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Asher Goldstein, MD - LDN Radio Show 2022 (LDN; low dose naltrexone)

Over the past 2.5 years that Dr. Goldstein has been prescribing low-dose naltrexone (LDN), he has shifted to a much lower and slower titration pack. He uses it for many applications in addition to pain, such as fibromyalgia, Crohn's, rheumatoid arthritis, multiple sclerosis, Hailey-Hailey, polycystic ovary syndrome (PCOS). He gets referrals for LDN prescriptions from pharmacies. He is quite impressed with how LDN works against pain, and discusses prescribing for pain. Onset of action can be short, or months, depending on various factors. He is very open to help educate healthcare professionals about LDN.

Linda Elsegood: Welcome to the LDN Radio Show brought to you by the LDN Research Trust. I'm your host, Linda Elsegood. I have an exciting lineup of guest speakers who are LDN experts in their field. We will be discussing low-dose naltrexone and its many uses in autoimmune diseases, cancers, etc. Thank you for joining us.

Today we joined pain specialist Dr Asher Goldstein from New Jersey. Thank you for joining us today.

Dr. Goldstein: Good afternoon, Linda, how are you?

Linda Elsegood: Good thank you. So, could you tell us what's been happening in your practice with LDN and pain?

Dr. Goldstein: I've been practicing now just about 15 years and only started using LDN about two and a half years ago. What's actually interesting is that I just attended a conference on Friday, two days ago, and when I last attended that conference in 2019, which was you know BC - before COVID – I had not even thought of LDN. I remember just flashing back to those three years previously. There was nothing about LDN said. I had nothing in my recollection about LDN. And interestingly enough, three years ago I went as an attendee, and this year I was invited to speak about LDN. So, they were very curious, and out of about a hundred doctors, pain specialists only about five had even heard about LDN. So, it was a very receptive audience with a lot of questions and answers during the non-technical sessions, just floating around. So, it was very good, and hopefully there'll be 95 other doctors that can help their patients as well in regards to LDN use and prescribing in the pharmacy.

It has developed and transformed dramatically over the past two and a half years that I've been using it. I've shifted in how I prescribe low-dose naltrexone.  I've gone to a much lower and slower titration pack. I start at half milligram, and I only go up by a half milligram a week. I have a compounding pharmacy that has made a Dr Goldstein titration pack, and by and large, the issues that patients had previously with side effects are 99% gone. I think I've had one or two patients stop LDN because of side effects in the last year, and that's nearly none. Everybody reports dreams at some point in time, but when they're warned about it, it's usually not an issue, and most patients will move their once-a-day medication to the morning, as opposed to the evening; and then generally, those patients move it back to the evening a few weeks later.

I really branched out and started using LDN in in many many applications, especially with patients that have come to me, not necessarily all the time with a specific diagnosis. I'll have patients come who have been in pain for 15 years 20 years. They've had a rheumatologic test here or there that sometimes shows something, sometimes doesn't. They don't have anything specific. They're feeling run down, they're feeling exhausted, and they're in pain and nothing else has worked. LDN seems to work very much for these patients even though they don't have specific diagnoses. I'm not even counting the patients that we're treating from a pain perspective, you know, rheumatoid arthritis, multiple sclerosis, fibromyalgia, Crohn's, you know the list is big. It's big and hopefully we'll get bigger. The list that we have has people that we can treat. I'm treating people even with non-painful conditions. I have a patient with Hailey-Hailey. My dermatologist friend was very upset with me because that's supposed to be his field. I'm like, I use LDN. He's like, hey I use LDN too. How did you know that it was very good? And then, polycystic ovary syndrome. Some patients have become referred from different pharmacies, so even patients without pain are coming just for the LDN.

I read extensively about it in the beginning, and you're like okay, I think I should use this. But then as a practitioner, once you actually see the proof in the pudding, it's amazing, just amazing. For me it has completely transformed my practice, and where some of the patients with difficult to treat pain syndromes are less difficult to treat pain syndromes now. So, it's been fantastic.

Linda Elsegood: So, the million dollar question that everybody asks is, I've been on pain medications for the last 20 years. Those pain medications aren't working. I'd like to try LDN. How can I go about starting?

Dr. Goldstein:  I tell the patient, but they'll usually say to me, the pain medications help me get around, but they don't really treat me well enough. They allow me to get out of bed. I tell them, a hammer can also put a screw into the to the wall, but a much better tool will be the screwdriver, right? And it makes less of a mess. So the opiates are the hammer, and it's hard, so you can either go the quick way, which is a little more difficult, or you can go the slower way, which is difficult in its own way. But look, if somebody's been on opiate medication 50, 20 years, they have to significantly reduce their load. Some doctors will want them to be completely off pain medication. I find that if we can reduce it to maybe 40 or 50 morphine milligram equivalents (MME) and people can look up what MMEs are online in regard to their particular medication, and how to convert it to MMEs. There are conversion calculators. But usually about 40 to 50 MMEs can still be handled with LDN as long as it's not extended-release medication. For example, oxycodone, a combination of acetaminophen, also sometimes known as Endocet, or Percocet in the United States. If somebody's taking seven and a half milligrams twice a day, three times a day, I can actually work that in together with LDN. I tell my patients as long as you're not taking the opiate medication four hours before or four hours after LDN, you should be okay. You can take it the other 16 hours of the day as long as you need, if you need to. For example, if they go to sleep at 10 pm and that's when they take their LDN, their last Percocet can be at 6 pm and the first one could be at 2 am if they wake up in the middle of the night. But between 8 pm and 2 am, this particular example, they can't take it. Now if somebody's on a higher dosage of that, they have to reduce it or eliminate it, and that could either be done over time with slow titration, or that could be done through medication withdrawal using suboxone. Both of them have their pluses and minuses. The suboxone is quicker, but it usually requires a patient to go through 24 to 36 hours of moderate discomfort. I call it going through the ring of fire, as until the suboxone kicks in. In order to help the patients, the other way is two to three months taper of lowering the opiates while not getting the LDN yet, which can also be uncomfortable, but it can be done. The bottom line is you don't have to eliminate it completely. It just has to be reduced.

