of your auto-injector, note the expiration date on your calendar and enquire your pharmacy about reminder services for prescription renewals.
Be certain to own two doses available, as the severe reaction may recur.
If you own had a history of severe reactions, take epinephrine as soon as you suspect you own eaten an allergy-causing food or if you feel a reaction starting. Epinephrine should be used immediately if you experience severe symptoms such as shortness of breath, repetitive coughing, feeble pulse, generalized hives, tightness in the throat, trouble breathing or swallowing, or a combination of symptoms from diverse body areas such as hives, rashes or swelling coupled with vomiting, diarrhea or abdominal pain. Repeated doses of epinephrine may be necessary.
If you are uncertain whether a reaction warrants epinephrine, use it correct away, because the benefits of epinephrine far outweigh the risk that a dose may not own been necessary.
Common side effects of epinephrine may include anxiety, restlessness, dizziness and shakiness.
Rarely, the medication can lead to abnormal heart rate or rhythm, heart attack, a sharp increase in blood pressure, and fluid buildup in the lungs. Patients with certain pre-existing conditions, such as diabetes or heart disease, may be at higher risk for adverse effects and should speak to their allergist about using epinephrine.
Your allergist will provide you with a written emergency treatment plan that outlines which medications should be istered and when (note that between 10 and 20 percent of life-threatening severe allergic reactions own no skin symptoms).
Be certain that you understand how to properly and promptly use an epinephrine auto-injector.
Once epinephrine has been istered, immediately call 911 and inform the dispatcher that epinephrine was given and that more may be needed from the emergency responders.
Other medications, such as antihistamine and corticosteroids, may be prescribed to treat symptoms of a food allergy, but it is significant to note that there is no substitute for epinephrine — this is the only medication that can reverse the life-threatening symptoms of anaphylaxis.
Managing food allergies in children
Because fatal and near-fatal wheat allergy reactions, love other food allergy symptoms, can develop when a kid is not with his or her family, parents need to make certain that their child’s school, day care or other program has a written emergency action plan with instructions on preventing, recognizing and managing these episodes in class and during activities such as sporting events and field trips.
A nonprofit group, Food Allergy Research & Education, has a list of resources for schools, parents and students in managing food allergies.
If your kid has been prescribed an auto-injector, be certain that you and those responsible for supervising your kid understand how to use it.
Not endless ago, gluten was just a little-known protein found in wheat, barley, and other grains—an ingredient that gives most breads, baked goods, and pastas their shape and serves as the glue that holds them together. It wasn’t vilified as a culprit of stomach bloating, weight acquire, or a host of other problems.
Back then, a gluten-free diet was reserved for the estimated 3 million Americans who own celiac disease, a digestive disorder caused by an immune reaction to gluten.
Today, however, ditching gluten is a diet trend, and gluten-free foods are every over the supermarket and are highlighted on restaurant menus.
Even celebrities are promoting gluten-free lives, and terms love “gluten intolerance,” “gluten sensitivity,” and “gluten allergy” are going mainstream. What do these terms actually mean? And is it a excellent thought to abstain from—or limit—gluten from your diet?
In 2007, my wife’s cake store did not offer a gluten-free option.
Six years later, hardly a month goes by without a request for a gluten-free tasting. Thanks in part to celebrities such as Oprah Winfrey and Lady Gaga, almost one-third of every consumers are now interested in gluten-free food, a multi-billion-dollar industry projected to exceed $10 billion by 2017. (Even children’s frolic sand now comes with a gluten-free guarantee!)
This is extremely perplexing, given that only 1 per cent of the population has coeliac disease and only 0.5 per cent is allergic to wheat. What could possibly be causing widespread reports of non-coeliac gluten intolerance, commonly blamed for a raft of symptoms including gas, bloating, diarrhoea, constipation, fatigue, goose bumps, dizziness, infertility, migraines, joint inflammation and even mood disorders?
Scientists are applying themselves to the riddle, and final February Slate‘s Darshak Sanghavi reported on an Italian study that confirmed the existence of gluten intolerance (“non-coeliac wheat sensitivity”) as a third, “distinct clinical condition”.
In the study, one-third of patients who self-identified as gluten-intolerant did in fact experience symptom relief after adopting a gluten-free diet. Case closed, right? Pass the gluten-free pasta.
Not so quick. An significant implication of the study is that two-thirds of people who ponder they are gluten intolerant really aren’t. In light of this, the even-handed Sanghavi suggested that “patients convinced they own gluten intolerance might do well to also accept that their self-diagnosis may be wrong”.
Predictably, the comment thread exploded with rebuttals: defensive anecdotes, doctrinal pronouncements about the evils of gluten and accusations of corporate malfeasance, every of which bear a striking resemblance in tone and content to the rhetoric of anti-MSG advocates.
For numerous, the truth of physiological gluten intolerance has now acquired a quasi-religious status.
Gluten intolerance spelled out
Gluten intolerance is a general term that encompasses both celiac disease and gluten sensitivity, explains Anthony Porto, MD, MPH, a Yale Medicine pediatric gastroenterologist. It means that the body has difficulty digesting gluten. So, if people with celiac or gluten sensitivity eat foods that contain gluten, they experience digestive symptoms, including diarrhea, gas, constipation, and abdominal pain.
Celiac disease, which is genetic, is an autoimmune disorder in which the body makes antibodies (infection-fighting cells) that attack normal cells by error.
Those antibodies harm the inner lining of the little intestine, flattening the finger-like tissues (villi) that assist your body absorb nutrients and thereby making it hard for them to do their job.
For people with celiac disease, eating even the smallest quantity of gluten triggers this reaction, which can also lead to problems absorbing nutrients and calories. Strictly adhering to a gluten-free diet is the only way to treat celiac disease.
