Celiac and Infertility

infertility and celiac

It’s time to say it… Infertility Sucks! Today I want to share the challenges I have with managing my celiac and infertility- especially at Christmas time!

The holidays don’t make this any easier as pregnant women seem to be out in droves and you wish you were hanging ornaments on your tree that said ‘My First Christmas.’

No ornaments, no big belly – just a fertility diet that clashes with Christmas buffets like Crocs with an evening gown.

 

‘Celiac and Infertility’ Family Recruitment Plan

But instead of going any further down the ‘infertility sucks’ road than I already have, I want find a way to get through this holiday enjoying each and every gathering with family and friends. This, I believe, is only going to happen with their support.

Celiac and InfertilitySo, since my body is thriving on my new fertility diet, I feel like I need to let my family know what I’m doing and why. This way, I don’t have to stumble over my words as I decline half the dishes on the table or pretend like I’m excited about the mounds of chocolate in my stocking (my mouth is watering as I just write the word).

Essentially, I want to recruit them to my team – which is a heck of a lot easier than always wondering how I can politely decline that appetizer again and wondering if I can resist the chocolate when it comes with,

“Oh, come on, a little sugar is good for you.”

My solution: Let them know exactly where I stand. The result is an email that I wrote yesterday. It came pouring out of me. There is no asking or explaining with apologies. Instead, I wrote about what I’ve been going through, how I feel, and how they can help.

When I hit the send button, a weight had been lifted off my shoulders.

Letter to My Family:

Hi Fam,

I wanted to send you guys this email to let you know what has been going on. It’s a bit long – but bear with me.

Over the past year I have been really struggling with my health.

I know I have talked about it a lot to the point where I seemed obsessed. The truth is: I was really scared.

I lost over ten pounds (dropped a pants and bra size), was losing my hair (noted by me and my hair dresser), was bleeding during bowel movements, had constipation, was extremely fatigued, had acne that the dermatologists couldn’t cure, woke up nightly with muscle cramps, had abdominal pain that kept me in bed some days for the whole day, had hip pain so strong that I could not sleep on my side, had tailbone pain that made sitting for longer periods painful.

This is a lot – and it’s not even everything!

I’ve tried really hard to gain the weight back over the last three months consuming around 2500 calories a day (many days eating more than Richard). But each morning I could still see my all my ribs in the mirror and hadn’t gained an ounce.

I finally went to the doctor several weeks ago. He found nothing except for low iron and an underactive thyroid.

He tested me for celiac disease (a disease in which gluten damages the intestine so you can’t absorb nutrients from food – which came back negative), but since I was already on a virtually gluten free diet, it wasn’t valid.

The only way to do a valid test is to eat a considerable amount of gluten for at least several weeks (a.k.a. – damage you intestine) and run the test which may take from months to years to show a positive reading. I did not want to do this.

Instead I increased my diet to 100% gluten free – after reading that only a ¼ gram can cause damage to your intestine without creating symptoms. This was three weeks ago.

Over the past three weeks I’ve watched my skin clear up entirely, my energy has returned, I have no tailbone pain, no bleeding during bowel movements, regular bowel movements, and I have no muscle cramps. And best of all: I gained 2 pounds!!!

I can’t express how happy I am.

So why am I telling you all this? I wanted to let you guys know for several reasons.

  • I can not eat gluten. Which means I am not eating out at all and when/if you cook for me I will either make my own or read all the ingredients you use. Gluten hides in everything (spices, sauces, etc).
  • When I am complicated because I make different food or don’t eat something, know that it is not because I want to do it: I have to do it. You don’t need to do anything extra for me, I just ask that you respect the situation and understand that this is not all in my head.
  • Celiac disease is hereditary. I do not have a diagnosis, but it could not be any more obvious (not to mention that both mom and grandma have discovered over the years that they have trouble with wheat/gluten). When I heard that our new arrivals in the family are having digestive problems I wanted to share this information with you. Undetected celiac disease can lead to a myriad of health problems because the body is not getting the nutrients it needs. And it would be important to diagnose because if you have it, you have to follow a 100% gluten free diet. A partially gluten free diet may reduce symptoms but does not prevent damage and, it complicates diagnosis.

And by the way, celiac disease has been linked to infertility. So, let’s hope that this solves my other problem.

Love,
Dina

 

Interesting Findings from A Celiac and Infertility Study

  • When women with undiagnosed celiac disease, had 11 more miscarriages per 1,000 pregnancies and 1.62 more stillbirths per 1,000 pregnancies.
  • In the two years leading up to a celiac disease diagnosis, women become pregnant less often, with 25 less pregnancies per 1,000.
  • Pregnancy problems in women undiagnosed was 15 more per 1,000 pregnancies compared to women who did not have celiac disease.
  • Women with infertility were 3.5 times more likely to have celiac than the ‘controls.’

