IMMUNE ISSUES
When implants begin to leak either silicone gel or saline, often the first symptom is signs of immune system failure especially involving the cellular immune system. The majority of patients will develop signs of systemic candidiasis including muscle aches, fatigue and mental clouding as well as the other symptoms listed above. Bacterial problems such as periodontal disease, sinusitis, bladder infections, bronchitis, H-Pylori infection, and other bacterial infections can become more prominent and more difficult to control. Implant patients have a variety of viral infections including Coxsackie, Epstein-Barr, Herpes, HHV6 as well as inability to clear quickly normal flu and cold viruses. Mold growing in or around breast implants with leaky valves may produce a bio-toxin that leads to immune dysfunction as white blood cells lose regulation of cytokine response. Therefore, attention to the immune system through immune supplements which increase both humeral and cellular immunity are an important part of the protocol. The immune symptoms usually appear before the auto-immune symptoms.
AUTOIMMUNE ISSUES
Autoimmune symptoms and signs include Raynaud’s syndrome, positive ANA’s, elevated sed rates (ESR) and positive rheumatoid factors. In patients with silicone deposits within muscles we see high CPK levels and in some patients we see elevated thyroglobulin antibodies and thyroid Peroxidase antibodies. We also see anti-cardiolipin antibodies in some patients as well as a variety of other antibodies which are positive in Scleroderma and lupus. As far as the auto-immune disease caused by silicone, I do not believe that this is either lupus or rheumatoid arthritis. I have seen some patients who appear to have Scleroderma but they are often treated effectively with long courses of either Cipro or Minocin combined with a holistic protocol with resolution of their symptoms. I also do not believe that the majority of patients come to me with a diagnosis of multiple sclerosis actually have multiple sclerosis. Very few of my patients with multiple sclerosis have any bladder or bowel problems or optic nerve problems. In a similar note, the patients with a diagnosis of lupus have no renal or CNS involvement which is very common in lupus. I believe these patients have atypical connective tissue disease, and atypical neurological disease caused by the silicone adjuvant mechanism or bio-toxin disease from mold bio-toxins. Overall, the majority of patients with auto-immune disease have clearing of the auto-immune disease with removal of the silicone followed by detoxification and immune support.
NEUROLOGICAL PROBLEMS
Neurological problems occur from several mechanisms which may be different in silicone versus saline patients. In silicone patients we see actual migration of the silicone perhaps via the macrophages or directly in some cases along the myelin sheaths up the arm into the axilla along the brachial plexus and down the arm. Many patients have abnormal nerve conduction tests and palpable tenderness along the brachial plexus and nerves of the upper arm. With silicone implants, the silicone migrates into the myelin sheath and auto-immune reaction can occur which can then affect the nerves. If only one side is ruptured and/or leaking it is not uncommon to have one sided neurological symptoms. Typically the upper extremities are affected first. Sensory is affected prior to motor and lower extremities are affected later. There is also a B12 deficiency commonly seen which may exacerbate the neurological disease. Many patients with intestinal candidiasis do not properly absorb B12. Therefore, either sublingual or injectable B12 is necessary. Dr. David Perlmutter, a holistic neurologist, has noted along with other doctors, that large doses of B12 (i.e. B12 3000 micrograms IM q week x 12 weeks) is effective in helping the neurological disease associated with silicone. Many silicone patients come in wheelchairs, unable to walk prior to surgery, are able to walk after appropriate surgical and medical treatment of this disease. It was noted in Canada where the general surgeons were doing the explants but not taking out the capsules and leaving a great deal of ruptured material in the women, that many more women became disabled in wheelchairs than in the US where plastic surgeons generally perform the procedure. Thus, it appears that if explantation is not properly performed, the patient can become very ill. The other supplement that may be important in treating neurological diseases is large doses of alpha Lipoic Acid, (i.e. 1,000 to 2,000 mgs. a day) which helps detoxification of neuro-toxic chemicals by increasing levels of intracellular glutathione.
