Dr John Kim on the LDN Radio Show - 7th December, 2016

Linda Elsegood: Today we're joined by Dr John Kim. Thank you for joining us, John.

Dr John Kim: Well, thank you for the invitation, Linda,

Linda Elsegood: For those people that haven't heard you on our Vimeo channel, would you like to tell us what it is you actually do in medicine?

Dr John Kim: I'm actually in-between transition, as some people may know. For the last ten years, I've been working in Georgia where 50% of my practice is in pain management, and then the other 50% is solving complex medical puzzles; especially autoimmune conditions. I actually discovered LDN as a part of the second part of the practice, and the second part of the practice actually came about because I had wonderful techniques to help patients with chronic pain, except for patients with autoimmune disease pain. Those pains just were harder and tougher, and I had to change my paradigm and look for other tools other than what I had, and kind of open the door through LDN to treat the whole bunch of other conditions, especially autoimmune conditions with a great deal of success.

Linda Elsegood: Would you like to tell us what it is you have trained in?

Dr John Kim: So the original training in medicine began with family medicine, and I chose that because it was the most holistic of all areas. But I wanted to train more, so I actually changed my career to a speciality; to preventative medicine, and then from there I learned medical acupuncture, and then went on for a fellowship in integrative medicine with Dr Andrew Weil as a residential fellow. That kind of sums up my traditional training, but I've also done extensive basic science research in biochemistry and pharmacology.

Linda Elsegood: What would you say the outcomes have been for the patients that you have prescribed LDN for?

Dr John Kim: LDN for me hits even closer because the LDN originally was brought to me by one of my favourite patients. I'm not supposed to have favourite patient, but the patient is a favourite because she one day said, ‘Hey,I have this condition called Hashimoto's thyroiditis, and the prognosis is really depressing. I get to take medication and as Hashimoto's thyroiditis destroys more of my thyroid I get to take more and more, and you never get off it’. And she said, ‘I found something interesting called low dose naltrexone, and would you please do research?’ And I said ‘sure’ and when I did research about it, that was about ten years ago, there were fewer research articles, but even then, it really looked like the risk-benefit profile, meaning how much risk is there and how much benefit is there, was very, very limited; small, and the benefits sound so incredible. So, I prescribed the medication and what happened was that her disease went into remission, full remission, and did not require any further use of hormone treatment. Then what had happened was that within several years she got pregnant and, retained her baby, because before she was having issues with, I think miscarriage, and then she gave birth. And then after the birth, her disease returned, almost like Graves and we again used low dose naltrexone very successfully and helped the illness to go into remission as well. 

Linda Elsegood: And did she take the LDN throughout her pregnancy?

Dr John Kim: Yes. LDN through pregnancy is a very interesting topic and I had them talk to their doctor, but you know, part of the acupuncture practice I have, a small part of it is fertility. And I've noticed that LDN helps patients to get pregnant. For those I think who have issues with their ability to get pregnant it’s often coming from an autoimmune condition, and I think that LDN can reverse that.

Then I've seen LDN reverse endometriosis, and again, I think that a lot of the illnesses that we have seen have an autoimmune basis. We don't use the word autoimmune, what I like to use is the dysfunctional or stunted immune system. The immune system is no longer being intelligent, and I think the LDN corrects it.

That's why I think that LDN is such an interesting drug because LDN seems to be what we call an adaptogen, which means that it brings a system into balance. So if it's too much, it brings it down. If it's too little, it kicks it up. And I think that's how LDN works for from everything. From autoimmune diseases to HIV, to cancer.

And LDN, I think is like almost a class of its own, because it does so many nifty, therapeutic actions with some limited side effects. 

Linda Elsegood: What side effects have you noticed with your patients?

Dr John Kim: There are at least two people that I've seen that had a severely depleted state of endorphin.

They’d been ill for a long, long, long time, and their resilience is very, very limited. And for those people, I've noticed that even with one microgram of low dose naltrexone, they have a hard time taking it. And. If there was a homoeopathic pharmacy, I wondered if they could make a nanogram dosing of low dose naltrexone for these people, but these people are few and far between.

