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Celiac.com 04/01/2024 - Recent research has shed light on a concerning correlation between celiac disease and various reproductive disorders in women, emphasizing the importance of awareness and proactive healthcare measures for individuals living with this autoimmune condition. According to a study presented at the 2023 annual meeting of the American College of Gastroenterology by lead researcher Rama Nanah, MD, patients with celiac disease face significantly elevated risks for several female reproductive disorders compared to those without the condition. The study, drawing from the comprehensive TriNetX database, revealed that women with celiac disease have a two times higher risk for endometriosis, three times higher risk for polycystic ovary syndrome (PCOS), and six times higher risk for ovarian dysfunction. The association between celiac disease and female reproductive disorders has been noted in previous studies, but the latest findings add new dimensions to our understanding. Notably, the study uncovered increased rates of PCOS and endometriosis among women with celiac disease, highlighting the urgent need for further investigation into these connections. A Range of Reproductive Health Abnormalities Associated with Celiac Disease The retrospective analysis, which included over 9,000 women with celiac disease and more than 25 million healthy controls, revealed a range of reproductive health abnormalities associated with celiac disease across different age groups. These include menstrual irregularities, delayed menarche, infertility, recurrent pregnancy loss, and pain associated with menstruation. Despite the compelling data, the exact mechanism underlying the association between celiac disease and reproductive disorders remains unclear. Dr. Nanah emphasized that the study did not establish causality, nor did it provide insights into whether adherence to a gluten-free diet could mitigate reproductive risks. While the study underscores the importance of considering undiagnosed celiac disease in women with gynecologic disorders, it also highlights the need for prospective studies to validate these findings and explore potential screening and risk reduction strategies. Benjamin Lebwohl, MD, MS, director of clinical research at the Celiac Disease Center at Columbia University, stressed the importance of future research to further elucidate these associations and inform evidence-based healthcare practices. For individuals living with celiac disease, the study underscores the importance of comprehensive healthcare management that includes regular screenings and discussions about reproductive health. By raising awareness and advancing research in this area, healthcare professionals can better support the unique needs of women with celiac disease, ultimately improving their overall quality of life and well-being. Read more at Gastroendonews.com

Celiac.com 02/07/2020 - Gluten sensitivity during pregnancy can profoundly impact fetal brain development. Gluten is a protein found in wheat, rye, and barley. Many people who have a gluten intolerance may also have other food sensitivities to common antigens like corn, soy, dairy, and sugar. Many times, without a histamine response like hives, people can be blissfully unaware of their food sensitivity. Studies have shown gluten sensitivity destroys brain and nervous tissue more than any other tissue in the body, and is linked to a number of other neurological disorders. (Read my blog Gluten Intolerance Testing for more information about this.) Eating Gluten During Pregnancy May Potentially Put Your Child At Risk Beginning before birth, the left and right hemispheres of the brain develop in stages according to a very sophisticated schedule. Each hemisphere depends on the other to meet its developmental goals within a precise window of time. While in-utero and in early childhood, viruses, infection, and inflammation (such as that from a gluten sensitivity), can throw a wrench in this intricate timing and hinder proper brain development. This sets the stage for a wide range of neurological disorders, attention-deficit/hyperactivity disorder (ADHD), autism, Tourette's syndrome, depression, anxiety, and other childhood brain disorders. Childhood mental disorders now affect one in five children, and the rates are increasing. Wheat Can impact Brain Function There are at least 13 different ways I know of that a gluten sensitivity can impact the brain. Let's look at a couple of the big ones. One mechanism is that there can be elevated antibodies to wheat and the cerebellum and GAD-65. Your cerebellum controls your muscle movements. After years of your body attacking this brain tissue, the brain may shrink. People with GAD-65 antibodies indicate a high trigger for anxiety and ADHD. Another common mechanism is hypoperfusion, a lack of blood flow going to the brain. 