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.
Emerging research reveals that higher-altitude living contributes to a higher risk for depression and suicide. While studies continue to look into the mechanisms behind this trend, it’s clear a variety of factors come into play. From the unique effects that altitude has on the brain to social and psychological aspects of life in the high country, many of these factors are influenced by your lifestyle and dietary choices.
In the United States, the highest suicide rates are in the intermountain area — in particular, Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah, and Wyoming. Wyoming comes in first with two times the national suicide average, and the other states on this list consistently score in the top ten nationwide.
Resort town life: A recipe for desperation and impulsiveness?
While some studies reveal physiological factors behind the altitude-linked descent into suicidal depression, the experts say social, economic and cultural factors can also play a role.
Mountain community is transient by nature. The mountain resort-town life revolves around two seasons: winter and summer. Ski season and summer tourist season are the main busy times separated by two off-seasons that locals like to call “mud season.”
During mud season, while everything is either buried in spring snowmelt or autumn rain, the tourists disappear, locals have little to no income, and one’s sense of displacement, isolation, depression, and uncertainty can increase dramatically. Having to make it through this tough time twice a year, every year can cause high levels of stress and depression. Schedule a FREE 15-Minute Consultationwith Dr. Celaya.
Social isolation. These remote communities are spread far apart, breaking up the interconnectedness that people have in more populated areas. In addition, many residents come and go during “mud season,” making it hard to develop strong social bonds. This undermines the creation of the well-established intergenerational relationships, deep social connections, and the resulting support systems known for supporting mental health and stability.
Financial struggle and uncertainty. When we think of resort towns, we think of enjoyment and freedom surrounded by natural beauty. However, the reality for many residents is a life of working two to four jobs during tourist season, the twice-yearly mud-season of unemployment, unaffordable housing that changes frequently, and constant financial worries. This puts enormous stress on individuals, families, and relationships.
Party culture and substance abuse. Resort towns are notorious party towns, and the use of alcohol and other drugs is more prevalent. According to Mental Health America, substance abuse is likely a factor in half of all suicides, and the lifetime rate of suicide among those with alcohol problems is three to four times the national average.
Altitude’s effect on the brain may increase suicide risk
A recent Harvard study analyzed previous studies linking life at higher altitudes to increased risk of depression and suicide.
While more than 80 percent of US suicides occur in low-altitude areas, that’s because most of the population lives near sea level. Adjusted for population distribution, suicide rates are almost four times higher at high altitude versus low altitude.
A possible physiological explanation for this trend has been considered: Chronic hypobaric hypoxia, or low blood oxygen, might alter serotonin and dopamine metabolism in the brain as well as negatively influence how energy is transferred in cells and tissues.
Lowered serotonin production. Studies also show high altitude reduces serotonin levels, which is associated with mood and anxiety disorders. And the higher you go, the greater your risk for suicide.
In fact, Salt Lake City residents have a 30 to 40 percent higher risk of suicide just based on their altitude compared to those at sea level. Nearby Alta and Snowbird — both ski resort towns — have a suicide rate two times that of the national average.
Raised dopamine production. On the other hand, altitude increases the production of dopamine, the brain neurotransmitter associated with pleasure-seeking and risk-taking.
This is complicated by the fact high altitude living attracts outdoorsy risk-takers who may already have increased dopamine levels that make them prone to the impulsivity associated with suicide.
Support your mental health with dietary and lifestyle measures
While we need more research into the altitude-suicide connection, it’s clear that high-mountain living presents many challenges to mental health. If you live in a high-altitude location, be aware of the factors below to see if your risk for depression and suicide may be higher.
Symptoms of impaired serotonin activity:
Loss of pleasure in hobbies and interests
Feelings of inner rage and anger
Feelings of depression
Difficulty finding joy from life pleasures
Depression when it is cloudy or when there is lack of sunlight
Loss of enthusiasm for favorite activities
Not enjoying favorite foods
Not enjoying friendships and relationships
Unable to fall into deep restful sleep
Symptoms of high dopamine activity:
Heightened cognitive acuity
Lack of self-control
Anti-inflammatory diet to support brain health. Ongoing research reveals a strong link between brain inflammation and various depressive disorders. Support your body’s ability to quell inflammation with a diet free of common allergens and reactive foods.
Symptoms of blood sugar dysregulation. Imbalances in blood sugar can be at the root of many mood issues.
Signs and symptoms of low blood sugar include:
Increased energy after meals
Craving for sweets between meals
Irritability if meals are missed
Dependency on coffee and sugar for energy
Becoming lightheaded if meals are missed
Eating to relieve fatigue
Feeling shaky, jittery, or tremulous
Feeling agitated and nervous
Poor memory, forgetfulness
Signs and symptoms of high blood sugar include:
Fatigue and drowsiness after meals
Intense cravings for sweets after meals
Waist girth equal to or larger than hip girth
Craving for sweets not relieved by eating them
Increased appetite and thirst
Difficulty losing weight
Trouble falling asleep
Support your stress response with adrenal adaptogens and phosphatidylserine.
