After assurance from breast implant makers that concerns about silicone leaks were a thing of the past, more than 10 million women worldwide have received silicone breast implants in the past decade. However, a growing body of research — supported by increased symptom reporting by women —links silicone breast implants to autoimmune disorders and a rare form of immune cancer.
Silicone breast implants linked to autoimmune disease
Doctors commonly advise potential breast implant candidates that the risks are minimal, yet multiple recent studies indicate otherwise.
A recent study at the University of Alberta comparing nearly 25,000 women with breast implants to nearly 100,000 without them confirmed that nearly one in four implant recipients is at risk of developing an autoimmune disorder.
The risk for women with breast implants developing an autoimmune disease is 45 percent higher than for those without implants.
While former studies on the topic have been criticized because they were based on self-reporting by subjects, this study used doctor-based diagnoses to confirm results.
Previous research has also found surgical mesh implants used for gynecological or hernia repair may be linked to autoimmune disorders such as rheumatoid arthritis and lupus. Additionally, patients with allergies prior to the procedure were significantly worse afterward.
In the Alberta study, the strongest links were shown between silicone implants and these autoimmune conditions:
Sjögren’s syndrome, an autoimmune disorder of the salivary and tear glands.
Sarcoidosis, an autoimmune disorder of the lung, skin and lymph nodes.
Systemic sclerosis, an autoimmune disorder of the connective tissue affecting the skin, arteries, and visceral organs such as lungs and kidneys.
The theory behind these findings is that foreign material of the mesh and silicone implants causes an activation of the immune system. The body continues to fight the “invader” and over time autoimmunity develops.
Emerging form of breast implant-related cancer on the rise
Individuals with breast implants are also at risk of developing breast implant large cell lymphoma, or BIA-ALCL. BIA-ALCL is not breast cancer but a form of non-Hodgkin’s lymphoma, a cancer of the immune system.
In most cases BIA-ALCL is found in fluid and scar tissue near the implant, however there are cases where it spreads throughout the body.
The FDA states, “At this time, most data suggest that BIA-ALCL occurs more frequently following implantation of breast implants with textured surfaces rather than those with smooth surfaces.”
Plastic surgeons have identified 615 cases of BIA-ALCL worldwide with the disease occurring at higher rates among women with textured implants. French authorities have recommended against the use of textured implants due to the cancer risk.
At present, however, the risks are difficult to determine due to significant limitations in world-wide reporting and lack of data.
Lax reporting rules at fault for lack of patient awareness
Prior to 2017 the FDA allowed breast implant companies to report breast implant injuries as routine events that did not require public disclosure. This effectively kept the information from the public and may have skewed opinions on the safety of using them.
In 2017 reporting rules were changed and reports of injuries soared. At the current rate, they are slated to increase more than 20-fold in the last two years from the previous two-year period.
According to an ICIJ analysis of FDA data, after the rule change the number of suspected breast implant injuries skyrocketed from 200 a year to more than 4,500 in 2017 alone.
In just the first half of 2018, that number almost doubled to more than 8,000 filed reports.
The increase in reports doesn’t mean implants are suddenly going bad but that they may never have been as safe as patients were told in the first place.
The FDA has acknowledged a “transparency issue” regarding the undisclosed injury reports and that the increase in numbers reflected the change in reporting rules.
Changing the system to better protect breast implant recipients
The FDA warns that as many as one in five women who receive breast implants will get them removed within a decade due to complications such as rupture, deflation, and painful contraction of scar tissue around the implant, but currently there is no warning about autoimmunity.
The good news is that in response to the new information, the FDA and agencies around the world acknowledge that more research needs to be done to determine the autoimmune and cancer risks of implants.
While current studies do not prove breast implants cause these diseases, they do show that women with the implants suffer them at significantly higher rates than women without implants.
It’s proposed that bacterial infection of a biofilm that surrounds the implants is the likely cause of implant-related illness, including BIA-ALCL.
Patient advocates propose rules requiring breast implants to be sold with “black box” label warnings, which are reserved for life-threatening and other serious risks.
Undoubtedly, it will take much larger and longer studies to root out the details and bring about protective actions, and in the meantime, doctors and patients need to have deeper conversations about the benefits and risks of silicone breast implants.
