LDN Video Interviews and Presentations

Pharmacist John Herr, LDN Radio Show 21 Nov 2018 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today I'm joined by pharmacist John Herr, and he's from New Jersey in the US. Thanks for joining me today. John. 

John Herr: Oh, you're welcome. Glad to be able to spend this time with you. 

Linda Elsegood: Good. And I didn't mention where you're from and you're from Town and Country Compounding. So first of all, tell us how you got into working as a pharmacist.

I mean, had you always been interested in pharmacy as a child? 

John Herr: Well, I've always been interested in pharmacy, and I've always been interested in like natural medicine or integrative, we now call it integrative medicine or functional medicine. But back in the day, I think we called it natural, and I was just lucky I went to a think John's University in New York City and, and I made the acquaintance of a physician who was, she was actually a pioneer in bringing natural or bioidentical progesterone into the United States. So back then, I was still in pharmacy school and, and I started to like working with patients with bioidentical progesterone.

And it just kinda changed the way that kind of, I thought as a pharmacist and I, I really consider myself like an integrative pharmacist now. So low dose naltrexone to me was just a natural progression of, you know, my knowledge and my interests.  

Linda Elsegood: so how long would you say that you've been compounding LDN now.

John Herr: Oh my God, I think it's gotta be around two, maybe around 2000 or 2002. You know, just when it was really becoming, you know, old people were starting to understand it. It's interesting. One of my patients, when I had my retail pharmacy, she ended up writing a book about it, about her husband.

It was called “Up the Creek with a Paddle”. and Mary Bradley and I, she had been in my pharmacy and her husband at the time had MS, and we were talking about, and I recommended the low dose naltrexone to her, and then she went and sought out Dr Bahari. And you know, she started, you know, they started her husband on that for his MS and that, that's where my original interest was.

And she ended up writing the book, you know, “Up the Creek with a Paddle”. And my biggest claim to fame is I’m mentioned in the book as the one who told her about researching low dose naltrexone. And then. Subsequently, after that, I became acquainted with a gentleman named Fritz Bell, who started a website, good shape because back then people were just, you know, going on the internet and they were buying the 50-milligram tablet and trying to, you know, create their own.

So, you know, Fritz had a big interest in that and, I filled prescriptions for his wife, but I also filled prescriptions for people where Fritz donated it to them because he wanted people to be able to take the medication and not have to compound their own.

So if they qualified to his standards, we would make it up and send it out, no charge. So those patients could start on the low dose naltrexone. So I go back way to the beginning. And you know, I think back then we just thought of low dose naltrexone and honestly for MS. But you know, subsequently, over the years we've just learned, you know, how vast different disease states we can treat and manage with low dose naltrexone.

Linda Elsegood: And what forms do you compound LDN in? 

John Herr: Well, the most typical is a capsule, uh, which we do an immediate release capsule. Um, we're in the process of buying a, uh, switching over to like a tablet so that we can, uh, you know, meet the need, you know, with a tablet machine. But right now we make capsules. We also make, um, we've actually done a transdermally.

I treat a lot of children on the autistic spectrum disorder. You know, we've had to do it in sublingual liquid for some of the children. Uh, we have a couple of patients on it right now, believe it or not, for a vaginal cream. We've also used it transdermally for like neuropathic pain on different areas of the body.

And I've been researching some articles recently. I'm using it as an Automic drop for chronic dry eye, but I've been talking to a couple of different integrative physicians about using it. But, uh, up to this point, we haven't have anybody try it for the ophthalmic. But I'll, I'll keep everybody appraised when we do because there is, there's a lot of interest in using it for that function as well.

Linda Elsegood: And I know that there are some dentists that are also using LDN, so that's another interesting one. And how about ultra-low-dose naltrexone? Is that used in your area that you cover? , 

John Herr: yeah, we have some patients on it. We also do a lot of pain management. We have, uh, we've managed intrathecal pumps in the home.

So I worked with a lot of doctors, pain doctors and I actually work with a doctor, a doctor speaking at the next conference in Portland. And so I work with his patients, and we have to start a lot lower on his patients because many of them are on opioids. And I've worked with some pain physicians where we've actually compounded as low as 100 microgram capsules because I think you really need a physician who is trained in pain management because they're actually weaning the patient off of the opioids as they're bringing the LDN up very gradually.

And it's a real balancing act because. You are going to detox that patient. So that's not something I would recommend for you, you know, like a general practice physician to you. Um, but we do have a lot of patients that are using it that way where they're getting off of this. And then I just, we just get tremendous feedback when they're off of the opioids, how they're then maintaining the pain with these, with, you know, LDN that we consider, you know, on that standard dose that we consider for pain.