Ref: 2018 Danish study published in the journal Human Reproduction.

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Infertility and Celiac Disease

Celiac Disease and Infertility

In this article we look at the link between infertility and Celiac Disease. Numerous studies have indicated that celiac disease may be more common in people with unexplained infertility, and that treatment may help restore fertility. Celiac has been linked to recurrent miscarriage, premature babies, and low-birth-weight babies.

 

What’s gluten?

Gluten is a protein found in wheat, rye and barley. It turns out that in approximately 1 out of 100 healthy Americans the immune system responds to the consumption of this protein by attacking the wall of the small intestine – harming its ability to absorb nutrients from food. An astonishing 97% of these people, however, do not even know they have this condition – called celiac disease. (1)

 

The Link Between Infertility and Celiac Disease

A lot! In fact, the University of Chicago says, “Any individual who has experienced persistent miscarriage or infertility where a medical cause could not be found needs to be tested for celiac disease.”(2) And they are not alone in their recommendation: The Wm. K. Warren Medical Research Center for Celiac Disease recommends 16 situations and/or conditions for which celiac should be considered, one of which is: “unexplained infertility or miscarriage” (3).

And although the probability of having celiac disease is around 1% for the average healthy American, the probability increases to 6% for women with unexplained infertility (1).

 

A Case of Infertility and Celiac Disease

infertility and celiac diseaseStacey Roberts from Sharkey’s Healing Center shared a case in her August 2008 newsletter that she had of a couple who had been trying to conceive for three years and received the diagnosis of unexplained infertility.

After one failed IVF cycle and a few months of herbs from the healing center with no success, the center recommend that the woman get tested for celiac disease since she had also mentioned having mild digestive problems (which did not respond to diet adjustments).

Her doctor was opposed to the idea, but did the tests anyway. The tests came back positive and after three months on a gluten-free diet the couple conceived and was in their second trimester when the newsletter was published.

 

Celiac Disease


Haven’t heard of celiac disease? This isn’t because it’s rare – it’s more common than Crohn’s Disease, Cystic Fibrosis, Multiple Sclerosis and Parkinson’s disease – combined (4). But this disease is not well known by the general public, or well understood by general practitioners, nor is it easy to diagnose: the average delay in diagnosis in the United States after the onset of symptoms is four years (1).

There are more than 200 signs and symptoms of celiac disease (2), but only 10% of patients have what are considered typical symptoms (5) and 41% of patients have no symptoms at all (1).

The Wm. K. Warren Medical Research Center for Celiac Disease at the University of California, San Diego states that the symptoms for celiac disease are varied, but may include any of the following (3):

  • Bloating, gas or abdominal pain
  • Diarrhea or constipation
  • Chronic fatigue and weakness
  • Indigestion
  • Itchy skin rash
  • Fatigue and weakness
  • Irritability or behavior change
  • Unexplained weight loss
  • Delayed growth
  • Mouth ulcers
  • Tingling or numbness in hands & feet

 

How is Celiac Disease Treated?

The treatment of celiac disease is a gluten-free diet for life. But experts strongly discourage going on a gluten-free diet until a firm diagnosis has been made since a gluten-free diet (even for just a month) makes a diagnosis difficult (6).

 

Is a Gluten-free Diet Everyone’s Solution?

No. Absolutely not. But since it’s not recognized well by doctors, it may be up to the patient to pay attention to their own signs and symptoms and suggest the testing.

 

Why am I so Interested in Infertility and Celiac Disease?


infertility and celiacI’ve been suffering from digestive issues for a while now. They include bloating, constipation, and blood in the stool. Unfortunately, I started a gluten-free diet before I being tested.

Gluten Challenge

If I wanted a definitive diagnosis now, after a gluten-free diet, I would have to do what is called a gluten challenge and eat gluten for 2-4 weeks before taking the tests.

If I have celiac disease, this would mean damaging my intestine to get a diagnosis. And not all patients can even test at the end of the four week challenge: some may have to wait years to relapse (7). I don’t have years in terms of fertility. So I’ve decided against going through this for a diagnosis.

Not Sticking to the Diet

Over the past few months, I’ve fallen off the gluten-free diet a bit. I’ve traveled a lot which leads to eating out, which leads to unintentionally ingesting gluten – if you’ve been on a gluten-free diet you know how easily this happens with gluten hiding in everything from spices, to pasta sauces, to grilled fish.

