dinsdag 7 februari 2012

Glutenintolerantie, coeliaki en ovruchtbaarheid

Waarom worden deze feiten niet aan onvruchtbare stellen verteld?

Miljoenen mensen hebben coeliaki, maar de meesten weten niet dat ze het hebben en dat komt deels omdat symptomen zo verschillend kunnen zijn. Het is vaak een over het hoofd geziene spijsverteringsziekte die schade toebrengt aan de dunne darm wanneer gluten, een eiwit dat in tarwe, gerst en rogge voorkomt gegeten wordt.
Onvruchtbaarheid lijkt meer voor te komen bij vrouwen met onbehandelde coeliaki. Andere gynaecologische problemen kunnen dan ook vaker voorkomen zoals miskramen en premature geboortes.
Voor mannen kunnen abnormaal sperma de problemen zijn; zoals lagere spermatellingen, vernaderde vorm en gereduceerde functie. Mannen met onbehandelde coeliaki kunnen ook lagere testosteronlevels hebben.
Het goede nieuws is dat een juiste behandeling met een glutenvrij dieet en bij correctie van deficiënties van nutriënten de vooruitzichten voor toekomstige zwangerschappen veel verbetert. 


Commentaar van Dr. Mercola (Engels)

Celiac disease – which prevents your body from properly digesting gluten, a protein found in wheat, rye, and barley - may be far more common than previously thought. A decade ago, it was believed that celiac disease affected just one in 10,000 Americans.
But a 2004 report by the National Institutes of Health (NIH) estimates that as many as one in every 133 Americans have it. That equates to roughly 2 million people suffering from gluten intolerance in the US alone.
There are many millions more that suffer from sub-clinical gluten intolerance - some estimate as many as 30 million Americans — so there is a very real possibility that you or someone you know is affected by this.
Unfortunately, celiac disease can manifest in so many ways, it's frequently misdiagnosed and/or mistreated. One study showed it takes an average of 11 years for patients to receive a correct diagnosis!

What is Celiac Disease?
Celiac disease (CD) is an autoimmune disease, much like lupus and rheumatoid arthritis. To get the disease, you must have both a genetic predisposition plus an environmental factor that triggers the disease.
In this case, the environmental trigger is gluten.
If you have celiac disease, eating gluten triggers an autoimmune response, provoking your body to attack itself and destroy healthy tissues, especially the villi in your small intestine. This can also have a detrimental effect on your body's ability to absorb and process nutrients.
Some of the most common symptoms of this disease process include:
  • Chronic diarrhea
  • Gas
  • Bloating
  • Acid reflux
  • Constipation
Even a small amount of gluten can trigger a response.

How Celiac Disease Can Affect Your Fertility
In the New York Times article above, Dr. Sheila Crowe, a professor in the division of gastroenterology and hepatology at the University of Virginia, provides information about a slightly lesser known side effect of celiac disease, namely infertility, which can affect both men and women with the disease.
Studies from various countries indicate that fertility problems are indeed more common in women with untreated celiac disease, compared to women who do not have it.
The risk of suffering other gynecological and obstetrical problems like miscarriage or preterm birth is also higher for those with celiac disease.
In addition, other common menstrual disorders that frequently affect women with celiac disease include:
  • Later onset of menstruation
  • Earlier menopause
  • Secondary amenorrhea (a condition in which menses starts but then stops)
These menstrual abnormalities, along with other hormonal disruptions they cause, can lead to fewer ovulations, which in turn results in a reduced chance of pregnancy.
Men with the disease, especially if it's undiagnosed, can also face fertility problems due to:
  • Abnormal sperm (reduced sperm count, altered shape, and reduced function)
  • Reduced testosterone levels
How to Diagnose Celiac Disease
As Dr. Crowe recommends, it might be wise to get screened for celiac disease if you suffer from repeated miscarriages or are unable to conceive for unknown reasons - especially if you suffer any of the most common symptoms.
Just remember that symptoms can vary widely, and symptoms are easily confused with those of other diseases, such as irritable bowel syndrome, iron-deficiency anemia, or even chronic fatigue syndrome.
Fortunately, there are now more reliable blood tests that can screen for the disease, so that you’re not left guessing and wondering.
People with celiac disease have higher than normal levels of certain autoantibodies in their blood. So to diagnose celiac disease, your doctor will need to test your blood for high levels of anti-tissue transglutaminase antibodies (tTGA) or anti-endomysium antibodies (EMA).
Please keep in mind that you need to continue eating a diet containing gluten, such as breads and pastas, in order to obtain an accurate test result! If you go on a gluten-free diet prior to being tested, the results may come up negative for celiac even though you might in fact have the disease.
If the test is positive for celiac disease, a biopsy of your small intestine may be performed to confirm your diagnosis. The biopsy checks for damage to the villi, which is a sign that celiac disease is damaging your intestines.

The Case for a Low- or No-Grain Diet - Whether You Have Celiac Disease or Not
The prevalence of celiac disease is yet more evidence that contemporary humans simply aren’t equipped to consume mass quantities of starch and sugar rich foods many modern diets consists of.
Most people simply consume far too much bread, cereal, pasta, corn (a grain, not a vegetable), rice, potatoes, snacks and junk foods, with grave consequences to their health.
A diet high in grains causes insulin resistance which causes far more problems than this dangerous autoimmune response. It's also a leading factor of obesity, which now affects a whopping two-thirds of all Americans.
Many of you are still focused on fat intake, but it's really not the fat in the foods you eat but rather the excess carbohydrates from your processed food diet that is making you overweight and unhealthy, and contributing to epidemic levels of other diseases such as diabetes.

How to Treat Celiac Disease
In my experience, gluten intolerance can be treated quite easily by eliminating gluten and most grainsfrom your daily diet.
It's important to realize that gluten can be hidden in many foods including soups, soy sauce, candies, cold cuts, and various low- and no-fat products, so check the labels before you eat it.
Also watch out for malt, starches, hydrolyzed vegetable protein (HVP), texturized vegetable protein (TVP) and natural flavoring.
Some pharmaceuticals, vinegars and alcohol can also contain gluten.
If you have celiac disease, it's imperative that you do not eat gluten in order to avoid further damage to your health. But it's not only people with gluten intolerance who would benefit from avoiding grains–in my estimation over 85 percent of the population would benefit from avoiding them, and this includes even whole, organic grains.
Remember, if you stick to a diet consisting mainly of whole foods, preferably locally-grown organics, you'll reap all the other beneficial side effects as well, such as increased energy, an enhanced mood, and a lower risk of other chronic illnesses.
Once you realize how good you can feel on a gluten-free diet, you'll probably have no problem avoiding it and living a full, healthy life!

Additional Resources
For more in-depth information about celiac disease and going on a gluten-free diet, here are three good sources:

Related Links:

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