Dr Eric Borgeson, PharmD, on the LDN Radio Show 9th October 2019

Linda Elsegood: Today I'd like to welcome my guest pharmacist, Eric, Borgeson from Jersey Shore Pharmacy in New Jersey. 

Thanks for joining us today, Eric. 

Dr Eric Borgeson: Thank you for having me today. 

Linda Elsegood: Could you tell us how you got into the pharmacy? 

Dr Eric Borgeson: I originally got into pharmacy when I was 15 years old.

I got a flyer in the mail, and it's about a Lamborghini, and I wanted to drive a Lamborghini and own one. So I got into pharmacy because there were three ways to get the money required to buy the Lamborghini. It was either to inherit, which wasn't most likely going to happen or to win the lottery, which did not happen.

And the third way was to cure a disease. Then while in college, I'm getting closer and closer to a degree. In pharmacy, your ideas change, your goals change. So I became more of a person who wanted to help people and to help take care of other people and help them with their medications and getting better and staying well.

Then it was about a sports car. 

Linda Elsegood: Hmm. And have you thought any more about, you know, curing a disease? 

Dr Eric Borgeson: Not so much. I mean, curing a disease seems almost impossible at some times to say, like, to be able to come down to the exact small things that actually caused the diseases. It's easy with something like HIV or AIDS where it's a virus, and you just have to figure out how to stop the virus and stop it from replicating versus a bigger disease such as cancer or MS or Crones when there are so many factors that go into it that you don't know how to stop it. One factor is great, but when it's still there and still happens, and we still don't have the answer, you’re scratching your head as to why is this still occurring? I thought we stopped it at the source. 

Linda Elsegood: Yeah. Okay, so in your pharmacy, what do you mainly do? 

Dr Eric Borgeson: We mainly make hormone replacement therapies that involve progesterone, testosterone, estriol, Estradiol.

In that, we also make supplements for various ailment that people have. And then other various ways that people wish to take. Well, we also do the low dose naltrexone, for those patients who have fibromyalgia. We also have patients who have that and chronic fatigue syndrome that we seem to help out with that.

Linda Elsegood: Do you have many doctors that are prescribing? 

Dr Eric Borgeson: It takes a special kind of doctor to prescribe it and seems like it has to be one that believes in trying a different approach, or what their patients bring to them to try. So we have about a half dozen neurologists that do prescribe it in the area.

Also, there are few alternative practice doctors that prescribe it in the area, but we don't really have any gastroenterologists who prescribe it much. 

Linda Elsegood: Oh, okay. And we always find that the most prolific prescribers are mainly nurse practitioners. Do you have many of those in your area or, or none at all? 

Dr Eric Borgeson: We do have a lot of those in our area.

A lot of physician assistants and a lot of nurse practitioners, but they seem to really do a lot of the alternative medicines, in the sense of the low dose naltrexone, tell their patients that way. They seem to stay more towards Western medicine. The ideal of this is what the book says, how I treat my patient or X, Y, Z.

Linda Elsegood: Well, we did three talks last year like a roadshow taking LDN out there and getting pharmacies and prescribers in the area invited to come to an evening, just a two-hour talk on LDN. That has been really successful. So maybe we need to come to your area and get your prescribers to come along and, and listen - if they will listen.

Dr Eric Borgeson: Sounds like an excellent idea. 

Linda Elsegood: Yeah, that, that definitely does, isn't it? 

So what forms do you compound LDN in? 

Dr Eric Borgeson: Primarily receive. We make a capsule for us. We've made liquid for one person before, but primarily we just make LDN capsules. There was a prescriber as a psychiatrist, with interest in a low dose naltrexone cream too.

But he didn't follow through with it or never found a need for it.

Linda Elsegood: Oh, that's a shame. I mean, it seems to be working extremely well for mental health issues and also with pain, even people that are taking high doses of opioids by using ultra-low dose naltrexone. Do you have any pain specialists in your area?

Dr Eric Borgeson: We do have some, there’s a large number of pain specialists in our area, but none of them has prescribed it. But that may just be, as you said, due to a lack of education about the product. Or even just the availability. There's a bunch of us out there and trying to promote ourselves and what we do and other people out there are telling people that there are other means than traditional medicine, that there is this alternative. Sometimes it seems to fall on deaf ears or doesn't make it to the right ear. 

