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Celiac.com 03/29/2018 - Fatigue is the most common symptom plaguing a majority of patients. Trouble sleeping, weight issues, PMS, headaches, fertility or libido issues, and achy joints are also very common and can all be affected by hormonal imbalance that continues after gluten has been removed from the diet. The trouble with trying to resolve such symptoms is that the root cause can vary. If every patient with fatigue had a thyroid problem, it would be easy to correct because we would know exactly where to look. If you're gluten intolerant you may have suffered from some of the complaints listed above prior to discovering your celiac disease or gluten sensitivity. But perhaps now, despite your gluten-free diet, some of these same symptoms continue to plague you. If so, read on. Let's review the list of symptoms and add a few more: Fatigue Trouble sleeping Weight trouble PMS Migraines Infertility or miscarriage Achy joints or muscles Allergies Light headedness Frequent illness Asthma While the list is long, believe it or not, there is a common cause to all of them. I'm not saying it's the only cause, but what I do wish to discuss is the reason why someone can be found gluten intolerant, successfully institute a gluten-free diet, yet continue to suffer from many of the above symptoms. There are two glands in your body called the adrenal glands. They sit atop each of your kidneys and they are the masters of multi-tasking! If I asked you if one part of your body was responsible for: Giving you energy, maintaining your weight, keeping your immune system strong, maintaining stable mood, anti-aging, controlling sleep quality, assisting with hormonal balance, keeping allergies at bay and more…what would you say? You might think to yourself that if there was one type of body part responsible for all those things then you had better start treating it well! You'd be very right in your analysis. As you've probably guessed the aforementioned adrenal glands are responsible for that very long list and, unfortunately, those very same adrenal glands tend to be quite stressed in the gluten intolerant individual. Why? Because adrenal glands are sensitive to, and get very stressed with, unstable blood sugar. Stable blood sugar comes from eating healthy food that your body finds nourishing. As you well know if you're gluten intolerant, gluten, for you, is a poison. Therefore years of eating gluten created unstable blood sugar and thereby put a tremendous strain on your adrenal glands. Because of the many, many jobs that the adrenal glands do, simply removing gluten as a stressor is typically insufficient to restore them to normal function. They need to be 're-set' with a nutritional and dietary program, to restore their good health. This explains why many who are gluten intolerant continue to suffer with the symptoms mentioned above. Therefore, even if your gluten intolerance has been diagnosed and you've instituted a strict gluten-free diet, if you haven't also found a clinician who understands and specializes in restoring health and function to the adrenal glands, you may very well continue to suffer with symptoms associated with adrenal stress. The good news is that the treatment to normalize adrenal function is not at all difficult. It is a completely natural program, when done correctly, involving no dangerous drugs or surgery. There are lab tests to determine the level of adrenal malfunction occurring but these are functional specialized lab tests rather than traditional ones. I mention this because I want to ensure that there is no confusion created when I mention adrenal function lab testing. The adrenal glands can become diseased but the disease isn't common. If you ask your traditional doctor to test for adrenal malfunction he or she will test for adrenal disease – once again a rare occurrence – and will likely pronounce your adrenal glands 'fine'. What I am discussing is malfunction vs. disease, two very different conditions. While adrenal gland disease is rare, adrenal gland malfunction is extremely common. It is this latter condition that we are discussing here. This is an important distinction because I want to make sure that if you are suffering from adrenal fatigue that you aren't given a 'clean bill of health' incorrectly. Unfortunately this happens often. If it took you a while to receive a diagnosis of gluten intolerance then you will understand this phenomenon. Sadly this area of health is fraught with misunderstanding and it is the patient who suffers, often unnecessarily. If you need any help finding a clinician to help you, feel free to contact me. Normalizing adrenal function is one of our areas of expertise and patients visit us for treatment, at our destination clinic, from across the country, as well as internationally. If we cannot find a clinician close to you that specializes in this then we are more than happy to see you here. The good news is that the treatment is natural and inexpensive. I look forward to hearing from you.

