Celiac disease is an autoimmune condition in which the small intestine is hypersensitive to gluten. When someone with celiac disease consumes food containing gluten, their immune system is triggered in such a way that their body attacks its own tissue in an attempt to rid it of gluten. As time goes on, the digestive tract can be destroyed due to this process.
Gluten-free labels adorn grocery store shelves across the United States, with even some beverage companies choosing to verify that even their water doesn’t contain gluten. And while jokes may be made about the gluten-free diet being just another fad (i.e. “we’ve eaten gluten for hundreds of years without any problems until now,” the research done on celiac disease confirms that it’s more than just a Millennial-fueled myth.
Some of the research that has been done does indeed point to an affirmative link between male fertility and celiac disease. However, a 2011 study done in Sweden finds the opposite to be true—that no link between celiac disease and male infertility can be found.
Below, learn more about the connection between male infertility and celiac disease, whether eating a gluten-free diet can help improve fertility in men, and whether celiac disease-related infertility can be reversed.
Research on male infertility and celiac disease
There hasn’t been much research done on the connection between celiac disease and male infertility but what has been done points to a link. Some studies found that men who have undiagnosed celiac disease suffer from infertility more than do men without the disease. Other studies have found this not to be the case. Still, more research needs to be done to definitively suggest that the two are interrelated.
One study, entitled “Reproductive changes associated with celiac disease,” found that celiacs had increased (although reversible) states of androgen resistance, which means their body didn’t respond correctly to testosterone. This study also discovered that “almost 20% of married celiacs had infertile marriages,” and that semen analysis revealed abnormalities in both sperm motility and morphology. In fact, sperm motility was reduced in two out of three celiacs who had infertile marriages, according to the study. These findings caused researchers to believe that celiac disease caused an overall disruption of their endocrine system. Others reported the presence of oligospermia, a term that refers to low sperm count in semen.
As mentioned earlier, a large study conducted in Sweden and published in 2011, looked at 7,121 men who had been diagnosed with celiac disease. The study followed them from early adulthood to middle age. The men who were diagnosed with celiac disease had similar numbers of children as the men who did not have celiac disease, pointing to the hypothesis that men with celiac disease did not actually have lower fertility rates than those without it.
These conflicting studies make it hard to know for certain which theory is true. Instead, we have to deduct that it’s entirely possible that gluten intolerance, or celiac disease, can be a contributing factor of male infertility but isn’t always.
How does celiac disease impact reproductive health?
Celiac disease can cause a wide range of health issues that may directly or indirectly affect reproductive health in men. Not only do men (and women, for that matter) with celiac disease possess a greater risk for developing thyroid disease, malnutrition, hormonal imbalances, poor sperm (or egg) health, and atrophy of the reproductive organs, they may also be at a higher risk for a pregnancy that results in stillbirth, miscarriage, or intrauterine growth restriction (IUGR).
- Pain in the abdomen or joints
- Burning in the chest
- Excessive burping
- Presence of fat in stool
- Bone loss
- Delayed puberty
- Lactose intolerance
- Skin rash
- Weight loss
Can adopting a gluten-free diet help improve male infertility?
The “Reproductive changes associated with celiac disease” study found that sperm morphology, plasma testosterone, free testosterone, and androgen resistance all improved when men with celiac disease or symptoms of the disease removed gluten from their diet.
These findings suggest that infertility related to celiac disease is reversible. It’s important to note, however, that male infertility may not be 100% tied to celiac disease, even when that is a contributing factor. In fact, male infertility has many causes including:
- Smoking cigarettes
- Use of recreational drugs
- Alcohol abuse
- Overly intense exercise
- Unhealthy dietary choices
- Exposure to environmental toxins
- Tight underwear (and overheated testicles)
- Excessive, prolonged stress levels
Removing gluten from the diet can help men to balance hormone levels and restore sperm to optimal health. Along with a change in diet, it’s key for men to also address any other underlying health issues—from exposure to harmful toxins to high stress to drug and alcohol use.
Some men who remove gluten from their diets tend to consume more soy products, especially if they’re also removing dairy. Unfortunately, soy products contain phytoestrogens which mimic natural estrogen, increasing their estrogen intake significantly. This can inhibit testosterone production, furthering harming their fertility.
Men who decide to adopt a gluten-free diet should be careful to limit their soy intake and, instead, ingest other foods that can boost testosterone production, such as chicken, eggs, and fish.
Nutrient deficiencies that impact fertility in men with celiac disease
In addition to removing gluten from their diet, men with celiac disease may also experience some nutrient deficiencies. This is largely caused by the body's inability to properly absorb nutrients.
- Protein — Since protein is absorbed mostly by the small intestine, people with celiac disease don’t always absorb as much as their body needs to function optimally. Protein is needed for energy, as well as for building and repairing the body’s tissues.
- Vitamin A — For men with celiac disease, deficiency of vitamin A can cause lowered testosterone and decreased development of mature sperm.
- Vitamin D — This critical vitamin is important for proper bone formation, the proliferation and differentiation of cells, as well as inflammation response. Low levels of Vitamin D can be linked to an altered immune system which makes the formation of autoimmune diseases, such as celiac disease, more likely.
- Vitamin E — This is an essential vitamin for reproductive health. When levels are healthy, sperm health and motility are elevated and the risk of miscarriage decreases. When levels are too low, sperm health and motility suffer, and the risk of miscarriage increases.
- Vitamin K — Proper levels of vitamin K are essential to the health of a developing fetus.
- Selenium, folate, iron, and zinc — These are all nutrients that many people with celiac disease are deficient in that may impact fertility.
Men who choose to remove gluten from their diet due to celiac disease should also ensure they are eating plenty of foods rich in the above nutrients. Supplements can also be a good option, as long as they are being absorbed properly.
Should anyone who is trying to get pregnant stop eating gluten?
Cutting back on or removing gluten from your diet can be helpful if you’re trying to get pregnant and display symptoms of gluten intolerance or celiac disease. Otherwise, gluten itself is not thought to cause any harm, to mom, dad, or baby. It’s not always possible to identify celiac disease through symptoms. If you’re struggling to get pregnant, it’s a good idea to talk to your doctor. They can give you a test to determine whether you have celiac disease. Knowing for sure can help you know what steps to take as you try to conceive.