Dr Judy Tsafrir, MD on the LDN Radio Show Oct 2019

Linda Elsegood: I'd like to welcome my guest today, Dr Judy Tsafrir. Thank you for joining us today Judy. 

Judy Tsafrir: Thanks for having me, Linda. 

Linda Elsegood: I mean, you were telling me you were from Boston, um, in your practice. What's the patient population that you treat with LDN? 

Judy Tsafrir: Um, I'm a psychiatrist, a holistic psychiatrist. I see both children and adults, the more adults and kids, and people seek me out because they do not want a conventional psychiatric approach to their depression or anxiety, or whatever it is that's troubling them, which is typically just the prescription of pharmaceuticals and perhaps, um, some sort of counselling. So my approach is essentially functional medicine where I am looking for the root causes of what's going on with them and having conversations with them about their diet and their lifestyle and sleep and exercise. Um, also I trained with someone named Dr William Walsh, who is a biochemist from Chicago, and he has correlated certain laboratory studies with psychiatric symptoms, for example, elevated copper or, um, high histamine, and there are protocols of nutrients that can be prescribed instead of pharmaceuticals. A lot of patients come to see me because they are chronically ill and they're not getting help from other doctors like they're, I'm not usually the first stop so they may have many patients who have autoimmune conditions, um, which often presents psychiatrically; like there's an anxiety piece. And I've developed, um, over the past couple of years interest and awareness about mould toxicity. And so patients will come to see me because they are suffering from symptoms related to mould toxins.

And, uh. When that is addressed, that can have a big positive impact on health. 

Linda Elsegood: But isn't it amazing that you could take some supplements like iron and copper instead of a pharmaceutical drug? You know, because all drugs have potential side effects, don't they?  

Judy Tsafrir: Yes, and that, you know, the model is conventionally is to identify symptoms and suppress them. And instead of seeing the symptoms as communication that there's something wrong and looking for what it is, that could be corrected. 

Linda Elsegood: But when you said that you help people with autoimmune diseases, I mean, there were so many people, um, that I know of who have had, say, fibromyalgia or chronic fatigue, MS and before they managed to get a diagnosis so many of them are told it's in your mind, you know, that there is nothing really wrong with you and that is very depressing. 

Judy Tsafrir: and very invalidating. That's an experience that many patients have when they come to see me, that somebody, there's such relief that somebody believes them.

Linda Elsegood: And it's getting people to listen to you, isn't it? Rather than just brushing you off without investigating. 

Judy Tsafrir: Right. You know, I just came back from a conference. I actually was in a conference over the weekend in California, which was all about electric hypersensitivity and the effects of electromagnetic frequencies on our health, and this was on my radar but in a much less focused way then it will be now going forward because I would tell my patients to turn off their routers at night and tell them to not carry their cell phone in their pockets. But, um, it goes much further than that. There really needs to be a lot of avoidance and awareness about the way that electromagnetic waves are impacting our health. And I think there may be a number of patients in my practice who I've been treating for mould who may have mould or who do have mould, but maybe they would be so much better if I would also be addressing the, um, electric hypersensitivity. So this is something that has newly, like really come into focus for me,  just over the weekend.

Linda Elsegood: And what about children? You said that you treat children as well, and it's very ... 

Judy Tsafrir: yes. I mean children have an attentional problem, and they have anxiety, and uh, there can be, just the same as with adults, there can be imbalances, and I think that a lot of these kids are actually tremendously affected by the electromagnetic frequencies, like all of the screen time, that kids are doing. It's really, um, there was a child psychiatrist who spoke at the meeting who, um, kids who were so behaviorally dysregulated and suffering so much, and the families were in such a terrible state because of the child being, um, so, uh, symptomatic that with the screen, you know, with the electronic “Fast” of one month, the symptoms completely resolved. 

Linda Elsegood: Wow. But if a parent had a problem with a child, with, let's say, anxiety, I mean, how old are they normally? the youngest that you see in your practice? 

Judy Tsafrir: Oh they can be very young. They can be, you know, six years old.