I’ve also been unknowingly including another food item that many experts think may not be safe – oats. I’ve had them almost every morning for breakfast.

Sticking with a Gluten Free Diet

I’m on a 100% gluten-free diet now though. For the last week I’ve strictly followed it – no eating out and no items with any questionable ingredients (it takes only ¼ gram of wheat to cause damage (8)).

The blood in my stool has completely disappeared and I haven’t had any spells of fatigue, nor found any sources that mention a link between gluten and blood in the stool, but I have tested it time and time again and for me it’s linked.

I haven’t been able to gain any weight, yet, but perhaps that’s coming. We’ll see how this 100% gluten-free diet goes. I do wish I had gotten a diagnosis first, though.

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Vegetarian Diet and Fertility- Will It Work?

meat diet and fertility

It’s official. I’m no longer a vegetarian. Not because I crave meat, not because I changed my mind about animal treatment, but because I believe that a vegetarian diet does not boost fertility. Or to put it more bluntly: I believe that a vegetarian diet and fertility don’t go together and contribute to infertility.

This is not the conclusion I wanted to come to as a vegetarian. But at the end of the day the facts and evidence point to animal protein as part of a healthy fertility diet. So after happily avoiding poultry for the past five years and red meat for the past fifteen years, I’m putting them back on my plate.

How did I come to this, for me, a radical decision? Research and experimentation.

 

Insulin Regulation is Vital to Fertility

vegetarian diet and fertilitySifting through books and articles on fertility and health I’ve come across various studies on the effects of animal and vegetable protein on fertility. There is, however, no consensus on which source is best for improving your changes of conception. What doctors and researchers do agree on, though, is that insulin regulation is vital to fertility.

 

What is Insulin Exactly?

When you eat easily digested carbohydrates – like potatoes or white bread – they’re broken down into sugar and enter the bloodstream. To lower this high blood sugar level the body produces insulin which escorts the sugar out of the bloodstream and into your cells. Sounds like a good system, but the insulin spikes caused by such easily digested carbohydrates reek havoc on your reproductive system.

 

Linked: Reproductive System, Insulin and Protein 

Dr. Ernest Zeringue from the Davis Fertility Clinic has successfully been using nutrition to control insulin with his fertility patients for years, and he describes the effect of elevated insulin levels on fertility by stating, “The insulin can interfere with the development of the eggs as they’re growing, as well as interfere with the establishment of a pregnancy inside the uterus.” (1)

Protein is key to controlling insulin levels.

Dr. Jeremy Groll, fertility doctor, research scientist and author of the book Fertility Foods recommends a diet and exercise program that “will improve your insulin sensitivity and make you more fertile.” For this, he points out, protein is critical: “Our goal in this plan is to promote lean body mass to reduce insulin, and you can’t do that without protein.” 

 

Vegetarian Diet and Fertility- Why is Animal Protein Necessary?

What we know then is that protein is key to regulating insulin and insulin regulation is key to boosting fertility. So why can’t insulin be regulated without animal protein?

Dr. Groll admits that getting enough protein (without dramatically increasing carbs) and getting all the essential amino acids is harder for vegetarians. He does believe it’s possible, but several other fertility specialists and I disagree. And here’s why:

There are a limited number of vegetable sources of protein and each source poses a unique problem to fertility. A high reliance on beans comes with a full load of carbohydrates, which can cause an imbalance in insulin levels. Dairy and soy are very controversial as to their role in infertility with numerous fertility specialists recommending these be kept to a minimum until the jury is out. That leaves nuts which shouldn’t be relied on too heavily because they deliver a lot of fat.

I’ve tried everything as a vegetarian to make a higher protein/lower carb fertility diet work, but for me, it was a dead end (see my blog: 4 Fertility Diet Principles).

Initially, I even tried adding fish as a protein source but it wasn’t enough because the weekly recommendation is limited to just two servings a week due to mercury contamination.

It’s important to point out that vegetarians certainly can, and do, get pregnant. But for those of us struggling with infertility, adding meat into our diet to control insulin could be the missing link that our body needs.

Some vegetarians may feel like this isn’t an option due to their beliefs, but for me it’s about the treatment of animals and buying only organic ensures that the animals are treated properly and are free of toxins.

 

Vegetarian Diet and Fertility- Making the Leap!

I can report that I’ve made the leap. Just the other night I made baked organic chicken with ginger and steamed vegetables on the side, not quite as tasty looking as the creations on the food channel, however, still worth a photo session. I have to say that I haven’t missed having poultry over the past 5 years, but you know what, I thought it tasted really good.

