Celiac Disease and Infertility…What’s the Connection?

 

glutenfreefertility

{Via}

I wrote this paper for my health class and thought that I’d share it here.  I’m not a “paper writer” so please be kind. ;0)

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Celiac disease is an autoimmune digestive disease that damages the villi of the small intestine and interferes with absorption of nutrients from food.  Celiac disease is triggered by consumption of the protein called gluten, which is found in wheat, barley and rye. When people with celiac disease eat foods containing gluten, their immune system responds by damaging the finger-like villi of the small intestine. When the villi become damaged, the body is unable to absorb nutrients into the bloodstream, which can lead to malnourishment. (NFCA)

Symptoms of Celiac Disease May Include One or More of the Following:

* Recurring bloating, gas, or abdominal pain
* Chronic diarrhea or constipation or both
* Unexplained weight loss or weight gain
* Pale, foul-smelling stool
* Unexplained anemia
* Bone or joint pain
* Behavior changes/depression/irritability
* Vitamin K Deficiency
* Fatigue, weakness or lack of energy
* Delayed growth or onset of puberty
* Failure to thrive (in infants)
* Missed menstrual periods
* Infertility male & female
* Spontaneous miscarriages
* Canker sores inside the mouth
* Tooth discoloration or loss of enamel

(Celiac Disease Foundation)

While you can see that this is just a short list of the 300 known symptoms of Celiac disease, I’m most interested in the connection between infertility and Celiac.

In my family, Celiac disease runs rampant in the females on my mom’s side.  It is highly hereditary, especially in women, although men can have Celiac disease, too.  Most of my aunts, my grandma, a few of my female cousins and my mom all have Celiac and have been diagnosed with it in the past five to ten years.  My mom and one of my cousins were most recently diagnosed.  For my mom, the effects of coming in contact with gluten are severe.  Her fingers go numb, she gets an instant headache, her tongue goes numb and then she’s also got the gastrointestinal issues to deal with as well.

Another cousin that is just a bit older than me was diagnosed a couple of years ago after having been misdiagnosed many times, which is often the case with Celiac disease.  It can take up to ten years to get a correct diagnosis because it shows itself as many other conditions.  With my cousin her side effects of gluten happen almost immediately (as with my mom, too) and she gets very, very sleepy and can pretty much fall asleep standing up.  She also gets the bloated, gaseous feeling and is in a bunch of pain.

I’ve been told that it’s very likely that I, myself, have Celiac disease but it hasn’t been confirmed.  For me, I believe that if I do have it, I’m mostly asymptomatic.  Unless, of course, it’s true that infertility can be a symptom of Celiac disease.  “Over the last 10 years, several studies have examined the link between celiac disease and infertility and found that women suffering from unexplained infertility may have clinically silent celiac disease.” (NFCA)   My husband and I have unexplained infertility, a term that is hard to deal with.  Not only because it means that we have no children but because there are no answers at this point in time as to WHY we can’t have children.  If I do, in fact, have Celiac disease, I’m interested to know if it will make a difference if we decide to go gluten-free.

One in 133 Americans suffer from Celiac, 95% are undiagnosed or misdiagnosed as other conditions.  Also, 17% of Celiac patients have immediate family members with the disease. (NFCA)  One of several studies done was at Thomas Jefferson University Hospital in Philadelphia and it found that there were more recurrent spontaneous abortion and infertility in Celiac patients is at least four times higher than the general population.

The Department of Medicine at Tampere University Hospital and Medical School at the University of Tampere Finland found that the rate of Celiac disease among women diagnosed with infertility was 4.1%.  The researchers believe that women that aren’t following a gluten-free diet have a shortened reproductive period and early menopause.  Males with Celiac disease have shown gonadal dysfunction, which could also contribute to fertility complications.

Another study has been conducted at Molinette Hospital in Turin Italy to find the link between Celiac disease and infertility.  Their early reports suggest that the prevalence of Celiac disease among women with unexplained infertility is 2.5% to 3.5% higher than non-celiacs.  They suggest that Celiac disease represents a risk for abortion, low birth weight babies and short breast-feeding periods, all of which can be corrected with a gluten-free diet. (NFCA)

One theory as to why women with Celiac disease can’t get pregnant is that because if you’ve got Celiac, you’re malnourished.  The body isn’t able to absorb the nutrients, therefore causing the malnourishment and now they’re looking at that being one of the contributing factors that women with Celiac are not able to get pregnant.