Linda Elsegood: Yes, true.  You know, if we can get people to come to the conference, that would be amazing. You know, watch the live stream.  But there is a lot of it. This year we had, I think, about 30 hours of pre-recorded presentations plus the two and a half days as well. It's quite a commitment to sit and watch them, or if you do have a year to watch the presentations. But nine out of 10 prescribers that watch it are so enthused by it. They will go and prescribe LDN.

And of course, as soon as they see patients doing well, they want to prescribe it more and more. 

Dr Eric Borgeson: Why don't we? Everyone has patients that they have who might be able to benefit from LDN. They're looking for something and they just can't seem to find that one magic bullet, but even something else that would help them with the bad effects of their illness and can’t think of what.

And then sometimes they're like, ‘Oh, let's try this!’ as you said. And then they're like, ‘Oh, that’s great, that worked really well for’, for example, ‘Ms Hill over there. Maybe we need it for Ms Parker over here or different elements for a different condition.’ This may help them because they had thought of it.

Linda Elsegood: Hmm, exactly. And it's, you know, a Eureka moment, isn't it? When you've had a patient who's really ill, and there's nothing else you can do and the patient isn't getting any better. And then discovering, LDN could possibly work and seeing what the results are. I find it really fascinating. 

Dr Eric Borgeson: It is fascinating and satisfying.

It's at that moment that you're able to feel like ‘that's where we got into medicine’, to help them out with these things, to make it, to give them the treatment that they need to help improve the lives that they have. 

Linda Elsegood: You said that you compound supplements as well. What would your recommendations be to patients who take LDN? What supplements would you say they should be taking or checking?  

Dr Eric Borgeson: Yes, because a lot of that's what attracts them to help with the inflammatory disorders. We usually recommend other anti-inflammatories to go with it.

Or perhaps B12. Or other complexes that we have, just an overall energy-boosting for our patients who have chronic fatigue syndrome, or it may be that we also recommend they get their iron levels tested to make sure that not just a vitamin D issue, that it actually sees if there's any iron component to it, that's missing, that they don't have enough steroids and things like that.

Linda Elsegood: Why would somebody have low iron if they had a healthy diet? 

Dr Eric Borgeson: They may not be getting enough iron from their natural diet. Over here in the States, we have a lot of vegans or vegetarians that if they don't get enough beans or other source of iron or even just iron supplements taken with something such as citric acid or even just orange juice with it.

They may actually get enough absorption, and they might not be getting enough just in their diets as I said, from lack of iron sources. It's like they're not getting enough iron from beans or things like that. 

Linda Elsegood: How would you know if your absorption was working correctly? 

Dr Eric Borgeson: You'd have to get a lab test from your doctor and then get a blood draw to see what the levels were and then take them, they do move slowly.

So you'd have to draw blood, with a retest after six to eight weeks to see if you were deficient. I had to get our tests in six, eight weeks to see if the levels are brought up or not. And then you can slowly continue to supplement from there. For example, my own baby, at 18 months, was getting a great diet and drank milk.

He did everything, but he still had an iron deficiency, which was surprising to us when we brought him to the doctor. So we give him a vitamin supplement, iron supplementation for three months or so, and now his iron levels are up to normal and up to date, and we've been able to stop the supplementation.  He's able to maintain his iron. 

Linda Elsegood: That's good. So you don't necessarily need to take it for life just to increase it. 

Dr Eric Borgeson: Well, no, that's good just to correct it.

Linda Elsegood: Yes. Okay. So when a patient comes to see you, I mean, obviously you're not prescribers, but if you notice there was something that could help a patient, how would you go about informing them?

Dr Eric Borgeson: If we see a deficiency that we can help with a patient, we'll write them up in a note and tell everything. Like, this is what we recommended to your doctor. And then we ask if they want us to fax it over to them on their behalf or if they want to bring it into their doctor or they want to call their doctor about it.

So we'd help educate them about what the issue is, why we think this is a good treatment for them. Why is it a good way to progress? Then for them, with the way to get what we suggest that they should get. Most prescribers in our area have worked with their patients for years, or decades even.

So anything that a patient brings to them, they're mostly willing, they're most likely to let them try it because it has a sound rationale behind it that's opposed to, you know, a patient saying, Hey, I found something on the internet. Great. 