Linda Elsegood: Okay, so what have the outcomes been, as in a time frame for LDN to actually start to work?

Dr. Goldstein: It's a huge variety of time for onset. I've seen as quick as a week. I've seen as long as six months.  The main thing is talking to the patients, realistic expectations, and setting an education, meaning patients have to understand that there are many different ways that people respond to the medication. Typically, patients with fibromyalgia go quicker; patients with things like polycystic ovary syndrome (PCOS) take longer. I've seen the patients with Crohn's - those go pretty quick. In general, the medication helps patients whose diseases have two things in common:  the immune system dysfunction - I don't like to say autoimmune, I like the “immune system dysfunction”; as well as an inflammatory state. In those patients that have more inflammation than immune system dysfunction, I find that the medication works quicker. And those patients that have more immune system dysfunction than inflammation, it takes longer. That's been my sort of empiric view of what I've seen.

And again, DNA is what really rules everything, so you can have the same disease in two different patients and they respond completely differently. My lowest dose to start LDN has been 0.3 milligrams, and I actually have one patient now, with polycystic ovary syndrome, at six and a half in the evening and two milligrams in the morning, so eight and a half milligrams. In the beginning I would have never even thought that a patient could respond at so low or so high, but what one thing I've learned about LDN is that don't ever put yourself in a box. You could, because LDN constantly is evolving in my mind, its use and how patients respond to it.

Linda Elsegood: You were saying there about the dosing range - have you gone higher than six and a half milligrams?

Dr. Goldstein: Not me personally. I have not had the need to. In a single dose, I haven't done higher than six and a half, but I have done the daily dose high of six and a half.

Linda Elsegood: Do you ever prescribe it more than twice a day?

Dr. Goldstein: Twice a day, okay, I'm open to it, but with those patients that I've found the need for the twice a day is usually where the second dose is having to deal with mood or energy versus pain. So those patients, once we get the second dose in the morning, that usually stabilizes them. That's typically why I'm giving a second dose. It's not necessarily for the pain, but more for the mood and energy. and as you say, everybody is individual, the dosing is individual. There are some doctors that are getting the patient stable, let's say on 4.5 milligrams, and then they will do a second dose in the morning of 4.5

Linda Elsegood: And you're doing it at a lower dose in the morning, but higher in the evening. It is so patient dependent, on what works best for that patient. How long would you say it takes to find that right dose for a patient?

Dr. Goldstein:  The right dose can work in as quick as a week. It's highly unusual - but that's the quickest. And I actually didn't believe the patient, so I sort of pushed them to go higher. Then they felt worse, and then I'm like okay, listen to your own advice, listen to the patient. We went back down to half milligram. It can take as long as six plus months. There's just a huge variety of responses. But like I said, the inflammatory-state patients respond quicker; the more immune dysfunction patients take longer. But the majority of patients that I've seen, that they're having their disease 5, 10, 15 years, so these patients have a lot of patience, typically, and as long as they perceive that the doctor is working together with them, listening to them, acknowledging, a lot of patients say to me, my family thinks I'm crazy, my doctors think I'm crazy. I'm like, you're not crazy, you have an atypical medication and an atypical issue, and atypical issues are sometimes difficult to deal with. When people don't want to deal with them, then sometimes we put names and labels on them.

Linda Elsegood: So for those patients who are on a very low dose, and LDN is working fine for them, do you try further down the road to increase that dose, or do you just…

Dr. Goldstein:  I mean, if it ain't broke, don't fix it kind of person, so usually not. I actually had a patient in this morning who said to me, and this is a person with a lot of both back issues as well as immune dysfunction issues, and basically it was fibromyalgia when he came in, and fibromyalgia is not a typical diagnosis in men, but this gentleman came in and I examined him. He was operating, he said, at 20% capacity when he started, and now he's at three milligrams and he's operating at 70% capacity, and he says, I'm happy where I am. He says, I don't want to push it any further up or further down. I'm worried that if I go up it'll be worse. He says 70% is a huge change from where he was. So again, if a patient wants me to push a little bit, I always tell them we can always move. I can write quarter milligram pills. If you can gently push it up or down, you have that ability. It's not a medication that's fixed in any which way. And then I speak to them that their need for the dose may increase or decrease with time, so they should just be aware that it's not fixed in stone. I even tell patients four and a half milligrams is just an aiming point. We have to aim somewhere.

Linda Elsegood: So, you can't see all the patients with pain around the world. What would you say to doctors who are presented with patients with pain, who don't really know anything about LDN, and don't feel confident prescribing it?

Dr. Goldstein: If I was able to spend a half an hour of educating a doctor, I get much more return on investment than half an hour educating the patient, right, because I can help one patient, but that doctor can help 100 patients a week. That's why I really want to go to the conferences that are not LDN conferences, and speak about LDN, and encourage doctors. I say, you know the upside is that it's relatively inexpensive, there are very few if any side effects, and very few if any drug-drug interactions. The downside for doctors is that you got to talk to your patients, but some doctors don't like to do that, strangely enough, as bizarre as that sounds. But that's really the downside - having sometimes to convince a doctor when they're like, I don't have the eight minutes to spend with the patient additionally, to speak with them about LDN. But I'm like, well first of all, you invest those eight minutes and they're going to wind up coming to you much less, complaining much less, taking up less of your time, because their pain is less, and if you can't do it, send me your Nurse Practitioner or your Physician Assistant. Let me educate them, and they can help the patients. It doesn't have to be you. As long as you're a doctor, there can be things that they don't quite understand, and you can help. You don't always have an exact formula on how to treat a patient. Sometimes, if the disease is not exact, then the medication doesn't have to be exact.

Linda Elsegood: So how can people get hold of you?