73% of people with a sensitivity to wheat have hypoperfusion. Just like your cells need hydration, your brain needs to be saturated. So many people go undiagnosed with a gluten-related disorder for years. Imagine what we are doing to our children (and ourselves) when we eat that bowl of cereal or toast before school or work. We are not able to function optimally. This is why "brain fog" is the most common symptom for people with a sensitivity to wheat. In 2006, a study looked at 132 people with symptoms of ADHD who had a wheat sensitivity. When they put them on a gluten-free diet, the researchers reported markedly significant improvement in all behavioral markers within six months. Gluten sensitivity may also more than double your child's risk of developing schizophrenia later in life. The first study to reveal food sensitivity was linked to a greater risk for psychosis, autism and other brain disorders in the child. Researchers looked at blood samples of nearly 800 individuals born in Sweden between 1975 and 1985. What did they find? People with schizophrenia had high levels of gluten antibodies in their blood at birth - meaning a gluten sensitivity was passed from mother to child. You Might Have an Undiagnosed Gluten Sensitivity Awareness is growing as rates of celiac disease, an intestinal autoimmune disease caused by gluten, have quadrupled in the last 50 years. The numbers could be much higher. In fact, it's estimated that 95 percent of those with celiac disease go undiagnosed. Researchers also estimate the numbers of people with gluten sensitivity — a non-celiac inflammatory reaction to gluten — range from 10 to 30 percent of the population. During Pregnancy, Mom's Gluten Sensitivity May Affect Her Baby's Brain If you look at the current explosion in inflammatory disorders today, the rise of these brain-based disorders is less of a mystery. Immune-activated mothers are giving birth to immune-activated babies. If you can, don't wait until pregnancy to look into food sensitivities. Every woman needs to consider a screen for gluten sensitivity. Look for anti-gliadin antibodies and, if that test comes back positive, go on a gluten-free diet. We don't know at which point during pregnancy a mother's gluten sensitivity impacts the fetal brain, but we do know the baby's brain and nervous system begin developing in the first trimester. Although the association between a mother's gluten sensitivity and the baby's increased risk of psychosis as an adult is not yet fully understood, it makes sense to err on the side of caution. "During My Pregnancy, I Didn't Get Nauseous. I Must Not Have Gluten Sensitivity, Right?" Not Necessarily. A lack of gut symptoms doesn't mean you're in the clear. Everyone reacts differently to gluten sensitivity. One person can have chronic skin rashes, another may have joint pain, and a third brain fog. In fact, research suggests the majority of people with gluten sensitivity have no gastrointestinal symptoms whatsoever. For every person with gut symptoms caused by gluten, there will be eight who have none, despite there being a gluten sensitivity present. An undiagnosed gluten sensitivity during pregnancy is in no way a guarantee that your child will develop schizophrenia or other brain disorders either. However, when an expectant mother produces autoimmune antibodies to brain tissue, 86% of their children are on the autism spectrum. If mom has an autoimmune mechanism going on inside her body, it can affect the baby. One of the most common food sensitivities associated with neurologic problems is wheat. Only a fraction of people who have a problem with wheat have celiac. Many more have gluten sensitivity. Many women —and men—may be better off on a gluten-free diet even though they do not have celiac disease. How do you reduce antibodies? First, screen for antibodies against the brain. Two great tools for screening are the Cyrex Array #5 and the Neural Zoomer. If you are producing antibodies, you need to eliminate the trigger(s). The goal is to stop the autoimmune cascade, particularly during pregnancy when the fetus is developing its entire body and establishing its own immune system that will set him or her up for life. Bacterial Colonies Change in the Vaginal Tract During Pregnancy In the last trimester of pregnancy, the bacterial colonies in the vaginal tract change completely to the point that there's a very high count of prevotella [bacteria]. Most of the time, there are practically no prevotella that are measurable in the vaginal tract at all. The change in the last trimester occurs because the prevotella is the substance that coats the baby as it comes down the birth canal. Prevotella migrates through the baby's nasal cavity and its mouth and goes down to turn on the genes in the gastrointestinal (GI) tract. These genes say, "Okay, this is the mammal that is going to start feeding you. Here are the codes for the protein that's about to come to you for food." The baby's digestive tract then starts turning on the digestive enzyme production capability for the specific proteins that are encoded in the prevotella bacteria. My Personal Story When we were first married, my ex-wife and I, despite all efforts, could not get pregnant. I was an intern at the time, and I called the seven most famous doctors I'd ever heard of, holistic doctors, and asked, "What can we do?" Because I was an intern, they asked, "Do you know this?" "Do you know that?" I'd say, "No." And they would respond: "Learn." So I put a program together, and we were pregnant in six weeks. A lot of people know that this began my study of gluten and the many effects it has on the body. Since then, I've helped hundreds of couples with infertility, recurrent miscarriages, and hormonal imbalances. There's not much in medicine that's all or every, but this is an every. What we learned early was that every person with hormone-related symptoms, whether it was infertility, miscarriages, estrogen dominance, testosterone deficiency, all