By, Heather Stern
October 22nd, 2009 - An important update to the continuing literature on Celiac Disease was recently published in the October issue of the Practical Gastroenterology, a peer reviewed clinical journal focusing on the diagnosis and management of digestive diseases. The article, a collaborative effort by Alice Bast, founder and president of the NFCA, Dr. Tom O’Bryan, and Elizabeth Bast, highlights five major issues associated with reproductive health; citing numerous scientific studies that have indicated reproductive health has one of the most pressing matters associated with the importance of advancing awareness. Of the 3 million estimated sufferers of Celiac Disease, 95% remained undiagnosed, and therefore may have a lot of unanswered questions without somewhere to turn.
The article focuses on a number of concerns that the general public may experience in association with reproductive health, including infertility and stillbirths. In a study of female fertility using patient-control pairs, a higher incidence of miscarriages occurred in patients with untreated celiac disease. An Italian study in the article is also quoted to find up to 50% of female celiac pregnancies result in unfavorable outcomes or miscarriages. There are also concerns around malnutrition in females that are undiagnosed with CD, which would effect not only their own health, but that of a developing baby. This reinforces the need for proper diagnosis and education of OBGYN’s and fertility specialists.
According to study results, more CD testing could also help the risk of low birth rate, or Intrauterine Growth Retardation or Restriction (IUGR) as retrospective studies have shown that higher rates of IUGR exist in celiac patients. In addition to the effect on pregnancies, the age of menarche and menopause in patients have been sited in multiple studies as linked to the presence of Celiac Disease; delaying the first menstrual period for up to 1. 5 years later for women who had CD but were not on a gluten free diet. Those with untreated CD were also found to enter menopause 4 or 5 years before those who were avoiding gluten.
The article emphasizes that the potentially negative effect on fertility is not just a concern for women either. 19% of male celiacs have been found to have infertile marriages, highlighting the need for CD testing in both sexes for couples with unexplained infertility. Studies site babies are five times higher at risk for a low birth weight baby when the father had CD that that of the general population. It was also noted that nutritional concerns such as huperporlactinaemia, fat malabsorption, selenium deficiencies, zinc deficiencies and iron deficiencies, all common consequences of men or women with undiagnosed CD, might also be contributing to infertility or impotence.
Overall, one of the most important results of this study is truly the need for additional research and testing in order to help the millions of undiagnosed sufferers that have no answers to their reproductive problems. It is also important to note that if you have been diagnosed with Celiac Disease, it is essential to start the gluten free diet in order to maintain many aspects of your health.
Source: Celiac Disease and Reproductive Health, Practical Gastroenterology- October 2009, Volume XXXV, No.10.
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