Holy basil leaf extract
Pantethine (B5) and B vitamins
Phosphatidylserine liposomal cream that delivers 2000mg per day
Moderate your caffeine intake. Caffeine can stress your adrenals, making it harder to cope with high stress.
Support serotonin levels with 5HTP (a serotonin precursor) or L-tryptophan.
Support brain bioenergetics with creatine.
Use moderate exercise to manage stress levels and support brain health.
Stress management practices such as meditation, chi gong, and yoga help to moderate stress and relieve depression.
Actively build community and social connections by joining a volunteer group, drama club, book club, or other organization.
Know the signs of increased social isolation in yourself and loved ones.
If you have substance abuse issues, please contact my office for a referral for assistance.
Check for deficiencies in vitamin D, B2, and iron, all of which can affect mood.
High altitude life has many joys and benefits, and it doesn’t have to be a recipe for depression disaster. To learn more about how you can support your well-being while living at altitude, please contact my office.
If you struggle with chronic exhaustion, insomnia, poor immunity, and persistent low blood sugar symptoms, you likely have poor function of the adrenal glands, which sit atop the kidneys and secrete stress hormones. However, your conventional doctor may have told you there is no such thing as adrenal fatigue based on guidance from The Hormone Foundation. What they may not understand is that there is a continuum of adrenal function and that the brain plays a role in adrenal fatigue.
The debate about adrenal fatigue versus primary adrenal insufficiency
The term “adrenal fatigue” has become a household word in the chronic illness world, and for good reason. The adrenal glands are our frontline against stressors large and small. In our constantly chaotic and nutritionally-depleted lives, these hard-working little glands can become worn down, sometimes to the point of barely working, right along with the areas of the brain that govern them.
What’s confusing is a recent statement by The Hormone Foundation which claimed adrenal fatigue does not exist and is not supported by any scientific facts, and that primary adrenal insufficiency is the only real version of adrenal dysfunction.
However, according to integrative physician Richard Shames, MD, both adrenal fatigue and primary adrenal insufficiency exist along the same continuum but are separated by the severity of symptoms and treatment methods. In a nutshell, adrenal fatigue can also be referred to as mild adrenal sufficiency.
Primary adrenal insufficiency is caused by damage to the adrenal glands, such as by an autoimmune condition like Addison’s disease that attacks and destroys adrenal tissue. Primary adrenal insufficiency is diagnosed through blood tests and can be treated with medications that replace adrenal hormones.
Symptoms of primary adrenal insufficiency include:
Loss of appetite with weight loss
Craving salty foods
Dizziness, low blood pressure
Feeling lightheaded when standing up
Gastrointestinal symptoms such as nausea, vomiting, and abdominal discomfort
Adrenal fatigue describes when lab tests don’t support a diagnosis of primary adrenal insufficiency but a person still experiences adrenal-related symptoms such as:
Excessive fatigue and exhaustion
Feeling overwhelmed by or unable to cope with stress
Craving salty foods
Functional medicine practitioners diagnose adrenal fatigue by considering symptoms as well as results from a 24-hour saliva cortisol test.
Current blood tests are good at diagnosing severe forms of adrenal insufficiency such as Addison’s disease but not mild adrenal insufficiency, or adrenal fatigue.
This debate between adrenal fatigue and primary adrenal insufficiency is reminiscent of the former debates about “mild” hypothyroidism. Twenty years ago, many endocrinologists denied mild hypothyroidism as a true diagnosis because they believed that as long as a patient was within conventional TSH reference ranges they could not possibly be sick.
However, doctors trained in functional medicine recognize that a functional reference range — a narrower TSH range that reflects optimum thyroid health — means that a serious thyroid problem can exist within the conventional TSH range.
As testing and recognition of adrenal fatigue, which affects many people, continues to gain medical acceptance, we will start to refer to it as mild adrenal insufficiency.
The role of the brain in adrenal fatigue
It’s important to understand the brain plays an important role in adrenal fatigue. This explains why nutrients to support your adrenal glands may not go the full mile when the real problem is happening between your ears.
Adrenal fatigue has at its roots poor function of the hypothalamus-pituitary-adrenal (HPA) axis. The HPA axis refers to the feedback loop between your body and areas of your brain that govern adrenal function. Unrelenting stress beats up this entire system, not just the adrenal glands, and it is more complicated and involved that simply low cortisol. The problem is compounded by the brain’s predilection for efficiency, in this case becoming so efficient at stress until the tiniest thing triggers a big stress response. Or, you are so advanced you are too tired to respond to anything.
How the adrenals become fatigued
When our bodies experience stress, no matter how small or large, our adrenals pump out hormones such as adrenaline and cortisol to help us fight or take flight. Our bodies are designed to return to baseline after a stressor so the nervous system can return to a “rest and digest” state necessary for daily function.
However, in our chronically stressed modern lifestyles, our bodies are constantly reacting to stressors, many we are not even aware of, such as dietary triggers, toxins, and even electromagnetic frequencies.
This constant state of high-stress hormones damages tissues in the body and brain and is linked to:
Insulin resistance and diabetes
High blood pressure
Increased belly fat
Removing all stressors in life is impossible, but there is much we can do to support adrenal function and buffer the damage of stress.
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.