Linda Elsegood: And what do you think the response would be if you suggested LDN for these chronic fatigue patients or MS patients.  Do you think the doctors would be open to that, those who haven't previously prescribed? 

Dr Eric Borgeson: I do think it happens with doctors who have previously prescribed it. Some may be sceptical about it at the beginning, but then they just want what's best for their patient. So if they don't have any negative experiences, they will invest my track record in my history.

In nineteen years, I'd never actually seen any really severe allergic reactions. And they don’t see any severe adverse effects from taking low dose naltrexone. All I've seen is that's what's happening with someone who was on opiates before and got a medium dose of naltrexone and they now went into withdrawal a little bit.

But that was the only a slight case of anyone who's had an adverse reaction from our experience with it. So most doctors in that instance, when presented with a lot of positives that can occur from it and not a lot of negatives, then they're more willing to prescribe it for their patients.  

Linda Elsegood: What would you say the outcome has been from the patients that have tried LDN?

Dr Eric Borgeson: I can say it's not all of our patients, unfortunately, that get benefits from it. It seems to really be about six out of 10 or seven out of 10 patients who do take it and take it regularly and as they're taking it at bedtime, take it roughly the same time, at bedtime. It seemed to have the best effects with it, but as not all medicines work the exact same way for everybody, it doesn’t work for everyone, unfortunately.  

Linda Elsegood: What dose range do you compound? 

Dr Eric Borgeson: The majority of our patients, we have a total range. Once we have to do one and a half; we have two-point ones, three ones, three and a half, four and a half. We have a few patients on six points, and we've done a few patients up to nine.

But the majority are down in the three and four and a half range. Because most of the studies in LDN, most of the tests and most of the studies have been done on the four and a half milligram variety of low dose naltrexone as opposed to higher doses. And then we start the lower doses because people should be titrated up slowly as opposed to just jumping to the highest dose.

Linda Elsegood: And what I was saying about pain specialists is because pain specialists now are using ultra-low dose LDN, which is 0.001 so it's, you know, really micro-dosing, and it seems to work absolutely amazingly by using this microdose alongside the opioids, not taking them off, keeping them on makes the opioids far more effective.

And then they're able to decrease the opioids while increasing the microdose, and in some cases actually weaning people off the opioids, some that have been on opioids even 20 years. I heard a story the other day about coming off the opioids on LDN and having better pain relief than they were on this cocktail of opioids and didn't go through withdrawal.

Dr Eric Borgeson: Now that is just amazing. 

Linda Elsegood: Yeah. We're doing a documentary on opioids and LDN, and we've interviewed several pain specialists who have amazing things to say, so we are hoping for big things with LDN, and hopefully, we will have to get you to make ultra-low-dose as well. 

Dr Eric Borgeson: Excellent. Well, we look forward to that.

We ought to have more papers on that? 

Linda Elsegood: Yes. 

Dr Eric Borgeson: So I thought they had talked about micro dosing and nano dosing. The question is more homoeopathic sometimes at that point where it's like, what? How small of a concentration can you have before you actually start to see an effect? That'd be fantastic.

That doesn't have to be that high, and it doesn't cause any withdrawal effects on you simultaneously. Improve anti-inflammatory at the same time, not have to use such high doses of opiates. 

Linda Elsegood: Exactly. And the pain specialists that do use LDN at 1.5, will use it with opioids, but only several hours apart.

So if you take one in the morning, you take the other one at night. We don't ever recommend that. Nobody does that themselves, that always has to be under medical supervision, but there are doctors that will do that and find that it does work really well, but maybe it's the same thing as the ultra-low dose alongside the opioid making it that much more effective, but it's certainly something that is a hot topic at the moment. Which is really interesting. So what's your next goal in your pharmacy? 

Dr Eric Borgeson: Our next goal? So, currently, we are rolling out our USP 100. We're working with the regulation part of that to improve us. And then we also have some creams out for testing now to help increase the bud study, like the beyond use stating that people can have for pregnant alone.

Cause right now there are no studies that pregnenolone is only good for 30 days based on U of T seven, nine, five. So we've put some out to a testing lab when we're on day 90. Now. We've had good results so far. Um, so we're pushing the boundaries there on science to see how long, um, we can get pregnant alone in this space for so that patients can, you know, have larger day supplies and less frequent turnover of medication, like having to order it and decreasing the burden on them.

