Miscarriage and coeliac disease

[Painful5]

Has anyone with celiac disease that is fully controlled suffered single or repeated early miscarriage and found it was related to coeliac despite having totally avoided gluten for several years

[knitty kitty]

@Painful5,

Welcome to the forum! 

We can have an immaculately gluten free diet for years, but until we address and correct the nutritional deficiencies inherit in Celiac Disease, our CeD is not "fully controlled".

Gluten free diets can be notoriously lacking in essential vitamins and minerals necessary for a successful pregnancy.  Additionally, malabsorption due to intestinal damage caused by the autoimmune reaction in CeD must be addressed.

Nutritional status of the mother prior to getting pregnant is as important as the mother's nutritional status throughout the pregnancy.  

Let's learn more about nutrition...

Evidence based recommendations for an optimal prenatal supplement for women in the US: vitamins and related nutrients

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275129/

And...

Vitamin D insufficiency as a risk factor for reproductive losses in miscarriage

https://pubmed.ncbi.nlm.nih.gov/34937516/

And...

Vitamin B3 levels in women who experience first-trimester miscarriage

https://pubmed.ncbi.nlm.nih.gov/33866568/

 

[Painful5]

1 hour ago, knitty kitty said:

@Painful5,

Welcome to the forum! 

We can have an immaculately gluten free diet for years, but until we address and correct the nutritional deficiencies inherit in Celiac Disease, our CeD is not "fully controlled".

Gluten free diets can be notoriously lacking in essential vitamins and minerals necessary for a successful pregnancy.  Additionally, malabsorption due to intestinal damage caused by the autoimmune reaction in CeD must be addressed.

Nutritional status of the mother prior to getting pregnant is as important as the mother's nutritional status throughout the pregnancy.  

Let's learn more about nutrition...

Evidence based recommendations for an optimal prenatal supplement for women in the US: vitamins and related nutrients

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275129/

And...

Vitamin D insufficiency as a risk factor for reproductive losses in miscarriage

https://pubmed.ncbi.nlm.nih.gov/34937516/

And...

Vitamin B3 levels in women who experience first-trimester miscarriage

https://pubmed.ncbi.nlm.nih.gov/33866568/

 

Thank you for this and I will have a read through. My bloods were checked early in my pregnancy and described as being optimum. I wasn’t lacking anything at all, including iron and folate. Obviously we don’t know why the embryo died at 6 weeks, could have been anything at all. It wasn’t discovered until 12 week scan but I just wanted to see what the view was on whether there was anything else in coeliac disease that might cause an issue in someone who seemed to have sufficient nutrients at the start of their pregnancy but miscarried early. The sonography showed no obvious issues with the embryo 

[Scott Adams]

Are you confident that your diet has been 100% gluten-free? Do you eat out in restaurants? This can be a source of regular contamination. It might make sense to do another celiac disease blood panel to see if your antibody levels are high, which might indicate that your diet isn't fully gluten-free.

This article has some detailed information on how to be 100% gluten-free, so it may be helpful (be sure to also read the comments section.):

 

 

[knitty kitty]

@Painful5,

Were you taking vitamins at the time the blood tests were done? 

Were you checked for vitamins other than B12, folate and iron? 

[Wheatwacked]

Dear Painful5,  I am sorry for your loss.

 

[Painful5]

10 hours ago, knitty kitty said:

@Painful5,

Were you taking vitamins at the time the blood tests were done? 

Were you checked for vitamins other than B12, folate and iron? 

To be truthful, I am not 100% sure and you have a very good point. I was just told that my bloods are very good, Take today as I am coeliac so this is definitely a consideration.

 

 

[Scott Adams]

We have many articles on this topic in this category, and you may find some of them helpful:

https://www.celiac.com/celiac-disease/celiac-disease-amp-related-diseases-and-disorders/fertility-pregnancy-miscarriage-and-celiac-disease/ 

[Raquel2021]

On 11/1/2023 at 11:13 AM, Painful5 said:

Has anyone with celiac disease that is fully controlled suffered single or repeated early miscarriage and found it was related to coeliac despite having totally avoided gluten for several years

I am sorry for your loss. My dietician had celiac and suffered multiple miscarriages.  

[knitty kitty]

@Painful5,

Whether they are from food or supplements consumed, vitamins can pass directly into the bloodstream from the digestive tract.  Blood tests for vitamins can be inaccurate.  These tests do not give much information about how well the vitamins are being utilized inside cells of organs and tissues.  Cells can have depleted vitamin stores inside but the body shows no deficiency in blood levels.  This depleting of stores is done in order to provide important organs like the brain and heart with sufficient nutrients via the bloodstream. 