Dr. Goldstein: They can call my office, Asher Goldstein, 201-645-4336, and make an appointment, then we can take it from there. If there are physicians that are listening to this, and you want to spend some additional time with me, I'll spend half an hour or an hour. I'll go out to dinner, I'll have coffee; we'll figure something out, because for me to help a medical professional understand that this is about as benign of a medication as possible, and it can help all those patients, that when you see those patients on the list and you're like oh my god how am I going to help this person today?

I wish I found this medication years ago. Maybe I would have ripped the hair out of my head. I tell my patients this medication doesn't do anything to you, which is why there are no side effects. They're like well, why am I going to take it if it doesn't do anything to me? So, I say, this medication allows your body to start working for itself again. That's all it does. It blocks a receptor for three to four hours, that's it, nothing else. And it does that for three to four hours, then the whole magic happens - the magic of normal level of endorphins, that is. That is the secret sauce, right? Bring the endorphin levels back up to normal, and then the body has the fuel that it needs to do the myriad of chemical reactions that normal levels of endorphins allow.

Linda Elsegood: Well, thank you so much for sharing your experience with us today. I mean, it's fantastic what you've done in such a short period of time.

Dr. Goldstein: I look forward to helping more patients, and I look forward educating more medical professionals.

Linda Elsegood: Thank you, thank you. Good to see you. Hopefully next time, in real life

Dr. Goldstein:  Yes, thank you, and take care. You know, I give your story when I lecture. I say look, there was this woman who was told to park herself at the corner, and she refused to take that for an answer, and because of her, I'm here today.

Linda Elsegood: Any questions or comments you may have, please email me, Linda, at contact@ldnresearchtrust.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.



Carol Petersen, RPh, CNP - Discussing Healthcare, LDN Radio Show 13 July 2022 (LDN; low dose naltrexone)

Pharmacist Carol Peterson is most interested in successful aging, working with bioidentical hormones. Along with a manufacturer of advanced nutritional systems, they developed a carrier solution with phospholipids for topical medications, that greatly enhances absorption. Another focus on aging is Beta 1,3 Glucan, which has a very positive effect on the immune system, important in autoimmune disease. She also discusses hormones and hormone testing. Her website is www.thewellnessbydesignproject.com, and she offers a free 15 minute get acquainted conversation to see if people are interested in what she can offer.

Linda Elsegood: Welcome to the LDN Radio Show brought to you by the LDN Research Trust. I'm your host, Linda Elsegood. I have an exciting lineup of guest speakers who are LDN experts in their field. We will be discussing low-dose naltrexone and its many uses in autoimmune diseases, cancers, etc. Thank you for joining us.

Today we're joined by pharmacist Carol Peterson, who's going to explain the new exciting things she is embarking on in her life. Thank you for joining us, Carol.

Carol Peterson: Thank you so much Linda. I'm not so directly involved with compounding LDN anymore, but I do follow this. I'm really interested in the most successful aging we can have, and so I spent many years directly with bioidentical hormones, which I think are a huge piece for people. And I'm continuing that work. You might find this interesting: I'm working with Quicksilver Scientific, and they've developed a dosage form that has phospholipids in it. Depending on whether the substance is water soluble or fat soluble, you can do a nano emulsion or a nano liposome, depending on your substance. And we're about to reach out to pharmacies to compound with this for hormones. One of the first pharmacists I talked to about this does a lot of compounding with LDN, so his question to me was, wouldn’t this be adaptable to LDN? Probably yes! We haven't done that yet, but it would be a phospholipid dosage form that you could use under the tongue. And in this case, it's going to be extremely well absorbed. We have really excellent data that using only tiny amounts of hormones will give you good blood levels and good function. So this could open up a whole wide area for a new dosage form for LDN, and maybe if we talk in a year, it'll be out there everywhere, I hope. Another potential would be to use it on the skin, because phospholipid dosage forms go through the skin very well, so it may be that tinier and tinier doses of LDN would be appropriate. It was kind of exciting for me. I'm also working with another two companies joined together, and they are US Enzymes and Master Supplements.

All my years of working with hormones is such a big pillar of having a successful aging process. I've added another two pillars. I think this is so important. A column of what's going to hold you up for your aging, and I think this is quite phenomenal, and just yesterday we've introduced, with Master Supplements/US Enzyme, a beta glucan. Why this should be interesting to anybody who uses LDN is, it's such a major stimulator of your immune system. This company has gotten Beta 1,3 Glucan, which has a linear, and they say has the most positive effect on your immune system, and should be applicable to any autoimmune disease. So that's kind of exciting for me. There's all these bridges from one place to another, and what else can I say. I'm doing some consulting online, I have a Facebook page and I've named it the Wellness by Design Project. I have a website, and I do individual consultations. If people want to work with me, they can. And this is not a big part of what I'm doing. I'm more interested in getting information out there. I have a blog I've been writing for the A4M website, worldhealth.net, and this gives me a huge voice that I was actually missing before. And I really am interested in helping a huge amount of people, and really Linda, that's exactly what you've done. I am just in awe of what a person can do when they're determined and what they can build. You are such an inspiring person to follow. So that's where I am right now.

Linda Elsegood: Wow, it's really exciting, isn't it? You've got your platform, and now you're going to go for it, which is amazing. Tell me a bit more about the carrier that you can put on the skin for LDN. Not being medical or having any pharmacy background. What is the difference between what you're talking about, and liquid or topical lotion?

Carol Peterson: Whether it's your mucous membrane in your mouth which, except for the mucus, it's skin too. And your whole esophagus is skin too, if you turn it inside out. But what happens is that you get an enhanced absorption with the phospholipids, and these are actually good for you too. Your skin, every cell in your body needs those lipids, the phospholipids, to put in their cell membrane. It actually could be used as a supplement all on its own. Therefore, I'm really excited about this, because you're feeding the body also, with the dosage form, instead of introducing chemicals, which I'm really against. I think there's a danger in the compounding world, and I think people should pay attention what their stuff is put into. I had a call from a woman, had a nice conference with her, and she called me because that was her number-one concern with a bioidentical hormone product, and she finally looked at all the ingredients in the cream base that she was getting, and she was horrified as she looked up every single one, one by one. That's 100% of what I'm concerned about. If you're using something that you're going to be using all the time, you shouldn’t be introducing things that could be potentially harmful or accumulate. We've got to consider our poor livers, because we're asking a lot of our livers in this toxic world, so there's no sense in adding to that toxicity. I guess we want to be using some things to help us, but don't introduce unhelpful things along with it.

