Thursday Night Live Mast Cells

Couple minutes early, we're gonna have everybody hop on. Gotta make sure you can see everything and have great audio. All right, everybody hop on. Hi, hi, Coco. Hey, Amity. Hi, Mary. We're live on Facebook, YouTube, Instagram, TikTok, LinkedIn, X, Substack. Got to see if my Substack link is actually working. Oh, it is. Perfect. All right, we've had a big week talking about mast cells. We're gonna round out the week. This week's lives were great. We had Dr. Tanya Dempsey on Tuesday night in the circle. And, um, really, uh, great to chat with her. Can everybody tell me, is the audio okay? Just let me know. Just want to double check. Just make sure, like, wave your hand, give me a thumbs up if the audio is all right. Any trouble with the audio, let me know. Anybody in the circle? Let me know if there's a problem with audio. Uh, Coco, uh, the chat with Dr. Dempsey is going to be posted live in my private, uh, community, or be posted in my live, uh, community. We'll get all that up. Make sure and share with your friends. Uh, Dr. Uh, Dempsey was phenomenal. Just can't thank her enough for coming on. All right, we have a lot to cover, so I just want to make one more check. There's a bit of a delay on one of my platforms. I'm just going to double-check something real quick. All right, thank you, Rhonda. Appreciate it. All right, everybody, let's get started. So most of what you've been told and others have been told about chronic illness is not true. Once again, not true. Uh, if you want to use the word lie, you can use that. And it's not meant to be malicious. Um, the doctors themselves are not, uh, being malicious. They're navigating what is modern immunology with a map from the '80s, basically. And if you've spent years bouncing between specialists, you've been told, um, your fatigue is stress, your brain fog is just anxiety, your racing heart is, uh, deconditioning, you need to exercise more. Um, but you already know there's something wrong with that map. And here's the truth: your body is not failing you. It's responding exactly as it was programmed to respond to, but it's just not designed to handle it. As many of you know, I'm Dr. Whitfield MD, board-certified plastic surgeon. For decades, my industry has sold a particular narrative, placing devices inside, um, are supposed to be inert. They're not supposed to have consequences and, um, kind of one and done almost. And obviously I think that's far from accurate. It doesn't matter what type of medical device you put in, um, if they're foreign, if they're implanted materials, The materials can break down, the devices themselves can fail. If they're mechanical devices, they can break. And I think more importantly, we just have to be honest, an approach with no specific emotions, not with anecdotes, you know, just with the facts and the physiology. And I'll be direct, like, you know, we don't specifically run like a wellness retreat. Um, I don't, uh, spend my time, um, tinkering anymore. Um, We are trying to treat this chronic illness issue that is fundamentally, um, broken in our patients. And, you know, here's how it's broken. So if your heart races every time you stand up and you have to go to the cardiologist, they may in fact diagnose you with POTS and give you a medication to slow that rate down. If your joints are hypermobile or painful, you're going to end up going to a rheumatologist. They'll tell you that's a potentially a mixed connective tissue disorder. Um, if you react to everything, and, and I mean everything as simple as like breaking out from drinking a glass of water you're going to end up going to an allergist, and they're going to put you on, um, a series of things to block that response, whether they're antihistamines or steroids. There's a lack of communication between all of those specialists. Obviously, the cardiologist is not going to look at your joints. The rheumatologist is not going to care about your gut microbiome. And the allergist may not be, uh, involved with much, if any, of those. So it's kind of treating the smoke without the fire. And in this situation, what starts the fire, the arsonist if you will, is the mast cell activation syndrome. And so like we had spoken, uh, before I hopped on I had Dr. Tanya Dempsey on my podcast, The Dr. Robert Whitfield MD Show, last week. It aired today. I put it ahead in the queue and had her come on my live stream on Tuesday night because she was available to talk inside the community. And, you know, she's shed even more light on something that I've been seeing more and more in my practice. MCAS doesn't affect a small, obscure number of people. The data shows it affects 17 to 20%, so 1 in 6 to 1 in 5 people. An overwhelming majority are misdiagnosed or, or not diagnosed at all. So just think about that. I, I had no idea it was that prevalent until Dr. Dempsey, you know, really hit that home on our Tuesday Night Live. So use, you know, this analogy, right? To understand what, what's happening, actually you need to understand what a mast cell actually is. So in a healthy body, mast cells are your border guards, if you will. They sit at every interface between you and the outside world— your skin, your gut, your, your lungs. Um, they carry these little packages of granules with a lot of inflammatory chemicals like histamine and tryptase and cytokines. When something is threatening to you, a pathogen like bacteria or parasites, the packages pop open and degranulate and release the contents of the package. That creates this inflammatory response. They want to neutralize the threat, and then they can relax. It's very simple, it's very