But it is a little tricky to get them off of those. Um. Yeah. Off the opioid, while you're bringing the low dose naltrexone up to the appropriate dose. 

Linda Elsegood: I mean, I've interviewed several pain specialists, and they seem to be using 0.001 which must be like a grain of sugar of naltrexone, and they explain, sorry, 

John Herr: carry on.

Zero one micrograms, 

Linda Elsegood: Linda. Yes. Wow. Yeah, so 

John Herr: I mean, 

Linda Elsegood: exactly, but by doing that and using it alongside the opioid, it makes the opioid stronger so that they can reduce the opioid and slowly increase the by 0.001 sorts of the thing. They do like sort everyday kind of thing, until they can bring the opioid really down and the LDN can take over.

And they have it by doing it so slowly, as you can imagine. Well, slowly by my thinking, um. Or, or rather fast by my thinking. They say it's slow, but it does seem to happen quite quickly where they get them off the opioids, and they have gone, they haven't gone through withdrawal, they haven't had any side effects.

And you know, the LDN, like you were saying, can be used in place of the opioids and give pain relief. It's just amazing to me that something so small that's not harmful or toxic or even expensive can work so well. 

John Herr: Yeah, it is amazing. I mean, I think we just, as I said, when I first started working with it, we just kind of thought of it for like autoimmune.

But how we, you know, now that we know that it's working on the immune system when we know it's working on, you know, with the upregulation of endorphins and we know that it's working on the toll like receptors for inflammation. And now that we see how it affects dopamine for depression, I just think the, I mean it's just amazing to me how many opportunities there are out there for physicians to learn how they can better treat their patients for numerous, you know, disease states,  

Linda Elsegood: and of course, most people that have an autoimmune condition, one of the underlying problems is the inflammation, isn't it?

So by reducing that inflammation alone helps the person feel so much better anyway, especially with the boost of endorphins as well. 

John Herr: Oh, yeah. Actually, my wife, who's a pharmacist, is a perfect example. Like she went and had all this blood work done in her, what they call her ANA level was through the roof.

So your traditional physician would look at that and say, Oh, you must have rheumatoid arthritis. Because she was getting, wasn't really achy joints, but she was getting pain, almost like fibromyalgia pain. So we knew it was inflammation, and at the same time, her blood pressure was uncontrollable. It was, you know, we actually had her on a heart monitor, and then one of the physicians that we work with, when they did, you know, we really started working more in-depth than they did the food allergies.

We found out she was severely allergic to dairy. So, you know, started her on, you know, obviously an elimination diet, and then low dose naltrexone, which she titrated up gradually to a dose about 4.5 milligrams, but the ANA level came down, you know, uh, you know, obviously with inflammation, all the inflammation markers went down. The pain went away. And the funny thing is like we had to get her off that blood pressure medication really quick. The pressure was just dropping. So now she's just on LDN and you know, obviously supplements and you know, dietary changes, but there's no more blood pressure medication needed, and she doesn't have the pain anymore.

So it's an example of, you know, the LDN is a tool, but you still have to take into account all of the other things that are going on. But the diet, nutrition, exercise, I always try to tell people it's a package deal. You know, the LDN is one of the most important pieces, but there are other things that you can do for your health.

Linda Elsegood: Oh, definitely. Um, I used to have to take, um, Omeprazole for Acid reflux, and if I didn't take it, I was in trouble. It's that severe, but by going gluten-free I now don't have any problems at all. I don't have to take the medication. I don't have any acid reflux at all. But if I go out to eat and you know what it's like you're going through the menu and say, you know, it doesn't look as though there'd be any gluten-free in this. Could you check with the chef for me? And they'll come back and say, no, there's no gluten in it. If there is, I don't sleep that night. The acid reflux is so bad. And I have to sit up. Right. If not, I'm just going to vomit. It's terrible. So I don't always believe people when they tell me there's no gluten, cause I know if there's any gluten in it.  Yeah. So it's amazing, isn't it? How you can just eliminate other medications just by diet. My husband has problems with these. The skin on his hands. He's allergic to milk, and he'd seen so many different doctors in the past, and nobody could tell him why the palms of his hands would go like white and dry.

But when he eliminates dairy, his skin is completely normal. And that was like 30 years of trying to find out what was wrong with his skin and never had an answer. . 

John Herr: Yeah, that's what I, my thing, when I'd give talks on this, I always tell people, patients, or if I'm talking to groups of physicians, you know, whoever it might be, I, I say at least I know in the United States, I say, we say that we're in healthcare in the United States, but we really are not.

