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    The Celiac Disease and Reproductive Health Connection


    Destiny Stone

    Celiac.com 08/16/2010 - There have been a number of studies connecting celiac disease with  impairments in women's reproductive health, including such disorders as infertility, delayed puberty, amenorrhea, and early menopause. Associations between celiac disease and oligomenorrhea, hypomenorrhea, metrorrhagia, and dysmenorrhea have also been observed.


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    In 2008, a case-controlled study in Italy was executed to determine the association between female reproductive health and celiac disease. The study evaluated 62 celiac women, and 186 healthy control patients between the ages of 15 and 49.

    Of the celiac women evaluated, the average age when diagnosed with celiac disease was about 24 years old. Most of the women, 69.3% exhibited a bloated stomach, 61.3% exhibited anemia, 51.6% exhibited weight loss, 40.3%  exhibited diarrhea, and 17.7% exhibited vomiting as their main symptom during onset of celiac disease. 40.3% of the women evaluated claimed to have other symptoms at the time they were diagnosed for celiac disease, including menstrual cycle disorders.

    Of the celiac women evaluated, 47.6% reported that they noticed the onset of their menstrual cycle disorders before they noticed any other classic celiac symptoms, 28.6% noticed the onset of the menstrual symptoms after the  other celiac related symptoms presented, and 19% noticed menstrual problems at the same time as other celiac symptoms.  19.4% of celiac women exhibited menstrual disorders.

    Exactly 50% of the celiac women tested and 50% of the controls tested had been pregnant at least once prior to entering the study. Celiac women reported 63 total pregnancies and 49 of those were brought to full term. The control group reported 203 pregnancies with 179 brought to full term. While only 11.8% of the control groups pregnancies ended in miscarriages, 22.2% of the women with celiac disease had miscarriages.

    Additionally, the average birth rate of the children born from the celiac mothers was lower than the birth rate of the control group babies.

    This study confirmed the association between celiac disease and pregnancy disorders. However, there have not been enough studies yet to determine the exact correlation between celiac disease and female related reproductive issues.

    It has been hypothesized that the connection  might be due to the fact that celiac disease can cause malabsorbtion and therefor malnutrition in some individuals, which could possibly play a role in ovarian dysfunction. Although from this study and others, the connection between celiac disease and reproductive disorders has been demonstrated to be significant enough that women exhibiting reproductive issues are recommended to undergo celiac screenings.

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    Were the celiac women in this study following a gluten free diet?

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    Guest atieh ghavamiadel

    Posted

    when I got pregnant, at 30, I suffered sever asthma, with no past history of that, and I got relieved after delivery. 15 years later I diagnosed with celiac. I never tried for another pregnancy.

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    I want to know weather the tested women were on gluten free diet or not, if you are on gluten free diet still you face such type of disorders?

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    Guest Teresa

    Posted

    Would love to know if one follows a gluten free diet, if these symptoms will still be an issue during pregnancy. I was diagnosed this past February with celiac disease. It's been a struggle to maintain a healthy weight (still under weight). I also have a thyroid disorder that was diagnosed last year, for the first time (underactive). I am in my mid-30's and do not have any children. I would like to start a family within the next year. But I want to be sure that the baby will not be negatively affected by my condition.

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  • About Me

    I diagnosed myself for gluten intolerance after a lifetime of bizarre, seemingly unrelated afflictions. If my doctors had their way, I would have already undergone neck surgery, still be on 3 different inhalers for asthma, be vomiting daily and having chronic panic attacks. However, since eliminating gluten from my diet in May 2009, I no longer suffer from any of those things. Even with the proof in the pudding (or gluten) my doctors now want me to ingest gluten to test for celiac-no can do.

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  • Related Articles

    Michelle Melin-Rogovin
    This article originally appeared in the Autumn 2002 edition of Celiac.coms Scott-Free newsletter.