elegant, it's— it can be very precise. But in this 20% of the population are our guards, if you will, are a little, uh, trigger-happy, and/or they're constantly activating or leaky. And at a baseline level, they're constantly releasing these low levels of these inflammatory— just think of like granules, like we talked about— into the bloodstream. And it may happen all day, every day, 7 days a week. And that can be without any threat. Now, that chronic low-grade histamine load dilates your blood vessels. Your nervous system compensates by jumping your heart rate up. And every time that happens when you stand up, so like you're having, you know, essentially the, the POTS and that same massive activation release of tryptase, an enzyme that degrades collagen, affects the connective tissue, and you become hypermobile. I had a patient the other day, you know, asked me about this in terms of positioning in the operating room, and we're always extremely, you know, careful. And the most extreme examples of this are patients with Ehlers-Danlos, and they are extremely hypermobile. So that's the, the far end of the spectrum. The hypermobility, we just have to be careful on positioning necks and shoulders. And we always communicate with patients when we're in the operating room prior to them receiving any medication so they can let us know about the positioning to make sure everybody's comfortable. So the MCAS, POTS, hypermobility, you know, triad is an important one. And I always worry about genetics and inheritance. And, you know, there's genetic inheritance that I know that puts our patients at more risk because 83% of the patients in my practice have limited detox. And if you have these other issues in addition MCAS, POTS, hypermobility, plus poor detox, it's very, very difficult. Um, I had a patient recently, um, where their, their POTS resolved after explant surgery, and obviously that's, that's tremendous for them, but that's not going to happen in every situation. So let's talk about what happens when we place an implant. So I used to place implants for both cancer reconstruction predominantly and occasionally cosmetics. And mostly what I did later in my career after, uh, cancer reconstruction was mostly, you know, helping care for patients who had problems with capsular contractures, malpositions, um, bottoming out, other, other implant-based issues. And so every time you place a device, it is a biological law, not a theory, a law that even any foreign object placed inside the human body immediately gets and causes this reaction within your body. And it starts as soon as it's placed, the, um, the device and everybody's careful about when devices are open in the operating room and passed to the surgeon. Everybody's super careful about protecting them from certainly skin bacteria like Staph epidermidis or Pityobacterium acnes. And those don't cause an acute infection after surgery. What I like to say happens is life. And over the time of the life of somebody, they can get bacteremic from having a skin infection or gut infection or a lung infection or urinary tract infection. Whatever the source is, you can get bacteremic. Now, in a big paper we published in September of '24, we looked at 694 consecutive scar tissue explant specimens, and we found that 29% had bacterial biofilm, and those were Staph epidermidis, Cutibacterium acnes. And so that biofilm, like the plaque on your teeth, creates this little fortress, and it makes it very difficult to treat. So people can have this low-grade chronic inflammatory process or infection, and that doesn't stop there. It communicates with the fatty acids of the breast, specifically oleic acid, as showed by Dr. Mathun-Sina and it creates an oxidative response and creates a product called oxylipentinone that goes through a series of reactions in your immune system and leads to symptoms, things like joint pain, muscle pain, brain fog, um, shortness of breath, all the things that we hear in and talk about with our patients. And that oxylipin 10-hom causes macrophage polarization to do that. So your own cells become the problem, and that is not fiction, that's scientific. It's been shown, uh, and there's multiple types of oxylipins now that have been profiled. And so in my study, I showed that roughly 1 in 3 have this low-grade chronic inflammatory process from these bacteria. We don't have a commercially available test to check for Oxalibacter pentenham. That was done in the laboratory, but it would track that that is happening in patients and giving patients symptoms. The other thing is a paper was published last summer, 2025, out of Denmark, and they profiled the immune response at the RNA level of T cells, B cells, and plasma cells and found that those B cells and plasma cells were upregulated in addition to T cells, which had traditionally been the cell that was upregulated. So that looks more like organ rejection rather than foreign body reaction. And that was an amazing paper for me to read. It tracks with everything I see. So like, what can we actually do about this? If I think we look at the traditional medical establishment The treatment's going to be antihistamines, over-the-counter, prescription. Really be careful with your diet. Avoid, you know, triggers, things like even the sun. And that can be just overwhelming for patients. And I think people just missing it now. I'm a little concerned because everybody in the livestream has probably heard of the GLP-1s, Ozempic, Wegovy, Mounjaro, Zepbound, and those, um, drugs were brought to market, those peptides were brought to market for weight loss and control of diabetes, and they're being used as