We're in sick care, you know, our, our system in this country is, I hate to say it, but it's run by big pharma. So you know where our physicians are, a lot, many of them are trained to wait until the patient presents with the disease and then give a pharmaceutical remedy for that disease, whereas an integrative medicine, or you can take like LDN, I think, you know, we're trying to get at the underlying cause and how can we correct that so that we can live healthier.

Linda Elsegood: yes. It's, um, quite common for people to tell me that. The doctors are only treating their symptoms, but not the root cause. So of course, you then end up with all these medications and some people are taking in between 14 even 22 different medications a day, and some of those are only needed because of the cocktail of drugs that they're taking cause side effects.

But that's okay cause they'll give you another tablet which will combat the side effects from the cocktail you're taking. 

John Herr: Yeah. Well, I think Linda your example was the perfect example there. You know, that drug was originally made for somebody who had an active ulcer and then you theoretically would take it for, you know, two or three months, to allow it to heal and then change your diet and, and you know, go on. But now people just live on that drug, you know, the purple pill. It's like they have to take it forever, which you know, it affects, then you're affecting your gastric pH, your digestion. It's a slippery slope. I agree with you. 100% 

Linda Elsegood: Hmm.

And of course, I also have people telling me that it's expensive to eat healthily, and especially when you've got children, it seems. So sad, and I can understand if you only have a limited amount of money and you've got several children, they all need feeding. But - we call them crisps - you call them chips over there, and we have biscuits, you call them cookies, but you, you, you get where I'm coming from. That is cheaper than buying apples, some pears and bananas and oranges and such, which would be a healthier option. But the price difference is quite amazing, isn't it? And especially if you have. Uh, mass-produced meat from a supermarket or you're buying organic local meat or vegetables.

Uh, the price difference is quite high, isn't it.

John Herr: Oh, yeah. It's much harder to try and eat organic and healthy. You're right. And then you see the commercials where McDonald's is our friend. The dollar meal menu. Oh, please don't just don't even eat there. But do you want you to understand? Some people though, socioeconomics, they don't, they don't have that choice.

But you know, everybody can make little changes, I believe. Do you know? Uh, and then that's what we try to educate them on. And as you mentioned, I mean, just the cost of medication, like, uh, it's gotten, even when they're covered by insurance in our country, many patients can't afford their medications with their copays.

So I, whereas the low dose naltrexone, you know, I'm such a big believer in it. I, you know. Okay. I worked with Dr Dahda who, you know, explains to me that, you know, his patients are chronic pain patients. So a lot of them are, you know, disabled or they, you know, they don't have a large income. So, you know, we, you know, once we have them too, they're titrated to their dose that the dose that they're going to be on for their pain, then we dispense like a 90 day supply.

It, you know, at a cost that in most cases is lower than their copay. Uh, cause we just believe in the therapy so much that we want to, you know, help it help patients and make it available to them. 

Linda Elsegood: What about shelf life on your capsules? How long do they last? 

John Herr: Well, you know, the USP governs that in our country, so I imagine they would last longer, but where, you know, only allowed to put 180 days on, on there.

Once we, from the date that we make it now, certainly at the pharmacist, I think it would last a lot longer. But because it's compounded, you know, the USP United, which is the United States pharmacopoeia, which is basically overseen by the, you know, the FDA, the food and drug administration, and then that's up to 180.

Yeah, a day, what we call the beyond use date or expiration date. So that's what most people are getting a 90 day supply. They'll certainly going to fall within that date range.  

Linda Elsegood: I understand. And so that would be the same for the tablets as well once you start making those if that is the rules and regulations of the land. The 180 days?

John Herr: Yeah that’s correct that’s a solid dosage form and then once you go into anything that was a liquid, for example, um, now if you'd like for it to stop, I had to make it into for a young tile than a liquid format, you know, then we would be restricted, believe it or not, to a 14 day supply? You can also do testing, you know, so you can test that it's stable to extend that beyond use date. But most of the patients we see are, are using the, you know, the solid oral dosage forms, the capsules or the tablets. Yes. So it's usually not that much of a problem.  

Linda Elsegood: and what fillers do you use. 

John Herr: Well, typically, like most people, we use avicell, which is just an inert starch that people do not have any problems with.

But because we, we, you know, my pharmacy, it's, you know, we were only compounding. So we work with a lot of functional medicine and integrative practitioners. So we have a person who did have like what we call chemical sensitivities. A lot of times I don't think that they're going to be allergic to the, uh, you know, to the low dose naltrexone or it, but it could be the filler.

So sometimes what we'll do is we'll give them different filler. We might give them some avicill capsules, we might give them some acidipholis capsules, or sometimes we'll use a vitamin, you know, nutritional that we know that they can take. And then we'll have them take the, you know, capsule, you know, for about a week or so with actually, without, with no now trucks on it.