So it's just phosphatidylcholine and different assorted similar molecules, and there's I think there's a little MCT oil in that. Lecithin has a phosphatidyl choline and associated molecules, so it's kind of an interesting thing, and I'm certainly going to going to plant that bug into your compounders’ ears when we get it out there. I think this dosage form has much more applications than just hormones.

Linda Elsegood: Would it be a case of using less LDN, which would make it more effective in that way, or would the dosing remain the same?

Carol Peterson: Probably the first thing to do would be to try equal dosing and see what happens, but potentially you need less. I'll use a hormone analogy like progesterone. I'm really against using the low-dose progesterone over-the-counter creams where they deliver 20-30 milligrams of progesterone, and women actually do have a hard time with this. They stimulate estrogen, and yet can't fill in all the things that progesterone needs to do with that little amount. They're miserable and they hate progesterone, that woman who is so anxious and can't sleep and irritable, has water retention, breast soreness. She needs like 200-300 milligrams, maybe in a cream. Then when you think about the rate of absorption through the array of creams available in compounding, you may have only 10% to maybe a maximum of 80% absorption. That's a thing that people don't understand. But with the phospholipid progesterone, Dr Shade, who is the owner of Quicksilver Scientific, said that he was able to get a luteal phase of 20 nanograms per deciliter. This is high-level phase level with only 20 milligrams of progesterone, whereas I just said it might take 200-300 milligrams to do that adequately. For a woman a lot of the times in conventional medicine, those low-dose progesterones are poo poo because you can't see it in the in the blood, and of course you can't see it because it's so tiny. It's just too weird, so I'm a real advocate of making sure there's enough. Probably there'd have to be some adjustment with people, and what's working, what's not; or maybe something's not working so well. Maybe it really is an absorption problem with some people who are not getting the results they could be from LDN. Changing the dosage form might be just the key.

Linda Elsegood: That's interesting. For people listening who think that you'd be able to help them with their issues with hormones and so on, how do they get hold of you? Could you give us your website address?

Carol Peterson: It's www.thewellnessbydesignproject.com. I chose it. It's rather long, but this was my web designer's idea. “Project”, because I used to be more black-and-white and think people should be able to be on a path and be an advocate for what they they're talking about. I was pretty judgmental. Now I realize that we're all in a path to make our health better, to make our whole lives more vital, and we're not going to get to perfection. But we can be on the path and get there, and that's why I said I want to help people with the project of themselves, and help them get better, get as much better as they can. As far as that's concerned, unless you're dead, I think you can improve, would you agree?

Linda Elsegood: Absolutely! So once people contact you for a consultation, how long is the consultation?

Carol Peterson: I'm offering a free 15 minutes so we can get acquainted and see if people are interested in that interaction. Why I think that's important is, whenever you're offering the gift of information, or you're the messenger, it might not be the right person at the right time, and I don't take that personally. I just feel that I've put a piece in the puzzle, and maybe it's going to help later on with somebody else. But if that person is ready to work with me, we can figure that out in 15 minutes. Then I offer our consultations, and then I offer a more extended program that would last over six months with more intense coaching.

Linda Elsegood: And does that involve any testing?

Carol Peterson: I like to see some testing. So much of the results, it's always clinical, whether it's LDN or whatever, you can't measure specifically very well. What your outcomes are, if you don't have the clinical outcomes, if you're not getting the results you want, testing makes no difference at all. What are you testing for? You can't measure what the person tells you about how they feel, how they're able to operate in the world. That's like 99% of what you're doing. But if I have somebody who's really rather complicated, I do a life extension panel. I like the elite panels for men and women. They measure the pituitary or growth hormones, thyroid hormones, adrenal hormones, sex hormones, Vitamin D. You have this whole measure, plus the blood chemistry, plus the blood differential, plus all the lipid stuff. It takes a lot of vitals of blood, and patients can order this themselves, unless they're from New York. It's self-directed. You can get your own test. I love it because you get a bigger picture. If you just go in and have your sex hormones measured, like people will do, it doesn't place it in the whole realm of all the endocrine system.

I have a hierarchy of hormones. The insulin - glucose is the most important, the most primitive of our hormones, and that makes so much difference. What we are going back to: we're going back to our nourishment, what we eat, how we eat. If that step isn't taken, you could be messing around with sex hormones all day long and not get whatever you want. Then adrenal hormones: if you don't have good adrenal activity, this is like life or death. This is quality of your life. Plus, if you need thyroid, thyroid becomes impossible to take if your adrenals aren't supporting that thyroid activity. Then finally, sex hormones. A lot of people know they have a hormone problem, but they'll think I know it's my sex hormones because I'm menopausal, but you really need the whole picture to do that justice. So, I like that more comprehensive test. If somebody is really not understanding what's going on with their body, and there's a lot you can get there, a test is no good if it doesn't give you direction. I was really happy: I arranged for a test for a young woman with difficult periods, a lot of pain, and putting on weight and acne, and I chose a panel. I was so happy, because a lot of the things were abnormal, and if you don't have a test that shows you where the abnormalities are, you can't do anything about it. You have no direction. How many people go to the doctor and have a test and they say oh, everything's normal. No, you haven't looked at the test results well enough, or you haven't picked the right test to use for that patient. So that's another piece of things that are going on.