For most of the other people who have side effects, they find it easier to handle. Like some people, instead of it helping them to sleep, it has the opposite effect. So, if that's the case, it's pretty simple, they just take it at dinner time or in certain cases, I just tell them to take it with lunch or even at breakfast time.

Linda Elsegood: Well, we did have a question, which fits in quite nicely with what you're saying, and it's from Deb, and she has her own thyroid group with LDN, and she says, ‘have you seen a patient with a genuine allergic reaction, not just a side effect on  1.5 milligrams of LDN?’

Dr John Kim: So I think that the allergic reaction if they're talking about an anaphylactic reaction, that's probably due to the filler, not necessarily to do with LDN. As I said, the two people that I have seen a reaction, even one microgram, those people, I think probably had the reaction that they're describing, which is closer to an allergy, however, I've not seen the typical, what they call anaphylactic or IgE mediated response to naltrexone, and it's theoretically possible, but I just haven't seen it at this point.

Linda Elsegood: We have a lady called Lynn from Australia who has been using LDN for two and a half years for graves' disease in kidney neuropathy, and it’s inactive now, but she does have small, reoccurring, low-grade bladder cancer.

Her naturopath suggested that she should take a test to show nutrients, which would affect the cell line of cancer patients, so she's asking ‘would this test be worth having in regard to bladder cancer and LDN?’

Dr John Kim: I think that's a wonderful question, and it also happens to be a complex question. And the reason why I say this is that the low dose naltrexone effect on cancer, I think that is very beyond theoretical. I think that we are beginning to have case series of studies that would be the basis of one day doing a randomized control trial using LDN to use either as an augmented complementary to the conventional therapy or standalone agent. In terms of the nutrition testing, which is very popular we call this approach ’functional medicine’, within the integrative medicine spear. And in that philosophy of testing everything that you can pass on, or micronutrient testing, or even testing of the agents that are a part of the Krebs cycle, and testing those intermediate, biological functional markers to be useful.

And I think that to be honest with you, that the research just is not yet fully there. Spectracell is one company that will basically test different types of antioxidants and vitamins, and I think that it's a reasonable thing to do for cancer patients.

I would not recommend it for everybody who is in good health, but for cancer patients, if you asked me six months ago, I would say, I'm not sure, but I think that because cancer is such a debilitating and life-threatening illness because the conventional medicines alone don’t have full control over cancer.

Because even with LDN, looking at Dr Biharis’s study, that wasn't a hundred per cent. I mean, he did not get a hundred per cent either. So, I think that we have partial answers, but with cancer, we have room for improvement. I think that some types of micronutrient testing for cancer patients makes sense.

Again, that’s not recommended on a healthy person, but for cancer patients, because the stakes are so high, and because of the latest protocol by Dr Berkson, who combined alpha-lipoic acid with low dose naltrexone to help stage four cancer patients to go into remission.

So, if you look at that, then, all of a sudden what else are we missing? I mean, are there systematic studies? No. So then if there are no systematic studies, then you have to become a study of one. And how do you do that? Just like what the natural path is suggesting. I think that it is reasonable for cancer patients, but unfortunately not for everyone.

I think there's part of us that can be narcissistic and say, I want to test everything on you; genetic markers and nutrients, but I think that moderation is often a good way to go, but with cancer, I think that my answer has changed in the last year; the more I think about it, and the more I read, and the more new studies come out.

Linda Elsegood: Okay, we have a question from Christina, and she says ‘I have postpartum thyroiditis from pregnancy in 2011. My thyroid has never recovered and is very large with hypothyroidism. I do not have Hashimoto's. Should I start off at a very low dose because of my thyroid issues?’

Dr John Kim: So that's the wonderful thing about low dose naltrexone. Like I think I've shared earlier, the patient who introduced me to LDN, in the beginning, had Hashimoto's. But then she had postpartum hypothyroidism and LDN works for both, and some people would think, how can that be?