Just to make sure that they're not having any type of re, you know, reaction to the, uh, to the filler. So, you know, typically we do avicell, but you know, for specific patients, you know, if they have chemical sensitivity, we will adapt it too, you know, whatever will agree with that particular patient, especially if they practice kinesiology.

I have a couple patients and practitioners, you know, practising aetiology so they can kind of, sometimes they can tell which filters are, you know, will react to a patient even. Just from the, you know, if you understand, can aetiology, how it works in the body versus even half the taking it to see if they have a side effect.

Linda Elsegood: Okay. And what about the capsules? Are they sort of, um, a vegan free capsule? 

John Herr: Yes, we can get a, um, they're, they're a vegetable base, so now they're not a,  typically they come gelatin or, or, or vegetables. So we can, you know, we can get either, our goal is to go. At least eventually to the tablets once we, um, you don't have the tablet machine running correctly, but with the tablet you're, you know, unfortunately, you have to kind of make a couple of strengths.

It's not that you can go, oh, I can just run or, you know, or make a runoff, you know if it was a strange or an odd strength, you know, let me just make 30 or a hundred of that. What you have to do that in bigger batches, I don't think I will ever not be also making capsules. You said if you have the patients that need them, the ultra-low dose or patients who.

Everybody used to think it was 4.5 milligrams like religion, but now we know some patients do better with nine milligrams, some patients do better on three milligrams. So I envisioned that will always be, you know, compounding capsules. But we'll also, for those patients that are taking the more common dose, we'll have the availability of the, you know, tablets that we can keep up with the demand because you know, myself being, and.

in this metropolitan area of New York City, New Jersey. There are so many patients who need this, uh, need this treatment. 

Linda Elsegood: And what area do you cover? Um, before we started, you said the Manhattan area, so. Could you just explain exactly where you, you cover? 

John Herr: Oh, sure, sure. Yeah. And in the United States, uh, again, the FDA requires that you have to be licensed as a pharmacist in any state that you're going to send, you know, medication into and low dose naltrexone is considered a, you know, prescription medication in our country. So, you know, you have to be licensed in those States. So I, I've concentrated my licenses in the Northeast, so I, you know, work in areas such as, you know, Massachusetts, Rhode Island, Connecticut, New York, New Jersey, Ohio, Pennsylvania, Delaware, Maryland, you know, the, in this area of the Northeast.

But, uh, you know, previously I was president of IACT, which is the international Academy of compounding pharmacists. So I know pharmacists all over the country. And a lot of times I'll get a request for, you know, low dose naltrexone in another state. So I always know, you know, a good colleague that I can refer to that prescription to if no, if I get, I have a request and, uh, to state that I'm not licensed then.

And compounding pharmacists generally kinda like to network and share ideas with one another, which, you know, it's very collegial, which is something that, you know, really makes me enjoy the profession. So I do many instances I send prescriptions that I get to people I know in other States because I'm not licensed in that state, so we always try to make sure the patient gets their medication.

Linda Elsegood: And since you've been compounding LDN for so many years, has anybody ever reported to you any adverse effects that may be unusual? 

John Herr: I have like one patient and that she's come to like three of my seminars and her husband's a physician, but she just has a funny reaction to the naltrexone, and we've tried it.

We've tried ultra-low-dose and, and everything, but it really just upsets her, you know, upsets her stomach or her head. She just doesn't feel right on it. And I mean, she's tried it so many times because of it just, she's read so much about it, and her husband's been a practitioner. She's all one patient that's just tough to treat. But other than that, we get the typical side effects you see, which are the, uh, you know, the vivid dreams, the stomach upset, you know, maybe like a slight little headache. But typically we just work with those patients and tell them that you need to start the dose slowly and titrate up gradually.

So we've actually put together a, a, you know, like a titration kit. You know, for patients, cause many of the doctors don't realize that many doctors hear about low dose naltrexone and they just, you know, they think they can simply write a prescription for a four milligram or a 4.5 milligram. So we'll, we'll go in and educate those physicians that we have, this titration kit that we go up gradually once the patient gets to be on, you know, the dose that seems effective for he or she, well, they then compounded into that particular strength. So I think that's really helped a lot for patients to, you know, avoid the side effects and, uh, you know, get to their particular individualized dosage. 

Linda Elsegood: Well, I've been on LDN since 2003, and at that time over here anyway, we were given three milligrams for a month, and then you went on to 4.5, and that was it.

But the dropout rate was really high starting on three milligrams because we have found now that some people, you know, two milligrams is as high as they can go. So you can imagine starting on three it was a no go from the start, you know, it was far too high for them. But now, depending on what the condition is, It might be as low as 0.5 milligrams starting or 1.5 but doing it gradually and slowly. We find that not many people drop out of taking it. They seem to tolerate it really well and notice benefits quite quickly. 