Supplements should be discontinued eight to twelve weeks prior to testing vitamin levels. 

Because the eight essential B vitamins all need each other to function properly, a B Complex supplement is a good idea.  Just supplementing one or two B vitamins can precipitate deficiencies in others.   The B Complex vitamins are water soluble so any excess the body doesn't need is easily excreted.  

Minerals like magnesium, calcium, zinc and iron are needed to work with the B vitamins and Vitamin C.  

Correction of nutritional deficiencies is part of proper follow up care for Celiacs.  It's important to correct deficiencies quickly so as not to leave permanent damage, so discuss with your doctor about the benefits of supplementing essential vitamins while healing from CeD.  However, doctors are not given much nutritional education, so ask for a referral to a nutritionist who can help you develop a nutritionally dense diet.  

I've experienced miscarriages, too, so I understand how you feel. 

 

[Wheatwacked]

This study was in 2014 in Denmark.  Sadly, it does not look like there was much follow up.  Then there is the increased cancer risk of vitamin A and E supplements and folic acid.  The effect of folic acid on the endometrium hasn't been studied as much as the prostate. 

"The reproductive systems of the male and female have some basic similarities and some specialized differences. They are the same in that most of the reproductive organs of both sexes develop from similar embryonic tissue, meaning they are homologous."    Reproductive System

Quote

For the entire period, multivitamin use was associated with a 12% increased crude risk of fetal death, restricted to early losses before 20 weeks of gestation   Periconceptional intake of vitamins and fetal death: a cohort study on multivitamins and folate

 

Quote

The main adverse effects associated with excessive vitamin A intake, particularly at the beginning of the first quarter of pregnancy, are congenital malformations involving the central nervous and cardiovascular systems and spontaneous abortion  Vitamin A and Pregnancy: A Narrative Review

 

Quote

The Carotene and Retinol Efficacy Trial (CARET)...trial was ended prematurely after a mean of 4 years, partly because the supplements were unexpectedly found to have increased lung cancer risk by 28% and death from lung cancer by 46%; the supplements also increased the risk of all-cause mortality by 17%. Among nonsmokers, beta-carotene and vitamin A supplements do not appear to affect the risk of cancer.  Vitamin A Factsheet for Health Professionals

Quote

In conclusion, this clinical trial provides evidence that daily supplementation with 1 mg of folic acid was associated with an increased risk of prostate cancer.     Folic Acid and Risk of Prostate Cancer: Results From a Randomized Clinical Trial

 

Edited November 3, 2023 by Wheatwacked

[Painful5]

17 hours ago, Raquel2021 said:

I am sorry for your loss. My dietician had celiac and suffered multiple miscarriages.  

Thank you, did she ever find out exactly why?

[Painful5]

22 hours ago, Scott Adams said:

We have many articles on this topic in this category, and you may find some of them helpful:

https://www.celiac.com/celiac-disease/celiac-disease-amp-related-diseases-and-disorders/fertility-pregnancy-miscarriage-and-celiac-disease/ 

Thank you Scott. The article about vitimin D was particularly interesting. I have seen a post today with a report suggesting that those who use multivitamins, with the exception of folate, have a higher chance of embryo/fetal demise, which has just left me even more confused!

On 11/2/2023 at 6:32 AM, Wheatwacked said:

Dear Painful5,  I am sorry for your loss.

 

Thank you x

[Raquel2021]

23 hours ago, Painful5 said:

Thank you, did she ever find out exactly why?

Yes. She told me it was because of the celiac. I am not sure though if she had any other autoimmune diseases which can also cause issues when pregnant.  So it is not an easy answer.  I know too other celias have been able to conceive and carry a pregnancy to term. Maybe try and work on eating a healthy diet such a Paleo diet and see if you have any nutritional deficiencies? 

[Painful5]

5 hours ago, Raquel2021 said:

Yes. She told me it was because of the celiac. I am not sure though if she had any other autoimmune diseases which can also cause issues when pregnant.  So it is not an easy answer.  I know too other celias have been able to conceive and carry a pregnancy to term. Maybe try and work on eating a healthy diet such a Paleo diet and see if you have any nutritional deficiencies? 