Celiac.com 11/05/2019 - After failing to conceive naturally over several years, the woman, Helen Tzouganatos, turned to IVF doctor Professor Mark Bowman. Tzouganatos says she and her husband had "tried every fertility trick in the book – expensive ovulation kits, herbal remedies, acupuncture, eating more of this and less of that, taking a holiday, taking another holiday – and nothing worked." During her intake, Tzouganatos told Dr. Bowman that she had no "serious" health issues just unexplained anemia since childhood, abdominal cramps and lactose intolerance. To his credit, Dr. Bowman immediately suspected she was a celiac. He ordered a celiac blood screen. When the results came back positive, everything became clear. "You’re a celiac and that is why you’re infertile," Dr. Bowman told her. "You need to cut gluten immediately.” Tzouganatos began a gluten-free diet immediately, and, after six rounds of IVF treatment, she conceived her son Vasili, followed by a daughter, Sofia, conceived on the second frozen embryo transfer 17 months later. Statistical data indicate that one in 70 Australians have celiac disease yet 80 per cent are undiagnosed. Tzouganatos is lucky that her celiac disease was discovered quickly by her IVF doctor, after sneaking under the radar for so long. Any women experiencing unexplained infertility, especially in conjunction with other celiac-related symptoms should be screened to rule out celiac disease. Quick adoption of a gluten-free diet can often lead to full healing and normal, or greatly improved fertility. Read more at SMH.com.au

Celiac.com 11/05/2012 - Over the last 40 years, studies have shown higher rates of menstrual abnormalities and pregnancy complications among women with celiac disease. However, the data from these studies have been inconsistent, and inconclusive regarding the actual effects of celiac disease on female fertility. To get a better picture of the relationship between celiac disease and female fertility and pregnancy, researchers recently conducted a more comprehensive study. The research team was led by Stephanie M. Moleski, MD, of Thomas Jefferson University Hospitals in Philadelphia. Dr. Moleski presented an abstract of the study data at the American College of Gastroenterology Annual Meeting 2012. In the abstract, she points out that women with biopsy-proven celiac disease had significantly higher rates of fertility and pregnancy complications and gave birth to less children than those without the disease. Because it is an abstract, the study data and conclusions should be regarded as preliminary until they appear in a peer-reviewed journal, where they can be given a fuller context and be more widely scrutinized. For their study, Dr. Moleski and her colleagues recruited patients treated for celiac disease at Thomas Jefferson University Hospitals, as well as members of the National Foundation for Celiac Awareness and the Gluten Intolerance Group, to respond in an anonymous Internet-based survey about fertility and pregnancy. Women without celiac disease also completed the survey and served as a control group. The survey included questions about celiac diagnosis and history, menstrual history, fertility, spontaneous abortions, and pregnancy outcomes. Approximately 1,000 women who completed the survey. Of those, 473 had physician-diagnosed celiac disease, while 298 women had the been confirmed for celiac via small-bowel biopsy. The researchers used the group with biopsy-proven disease to compare against 560 women without celiac disease. The data showed that 41.2% of women with celiac disease had increased difficulty conceiving compared with 36.5% of control subjects (P=0.03). Women with celiac disease also had more consultations with fertility specialists and higher rates of spontaneous abortion, preterm delivery, and cesarean section, compared with control subjects. Additionally, women with celiac disease were shown to have a shorter duration of fertility, to have a later onset of menarche and be younger when they experienced menopause, said Dr. Moleski. The data also revealed important differences between women with and without celiac disease. In all, 22.4% of women with celiac disease had consulted with fertility specialists, compared with 19% of those without (P=0.04). Also, 43.3% of celiacs had a history of spontaneous abortion, compared with 36.6% of non-celiacs (P=0.02). Compared with the control group of non-celiacs, women with celiac disease also had higher rates of cesarean delivery, 26.4% versus 23.8% of non-celiac women. Lastly, rates of preterm delivery were 23.2% for celiac women, and 14% for those without celiac disease (P=0.007), while the group with celiac disease was was also slightly older at the onset of their first period (12.7 versus 12.4 years, P=0.01). Among women reporting a history of spontaneous abortion, more than 80% of miscarriages occurred prior to diagnosis of celiac disease, said Dr. Moleski. She concluded that the retrospective analysis done by her team shows a clear relationship between celiac disease, fertility, and pregnancy outcomes, and suggests that the results demonstrate "a need for increased awareness of this association among patients and physicians." Sources: Medpagetoday.com American College of Gastroenterology, 2012; Moleski SM, et al "Infertility and pregnancy outcomes in celiac disease" ACG 2012; Abstract 15.