John Herr: Oh, I agree with you, Linda. 100% on that. And then the other thing, like I always try to caution patients on it is that don't give up on it.

Because sometimes, even though maybe they didn't get any side effects, the patient thinks they're not getting the effects from the low dose naltrexone. And it's funny, we had two women, they were, you know, they were, you know, they were girlfriend, you know, and they both had a similar condition around the same age, and they went to the same physician, both started on the titration kit and, and the one woman that she got to 3.5 mg and she was just feeling wonderful. And the other lady kept going up and she got to like 4.5 and wasn't experiencing any, um, any relief from her. Uh, you know, what she was trying to treat,  but we just told her, you know, you gotta stick with it, stick with it. And you know, she was discouraged because the girlfriend was, you know, she was not even 30, you know, it's about 30 days. And she was feeling well, and she wasn't getting any benefit that she perceived. And lo and behold, it took four months.

And then she started to get the relief. So the other thing is like, even though you know you start low on the dose and titrate, which you know, we agree 100%, you also have to make sure that the patient realizes that sometimes you need it can take six months before the low dose naltrexone really start to show differences in their body.

And I always try to caution patients, you know, depending on the disease that they're trying to treat or the condition they're talking to trying to treat, I tell them, look, this didn't happen to you overnight. You know, this whole thing was probably going on your own, in your body for a long period of time.

So, you know, you're thinking traditional medicine, like, you know, you had a toothache and somebody gave you Tylenol with Codeine, and of course, it's going to work immediately. But with this, we're trying to upregulate your body and get your body to correct what's going on. So you do have to caution patients that, you know, give it time.

I usually recommend, give it a good six months before you say it's not doing anything for you.  

Linda Elsegood: well, we noticed, um, when we did a survey that some people said they had no symptom relief, but their disease stabilized. So I mean, that's a win in my book if you've managed to stop progression, but then between 15 and 18 months there was, um, 2% of people, whatever it was, didn't find symptom relief until they'd been taking it 15 to 18 months, which is a really long time. But they had stabilized before then. Um, and only 5% of people at that time or have any side effects at all. But the number of people who have stopped LDN because it probably wasn't working, or it was too expensive, but they stopped. And those people normally come back to me in about three, four weeks and say, in actual fact, the LDN was working for me. I'd forgotten that my bladder used to play up. I'd forgotten the pain that I had, “I’d forgotten …..”. You know, it wasn't until they'd stopped that they noticed that LDN in actual fact was working for them.

John Herr: yeah. I agree with that 100%. I've, you know, I've had like another woman, we would just counselling who hang out with her. Uh, you know, general, like almost like fibromyalgia pain and everything. Had ah It's totally a had gone away while she's been on the low dose naltrexone, but then all of a sudden she started to get pain in that.

And uh, you know, she's gotten real nervous. Like, Oh no, but I held the end isn't working for me anymore. I have to have this. This is how it is. This has been a miracle for me. What's going on? But then again, you know, functional, integrative medicine, when we talked to the patient with what's going on in your life, he starts to see that, Oh, you know, now you're going through, you know, you're right at the, into perimenopause, going into menopause, you have the pain.

Oh, it's right around my menstrual cycle. Okay, what's happening there? You're probably. Your estrogen level isn't where it used to be. And we know when women, particularly that when their estrogen and the estrodile goes down, they tend to get aches and pains. Hmm. So maybe it's a matter of, you know, adjusting your estrogen at this point.

It's not that the LDN stopped working, so you always have to look at your patients, and that's why the patient always has to go back and, uh, you know, consult with there, either their compounding pharmacist who can send them back to their physician or their physician. But it's not always just the, uh, you can't always blame it on the LDN.

Other things, you know, are happening in your life are happening with your body as, as we, as we age. So it's, uh, that's why I say it's a package. 

Linda Elsegood: I was asked a question this week, and a gentleman said,

it would appear on the forums that he's been reading that LDN doesn't work as well for men as it does for women. And was this a hormonal problem? Have you noticed it doesn't work as well for men as women, it seems, 

John Herr: you know, you're right. We have more of women that, uh, that are on low dose naltrexone, but I, I don't know why, but I thought like when we were talking pain, you know, certainly the, um, I think it works for both men and women equally well, but when we have other conditions such as fibromyalgia, that it makes you wonder, is it, is it also something going on with the hormones or, I think I have a great interest now in, in like Lyme disease and low dose naltrexone. And, and we know surely that Lyme disease, you know, uh, affects the pituitary, which is signalling in the body to produce hormones. And also, if you think about chronic pain, when people are in chronic pain, they're not producing their hormones the same.