So many people are told, especially with the thyroid, that it's fine, your levels are great, there's nothing wrong, when people are feeling really ill. You know yes, there is something wrong. I myself have secondary hypothyroidism, and that is my pituitary TSH, which is what they measure all the time, is simply always low. It's low if I use thyroid, it's low if I don't. I think my pituitary was poisoned. It came from an area of a country with the biggest amount of atrazine in the ground water, and atrazine is a pituitary poison. I've been working on that. But what do you do when your TSH is so low, and your other pituitary hormones are low? You treat what follows. You treat the thyroid, you treat the adrenals, you treat the sex hormone function. That's how I've been managing myself. But interesting enough, a doctor can look at you, and you have every symptom of hypothyroidism, and they would take a look at a very low TSH, and say you're hyper, and that's that, because they haven't even thought about the pituitary actually producing that hormone, and being unable to. It's shocking to me how many times they see this.

I follow a lot of Facebook pages. I do follow one on LDN, and I follow menopause and osteoporosis, and <perry>. There are so many people out there that are suffering needlessly, and sometimes they write about their pharma experience. One drug after another. And their lives are devastated. I want people to know I'm a pharmacist, and I would say renegade pharmacist. Drugs do not return you to health, never ever. To go down that pathway, as soon as you start it, the drug is going to cause damage, and create more symptoms of discomfort. You're going to add another drug, and another drug, and you are doomed to a marginal existence, and none of this is necessary.

Linda Elsegood: Well, that's amazing.

Carol Peterson: Everybody is aiming for their optimal health, right, and it's achievable. Always, the people with the most trouble have the greatest gains to be made. I'm reading an old book by Andrew Saul called Doctor Yourself. I love the philosophy, but he is really making a point, over and over and over again: things that we consider illnesses are most often deficiencies in something, and we know enough about biochemistry now, and in physiology we're able to target certain nutrients for certain things. The more you know about that, the more tools you have to help yourself. That's what you have to do in the end, when you go to a doctor with whatever you have, you should be in charge. You are the person who is the buyer, and the seller is trying to sell you information, or a protocol, or something to do. You have to keep that in mind. You would spend a lot more time comparing cars than you do comparing what that doctor is able to offer you. And doctors have forgotten that they are a seller, partially because they offer you a pathway, and they're not allowed to deviate from that pathway they're offering. We've got our medical system so entrenched in, like, flow chart medicine, that doctors can no longer develop a patient-doctor relationship, where they're interested in the patient, and go right along with the patient, and examine the information out there. When you think about it, we have a whole world of smart people in country after country after country. We have no database that we could really touch into for finding that person, say in South Africa, who's gotten wonderful results doing a certain thing. We have no way of knowing that. In this age of information, not having access to the world's information on how to keep healthy and at optimal health, it's sad really, We should be able to do that.

Linda Elsegood: Well fingers crossed that you're laying the foundations for that.

Carol Peterson: Okay!

Linda Elsegood: Any questions or comments you may have, please email me, Linda, at contact@ldnresearchtrust.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.



LDN Research Trust - Low Dose Naltrexone Angie Fielden, LDN Specialist shares her experience of Low Dose Naltrexone.

Please visit our website https://www.ldnresearchtrust.org, which is packed with information on Low Dose Naltrexone (LDN) for Autoimmune Conditions, Cancers, Chronic Pain, Women's Health, Children's Health etc., plus we have a very active FB Closed Group https://www.facebook.com/groups/LDNRT/

Linda Elsegood: Welcome to the LDN Radio Show brought to you by the LDN Research Trust. I'm your host, Linda Elsegood. I have an exciting lineup of guest speakers who are LDN experts in their field. We will be discussing low-dose naltrexone and its many uses in autoimmune diseases, cancers, etc. Thank you for joining us.

Solutions Pharmacy is licensed in 20 states and located in Chattanooga in Tennessee. They have led the compounding industry with excellence for over 60 years, specializing in LDN, hormones, fibromyalgia, pediatrics, and autoimmune conditions. They offer an LDN program to patients who need help starting LDN. Call 423-486-1811 for a consultation.

Today we're joined by Angie Fielden from Solutions Pharmacy in Tennessee. Thank you for joining us today, Angie.

Angie Fielden: My pleasure. Thank you for having me.

Linda Elsegood: Now, I know that you took the Masterclass, which is totally amazing, and you did really really well, and you've been using that knowledge; and, I understand you've been holding monthly, public, free seminars. Could you tell us how well that's going?

Angie Fielden: It's going absolutely fabulous. The lowest class we had was the very first one and it was kind of a quick turnaround in that we had two people in there, both people signed up for our LDN program. We average around, I would say, 5-8 people each month. It lasts about an hour to an hour and 15 minutes. The educational part is around 45 minutes, and then there's Q&A time, and then afterwards we always have our LDN books up there, and they'll usually have a few people that will buy those. We sign them up for their consultation. If they choose to go forward, and we usually have about 80 to 100 percent that sign up, and they desire to start on LDN.

Linda Elsegood: Okay! You say sign up to your program. Tell us more about your program.

Angie Fielden: When we decided to launch an LDN program, it was because we noticed that there were a lot of physicians, a lot of providers in general, that didn't know a lot about LDN. What is low-dose naltrexone? So, we thought well, let's do an LDN program where we can send this information about our program to providers to let them know we're going to offer a service for you, and this is what the service is. We do free educational seminars, or we will educate patients one-on-one. We will do a patient consultation for that provider. Basically, the patient fills out an assessment form on their medical history: what their issues are and why are they seeking help for that medical condition. We then decide if we think they're going to be a good fit for LDN: is LDN going to potentially help them with this disease issue or case that they have. Then we take all of this information with, let's say they have a disease state of fibromyalgia, we're going to pull some studies on fibromyalgia patients that used LDN and let the providers see how their condition was helped with LDN. We always send a study or two about that disease state that that patient has along with their assessment form, and along with basic information about LDN itself. Then we also provide them with an Rx prescribing form that has the starter - depending on how we were going to start that patient. There are several different starters, so we would check which one we think would be best for that patient. And then we also tell them about maintenance. We also have a patient information sheet that we give each patient as they pick up their prescription. The information sheet tells them exactly how to take it, and some what-ifs, and we also put a little encouraging thing in there: this is the reason why you want to stay with it; it's not necessarily going to be everything you need within two to four weeks; it might take a little bit longer. So, we kind of give them a little motivational in there. We also give the patients ability to call us if they feel that they need to not titrate up to the next dose yet because something is going on. They call us, so we take that time that a patient would need to speak to a professional off of the provider, and we do that ourselves. Not me, but one of our pharmacists does that. Our pharmacists are the ones that talk to the patients about any medical issue. What my job is to get the information to the providers, the correct information. I extract the information from the patient, put it on paper, and then I give them over to our pharmacist, and he conducts the patient assessment. Then I'll put all the paperwork together for the provider and get that over there. So that's kind of how the LDN program works, and it comes at a very affordable price. They use us ongoing; we do follow-ups with the patient at 90 days and at 6 months, so 3 months and 6 months we do follow-ups. And by that time, they're generally pretty good. And we send the follow-ups to the provider as well.