Bio-toxins from mold in and around the breast implants are neurotoxins which can cause the following if the breast implant is infected:
numbness
weakness
fasciculations or muscle twitching
blurred vision
headaches
abnormal brain MRI’s
mental clouding
cardiac arrhythmias
seizures
ENDOCRINE PROBLEMS
Endocrine symptoms occur because of silicone, chemical or bio-toxin activity which acts as an endocrine disruptor. Many women with silicone breast implants have low alpha MSH levels which cause problems with the hypothalamus (see the bio-toxin pathology diagram at www.chronicneurotoxins.com. Silicone is also estrogenic in nature, therefore, women with ruptured and/or leaking silicone gel implants can have increased problems with fibrocystic disease, ovarian cysts and uterine fibroids. It is interesting to note that silicone, because of its cytokine production and pressure from the implant within the breast, actually decreases the risk of breast cancer. The endocrine system which is affected as well, includes a decrease in ADH which presents as nocturnal enuresis which may contribute to the sleep deprivation in the women. If a woman is getting up more than 2 times during the night to urinate, it would be helpful to prescribe Desmopressin nasal spray 0.2 cc. intranasally before bed. Many patients also have sub-clinical hypothyroidism which can be evaluated with use of basal metabolic temperature and the free T4. If the free T4 is in the lower range of 0.8 to 1.0 associated with a basal metabolic temperature below 97, small amounts of Armour Thyroid in the 30 to 90 mg. range and/or appropriate T4 and T3 combinations can greatly improve the fatigue, weight gain, constipation, dry skin, and hair loss. The hair loss is particularly concerning to these women. Many women also have a selenium deficiency where by T4 to T3 conversion is decreased therefore selenium replacement at 200 mcg. a day may be necessary. The third part of the endocrine system which may be disrupted is the adrenal system. Many patients have adrenal insufficiency which can be diagnosed by shining a light on the pupil. If the pupil fails to maintain its constriction but instead waivers back and forth, this indicates adrenal insufficiency. Adrenal stress indices can be measured. If the patient does have cortisol deficiencies, Cortef or other corticosteroids can be prescribed until the condition is corrected via surgery and the detoxification program. Supplements such as Adrenal Stress End, DHEA, and other adrenal support supplements are useful. Some women also have reduced sex hormones which can lead to irregular or altered menses and premature menopause.
METABOLIC PROBLEMS
The metabolic problems of silicone include disruption of a portion of the Kreb’s cycle. This may account for some of the fatigue via mitochondrial disruption. It is interesting to note that the hyperbaric oxygen is very successful in helping the fatigue associated with silicone immune dysfunction. We have a great deal to learn about the metabolic effects of silicone. Dr. Arthur Brawer has written an informative paper in this area where he also discusses the effects of silicone at the cellular level.8
In summary, the most important treatment plan for these patients is removal of the silicone and/or saline implants along with any remaining silicone which has migrated throughout the chest wall and axilla that can be surgically removed. The second most important treatment program is the treatment of the candidiasis and other fungal infections that might be present within the saline implants and can certainly affect the silicone patients as well. This is started usually with Diflucan 200 mgs. po q day x 30 days if liver functions are normal. Other anti-fungals that can be used are Nizoral 200 mg. orally twice a day, Sporanox 200 mg. orally once a day and Vorconizole 200 mg. orally twice a day. It is important to maintain the patient on alpha Lipoic Acid and Milk Thistle (Super Thistle X) during this time for liver protection. There are other anti-virals supplements which are available. Bacterial infections are generally treated with antibiotics. It is important to always maintain the patient on an anti-fungal while on antibiotics. I have had remarkable response to patient’s pain condition just by treating with anti-fungal agents alones. It is not uncommon to have to treat these patients with several courses of antibiotics combined with anti-fungal therapy. If a patient is on antibiotics for a different condition it is not uncommon to have to treat with anti-fungals for a long period of time. Please be aware that patients develop resistance to anti-fungals and alternative anti-fungal treatment may be necessary. In general, patients undergoing the surgical and medical treatment for silicone immune toxicity have improved with the treatment. Many patients have regained their health entirely and the patients that continue to have problems are the ones in which the silicone has been leaking and/or ruptured for the longest period of time prior to the removal of the implants. A scientific paper published in the PPRS journal states that women who have had ruptured implants for over 13 years tend to not improve.9 However,some do improve probably due to the medical detoxification and holistic therapies provided that address medical issues in may different systems. A holistic approach works best as silicone and saline breast implant disease is truly a holistic illness.
