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Suzanne Tapper, Natural & Integrated Medicine

gluten and fertility

Gluten And Fertility

What You Need to Know About Gluten And Fertility

There have been a number of discussions in recent years regarding gluten and fertility.  Some claim that a gluten free diet will help increase one’s chances of getting pregnant, while others say there is no real effect at all. As with many foods, there is no one size fits all and an appraisal of your individual presentation is important to consider.

What is gluten?

Gluten is a protein substance found in rye, barley, cereal grains and especially wheat.  It is responsible for the elasticity of dough and the chewy consistency of food made from wheat flour, like bread and pasta. You will also find it added to many processed foods to thicken or create bulk or texture. Commonly you will find it in commercial soups, sauces, dips, pre-cut fries, chocolate bars and a variety of other food types.

Gluten Sensitivity

Gluten is not bad, in general, but there are some people who are gluten sensitive or intolerant.

It is estimated that 1 in every 100 people suffers from celiac disease, a serious autoimmune disorder that can occur in genetically predisposed people where the ingestion of gluten causes inflammation, irritation and possible tissue breakdown along the digestive tract. There are also those with non-celiac gluten sensitivity (NCGS), or people who have reactions to gluten but lack the characteristic markers of celiac disease. However, both react differently when breaking down gluten during digestion and nutrients are not being properly absorbed by the body and both are often undiagnosed.

How does gluten affect fertility?

Gluten and fertility issues are a real issue for some women. If a woman with gluten sensitivity does not deliberately go on a gluten-free diet she is effectively putting herself in a chronic inflammatory state.  The inflammation develops in the lining of the small intestine that interferes with nutrient absorption, including the ones needed for healthy conception and pregnancy. Nutrients such as zinc, selenium, iron, vitamin D, and calcium are all vital to conceiving and carrying a healthy pregnancy to term.

What can be done?

Although not a lot of studies have been made, some have shown that among couples who have been trying for years to conceive, those that eliminated gluten from their diet have had a better chance of conceiving and establishing successful pregnancies.

In the past, I routinely tested fertility clients for celiac markers. Only once have I found someone who tested positive for celiacs disease but who reported having no symptoms typically associated with gluten issues. This person had been struggling with infertility for a few years with all usual fertility testing showing nothing out of the ordinary however. It may have been that removing gluten from her diet was in fact all that needed to change to achieve her baby dream. Now I recommend gluten exposure is either eliminated or kept to a minimum. If you are struggling to conceive and are reluctant to eliminate gluten completely, then I recommend you get tested to rule out an issue between gluten and fertility – just to be sure.

I frequently see people who gain improved digestive processes and energy when they remove or greatly reduce their gluten exposure. So now, I suggest to anyone who has any of the following symptoms, to try at least one week completely gluten free. If symptoms improve then that could be an indicator that gluten is creating an inflammatory environment in their body which could potentially be affecting their fertility.

  • Tummy pain
  • Flatulence/gas/abdominal bloating
  • Incomplete bowel movements
  • Loose stools
  • Constipation i.e less than one bowel movement per day
  • More than 2 bowel movements per day
  • Fatigue/sleepiness after eating gluten products

Steps to becoming gluten free

Becoming gluten free requires some vigilance but is not difficult to do once your have established where your exposure is from.

  1. Initially most people need to start by reading food labels on anything store bought. Many people who originally thought their diet was low gluten are very surprised by what it is found in.
  2. Sometimes you can easily substitute
    • If you like having  toast for breakfast or a sandwich for lunch, fins a good gluten free version
    • There are a variety of gluten free pastas – experiment until you find one you like.
    • Use rice crackers instead of grain crackers
    • Use cornflour instead of wheat flour as a thickener
    • Use gluten-free flour mixes for baking. These can vary, so experiment with different varieties to find one you like.
  3. Create some new habits. Nutritional variation is important. Many gluten based products are used as a quick and easy filler rather than for good nutritional content.
    • Maybe you would be better to bulk cook some nutritious soups and other meals that can be frozen in smaller amounts for thawing and heating.
    • Try cooking more of your larger meal and using the leftovers for another meal e.g have dinner leftovers for lunch
    • Consider eating more vegetables, nuts, seeds, proteins and other nutritionally dense foods rather than filling up on bread and cereals.

Bibliography:

Bold J1, Rostami K2. “Non-coeliac gluten sensitivity and reproductive disorders.” Gastroenterol Hepatol Bed Bench. 2015 Fall;8(4):294-7.

Bradley RJ1, Rosen MP. “Subfertility and gastrointestinal disease: ‘unexplained’ is often undiagnosed.” Obstet Gynecol Surv. 2004 Feb;59(2):108-17.

Caserta D, Matteucci E, Ralli E, Bordi G, Moscarini M. “Celiac disease and endometriosis: an insidious and worrisome association hard to diagnose: a case report.” Clin Exp Obstet Gynecol. 2014;41(3):346-8.

Carroccio A1, D’Alcamo A2, Cavataio F3, Soresi M2, Seidita A2, Sciumè C4, Geraci G4, Iacono G3, Mansueto P2. “High Proportions of People With Non-celiac Wheat Sensitivity Have Autoimmune Disease or Antinuclear Antibodies.” Gastroenterology. 2015 Sep;149(3):596-603.e1. doi: 10.1053/j.gastro.2015.05.040. Epub 2015 May 27.