of them, when tested properly, had a sensitivity to foods that they were eating — foods that they did not know were making them sick. When you eat a food that you're sensitive to, it triggers inflammation in the body. The immune system responds to try to protect you from something it considers an invader, and it creates an inflammatory reaction. I have said this so many times over the years: "Ms. Patient. If you pull at a chain, the chain always breaks at the weakest link. So, the first thing to do is to learn what's pulling on the chain." We found out something amazing... Food Sensitivities Were a Component Every Time Often there were more, but it was an important component. I found that the most frequent food sensitivity was wheat. So I started reading the literature on wheat way back in 1980. Our daughter was also born in 1980, and I started talking about it shortly thereafter because the studies were blowing me away. By 2004, I was lecturing professionally onstage about wheat sensitivities with or without celiac disease. That progressed and progressed until 2008, when a nutritional company called Metagenics sponsored me to go around the world. I went to 26 different cities and gave full eight-hour presentations on wheat sensitivity. The presentation dropped everybody's jaw. No one had ever seen these studies about different types of spondyloarthropathy, rheumatoid arthritis, psoriasis, multiple sclerosis, attention deficit disorder, autism, or Alzheimer's and how it would benefit some of those people just by getting off of wheat. They started to get better, sometimes dramatically, but often to some degree. In 2009, I did the same 26 cities for a full eight-hour presentation on the development of autoimmunity. What triggers the development of autoimmunity? And what do you do to address autoimmunity? It was infertility, successfully addressed by looking at food sensitivities and a couple of other things that led me into learning about wheat sensitivity; gluten sensitivity; and the trigger of intestinal permeability. For example, in the United States, 78% of the prebiotic diet is wheat. If you take wheat out of your diet, which is a very important thing, what you're also taking out is the major source of your prebiotics. And prebiotics feed probiotics, which are the good bacteria in your gut. If you take wheat out of your diet without the right education or mentorship, you lose the main prebiotic source, and, as a result, probiotics in your gut (the good bacteria that need that food) start starving. Some probiotics begin to die off, and the bad guys in your gut that have been kept in check to some degree by those probiotics now become opportunistic and rear their ugly heads. This is why it is so helpful to find a certified gluten-free practitioner or nutritionist when you are on a gluten-free diet: This is especially important before and during pregnancy. You want to prepare your body to be free of antibodies prior to conception, and you want the proper nutrition to support both you and a developing baby.

Celiac.com 09/01/2018 - Celiac disease is a common disease triggered by gliadin exposure in genetically sensitive individuals. It has long been known that untreated celiac disease is associated with intestinal malabsorption, but it is also associated with ongoing inflammation. This inflammation may have adverse effects on the uptake of important nutrients. This is probably the underlying reason for the increased risk of osteoporosis demonstrated in patients with celiac disease. Malabsorption and ongoing inflammation in untreated celiac disease could also potentially have a negative effect on fetal development. Several reports have indicated an adverse effect of untreated celiac disease on pregnancy outcome. We set out to use the national registers of Sweden to: Evaluate the association of untreated celiac disease and birth weight, pregnancy duration and intrauterine growth. Evaluate the same association in treated celiac disease. Compare the risk of the above two groups with a reference group of 2.8 million births to mothers who never had a diagnosis of celiac disease. A fourth objective was to evaluate placental weight to see if lower placental weight was more frequent in women with celiac disease. We found that untreated celiac disease (women diagnosed after pregnancy, but most likely having untreated celiac disease at time of pregnancy) was associated with a two-fold risk of low birth weight, pre-term birth, intrauterine growth retardation and cesarean section. The low birth weight and intrauterine growth retardation may have been mediated through malabsorption, since placental weight was lowest in women with untreated celiac disease. This study was published in Gastroenterology Aug 2005. A link to this paper can be found here: gastrojournal.org After that we set out to evaluate the association between adverse pregnancy outcome in males with untreated and treated celiac disease. In a previous paper, we had found an increased risk of adverse pregnancy outcome when the father had celiac disease (Ludvigsson et al, Gut, 2001). Now, taking advantage of the large Swedish national registers (all births since 1973 and onwards are recorded), we found no increased risk of low birth weight, pre-term birth or cesarean section in infants to fathers with untreated or treated celiac disease. This study was published in the Scandinavian Journal of Gastroenterology in Feb 2006.