So that's where I think we have to not just think that it's just a panacea and then we can just give low dose naltrexone, but we have to measure those patients hormone levels. And adjust them accordingly. So, and I think. You know, honestly, that may be what you, what you just elucidated is that you know, women will tend to, you know, go through menopause or their hormones will change at a much earlier age than men.

So, you know, for a woman, you know, we usually say around age 50 our hormones are trying to change. Men won't happen later on in life. So maybe it's not a difference, you know, in between males and females as much as, is it also something that has to do with the relationship between the hormonal changes.

And women getting them at an earlier age than then we're associating that more women do better than men, but reality maybe. Cause it's that man still has this testosterone in his body. 

Linda Elsegood: Oh, okay. It does. It does. And we're now out of time, but I have to have you back another day. We could have carried on talking there forever.

Could you tell people how they can contact you? 

John Herr: Well, certainly, uh, you can call us at our pharmacy directly, which is a 201 447 2020, and then you can always find us on the internet. Our, uh, pharmacy is https://tccompound.com/ and from there you can even email the pharmacist a question or, you know, call us directly.

And we just love talking to patients, and that's what we do. And we, and we do hold seminars, usually monthly on low dose naltrexone, which we will post on Facebook and on our website. And, you know, make people aware that if they're, you know, in the area that they can come in and see it. 

Linda Elsegood: Wow. Amazing. Well, thank you very much for all your hard work and for promoting LDN to your patients all these years.

Um, absolutely fantastic. And for educating people, so thank you very much. 

John Herr: Oh, thank you, Linda. I love talking with you and, uh, looking forward to doing it again. 

Linda Elsegood: Thank you.

At the town, a country compounding pharmacy in Ringwood, New Jersey, owner, pharmacist, John Herr and his team are passionate about low dose naltrexone. They have compounded LDN for over 15 years. And they're committed to compounding high-quality medications and serving as an educational resource for patients and practitioners alike.

Visit https://tccompound.com/

any questions or comments you may have. Please email me contact@ldnresearchtrust.org. I look forward to hearing from you. Thank you for joining us today. We really appreciate your company. Until next time, stay safe and keep well.

Paul Battle PA-C, LDN Radio Show 22 Feb 2017 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: today. Our guest is physician assistant Paul Battle from Colorado. Paul is an experienced LDN prescriber and also has personal experience of LDN.

Paul Battle PA-C: Thank you. I really appreciate it.

Linda Elsegood: Well, I know you've been prescribing LDN for many years. How long has it been now?

Paul Battle PA-C:  Since 2008 I believe.

Linda Elsegood: Okay. I thought it was longer than that. At that time, how many different conditions do you think you've prescribed LDN for?

Paul Battle PA-C: Approximately 20 or so. Ones that I can recall right now, all varying different conditions, an autoimmune disease. It does help with cancers that have had treatment already. I can't say it's a cure for cancer, but it's a, like a supplemental treatment, especially for people who've already had cancer therapy, stage four cancers.

And then certainly the autoimmune diseases, which can include Lupus, Crohn's disease, all sort of Colitis, Complex Regional Pain Syndrome. What I generally do is look at the disease mechanism, what the aetiology of it. If it has some antibody-associated mechanism, autoimmune disease, then I consider LDN and the treatment.

Many of these people really don't have any other option. They tried multiple drugs. A lot of the drugs will have side effects and they just are looking for another answer. LDN can help with a lot of people that don't have any other options. 

Linda Elsegood: And from the patients that you've prescribed LDN for, what has been their success rate?

Paul Battle PA-C: I would say the majority of the patients get some positive response. I would say probably close to 85% of people will get some positive response. Some are very dramatic responses. For example, I had a 13-year-old girl with Crohn's disease who after just 3 months, she had already been on the biologics and was losing weight and having difficulty she had no more symptoms. All her inflammatory markers were completely normal and she's still doing well. That was probably about a year and a half ago, just a couple months ago and she's just doing remarkably well. Same with some of the complex regional pain syndrome. This is a terrible disease that plagues people, that causes severe pain due to some dysfunction or dysregulation of the immune system related to the nervous system. It's called the neural glial cells. And some people, I've had 80% relief from complex regional pain syndrome. I first started that in 2010 when this young woman who was attending college couldn't finish college. We had put a spinal cord stimulator in her neck to try and control the pain, but she still wasn't doing well.

That was my first proposal ever for CRPS and Dr Chopra wrote an article, then published an article a couple of years later after I started this young lady on it, and it worked for her. She finished college, got a career, and after a year and a half, she went off LDN without a problem and since then, I've been treating multiple people with that disease with varying success. So it really varies though, like I never can guarantee to somebody that I'm going to cure them or they're going to get 90% relief. We're just trying to improve the quality of their life.