anti-inflammatory in many cases. And in MCAS patients are seeing a very, very good response with low-dose GLP-1 therapy. So why is that happening? Because that drug GLAS operates really through dual mechanism. That has not anything to really do with appetite suppression. First, it's affecting insulin resistance, and if you can resolve insulin resistance, you can really affect the immune system. Second, and more importantly, there are GLP-1 receptors directly expressed on the surface of human mast cells. And when you bind those receptors, you just don't regulate blood sugar, uh, like we've been discussing. You stabilize the mast cell membrane directly. You stop the leakiness, and that helps calm that down and turn off that, uh, system that's been activated. And so that's a true mechanism, and that's probably why a lot of patients are deriving a lot of relief, from that therapy in terms of it being anti-inflammatory. So I often get patients on GLP-1s and they feel much better, and that makes sense. Um, they often come to see me and want to do simultaneous explant fat transfer, but I can't really, um, solve for fat transfers in the face of GLP-1s because those are very effective about what we just talked about, appetite suppression, and they are affected at burning fat. So here's where we need to look at really that full map now. So the implant is a structure that definitely can trigger mast cell activation because it's at the tissue level and your tissues have mast cells. That is ongoing. We already now know that there's upregulation of T cell, B cell, plasma cells by the study out of Denmark I spoke about. Now all you need to do is have some poor detox pathways, and then a— let's think of like what I see a lot, which is a mold exposure. So you put some mycotoxins from mold and some organophosphates from pesticides, um, maybe you ingested them Glyphosate, Roundup, things that we get in the food supply. And now your bucket is really, really full. So you've got a device, you've got mast cell activation, you've got mold, you may have a parasite, you have glyphosate exposures, and that's more than you can cope with. That creates the perfect storm, if you will. And so I deal with this routinely. Um, I've seen such an uptick in MCAS since the pandemic, and more and more is being brought to light about it. Um, I want to save everybody some time. I mean, we see this clearly every week in our clinic, and, um, I think what I try to do most of all in my clinic is prepare patients And I do that, um, intentionally with, uh, the Sharp Method, the book we wrote describing how we work patients up. So I was taught to do, um, simple blood work, maybe a chest X-ray, EKG, and, um, electrolyte panel, and make sure that everybody was prepared that way to go to surgery. Now everybody coming to see me has had loads of blood work. You can get, you know, so many biomarkers now. It's amazing. They'll, you know, come to your home. You can go to Quest, LabCorp and get that done. What we really look at are genetics. So how are you detoxing? And then look at your toxicity burden. What are your exposures? Like we talked about mold, parasites, environmental toxins, heavy metals. I said, you know, parasites, I'll say it again, gut health's very important. I'm convinced a ton of people have problems with toxoplasmosis and Cryptosporidium and Entamoeba histolytica. We've had personal experience with this in our clinic. Um, food sensitivities are a huge problem. Hormonal balance— I have a lot of patients come in with really suppressed hormones or really elevated levels of estrone from poor estrogen metabolism. So we want to know all those things and help prepare patients because just doing an explant is not going to resolve all these symptoms. So we know that. I know that there's been a lot of discussion about capsulectomy, but if a third of them have infection, or recently what's came to light is patients are getting explants done under local even if they have ruptured silicone gel implants and they're terming that a simple explant. So That I consider to be unethical because you cannot get the silicone gel out of the pocket. It gets stuck in the tissues just like we're describing here, and it creates constant signaling. If you combine that with biofilm, that's yet another signal that's not relieved. So we removed the scar tissue. In my first 1,000 cases, I had a B-cell lymphoma, which at that point was 1 of 8 in the world. We've had a, uh, obviously a number of breast cancers because that's the most common thing you would find. Fortunately, we haven't had any more lymphomas, and I took out a pair of textured McGann implants that were 20 years old today. So the pa— the capsule is not passive. It's where the biofilm lives. It's where cancer can develop. It's where we have this interaction between our macrophages and our mast cells, and We do total capsulectomies always because of this, for this reason. And I think the bigger, you know, take-home message is not surgery being the cure for this in particular, but a component of a much, much larger treatment plan. I have a nurse practitioner who works diligently with all of our surgical patients. And then we have a, a 3-person detox team that takes groups of patients through detox. And we have lots of options for detox that are both medical and homeopathic. And we obviously don't feel like surgery is the cure for mast cell activation. It's not going to solve that problem. We're trying to take away a trigger or a stimulus to that.. And that will help calm things down. I already mentioned I had a patient recently, she's a doctor in the Houston area. I hope she's watching tonight. And her POTS has resolved according to her, and I hope it stays that way for her. I think that is phenomenal. I would, I would be truly very happy if that, that remained the case for her. And so, you know, we do all this preparation. We really work hard to drop the— what's going to be a big cortisol burst for surgery and then get people recovering quickly. In my office, I have the Human Regenerator. You should look it up. It's one of the best things going for recovery. We have lymphatic massage with Lopressa. We have vertical hyperbaric chamber because I want my patients to sit up and be comfortable. 