How can LDN increase the function of the thyroid and also decrease the function of the thyroid? If you look at it as LDN is an adaptogen for the immune system, meaning LDN restores the balance of the immune system, then everything makes sense. It's because the low dose naltrexone can increase the overall balance of the immune system that it can help with hyperthyroidism. It can help with hypothyroidism because the mechanism in both cases is exactly the same. Decrease the abnormalities within the immune system, and it does this it seems through glial cells binding through glial cells to There is a certain type of receptor that is responsible for releasing pro-inflammatory molecules. So, LDN binds to that site and does not allow for the release of inflammatory molecules. So, I think that the answer would be yes for somebody in that area, who is capable and is familiar with using LDN for those circumstances. And the other thing is that in such circumstances, I think aggressive testing makes sense.

So for me, if I had patients like that, I’d keep a very close eye on them, and I would test them even monthly to see what their labs are doing.

Linda Elsegood: Oh, she then goes on to say that she's actually been on LDN 1.5 milligrams and she had to take it every other day in the morning because she got very jittery.

She said she built it up to 1.5 milligrams daily and felt better. But then, after three or four weeks, her symptoms suddenly came on strong. She says, ‘does LDN bring out the disease and make you worse before you get better? Should I increase if I start to feel worse? And how long should I expect to feel worse before I start to feel better?’

Dr John Kim: I think that it's very rare. With my patients, I have seen or heard of those reactions. And I think that in one of the emails you sent me, I think that person had a similar reaction, were that there seemed to be a sudden release of catecholamines, which means molecules like epinephrine norepinephrine get released. And in such cases, you really have no choice but to go slowly, and to utilize incremental increases. I think whenever people have like a complex reaction, I will recommend them to consider having more than the standard use of LDN. I would say, you need to use more of a shotgun approach and utilize multiple assets. And I think that seems to be a good example because she's having a complex reaction; it's not a typical reaction. And so, for that, more diagnosis is needed, to see if there are any kind of issues of catecholamines being higher in her body than they should be. There's a test that they can do over 24 hours of urine collection. They can measure the overall amount of catecholamines in the body, and that indicates other problems that can be present. But if she wants to solve the issue, I think the best thing to do is branch out to other tools, and that's where I really love having more than just one tool. So, for example, I would use the LDN, I would use acupuncture because it also increases endorphins and decreases inflammation. Supplements that can also reduce inflammation, as well as immunotherapy that I talked about and those five things are what I recommend people to try before going to the conventional medications. In some cases, I see that even combining all those is not good enough, and then they have to use number six, which is conventional medications and conventional approaches. I think that it's just important that conventional medicine is not our enemy. It is neither a friend nor an enemy.

It's supposed to be our servant. We don't want it to be a master. We don't want it to be a dictator and create all kinds of problems.

Linda Elsegood: Okay. Well, we'll get ready to go into a break. If anybody out there would like to phone in and ask your questions to Dr John Kim, if you want the numbers, just go to www.ldnradio.org.

Linda Elsegood: Now we will take a call. Hello? Can you hear us?

Caller:  I can hear you, yes. Can you hear me?

Linda Elsegood: Fantastic. I can indeed. Yep.

Caller: Getting that somehow, right. Well, I refer to the guy that Dr John said had had a cancer diagnosis three years ago, bowel cancer. I haven't been using naltrexone yet, and I've had some chemotherapy, but on-base occasions I had Capecitabine to start with, and then I had Fluorouracil, and both of them threw me into A & E, so I've gone off the idea completely of conventional, well, what's it called? Chemotherapy. I'm just looking for alternatives. We've changed our diet. We’ve done all sorts of things and are feeling very positive, but just want to find out from you whether you think that I can be helped by LDN.

Dr John Kim: May I ask you what stage of cancer you were diagnosed with?

Caller: Oh, I think it was one.

Dr John Kim: So, then you are cancer-free at this time?