Celiac.com 07/08/2019 - A sneaky fertility doctor who used his own sperm to impregnate patients and then lied about it has had his medical license revoked by the Ontario College of Physicians and Surgeons. The doctor's duplicitous actions only came to light after the daughter of a patient was diagnosed with celiac disease, even though neither parent carries the genes or has the disease. The evidence showed that Ottawa Dr. Bernard Norman Barwin impregnated at least 11 of his patients with his own sperm; without their knowledge and consent. The doctor also impregnated a number of other patients with the wrong sperm--sperm other than that of intended donors. This was Dr. Barwin's third disciplinary hearing before the Ontario Physicians and Surgeons since 2012. The group found Dr. Barwin guilty of professional misconduct and incompetence, and permanently revoked his medical license; he will not be permitted to practice medicine again in Canada. “Your behavior has been beyond reprehensible,” said board member Dr. Steven Bodley in reprimanding Dr. Barwin, 80. Astonisingly, Dr. Barwin had already resigned voluntarily at a second disciplinary hearing in 2014, and in 2012 had agreed to stop practicing artificial insemination and intrauterine insemination. When he was finally confronted, the doctor tried to argue that his sperm had inadvertently inseminated some of his patients by "accident." According to prosecutor Carolyn Silver, Dr. Barwin's excuse was a convenient and questionable lie. “Barwin certainly knew that this was not how multiple patients became impregnated with his sperm,” Silver said. “He knew this explanation was a lie.” Dr. Barwin did not attend the most recent disciplinary hearing, but pleaded no contest to the allegations through his lawyer, Meghan O’Brien. Addressing Dr. Barwin through his lawyer, Dr. Bodley said, “It seems immensely unfair that you’re not here to face the victims of your disgraceful conduct...vulnerable patients placed themselves and their families completely in your trust. You completely betrayed that trust." One couple who Barwin treated was Davina and Daniel Dixon, who turned to Barwin’s for help in conceiving a baby in 1989. Dr. Barwin was supposed to impregnate Davina using Daniel’s sperm. Dr. Barwin's treatment resulted in the birth of a daughter, Rebecca in 1990. When Rebecca was 26 years old in 2016, she was diagnosed with celiac disease, which is genetic. Neither Davina nor David has celiac disease. Blood testing showed that Daniel was not Rebecca's biological father. Eventually, genetic tests revealed Dr. Barwin to be the biological father. “The family was shocked,” Silver said. Fortunately, this case resulted in the revocation of Dr. Barwin's medical license. Stay tuned for more details as information develops.

Celiac.com 11/12/2018 - Here’s an uplifting celiac story. Now, this happened a while back, but it's all just coming to light in the way that so many warm and fuzzy family stories do. It starts like this: Once upon a time, a simple check for celiac disease opened the door to parenthood for couple. Just over ten years ago, AnnMarie Bradley from Celbridge, Co Kildare, thought she’d never become a mother. After two devastating miscarriages over a decade, Bradley, who is 47 years old, and her husband Christopher (48) were at wit’s end. "I was just heartbroken,” said Ms Bradley. Then, a simple visit to her doctor changed everything. A blood test indicated she might have celiac disease, which further evaluation confirmed. She began a gluten-free diet, and less than a year later, Bradley was pregnant with her son, Cameron. “Being a mother had been everything I'd wanted," she said. Cameron is nearly 16 now, and has an 11-year old sister, Emily. And they all lived happily and gluten-free ever after. In the UK, the Coeliac Society advises women struggling to conceive to consider celiac testing. Read more at: Independent.ie