Fats are a hot topic of debate in the health-conscious community, and recent reports have made it hard to separate facts from fear-mongering. Canola and coconut oils are two popular fats that have received a lot of attention over the years, and thankfully recent studies are showing us more clearly which fats to embrace, and which to avoid.
To understand which fats are healthy, it’s helpful to understand “good” HDL and “bad” LDL cholesterol, small fat and protein packages that transport cholesterol throughout the body.
High-density lipoprotein (HDL) or “good” cholesterol helps protect your arteries from cholesterol and removes excess arterial plaque.
Low-density lipoprotein (LDL) or “bad” cholesterol can accumulate in the arteries to form plaque that narrows them and makes them less flexible (atherosclerosis).
Triglycerides. Elevated levels are linked to heart disease and diabetes. Risk factors include smoking, physical inactivity, excessive drinking, overweight, and a diet high in sugars and grains.
HDL, LDL, and triglycerides come in small and large particles. While the large particles are practically harmless, the small, dense particles are more dangerous. They can lodge in arterial walls, leading to inflammation, plaque buildup, and damage that eventually leads to heart disease.
When considering test results, your doctor will note:
HDL levels versus LDL levels
The ratio between triglycerides to HDL
The ratio between total cholesterol and HDL
The size of the particles
Here’s where the former warnings about fats and cholesterol have been misleading: We now understand that more important than knowing your total cholesterol is knowing the ratio between your HDL and your LDL, and especially the size of the particles.
In addition, the Mayo Clinic says many doctors now believe that for predicting heart disease risk, total non-HDL may be more useful than calculating your cholesterol ratio. Non-HDL cholesterol is figured by subtracting your HDL cholesterol number from your total cholesterol number.
Finally, either option appears to be a better risk predictor than your total cholesterol level or simply your LDL level.
Note: In some cases, people have a genetic tendency toward extremely high cholesterol. In those situations, it may take more than diet to manage cholesterol levels.
Should I consume saturated fats?
Sourced from tropical oils and animal products, saturated fats are typically solid or semi-solid at room temperature. Common dietary sources include beef, pork, lamb, poultry skin, high-fat dairy, palm oil, and coconut oil.
Saturated fat sits at the forefront of the debate about dietary oils. Why? For years, we’ve been warned that it increases the risk for cardiovascular disease because it raises LDL, the “bad” type of cholesterol.
This recommendation was based on four hand-picked studies done nearly 40 years ago and doesn’t reflect recent studies that shine a different light on fat intake. What the studies didn’t do is take into consideration other things saturated fats do to help balance the equation:
Raise HDL (“good”) cholesterol.
Change LDL (“bad”) cholesterol from small, dense particles — dangerous for heart health — to large particle LDL, which does not increase heart disease risk.
Support brain health.
Possibly reduce stroke risk.
In fact, a recent meta-analysis of studies showed there is no significant evidence that dietary saturated fat is associated with an increased risk of coronary heart disease or cardiovascular disease.
For some people there are legitimate reasons to moderate saturated fat intake:
Saturated fat intake can be associated with lighter, less restorative, more disruptive sleep (yet increased fiber can help increase sleep quality).
ApoE4 carriers (increased Alzheimer’s risk) see a much higher spike in LDL cholesterol from high saturated fat in the diet, without a matching rise in HDL. They may benefit from lower intake of saturated fat which can lower LDL cholesterol and improve HDL/LDL ratio.
A small percent of the population does experience a skyrocketing increase in LDL concentrations along with increased inflammation levels measured by C-reactive protein.
Ask meabout a diet that is sufficient in healthy fats, void of bad fats, and customized to your dietary needs.
Many of us start the day with a small breakfast as we run out the door, followed by a medium sized lunch and a large dinner. We also tend to snack throughout the day and even grab a bite before bed. However, while what we eat is important, a growing body of research suggests when we eat matters too.
The digestive system’s circadian rhythm
While you have likely heard of the circadian rhythm, the master “clock” in the brain that governs our sleep-wake cycle, we actually have a variety of circadian clocks that govern the daily cycle of activity for every organ.
