Who Should Not Take Barley: Risks and Precautions

November 21, 2025 •

4 min read

Barley is a gluten-containing grain that must be strictly avoided by those with celiac disease. Understanding who should not take barley is vital for preventing adverse health effects, as it poses significant risks for individuals with specific medical conditions.

Quick Summary

This guide details the medical conditions and scenarios where barley consumption is unsafe. It covers celiac disease, non-celiac gluten sensitivity, IBS, diabetes management concerns, medication interactions, and pre-surgery precautions.

Key Points

Celiac Disease and Gluten Sensitivity: Individuals with celiac disease or NCGS must completely avoid barley due to its gluten content.
IBS and Digestive Issues: The fermentable fructan fiber in barley can cause gas, bloating, and discomfort in people with Irritable Bowel Syndrome.
Diabetes Management: Barley can lower blood sugar and may interact with diabetes medications, potentially causing hypoglycemia; consult a doctor for advice.
Pre-Surgery Patient: Discontinue barley consumption at least two weeks before a scheduled surgery, as it can affect blood sugar control.
Oral Medication Users: Barley's high fiber can hinder the absorption of some oral medications; take medications at a different time to ensure efficacy.
Allergies: Anyone with a diagnosed barley allergy or other cereal grain sensitivities should avoid barley to prevent allergic reactions.
Malt is a Warning: Read labels for 'malt' or 'malted' as these indicate the presence of barley, even in unexpected foods.

Reasons to Avoid Barley

For most people, barley is a nutritious whole grain, but for certain individuals, it can be detrimental to their health. The risks are primarily associated with its gluten content, high fiber, and impact on blood sugar and medication absorption.

Celiac Disease and Non-Celiac Gluten Sensitivity

Barley contains gluten, a protein that triggers an autoimmune response in individuals with celiac disease. This reaction damages the lining of the small intestine, leading to nutrient malabsorption and other serious health problems. Similarly, those with non-celiac gluten sensitivity (NCGS) experience negative symptoms like bloating, fatigue, or headaches after ingesting gluten. Even without the intestinal damage seen in celiac disease, NCGS can significantly affect daily life and requires a gluten-free diet, which means avoiding all barley products.

Wheat and Grain Allergies

People with an IgE-mediated allergic reaction to barley should avoid it completely. While separate from celiac disease, an allergy can cause symptoms ranging from rashes and stomach cramps to life-threatening anaphylaxis. Furthermore, individuals with allergies to other cereal grains like wheat or rye may experience cross-reactions to barley and should exercise caution.

Digestive Disorders and High Fiber Intake

Barley's high fiber content, while beneficial for most, can exacerbate symptoms for some. For those with Irritable Bowel Syndrome (IBS), the short-chain carbohydrates known as fructans in barley are a fermentable type of fiber that can trigger gas, bloating, and digestive discomfort. For anyone introducing more fiber into their diet, a sudden increase can lead to temporary digestive issues like gas and bloating as the body adjusts. It is important to increase fiber intake gradually and ensure adequate hydration.

Medical Interactions and Special Precautions

Certain health conditions and treatments require individuals to avoid or moderate their barley intake due to its potent effects.

Diabetes and Blood Sugar Regulation

Because of its ability to significantly lower blood sugar, individuals with diabetes who are taking insulin or other blood-sugar-lowering medications should exercise caution. Combining barley with these medications could cause blood sugar to drop too low, a condition known as hypoglycemia. Any changes to a diabetic diet should be discussed with a healthcare provider to ensure proper dosage adjustment.

Pre-Surgery Precautions

For those undergoing surgery, barley is best avoided. The grain's effect on blood sugar levels could interfere with blood glucose control during and after the procedure. It is generally recommended to stop consuming barley at least two weeks before a scheduled surgery to mitigate this risk.

Interference with Oral Medications

Barley's high fiber content can decrease the body's absorption of various oral medications, thereby reducing their effectiveness. To prevent this interaction, it is advisable to take medications at least one hour after consuming barley.

Hidden Sources of Barley to Avoid

Barley can be present in foods and beverages where it is not immediately obvious. The word 'malt' is a key indicator that the product contains barley.

Common Products Containing Barley:

Malt and Malt Flavoring: Found in many cereals, candies, and snack foods.
Beer and Other Malted Beverages: Most beers and ales are brewed with barley.
Food Colorings: Some food colorings may contain barley derivatives.
Soup and Stew Bases: Barley is a common ingredient in many pre-packaged soup and stew mixes.
Natural Flavorings: The term "natural flavoring" can sometimes hide barley ingredients.
Sake: While typically made from rice, sake can sometimes include barley derivatives.

Comparison Table: Barley vs. Gluten-Free Alternatives

To help those who need to avoid barley, here is a comparison of its characteristics with some popular gluten-free grain alternatives.


Feature	Barley (Hulled)	Quinoa	Brown Rice	Oats (Certified GF)
Contains Gluten?	Yes	No	No	No
Key Dietary Benefits	High in fiber (beta-glucan), manganese, selenium	High in protein, fiber, and iron	Good source of fiber, manganese, and selenium	High in beta-glucan fiber, vitamins, minerals
Suitability for Celiacs/NCGS	Unsafe	Safe	Safe	Safe (if certified GF)
Suitability for IBS	Potential Trigger (high fructans)	Usually Safe	Safe	Often safe; can be a trigger for some
Typical Texture	Chewy	Fluffy, slightly crunchy	Chewy	Soft, creamy

Conclusion: Consult a Healthcare Professional

Barley is a valuable and nutritious grain for the general population but can pose health risks for specific groups. Individuals with celiac disease, non-celiac gluten sensitivity, and certain grain allergies must avoid it entirely. Furthermore, caution is necessary for those managing diabetes, preparing for surgery, or taking oral medications. For those with digestive sensitivities like IBS, paying attention to how barley affects their body is critical. Always consult a healthcare professional, especially a registered dietitian, for personalized dietary advice, particularly before making significant changes based on conditions like diabetes or digestive disorders. It is also important for individuals with celiac disease to be vigilant in reading food labels for hidden sources of barley, such as malt.

This content is for informational purposes only and does not constitute medical advice. For any medical concerns, please consult a healthcare professional. You can read more about gluten-containing grains from the National Institutes of Health (NIH).(https://pmc.ncbi.nlm.nih.gov/articles/PMC1862315/)

Frequently Asked Questions

No. Barley contains gluten, which triggers an autoimmune response in individuals with celiac disease and can damage the small intestine. It must be strictly avoided.

Yes, unless specifically labeled as gluten-free, barley water is made from barley grains and contains gluten. It should be avoided by anyone with celiac disease or gluten sensitivity.

Barley can lower blood sugar levels. Individuals with diabetes, especially those taking insulin or medication, must monitor their blood sugar closely and consult their doctor before adding barley to their diet to avoid hypoglycemia.

Common hidden sources include products containing 'malt' or 'malted' ingredients, such as malted beverages (like beer), malt vinegar, and some cereals and flavorings.

Excellent gluten-free alternatives include quinoa, brown rice, corn, millet, and oats (if they are certified gluten-free to prevent cross-contamination).

Barley contains fermentable carbohydrates called fructans. For people with Irritable Bowel Syndrome, these can lead to increased gas, bloating, and other digestive discomfort.

Barley in amounts typically found in food is considered safe during pregnancy. However, barley sprouts are potentially unsafe and should not be consumed in high amounts.

Yes, pearled barley has had its hull and some of the bran removed, but it still contains the gluten protein found throughout the grain. It is not gluten-free.