Caller: No. I had a CT scan a couple of weeks ago in November, and that showed that the tumours that they found, that showed up in April, have actually got bigger on my liver and in my right lung. I did have an operation to remove tumours from my left lung. So, I had the left upper lung removed and also I had about 30% of the liver removed.

Dr John Kim: So, when cancer that starts in one area goes to different areas such as liver and lung, it’s considered metastatic or stage four cancer. So the use of low dose effects for cancer that I've read about and that inspired me to use it actually are twofold. One is the original physician who made it popular or known to use LDN. Dr Bihari used low dose naltrexone for treating cancer very successfully and he had documented it. Now there's a second physician. Dr Berkson, who is in New Mexico, who is utilizing low dose naltrexone and alpha-lipoic acid, and in his case he does injections very successfully. So both parties have written about it. Dr Berkson has published his work. So, right now, all of my patients that have cancer, who come to me, pretty much, I recommend them a protocol of low dose naltrexone as well as alpha-lipoic acid, as well as other supplementation.

Now as for stage four cancer, fighting it just using low dose naltrexone generally, you know, I don't recommend it. I recommend using all the tools that you have because of the grade of the diagnosis. Using all the tools is what I recommend. Now, having said that, Dr Berkson does have documented patients who have used low dose naltrexone, and alpha-lipoic acid and the other protocols that he utilizes.

And my recommendation is to find someone near you who has utilized that protocol to success.

Caller: Wasn’t it Professor Dalgleish in the UK?  He's been fairly active I think in the LDN and cancer field. Have you come across him?

Dr John Kim: There's also Professor Liu, with whom Linda has connected me with. And you are part of the LDN research trust on Facebook, right?

Caller: No, I don’t do Facebook.

Dr Kim John: I'd like to highly recommend you to join. It's a really wonderful community to ask other people, especially in your circumstances. In general, I recommend for patients for fighting cancer for integrative medicine, low dose naltrexone, to use all the tools that make sense to them at their disposal. Because really, in my experience at least with stage four cancer, it's really difficult to make peace with stage four cancer. Cancer wants to grow, continues and there is no 99%, it has to be a hundred per cent because if you leave even 1%, it's alive.

It will double, and double. We call that tumour burden, and after the tumour has grown to a certain size, it puts a tremendous amount of burden in or way.

Linda Elsegood: The next caller now, if not, we won't have a chance to get through the queue.

Caller: Oh, sure.

Linda Elsegood: Okay. Thank you. Thank you for your call.

Caller: Thank you very much, Dr John.

Dr John Kim: Yes sir.

Linda Elsegood: Okay. I think we have another question here that may be cancer. Hello? Hello? Are you there?

Caller:  Hello? Are you talking to me?

Linda Elsegood: Yes, I am.

Caller: Okay. This is still us. No, this one wasn't cancer-related, but I can probably find one if you want.

Linda Elsegood: No, that’s fine.

Caller: This is about mast cell activation disorder, and if Dr Kim has ever prescribed or treated anyone with that condition. Has he prescribed LDN?

Dr John Kim: I have not seen one prescribed as such, but I've seen many patients who have the symptoms of this, and I think mast cell activation disorder is closer to what the physician's call IGE, mediated allergic reaction. You know, the mast cells release histamine, and some of the interesting things about that are the speed at which it can occur. It’s very rapid. In some people, you just have to scratch their skin, and you can see a welt developing very quickly.  Is your symptom like that?

Caller: This is a question and from a group member. Not me personally.

Dr John Kim: The answer is that yes, I have utilized LDN, but the utilization of LDN in such cases is an excellent question. I think LDN is a wonder drug for autoimmune diseases, but I don't think LDN, in many cases, should be utilized alone; like the previous caller wanted to use LDN for stage four cancer.