Choi JM1, Lebwohl B, Wang J, Lee SK, Murray JA, Sauer MV, Green PH. “Increased prevalence of celiac disease in patients with unexplained infertility in the United States.” J Reprod Med. 2011 May-Jun;56(5-6):199-203.

Collin P, et al, Infertility and coeliac disease. Gut 1996;39:382-384 doi:10.1136/gut.39.3.382

Cosnes J1, Cellier C, Viola S, Colombel JF, Michaud L, Sarles J, Hugot JP, Ginies JL, Dabadie A, Mouterde O, Allez M, Nion-Larmurier I; Groupe D’Etude et de Recherche Sur la Maladie Coeliaque. “Incidence of autoimmune diseases in celiac disease: protective effect of the gluten-free diet.” Clin Gastroenterol Hepatol. 2008 Jul;6(7):753-8. doi: 10.1016/j.cgh.2007.12.022. Epub 2008 Feb 6.

Czaja-Bulsa G1. “Non coeliac gluten sensitivity – A new disease with gluten intolerance.” Clin Nutr. 2015 Apr;34(2):189-94. doi: 10.1016/j.clnu.2014.08.012. Epub 2014 Aug 29.

Dhalwani NN1, West J2, Sultan AA2, Ban L2, Tata LJ2. “Women with celiac disease present with fertility problems no more often than women in the general population.” Gastroenterology. 2014 Dec;147(6):1267-74.e1; quiz e13-4. doi: 10.1053/j.gastro.2014.08.025. Epub 2014 Aug 23.

Kikuchi K1, Shibahara H, Hirano Y, Kohno T, Hirashima C, Suzuki T, Takamizawa S, Suzuki M. “Antinuclear antibody reduces the pregnancy rate in the first IVF-ET treatment cycle but not the cumulative pregnancy rate without specific medication.” Am J Reprod Immunol. 2003 Oct;50(4):363-7.

Kotze LM1. “Gynecologic and obstetric findings related to nutritional status and adherence to a gluten-free diet in Brazilian patients with celiac disease.” J Clin Gastroenterol. 2004 Aug;38(7):567-74.

Larsen J1, Dall M, Antvorskov JC, Weile C, Engkilde K, Josefsen K, Buschard K. “Dietary gluten increases natural killer cell cytotoxicity and cytokine secretion.” Eur J Immunol. 2014 Oct;44(10):3056-67. doi: 10.1002/eji.201344264. Epub 2014 Sep 18.

Lasa JS1, Zubiaurre I1, Soifer LO1. “Risk of infertility in patients with celiac disease: a meta-analysis of observational studies.” Arq Gastroenterol. 2014 Apr-Jun;51(2):144-50.

Marziali M1, Venza M, Lazzaro S, Lazzaro A, Micossi C, Stolfi VM. “Gluten-free diet: a new strategy for management of painful endometriosis related symptoms?” Minerva Chir. 2012 Dec;67(6):499-504.

Nenna R, Mennini M, Petrarca L, Bonamico. “Immediate effect on fertility of a gluten-free diet in women with untreated coeliac disease.” Gut. 2011 Jul;60(7):1023-4. doi: 10.1136/gut.2010.232892. Epub 2010 Dec 29.

Shah, S and D Leffler. Celiac disease: an underappreciated issue in women’s health. Womens Health (Lond Engl). Sep 2010; 6(5): 753–766. doi:  10.2217/whe.10.57

Singh P, et al. Celiac Disease in Women With Infertility: A Meta-Analysis. J Clin Gastroenterol. 2015 Jan 1. [Epub ahead of print]

Tersigni C1, Castellani R1, de Waure C2, Fattorossi A1, De Spirito M3, Gasbarrini A4, Scambia G1, Di Simone N5. “Celiac disease and reproductive disorders: meta-analysis of epidemiologic associations and potential pathogenic mechanisms.” Hum Reprod Update. 2014 Jul-Aug;20(4):582-93. doi: 10.1093/humupd/dmu007. Epub 2014 Mar 11.

Sirota I, et al. Potential influence of the microbiome on infertility and assisted reproductive technology. Semin Reprod Med. 2014 Jan;32(1):35-42. doi: 10.1055/s-0033-1361821.

Stojanović N, et al Normal vaginal flora, disorders and application of probiotics in pregnancy. Arch Gynecol Obstet. 2012 Aug;286(2):325-32. doi: 10.1007/s00404-012-2293-7.

Zhu Q1, Wu L, Xu B, Hu MH, Tong XH, Ji JJ, Liu YS. “A retrospective study on IVF/ICSI outcome in patients with anti-nuclear antibodies: the effects of prednisone plus low-dose aspirin adjuvant treatment.” Reprod Biol Endocrinol. 2013 Oct 5;11:98. doi: 10.1186/1477-7827-11-98.

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Suzanne

I’m passionate about helping people find ‘outside the box’ solutions to improve their health and functionality at all levels. I believe good solutions for less than optimal health, including issues with sleep, vitality, hormones, fertility and general well-being, come from deeply investigating the reasons “Why” a particular barrier to optimal wellness has arisen for an individual.

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