While a lot of people feel that there is a positive correlation between Celiac disease and infertility, there’s not a lot of information readily available that states HOW.  Just that the statistics and studies show, as mentioned above, that there seems to definitely be a connection.

In an article on Celiac.com titled “Fertility and Pregnancy in Women with Celiac Disease” by Michelle Melin-Rogovin, the author talks about a study that was done at the University Chicago for the Celiac Disease Program.  She states that four to eight percent of women that come in with Celiac disease, also have unexplained infertility.  While the unexplained infertility can be treated with a gluten-free diet, they also showed that there are often times other factors other than malnutrition that resulted in the infertility such as delayed start of the menstrual cycle and early menopause.

At the University Chicago Celiac Disease Program, they did two large case control studies where they examined the delayed menstrual cycles, early menopause, and amenorrhea in women with Celiac.  What they found was that the women that were not on a gluten-free diet started their periods a year and a half later than women with Celiac disease that were gluten-free.  As well, they found that 39% of women that were not gluten-free experienced amenorrhea compared to the nine percent of women who were gluten-free.  Also, they found that the women with Celiac disease that were not on a gluten-free diet started menopause four to five years earlier that the Celiac women that were gluten-free.

The researchers at the University of Chicago program also looked at the infertile women and found that they tested positive for the Celiac disease-related antibodies at a rate that is ten times higher than the general population.  If an infertile woman was diagnosed with Celiac, she was not always deficient in the needed vitamins or nutrients, which then showed the researchers that there were other Celiac disease-related explanations for their infertility. (Melin-Rogovin, 1996)

Celiac doesn’t only cause infertility in women, but also in men.  Something that was interesting to me is a question that someone posed in a forum on Celiac.com.  The question was regarding gluten in the sperm of a non-celiac affecting the fertility of a woman with Celiac.  The people that responded didn’t think that there could be gluten in the sperm but that it was more likely that the man actually had Celiac which was just undiagnosed, and that was causing the infertility for the couple.

According to an article on PubMed Central, there was a study done on men to see if those with Celiac disease and Crohn’s disease had decreased gonadal function, sexual dysfunction, and infertility and to determine their semen quality.  They tested 28 men with Celiac and compared their results to 19 men with Crohn’s.  Two of the 28 Celiacs had clinical evidence of hypogonadism but impotence and decreased sexual activity was more common, the latter apparently improving after going gluten-free.  Of those tested, 19% that were married, had infertile marriages.  After seminal analysis, it was discovered that the men with Celiac had abnormalities of the morphology and motility in their sperm, but only the morphology improved after going gluten-free.  There’s a bit more to the study, but this is the gist of it: The pathogenesis of infertility and sexual dysfunction in Celiac disease remains unclear, suggesting that factors such as endocrine dysfunction or other specific nutritional deficiency may be involved. (PubMed Central)

Crohn’s disease is very similar to Ulcerative Colitis, which my husband has been diagnosed with so the above study was interesting to me as well as the connection between it, Celiac and infertility in men.

The thing with Celiac disease is that because it is an autoimmune disease, there is no getting rid of it.  The only way to make it go completely dormant and to reduce the effects on your body is to introduce a 100% gluten-free diet into your life.  Once a person knows about Celiac, they are better equipped to do something about it.  For me, it intimidates me because it is changing your entire way of eating.  So many things you wouldn’t think have gluten do.  Some medications, for instance, have gluten and the powder on gum; toothpaste, shampoos and conditioners.  The idea of switching everything that you know (and love) around to accommodate a gluten-free lifestyle is just daunting.  People do it every day, though.

In my case, if I decided that my husband and I are going to live a gluten-free life, at least we’ve got family members that can help us along the way.  We’ll have to learn how to eat out differently, cook and bake differently.  It can be done, it’s just going to take a while to learn what we can and cannot have.  But if in the end, we end up overcoming our infertility, it will all be worth it.  Now, we just have to make the decision to do it and stick with it.