I think that of course, it can be done, if he can find a physician willing to do it, but I think that the better approach in this case and I’ve had patients with similar symptoms, is that LDN combines wonderfully with another immunotherapy, which is more common in Europe. It's called allergy drops, and what you do is you test the person for offending agents from the environment, as well as food. And mostly if IGE with food IGG can also be included. And the wonderful thing about is once you are armed with information, what things can trigger them, you can utilize allergy drops and LDN together to allow the immune system to be reeducated.

So, I'll give you an example. One patient came to me with a mast cell activation, and hers would begin with eating fruit, whatever kind of fruit, she would just not be able to breathe. And she loved fruit, but for ten years, she couldn't eat fruit. And so, I put her on LDN, and it made her symptoms a little bit better. In a year of allergy drops plus

LDN she was able to eat fruits again, and she has no reaction. So in that case, can you get that reaction just by using allergy drops? I think it's possible, but usually allergy drops alone it takes five years. Whereas in this case, within less than a year with both LDN and allergy drop, we were able to get that rapid reaction.

So, I think that LDN is a wonderful tool. Anytime the immune system is not behaving, if it’s hyperactive or sluggish, I think LDN is a wonderful tool, but I think there is this idea, a temptation almost, to view LDN as a single agent for everything. I think that everything has a tool and for some of the patients that have had severe symptoms, I'm not afraid to use LDN and Montelukast, which is also sold under the name of Singulair, and is a prescription medication, or some of them I ask to take Zyrtec and then the allergy drops. And the wonderful thing about LDN is that it seems to re-educate the immune system, so it's almost like an intelligent approach, and it compliments the allergy drop because that is also an intelligent approach.

Caller: Understood. I guess this question probably has the same answer. I’ll just ask it in a different way. Can LDN work to help histamine inflammation? So, would that basically be the same answer?

Dr John Kim: Well, I think the answer is, I think, that I would be more careful to use histamine because what we’re talking about is that what happens after the mast cells have released histamine. So, in this case, what you're looking for is rapid response. Can LDN be used to stop an anaphylactic reaction? I don't think anyone has done the study, but I don't recommend that clinically. If someone is having an acute reaction, I think the proper response would be either Benadryl shot or Benadryl liquid.

Caller: You use the word inflammation. I don't know if that's different from a reaction.

Dr John Kim: The histamine inflammation is very rapid, and I would say if you're in that rapid phase of inflammation and the answer, I think it's similar when you're having rapid phase reaction of inflammation, I think that you have to use all the tools that are required, including steroids,  in case of histamine reaction, an anti-histamine, and then use LDN long term to get gain control. And we basically create another equation, change the equation because LDN can change the basic equation, but at the time, the house is burning down. You want to use everything. LDN is a wonderful tool to redesign the infrastructure so that the immune system just only has one response, inflammation, inflammation, inflammation. LDN can change that, and it's very interesting, because people who have a reaction, in that situation, often their immune system is actually depleted, so that means they get sick easier.

I tell them that's very similar to police being told by naughty teenagers twenty-four-seven that they can't do their job. Whereas the well-rested, police force can respond to emergency calls quite adequately.

Linda Elsegood: Okay. Yes.

Caller: Thank you.

Linda Elsegood: Okay. We're back. And what I would like you to do now John, is could you answer some of the emails that were sent in, please?

Dr John Kim: Absolutely. I really love the questions from your readers or your Facebook group members. They are just so intelligent and wonderful. One of the questions that I had was from a patient who was diagnosed with pancreatic cancer.

She's taking Tramadol for pain, and clinic basically is agreeable to put her on LDN. I'm sorry her or him. But the thing is that they want the person off Tramadol and the person is asking what do you do? I've often seen this sort of question regarding Tramadol or Ultram, which is a brand name and is basically a form of synthetic opioid that's not a full-on opioid. What I mean by that is that it's got two different activities. Number one is that it does bind to the mu-opioid receptor, but it also works as a serotonin and norepinephrine uptake inhibitor.

