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Infertility & Celiac Disease

CD, an auto-immune response to gluten (the protein found in wheat, rye, barley and oats), is estimated to affect 3 million Americans with another 18 million suffering from gluten-sensitivity.

When left undiagnosed and untreated, celiac disease is associated with multiple comorbidities including hormone imbalance and infertility.

Typically thought to consist of primarily enteropathic symptoms (chronic diarrhea, malabsorption & delayed growth) in children of northern European descent, CD can actually afflict individuals of any age or heritage. Histologic changes of the duodenal portion of the small intestine may assist in diagnosis of the disease, although the signs and symptoms that suggest evaluation for CD include changes in the skin, endocrine, skeletal and neurologic systems.

 There is a small population of people with silent celiac disease who present with a complete lack of symptoms. Perhaps one of the most surprising comorbidities associated with CD is infertility. Up to 50% of women with untreated CD may experience infertility issues and/or unfavorable outcomes of pregnancy including repeated miscarriage, low birth weight babies and shortened durations of nursing.

The exact mechanism by which CD causes infertility issues in women is unknown.  However; nutrient deficiencies (iron, folic acid and fat soluble vitamins) associated with malabsorption may play a role. Additionally, a portion of the explanation may involve hormone imbalance mediated by the adrenal glands.

Gluten ingestion by an individual with CD is a continued stress to the body and can take its toll on the adrenals. This continued stress may contribute to adrenal hypofunction resulting in pregnenolone steal, decreased progesterone, anovulation and difficulty conceiving.

Individuals with celiac disease are also at increased risk for additional autoimmune conditions including thyroid imbalances which, if left untreated, can affect a woman's menstrual cycle and ability to conceive. Furthermore, there is increasing evidence that endometriosis (often associated with infertility) may have an autoimmune component.

 

Though recent study results suggest that men with CD may not suffer from the same increased infertility risks as women with CD, it is known that men with untreated CD show tissue resistance to androgens (testosterone and DHEA) and increases of follicle stimulating hormone and prolactin levels that indicate an imbalance at the hypothalamic-pituitary axis.

The good news? When adhering to a gluten free diet, the increased risks of diseases and syndromes associated with CD, including infertility, return to that of the population at You can utilize our Fertility Kit to provide a comprehensive analysis of your hrmone profile. This will assist you in creating an exceptional and comprehensive individualized treatment plan to aid in reaching their conception goals while on the path to optimal health.

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References:

Martinelli P, et. al. Celiac disease and unfavorable outcome of pregnancy. Gut. 2000 Mar;46(3):332-5.

Pradhan M, et.al. Celiac disease as a rare cause of primary amenorrhea: a case report. J Reprod Med. 2007 May;52(5):453-5.

Stazi AV, Trinti B. Reproductive aspects of celiac disease. Ann Ital Med Int. 2005 Oct-Dec;20(4):263.
Daniela Zugna, Ph.D; et.al. Celiac disease is not a risk factor for infertility in men. Fertility and Sterility. Volume 95, Issue 5, Pages 1709-1713.e3, April 2011.
J. Wilson, ND, DC, PhD. Adrenal Fatigue, The 21st Century Stress Syndrome. 2001.
Nothnick WB. Treating endometriosis as an autoimmune disease. Fertil Steril. 2001 Aug: 76(2):223-31.

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The Canary Club is an educational advisory group with a team of medical advisors headed by Richard Shames, M.D.