These rhythms exist because every organ needs downtime for repair and regeneration.
The digestive system is no exception. During the day, the pancreas increases production of insulin, which controls blood sugar levels, and then ramps it down at night.
Circadian clocks optimize our health by aligning our biological functions with regular and predictable environmental patterns. Disrupting our circadian clocks — such as by skipping breakfast or eating at midnight — can result in health issues such as weight gain, metabolic syndrome, cancer, cardiovascular disease, and more, and if you want to know more about YOU and YOUR health, schedule a FREE 15-minute consultation with Dr. Celaya.
Eat breakfast daily
About 20 to 30 percent of American adults skip breakfast. Some do it to save time, many do it in an effort to lose weight. However, studies show that people who eat breakfast daily are less likely to be obese, malnourished, suffer from impaired blood sugar metabolism, or be diagnosed with diabetes.
They are also less likely to have the heart disease risk factors of high blood pressure and high cholesterol. Even the American Heart Association recently endorsed biologically appropriate meal timing to reduce the risk of heart disease.
Just eating breakfast isn’t the only important thing, however. It’s critical to start the day with a breakfast that provides plenty of protein and healthy fats, and a minimum of sugars. This helps support blood sugar balance and proper brain function throughout the day.
Make breakfast the largest meal for weight control and fat loss
The timing in relation to the size of our meals is also important.
Research shows having the largest meal in the morning appears to help with weight control compared to having a large meal in the evening.
In fact, a person eating the identical meal at different times of day might deposit more fat after an evening meal than a morning meal.
This is partially because insulin, a hormone that helps with blood sugar control, appears to be most efficient in the morning. In addition, we burn more calories and digest food more efficiently in the morning than later in the day when most of us eat our largest meal.
In one study, a group of overweight women with metabolic problems were put on a 1400 calorie-per-day diet. Half consumed 700 calories at breakfast, 500 calories at lunch, and 200 calories at supper and the other half reversed that pattern.
Women in both groups lost weight and experienced reduction in fasting glucose, insulin, and ghrelin (a hunger hormone), but in the same time frame the large-breakfast group experienced added benefits:
They lost 2.5 times the weight compared to those who ate the largest meal at dinner.
They had a significantly greater decrease in fasting glucose, insulin, and triglyceride levels.
Their satiety (sense of fullness) scores were significantly higher.
They also lost more body fat, especially in the belly.
According to the researchers, a high-calorie breakfast and a reduced calorie dinner is beneficial and might be a useful alternative for managing obesity and metabolic syndrome.
The body needs fasting periods for optimum health
Fasting signals to the body to start burning stores of fat for fuel. Most of us eat meals and snack from the time we wake up until shortly before bed — or even in the middle of the night. In fact, studies show the average person eats over a 15-hour period during the day. This short fasting time period may interfere with optimal metabolism and increase weight gain.
Researchers put a group of prediabetic men through two eating cycles. In one phase, they ate meals within a 12-hour window for five weeks.
Then in another phase, they ate the same meals in a time-restricted six-hour window starting in the morning.
They ate enough to maintain their weight, so they could assess whether the time-restricted regimen had benefits unrelated to weight loss.
In addition, the men who ate only one or two meals per day fared better than those who ate three meals.
A recent review of the dietary patterns of 50,000 adults over seven years provides added evidence that we should ingest most of our calories early in the day, including a plentiful breakfast, a smaller lunch, and a light supper.
The researchers said that eating breakfast and lunch five to six hours apart and making the overnight fast last 18 to 19 hours may be an effective method for preventing long-term weight gain.
Another recent study found that subjects who added snacks to their daily meals tended to gain weight over time, while those who had no snacks tended to lose weight.
Light exposure is key for proper metabolism
Sufficient exposure to natural light and darkness also play an important role in how we metabolize food for either energy production or fat gain.
At night, the lack of sunlight signals our brain to release melatonin, the hormone that prepares us for sleep. In the morning, the light stops melatonin production and we wake up.
When we change that signaling — whether from a late-night meal, artificial lighting at night (especially blue screen light), shift work, flying and travel, or changing our eating patterns — it confuses our bodies’ circadian clocks. Eating at the wrong time of day strains the digestive organs, forcing them to work when they are supposed to rest.
