What is a wheat gluten allergy
Gluten Free Info
After a lot of testing and experimentation, we own modified some of our core ingredients in order to permit you to order anything from our menu, gluten-free. We are capable to do this because now our bechamel does not contain any wheat flour, and our breadcrumbs are made from gluten-free cornflakes, and not actual bread. For gluten-free orders we use Brown Rice elbow macaroni.
Please be advised that this restaurant contains the following gluten containing items and there is always a chance, however remote, of cross-contamination during normal kitchen operations involving shared cooking and preparation areas.
Regular Elbow Macaroni
Multi-Grain Elbow Macaroni
This menu and the information on it is provided by S’MAC as a service to our customers.
Patrons are encouraged to their own satisfaction, to consider this information in light of their individual requirements and needs. In addition, this information is based on the most current ingredient information from our food suppliers and their stated absence of wheat/gluten in these items.
Any S’MAC from our menu can be made gluten-free for an additional cost:
Nosh — $1.50
Major Munch — $3.00
Mongo — $6.00
For additional information and customer experiences please visit the following blogs:
NYC Celiac Meetup
Gluten Free Guide
Testing for IgE antibodies may be useful to establish the diagnosis of an allergic disease and to define the allergens responsible for eliciting signs and symptoms.
Testing also may be useful to identify allergens which may be responsible for allergic disease and/or anaphylactic episode, to confirm sensitization to specific allergens prior to beginning immunotherapy, and to investigate the specificity of allergic reactions to insect venom allergens, drugs, or chemical allergens.
Clinical manifestations of immediate hypersensitivity (allergic) diseases are caused by the release of proinflammatory mediators (histamine, leukotrienes, and prostaglandins) from immunoglobulin E (IgE)-sensitized effector cells (mast cells and basophils) when cell-bound IgE antibodies interact with allergen.
In vitro serum testing for IgE antibodies provides an indication of the immune response to allergen(s) that may be associated with allergic disease.
The allergens chosen for testing often depend upon the age of the patient, history of allergen exposure, season of the year, and clinical manifestations.
In individuals predisposed to develop allergic disease(s), the sequence of sensitization and clinical manifestations proceed as follows: eczema and respiratory disease (rhinitis and bronchospasm) in infants and children less than 5 years due to food sensitivity (milk, egg, soy, and wheat proteins) followed by respiratory disease (rhinitis and asthma) in older children and adults due to sensitivity to inhalant allergens (dust mite, mold, and pollen inhalants).
Detection of IgE antibodies in serum (Class 1 or greater) indicates an increased likelihood of allergic disease as opposed to other etiologies and defines the allergens that may be responsible for eliciting signs and symptoms.
The level of IgE antibodies in serum varies directly with the concentration of IgE antibodies expressed as a class score or kU/L.
Testing for IgE antibodies is not useful in patients previously treated with immunotherapy to determine if residual clinical sensitivity exists, or in patients in whom the medical management does not depend upon identification of allergen specificity.
Some individuals with clinically insignificant sensitivity to allergens may own measurable levels of IgE antibodies in serum, and results must be interpreted in the clinical context.
False-positive results for IgE antibodies may happen in patients with markedly elevated serum IgE (>2,500 kU/L) due to nonspecific binding to allergen solid phases.
Homburger HA: Chapter 53: Allergic diseases. In Clinical Diagnosis and Management by Laboratory Methods. 21st edition.
Edited by RA McPherson, MR Pincus. WB Saunders Company, New York, 2007, Part VI, pp 961-971
Special InstructionsLibrary of PDFs including pertinent information and forms related to the test
Celiac disease is an autoimmune disease in which the ingestion of gluten induces enteropathy, or inflammation of the gut, in genetically susceptible individuals. This destruction of the gut means that nutrients cannot be absorbed, leading to a variety of clinical symptoms: anemia due to the lack of iron, atherosclerosis due to the lack of calcium, failure to thrive in children, and GI stress, among others.
Gluten is the primary protein component of wheat – it is what gives breads their yummy chewy texture. The only known cure for celiac disease is finish elimination of gluten from the diet – so no pizza, bagels, pasta, pancakes, waffles, doughnuts, cookies, soy sauce (it has wheat in it), licorice (ditto) … you get the thought. Even communion wafers are verboten.
Although this is obviously extremely onerous on numerous levels, unlike any drug regimen it is 100 percent effective and free of side effects.
Ingestion of gluten puts celiacs at risk for developing other autoimmune diseases and lymphomas.
Celiac disease was first described in A.D. 100 by the Greek doctor Aretaeus. When his extant works were first published in Latin in 1552 the Greek expression for abdominal, koiliaki, was transcribed to celiac.1
But it was not until the Dutch famine of 1944 that wheat was positively identified as the factor instigating the enteropathy. An observant pediatrician, Willem Dicke, noticed that the celiac patients on his ward improved with the strict rationing of flour.
When the first supplies of precious bread were generously given to these ill children they relapsed, proving that wheat was in fact the culprit2.
The scarcity of celiac diagnoses in this country had been a self fulfilling prophecy for numerous years: medical students were taught that celiac was so rare they would probably never encounter it, so they never bothered looking. The variable clinical presentations compounded this thought. When doctors started looking for it, they found it in roughly the same rates as it is found in Europe: 1 in 133 people3.
Although numerous autoimmune diseases are thought to result from an interplay of genetic and environmental components, celiac is the only one for which the environmental trigger is actually known.
It is gluten, as well as hordein and secalin, the homologous protein components of barley and rye. So no beer or malt vinegar for celiacs either. For the sake of convenience, foods labeled “gluten free” are free of these proteins as well. But foods labeled “wheat free” may still contain them, so these foods are not necessarily gluten free.