Organic red meat was supposed to be next. But I chickened out. I bought it and it’s been sitting in my freezer for the past several days. I can’t bring myself to cook it. My husband has volunteered to make something “yummy”, but I’m skeptical, of the meat, not the cooking of course!

But seriously, I can better meet my four fertility diet principles (for more see my blog: 4 Fertility Diet Principles) with poultry and meat on my menu and hopefully it will bring my body into balance.

If you enjoyed reading my blog, please write a comment here or bookmark it to a social bookmarking site by using the link below. Thanks!

Probiotics and Fertility Diet Part 2

fertility foods

If you haven’t read part 1 of this blog yet, you might want to start there (it covers the basics and the potential connection to fertility): Probiotics and Fertility Diet Part 1.

Otherwise more on those critters in our gut…

Probiotics and Fertility- An Unbalanced Vaginal Microbiome

Research has found a connection between the microbiome and fertility and how probiotics improve fertility. The abnormal vaginal microbiota has been found to negatively impact the birth rate.

Studies

Probiotics and Fertility DietA Danish study of 130 women undergoing in vitro fertilization (IVF), researchers found that those who had abnormal vaginal microbiota had a harder time getting pregnant.

Of the 84 patients who completed IVF treatment, 29 were able to get pregnant. Only 9% of those who had abnormal vaginal microbiota obtained a clinical pregnancy, whilst 44% of the women with normal microbiota bacteria were able to get pregnant.

A Philadelphian study of 1,950 women found that a diagnosis of a common infection (bacterial vaginosis) in the first trimester more than doubled the risk of spontaneous pregnancy loss in the next trimester. It also found that the low levels of the Lactobacillus bacteria in the first trimester also significantly increased the risk of pregnancy loss.

A BJOG Publication Study with over 700 pregnant women, found that those with abnormal vaginal flora – specifically those lacking lactobacilli bacteria – were 75% more likely to have a preterm birth. Also, the risk of miscarriage was significantly increased.

Create a Healthy Digestive System with Probiotic Bacteria

The importance of probiotic bacteria in our bodies is uncontested, but how, and to what extent, we can influence this delicate balance is still being researched.

The research results are very encouraging though. Many experts recommend we ‘cultivate the garden within’ for a healthy body by adopting the right diet, reducing stress, avoiding antibiotics whenever possible, and in some cases supplementing with probiotics and prebiotics.

Foods that Contain Probiotic Bacteria and Prebiotics

We may be able to influence the balance of bacteria in our bodies with food in two ways: by eating foods that contain the good bacteria and by eating the types of food that good bacteria feed off of (prebiotics).

Choose Carefully: not all traditionally fermented foods contain these helpful bacteria. Industrialization of fermentation has lead to efficiency in production and more consistent tasting products, however, it ruins some of the healthful benefits by killing the probiotic bacteria. Pasteurizing, for example, effectively kills all the healthful bacteria.

Foods that naturally contain probiotic bacteria are cultured/fermented foods.

Foods with Probiotic Bacteria

  • Raw Sauerkraut
  • Kimchi
  • Cottage cheese
  • Kefir
  • Yogurt
  • Tofu
  • Miso
  • Tamari sauce
  • Soy sauce
  • Tempeh
  • Pickles (made with brine not vinegar)
  • Pickled ginger
  • Beer
  • Wine
  • Vinegar

Interestingly, cultured foods have long been recognized as an integral part of a healthy diet like Miso in Japan, Lassi drinks in India, Kimchi in Asia and sauerkraut in Europe – just to name a few.

The second way to boost probiotic bacteria is to eat foods that provide prebiotics. Two well documented prebiotics are FOS and inulin, which are naturally occurring carbohydrates found in the following foods.

Fertility Boosting FoodsFoods that Contain Prebiotics

  • Asparagus
  • Chicory
  • Chinese chive
  • Burdock root
  • Eggplant
  • Fruit (especially bananas)
  • Garlic
  • Jerusalem artichokes
  • Leeks
  • Legumes
  • Onions
  • Peas
  • Soybeans
  • Sugar maple
  • Tomatoes

Probiotic Supplements

Probiotic supplements are high doses of specific strains of beneficial bacteria in an easy to take form (liquid, power, or capsule). Initial studies are encouraging and suggest that probiotic supplements can be used to treat various health issues.

Numerous doctors, naturopaths and nutritionists recommend probiotics for this reason, however, the extent of the claims being made has not yet been rigorously proven through research.

Elizabeth Lipski, author of Digestive Wellness, recommends that already healthy people can maintain their healthy bacteria by eating cultured foods, but says supplements are necessary when disease producing microbes have colonized.