They can be five years old. Just a kid who's not sleeping, who, you know, can't separate. Um, you know, I'm, I'm trained originally as a psychoanalyst and my model, previous to learning all of this functional medicine, would be to really think that there was some kind of, um, psychological dynamic going on between the parent and child, which they may also be, but there is so much to be understood in terms of what can be going on biologically In addition to all of that.  

Linda Elsegood: And would bed wetting come under that umbrella as well? 

Judy Tsafrir: Of course. I mean, that is often like a, um, an immaturity of the neurological system. And that can be developmental and can improve with time. But, um, everything that is going on, you know, can be due to, um, many different factors. Including trauma and, um, adverse experiences. But it's just, it needs to be looked at from so many different angles, including the spiritual. 

Linda Elsegood: I mean, you said that you look for the root cause, but to find the root cause for a child, obviously, you listen to the child, but their communication is going to be limited.

And of course, then you'd have to listen to the parents. How do you …?

Judy Tsafrir: And the school 

Linda Elsegood: Okay. And the school, how do you get to the root cause if you know, if there's somebody listening with a child that is having problems, what would be the process you would go through to find out what you could do to help a child?

Judy Tsafrir: The most important thing is the history and to try and get a sense from the parent, you know, what is going on, what has gone on, you know, like even going as far back as ancestrally, like, was there a lot of trauma in the parent's history? Because that can also be passed along epigenetically. Um. But then to learn about the birth and the child's development and the child's diet and the whole environment.

And when did the symptoms start? You know, was there any kind of car accident or death? I mean, our whole being is so, uh, it's such a mixture of mind, body, and spirit that it's really complicated, and you can't just typically pinpoint one thing, like you may have a car accident, but then that completely dysregulates the immune system and sets off a mass cell activation disorder.

And then they're having all kinds of very weird symptoms and maybe not tolerating foods and having strange neurological things. And, and this all may be totally exacerbated by the electromagnetic frequencies. It's just. It's very complex. So you want to try and understand as much as possible what are all the factors and try and support the person from many different directions. But it's usually not like one thing. It's like a whole confluence of different things coming together to create a kind of perfect storm. 

Linda Elsegood: So your approach would be more of a natural approach rather than, um, prescription medications? 

Judy Tsafrir: Absolutely. I mean, a lot of times people seek me out because they're on medications and they want to get off of medications.

And the typical approach for a person to get off medication, many psychiatrists are not willing to take patients off of medications, they're afraid that the patient will become destabilized and then they'll reduce the dose of medications way too quickly and then a person will have a reaction, like a withdrawal symptom; a syndrome from withdrawing from the medications and then the psychiatrist will mistakenly believe that this is as proof that “you see, you do need it for your anxiety because you are having problems”. But in fact, it's like a withdrawal syndrome and not the original problem. So. Like I, if somebody calls me and they want to simply, you know, get stimulants for their attentional problems, I tell them that I'm really not the right doctor for them.

And you know, if somebody is interested in working with me to come off of their medications, that is much more what I find interesting. And, um, I'm feeling it’s like a useful, valuable thing to do. 

Linda Elsegood: And what's your success rate with getting patients of pharmaceutical drugs? 

Judy Tsafrir: I would say probably about 75%. It's not everybody. You know, like some people, it's really difficult, particularly, um, some of the antianxiety medicines can be really hard to get off of, but you know, like this is like, I recommend, um. Low dose naltrexone to all of my patients, essentially. And you know, I also make dietary recommendations to all of my patients, and I make recommendations about, you know, hygiene with their electronics equipment and about exercise and about sleep, um, and all of those things together make it much more possible to withdraw from medications rather than just trying to withdraw from the medication without supporting the person in any other way.  

Linda Elsegood: how long do you think it takes a patient with anxiety problems taking LDN for them to notice it's doing something for them? 

Judy Tsafrir: It's so variable. I mean, I feel like low dose naltrexone is really unpredictable in terms of if it's going to be helpful, how it's going to be helpful, for what it's going to be helpful. So for me, because it's so safe and inexpensive and potentially so effective that I really recommend it to everyone for whom it's not contraindicated, like if they're on, you know, some kind of cancer protocol and immune suppression or, but I recommend it to everyone. And, um, it really is variable in terms of the response, quite variable. 

Linda Elsegood: And what sort of dose do you start the patients on?