Yes, it is a well documented fact that sticking to a true gluten-free diet should alleviate the conception and pregnancy issues known to plague those with celiac disease. Perhaps this was before she was diagnosed. I am going to try again and see what happens (and pray hard!!). If it happens again I will get my bloods checked, celiac screen, autoimmunity, blood clotting and full vitamin profile and see what comes back. I am hoping that there might be something obvious in the path report but they don’t do a really full check until you have had three losses so I will just have to see. I am very rigid with my gluten checks, always have been. Diagnosed more than 10 years ago x

[knitty kitty]

@Painful5,

I apologize that one of those articles upset you.  It wasn't a well done study because no one was checked for nutritional deficiencies during the study.  Taking multivitamins doesn't correct existing nutritional insufficiency or deficiency immediately.  The study  looked at vitamin usage ONLY in the six weeks before and after conception.  And some of those using multivitamins already had problems.

Quoting from the article...

"Compared with non-users, multivitamin and folate-only users were more likely to be nulliparous, 25–35 years old and to have lower BMI. They reported more often planned pregnancies, a longer waiting time to pregnancy, more frequent use of infertility treatment and a history of miscarriage."

Here's a much better article...

Evidence based recommendations for an optimal prenatal supplement for women in the US: vitamins and related nutrients

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275129/

And...

Vitamin D and miscarriage: a systematic review and meta-analysis

https://pubmed.ncbi.nlm.nih.gov/35637024/

 

Many Celiacs have the MTHFR genetic mutation which can result in Histamine Intolerance.  Many Celiacs have Histamine Intolerance.  High histamine levels are problematic in pregnancy.  

Taking methylated forms of vitamins, following a low histamine Paleo diet, and supplementation with DAO helps.

Other helpful articles....

Histamine Intolerance Originates in the Gut

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8069563/

And...Effects of histamine and diamine oxidase activities on pregnancy: a critical review 

https://academic.oup.com/humupd/article/14/5/485/812106

And...MTHFR gene polymorphism and homocysteine levels in spontaneous abortion of pregnant women

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8290815/

Keep us posted on your progress!

[Painful5]

8 hours ago, knitty kitty said:

@Painful5,

I apologize that one of those articles upset you.  It wasn't a well done study because no one was checked for nutritional deficiencies during the study.  Taking multivitamins doesn't correct existing nutritional insufficiency or deficiency immediately.  The study  looked at vitamin usage ONLY in the six weeks before and after conception.  And some of those using multivitamins already had problems.

Quoting from the article...

"Compared with non-users, multivitamin and folate-only users were more likely to be nulliparous, 25–35 years old and to have lower BMI. They reported more often planned pregnancies, a longer waiting time to pregnancy, more frequent use of infertility treatment and a history of miscarriage."

Here's a much better article...

Evidence based recommendations for an optimal prenatal supplement for women in the US: vitamins and related nutrients

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275129/

And...

Vitamin D and miscarriage: a systematic review and meta-analysis

https://pubmed.ncbi.nlm.nih.gov/35637024/

 

Many Celiacs have the MTHFR genetic mutation which can result in Histamine Intolerance.  Many Celiacs have Histamine Intolerance.  High histamine levels are problematic in pregnancy.  

Taking methylated forms of vitamins, following a low histamine Paleo diet, and supplementation with DAO helps.

Other helpful articles....

Histamine Intolerance Originates in the Gut

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8069563/

And...Effects of histamine and diamine oxidase activities on pregnancy: a critical review 

https://academic.oup.com/humupd/article/14/5/485/812106

And...MTHFR gene polymorphism and homocysteine levels in spontaneous abortion of pregnant women

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8290815/

Keep us posted on your progress!

Thank you, I will have a read through. I wasn’t offended though. Just trying to get as much info as possible and finding it a bit of a jungle x

[knitty kitty]

@Painful5,

Yes, knowledge is valuable.  I'm here to share what I have learned the hard way so that others will have an easier journey.  I've struggled with the same things I write about.  My university degree in microbiology was earned in pursuit of answers.  I'm thankful @Scott Adams has provided a place we can share our experiences.  

Do discuss these options with your doctor and nutritionist.  Many doctors are not as up to speed on Celiac Disease as those of us who have lived with it for a lifetime.  

Your jungle guide, 

kk

[Painful5]

4 hours ago, knitty kitty said:

@Painful5,

Yes, knowledge is valuable.  I'm here to share what I have learned the hard way so that others will have an easier journey.  I've struggled with the same things I write about.  My university degree in microbiology was earned in pursuit of answers.  I'm thankful @Scott Adams has provided a place we can share our experiences.  

Do discuss these options with your doctor and nutritionist.  Many doctors are not as up to speed on Celiac Disease as those of us who have lived with it for a lifetime.  

Your jungle guide, 

kk

Thanks KK and I will speak to my doc and get the initial bloods done x