Dr. Haas makes a similar recommendation in his book, Staying Healthy with Nutrition, by recommending probiotics for use after a course of antibiotics or to treat yeast overgrowth, otherwise, he says, “I recommend them for one to two weeks once or twice a year…”.

It’s important to note that probiotics do not all have the same quality.

Some guidelines for choosing probiotics are:

  • Probiotics requiring refrigeration at the store and at home tend to be the best
  • Accompanying probiotics with prebiotics may be more effective since this provides food for the bacteria once they they enter your digestive system
  • Probiotics that include several strains are helpful

Elizabeth Lipski also emphasizes in her book, Digestive Wellness the following tips:

  • Different combinations will work for different people and to a greater or lesser effect.
  • You’ll have to experiment with different brands and see which are most helpful.
  • Remember to begin with a small dosage and increase slowly. You are changing your gut ecology and you want to do it gradually.

Another important aspect to taking probiotics that Elizabeth Lipski points out is that it’s not necessarily a bad sign if the supplements cause a sudden bloating, diarrhea, gas, or worsening of symptoms. She explains that, as the bad bacteria and fungus die, they release chemicals that aggravate symptoms. If this happens, she recommends beginning again and building up slowly.

Naturopath Linda Page suggests that probiotic supplements are not for everyone because each person’s digestive system is highly individual. She recommends getting probiotic bacteria from food and by supplementing with prebiotics.

The good side to this new dietary supplement is that probiotics have no toxic effects and the American Cancer Society addresses the safety of one of the more popular probiotics strains, Lactobacillus acidophilus, by stating that; except in rare cases acidophilus is safe.

Probiotics and Fertility Conclusion

Although, I haven’t covered them in detail here prebiotics are also available in supplemental form.

For my next blog I’ll be writing about how I’m getting probiotics and prebiotics, how my body likes/dislikes them along with a list of some helpful resources. Until then, happy bacteria consumption.

Pregnancy After 30 – Weighing the Risks

Getting pregnant after 30

In this modern age, many women now choose to wait to have children until after 30. This choice comes with women having more independence than ever before. Sometimes the choice to wait is based on establishing a career and being financially sound first, other times it can be due to not finding the right partner or other reasons that are unique to this day and age. Whatever the case, pregnancy after 30 comes with its challenges.

We are past the point when girls were expected to grow up, get married, have a family and stop at that.

Pregnancy After 30 Risk Factors

Although the benefits of this new age of choice are many, with it also comes plenty of risk factors. Child birth over the age of 30 has the risk of increased complications, and is considered to be a high risk pregnancy.

Rush University Medical Center states chromosomal abnormalities such as Down Syndrome to be one of the biggest risks, with chances of having a Down Syndrome baby jumping from 1 in 1,100 when a mother is between ages 25 and 29, to 1 in 350 when she is 35.

Pregnancy After 30Largely attributed to this increase in chromosomal abnormalities is also the occurrence of more miscarriages in this age group than with younger women.

According to Health & Lifestyle Magazine, other potential health issue for women associated getting pregnant in their 30s, include heart disease, high blood pressure, and kidney problems.

Diabetes is also commonly associated with this type of pregnancy, as well as an increased risk of breast cancer later in life. Although, Womenshealth.gov says that breastfeeding will help to decrease the threat of breast cancer.

Proper prenatal care is a highly important aspect to the safety of mother and child with any pregnancy, but especially so in the instance of a pregnancy over age 30.

It Isn’t All Doom and Gloom

In any case, women are still making the choice to have children after age 30, and many of these mothers and their children are still healthy and happy. Well-known women have taken the stage in becoming mothers later in life, and everyday women have become celebrities in doing so.

The good news is that when a baby is born in a state of normal health, it is unlikely to have any more complications than a child of a younger woman.

Many women are saying that a settled lifestyle that comes with age is more conducive to raising a family at this time than in younger years.

Other Possible Benefits of Having a Baby Later in Life

  • Boost your brain power
  • The child may have a reduced risk of injury
  • Parents may be more prepared emotionally
  • The child is likely to be more tech-savvy and better educated
  • Parents may be more financially stable
  • Parents may live even longer

What Can Women Do to Increase Pregnancy After 30?

  • Aim for a healthy weight – speak with their doctor or nurse to understand what is a healthy weight range
  • Eat a healthy, balanced diet
  • Take folate and iodine supplements as directed by a doctor
  • Do regular, moderate exercise
  • Relax- do yoga, meditate
  • Avoid alcohol, drugs and smoking