Celiac disease is hardly the beginning and finish of this tale. Dermatitis herpetiformis is a rash that results when gluten induces an autoimmune response in the skin rather than the gut, and there is evidence that gluten can provoke a similar autoimmune response in the brain as well1.
Gluten sensitivity or intolerance – a somewhat vague claim by people who definitely do not own celiac that they feel better when they eliminate gluten – was belittled by the scientific and medical establishment for a endless time because it had no discernable cause or explanation, but now they are starting to come around and believe that it might be real4. It might be mediated by the innate, rather than the adaptive, immune system, meaning that T and B cells are not involved5.
All this is completely separate from wheat allergies, which are mediated by a completely separate adaptive immune response (allergies are mediated by IgE class antibodies, and celiac antibodies are IgA).
People with wheat allergies can safely eat spelt as well as barley and rye, while those with celiac cannot. And allergies can be outgrown, whereas celiac is forever.
So whether it is due to an actual increase in occurrence or merely an increase in diagnosis, there are certainly more celiacs around than there used to be. Wheat has been cultivated by humans for some 10,000 years, but as is the case with so numerous favorite crops, the number of varieties we used to grow and consume has been reduced to those few that are commercially viable.6
The soft white winter wheat that was traditionally grown in the mid-Atlantic states is low in gluten, so it is grand for pastry and cake flour but not so much for bread.
Now, most wheat used in this country is hard wheat grown in the Midwest, and it is bred to yield flour that is consistent in taste and texture. Hard wheat contains twice as much gluten as soft wheat does, so it produces chewy loaves of bread with crunchy crusts rather than flaky pie crusts.
As of now, FDA labeling laws do not require that the presence of gluten in foods be disclosed. These laws require only that the presence of eight major allergens be declared on food labels. Wheat is one of these allergens, but gluten is not. Manufacturers may label foods as gluten free, but such labeling is voluntary. For the millions of Americans with celiac disease, dermatitis herpetiformis, and gluten intolerance who must ensure that they are not consuming any gluten, this translates to A LOT of time spent reading labels in supermarket aisles.
Hadjivassiliou M, Sanders DS, Grünewald RA, Woodroofe N, Boscolo S, and Aeschlimann D. Gluten sensitivity: from gut to brain. Lancet Neurol 2010; 9: 318–30
van Berge-Henegouwen GP, and Mulder CJ. Pioneer in the gluten free diet: Willem-Karel Dicke 1905-1962, over 50 years of gluten free diet. Gut. 1993 34(11): 1473–1475.
3. Roberts AG. Gluten Free Baking Classics. Surry Books, Chicago, 2006.
4. Biesiekierski JR, Newnham ED, Irving PM, Barrett JS, Haines M, Doecke JD, Shepherd SJ, Muir JG, and Gibson PR. Gluten causes gastrointestinal symptoms in subjects without celiac disease: a double-blind randomized placebo-controlled trial. Am J Gastroenterol. 2011 106(3):508-14.
5. Sapone A, Lammers KM, Casolaro V, Cammarota M, Giuliano MT, De Rosa M, Stefanile R, Mazzarella G, Tolone C, Russo MI, Esposito P, Ferraraccio F, Cartenì M, Riegler G, de Magistris L, and Fasano A.
Divergence of gut permeability and mucosal immune gene expression in two gluten-associated conditions: celiac disease and gluten sensitivity. BMC Med. 2011; 9: 23.
6. Indrani Sen. Flour that has the flavor of home. The New York Times Sept. 10, 2008.
About The Author: Diana Gitig received her Ph.D. in Cell Biology and Genetics from Cornell University’s Graduate School of Medical Sciences in 2001. Since then she is a freelance science author. Diana is based in New York.
The views expressed are those of the author and are not necessarily those of Scientific American.
1. Digestive issues such as gas, bloating, diarrhea and even constipation.
I see the constipation particularly in children after eating gluten.
2. Keratosis Pilaris, (also known as ‘chicken skin’ on the back of your arms).
This tends be as a result of a fatty acid deficiency and vitamin A deficiency secondary to fat-malabsorption caused by gluten damaging the gut.
3. Fatigue, brain fog or feeling tired after eating a meal that contains gluten.
4. Diagnosis of an autoimmune disease such as Hashimoto’s thyroiditis, Rheumatoid arthritis, Ulcerative colitis, Lupus, Psoriasis, Scleroderma or Multiple sclerosis.
5. Neurologic symptoms such as dizziness or feeling of being off balance.
Hormone imbalances such as PMS, PCOS or unexplained infertility.
8. Diagnosis of chronic fatigue or fibromyalgia. These diagnoses simply indicate your conventional doctor cannot pin point the cause of your fatigue or pain.
9. Inflammation, swelling or pain in your joints such as fingers, knees or hips.
Mood issues such as anxiety, depression, mood swings and ADD.
In celiac disease, gluten – found in wheat, barley and rye – affects the lining of the little intestine and predisposes to malabsorption of nutrients and multiple vitamins. There are various symptoms and over time, it can lead to bone disease.
It is also associated with several conditions, including osteoporosis, depression, thyroid disease and foggy thinking. Other associated conditions include anemia, refractory celiac disease and extremely rarely, intestinal lymphoma.
Patients diagnosed with celiac disease need expert care and guidance to assist navigate their dietary and treatment options and manage the disorder, as well as associated nutritional problems.
At Penn State Celiac Clinic, you get coordinated care provided by a comprehensive team that includes:
- Gastroenterologist for diagnosis and medical care
- Registered dietitian for guidance on a gluten-free diet plan
- Celiac community support organization
Together, this group will work closely with you through diagnosis, dietary changes, genetic concerns, cancer risks and disease management of celiac disease.