Judy Tsafrir:  0.5 and then I asked them to work their way up as tolerated, as fast as it is tolerated for them to 4.5 milligrams. And that's, you know, in some people, you know, they feel well at three, but when they go up to 3.5, then they don't feel as well. So then we stay at 3, it's really titrated according to how the individual feels.  

Linda Elsegood: I mean, that's the thing with LDN, isn't it? It’s unique to that person. You know, you can't say ..

Judy Tsafrir: Unique to the person

Linda Elsegood: Exactly. Cause some people to find that 2.5 works really well. They go up to three that don't feel as well. But 

Judy Tsafrir: right. 

Linda Elsegood: Sometimes they've read everything online, and they feel that if they're not on 4.5, they're doing something wrong, that they should push themselves. But that isn't the case, is it? 

Judy Tsafrir: No, that's a misunderstanding. And you know, it really is like so helpful for so many different things. And so it makes sense to me that the dose would also not be one size fits all.  

Linda Elsegood: exactly. I mean, some people try to justify a dose by saying how tall they are and how much they weigh but that ... 

Judy Tsafrir: Right, that doesn’t make any sense

Linda Elsegood:  it doesn't because, I mean, there are some men who are rugby players who can't get any further than three. And then a small lady who's very petite, like five foot tall can take 4.5 no problem. So I always think that's a, a good rule to tell people that you, you just can't pigeonhole people. It's how your body responds. With depression, and you were saying that you treat people with autoimmune diseases. Um, would you say depression for somebody with an autoimmune disease might be to do with all the symptoms and the things that they have to live with that cause the depression? 

Judy Tsafrir: Well, again, I think it's such a multifactorial situation. I mean, very often depression is either caused by or mediated through cellular inflammation. So like when a person has inflammation in their body, they have inflammation in their brain, and they feel depressed. But then when a person has, Um, chronic illness and they're living with chronic illness, and they can't find anybody who's going to help them, and, uh, they're being told it's all in their head, and it's a very hopeless and depressing situation. Another thing that I recommend to my patients that I haven't mentioned so far is dynamic neural retraining system, DNRs, which is, it's like a program of visualizations and meditations and affirmations and something that you do with your consciousness that, um, helps rewire and retrain the limbic system, which is the deep structure in the brain that is associated with trauma. And when it's activated, it can cause all kinds of physical problems and all kinds of psychiatric problems, anxiety, depression. So if a person works with this program, uh, consistently, very often they're able to really calm down their autonomic nervous system and they will be in a state of, um, not in a constant state of like sympathetic overdrive, fight or flight.

And they'll just feel much calmer and much better, but it's not also alone. It's also, you know, in combination with diet, in combination with low dose naltrexone, with this combination with other supplements that are helpful for inflammation and for rebalancing, whatever it is that is troubling the person and in psychotherapy can be very helpful as well, having a relationship with someone where you can talk through things and someone who understands and who can help you make connections and can help you see that you're responding to the present because of something that happened in the past and that's not really relevant to today. I mean.

Everything together and, and, and I recommend the spiritual practice to my patients. Uh, prayer can be very helpful. Performing rituals can be very helpful. Uh, gratitude journals can be very helpful. It's just - there are so many different things that need to be recruited together to heal a person holistically.

And before I take a person into my practice, I have quite a long conversation with them on the phone and try to assess how motivated they are to make all of these different kinds of changes because it's not like taking Prozac. 

Linda Elsegood: It’s definitely something you have to work at, isn't it?  

Judy Tsafrir: Absolutely. It's a lot of work, but you know, instead of, you know, your health being degraded, you're optimizing your health  

Linda Elsegood: it's very easy to keep things to yourself in like a family situation, not talking to family and friends, but to actually be able to talk to somebody outside of your circle.

You can say what you like. You're not going to upset anybody. They're not going to feel guilty.

Judy Tsafrir: You don't worry about burdening them. And also there's somebody who is hopefully very trained and experienced in listening to people and knowing about what are dynamics like in the family and understanding a lot about human nature and the way people feel. I mean, I also think that meditation and yoga and Tai Chi and all of these kinds of, um, mind, body, spirit practices are tremendously helpful and stabilizing and help one not totally identify with whatever, you know, upset emotion one is feeling at the moment, that there are more equanimity and more peace brought into the person's life.