Linda Elsegood: Well, what a service! I mean, this is what the LDN Research Trust was hoping, you know, educate the pharmacists, get the pharmacists happy for the pharmacist to educate the providers, because I don't know how many staff you have in your pharmacy, but you know there is a limited number of hours in a week. But once you've educated one provider, that one provider could treat, you know 100-200 patients.

Angie Fielden: Yes.

Linda Elsegood: And not only do you get the opportunity to educate more providers, the provider that is using LDN can see that LDN is helping their patients. They then tell their other medical professional friends and that's how it snowballs isn't it?

Angie Fielden: Yes, and just last week I had two luncheons, so as the marketing director, what my job is is to go to providers’ offices and deliver information about what we compound. LDN was my main focus this last week, to two places. They were arthritis centers, so they can really use LDN. And it was surprising that neither of the physicians at this one office knew anything about LDN. I do come across that all the time. I presented the information - I already had everything printed out to where they could just go through it, just like this. I give a quick read, If they want to just read. Basically, I kind of regurgitate to them what's on that paper quickly, so they don't have to read it; and then usually I tell them a success story. I have a success story myself. I'm using LDN, and it has given me my life back. But we also have a patient that is a poster child. She is a fibromyalgia patient, an RN, and she'd been out of work for 20 years. Her story is phenomenal, and I love telling that story to our providers. Their ears kind of perk up, and they say, oh tell me more. They're really excited about learning about it. So, my job is so fun because I'm the first point of information for them. Then they have access to our pharmacist. They have also access to come to one of our free public seminars. We have three providers that are coming to our next seminar. It's so exciting, and you're right, it trickles down, and then they can help hundreds of patients. That's why I'm so passionate about being an LDN Specialist. I just absolutely love to see that trickle effect of helping, and people are saying “it saved my life, it's given me my life back; my husband has his wife back; things like that is what keep hearing.

Linda Elsegood: So, what conditions would you say that your patients are using LDN for 

Angie Fielden: We've had some rare conditions as well. Fibromyalgia, arthritis, and pediatrics are our top three conditions that we see a lot. But we've had some cancer patients and we had a chronic regional pain syndrome which we're just now dealing with, that provider and patient, and it's so exciting to see how this girl is going to progress in getting her life back. She had been in a wheelchair. She's a microbiologist in her college at Tennessee Knoxville, and it's phenomenal to see her be able to do everything she's doing with the condition that she has. We really feel, and the provider feels, that this may be exactly what she needs, and he's familiar with LDN. So I'm excited: she'll be starting it in about two or three weeks, when she graduates; or any time now she'll be starting it, and I'm excited to see how her life is going to change and improve.

Linda Elsegood: So, all this education that you do for patients and providers, how do you go about letting them know? I mean, obviously you can only visit so many offices in a week. Do you advertise in any which way shape or form?

Angie Fielden: In the lobby we have a pop-up banner that talks about LDN, and conditions and symptoms, and that if you're having certain symptoms, you may be interested in our in our seminar. We get a lot of seminar patients that way. We have a banner that we put out by the roadside. In fact, let's see if you can see that tall banner.

Linda Elsegood: Oh yes! 

Angie Fielden: It says “free seminar tonight”, so we'll put that out on seminar night. We do quite a bit on social media, we do our website, we have a banner on our website about the LDN seminar, we have an LDN section on our website - so we get a lot of people from our website that sign up for our free seminar because they're learning about LDN. We've had people that found us from your website actually, and have come to our seminar by seeing that there was an LDN Specialist there. Then they check out our website, and then they end up coming to the seminar. It's so cool to see how we're all working together to help any and everybody in all different places. So those are some of the advertisings we do.

Linda Elsegood: What forms do you compound LDN in?

Angie Fielden: We do mostly capsules, but we have done a liquid formula a couple of times. One was for a cancer patient, and he could not swallow, so he had a feeding tube and had to put the liquid in a feeding tube. And he remarkably made improvements pretty fast once he started. The provider wanted to start at a higher dose - and this was this is what's great about the LDN Research Trust and being an LDN Specialist - I was able to work with you, Linda, and you helped put me in contact with some of the speakers that spoke on cancer, and I was able to email them and get two suggestions from two different people about where to start with this case. This is a unique case. This guy is stage four cancer, where do I start? They both told me the exact same thing. It was phenomenal, and it's so refreshing to know that we're going to get the exact information needed. It's going to be precise. It's going to be consistent with each other. They both told us to start at a higher level. This is a case where you don't titrate up. You go ahead and start at the four milligrams. Time is of the essence, and we have to act quick. And the patient began to turn around! It's another one of those stories that the wife, when she contacted me, said he is home now, he is no longer on a feeding tube, he's still on his LDN, his seizures have stopped, his pain level is manageable. It's just phenomenal to see how well LDN is helping.

Linda Elsegood: Well, that's good! I mean, the LDN Research Trust has been going over 18 years, and we have amazing people on board who don't mind sharing that knowledge, because they realize they are one person. They can only treat so many. But if they can help educate other providers, the number is infinite, isn't it? 

