Dr. Lowe on silicone breast implants

[Guest guest]

Thyroid Antibodies

http://www.drlowe.com/QandA/askdrlowe/antibody.htm#November 18, 2001

November 18, 2001Question: My fibromyalgia (hypothyroid) symptoms started six months after I had silicone breast implants put in. Several months later my doctor found that I had high thyroid antibodies. Tests over the next three years showed that my antibodies stayed high. Several months after I had the implants removed, two different tests showed that my antibodies were normal again. My doctor told me there’s no relation between fibromyalgia, hypothyroidism, and breast implants. Instinctively, I don’t believe him, but I’d like to know what you think.

Dr. Lowe: Many patients with silicone breast implants have fibromyalgia symptoms. These symptoms are the same as those of many patients with hypothyroidism caused by autoimmune thyroid disease. Some implant patients have positive immune function test results. The most common positive immune test result is a high level of anti-nuclear antibodies. This test result, however, isn’t specific to any of the body's organ systems. Some implant patients have high levels of "anti-thyroglobulin" and "thyroid peroxidase" antibodies. These antibodies, of course, are highly specific to the thyroid gland.

As I wrote at length in The Metabolic Treatment of Fibromyalgia, studies clearly show that silicone implants commonly rupture and leak, and bacteria often colonize the implants. These findings make it plausible that decomposing implants activate the immune system, and that this activation leads to autoimmune disease in susceptible women. It’s equally tenable that the autoimmune disease in some breast implant patients involves the thyroid gland. If the autoimmune disease suppresses thyroid gland function, the women may develop so-called "fibromyalgia" symptoms. If the women had fibromyalgia before getting the implants, their symptoms may worsen.

In 1997, researchers published a report of two patients who developed Hashimoto’s thyroiditis after receiving silicone breast implants for cosmetic purposes.[1] A 45-year-old woman received her implants 1976. In 1991, she developed Hashimoto’s thyroiditis that led to a deficiency of thyroid hormone. For treatment, she took T4 alone. As often happens, the T4 alone was ineffective, and her symptoms continued. She was chronically fatigued and had joint pain and morning stiffness; her eyes were so dry that she had to use artificial tears. In 1995, she had a high level of both antinuclear antibodies and thyroid peroxidase antibodies. Her gamma globulin level was elevated by 22.6%, and her thyroid gland was diffusely enlarged. Because her implants were painful, she had them removed in 1996. A pathologist performed a microscopic exam of the implant materials from the woman. He reported that each implant had a fibrous capsule with extremely dense connective tissue and fibrosis. This, of course, is evidence of immune reaction to the implant materials. The second patient was 55 years old. She received silicone breast implants in 1984. In 1995, she developed Hashimoto’s thyroiditis. Her thyroid gland was painful and tender when palpated. She had mild hyperthyroidism and positive anti-thyroglobulin antibodies. She underwent corticosteroid treatment for five months. In 1996, her test for antinuclear antibodies was positive. She had the implants removed because her breasts were painful.

The researchers who reported these two cases wrote that Hashimoto’s thyroiditis is only rarely associated with silicone breast implants. They also wrote that the patients’ implants may have had nothing to do with the thyroiditis.[1] If silicone implants have nothing to do with patients' autoimmune thyroiditis, however, we could accurately predict that women with breast implants would have no higher incidence of anti-thyroid antibodies than women in the general population. But this prediction is refuted by a report I just read from AAL Reference Laboratories. The report states, "We have found [thyroglobulin and thyroid peroxidase antibodies] present in the sera of 24% of patients with silicone gel breast implants."[2]

For comparison, let's consider the percentages of 1,314 health individuals with high levels of the antithyroid antibodies. Of 870 males, 2.6% had high thyroglobulin antibodies, 3.9% had high thyroid peroxidase antibodies, and 2.2% had high levels of both. Of 484 females, 6.2% had high thyroglobulin antibodies, 9.5% had high thyroid peroxidase antibodies, and 6.0% had high levels of both.[3]

Obviously, by comparison, the 24% incidence of antithyroid antibodies among implant patients is a far higher than in the population at large. The higher percentage suggests that silicone implants leads to autoimmune thyroid disease in a significant percentage of women. We certainly need more studies of this issue by unbiased researchers. For the time being, though, I personally believe women with silicone implants have reasonable concerns—despite firm reassurances of medical researchers with financial ties to the silicone implant industry.

References[1] Vayssairat, M., Mimoun, M., Houot, B., Abuaf, N., Rouquette, A.M., and Chaouat, M.: Hashimoto’s thyroiditis and silicone breast implants: two cases. J. Mal. Vasc., 22(3): 198-199, 1997. [2] AAL Reference Laboratories, Inc., in Santa Ana, California, May 8, 2001. [3]Tajiri, J., Higashi, K., Morita, M,., et al.: Thyroid antibodies in healthy blood donors. Endocrinol. Jpn., 31(6):837-843, 1984.