Linda Elsegood: So what, what is that actually for? 

Dr Eric Borgeson: Oh, pregnant. It's part of 'em. Uh, the hormone. a homeowner placed on therapy greens and helped synthesize other hormones for you. That's like a precursor. 

Linda Elsegood: So when people take hormone replacement medication, I mean. Is that just one medication once a day or do they have to take more?

Dr Eric Borgeson: Some prescribers use it once a day, and then some prescribers do it twice a day. It depends on the doctrine—the prescriber.

Some doctors want to keep the levels up more sustained and found that trees, it's the cream today seems to be more effective than once a day. So, again, that goes back to being patient dependent as some of their patients only use them once a day, and they seem perfectly happy with it. And sometimes it's just replacing progesterone that we've, that women lose over time, like people who are over 50, maybe experienced progesterone loss.

So then it's just bringing their progesterone levels back up to where they were normally originally. Um, so we're just, then at that point, you're just supplementing the progesterone at bedtime, and that's it. Cause it can cause drowsiness and some people as well. So, um, you wouldn't let me drive there during the day.

So the prescribers prescribing more. 

Linda Elsegood: And what about, um, blood tests? Do they always come back showing that they're, the tests are negative or positive even for thyroid problems, hormone problems? What I'm trying to ask is, is it a, is it a clear cut thing where, you know, this is the marker you've got, so you definitely need some help or, or are the grey areas.

Dr Eric Borgeson: I would say there's a grey area. There are black and grey areas where it's like, while you're, it depends on what level they're looking for. Like people who are high roid. Some people just look at the thyroid-stimulating hormone levels and base it off of that when they should really be using more of a direct T three and T four, um, blood tests.

It's a little bit more expensive obviously, but they use the direct T three and T four just to ensure that your body is converting. The T four into the active teeth three and then back to the inactive T four. And if it's not getting to the active state, then it looks fine on your blood work on just a thyroid-stimulating hormone side.

Ella is finding your blood work, so then it won't be fine. Um, once they, once you take the direct levels. 

Linda Elsegood: Hmm. Because I know, I know some people have had tests gone to one doctor and had the tests and been told the fine, then go to another doctor would have a different test and find they actually do need help.

I'm 

Dr Eric Borgeson: really alone in college where I was like, are you treating the numbers or you're treating the pain. And so they would be looking at the symptoms that the patient's experience in regards to, you know, are they losing weight? Are they having excessive sweating or, you know, are they just gaining weight.

The irritable or you somnolent infant, you know, are they, are they too tired? Not tired enough, too much energy, not enough energy. There are so many variations, professor, for the thyroid patients that they have to take into consideration, 

Linda Elsegood: but it's not helpful. Is it? When you go to the doctor in the field.

Really unwell to be told that your blood tests are normal. There's no further action that needs taking, you know, but hang on, I don't feel very well. There is something wrong with me. And then, of course, some of these patients are then told it's all in your head, you know, that you imagine it. 

Dr Eric Borgeson: Yeah, there's that.

There's that. Unfortunately, that does occur. Um, but yeah, I look, people always want to go, you got the people who don't even want to go to their doctors, but then they're like, well, I need an answer. I need to know what is wrong. And then after going their doctor, they're like, my doctor said there's nothing wrong and enough must not be anything wrong.

Linda Elsegood: So what, what are you going to say? What are you able to do as a pharmacist? If a patient comes to you and says, ah, I've had these blood tests, and they're all negative. There's nothing wrong with me yet. I'm really not. Well, how do you help those patients? 

Dr Eric Borgeson: We interview the patient at that point. Part of that is not feeling well and then try to find what may have paused that from the start, like more of the history and the biography of what caused their own wellness and then what things they've tried to further on wellness.

And then either possibly recommend a different doctor for them if they didn't go with a doctor who specializes in what seems to be wrong with them. Um, or maybe we've had to do tiny on what they say. We might have to do some further research. With them to see what else we can find on their topic of what seems to be ailing them.

What are things that we may not have even considered? 

Linda Elsegood: Yes. Yeah. Now, as I say, you're in New Jersey, so how far, you know, if you look at the whole state of New Jersey, whereabouts are you based? 

Dr Eric Borgeson: What about in the middle? Against the shore. We're, we're an hour and 15 minutes South of New York City, about an hour north of Atlantic City and an hour and 15 minutes diagonal from Philadelphia.