Celiac.com

Michelle Melin-Rogovin (1996). Fertility and Pregnancy in Women with Celiac Disease. Retrieved from http://www.celiac.com/articles/643/1/Fertility-and-Pregnancy-in-Women-with-Celiac-Disease-by-Michelle-Melin-Rogovin/Page1.html.

Celiac Disease Foundation
http://www.celiac.org/index.php?option=com_content&view=article&id=6&Itemid=25

National Foundation for Celiac Awareness (NFCA)

http://www.celiaccentral.org/Celiac-Disease/21/?gclid=CPS45sbooqMCFQkjawod_wdi2w

PubMed Central

M J G Farthing, C R W Edwards, L H Rees, and A M Dawson (1982). Male gonadal function in coeliac disease: 1. Sexual dysfunction, infertility, and semen quality. Gut. 1982 July; 23(7): 608–614.  Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1419778/

 

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Comments

  1. I say go gluten free and see what happens! If your family members do it than it will be much easier. Spend a month collecting recipes, brands of toothpaste etc and then go for it. The worst that can happen is nothing so why not? Good luck!

  2. This was super-informative. It never occurred to me that a person could have celiac’s WITHOUT symptoms. I certainly have enough medical explanations for my IF that I don’t need to go looking for more, but I will be thinking about this.

  3. Most informative! Thanks. My mother in law suggested gluten-free a while back, but I was very skeptical, so I decided to get a blood test (one of the first steps you can take). To my shock, I have a gluten sensitivity. As you probably know, Celiac cannot be positively confirmed without surgery and looking inside of your intestines. So, nearly 5 months ago, I decided to go gluten free. The first two weeks were TORTURE. It is still extremely hard. Like you, I have no symptoms, so it seems silly to give up the foods I love. Now, the diet is mostly just something that I’m tolerating. We are doing an embryo adoption transfer next month, and I told myself I would do the diet until the transfer(s) to see if it works. If they don’t, the first thing I want is a peanut butter sandwich!
    Let me know if you have any questions — but it sounds like you’ve armed yourself with lots of research, knowledge, and people who are living gluten-free.
    I’m at tyghbritneybrae.blogspot.com
    Take care!

  4. This is a very is a super informative post! I was just recently (May) diagnosed with Celiac and wonder if it didn’t play a role in my infertility (as well as my endo). So while I’m still adjusting to a gluten-free lifestyle, there are definitely a lot more options out there (than say even 10 years ago!).

  5. megan – i know you and i talked about this a while ago and i can not tell you enough how happy i am that you are seriously considering doing this. maybe i’m crazy but i didn’t think it was hard at all. yes, going out to eat can be a pain in the butt – but that’s such a small price to pay. we’ve been gf now for five months – it’s been life changing for me – and we got my hubby tested because he is the one who has some IF issues that are unexplained. i no longer have mood swings, bloating, gas, stuffy nose – i really believe i should have been the one that got tested. oh – and i lost 30lbs – not kidding! i feel a million times better and i don’t ever see myself going back – i accidently had gluten and i got so sick. it’s worth it…. and if a baby comes out of it – wowza 🙂

  6. Very informative! I checked into infertility and gluten a while back because of the infertility, miscarriages, and missed periods. I also have abdominal pain, but it’s gone down since then.

    I always wondered if I was gluten intolerant, guess I should get tested to confirm! I agree though, changing to gluten free has to be tough but you do what you need to do sometimes!

  7. I found the link between men with Celiac and infertility very interesting. I’d never thought about it from that angle!

    Going gluten free is difficult at first, but it doesn’t remain horrible. I now know what I can eat and what I can’t – even if I don’t have an ingredients list I can usually make an accurate guess if something is safe for me to eat or not. I can find gluten free alternatives to almost all of my favorite foods (Garlic Jim’s, which can be found all along Western Washington and Oregon, serves a fantastic gluten free pizza) and once you figure out what to eat and where to find it, living gluten free becomes just as pleasant (if not more so) than living with gluten.

    I made a lazy start of it – for the first month, I was so confused about what to eat so every meal was a variety of fruits, vegetables, salads, nuts… only items that were completely and naturally gluten free. Then I started adding in a few packaged foods – but nothing with more than ten ingredients (I made the rule because I was spending way too much time reading labels and grocery shopping took me FOREVER, but I stuck with it because I realized that when more ingredients were listed, it was usually just a lot of very questionable preservatives… and I don’t want to eat those anyway).

