The number of patients with autoimmune disease Dr. Cottel is seeing has increased, particularly thanks to her presence on the LDN Research Trust website. She also is treating more patients with alcohol use disorder (AUD) with LDN than before, with very good results.
Q: In a patient with a pain disorder, on 4.5mg LDN without good result, should he increase his dose?
A: Essentially, if you’re not getting relief on lower doses, it may work increasing the dose, but it is not well studied. Linda commented on reaching opiate blockade and the need to reduce the dose.
Q: Address where a patient with Sjogren’s has GI side effects from LDN even at ultra-low doses.
A: Have compounding pharmacy prepare LDN in water at 1mg/ml and start at a very low dose eg 0.1mg and increase by 0.1mg as tolerated, slowly. Take at bedtime. Linda commented that sublingual drops work very well also to avoid GI absorption.
Q: In a patient with MS on LDN 3.0mg developed double vision, is higher dose LDN advised? What about Vitamin K2 for MS, will it re-wrap the nerves? Can Mediterranean diet decrease inflammation?
A: Always have double vision checked to be sure of cause. If from MS, increasing LDN to 4.5mg may help. As for Vitamin K2, some studies suggest K2 may inhibit inflammation of anti-microglial cells, and perhaps the body could heal itself. Yes, that diet decreases inflammation; diet is very important in treating autoimmune disease.
Q: Patient with Hashimoto’s starting LDN, what side effects should be looked for.
A: Typically, LDN is well tolerated. Perhaps headaches or vivid dreams early on, and patients with GI problems may have diarrhea.
Q: Can LDN help fibromyalgia and cancer prevention?
A: Yes for fibromyalgia, but not everyone goes into full remission. Probably yes for cancer prevention; there are animal studies to support that, as well as that LDN is used in treatment of cancer.
Q: Patient on prednisolone for polymyalgia and can’t get off steroids. Will LDN help?
A: Yes, recommend adding LDN then tapering steroids. There are complications from chronic steroid use.
Q: Can LDN and thyroid medications be taken at the same time?
A: Thyroid medications are to be taken alone, at least 1 hour from other medications.
Q: Is LDN for real?
A: Yes! There are lots of sources for information from prescribers, patients, and through small studies.
Q: Use LDN in post-polio syndrome?
A: In her one patient with post-polio syndrome, LDN has helped with the pain, but in post-polio syndrome there are many sources for pain, and as LDN is so well tolerated, she recommends its use.
Q: How do you know LDN is working (patient with Hashimoto’s)? Can gluten ever be re-introduced?
A: Clinical response is the indicator of success in Hashimoto’s. Dr. Tom O’Bryan has a series on this. Once you have antibodies to gluten, they will increase when exposed to gluten, and can interfere with how LDN works.
< Note: the LDN App was retired >
Q: Will LDN help with pernicious anemia and rheumatoid arthritis (RA) and how do I get it?
A: Get information from the LDN Research Trust website to take to your doctor. LDN is an immune modulator and calms RA. Pernicious anemia is an autoimmune disorder, traditionally treated with B12 injections so use of LDN and pernicious anemia would be interesting to study.
Q: Can you take LDN and Chantix, a medication used for smoking cessation? Are there studies on LDN and vitiligo?
A: LDN may help with smoking cessation and Chantix. Linda has heard of patient using LDN for vitiligo with great success.
Q: Can going on/off LDN be a problem?
A: For those on LDN for a long time, it’s not likely to cause a problem, but you may notice a return of symptoms.
Q: In Type I diabetes and alopecia universalis
A: Dr. Cottel has seen few cases but has not seen great success with LDN. Linda noted she has spoken with patients who had great success with LDN for alopecia; but LDN is not a miracle drug nor does it work in all people.
Q: Is it ok to take LDN for fibromyalgia with thyroid medication?
A: They can be taken together, but be sure to take them at least an hour apart.
Q: Hashimoto’s and Sjogren’s who is pregnant. Is LDN safe during pregnancy?
A: Dr. Phil Boyle covered this at the last conference: no problems taking LDN during pregnancy
Q: Can LDN be used in Crohn’s disease the same way as the immunosuppressants used?
A: LDN is effective in some patients with Crohn’s disease and might allow tapering off other immunosuppressants.
Q: Can LDN be used in patients with glioblastoma?
A: Many prescribers use LDN in treating cancer as part of a complete treatment program.
Q: If LDN helps with pain in a neuropathic pain condition, does it mean the condition is autoimmune?
A: No. You can get pain relief from the endorphin effect of LDN.
This is a summary. Please listen to the full interview.