So we're ready against the shore about halfway up 

Linda Elsegood: on the coast. Okay. Yeah. I've actually been to Atlantic city as well. I, I came back, and I think I was home about a week and they had those terrible storms or hurricane or something and it ripped all the boardwalk up, but it was quite nice. I was saying to my family; I went here. I went there.

It didn't look like that, though. Um, I think I would have been, yeah. Quite frightened if I'd been there when that happened, but I did 

Dr Eric Borgeson: see it. Hurricane Sandy was not a nice hurricane. I had lost power for a day or two. There are people that have the pharmacy. I worked at the time. It didn't have power for a week.

Wow. You know, it was very, very traumatic. That was even in that, in inland, like 10 miles, like 10 15 miles. Like it was a very. Like for all the trees and knocked down and all the damage it did. It wasn't just the ravaging shoreline, which it did that as well. Burying houses and just strolling the entire, every house on the Island pretty much was almost seemed to be knocked down at some point.

Linda Elsegood: Goodness, 

Dr Eric Borgeson: there's so much damage on the Island, 

Linda Elsegood: but wow. 

Dr Eric Borgeson: I mean, we rebuild them. It's better than it was before, 

Linda Elsegood: but you do have more extreme weather them than we have here. 

Dr Eric Borgeson: Occasionally there's not, you know, that's, I've only had one hurricane since I've been here, and that's the one. 

Linda Elsegood: Okay, well, that's not so bad.

That isn't 

Dr Eric Borgeson: it. Did you get some torrential downpours? Do get some lightning and thunder. They are always borne up tornadoes, but no ones. I'd never seen one in this area.

but you're  

Linda Elsegood: but your position, um, how you will be located. You know, what area do you cover around your pharmacy? How far do people travel?  

Dr Eric Borgeson: ah, people can keep seeing how people travel up to 45 minutes to come to us. But we do mail like we ship prescriptions. Um, we just compounded prescriptions. We do ship for free throughout the state.

Because we're licensed in all States, so we'll have the doctor, well, doctors will fax over their prescriptions, or they'll call them in, and then we'll get them ready, and then we send them out to the patient, so they don't have to make them if they're over 45 minutes away, they don't have to travel there to get their prescription if they can't get anywhere else.

Linda Elsegood: And your license in which States did you 

Dr Eric Borgeson: say it's in New Jersey where we are, but we're licensed in eight States, I believe. 

Linda Elsegood: Okay. 

Dr Eric Borgeson: We're licensed in Arizona, Connecticut, Colorado, Ohio, Pennsylvania, New York,

Florida, Maryland. Those are the ones that come to mind 

Linda Elsegood: for pushing you on the spotlight. It's a tricky, tricky to remember, isn't it? Wow. So do you think, um, Philadelphia, didn't you say you near Philadelphia?

What was it about Philadelphia? Do you ship there, Pennsylvania? 

Dr Eric Borgeson: Yes. We do ship to Pennsylvania. There's a children's hospital on the edge of Pennsylvania that we do a lot of compounds for. There's a children's hospital, Philadelphia, and we help take care of some of their patients. 

Linda Elsegood: Oh, okay. Wow. We've just about come to an end.

Um, you've already given your contact details, and that will be on the video for people to see. So thank you very much for having been my guest today. 

Dr Eric Borgeson: Thank you very much for having me. I look forward to seeing you guys may come to visit New Jersey. 

Linda Elsegood: Thank you.

 

Jersey Shore Pharmacy is a fully licensed and accredited pharmacy in New Jersey, specializing in compounding formulations. Such as LDN, bioidentical, hormone creams, home appraisal, and pet medications. They strive to help everyone with their individual needs. Visit https://www.jerseyshore.pharmacy/  or call 01 (609) 660-1111 Monday to Friday 9:00 AM until 7:00 PM. Saturdays. 9:00 AM till 3:00 PM.  You can also find them on Facebook. Today I'd like to welcome my guest pharmacist, Eric, Borgeson from Jersey Shore Pharmacy in New Jersey. 

 

Any questions or comments? You may have. Please email me and Linda, L I N D a@ldnrt.org I look forward to hearing from you. Thank you for joining us today. We really appreciated your company. Until next time, stay safe and keep well.