    At the University of Chicago Celiac Disease Program, women with celiac disease who have recently become pregnant often contact us. Remarkably, the questions we receive from these women seldom stray from one issue, that is, whether or not to maintain a gluten-free diet while pregnant. Most women mistakenly believe that the gluten-free diet will deprive their developing fetus with the nutrients it needs, and hurt the growing baby. In fact, for a pregnant woman with celiac disease, remaining ON the gluten-free diet is the best and only option for the health of mother and child. The gluten-free diet provides pregnant women and their babies with all of the nutrients they need to grow and be healthy.
    Fortunately, for all concerned, there have been excellent research studies on fertility, pregnancy and celiac disease conducted by top-notch investigators around the world. While this important research has mainly focused on women, it is important to note that researchers have established (since the 1950s) that men also suffer from infertility due to undiagnosed celiac disease.
    Celiac Disease and Fertility
    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.
    Celiac Disease and Pregnancy
    Researchers have also studied the effect of the gluten-free diet in pregnant women with celiac disease, in order to determine any impact on the developing fetus and the pregnancy outcome. In a study of 25 patients and 60 pregnancies researchers found that 21% of women who were not on the gluten-free diet experienced pregnancy loss, and 16% of women experienced fetal growth restriction. Researchers also remarked, however, that successful pregnancies occurred before and after diagnoses for many women in the study.
    In a large Danish study with 211 infants and 127 mothers with celiac disease, researchers found that the mean birth weight of children born to mothers on a gluten-containing diet was significantly lower than babies born to mothers without celiac disease. Interestingly, this same study determined that women on the gluten-free diet gave birth to children weighing more than those born to mothers without celiac disease!
    In a case-control study that looked at the effect of the gluten-free diet on pregnancy and lactation, investigators learned that women with celiac disease who were not on the gluten-free diet experienced pregnancy loss at a rate of 17.8%, compared to 2.4% of women with celiac disease who were on the gluten-free diet. These researchers found that there was no difference in the occurrence of pregnancy and fertility problems in women with sub-clinical (positive blood test, negative biopsy) or clinical disease (positive blood test, positive biopsy).
    Finally, in a group of women with celiac disease who had been pregnant more than once, researchers looked at the effect of the gluten-free diet on their future pregnancies. They concluded that the institution of the gluten-free diet upon diagnosis caused a relative 35.6% drop in pregnancy loss, 29.4% drop in low-birth weight babies and an increase of two and a half months of breastfeeding.
    While the malabsorption of nutrients is not the only cause of fertility and pregnancy-related problems for women with celiac disease, the gluten-free diet is essential to improving the health of women and their babies.


    Scott Adams
    Gastroenterology, 2005; 128: 849-855
    Celiac.com 04/29/2005 – In contrast to previous studies, the findings of a study by researchers in the United Kingdom indicate that women with celiac disease do not have an increased risk of infertility. Their study compared computerized primary care data on 1,521 women with celiac disease, and, unlike past studies, compared that data with 7,732 age and practice-matched women without celiac disease. They found that fertility rates were 48.2 live births per 1,000 person-years for women without celiac disease, while those with the disease had 47.7 live births. Interestingly the researchers found that women with celiac disease had lower fertility rates when they were younger, and higher rates when they were older, compared to the non-celiac group, and the increase in fertility seen in older women with the disease was not affected by whether they were on a gluten-containing vs. gluten-free diet. The researchers noted a slightly higher risk of miscarriage and delivery by cesarean section in the group of women with celiac disease, while all other negative outcomes occurred at a level similar to that of the healthy control group. The researchers conclude that women with celiac disease have similar fertility rates to that of the normal female population, and they tend to have their babies at an older age.

    Scott Adams
    Gastroenterology, Volume 129, Issue 2, Pages 454-463 (August 2005) Celiac.com 08/11/2005 - A large study by Swedish and American researchers has determined that untreated celiac disease is associated with an increased risk of adverse fetal outcome. In contrast to several small studies that have been done in the past that produced conflicting results, this study looked at 2,078 births to women who were diagnosed with celiac disease—1,149 were diagnosed prior to their child’s birth, while 929 were diagnosed after. The researches employed a national register-based cohort study (1964-2001) that was restricted to women between 15-44 years old who had a single live birth. The researchers measured intrauterine growth retardation, low birth weight, very low birth weight, preterm birth, very preterm birth and birth by caesarean section for each child in the study.
    The results of the study indicate that undiagnosed celiac disease is associated with an increased risk of intrauterine growth retardation (OR = 1.62; 95% CI: 1.22-2.15), low birth weight (OR = 2.13; 95% CI: 1.66-2.75), very low birth weight (OR =2.45; 95% CI: 1.35-4.43), preterm birth (OR = 1.71; 95% CI: 1.35-2.17), and caesarean section (OR = 1.82; 95% CI: 1.27-2.60). In contrast, those diagnosed with celiac disease before their births were not at increased risk for these adverse fetal outcomes.
    The researchers conclude that undiagnosed celiac disease increases the risk of unfavorable fetal outcomes—a risk that is reduced in those with diagnosed celiac disease, presumably because they have been treated with a gluten-free diet.

