It is not rare to hear a patient say...'my Botox seems to be wearing off earlier than usual'...or...'I had Botox but it didn't seem to work'. Some few patients even suggest that they may be immune to Botox or that they are becoming resistant ot it. Many physicians and even manufacturer reps say that such immunity is impossible. But is it? Is immunity to Botox real?
First and foremost any drug, no matter what its mechanism of action, poses the potential of diminished effectiveness with repeated use. The most classic example is that of antibiotics. (although this really represents resistance of the infecting bacteria not necessarily how the body responds to it) But immunity or developing an immune response to a toxin, an unnatural molecule that the body may eventually recognize as both foreign and harmful, is particularly likely. While I hold most responses on the internet as not a source of absolute scientific information, there is too many patient responses on many different websites that claim a lack of response after injection or a dramatic dropoff in effectiveness after a period of years of successful use. (most common) While some, if not many, of these may be the result of using overdiluted or old Botox or from poor injection technique, all of them can't be completely drug or injector-related issues. Resistance to serotype A of botulinum toxin (Botox and Dysport) has been reported in some physician series but the incidence is quite low. (usually less than 1%) The point is...it has been reported in professional medical journals in large patient series. Anectodal statements by some physicians such as 'I have never seen it' and the like does not count as scientific evidence. Never having seen it does not mean it doesn't exist. Most of us have never seen a platypus in the wild either, but we know they do exist.
Once you develop Botox immunity, what can you do? There is no absolute answer to this uncommon problem. Perhaps waiting a period of time ( 6 months to a year?) before trying repeat Botox is one option to see if your immune response lessens. The other option is to use a different serotype, type B (Myobloc), and see if you get a response. In theory, different serotypes have slightly different molecules so your immune response may be quite specific to type A only.
Whether someone can be completely immune to Botox, without PRIOR injections, is a different matter. There would be no natural immunity to Botox since most of our immune systems have never seen the molecule before. When a first-time patient of mine calls and tells me they have had no response, actual examination everytime demonstrates that they actually have had a response it is just not as profound as they thought it to be. This is an issue of managing expectations and dosing, rather than some natural resistance to the drug.
By far, the most common patient experience in my practice with Botox is that patients actually develop a somewhat lesser need with Botox over time. After three or four treatments, many patients find that the Botox seems to 'last longer' and they may only need injections twice a year as opposed to every three or four months. This is not because the patient has developed greater sensitivity to the drug but because they have most likely 'retrained' their expressions. which are learned movements anyway. Once you have not moved or have less movement of any muscle for a long enough period of time, you may have inadvertently retrained your expressions to some degree.
Acquired Botox immunity is a real but uncommon event. It usually presents in the patient who has had Botox for multiple treatments, after a year or two, with a diminished response to a proven dose or sometimes as no response at all. Botox resistance without prior exposure is more likely an issue of expectations and proper dosing rather than a natural immunity.
After that fateful day when hoodia gordonii was introduced to the whole country as the next weight loss wonder in the health world, a great demand for it rose. The facts that this wild succulent plant only grows in the South African desert and can only be harvested after 5 years, make the supply of this plant far lower than the demand for it.
The tricks of the trade
From this great scarcity of hoodia gordonii stems the counterfeit products in the market which claim to have the genuine plant. Being choosy is the least thing you can do as a consumer as about 80% of weight loss pills claiming to have this plant are actually fake.
So how do you know then if a certain weight loss product you wish to buy contains that same hoodia gordonii cultivated in South Africa? How can you tell if a nutritional supplement does have authentic hoodia gordonii and not just some starch or sawdust?
Separating an authentic hoodia gordonii product from an adulterated one is not just one whole simple procedure. This is for the reason that two labs heading the giving of authentication to various companies in the United States actually conduct different processes. Apart from this, they disagree on how these processes must be done and even on the very definition of what real hoodia gordonii is. Needless to say, some companies may get authentication from one lab and none from the other so this makes the whole testing for consumers more complicated.
Penned on paper
Now most websites, even those owned by health companies themselves, always advise that you look for a company's C.I.T.E.S. certificate. C.I.T.E.S. stands for Convention on International Trade of Endangered Species of Wild Fauna and Flora, which is based in Cape Nature of South Africa. They issue this document to regulate the exportation of hoodia gordonii as this plant is a protected plant species.
However, seeing that a company has a copy of the C.I.T.E.S. certificate does not guarantee authentication. This is because a lot of companies result to fraud by copying certificates uploaded by other companies and editing them in Photoshop to make them look real.
Another way to know if a company is a legal hoodia importer is to look for their USDA Import License. All companies who import real hoodia gordonii are granted license by the USDA and are registered by them.
The last method to determine if, indeed, a hoodia gordonii product is authentic is by passing it to Alkemists Pharmaceuticals for a series of lab tests. This lab's tests can detect if a sealed product contains real and pure hoodia gordonii. However, you must make sure that their lab report for a company's product is not more than 6 months ago.
Filtering fact from fiction
Despite the fact that the authentications mentioned can be adulterated by several companies, it's a good thing that there are still some ways to make sure that a hoodia gordonii product is genuine without spending too much.
Pay attention to the price. Don't think that buying a $25 product is bang for your buck. Pure and genuine hoodia gordonii costs from $200 to $350 per kilo. This means that the food supplement must really be costly, especially considering its scarcity. It is best to trust those companies who sell their products for more than $40. However, some companies who put sawdust in their products even raise their prices as they know this fact.
That is why you can turn to some independent writers out there who provide honest articles about the hoodia gordonii industry. Make sure that they have no affiliation with any health company. They are usually investigative journalists who recommend authentic hoodia gordonii products in the market without getting paid by any health company. Most of them have tried the products themselves and have encountered several fraudulent companies who fool the public by selling counterfeit hoodia gordonii.
The best thing you can do as a consumer is to filter all testimonials and articles you see online and distinguish the true information from the fictitious ones. Even online forums could be contaminated by false testimonials, thus, it is best to take it from independent writers themselves.
Both Dr Barry Eppley & Roberto Bell are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.
Dr Barry Eppley has sinced written about articles on various topics from Anger Control, Cosmetic Surgery and Botox. Dr Barry Eppley, board-certified plastic surgeon of Indianapolis, operates a private practice at Clarian North and West Medical Centers in suburban Indianapolis. He writes a daily blogs on topics and trends in plastic surgery at. Dr Barry Eppley's top article generates over 165000 views. to your Favourites.
Roberto Bell has sinced written about articles on various topics from Food and Drink, Health and Colon Cleanse. Read more about , ,. Roberto Bell's top article generates over 90500 views. to your Favourites.