The first eye-catching paper of 2023 has landed, and it further adds weight to the proposition that those with food allergy have a considerably higher rate of coeliac disease than the ordinary population. It’s in the Journal of Pediatric Gastroenterology and Nutrition and you can read the abstract here.
This may be news to some followers of research in the field of food hypersensitivity, but there have been suggestions of such a link before.
In 2015, following the publication of a paper suggesting up to 5% of those with food allergy may have coeliac disease, I wrote about these possible associations here. I had first heard mutterings about it in 2009, and it’s interesting to see it resurface again now. Both papers are from teams at the University of Trieste in Italy.
I don’t have much to add to what I wrote in 2015 about this, except the following.
If you have a wheat allergy, and therefore strictly avoid all forms of wheat, you may or may not consume other cereals containing gluten, such as rye, barley or oats. (Wheat allergy is usually an allergy to non-gluten proteins in wheat.) Perhaps you keep intake very low, possibly due to a concern that these grains can often be cross-contaminated with one another, or maybe you consume them more freely, e.g. in rye bread (not usually advised, I don’t believe, but you may do so if your wheat allergy manifests solely as exercise-dependent). Or perhaps you only consume gluten free forms of these grains — such as the deglutenised barley in enzyme-treated gluten-free beer.
Is it possible that you might be consuming very low, but still sufficient gluten in your diet to be triggering coeliac-related symptoms, possibly fairly mild ones, which you put down to your diagnosed allergy or allergies or IBS? Is it therefore possible you may have undiagnosed coeliac disease?
I think it may be worth asking these questions and speaking with your doctors if you find yourself in this very particular situation — although please don’t prematurely act on my speculative theory or suggestion and absolutely don’t change your diet until you do so.
If the 5–6% rates are accurate, they represent figures roughly in line with the risk of coeliac disease in those with type 1 diabetes and many other autoimmune conditions, and are not far off the 10% suggested for first-degree relatives — all scenarios that NICE guidelines suggest should require coeliac screening.
Is it time to add food allergy to those guidelines?
In the meantime, I’d be very interested to hear from those with both CD and FA. What are your experiences of having both? Which is tougher to manage? Or more expensive? And which was diagnosed first?