When implants begin to leak either silicone gel or saline, often the first symptom is signs of immune system failure especially involving the cellular immune system. The majority of patients will develop signs of systemic candidiasis including muscle aches, fatigue and mental clouding as well as the other symptoms listed above. Bacterial problems such as periodontal disease, sinusitis, bladder infections, bronchitis, H-Pylori infection, and other bacterial infections can become more prominent and more difficult to control. Implant patients have a variety of viral infections including Coxsackie, Epstein-Barr, Herpes, HHV6 as well as inability to clear quickly normal flu and cold viruses. Mold growing in or around breast implants with leaky valves may produce a bio-toxin that leads to immune dysfunction as white blood cells lose regulation of cytokine response. Therefore, attention to the immune system through immune supplements which increase both humeral and cellular immunity are an important part of the protocol. The immune symptoms usually appear before the auto-immune symptoms.
AUTOIMMUNE ISSUES
Autoimmune symptoms and signs include Raynaud’s syndrome, positive ANA’s, elevated sed rates (ESR) and positive rheumatoid factors. In patients with silicone deposits within muscles we see high CPK levels and in some patients we see elevated thyroglobulin antibodies and thyroid Peroxidase antibodies. We also see anti-cardiolipin antibodies in some patients as well as a variety of other antibodies which are positive in Scleroderma and lupus. As far as the auto-immune disease caused by silicone, I do not believe that this is either lupus or rheumatoid arthritis. I have seen some patients who appear to have Scleroderma but they are often treated effectively with long courses of either Cipro or Minocin combined with a holistic protocol with resolution of their symptoms. I also do not believe that the majority of patients come to me with a diagnosis of multiple sclerosis actually have multiple sclerosis. Very few of my patients with multiple sclerosis have any bladder or bowel problems or optic nerve problems. In a similar note, the patients with a diagnosis of lupus have no renal or CNS involvement which is very common in lupus. I believe these patients have atypical connective tissue disease, and atypical neurological disease caused by the silicone adjuvant mechanism or bio-toxin disease from mold bio-toxins. Overall, the majority of patients with auto-immune disease have clearing of the auto-immune disease with removal of the silicone followed by detoxification and immune support.
NEUROLOGICAL PROBLEMS
Neurological problems occur from several mechanisms which may be different in silicone versus saline patients. In silicone patients we see actual migration of the silicone perhaps via the macrophages or directly in some cases along the myelin sheaths up the arm into the axilla along the brachial plexus and down the arm. Many patients have abnormal nerve conduction tests and palpable tenderness along the brachial plexus and nerves of the upper arm. With silicone implants, the silicone migrates into the myelin sheath and auto-immune reaction can occur which can then affect the nerves. If only one side is ruptured and/or leaking it is not uncommon to have one sided neurological symptoms. Typically the upper extremities are affected first. Sensory is affected prior to motor and lower extremities are affected later. There is also a B12 deficiency commonly seen which may exacerbate the neurological disease. Many patients with intestinal candidiasis do not properly absorb B12. Therefore, either sublingual or injectable B12 is necessary. Dr. David Perlmutter, a holistic neurologist, has noted along with other doctors, that large doses of B12 (i.e. B12 3000 micrograms IM q week x 12 weeks) is effective in helping the neurological disease associated with silicone. Many silicone patients come in wheelchairs, unable to walk prior to surgery, are able to walk after appropriate surgical and medical treatment of this disease. It was noted in Canada where the general surgeons were doing the explants but not taking out the capsules and leaving a great deal of ruptured material in the women, that many more women became disabled in wheelchairs than in the US where plastic surgeons generally perform the procedure. Thus, it appears that if explantation is not properly performed, the patient can become very ill. The other supplement that may be important in treating neurological diseases is large doses of alpha Lipoic Acid, (i.e. 1,000 to 2,000 mgs. a day) which helps detoxification of neuro-toxic chemicals by increasing levels of intracellular glutathione.