And I think that it seems to me that this has multiple answers. So, part of the answer is that if the clinic says no, you can't take LDN and Tramadol together, I would say that the person can explore a herb which is very effective, known as corydalis. Corydalis does not use opioid receptor but has high effectiveness for controlling pain.

That is my go-to herb to control pain. The secondary herb can be something like curcumin, and especially if they can find long-acting curcumin, it can be helpful for controlling pain. Another tool that I find exceptionally well-suited that works in conjunction with low dose naltrexone is what I call neuroanatomical approach to acupuncture and is a new way of using acupuncture using scientific principles. And it works on strengthening the endorphin system and reorganizing the neurological signals that are pain prosthesis. The underlying question to this is, can you combine narcotics and LDN? And I think the answer is yes.

I formulate this from research done using what we call the microdose, dosing of LDN. So instead of using the normal dose, LDN use is 1.5 milligrams to 4.5 milligrams, but in micro-dosing, you use microgram doses. A thousand times less than one milligram would be one microgram, and that, even in my clinical use when people are using narcotic agents, my to-go game is to utilize a microdose gram dosing of LDN, and it seems to actually help patients to get pain relief longer. Then what I do is increase the dose of microgram dosing of LDN to push it up. And then what happens is similar to them not taking the medication you're just doing backwards.

By increasing the inhibitor strength, you're basically taking down the amount of narcotic that is effectively available and just two different approaches. But I think that it's more humane and I'm not convinced, because the effective dose for the naltrexone to overcome narcotics is about 5,200 milligrams anyway.

I don't think adding 1.5 milligrams or five milligrams will make a difference in the majority of people. Now I have to say, that because I know that in literature, there are people who are exquisitely sensitive, that even utilization of anaesthetic during surgery didn't work. They had to use massive amounts, and then at the end of they said, what on earth is going on with you? Why is it that I have to use massive doses on narcotics? They say ‘oh, yeah, I'm taking the LDN’. And so in that case, you know that in those people the LDN, is working so well, or probably what is happening to those people is that their affinity; the LDN attraction to the receptor, is exceptionally stronger than the general population.

But in general, I think that LDN, especially micro-dosing naltrexone or very low dose naltrexone, is safe with utilizing narcotics. I think that was a wonderful question.

Linda Elsegood: Do you have time to answer another one?

Dr John Kim: Oh, yes. Oh, there was another question of RSD or the CR, complex regional pain syndrome. That is a really heartbreaking condition.

‘My neurologist started me on 3 milligrams, then 4 milligrams and then 4.5 milligrams. I had some pain relief for six weeks, but the burning pain has returned to the same level. Do you know? Is there a reason? Is this a typical reaction? Do you agree with my doctor’s opinion that I would get more benefits after five months?’

I think that it's, it's kind of interesting because 1.5 milligrams to 4.5 is like the standard, and that's written in stone, but if you really dig in and do the research, those response studies that were performed on low dose naltrexone was sort of a convention developed over time, accepted by researchers. But I think that there are multiple ways low dose naltrexone works, and one way of course, is that it works through the immune system, and I think that the dosing of 1.5 to 4.5 often works quite well.

However, there's another way that LDN and especially for CRPS and neuropathy that LDN can be helpful is that LDN also works as an anti-inflammatory agent for the central nervous system. What that means is that in that setting, the dosing of LDN is going to be more dose-response curve, what I call linear response.

What that means is that depending on who you are, you will need more than 4.5mg. I had patients who needed six milligrams, and who do very well on 6 milligrams or even 7.5 milligrams, and obviously, I don't start a patient on that. I titrate them. And if you look at the original dose of medicine being 5 milligrams, I think even 9 milligrams is not unreasonable for the minority of people, but I think that rather than waiting five months, what I would do is push the dose to 5 milligrams and then 6 milligrams to see or and 7 milligrams to see if that's helpful. The other part is that CRPS is a nervous system disorder, so alpha-lipoic acid would be another tool that can be very helpful, also taking a very high dose of fish oil also can be helpful, but taking a high dose of fish oil can result in bleeding episodes or even bruising episodes. So, it would be better if you are under the care of a physician or a naturopath who is familiar with that. With alpha lipoic acid you also have to be aware that you can lower your blood sugar levels so that's another a thing you have to watch out for. 