    A tip: be sure to keep the ‘treats’ you love on hand (the gluten free kind) during the first few months, like cookies or pizza crusts – that way you will be less tempted to cheat. And with Celiac, it’s very, very important not to cheat because even a little bit of gluten causes instant damage to the intestine.

    I promise, it becomes pretty easy – even Mike has a good feel for what’s gluten free and what isn’t – and that’s just from living and eating with me.

  8. Very interesting. I had never even heard of it until a girl I went to high school with talked about her and her daughter having it. She also had a hard time conceiving until she got hers under control and her daughter was just recently diagnosed with it. Its definitely worth trying to go gluten free to see if that makes any difference for you.

  9. Megan,

    I am a diagnosed Celiac x 2 years. I have suffered from reproductive issues since puberty. As a teenager, I had so many test done with nothing showing that I had any problems except that I was overweight.

    I have been diagnosed with Polycystic Ovarian Disease as well but between the metformin and the gluten free diet my body has finally started to work correctly! With my first comfirmation that I am ovulating!

    Good luck with everything!

  10. Wow! Very interesting and informative. I have never heard of this before. I will have to check it out. I have IC, so I have already had to change my diet for that, so looking into changing it even more could be hard, but not really that big of a deal, since I am already used to eating a restricted diet. Plus if there is any possibility it could be playing a part in my infertility issues it is worth the work for sure!!
    Hope this helps with your infertility issues!! I will be excited to see what happens…

  11. If anyone wants to have the first step to Celiac disease testing done and lives near Chicago, the University of Chicago Celiac Foundation does an annual testing in October for free. Here is the web link….call soon as it does fill up. You have to be eating gluten though to have an accurate test done. http://www.celiacdisease.net/free-blood-screening

  12. Wow, Megan-this one sure scored a lot of “discussion.” Great job on all of the research. Sounds like a worthwhile endeavor. -Eastlyn

  13. Megan, I have Cealiacs, I was infertal. for me it is too late to have a baby. Had I know that something as simple (yes I said simple) as going gluten free could have helped in any way even the tinyest bit I would have done it in a heartbeat. Going gluten free not only may help wth infertility and I believe with all my heart that it will, it can also save your life and give you a healthy future. That is something I also wish I had I know earlier. I have had a large portion of my colon removed due to problems and havoc reaked on my body from cealics. The diet and life style change is the easy part believe me. Living life in pain and wanting a child is much harder. Don’t wait for a Dr to diagnose you. You may be waiting forever… trust me sometimes iCealiacs is hard to find and they just don’t beleive you have it. Best of luck to you.

  14. Great post. Nice to see someone bringing attention gluten and fertility issues. Thought I would share the love and give another resource:
    http://www.glutenfreesociety.org/gluten-free-society-blog/gluten-intolerance-causes-infertility/

  15. My son has asperger’s and lots of people have recommended a gluten free diet to us for that too so we may be trying it soon too.

  16. I can relate VERY well to this post. I have autoimmune (systemic) disease and I am sterile (officially…had to have uterine surgery in January at age 31). I wish you well and hope you get to the bottom of your infertility issues. I have a friend who tried for 10.5 years to get pregnant…over a decade! And she finally did! 🙂 🙂 🙂 I hope that encourages you on your journey. God bless!

  17. Although celiac disease is a gluten allergy, it is only one form of gluten allergy. Many react to gluten and may have elevated serum antigliadin antibodies, but they do not have damage to the small intestine. These people have a negative biopsy of the small intestine, as well as negative antiendomysial antibody and tissue transglutaminase tests.
    celiac disease symptoms

  18. have you been tested? The only reason I ask is that you can’t really be tested once you’ve eaten GF for a period of time.

    I’ve been diagnosed 6 years. I was so sick and anemic during my first pregnancy. I was hospitalized and had blood transfusions. That’s why they decided to test. Just yesterday I had my two daughters genetically tested. They have been tested for the disease before (negative), but with the genetic test, I will know whether I should watch them or if it’s not even a possibility for them.

    Hope this helps with the infertility!!!

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