The disease is typically diagnosed via a blood test, though it is significant to note that if you own been following a strict gluten-free diet, the test may give a false-negative result. (So, don’t start a gluten-free diet until after you own consulted with a physician.) An upper gastrointestinal (GI) endoscopy, which is performed by inserting a flexible tube with a camera below your esophagus, can also be used to diagnose celiac disease by showing if there is damage to the intestine.
Chinese restaurant syndrome
In April 1968, the New England Journal of Medicine published a letter by Robert Ho Man Kwok that described a strange set of symptoms: “Numbness at the back of the neck, gradually radiating to both arms and the back, general weakness and palpitation.” Stranger still was the fact that Kwok, himself a Chinese immigrant, typically noted the onset of these symptoms 20 minutes after eating at restaurants serving “Northern Chinese food”.
An editor at the journal titled Kwok’s letter “Chinese restaurant syndrome”, and thus began a minor epidemic. For countless sufferers, a mystery had been finally solved.
“No MSG” signs sprang up across the US, and, eventually, the world. Study upon study confirmed the syndrome’s existence and speculated about the science underlying it.
But after reading some of these studies, even a layperson will start to get suspicious. Take the editorial note that precedes Russell Asnes’s article “Chinese restaurant syndrome in an infant”: “The evidence that this baby had the Chinese Restaurant syndrome may be only circumstantial. However, the description of the symptom is precise as attested to by the Editor’s wife who suffers from the same malady.
Incidentally, she remains a devotee of Chinese cuisine.”
Science, that sworn enemy of circumstantial evidence, marched on, and slowly but surely physiological explanations of Chinese restaurant syndrome began to lose credibility. Double-blinded studies failed to turn up evidence of a clinical condition. MSG, numerous people noted, appears in everything from sushi to Doritos. Journalists performed experiments similar to mine, their results echoing the consensus of professional scientists: in the overwhelming majority of cases, MSG sensitivity is a psychological phenomenon.
Despite this thorough debunking, a surprisingly large number of people – generally those who lived through the epidemic – still insist they are sensitive to MSG.
around and you’ll turn up scores of alarmist websites, which tend to combine outdated research with anecdotal, indignant rebuttals of the current scientific wisdom: “How dare you propose my MSG sensitivity is only in my head? Why, just the other day I went out for Chinese and forgot to enquire about MSG.
After 45 minutes I couldn’t breathe and my heart was racing.”
Occasionally, as with vaccines and climate change denial, alarmism veers into paranoia, yielding accusations that a shadowy east Asian cabal is paying off scientists and journalists to regurgitate their propaganda. (Ajinomoto Corporation, I await your cheque!). For a little minority, MSG sensitivity somehow became more than a medical condition, and challenging its physiological basis poses a threat to their extremely identity. The harmfulness of MSG, a seemingly unimportant assertion, took on the importance of a religious doctrine, a fundamental truth to be defended at any cost. But why?
Confirmation bias meets physiology in the placebo effect, a well-documented phenomenon in medical treatments ranging from sham drugs to sham acupuncture (where patients reply positively to sham needles) to sham knee surgery.
People’s desire to believe in a cure actually affects their symptoms.
That’s why placebo-controlled, double-blinded studies are integral to medical research. Without them, we’d be in constant harm of ascribing physiological causality to treatments that are actually psychological.
Needless to tell, placebo effects aren’t always beneficial. Strong belief can also render a harmless substance poisonous, which is exactly what happened with MSG. Scientists refer to this as the nocebo effect, and it means that careful studies are necessary to distinguish between poisons and poisonous beliefs.
None of this minimises the relief felt by those who undergo sham acupuncture, or the symptoms of those who ponder they are gluten intolerant.
Pain is pain; chronic diarrhoea is chronic diarrhoea. Every it means is that pain relief might not be caused by the physical presence of an acupuncture needle, and diarrhoea might not be caused by the physical presence of gluten. In these instances, the symptoms may be genuine, but their cause (and potential resolution) is every in our heads.
Allergic to evidence
No one likes to be told they are mistaken about the foundation of their most dearly held beliefs.
It offended the loyal when Karl Marx suggested that religions are psychological tools meant to placate the masses. Suggesting that gluten intolerance might own a psychological basis threatens a similarly foundational belief, namely that we are rational beings, capable interpreters of reality immune to mass hysteria and self-deception.
Obviously this is not the case. For one, our memories are notoriously unreliable. You may remember getting headaches from Chinese food when in fact those memories were created when you read about Chinese restaurant syndrome in the news.
The same is true for memories of gluten intolerance. Don’t forget, certainty about your memories is not sufficient evidence of their truth: “Look, I know that for the final 20 years, every time I ate gluten it gave me terrible gas.”
Under oath, eyewitnesses constantly forget crucial details and replace them with their own fabrications. They aren’t liars – they’re just human. One reason for this unreliability is that memory and perception are prone to confirmation bias.
Once a bias is in put, we’ll selectively remember – and notice – whatever facts assist confirm it.
Food historian Ian Mosby has explained the “success” of Chinese restaurant syndrome by connecting it to racialised discourse that drew on a vision of Chinese cooking as bizarre or extreme. In the case of gluten intolerance, it doesn’t take much to come up with a plausible confirmation bias. Only nine years ago, 1 in every 11 Americans was on a low-carb diet. In a country terrified of weight acquire and recently obsessed with the Atkins diet, gluten makes a grand villain.
It’s hard not to notice the theme of weight loss on gluten-free sites. Pasta, bread, cake, cookies, pretzels – they don’t just make you fat, they make you sick! (Added bonus: diets motivated by a medical condition are far more effective – enquire any diabetic.)