Bio-toxins from mold in and around the breast implants are neurotoxins which can cause the following if the breast implant is infected:
numbness
weakness
fasciculations or muscle twitching
blurred vision
headaches
abnormal brain MRI’s
mental clouding
cardiac arrhythmias
seizures
ENDOCRINE PROBLEMS
Endocrine symptoms occur because of silicone, chemical or bio-toxin activity which acts as an endocrine disruptor. Many women with silicone breast implants have low alpha MSH levels which cause problems with the hypothalamus (see the bio-toxin pathology diagram at www.chronicneurotoxins.com. Silicone is also estrogenic in nature, therefore, women with ruptured and/or leaking silicone gel implants can have increased problems with fibrocystic disease, ovarian cysts and uterine fibroids. It is interesting to note that silicone, because of its cytokine production and pressure from the implant within the breast, actually decreases the risk of breast cancer. The endocrine system which is affected as well, includes a decrease in ADH which presents as nocturnal enuresis which may contribute to the sleep deprivation in the women. If a woman is getting up more than 2 times during the night to urinate, it would be helpful to prescribe Desmopressin nasal spray 0.2 cc. intranasally before bed. Many patients also have sub-clinical hypothyroidism which can be evaluated with use of basal metabolic temperature and the free T4. If the free T4 is in the lower range of 0.8 to 1.0 associated with a basal metabolic temperature below 97, small amounts of Armour Thyroid in the 30 to 90 mg. range and/or appropriate T4 and T3 combinations can greatly improve the fatigue, weight gain, constipation, dry skin, and hair loss. The hair loss is particularly concerning to these women. Many women also have a selenium deficiency where by T4 to T3 conversion is decreased therefore selenium replacement at 200 mcg. a day may be necessary. The third part of the endocrine system which may be disrupted is the adrenal system. Many patients have adrenal insufficiency which can be diagnosed by shining a light on the pupil. If the pupil fails to maintain its constriction but instead waivers back and forth, this indicates adrenal insufficiency. Adrenal stress indices can be measured. If the patient does have cortisol deficiencies, Cortef or other corticosteroids can be prescribed until the condition is corrected via surgery and the detoxification program. Supplements such as Adrenal Stress End, DHEA, and other adrenal support supplements are useful. Some women also have reduced sex hormones which can lead to irregular or altered menses and premature menopause.
METABOLIC PROBLEMS
The metabolic problems of silicone include disruption of a portion of the Kreb’s cycle. This may account for some of the fatigue via mitochondrial disruption. It is interesting to note that the hyperbaric oxygen is very successful in helping the fatigue associated with silicone immune dysfunction. We have a great deal to learn about the metabolic effects of silicone. Dr. Arthur Brawer has written an informative paper in this area where he also discusses the effects of silicone at the cellular level.8
In summary, the most important treatment plan for these patients is removal of the silicone and/or saline implants along with any remaining silicone which has migrated throughout the chest wall and axilla that can be surgically removed. The second most important treatment program is the treatment of the candidiasis and other fungal infections that might be present within the saline implants and can certainly affect the silicone patients as well. This is started usually with Diflucan 200 mgs. po q day x 30 days if liver functions are normal. Other anti-fungals that can be used are Nizoral 200 mg. orally twice a day, Sporanox 200 mg. orally once a day and Vorconizole 200 mg. orally twice a day. It is important to maintain the patient on alpha Lipoic Acid and Milk Thistle (Super Thistle X) during this time for liver protection. There are other anti-virals supplements which are available. Bacterial infections are generally treated with antibiotics. It is important to always maintain the patient on an anti-fungal while on antibiotics. I have had remarkable response to patient’s pain condition just by treating with anti-fungal agents alones. It is not uncommon to have to treat these patients with several courses of antibiotics combined with anti-fungal therapy. If a patient is on antibiotics for a different condition it is not uncommon to have to treat with anti-fungals for a long period of time. Please be aware that patients develop resistance to anti-fungals and alternative anti-fungal treatment may be necessary. In general, patients undergoing the surgical and medical treatment for silicone immune toxicity have improved with the treatment. Many patients have regained their health entirely and the patients that continue to have problems are the ones in which the silicone has been leaking and/or ruptured for the longest period of time prior to the removal of the implants. A scientific paper published in the PPRS journal states that women who have had ruptured implants for over 13 years tend to not improve.9 However,some do improve probably due to the medical detoxification and holistic therapies provided that address medical issues in may different systems. A holistic approach works best as silicone and saline breast implant disease is truly a holistic illness.