Linda Elsegood: Something we were talking about before. How important is diet?

Dr John Kim: You know, I think that there is again a very romantic idea that you take LDN and it's like a magic bullet. It works for everything. I think that diet is important because of the way that that LDN works. You know, in my own practice, what

I do when I take in patients with autoimmune diseases, in the beginning, I just say eat well, and patients would not listen, and the minority wouldn’t.  So now I just do the full food allergy testing because that way, I can see, and show them, and then lead them to not eat these groups of food.

And second, we need to do allergy drops to normalize your response to that food because obviously it's not killing off our population, but I also would say that there's something that has changed, that our people are having autoimmune diseases. It’s like an epidemic. You know this is everywhere. Everyone is having an autoimmune condition. Why is that? I think it has to do with we're doing something different. Has our genetics changed in 50 years? I don't think so. What has changed? Our diet has changed, and our pollutant exposure has changed. So, I think that we will find more than a lot of the plastic exposures they were having, we’re going to find to be harmful to our immune system.

I think that research is just beginning on that, but diet I think, is important. Why? Because everything that happens in our body biochemically is predicated by what we eat, what we put in our body. Then if we eat anti-inflammatory food then our body will become anti-inflammatory. If we eat pro-inflammatory food then the end result is that we will be suffering from the high levels of inflammation in the body. So, I think that LDN is a wonderful tool: however, it does not give you permission to eat badly every day, smoke, and pursue an unhealthy lifestyle.

Linda Elsegood: We've just had a question come in, and it says ‘could you define allergy drops?’

Dr John Kim: So allergy drop is basically, I think that everyone has heard of allergy shots. When you have a severe allergy you give shots to people. It does work, but  I just don't like giving shots. My family members hate shots, patients hate shots.

So, what I've done, is looking for a solution that doesn't involve all shooting allergies. It makes sense to me that if it works by giving shots, it will make sense using the GI system because a big portion of our immune system is in our gut anyway. So, I've been looking for a solution to this problem for about five years. I found a solution.

I'm told that this is the more common approach in Europe to the use of allergy drops and allergy drop means that you, whatever your allergy, whether you're allergic to food or environment, you can create an antigen dose that corresponds to how much you're allergic to.

So, if you're allergic to huge levels, then you give them a minute amount of allergen, and then you systematically teach the immune system by exposure not to overreact. So, you can do that to peanuts, you can do that to wheat., you can do that to milk, you can do that for grass, fungus; the big thing that I see is yeast.

So that's the allergy drops that I talk about. I think that as I said, LDN and immunotherapy go hand in hand in my opinion, for autoimmune, and the reason is very simple; both of them are the intelligent approach to re-educating the immune system. And it seems the immune system is amazing because, that one patient I talked about that she was allergic to the fruit, what I found out was that she was allergic to grass. And grass, of course, is the cousin of fruit. So, I treated her grass allergy for about a year, and low and behold, she was able to eat fruits again, and I never went to even specific foods. I just treated grass, because that was the one thing that she was most allergic to.

So, it shows how intelligent immune system is. Of course, she was also taking LDN at the same time, which I think shortened the duration needed for her to go into remission.

Linda Elsegood: Well, I'd actually like to now talk about your LDN book that you've just managed to get published, and it's available on Amazon.

Could you tell us more about your book?

Dr John Kim: Yes, you know, it kind of began as my notes, because in the beginning, LDN was like magic. It would work. It would work. And I was almost thinking, why does it work? Why does it work? So, I started reading, and first, it was blogged on your website.

And then I just dug deeper, because of my research background I just went to the research databases and I would just read different studies, and understand better how low dose naltrexone would work. And of course, there are books already available. I think you were the editor in one of those books, but I wanted to go to the source and learn more.