Linda Elsegood: I used to do a lot of yoga and I learned at a very early age, to put myself to sleep. And it still works today. You know, the deep relaxation and your breathing and focusing.  And I can, you know, even if my mind is spinning, if I can just stop my mind and actually relax and focus, probably about two minutes and I can be asleep.


Judy Tsafrir: I say that that's just like a practice, something that you've learned and it can be taught and um, it's just so useful and so much better than taking Ambien, you know, instead of taking a pill, but, you know, maybe then you feel like very tired the next day and forgetful and, um, spaced out. 

Linda Elsegood: I was going to say, who would want to feel like that? Waking up feeling like that at the start of the day.

It doesn't sound like something we would want to do. But I can remember when I was very sick, and people would say, you know, family, and look at you, how are you? And I would say, Oh, I'm fine. Because you didn't want to say, well, actually I’m anything but fine. 

Judy Tsafrir: Right, right, right. And I mean, and also when you're feeling that way, you feel like you don't want to burden people and you know that you can't really turn to people for help. And there's some kind of shame involved in the whole thing. Like, what's wrong with you that you don't feel fine? And, um, I mean, a lot of times for, you know, that there's like, we're not, for many people, like in my, in Boston, we're not living in a war-torn area.

You know, like, it's not like there are food shortages and bombs going off, and yet people are feeling terrible, but there's nothing to point at like that. 

Linda Elsegood: Yes. Yeah, well, I can remember being rather concerned that every week I was deteriorating and it was noticeable. And I can remember lying on the sofa, my cat lying on my chest and it hurt. And, um, my mother was here, and she took him off me because it was uncomfortable for me. And I was thinking, if I keep going downhill like this, I'm going to die. You know? And it was really scary, and it was frightening. And I had nobody that I felt I could say that to, you know, “Am I going to die?” 

Judy Tsafrir: .. terrifying and lonely, so lonely, and yeah you know, like, it's not surprising that people become suicidal in that situation. They just feel so alone and so desperate. And there's no light at the end of the tunnel. 

Linda Elsegood: Yes. But luckily for me, there was LDN at the end of the tunnel. So I had, I had the light. So, 

Judy Tsafrir: that really just turned things around like really quickly? 

Linda Elsegood: uh, in three weeks.

I mean, I just very quickly, the left-hand side of my body was numb with pins and needles. I had cognitive problems. It was like English had become my second language, I couldn't recall vocabulary. Everything muddled. I slurred my speech like somebody had had a stroke. I started choking on my food, forgetting things, tripping, falling, stumbling over nothing.

I lost my leg. Strength in my left, like at double vision, lost the hearing in my left ear, had twitching muscles, restless legs and pain. Um, and I'd been told at that point by the neurologist who checked me over and sat me down and put his hands across the desk, shook my hands and said, “I'm really sorry you're secondary progressive now, and there's nothing more we can do” and he opened the door to show me out  

Judy Tsafrir: you had multiple sclerosis?  Terrible, that’s terrible, and you're sort of taught in medical school, If a person has one symptom, okay, then you try and help them. If they have ten symptoms involving ten different organ systems, then it's all in their head.

You know? Then it's, it can't be real, you know, not understanding that that is more and more and more common these days with all of the toxins in our environment and all of the electrosmog and the GMOs and the degraded food supply that this kind of chronic illness is more and more commonly seen with involving multiple organ systems.

And it doesn't fit any kind of classically recognized pattern. 

Linda Elsegood: But in three weeks, um, and I'd lost my bowel and bladder control as well, but in three weeks I started cognitively -  in my head, it was like a television set, not tuned in, and suddenly somebody was tuning it in - and I started to be able to process thoughts, being able to see properly.

The hearing had completely gone in my left ear, and that started to come back, and it was amazing. It was absolutely amazing, but it did take me 18 months to feel like, yeah, I mean, I still know I have MS and I have learned to work around things, but I can achieve things again, which was very devastating.

I can remember I had to go and see the company doctor and he said he sent a letter, and it said that I was, I'm a workaholic. And he said that I was unemployable for the foreseeable future, and that was just like a punch in the stomach. It physically hurt. Um, and I kept this letter for quite a while, and they don't come across it, and I'd read it, and I'd have the same reaction.

