Wicked wheat: a connection between gluten and infertility

Let me guess—you’re already eating like a monk.  In the hope of improving your conception chances, you’ve cut out caffeine, booze, trans fats, refined carbs and sugar.  If you balance the good and bad foods listed in the thousand different books and websites you’ve read, the only safe thing left to eat is sticks and twigs.  (Correction: organic sticks and twigs).  You’re only a roasted squirrel away from Grizzly Adams’ carte du jour.  You have my advance apologies, but I’m about to throw another possible nutritional concern into the infertility fray.  Let’s talk about undiagnosed celiac disease.

Celiac disease affects about one percent of the population.  It’s a digestive condition that occurs when gluten found in wheat, barley and rye causes inflammation in the gut.  In celiac disease, gluten damages the lining of the small intestine which leads to the malabsorption of macro- and micro-nutrients.  The body’s inability to absorb nutrients can cause deficiencies that can affect the brain, liver, bones, nervous system and other organs, not least of which include the reproductive systems of both men and women.  Celiac disease can’t be cured, but it can be successfully controlled with a gluten-free diet.

As early as the 1970s, scientists started drawing a connection between celiac disease and unexplained infertility.  More recent studies confirm that those suspicions may be substantiated.  Research reveals that when women with unexplained infertility are tested for celiac disease-related antibodies, their rate of celiac disease can be up to three-and-a-half times higher than the normal population[1][2][3].  This is potential cause for concern when you consider how widespread the disease may be. For every person diagnosed with celiac disease, there’s an estimated eight people who have the disease but don’t know it.  Because the average delay in diagnosis of celiac disease is 11 years, most celiac patients are not diagnosed until they’re aged 40 years and over.  They often have negligible symptoms or they attribute their symptoms to other causes[4].

The potential connection between unexplained infertility and celiac disease is strong enough for researchers to make statements such as these:

“Screening for celiac disease should be partof the diagnostic work-up of infertile women, particularly whenno apparent cause can be ascertained after standard evaluation (Meloni et al in Human Reproduction 1999).

“… celiac disease should be considered and screening tests performed on women presenting with menstrual and reproductive problems…” (Soni & Badawy in Journal of Reproductive Medicine 2010).

“The prevalence of celiac disease among women with unexplained infertility is 2.5 to 3.5 percent higher … Each woman with unexplained infertility should be screened for celiac disease” (Pelicano et al in Minerva Med 2007).

“[Testing for celiac disease] provides an opportunity not only to increase the probability of conception and uncomplicated pregnancy, but also to improve overall maternal health” (Bradley & Rosen in Obstetrics & Gynecological Survey 2004).

According to the Mayo Clinic, the classic symptoms of celiac disease include intermittent diarrhea, bloating and abdominal pain.  But many people have no gastrointestinal symptoms at all or they have symptoms that mimic other conditions, such as irritable bowel syndrome (IBS), gastric ulcers, Crohn’s disease, parasite infections, anemia, skin disorders or a nervous condition.   The Mayo Clinic says that celiac disease may also present itself in less obvious ways, including irritability or depression, anemia, stomach upset, joint pain, muscle cramps, skin rash, mouth sores, dental and bone disorders (such as osteoporosis), and tingling in the legs and feet (neuropathy).  Weight loss and low weight is a common indicator of malnutrition, but many celiac sufferers are in the normal to heavy weight range.  Celiac patients can also be intolerant to lactose found in dairy foods.

Screening for celiac disease is done via a quick and easy blood test that looks for certain antibodies.  If you test positive to the antibodies, your doctor may want to confirm the diagnosis with a biopsy of your intestinal tissue.  But, unfortunately, negative celiac screening results are often inconclusive because around nine percent of celiac sufferers are antibody negative.  Researchers suggest that the most reliable results come after a patient has been eating a gluten-containing diet for at least six weeks. In other words, if you’ve already removed wheat and other gluten-containing products from your diet, you may not get a reliable test result.  Another way of testing your gluten-tolerance is to go on a gluten-free diet and see if it makes a difference to how you feel.

The relationship between celiac disease and infertility is unknown, but malnutrition is very likely to be the primary culprit.  This suggests that women with unexplained infertility should never scrimp on a high quality multi-vitamin that includes iron, vitamin D and folic acid, as well as a diet that’s packed with a diverse range of fresh, nutrient-rich foods.

Please do talk to your practitioner before embarking on any changes to your diet.

[1] Tiboni, GM et al in Human Reproduction 2006.

[2] Aguiar, FM et al in Clinical and Experimental Obstetrics & Gynecology 2009.

[3] Stazi & Trinti in Annali Italiani di Medicina Interna 2005.

[4] Evans et al in Practitioner 2009.

Written by Kylie Hughes for Conceivery.com

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