    Jefferson Adams
    Celiac.com 01/17/2011 - Women with latent celiac disease, those who test positive for celiac antibodies but show normal small bowel biopsies, may develop more reproductive problems, according to a report by Indian published in the World Journal of Gastroenterology.
    "Women having unexplained infertility, recurrent abortions, stillbirths or intrauterine growth retardation could have subclinical celiac disease, which can be detected by serological screening tests," Dr. Ashok Kumar told Reuters Health by email.
    Improved diagnostic tools, and greater access to screening have led to greater meant more latent or subclinical celiac disease, says Dr. Kumar, of Maulana Azad Medical College & Lok Nayak Hospital in New Delhi.
    Doctors know that women with full, biopsy-proven, untreated celiac disease have more reproductive problems if they don't follow a gluten-free diet.
    Until now, there have been "very few studies regarding the effect of latent celiac disease on reproductive performance; the association has never before been investigated in India," say the authors.
    To study the effect of latent celiac disease on reproductive performance, the researchers examined 893 women.
    They found that a total of 104 women had undergone idiopathic recurrent abortion, 104 had unexplained stillbirth, 230 had unexplained infertility, and 150 were pregnant, but showed idiopathic intrauterine growth restriction. The remaining 305 women, with normal obstetric histories, and served as control subjects.
    Based on IgA tTG antibody titers, latent celiac disease was 5.43 times more common in the group with recurrent spontaneous abortion than in the control group.
    Rates of latent celiac disease for the group with stillbirth were 4.61 times greater than the control group.
    Rates for the group with intrauterine growth restriction were 7.75 times greater than control subjects, while rates for those with unexplained infertility were 4.51 higher.
    The researchers also found that women with positive blood screens showed higher rates of  previous early births, low-weight births, and cesarean sections than did seronegative subjects.
    Not every study shows a clear reduction in fertility, the researchers admit, but a number do show a higher risk of adverse pregnancy outcomes for women with latent celiac disease.
    Spotting the celiac disease and treating it with a gluten free diet may reduce these associated risks.
    Moreover, the researchers note that "the classic presentation of diarrhea and malabsorption is now less common, and atypical and silent presentations are increasing."
    As a result of their findings, Dr. Kumar and his colleagues are recommending celiac disease blood screens for women with idiopathic cases of poor reproductive performance.
    Source:

    World J Gastroenterol. 2010 Dec 14;16(46):5810-4

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    Jefferson Adams
    Celiac.com 06/21/2018 - Would you buy a house advertised as ‘gluten-free’? Yes, there really is such a house for sale. 
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    Celiac.com 06/20/2018 - Currently, the only way to manage celiac disease is to eliminate gluten from the diet. That could be set to change as clinical trials begin in Australia for a new vaccine that aims to switch off the immune response to gluten. 
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    Source:
    FoodProcessing.com.au

    Jefferson Adams
    Celiac.com 06/19/2018 - Could baking soda help reduce the inflammation and damage caused by autoimmune diseases like rheumatoid arthritis, and celiac disease? Scientists at the Medical College of Georgia at Augusta University say that a daily dose of baking soda may in fact help reduce inflammation and damage caused by autoimmune diseases like rheumatoid arthritis, and celiac disease.
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    The research was funded by the National Institutes of Health.
    Read more at: Sciencedaily.com

    Jefferson Adams
    Celiac.com 06/18/2018 - Celiac disease has been mainly associated with Caucasian populations in Northern Europe, and their descendants in other countries, but new scientific evidence is beginning to challenge that view. Still, the exact global prevalence of celiac disease remains unknown.  To get better data on that issue, a team of researchers recently conducted a comprehensive review and meta-analysis to get a reasonably accurate estimate the global prevalence of celiac disease. 
    The research team included P Singh, A Arora, TA Strand, DA Leffler, C Catassi, PH Green, CP Kelly, V Ahuja, and GK Makharia. They are variously affiliated with the Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Lady Hardinge Medical College, New Delhi, India; Innlandet Hospital Trust, Lillehammer, Norway; Centre for International Health, University of Bergen, Bergen, Norway; Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Gastroenterology Research and Development, Takeda Pharmaceuticals Inc, Cambridge, MA; Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy; Department of Medicine, Columbia University Medical Center, New York, New York; USA Celiac Disease Center, Columbia University Medical Center, New York, New York; and the Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
    For their review, the team searched Medline, PubMed, and EMBASE for the keywords ‘celiac disease,’ ‘celiac,’ ‘tissue transglutaminase antibody,’ ‘anti-endomysium antibody,’ ‘endomysial antibody,’ and ‘prevalence’ for studies published from January 1991 through March 2016. 
    The team cross-referenced each article with the words ‘Asia,’ ‘Europe,’ ‘Africa,’ ‘South America,’ ‘North America,’ and ‘Australia.’ They defined celiac diagnosis based on European Society of Pediatric Gastroenterology, Hepatology, and Nutrition guidelines. The team used 96 articles of 3,843 articles in their final analysis.
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    Rates of celiac disease were 0.4% in South America, 0.5% in Africa and North America, 0.6% in Asia, and 0.8% in Europe and Oceania; the prevalence was 0.6% in female vs 0.4% males. Celiac disease was significantly more common in children than adults.
    This systematic review and meta-analysis showed celiac disease to be reported worldwide. Blood test data shows celiac disease rate of 1.4%, while biopsy data shows 0.7%. The prevalence of celiac disease varies with sex, age, and location. 
    This review demonstrates a need for more comprehensive population-based studies of celiac disease in numerous countries.  The 1.4% rate indicates that there are 91.2 million people worldwide with celiac disease, and 3.9 million are in the U.S.A.
    Source:
    Clin Gastroenterol Hepatol. 2018 Jun;16(6):823-836.e2. doi: 10.1016/j.cgh.2017.06.037.