One day I thought, well, why am I reading this letter. If I shred it, I haven't got it anymore, and I won't be able to read it, and it won't depress me, you know? I know it was there, but I don't need to physically keep seeing it. But my whole point was to prove everybody wrong. 

Judy Tsafrir: Right. So I mean it was the only thing you did was Low Dose Naltrexone or did you also do other things in addition to that? Did you, I mean you attend to your diet? 

Linda Elsegood: Because I was in the situation that I couldn't cook for myself my diet actually got worse originally. My husband did the best he could do which was just to put something in the oven that was frozen but gradually he learned to cook. Um, because I couldn't get out of bed

I was asleep most of the time, which was a blessing because I really didn't feel well. But, um, as I improved and he improved, we started to get a better diet. But I didn't become gluten-free, dairy-free and process sugar-free for quite a while. Um, I was given three courses of intravenous steroids in an 18 month period, and the first two were only six weeks apart.

I'm a very pale person, and my face blew up and I looked like a tomato. I was so red, and so round. And I gained, um, 50 pounds in these 18 months. And then, Hey, I was type two diabetic. Um, so I was then put on the Metformin, but once, and it was very difficult to lose the weight, not being active enough and exercise was too tiring.  Still is to a point. Um, but there are certain things you can do. But once I changed my diet, I managed and I'm now classified as a diabetic in remission so I don't have to take the Metformin anymore. And I'm really pleased and I didn't realize I was told that I'd have to have Metformin for life. Nobody had actually said to me it can be reversed. I did not know that. 

Judy Tsafrir: Right. And nobody told you that, you know, if you limited your carbohydrate intake or you didn't, you know, eat gluten and dairy or sugar, that that would be beneficial to you? 

Linda Elsegood: No. Um, my mother, I, um, unfortunately, she had cancer, and it was lots of other issues, and LDN didn't work, which knocked my confidence in LDN a little bit because I really wanted it to work. But anyway, my mother knew that she was dying and all she was worried about was the trauma that it would cause me with her dying. You know, what's going to happen? I'm not going to be here to look after you. You know, she was completely selfless.

And the, she asked the doctor to look after me after she'd gone. So the doctor wanted to see me. I went to see her, and I said, you know, I was doing fine. Um, and that I really watch my diet. And I was telling her, and she said, why are you doing that? And I looked at her, and I was feeling very sad cause I just lost my mother and I looked at her and I thought “seriously, you're asking me why I have changed my diet?”. What do I say? 

Judy Tsafrir: Incredible. 

Linda Elsegood: And I just said, “because it makes me feel better”. I couldn't bare the thought of explaining to a doctor why I had changed my diet, but I was really pleased, the fact that I don't have to have the Metformin, but it was quite funny because I was given Metformin initially, and it was a, I don't know what brand it was, but it was so strong - the nausea was so bad - I couldn't, I really couldn't tolerate it. I couldn't bear to eat anything or move my head or talk to anybody. It was awful and I suffered with it for about two and a half weeks and I went back to the doctor because “I was going to die” in inverted commas if I didn't take this Metformin.

So I went back, and I said to her, well, I think I'm going to have to die because I really can't take it, it is making me feel so ill. I just can't do it. And she laughed, and she said, “Oh, there are other versions you can have” And I thought, well, I'll just come back sooner. And I didn't realize that, you know, after the first two or three days.

So then I had Glucophage, which was a slow-release Metformin, and I can tolerate that. That was fine, but apparently, it was far more expensive, so they tried to get people on the cheaper ones first. 

Judy Tsafrir: Right. But all the money, 

Linda Elsegood: thanks actually, luckily, but it's been amazing talking to you, and I realize we've run out of time.

Thank you for having been my guest today.

Judy Tsafrir, MD is a board-certified Harvard faculty member with a private practice of holistic adult and child psychiatry in the Boston area. A special area of interest is environmentally acquired illness, in particular, mould toxicity and the chronic inflammatory response syndrome. Her website is https://www.judytsafrirmd.com/.  Phone number (617) 965-3020.

Any questions or comments? You may have; please email me Linda@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.