Shift workers, who account for about 20 percent of the country’s workforce, have a particular problem with disturbed circadian clocks. Many frequently work overnight shifts, forcing them to eat and sleep at odd times. Nighttime shift work has been linked to increased risk of obesity, diabetes, heart disease, and breast cancer.
Studies have linked poor melatonin activity and disrupted sleep-wake cycles with an increased risk of dementia and Alzheimer’s, cancer, autoimmune flare-ups, obesity, and more.
Low blood sugar may require a before-bed snack
One important exception to the “don’t eat right before bed” rule is for those who have chronic low blood sugar. For these people, keeping blood sugar stable throughout the day — and night — is critical for brain health, energy level, and more.
If you suffer from the following chronic low blood sugar symptoms, it may be best to take a small, high-protein low sugar snack just before bed:
Constant sugar cravings
Nausea or lack of appetite in the morning
Irritability, light-headedness, dizziness, or brain fog if meals are missed
Craving caffeine for energy
Eating to relieve fatigue
Afternoon energy crashes
Waking around 3 a.m.
Daily habits to maximize your dietary rhythm
To help maximize your meal timing and metabolism, incorporate the following habits into your day:
Make breakfast your largest meal and make dinner your smallest. While this may prove difficult for those with a busy social life or family that sits down to a big dinner every evening, make the evening meal smaller whenever possible.
Prioritize protein and healthy fats with breakfast, and minimize sugar and caffeine intake especially before lunch, to stabilize blood sugar and regulate metabolism.
Avoid between-meal snacks and bedtime goodies. The exception is for those who have chronic low blood sugar as mentioned above.
Try a time-restricted eating pattern, or intermittent fasting, to maximize weight management.
Manage exposure to blue light at night:
Avoid screen light in the evening
Install the f.lux app on your phone and computer
Read a book
Wear blue-blocker glasses at night
Install amber or red light bulbs for evening use
If you have chronic low blood sugar, a small before-bed snack with plenty of protein may be a good idea to keep your blood sugar stable all night and prevent that 3 a.m. wake-up.
While studies suggest that prioritizing larger meals early in the day helps support metabolic health, it does not necessarily mean that you should skip dinner. Instead, have your dinners earlier and make them relatively light.
The take-home message here is like the old proverb, “Eat breakfast like a king, lunch like a prince and dinner like a pauper.” Schedule a FREE 15-Minute Consultation with Dr. Celaya.
It’s not easy being female — the hormonal ups and downs each month through puberty and then menopause can range from mildly irritating to downright debilitating. Although many, if not most, women suffer from some degree of premenstrual syndrome (PMS), the extreme health and mood imbalances associated with PMS and menopause are a sign your system is out of whack, most likely because of stress.
Hormone balance is very sensitive to stress, inflammation, toxins, poor diet, sleep deprivation, lack of exercise, too little sunlight, and other common factors of modern life. Because the reproductive hormones play an important role in brain health, mood, and brain inflammation, when they’re off, brain function and mood suffer.
In women, imbalances are characterized by excess estrogen, insufficient progesterone, or too much testosterone. Stress and blood sugar that is either too low (hypoglycemia) or too high (insulin resistance) are the most common culprits of PMS symptoms and a miserable menopause transition.
Symptoms of hormonal imbalances in women include:
Frequent or irregular menstruation
Changes in weight or appetite
Low progesterone from chronic stress
One of the more common reasons for hormonal imbalance is low progesterone caused by chronic stress. This is a mechanism called “pregnenolone steal,” when chronic stress robs the compounds needed to make progesterone in order to make stress hormones instead. This leads to PMS and sets the stage for a miserable menopause transition.
When it comes to stress, the brain does not know whether you are angry at traffic, soaring and crashing after snacking on a glazed donut and triple-shot caramel latte, or narrowly escaping being trampled by a bison. All it knows is to prepare for fight or flight and that reproduction hormones can wait until things have settled down. But for many sleep-deprived, over-stressed Americans fueled on caffeine and sugar, settling down rarely truly happens.