Angie Fielden: Don't you see also that they all equally have the passion to help people? That's what it seems like to me, that the passion that everyone holds, and that's why they want to help everybody.

Linda Elsegood: Exactly, exactly! So, if you were going to make an appointment to see a provider, and if we have providers listening thinking “I can't dedicate hours to learning this” you know, initially how long do you need to talk to a provider?

Angie Fielden: What I would need to talk to providers and what I actually get are two different things. At one of my luncheons, I had 20 full minutes. That's a long time to have with a provider. At a luncheon you normally don't get that. You might get three to six minutes, which isn't much time. You're regurgitating as quick as possible. Thankfully, God gifted me with fast-speaking ability. That's why it's crucial that I take an information packet that is fully able to teach them what they need to know, so I'm going to give them a snippet of what I’m actually handing them. I average five to eight minutes, I would say, per provider. But where they really learn is probably the written information that I give them, and it's a packet, maybe 20 pages long, but they're in different forms, like the information packet that you guys have on your website for providers. That's a quick read. They can read that and learn quite a bit about it. We have other forms. We always give them enough information that they can learn more about it. 

Linda Elsegood: It's a balance, isn't it? Give them too much and they don't want to read it because it's going to take too long.

Angie Fielden: Correct.

Linda Elsegood: But it's got to be long enough to pique their interest to get them to want to read more.

Angie Fielden: They love the studies, so if I give a study according to what types of patients they see. it sparks their interest. Usually I will give them one or two studies and that's it, and I highlight the conclusion - they know how to find it, but I usually highlight what I really want them to read, so that it will spark their interest to want to read more about that study. I think the studies help, that one quick information sheet helps. I give them the Rx form that is personalized to them, so it makes it so easy for them. I actually give them a sample form filled out so that they see very clearly how easy this form makes your life. A lot of people e-scribe now, but what my form can do for them is tell them how to write the directions, or how many milligrams, how to titrate it up. I also give them that patient information sheet, so they know exactly how to educate their patients on what they're going to be doing so. I think it's not as much the time I’m able to speak with them as much as it is the information I’m able to give them. Doctors are busy nowadays, and they don't have a lot of time to read or to research. So I’m hoping that I am shortening that time frame for them and they can learn quickly

Linda Elsegood: I know that you ship LDN to many states. How many states is it you ship to?

Angie Fielden: We're licensed in 20 states, soon to be 21. We ship an average of 400 packages a day; and then we have a lot of local.

Linda Elsegood: I'm moving ahead here with my thoughts: for people who would like to attend a seminar who live in a state that is too far away and can't get to one of your in-person events, are you thinking later of having them as a zoom webinar, where people can participate from those states that you could ship to?

Angie Fielden: Yes Linda, that is coming. We're so excited about it. We wanted to do several live seminars to get the pharmacist, because the pharmacist does the lecture in the PowerPoints. I open this up; he does the lecture in the PowerPoint; and then I do testimony, and tell them about our LDN program. It's pretty quick like that. We will have a recorded seminar for physicians that our pharmacist in charge is going to deliver, and then we'll open up a live portion where physicians can ask questions; and then we'll also do that exact same exact thing for patients. So yes, that is coming, and we're super excited about that. We probably will develop that this summer, so within the next couple of months, I would say, we'll have that ability. There are a lot of patients that ask us about it. They'll happen to follow on our website, see it and ask about a recorded version, and so our physicians are asking do you have a recorded version. It is a need that we need to fill, and we are going to be working on that very soon.

Linda Elsegood: Well, all I can say is we wish you every success! Anything the LDN Research Trust can do to help, just ask. We look forward to interviewing you again on your next stage. 

Angie Fielden: Thank you.

Linda Elsegood: Solutions Pharmacy is licensed in 20 states and located in Chattanooga, Tennessee. They have led the compounding industry with excellence for over 60 years. Specializing in LDN hormones fibromyalgia, pediatrics, and autoimmune conditions, they offer an LDN program to patients who need help starting LDN. Call 423-486-1811

Any questions or comments you may have, please email me at contact@ldnresearchtrust.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.


Lynn Gufeld, AGACNP - LDN Specialist (LDN; low dose naltrexone)




Ellen is from the United States and takes LDN for lupus, Sjogren’s, Hashimoto's and interstitial cystitis, and for pain. She is in her 70s, and began with autoimmune issues at 24. When she started LDN, she quickly had this overall feeling of feeling good, and was able to increase her activity levels greatly.

Full edited text:

Linda Elsegood: Welcome to the LDN Radio Show brought to you by the LDN Research Trust. I'm your host, Linda Elsegood. I have an exciting lineup of guest speakers who are LDN experts in their field. We will be discussing low-dose naltrexone and its many uses in autoimmune diseases, cancers, etc. Thank you for joining us.

Today I'd like to introduce Ellen from the United States, who uses LDN for multiple conditions. Thank you for joining us today, Ellen

Ellen: You're welcome. Thanks for interviewing me.

Linda Elsegood: Could you tell us what it is you take LDN for

Ellen: I take LDN for autoimmune diseases. I have lupus, Sjogren’s, Hashimoto's and interstitial cystitis. But, I was hoping to take it to get rid of pain

Linda Elsegood: Right. When did these conditions start? How long have you had them?

Ellen: I got Hashimoto's when I was 24 years old, and interstitial cystitis in my 30s, and I think I might have had lupus in my 40s, but I don't know, you know, people would say, why is your face… So I think it was the butterfly rash. I was tired all the time. I had pain all the time. I just thought that's what everybody lived with. Then the <rainy> started in my late 30s and early 40s, and we moved away from this small town in north-central Pennsylvania, and I moved to Savannah, Georgia, and I began to play tennis every day for hours, and I didn't use any sunblock, and all of a sudden, my head, this terrible rash itching, and then I got really tired. I was diagnosed with lupus actually at age 61. Then, in my 40s, I got ulcers on my cornea from dry eyes, but nobody picked up on that, and so recently, my eye doctor said I had Sjogren's, and I had another rheumatologist say yes, you have Sjogren's. So it's just like, everything kind of, just every decade, it’s something new.