Linda Elsegood: And how long would you say it takes on average for somebody to notice that LDN is doing something for them?

Paul Battle PA-C: Well, I've seen people respond in some positive fashion within 2 to 3 weeks. For example, my son, (that's how I got interested in all this) within 2 weeks with his Crohn's disease started having a positive response, getting a better colour, less pain, fewer symptoms. But I've also had people where it's taken six months.

I had a woman who was a university professor with Complex Regional Pain Syndrome who just persisted. I said," just keep on, keep on. " And she was in a wheelchair. Her symptoms were so bad. She was disabled in a wheelchair.  Then six months later, I got all these Facebook invitations to look at this video, and here she was returning to work, which was a glorious thing.

And now she just texted me last week saying she did a five kms. That's going from a person in a wheelchair totally disabled to now running five kms. That's been about a year and a half now, but she stuck it out. And I asked people to be patient. Sometimes they do not think it's doing anything. For example, in her case, she said: " I don't know if this is working.

I'm just gonna see how it goes without it." So one Friday night, she ran out of it, and that was the last time she ever skipped a dose that she said it was the worst, she described her spinal cord on fire. And I've had a number of other people saying, "well, I'm not sure if it's working."

They stop it, and then they discover it was really a mistake to stop it. So I tell people in where from a couple, three weeks to six months. 

Linda Elsegood: And from all the patients that you have prescribed LDN for, have any had negative side effects?

Paul Battle PA-C: I think some people describe a kind of tiredness or a little fatigue they may have and sometimes it depends on when they take it. For example, most people take it at night, but I have a lot of patients with these syndromes that really creates sleep deprivation anyway. I don't want to have them risk their restorative sleep. So I have them take it in the daytime and I think those people probably have a little bit more fatigued and tiredness than the people take it at night.

I met some people that just like any other medications have a little stomach distress from it, but that's pretty unusual. And you know, I'm not even sure if it's the LDN, but, the sleep deprivation, I really haven't had troubles with that too much, because I titrate them up, fairly solidly over three weeks, sometimes four week time period.

Linda Elsegood: And would you say there's any condition better than any other that you found LDN works best for?

Paul Battle PA-C: I would say the inflammatory conditions of the joints work really well. Dr Berkson,  done great the presentations on Rheumatoid Arthritis, iPad, people who were on the biologics,  that is,  the biologic agents that are what's called tissue necrosis factor inhibitors, who were doing okay on those and, they couldn't afford anymore so they want an LDN and they actually got better results. One patient of mine now was mountain climbing. He wasn't able to move his shoulders for 3 years, went on LDN, and now he's welling up that he's climbing with his kids. So I think that the joint arthritis issues, the inflammatory bowel disease, especially Crohn's. I don't find all sort of colitis as responsive as the Crohn's patients. So I'm careful to say how successful it is with Ulcerative Colitis patients, but it's certainly always a good idea to try it. The gastroenterologists recognize the Ulcerative Colitis and Crohn's that may have some different mechanisms of action.

The cancer patients, I've had several stages for cancer patients. They're living any of them with the same diagnosis. That's been good. And how much of that is the LDN? How much is it good health and a good attitude? I don't know, but I just know the other people that were treated without LDN in their particular type of cancers are no longer with us.

So I think it is a help because of the two mechanisms that LDN works. It inhibits cancer cell reproduction, and it also, according to the new research done last year by Angus, Down in Great Britain where it actually helps change the gene action with apoptosis of the cancer cells. So I think it has a dual benefit therewith, with cancer.

Linda Elsegood: We have a few questions here and we will start with the question from Randy who has Graves' and Hashimoto's. And the question is," I've heard that LDN can lower thyroid hormone and sent a person hyperthyroid, but in the information, it says it can quickly make a person hyperthyroid.

Can it really have such opposite effect."

Paul Battle PA-C: Usually it's hyper because what happens is the Hashimoto's usually has a tendency, depending on what phase of the disease you're in. Graves', usually you're hyper and that could possibly cause the problem but what it is is the Naltrexone interacts with the antibodies so if a person is Hypothyroid from Hashimoto's thyroiditis, I always tell them to reduce their thyroid supplements by half or 25% because there's been a number of people who are hyperthyroid, they're on their thyroid medication, they take the LDN and the next day they're agitated, they are like high, they're hyperthyroid because what happens is it has a tendency to neutralize the antibody action, whether it actually reduces the antibodies or how the antibodies respond to the cellular receptors with antibodies to thyroid.

