Miscarriage

woman grieving after a miscarriage

Reasons for Miscarriage or Recurrent Miscarriage

By Dr Pamela Frank, BSc(Hons), ND

What Causes Miscarriage?

There are a number of factors that can contribute to recurrent miscarriage:

  1. Genetic defects with the fetus.  These can be caused by oxidative stress/oxidation, MTHFR genetic mutation and/or exposure to toxins and pollutants. These are all issues that can be helped through naturopathic medicine.
  2. Low luteal phase progesterone/luteal phase defect.  A shortened luteal phase or suboptimal production of progesterone during a normal length luteal phase can affect implantation and fetal development.  Progesterone levels can be improved through the use of specific vitamins and herbs.
  3. Gluten allergy/intolerance.  Undiagnosed celiac disease and/or gluten intolerance have been correlated with recurrent miscarriage.  As an ND, I can test for Celiac disease or gluten intolerance and advise as to proper diet for fertility.
  4. Autoimmune.  In autoimmune disorders, such as Hashimoto’s thyroiditis, there are several factors that may cause overactivity of the immune system such as under-functioning adrenal glands, poor gut health and food allergies like gluten.  Supporting healthy adrenal gland function, addressing gut dysbiosis, food sensitivities and gut wall integrity can help.
  5. Hormone imbalance.  Consuming a high glycemic index diet can cause various hormone imbalances that can contribute to miscarriage. Eating a healthy, fertility diet can help, I can advise as to what to eat and what to avoid for optimal fertility.
  6. Low thyroid function.  Even at fertility clinics, thyroid disorders sometimes go undiagnosed.  I can do thorough thyroid testing and ensure that your thyroid working at optimal efficiency.

How Can You Prevent a Miscarriage?

To prevent miscarriages, as a naturopath, I would address each of these factors accordingly:

  1. Genetic defects can occur due to:
    a)  high oxidative stress in either the mother or the father, remember the dad contributes half of the DNA that goes into the fetus.  Reducing factors that contribute to oxidative stress like diet, sedentary lifestyle, smoking and increasing antioxidant intake can help.
    b)  an MTHFR genetic mutation in either the mother or father.  Most people would have no idea if they had this (although 25-60% of the population has) or even what it is.  Most doctors wouldn’t even know what it is, although there is a test that can be done for it.  Having this mutation means that an individual can’t reap the benefits of folic acid in preventing birth defects and DNA damage.  This can be overcome by using exclusively ACTIVE folic acid, 5MTHF.
    c)  toxin accumulation.  The liver is responsible for breaking down toxins like body waste, pollution, pesticides etc for excretion.  If the liver is lacking a vital vitamin, mineral or amino acid to do this, then toxins accumulate in your system.  Providing vitamin B6, vitamin B12, 5MTHF, magnesium, indole-3-carbinol and calcium-d-glucarate can facilitate healthy excretion of toxins and balance hormones.
  2. Male genetic defects.  Half of the DNA that is going into the fetus is coming from the father.  Research has shown that correcting adverse lifestyle factors, varicocelectomy and antioxidant therapy can improve DNA fragmentation and reduce recurrent pregnancy loss.
  3. Low luteal phase progesterone is frequently the cause of miscarriage.  Having adequate progesterone enables healthy embryo implantation and maintains the pregnancy through the first trimester.  Diet, stress and exercise play a significant role in determining progesterone production.  Herbs and vitamins can be used to enhance progesterone production.
  4. Gluten allergy/intolerance – bloating, gas, constipation, diarrhea, tiredness after eating, and heartburn can all be possible signs of a gluten allergy or intolerance.  Studies have shown a significant correlation between gluten allergy/intolerance and recurrent miscarriage.
  5. Autoimmune issues – Sometimes a miscarriage occurs due to antibodies produced against the fetus.  The body should recognize the fetus as safe and not produce such antibodies, but under conditions of poor adrenal gland function, dysbiosis in the digestive tract and/or food allergies antibodies can be produced that can then cross-react with fetal tissue.  Adrenal support, probiotics and removal of food sensitivities can help tone down the immune system.
  6. Hormone imbalance – Standard North American diets that are heavy in carbs tend to promote hormone imbalances that can cause infertility and/or recurrent miscarriage.  A low glycemic index/low glycemic load diet can help.
  7. An underactive thyroid can contribute to miscarriage.  The standard blood test for thyroid function is called a TSH level, or thyroid stimulating hormone.  The normal range for TSH = 0.35 – 5.00.  This range is exceptionally broad (like saying 35-500 is normal!).  Many fertility clinics are now giving thyroid medication to women whose TSH is greater than 2.00.  In some instances to improve thyroid function, the thyroid just needs to be supported nutritionally, in others, autoimmune conditions need to be corrected (Hashimoto’s), and in some patients thyroid medication appears to be the only solution.   Ideal thyroid levels are vital to maintaining a pregnancy and having a healthy child.

As a naturopathic doctor, with a special interest in fertility, I can address all of the above to make sure your body is in the best possible place to have a healthy pregnancy and child.

Miscarriage Research

Here is a small sampling of the research linking modifiable factors like vitamins and minerals to recurrent pregnancy loss:

Omega 3, vitamin D3, and B complex

Elevated cytokine ratios have been linked with adverse reproductive outcomes, and proposed treatments have included biological immunomodulators which antagonise TNFa, but come with significant associated cost implications and more importantly, cytotoxic side-effects. A dietary regime is more patient-friendly and lower risk, while still achieving a similar effect in many patients.  Fertil Res Pract. 2018 Mar 2;4:1. doi: 10.1186/s40738-018-0046-4. eCollection 2018. Anti-oxidant mediated normalisation of raised intracellular cytokines in patients with reproductive failure. Marron K1, Kennedy JF1, Harrity C2.

Male Genetic Factors

This paper outlines the positive effects of correcting adverse lifestyle factors, varicocelectomy and antioxidant therapy on helping to reduce recurrent pregnancy loss.  Urologiia. 2016 Mar;(1 Suppl 1):35-43. A man’s role in recurrent miscarriage in a spouse.  Gamidov SI1,2, Ovchinnikov RI1, Popova AY1,2, Golubeva ON3, Ushakova IV3.

Celiac Disease

Celiac disease should be researched in infertility, spontaneous and recurrent abortions, delayed menarche, amenorrhea, early menopause, and children with low birth-weight.  Gastroenterol Hepatol Bed Bench. 2016 Fall;9(4):241-249. Celiac disease and obstetrical-gynecological contribution. Casella G1, Orfanotti G2, Giacomantonio L2, Bella CD3, Crisafulli V4, Villanacci V4, Baldini V1, Bassotti G5.

Causes of Recurrent Miscarriage

Known causes include abnormal chromosomes, endocrinological disorders and uterine abnormalities.  Postgrad Med J. 2015 Mar;91(1073):151-62. doi: 10.1136/postgradmedj-2014-132672. Epub 2015 Feb 13. Recurrent miscarriage: causes, evaluation and management.  Garrido-Gimenez C1, Alijotas-Reig J2.