The connection between autoimmune problems and miscarriages has been known by the medical community for many years. The National Institutes of Health published a study titled “Autoimmune diseases and pregnancy: analysis of a series of cases” which concluded that there is “a strong association between autoimmune disease and obstetric complications.” Yet addressing autoimmunity in order to increase a woman’s chance of carrying a pregnancy to term is not on most doctors’ radar. Instead, a variety of treatments are tried or women are told to “just keep trying”; unfortunately for many, yet more miscarriages occur. Understandably, this leads to depression, anxiety, self-blame and other psychological issues in the women who are affected, especially those who suffer multiple miscarriages.
According to the American Pregnancy Association (APA), between 10 and 25 percent of all pregnancies in the US end in miscarriage (this increases in women over the age of 35); the APA also estimates that once a woman has one miscarriage, there is a 25 percent chance that she will experience another. After two clinical miscarriages, they’re considered recurrent pregnancy losses (RPL), or recurrent miscarriages, and the chances of her experiencing more miscarriages elevates beyond 25 percent. In research conducted by the American College of Obstetricians and Gynecologists, doctors are unable to find a cause for recurrent miscarriages in 50 to 75 percent of their cases.
There are uncountable stories of women going from doctor to doctor—even going to doctors in different countries—in an effort to find someone who can correct whatever is causing their recurrent miscarriages. In approximately 60 percent of miscarriages, there is evidence of genetic (chromosomal) abnormalities. But once doctors ascribe the blame for a miscarriage on genetic abnormalities, no further investigation is done. However, two things need to be considered: there can be underlying causes for these genetic abnormalities, and autoimmunity issues can appear as genetic abnormalities. The medical journal Autoimmunity Reviews published research in 2011 stating that there is substantial evidence that a pregnant woman’s autoimmunity alone can increase the risk of genetic abnormalities in embryos, which can lead to miscarriages.
As with any health issue, the root causes will differ for each person, and the same is true for women experiencing recurrent miscarriages. If it’s determined that a woman has autoimmunity issues, such as celiac disease, Crohn’s disease, Hashimoto’s, rheumatoid arthritis, Grave’s disease, etc., then her functional medicine doctor can perform comprehensive testing to discover which health issue(s) exist, whether there are additional factors complicating or causing the problem, and how to best go about reversing or improving these issues without dangerous prescription medications. This will ultimately achieve two things: the patient’s health in general will be improved and associated future health concerns may be avoided, and she will have a better chance of carrying a pregnancy to term.
The connection between multiple miscarriages and celiac disease (it’s important to note here that not all women with celiac experience miscarriages) is not completely understood, although there is strong evidence for a link. However, while conventional medicine rarely addresses celiac issues as a cause for RPL, there are documented cases in which functional medicine doctors have found elevated anti-gliadin and anti-transglutaminase antibodies in women with celiac who have experienced recurrent miscarriages. After removing gluten from these women’s diets and using appropriate natural supplementation, viable pregnancies were achieved.
Healthy thyroid function in expectant mothers is critical to a healthy, full-term pregnancy as well as to the development of the baby’s brain and nervous system. While standard monitoring of TSH, T3 and T4 levels in women with RPL may show acceptable “normal” levels, these tests don’t show whether there are elevated levels of thyroid antibodies (these may also be present before pregnancy), which can be responsible for multiple miscarriages.
While there are certainly other reasons for recurrent miscarriages that need to be addressed differently, autoimmune issues are one area where the underlying cause can be either eliminated or lessened naturally, which will improve the overall health of the patient in both the short and long term and may improve pregnancy outcomes.