08/21/2018 - Does celiac disease have any kind of adverse effect on ovarian reserve levels in women of reproductive age? To get an answer, a team of researchers recently conducted a study of ovarian reserve in patients of reproductive age with celiac disease using anti-Müllerian hormone (AMH) levels, antral follicle counts (AFCs), and ovarian volume. The research team included Erol Cakmak, Savas Karakus, Ozlem Demirpence, and Banu Demet Coskun. They are variously affiliated with the Department of Gastroenterology, the Department of Obstetrics and Gynecology, the Department of Biochemistry, Cumhuriyet University Faculty of Medicine, Sivas, Turkey, and with the Department of Gastroenterology, Kayseri Training and Research Hospital in Kayseri, Turkey. For this study, their team included 46 female celiac patients and 40 healthy female subjects of reproductive age, 18–45 years of age. The team drew blood samples from both groups on days 2–4 of the menstrual cycle, and measured follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), prolactin (PRL), and AMH levels. On the same day, the team measured AFCs and ovarian volume for each patient. They also recorded patient body mass index (BMI), gravidity/parity/abortions/alive counts, disease duration, and Marsh histological classification. The results showed no statistically significant differences between celiac disease patients and control groups in terms of mean age, BMI, or median gravidity/parity/abortions/alive counts. Also, there were no statistically significant differences between the groups in terms of average FSH, LH, E2, PRL levels, right and left ovarian volumes, and median right and left ovarian AFCs. The team found AMH levels to be markedly lower in the celiac group. The Spearman correlation test showed no significant connection between AMH levels and age, BMI, FSH, LH, E2, PRL levels, right and left ovarian volumes, right and left ovarian AFCs, or Marsh histological classification. However, the team did find that, compared to healthy controls, female celiac patients of reproductive age showed decreased AMH levels and ovarian reserves that reflected the length of celiac duration; the longer the celiac disease, the greater the decrease. It appears that, especially over time, celiac disease can reduce ovarian reserves, which could have an adverse affect on fertility. Read more at: Med Sci Monit. 2018; 24: 1152–1157.

Celiac.com 11/21/2016 - Even early on, strange inconsistencies caused Dan and Davina Dixon to wonder about her daughter, Rebecca. With dark hair and olive skin, Rebecca looked visibly different from her fair-complected parents. She looked different enough to wonder, as a child, if was adopted, if Dan and Davina were really her biological parents, as they assured her they were. Later, in her twenties, Rebecca developed celiac disease, which usually runs in families, even though no one else in their extended family suffered from it. Most of this was merely fodder for curiosity, until the day Davina saw a Facebook post that mentioned how rare it is for parents with blue eyes to have a child with brown eyes. Wondering about Rebecca's brown eyes, Davina went to the family doctor, who suggested a blood test. That's when the real mystery began: The blood test revealed that Rebecca's dad, Dan, was not, in fact, her biological father. There was absolutely no doubt. Dan's blood type was AB, while Rebecca's was O-Positive. That makes it impossible for Dan to be her father. A paternity test followed, and confirmed the blood results. There was simply no chance that Dan was Rebecca's biological father. Naturally, the Dixons began to search for answers. As reported by Kidspot, Rebecca was raised believing that Dan and Davina were her biological parents. The couple had tried for years to conceive a child. Unsuccessful, they turned to Dr. Norman Barwin, a gynecologist and fertility expert known by many as Canada's "baby god." The couple wondered whether there could have been some sort of mix-up in Barwin's office. Eventually, they noticed Rebecca bore a striking resemblance to Dr. Barwin, himself. Soon after that, as CTV News reported, a woman conceived at the same clinic learned that she was genetically related to Barwin. A DNA test confirmed that Rebecca and the woman were half-sisters, and their father was Dr. Barwin. Apparently, Barwin's role as a sperm donor to his own medical practice was kept secret from both sets of parents. The Dixon family is now suing Dr. Barwin for negligence and breach of trust. The lawsuit requests that Barwin turn over a DNA sample, to determine if any other children conceived at his clinic are his offspring, and to notify them accordingly. Read more at: Kidspot.com CTV News IJR.com

