Fertility and Pregnancy in Women with Celiac Disease
I am currently taking a Holistic Nutrition class and we have a monthly chat session. Last night’s topic was Celiac Disease which until last night, I knew very little about. The instructor mentioned a link between Celiac Disease and infertility so I did some research and found a great article, Fertility and Pregnancy in Women with Celiac Disease by Michelle Melin-Rogovin.
In this very informative article, Melin-Rogovin discusses Celiac Disease in relation with fertility and pregnancy. In the section Celiac Disease and Fertility, she writes
In research studies to date, the incidence of celiac disease in women with unexplained infertility has been estimated at four to eight percent. While a number of studies have demonstrated that unexplained infertility can be successfully treated with the gluten-free diet, others have shown that there are factors other than malabsorption of nutrients that result in infertility, delayed menarche (the start of the menstrual cycle) and early menopause.
In two large case control studies, researchers examined the incidence of delayed menarche, amenorrhea (cessation of the menstrual cycle for short periods of time), and early menopause. Both studies enrolled women with celiac disease who were following the gluten-free diet or eating a gluten-containing diet.
They found that women who were not on the gluten-free diet started their menstrual cycle up to a year and a half later than women with celiac disease who were following the diet. In addition, researchers found that up to 39% of women not on the diet experienced periods of amenorrhea, compared to only nine percent of women who were on the gluten-free diet. As you would expect, women with celiac disease who were not on the gluten-free diet were found to enter menopause four to five years earlier than women with celiac disease who were on the diet.
Researchers who have studied women with infertility have found that they test positive for celiac disease-related antibodies at a rate that is ten-fold higher than the normal population. They have also demonstrated that women with infertility who are diagnosed with celiac disease do not always exhibit iron, B-12, or folate deficiencies, which points to other celiac disease-related explanations for the development of their infertility.
For a description of Celiac Disease, I went to the MayoClinic.com site and this is their definition-
Celiac disease is a digestive condition triggered by consumption of the protein gluten, which is found in bread, pasta, cookies, pizza crust and many other foods containing wheat, barley or rye. Oats may contain gluten as well. When a person with celiac disease eats foods containing gluten, an immune reaction occurs in the small intestine, resulting in damage to the surface of the small intestine and an inability to absorb certain nutrients from food.
Eventually, decreased absorption of nutrients (malabsorption) can cause vitamin deficiencies that deprive your brain, peripheral nervous system, bones, liver and other organs of vital nourishment, which can lead to other illnesses. The decreased nutrient absorption that occurs in celiac disease is especially serious in children, who need proper nutrition to develop and grow.
No treatment can cure celiac disease. However, you can effectively manage celiac disease through changing your diet.
In our class last night some of my fellow students told stories of their children being diagnosed in their teens and one women was telling a story of her 21 year old daughter being tested for it. She also mentioned that in Italy celiac disease is routinely tested for. Another interesting note I learnt is that there can be a variety of symptoms presented which can also confuse the diagnosis.
There is a blood test but it is not reliable. An antibody test is also available but the gold standard for diagnosis is to analyze a biopsy sample.
A DNA test cannot confirm a diagnosis of celiac disease. It can only show whether or not a person has one or both of the currently identified genes that predispose to this disorder. Just because a person has the DQ8 and/or DQ2 gene, it does not mean that celiac disease is inevitable. It just means this person might develop a sensitivity to gluten. A person is extremely unlikely to develop celiac disease if they don’t have either of these genes.
Celiac disease is the most common genetic disease in Europe. In Italy about 1 in 250 people and in Ireland about 1 in 300 people have celiac disease. It is rarely diagnosed in African, Chinese, and Japanese people. In Italy, all children are screened by age 6 so that even asymptomatic disease is caught early. In addition, Italians of any age are tested for the disease as soon as they show symptoms. As a result of this vigilance, the time between when symptoms begin and the disease is diagnosed is usually only 2 to 3 weeks. In the United States, the time between the first symptoms and diagnosis averages about 10 years.
November 7th, 2008 at 7:30 pm
Fertility and Pregnancy in Women with Celiac Disease…
Last night’s topic was Celiac Disease which until last night, I knew very little about. The instructor mentioned a link between Celiac Disease and infertility so I did some research and found a great article, Fertility and Pregnancy in ……