Celiac.com 08/16/2016 - The short answer, yes! Although some women, due to certain complications are told not to exercise, for the most part exercise is totally fine while pregnant and actually quite a valid implementation to a healthy pregnancy. There used to be this myth that women had to be extremely careful with physical activity while pregnant due to the risk of possible miscarriage. Now we see pregnant women doing CrossFit, running, lifting weights, etc., as well as all sorts of beautiful yoga poses. This doesn't mean that if you haven’t worked out in 5 years and are pregnant you should suddenly start running 12 hours a day. No, not at all. On the other hand, if you have kept up a normal exercise routine it is totally fine to keep it up. Listen to your own body and understand things may feel different so don’t push yourself too much. I worked out plenty before getting pregnant and continued my many normal activities up until around 7 months. At that point I was very round and more tired than usual and going for regular walks, swimming and yoga was plenty enough "exercise" for me. I am celiac and I maintained my gluten-free diet during my pregnancy. I felt it was extremely important for me to be as healthy as I could so my body would feel good and therefore make my pregnancy that much easier. I have read that exercising throughout one's pregnancy can possibly shorten the labor too. Now this is a win-win in my eyes! The benefits of exercising while pregnant also include a lower risk of getting sick, lower risk of gestational diabetes, lower risk of depression and the list goes on. Plus, you can work on that lower core and strengthen your pelvis which will help a lot with back pains and hip issues that are all too familiar to pregnant women. Ask your OB-GYN or midwife for approval and once you get the green light go have some fun. You are more than likely to meet some other wonderful "future" moms, many of which are also looking to connect up and make friends. This is also a perfect opportunity to help other moms who may have some "odd symptoms", and if you are well-versed in the gluten-free diet and the symptoms of gluten sensitivity or intolerance, you can help another woman in need, hence her future baby. Moms uniting and sharing their tested knowledge is a lovely aspect of pregnancy these days. I hope this has inspired you and please feel free to contact me at any time with any questions. I focus on the gluten-free diet as well as the grain free diet, celiac disease, motherhood, and children issues. These are all subjects that I'm very passionate about.

Celiac.com 06/12/2013 - Pregnant women with higher levels of issue transglutaminase (anti-tTG), an antibody common in people with celiac disease, at risk for low fetal and birth weight in their babies, according to a new study in Gastroenterology. A number of studies before this one have confirmed an association between celiac disease and poor growth fetus growth, but very little study had been done as to how the level of celiac disease might affect fetal growth, birth weight or birth outcome. In an effort to better understand how the level of celiac disease affects fetal growth, birth weight, and birth outcome, a team of researchers set out to assess the associations between levels of antibodies against tissue transglutaminase (anti-tTG, a celiac disease marker) and fetal growth and birth outcomes for pregnant women. The research team included J.C. Kiefte-de Jong, V.W. Jaddoe, A.G. Uitterlinden, E. A. Steegers, S.P. Willemsen, A. Hofman, H.Hooijkaas, and H.A. Moll of the Generation R Study Group at Erasmus University Medical Center in Rotterdam, The Netherlands. They conducted a population-based prospective birth cohort study of 7046 pregnant women. Serum samples were collected during the second trimester of pregnancy and analyzed for levels of anti-tTG. Based on these levels, they grouped each woman into groups of negative anti-tTG (≤0.79 U/mL; n = 6702), intermediate anti-tTG (0.8 to ≤6 U/mL; n = 308), or high anti-tTG individuals (over 6 U/mL; n = 36). They then collected data for fetal growth and birth outcomes from ultrasound measurements and medical records. The fetal growth data showed that, on average, fetuses of women in the positive anti-tTG group were 16 g lighter than those of women in the negative anti-tTG group (95% confidence interval [CI], -32 to -1 g) during the second trimester and weighed 74 g less (95% CI, -140 to -8 g) during the third trimester. The birth outcome data revealed that newborns of women in the intermediate and positive anti-tTG groups weighed 53 g (95% CI, -106 to -1 g) and 159 g (95% CI, -316 to -1 g) less at birth, respectively, than those of women in the negative anti-tTG group. Of mothers in the intermediate anti-tTG group, those with HLA-DQ2 or -DQ8 had reduced birth weights that were double those of mothers without HLA-DQ2 or -DQ8. This study led the researchers to conclude that levels of anti-tTG in pregnant women are inversely associated with fetal growth. The higher the anti-tTG in women, the lower the birth weights of their babies. So, women with the highest levels of anti-tTG (over 6 U/mL) saw the greatest reduction in birth weight of their babies. Also, women with intermediate levels of anti-tTG (0.8 to ≤6 U/mL) saw lower birth weights that were even further reduced if they carried the HLA-DQ2 and -DQ8 gene markers. Source: Gastroenterology. 2013 Apr;144(4):726-735.e2. doi: 10.1053/j.gastro.2013.01.003.