6-foot-tall, uh, Juve red light, nanoV therapy, tons of, uh, you know, what we consider to be appropriate amino acid and protein therapy for nutritional support. And, um, it takes time to get back to health. So a lot of folks get really impatient, and, and that's the last thing I want you to do. So, excuse me, you know, I think the path forward is to eliminate as many triggers as possible. And if you've confirmed MCAS, if you have implants, then you have, need to have a discussion and think about explant. Think about the capsule and certainly consider who you can go to and who you can get help from. I think there's a lot more surgeons doing effective capsulectomies now. We run our, uh, Sharp Method recovery and preparation programs remotely now, so people can work with my team from not just all over Texas or all over the region, but all over the country and globally. So that's going to be our big contribution, is really helping patients get from one side to the other. So the Sharp Method is the book I wrote, and that's our prep and recovery program. So those are all big components. We prioritize sleep. If you have a device to track or measure, that's important. I don't have my Whoop strap on right now, but it becomes the most sensitive and specific instrument I've used for that. I also have an Ultrahuman ring. Those are good tools. Um, we have to get your circadian rhythm reset. Sleep hygiene is and nutritional support's important. Reduce the environmental toxin burden. I definitely concentrate on air quality a lot in my clinic. If you come to visit our clinic in Austin, there's all these filters running all the time. I have a, a Swiss IQ next to me. We have jaspers in the office and other filters as well. So as much as I love to operate, you know, I'm a surgeon at heart, of course. I'll be the first one to tell you that surgery is not going to solve this problem completely. That's why we created the program. That's why I wrote the book. I wasn't going to write any books, but now I've written a couple. One is The Sharp Method, the other is Breast Implants Explant Surgery and Breast Implant Illness: Everything You Need to Know About BII. So, you know, we'll do our part with preparation, surgery, and recovery if you come to us. And you have to do your part to really control the things you can control. You have to do your best to get your rest, have a proper diet, get up, reset your circadian rhythm, go for a walk, get some sunlight. Um, those are all things that you can start doing tomorrow, and that will help start putting out the fire. Um, that will help stop that feedback that you're getting that's causing you so much trouble. So once again, I'm Dr. Whitfield MD. I don't want you to manage the symptoms. I want you to improve and have a healthy and, and as well life as possible. So I'm going to take a couple questions now, and then we're going to go into my live community. Um, go to drrobcircle.com, join us, it's free to join. And then, uh, The interview I did with Tanya Dempsey, Dr. Dempsey, on Tuesday night will get posted in my community, uh, either tonight or tomorrow. I'm kind of tired. I've been operating today. So it's drrobscircle.com. That's where I'm going to go do live Q&A. I do not know how to do this on, uh, TikTok. Can someone just post the comment drrobcircle.com in the chat in TikTok? That'd be awesome. Thank you. Somebody do that for me. And I have Rhonda in the chat. I have Leah in the chat, in the circle. So we'll be heading there shortly. It's been a long day. All right, do we have any questions I can take care of before I go? So I have a lot of experience with methylene blue. As it relates to what? Uh, we don't use it as part of our program in the operating room. It can cause a couple issues with just measuring oxygen saturation, so we don't use it there at all. Um, I haven't incorporated into part of our stack. Now Barbie's asking, can MCAS make you reject medical devices like ports and shunts? Yeah, I think it's just the response of the tissues. Um, I think it's hard to say it's a, a rejection episode without the tissue, um, RNA levels that I talked about in that other paper. Um, I wish that was commercially available because it could answer the question, but that is a research protocol they did in Denmark. And so that may in fact be the case. I just can't, I can't prove that. The Alicia, it is the Sharp Method. That is our prep and recovery program. Anybody can take advantage of it in Austin, in Texas, ATAP, uh, in, um, North America obviously, and, uh, globally if you like. There was a question. Coco, we'll get that up either tonight or tomorrow. I just, it's been a long day. All right, any questions before I hop off here? We're going to drrobscircle.com. It's free to join. Hop in there and we can answer any more questions. Too Tall RN, people must detox metals, molds, and parasites. Yeah, it's a lot. You said a lot right there. All right, I'll see y'all in the circle. All right, I have to turn off these other streams and then Excuse me. Oh, let me see here. All right.