Autoimmune disease and getting pregnant

Preparing for Pregnancy is a journey that is different for all of us. Some women fall pregnant without thinking about it or trying, and others only have to think about it and it happens. For some, it takes years and years of heartbreak and missed opportunities, and for other couples meticulous and careful preparation. Women with autoimmune illness are not exempt from any of the things that any other woman of reproductive age are, however, their journey with autoimmune disease and getting pregnant can be cause for added anxiety and stress.

Simply put an autoimmune disease is when the body does not do its job properly to protect itself from bacteria and illness, and starts to attack its own tissues. The last 20 years have seen a rise in autoimmune thyroid disease, Celiac Disease, Diabetes, Hashimoto’s, and Psoriasis…to name just a few.  Evidence also suggests that certain autoimmune processes may influence reproduction and fertility of both sexes. Pregnancy with an autoimmune disease in the classic medical model will often be classed as high risk. For some women who have an autoimmune disease, pregnancy can improve symptoms, such as in Rheumatoid Arthritis. While for others it can either exacerbate the symptoms or have no effect such as in Systemic Lupus.

Symptoms that may indicate your immune system is out of balance:

(which can have a severe impact on your chances of falling pregnant.)

• Digestive complaints,
• Recurrent illness,  
• Allergies/skin rashes,
• Chronic fatigue,
• Muscle and joint pain,
• Difficulty concentrating/brain fog 
• Blood sugar instability 

It is, if at all possible, vital to prepare for pregnancy as the health of both yourself and your partner can have far-reaching effects on your new baby…as new evidence comes to light every day. A planned and prepared for pregnancy has the chance of a better outcome regardless of autoimmunity.

Complications with autoimmune disease depend on which area of the body is compromised. Thyroid conditions can often be managed with good protocols put in place to monitor diet and blood levels. Joint problems will often be aggravated, and kidney and heart conditions can be problematic for the pregnancy. There is limited data on the safety of medications in pregnancy and the side effects may cause further issues with anemia, retention, and a host of side effects that come with steroid use. Hence why preparation is extremely important.

There are things that you can do to help combat Autoimmune Issues. Some of these include dietary, lifestyle changes and supplementation. Due to the diverse scope of autoimmune illness, a one size fits all information hand out is difficult to produce as every couple’s fertility journey will be unique. Therefore consultation with your Fertility Specialist, Naturopath, and/or Nutritional Medicine Practitioner is advised.

Dietary support for trying to conceive with an autoimmune disorder

Dietary changes are one of the most simple things that you can begin with, making sure to include macronutrients and micronutrients which have been documented to have beneficial effects on ovulatory function and fertility in women with autoimmune issues. There are many variations of a fertility diet published, but the basics are:

1. Plenty of coloured vegetables. Organic is preferable, but it isn’t always realistic or doable for many.  In this case look at the clean 15 and dirty dozen lists, and make sure your vegetables are washed. Aim for a good variety and all the colors of the rainbow.
2. Protein is very important for repairing cells as well as making new ones and is involved in a huge number of mechanisms and building blocks within the body. Women need to be aware of the hormone residues in meat products, particularly beef, as this may cause adverse reproductive issues hence the reasoning for grass-fed/organic meat if possible. Free range chicken and deep sea fish are good sources of both protein and omega 3 fats. For those who are vegetarian look at good quality sources of vegetarian proteins.
3. Dietary fats in studies of humans show that an increased intake of polyunsaturated fatty acids is associated with improved metabolic and endocrine characteristics in women with Polycystic Ovarian Syndrom (PCOS). Olive oil, coconut oil, avocado, and oily fish like deep sea salmon are good fats and help reduce inflammation.
4. Herbs such as curcumin, turmeric, parsley, coriander, and sage add flavor to dishes, but also have a host of hidden minerals and vitamins and are anti-inflammatory in nature.
5. Herbal teas can be calming, can improve the formation of new blood cells and improve cell integrity. Choose calming chamomile and lavender tisanes, hibiscus and lemon balm, ginger, and nettle leaf. Green tea is caffeine free, contains antioxidants and helps the liver detox.
6. Dairy and Gluten and most grains are inflammatory and should be avoided by people with autoimmune issues. Studies have documented a correlation between anti-sperm antibodies and food sensitivities, therefore, excluding these grains are worthwhile. Alternatives to dairy can include coconut milk and properly soured yogurt. Gluten is found in everything these days – watch for anything containing wheat, oats, barley, rye, spelt, or semolina. Even bottled sauces and condiments may contain gluten, so you need to check labels and be mindful. Everyone is different and some grains are tolerated by some people. Quinoa, organic rice, and amaranth in small quantities should be okay for some. Besides the inflammatory issue with grains, clinical trials have documented that a high intake of high glycemic index foods such as white bread and white potatoes were more prevalent in the diets of women with autoimmune issues. Alternatively, when women consumed a lower carbohydrate diet there were beneficial reductions in testosterone hormones that could, in turn, increase ovulatory function. For those needing to keep their carbohydrates levels up try lots of starchy vegetables like sweet potato and pumpkin.
7. Eliminate processed and packaged foods which contain trans fats.
8. The addition of micronutrients such as Folate, Vitamin D, and Iron has been significantly reported in many studies for the support of ovulation, so a key factor for women with immune issues where these micronutrients in most cases will be low.