Celiac.com 10/07/2011 - A number of studies suggest that women with celiac disease have reproductive difficulties, but data have been inconclusive and contradictory. A research team recently set out to assess fertility in women with biopsy-verified celiac disease. The study team included Daniela Zugna, Lorenzo Richiardi, Olof Akre, Olof Stephansson, and Jonas F Ludvigsson. They are affiliated variously with the Cancer Epidemiology Unit at the Centre for Experimental Research and Medical Studies and Centre for Oncologic Prevention at the University of Turin in Turin, Italy, the Department of Paediatrics at Örebro University Hospital in Örebro, Sweden, and with Clinical Epidemiology Unit of the Department of Medicine, the Department of Molecular Medicine and Surgery, the Division of Obstetrics and Gynaecology, and the Department of Women's and Children's Health at the Karolinska Institutet in Karolinska, Sweden. For their Swedish population-based cohort study, the team gathered data all 28 pathology departments in Sweden on 18,005 biopsy-proven duodenal/jejunal biopsy, using Marsh III, villous atrophy as their baseline. They also established a control group of 51,109 age-matched women without celiac disease. They then found 11,495 women with celiac disease who were aged 18–45 years. The team used multinomial logistic regression and Cox regression to estimate fertility in these women compared with the age-matched reference women. The team defined 'fertility' as the number of children according to the Swedish Multi-Generation Register. Their results showed that women with celiac disease had 16,309 births compared with 69,245 for the reference group. Overall, the total number of children in the group of women with celiac disease was slightly higher compared with the reference group. Adjusting for age, calendar period and parity and stratifying by education, the overall fertility hazard ratio (HR) for women with celiac disease was 1.03 (95% CI 1.01 to 1.05). Specifically, the fertility HR was 1.05 (95% CI 0.96 to 1.14) for celiac disease diagnosed in women under 18-years of age, 1.04 (95% CI 1.01 to 1.07) for celiac disease diagnosed in women between 18 and 45 years, and 1.02 (95% CI 0.99 to 1.04) for celiac disease diagnosed in women >45 years of age. Factoring in the dates of celiac disease diagnosis, fertility was decreased 0–2 years before time of diagnosis (HR=0.63; 95% CI 0.57 to 0.70), but was identical to that of controls 0–5 years subsequent to diagnosis and increased to 1.12 (95% CI 1.03 to 1.21) thereafter. The data for this study show that women with celiac disease had a normal fertility, but their fertility was decreased in the last two years before diagnosis. Interestingly, fertility in women with celiac disease was also slightly higher after five years, comported to the control group. Stay tuned... Source: Gut 2010;59:1471-1475. doi:10.1136/gut.2010.219030

Celiac.com 06/20/2011 - A team of researchers set out to assess menopause-associated disorders and fertile life span in women with untreated celiac disease compared to those who followed a long-term gluten-free diet. The research team included Antonella Santonicola, MD, Paola Iovino, MD, Carmelina Cappello, MD, Pietro Capone, MD, Paolo Andreozzi, MD, and Carolina Ciacci, MD. For their study, the team recruited 33 post-menopausal women with untreated celiac disease, 25 celiac women who had followed a gluten-free diet for at least ten years before menopause, and 45 healthy volunteers as a control group. The team used the Menopause Rating Scale questionnaire to gather information on menopause-associated disorders among study participants. They also used the International Physical Activity Questionnaire to chart information on physical activity. Overall, results showed that the women with untreated celiac disease had a shorter overall fertile life spans than did the control women. This was due to both a higher age of menarche and a lower age of menopause (P G 0.01). Women with untreated celiac disease also showed higher scores for hot flushes, muscle/joint problems, and irritability than the control group. An increase of 49.4%, 121.4%, and 58.6%, respectively; P G 0.05). In contrast with the untreated celiac women, those who followed a long-term gluten-free diet showed no significant difference in the duration of fertile life span. They also had about half as many muscle/joint problems than the untreated group, with a total reduction of 47.1%; P G 0.05. The data show that women with untreated celiac disease have later menarche and earlier menopause, which shortens their fertility periods compared to healthy women without celiac disease. Also, they perceive hot flushes and irritability much more intensely than control subjects. Women with celiac disease can prolong their fertility life span at least ten years prior to starting menopause. Lastly, untreated celiac disease may increase women's overall discomfort levels, and thus contribute to low physical exercise and/or poorer quality of life frequently reported by untreated celiac women. Source: The North American Menopause Society DOI: 10.1097/gme.0b013e3182188421