Linda Elsegood: What did the medical professionals do to help you cope with what you were experiencing?

Ellen: Oh, nothing, because I don't think I told anybody, because they thought I was normal. This was normal. I know I had two young children 21, 20 months apart, and my husband was a lot older, so I did everything, and it was very stressful, the Hashimoto’s. I think I know that my aunt and two uncles had Hashimoto's, so that was sort of, I guess inherited. I'm not sure if you can say that. But the other things that came on, I think it was I had very high-stress in my 30s, in my 40s, and my 50s, and then when my husband died, I don't know. It was kind of a relief, but he was older, and he was kind of stressful. An interesting thing is that I moved to Savannah, Georgia, when I met my third, but I was never too sure.

So, what LDN has done for me: the very first time I took it, I just had this overall feeling of feeling good. I felt positive. I felt like I could do the laundry, I could cook dinner, I could swim, I could play tennis. Yeah, it was just wonderful, how easy was it to get a prescription. Well, I thought it was easy. Even though I was in my 60s - a lot of people aren't familiar with the internet and stuff - I just went on the internet. I looked at your webpage, and I found how to find a doctor, and I arranged an interview and paid my hundred dollars, and he prescribed it for me. It was real easy.

Linda Elsegood: And how long ago was that?

Ellen: the only time I had side effects is when I went up to six milligrams. I thought if I took a larger amount, maybe the pain would be less, but I kind of had hot flashes. I was really hot and sweat profusely, and then I would get real cold, so I went back down to three. Now three seems to be okay.

Linda Elsegood: And what are your pain levels like on three?

Ellen: Well, my pain is not too bad, but I think it's some other things that I'm taking. I am not really sure if yes, low dose naltexone is reducing the pain, but I feel good on it so I just keep taking it. Yes, I feel good. I feel good,

Linda Elsegood: If you were to rate your quality of life prior to starting LDN, what would it have been?

Ellen: My quality of life was pretty low. I didn't feel well. I was so tired and just lethargic, and I just kind of did a lot of sitting around, and all of a sudden, I took it, and it was RESULT. I feel good. I think the release of the endorphins just makes you feel better. It could be, I just don't know, but I don't have a lot of pain right now. I don't, so it's good. It's good. It could be the LDN, it could be, yeah.

Linda Elsegood: Do you have any thyroid problems, and what about the cystitis, is that under control?

Ellen: I cope with it; I don't notice it during the daytime. When I go to bed at night, I have pain; I take two muscle relaxers at night and the low dose naltexone, and it's not excruciating pain. I'm so used to it. I just sort of go okay, take a deep breath. It's just a nuisance, basically. I did have treatment for that at one time, and I'm thinking about doing that again, but for now I’m just trying to ignore it, and to be frank with you, I eat too much citrus things, and that's a real irritant. If I would cut down on that, it would be better. Coffee isn't good even for bladder, and I love my coffee. I'm just going to be 73 in August, and I just don't want to do certain things. I just want to live my life, and I'll put up with the pain. But I told you, I play golf and I play tennis, and I swim on the swim team, so to speak - I go to swim, me! So yeah, I'm doing okay lady!

Linda Elsegood: What about the dry eyes? How are you coping with that?

Ellen: That is really amazing. I have been doing my drops twice a day now, and if I do that, I seem to be doing well. I also have a prescription in the refrigerator from my eye doctor, with the prednisone drop, so if my eyes flare up, I'll use the drops, and the eye doctor is okay with that. She will check the pressure in my eyes to make sure it's okay, but the dry eye can be really bad. And then the dry mouth is a nightmare, which is… So, I have a lot of things that could make people depressed ,but I guess I've just sort of gotten used to it, and I just get up every day, and I try to do everything I can do and try not to overdo it.

But today, I did. I went to my garden, and I stayed too long. I am in bed.

Linda Elsegood: I hope you recuperate quickly. I mean, we, it's something I think we all tend to do when you feel good. You want to do as much as you can while you feel good, and then you have to pay it back with interest. Do you manage to bounce back quickly? I mean, would the next day, like tomorrow, be okay or would you still be really fatigued?

Ellen: Well, I was so bad when I got home. We decided to take another five milligrams of low dose naltrexone in the hopes of keeping a square away, so I did that. And I won't be on that one, but I take five milligrams, I took an extra one.

Linda Elsegood: Thank you for sharing your story with us today. I hope you get enough rest today to feel fighting fit tomorrow.

Any questions or comments you may have, please email me, Linda, at contact@ldnresearchtrust.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.

Ellen takes LDN for Lupus, Sjogren’s, Hashimoto's and interstitial cystitis, and for pain. She is in her 70s, and began with autoimmune issues at 24. When she started LDN, she quickly had this overall feeling of feeling good, and was able to increase her activity levels greatly.


Liz - Scotland: Multiple Sclerosis (MS) (LDN; low dose naltrexone)

Liz considers she has MS since childhood, but didn’t get the formal diagnosis until she was 52, after several relapses and remitting remissions. She has the secondary progressive form of MS. About 8 years ago she started LDN, slowly at first because she also has restless leg syndrome. She quickly regained control of her bladder, which eliminated her recurring bladder infections, the leg spasms and pain diminished. Her max dose is 3.5, over which some spasticity returns. She remarks her partner takes LDN for arthritis, and she notes LDN also improves mood. She states her quality of life has improved from a 4 to about 8. In order to obtain LDN initially, she used Dickson’s Chemist in Glasgow, but when her doctor saw how much good it was doing, she now prescribes it.


LDN Webinar Presentation 18 May 2022: Dr Masoud Rashidi - LDN, Dosing, Fillers and Compounded Options. LDN, ULDN and Pain/Opioid Issues

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LDN Webinar Presentation 18 May 2022: Dr Mathewson - LDN as supportive care for Oncology and Autoimmune patients: Case Reviews

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