Malt Allergy

Malt is actually not a natural food product like many people assume it to be.  It is a by-product of a food process called malting.  Certain types of grain, usually barley, go through a process of fermentation creating malt.  Malt adds flavour and nutrients to the grain products.  Malting grains develops enzymes required to modify the grain’s starches into sugars including glucose, fructose, sucrose and maltose. The malted grain can be used to make malt beer, malt whisky, malt vinegar, baked goods, cereals, chocolate products, and sauces like Worcestershire sauce.

The unfortunate individual who has an allergy to malted products will most likely develop an allergy to wheat, oats, barley, and sometimes to yeast. Unlike malt allergy, the earlier mentioned allergies are easier to detect.  Distinguishing whether or not a person is allergic to malt can prove to be quite a challenge on the part of the individual and even the scientific community.  It takes much testing and much time before finally concluding that the allergy is towards malt. 

Mechanism of the Allergic Reaction

Malt allergies can be attributed to the presence of certain proteins (such as Hor v 1 and Hor v 9 in barley) that is considered an allergen and activates the immune response of the body. Specifically, it is a type 1 hypersensitivity reaction wherein IgE antibodies against these allergens are produced. They bind to mast cells and basophils thus becoming “sensitized”. Upon the re-exposure, the allergen will bind to specific IgE antibodies causing degranulation of the sensitized mast cells and basophils which releases chemicals that can lead to various cutaneous and respiratory symptoms.

Symptoms of malt allergy includes triggering of asthma (for asthmatic individuals), facial itching, skin inflammation, mouth swelling, lip swelling, tongue swelling, abdominal pains (may include cramps or vomiting), and anaphylaxis.  Among these symptoms, anaphylaxis is the most severe complication. Anaphylaxis is an allergic reaction characterized by skin rashes, itching, nausea, dizziness, wheezing, and a drop in blood pressure. If a person suffering from anaphylaxis is not given proper medical attention, it can lead to an acute swelling of the respiratory airways, leading to difficulty in breathing and eventually, shock. Anaphylactic shock due to malt allergy is very rare, but highly fatal hence; medical intervention should be instituted immediately.

A less common reaction to grains or malt is allergic alveolitis. Allergic alveolitis or hypersensitivity pneumonia has a different mechanism of reaction which can either be type 3 or type 4 hypersensitivity reactions. This is caused by the inhalation of moldy barley.

What Your Doctor Can Do For You

Your physician will have to do some skin or blood testing to rule out any other allergies or underlying disease such as Celiac disease. If tested positive for malt allergy, malt-containing foods should be avoided including barley malt, malt vinegar, Worcestershire sauce, malt extract, malt loaf, and malt beverages such as beer. The goal of treatment is to minimize the symptoms by using antihistamines.

What you Can Do

If you suspect yourself to have grain, oat, barley, or even yeast allergy, go to any hospital or medical professionals to have a testing for malt allergy as well.  Who knows?  The main culprit to your discomfort may really be malt.  Once tested positive for this type of allergy, be very careful in choosing your food.  Check out the ingredients and product labels before consumption.  It is also crucial to monitor your symptoms while consuming food products with malt.  Be careful also of food products made from corn.  Sometimes malt is not listed in the list of ingredients, but on some occassions, the corn may have gone through a malting process.

Aside from having a medical consultation is to check out the allergy product called EpiPen.  Talk to your physician about it.  It is a personal syringe that carries a small pre-loaded dose of epinephrine, in case of acquiring severe allergic reactions due to malt allergy, EpiPen can be administered directly into the thigh, relieving symptoms such as narrowing of the airways until further medical attention is sought.  It is best also to teach another person like your family members or significant others on how to use EpiPen.  The EpiPen is easy to administer and handy so you can take it with you anytime.  Aside from this, you may also need to bring antihistamines or prednisone with you as prescribed. 

Be safe from the distressful effects brought about by ANY FOOD ALLERGY.  Be wise.  Always consult your physician for further diagnosis and treatment before conducting and self-medicating.