Possible to have both Wheat Allergy and Gluten Intolerance?

[MistyW]

Marathoner/Cyclist/UltraRunner 36 year old female 

I have had neurological symptoms for many years that have slowly gotten worse as I've gotten older of, what I believe to be, Gluten Intolerance.  Namely: anxiety and depression (I never sought an official diagnosis because I didn't want to be medicated), ADHD/bad short-term memory (My mom said that I've always "just been like that"), brain fog and extreme fatigue/naps ("It's because you're getting older, haha drink more caffeine, quit running so much," etc), occasional migraines ("It's hereditary"), and, more recently, joint pain ("You need to quit running and get more rest").

I have a tip-top diet eating LOTS of fresh organic green vegetables, fruits, whole grains, eggs, quinoa, seafood, chicken, limited dairy, and I take the right supplements for my activity level. I have never displayed irritable bowel with gluten but I did have more unstable bathroom habits while on training runs.

After being so frustrated with my fading energy levels and brain fog, I did tons of Googling of my symptoms that apparently only *I* thought were concerning. I began to suspect a Vitamin B12 deficiency was to blame for my lethargy. I began to supplement with sublingual B12 and it seemed to help but I was super-confused as to why I wasn't absorbing B12 from my diet which was plentiful in B12. 

After a bout with the flu this last winter, I suddenly developed a sort of whole-body rash that would develop after each and every training run. It was a strange rash because it happened right after finishing a run, and broke out primarily on my elbows, knees, buttocks, abdomen, and sometimes my neck and face. The bumps were more like HIVES, raised, sometimes as wide as an inch, and itchy. My airway was never affected and so I kind of tolerated it for awhile, thinking it was a strange phase.  When it didn't go away, I started Googling again. I came up with something called "food-dependant, exercise induced anaphylaxis." One of the triggers of FDEIA was wheat. And when I looked more into the multiple symptoms of gluten intolerance, a big fat lightbulb clicked on in my head. 

All of the troublesome symptoms that I was blaming on age and running and heredity matched up pretty darn well with WHEAT. I immediately experimented by cutting wheat out of my diet completely and within 1-2 weeks, my annoying symptoms were gone, I felt rested, clearer minded, with a brighter mood. The post-exercise rash went away.

I began thinking about trying to get an official diagnosis (am I gluten sensetive? intolerant? allergic? celiac?). When I learned that I would have to go back on wheat for awhile to get a diagnosis I decided to just live wheat-free without the diagnosis, however, part of me really wants to know!

Is it possible to be both allergic to (post-exercise hives) and intolerant to (brain fog, adhd, fatigue, loose bowels, joint pain, anxiety) wheat?

Thanks for any insight!!~~~~~~~~

For the record, I ate pizza about a week ago just because.....and while nothing significant happened after I ate, I broke out in a horrible hivey rash the very next time I went on a run. Bodies are strange!

[GFinDC]

Hi, yes, you can have an allergy and a food intolerance.  Allergies are IgE immune reactions, food intolerances are IgA or IgG immune reactions.  You can get tested for allergies with a skin prick test.

They test for celiac disease with a blood test first, and then an endoscopy later.

The celiac blood tests are:

DGP IgA

DGP IgG

EMA IgA

Ttg IgA

Total serum  IgA

Each of these antibody tests have a range of possible values that varies by the lab.  You need the ranges to interpret the test results.

The 2nd test is the endoscopy where they take 4 to 6 small biopsy samples of the small intestine lining.  Then they check the biopsies with a  microscope for damage characteristic of celiac disease.

There is also the DH (dermatitis herpetiformis) test.  DH is a skin rash that only people with celiac disease get.  They test for it by taking a small skin biopsy from next to a lesion.  DH tends to appear in a symmetrical pattern on both elbows, butt cheeks, knees etc.  DH can be very itchy also.

[Ennis-TX]

I would really suggest following up with GFinDC suggestion and get tested for celiac. Your complaints about the fatigue, joint issues, fog, anxiety, depression and worsening ADHD are all things I used to get in highschool way before my diagnosis. See about starting the gluten challenge of eating it daily for 8-12 weeks and getting the blood test. If you feel it will interfere with your life, try taking like a tsp or 2 of vital wheat gluten before bed and trying to sleep it off.

Knowing the issue will be a big relieve and will help with sticking more strictly to the diet and getting support from family and doctors about the diet.

[apprehensiveengineer]

Others have given you good advice with regard to getting screened/diagnosed, but I wanted to chime in since I am a fellow "serious" runner. I spent much of my teens/early 20s training at a high level with increasingly intrusive symptoms, much like you described. I normalized a lot of it for years, but got to a breaking point where I simply couldn't any more.

I think within the running community, IBS-like symptoms (constantly having to stop to poop on the run) are normalized, so I didn't think much of this - never had diarrhea, just high volume, fatty stools. Since being on a GFD, I have not had to stop to poop once while running, except on occasions where I have poisoned myself. My workouts/long runs are >2hrs in length. I also had a number of stress fractures and issues with iron deficiency/anemia, which were also overlooked because they are "normal" in elite female runners. I also experienced creaky/stiff joints, but didn't realize this until later when they stopped being that way.

What really broke me was the odd fatigue symptoms I would have. I would be in the best shape of my life, then do a random harder effort (eg. race, track workout) and be bedridden for a week. I could not convince anyone that I was not overtraining. Eventually, I learned to sandbag workouts/races to avoid having this happen, which was frustrating to do as someone who is competitive.

I also get a rash, which is worsened by sweating and friction - sports bra seams, armpits, shorts seams. It does appear elsewhere, but these are the hot spots. At its worst, I had to stop sometimes on runs to scratch because it was so unbearably itchy. At first I thought it was an allergy to detergent or perhaps a bacterial/fungal issue, but the rash was unresponsive to addressing those issues.

Unfortunately, despite my rather suspicious symptoms, the GPs I saw did not elect to test me for celiac disease. I accidentally discovered that gluten appeared to be causing my issues while doing a supervised elimination diet (for food allergies/intolerances). At that point, I had been gluten-free too long for a reliable test, and couldn't bear subjecting myself to the gluten challenge to confirm celiac disease/DH officially (in part because of the psychological symptoms that gluten ingestion seemed to elicit). This is not a pathway I would recommend if you can avoid it - get tested for celiac disease now while you still can.