And so this book is called LDN primer, and I call it primer because I feel like even after 15 years of using low dose naltrexone, I'm still a beginner. And in here I just talk about the history of LDN, and LDN as a noble anti-inflammatory agent for our central nervous system, which I don't think is utilized very often outside my clinic.

And then LDN for treating endorphin deficiency syndrome. Again, I'm looking at the conditions that LDN can treat as groups, so if you have an inflammatory condition for the central nervous system, LDN can be useful, even though it's not an autoimmune condition. LDN can be useful for people who have endorphin deficiency, and who knows if the bipolar disorder, depression, anxiety are a subset of endorphin deficiency syndrome, and I certainly treat it that way, and I have utilized LDN alongside an SSRI with great effect. And even a bipolar disorder with great effect. And then the other thing is LDN as Immuno adaptogen, and then I talk about atypical uses of LDN.

And then the last chapter I talk about clinical considerations of using LDN and share stories of my patients and my observations and ideas that I had, like dosing, you know, and how the dosing is determined. It's not scientific. It's been just supposition. I was just guessing. So then means we have the right to ask.

And what's really wonderful about your Facebook group is the interactiveness, and I see what they mean because some of the people start 0.5 and they think that's too much. I had to cut to 0.1 because.

Like in my practice, that's what I do. I look at a person and try to determine how much endorphin reserve do they have in their life.

If someone has high functionality, then I don't mind starting off 1.5 and then rapidly branch up, going up to 4.5. But if I get the sense that they are very depleted, I would start at 0.1 and then march slowly to get them to 4.5, but take my time doing it and looking for any side effects. So it's been a result of me wanting to understand LDN better and starting a blog and just continued writing.

And I kind of got caught in the web of interestingness of LDN, and I just couldn't stop writing and stop researching. And even preparing for this show, I found out there are more studies out now, and it's really a fascinating subject.

Linda Elsegood: I know a lot of people want to know how do they know how high to go if 4.5 isn't the sealing. How do they know that the dose is right for them?

Dr John Kim: Yeah. So, I think that again, understanding how LDN works is crucial. So, I call it two different dosings. One dosing is linear dosing, the other dosing is synergy dosing. So what do I mean by that? The synergy dosing; I'm referring to the LDN educating the immune system to calm down. So for most autoimmune diseases, I utilize LDN; the lowest amount of LDN required to put a patient into remission, or their symptoms into zero. So, in those cases, some patients are taking 0.5. if they're in remission. I don't want to increase it, because if their disease comes back, then I want to have a little bit of room left over to increase the dosing.

But if there are other people who have central nervous system issues, so I'll give you an example of what I mean by this. Neuropathy would be a great peripheral neuropathy. Diabetic neuropathy would be a great example. Or another example would be post-herpetic neuralgia, and LDN can do amazing things, but in those settings, we are not really counting on the LDN to reset the immune system, we’re using LDN as conventional medication, as an agent to create an anti-inflammatory effect in the central nervous system. And for that, I think that 1.5 to 4.5 dosing is a bit limited, and you have to look for ways to either make LDN work harder and then bring out the LDN synergy, and my to-go tool for that is acupuncture, especially the neuroanatomical approach to acupuncture seems to go very well with LDN. Another tool that I use routinely is alpha-lipoic acid. It seems it can enter the central nervous system with ease and works very well in synergy with LDN.

Linda Elsegood: I'm going to have to stop you there, John. We'll have to have you back on another show. And we really appreciate you being here with us today.

Dr John Kim: Thank you.

Belmar Pharmacy is a nationally respected compounding pharmacy. They compound low dose naltrexone, LDN bio-identical hormones. And accustom amino acids and mineral blends. They're based in Colorado and ship nationwide. Their goal is better patient outcomes through quality compounding, combining effective communication between practitioner, pharmacist, and patient.

Call +1 800-525-9473 or visit Belmarpharmacy.com.

Linda Elsegood:  Any questions or comments you may have, please Contact Us.  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.