The fix isn’t necessarily in a tub of progesterone cream; first address the sources of stress. A primary stress-buster is a diet that stabilizes blood sugar. People often either eat too infrequently and too sparingly, or they overeat and eat too much sugar. Both are stressful for the body.
Here are some other common causes of chronic stress that lead to miserable PMS and menopause:
Sugar, sweeteners, starchy foods (rice, pasta, bread, etc.), too much caffeine
Leaky gut and gut inflammation symptoms — gas, bloating, indigestion, heartburn, diarrhea, constipation, stomach pain, irritable bowel
Pain and inflammation — joint and muscle pain, skin rashes, respiratory issues, brain fog, fatigue, depression
Autoimmune diseases such as Hashimoto’s hypothyroidism
Overdoing it, over exercising, not taking time for yourself
Bad diet of junk foods, fast foods, processed foods
Restoring hormonal balance naturally
Ideas to halt pregnenolone steal include an anti-inflammatory diet, stabilizing blood sugar, restoring gut health, dampening pain and inflammation, and managing autoimmunity. These are functional medicine basics. Make sure you are eating the right amounts and kinds of essential fatty acids. Additionally, certain botanicals are effective in supporting female hormone health and the body’s stress handling systems. Ask my office for more advice.
It’s now common knowledge that nighttime exposure to computer, tablet, and TV screens sabotages sleep —the light they emit simulates sunlight, thus suppressing sleep hormones. However, plenty of daytime sunlight is vital for good sleep. Most of us don’t get near enough.
Research shows the average person spends less than an hour a day outside. For shift workers it’s even worse. Lack of exposure to sunlight inhibits production of melatonin, a hormone that puts us to sleep.
A Finnish rat study observed one group living under fluorescent lighting and another group exposed only to sunlight through windows every day. While both groups received the same duration of both light and darkness during the study, the rats exposed to sunlight produced significantly more melatonin.
It’s not that the artificial light was detrimental. It simply wasn’t strong enough — the sunlight was more than seven times brighter than the fluorescent light. This is what boosted melatonin production. Researchers assert variation of light throughout the day, from dawn to dusk, also supports healthy melatonin production.
During a sunny day, lux levels (which measure the intensity of light) reach 50,000. Compare this to indoor lighting, which ranges in the low to mid hundreds at the most. For most of human history we have lived with natural light and it plays a significant role in the function of the body and brain.
Why melatonin and light rhythms are so important
Anyone who has suffered through insomnia and sleep deprivation understands the importance of sufficient and quality sleep.
However, melatonin and our sleep-wake cycle (also called circadian rhythm) are intertwined with every system in the body, affecting much more than how rested or tired we feel. Heaps of studies point to the importance of a healthy sleep-wake cycle for overall immune, hormonal, and mental health.
For instance, one study found that women suffering from PMS show chronically low melatonin levels. Just two hours a day of exposure to sunlight increased their melatonin levels and relieved their symptoms.
A German study showed subjects with mood imbalances exhibited healthier serotonin levels after just one week of light therapy.
Another study showed subjects experienced a 160 percent increase in melatonin at night after just a half hour of exposure to bright light from a light box.
How to get enough outdoor light in an indoor world
It’s not easy getting enough sunlight when you’re indoors all day working or going to school. But it’s vital for healthy sleep, brain function, and metabolic function to get enough light exposure.
Some solutions are obvious — spend time outside as much as you can. Eat lunch outside and go for a walk on your breaks. Maybe you can even work outside on your laptop if your job is portable.
If possible, work near windows that get plenty of natural light. One study showed employees working near a window received twice as much light as their coworkers who didn’t and hence enjoyed more sleep.
If sufficient exposure to natural light isn’t possible, indoor light therapy has been shown to help relieve sleep and mood imbalances.
Look for a light box that delivers plenty of lux and is big enough for sufficient exposure. The Center for Environmental Therapeutics provides criteria for purchasing a reliable light box, which they recommend using for at least a half hour in the morning.
Have you ever wanted to know everything there is to know about your thyroid? This 7-part video series will cover thyroid lab testing, nutrition and infections that affect the thyroid, toxins, thyroid hormone conversion, lifestyle, and adrenal interplay.