Also avoid caffeine, alcohol, and smoking.

Herbal fertility treatments for autoimmune disorders

Herbs are helpful for both fertility and immune problems, however, it is highly recommended that you see someone qualified in this area that can liaise with your specialist if you are on any medications as there can sometimes be interactions between the two.

• Curcumin as previously mentioned is a common household herb. In supplement form, it is beneficial as a natural anti-inflammatory and improves clotting factors.
• Dong Quai is a herb that supports the stress response. It helps balance immunity and reduce inflammation and is also great for mental support.
• Shatavari is a herb that has a long list of health benefits but especially good if you are trying to conceive and have additional immune related issues. It is great for helping the body adapt to stress, can help regulate oestrogen and studies show that it has an anti oxytocin effect thereby helping to prevent miscarriage. It improves ovulation and secretion of cervical mucus and helps the body to eliminate the build-up of toxins in the body, thereby creating a healthier environment for the sperm and egg to be nourished.
• Tribulus Terrestris is a herb that both men and women can take for increased fertility. Studies have shown that in couples with sperm antibodies that contribute to infertility, Tribulus was documented to have a 61% increase in conception rates.
• Maca is a puruvian root vegetable that has been deemed as a superfood for assisting fertility. It nourishes the endocrine system supporting both the adrenal, thyroid and pituitary glands. These glands are all involved in keeping balance within the hormones and being first responders to stress, thereby assisting maintenance of proper immune function.

Other natural fertility treatments for autoimmune disorders may include:

It is strongly advised to consult with a Naturopathic Practitioner who can treat your condition and symptoms specifically and also advise a range of laboratory/pathology testing that may not normally be tested by your conventional medical doctor. The following list is a broad, general list and may be quite different depending on the Autoimmune Illness that is being treated.

• Stress reduction: Stress is a huge factor contributing to any illness. Stress aggravates autoimmune diseases and can have an effect on the thyroid and immunity. Therefore it is very important to address this when considering a pregnancy. Look at relaxation therapies that resonate for you whether that be a walk on the beach, a bath, yoga, meditation, exercise. Aim to get adequate sleep and look at things that will support the adrenal glands.
• Support the liver – this can be done with whole foods, herbs
• Repair the gut, take daily probiotics and treat any candida infections present.
• High-quality omega 3 fish oils are documented to support autoimmune markers.
• Antioxidants such as those found in green tea, have been found to be beneficial
• Vitamins B6 and B12

Conventional fertility treatments for autoimmune disorders may include:

• Low dose aspirin
• Anticoagulants
• Steroids
• Intravenous Immunoglobulin Therapy
• Lymphocyte Immunization Therapy
• TNF Alpha Blockers which are drugs that suppress inflammation. They are used for the treatment of diseases such as: arthritis, psoriasis, rheumatoid arthritis, juvenile arthritis, Crohn’s disease, Ulcerative colitis, and ankylosing spondylitis.

These treatments are often combined with IVF and other assisted reproductive techniques.

When the body is properly nourished it has the ability to adapt better to its internal environment, as well as the daily stress, toxic environmental overload, trauma, surgery etc..  Nutrition and exercise help in the healing process. When pregnant the options for effective treatment for immune-related issues become even more tricky. Therefore adequate preparation by supporting the body to function correctly with a number of modalities will allow for improved functioning, better able to tolerate stress, and better long-term outcomes for both mother and baby.

Written by Angela Smith: Registered Nurse, Midwife, and Integrative Health Practitioner from Perth, Australia

Hi, I’m Angela. I am a qualified Registered Nurse and Midwife and have primary qualifications in Nutritional Medicine and Reiki. I have been involved in healthcare since 1991, with extensive experience in high-risk pregnancy and birth and emergency nursing. I have always loved babies and wanted to work with them for as long as I can remember…along with an interest in Natural Health as a tool for health promotion. However, it wasn’t until a sojourn living overseas for 2 years that my path took a different turn and my interest in Nutritional Medicine..among other things resurfaced.

My vision is to explore further the mind-body component to illness and healing and educate others about the value of integrating a wide modality of healing tools for gaining wellness and to empower people to realize their own potential for the body’s capacity to heal.

I currently offer holistic, nutritional education and advice for fertility, pregnancy and postnatal as well as support for traumatic pregnancy and birth.

Inspired by You Healing and Wellness website and Facebook page

References

https://www.ncbi.nlm.nih.gov/pubmed/22284905

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2709983/

https://www.smartparents.sg/pregnancy/while-pregnant/how-autoimmune-disorders-affect-your-pregnancy-6933714

https://natural-fertility-prescription.com/immune-system-infertility/

http://www.whitelotusclinic.ca/blog/dr-fiona-nd/natural-treatments-for-autoimmune-infertility-concerns/

https://natural-fertility-info.com/immune-infertility.html

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