We don't know, but I always warn people to cut their dose down before they take their Naltrexone. In the case of Graves' disease, I haven't heard of it causing I hypothyroidism. I guess that would be possible if it's, a lot of the inflammation is causing a hyperthyroid state, which you can't get in Grave's disease and you reduce that inflammation, you could possibly reduce the thyroid activity there.

But I haven't had that personal experience with Graves' disease. Mostly I treat the Hashimoto's thyroiditis, and that's the most common cause of hypothyroidism.

Linda Elsegood: Thank you for answering that question for Randy. We have a quite long question here, so bear with me. It's from Shantelle.

She says, "So thank you for being on the show and greetings." And she's a 54-year-old woman diagnosed with disposed systemic CIRCLE DOMA 15 years ago. The only medication she's presently taking is IVIG and Plaquenil a 0.25. She lives in the UK and is currently in the process of finding an LDN doctor.

She says she's noticed that you have experience in bioidentical hormones, and she would be very interested in your views on estrogen and testosterone. Four months ago, she changed from oral HRT to testosterone gel to having biodentical pellet implants of estrogen 50 mgs and testosterone at 100 mg.

And since she's had the pellets, she's never felt so awful in her life in terms of depression, mood and run down. And she seems to catch every bug going around compared with the four months that she was on oral.

Paul Battle PA-C: I didn't quite catch the initial diagnosis but if she's being treated with IVIG that puts it in the same class of diseases that can be treated with LDN because it's going after the same problem. That is an autoimmune disease immune dysregulation. I have a young girl who was also going to be treated with IIVIG  for an antibody associated Peripheral Neuropathy.

She had problems with antibodies to her nerve receptors so she basically did not have a lot of function in her muscles, her GI tract and they were going to give her IVIG, but it wasn't insurance approved here in the United States, at least with their insurance so I offered a LDN, and that has proven to be very good for her.

She's back in school, halftime. She was in bed or missed all of last year. So the answer to her question is: I think LDN would be a very reasonable possibility for her to approach her other disease. Do you want me to answer the question about the hormone?

Linda Elsegood: Hang on. The main question when you get to the bottom there, because the testosterone and the estrogen implant is making her feel very depressed, very down, very moody.

She feels awful. She felt quite good on the oral HRT. So she's saying to you, she wants to go on the LDN, which should she take? Should she stick with the oral or the pellets?

Paul Battle PA-C: Well, I usually use the oral just because it's easier to titrate the dose. Once she got inserted pellets with estrogen, it might've been too high of a dose, and once you put the pallet in the subcutaneous tissue, it's very difficult to adjust the dose.

So she may be running very high. I usually like to estrogen to run around 60 to 100. That's what the literature shows to be protective against osteoporosis and coronary artery disease. But if you have too much, you can certainly have psychiatric side effects just like women get what they are on the birth control pill, they can have depression.

And as far as the testosterone pellets, the same thing, once you insert those, you're kind of stuck with those for 3 or 4 months. So some people love pellets because they don't have to deal with the daily pill and adjusting things but in my experience, it's just easier to adjust. If she has trouble with estrogen, you can just reduce the pill dosage.

I work with compounding pharmacy so I can make it whatever dose I want.1 milligram, 2 milligrams. The oral therapy for estrogen has been shown to be more cardioprotective than for example, a pellet form or a cream form. So for that reason, the dosing can be easier adjusted when it's in a pill or a cream form.

Linda Elsegood: Well, that's good. I think that was the route she was hoping to go down because she felt so ill and so down. So I think you've just confirmed it for her, so thank you for that. Here's a good one. Have you prescribed LDN for migraine headaches?

Paul Battle PA-C: I have. I have several patients with migraines that I prescribed LDN mostly because the current theory on migraine headaches is not our old theory of spasm of the arteries because they've done arteriograms and found that the artery diameter doesn't really change a lot when people have migraines.

So it's really more thought to be an inflammatory process of the nerves and therefore the LDN would be appropriate to try and adjust to an inflammatory condition like that. So I do have several patients with migraines on LDN. I do other things too but it seems like that's helped them.

They were treated in traditional medications for years, probably 5 or 10 years and I seem to be getting better results with the LDN. They stay with me, so obviously I'm doing something right for them.

Linda Elsegood: And I'm talking about headaches and migraines. Have you ever known LDN to cause a migraine headache?

Paul Battle PA-C: I haven't noticed it cause a migraine, but  I have had several patients say it does cause a headache more of the dull headache, not so much the pounding vascular headache type of symptoms.

Linda Elsegood:  And we have another question. It says," Have you seen LDN improve acne breakouts?

Paul Battle PA-C:  I have not seen that. I just haven't noticed that. I use other things for acne so I haven't observed that.

Linda Elsegood: Okay. Thank you. And what it's your opinion of using Ketamine infusions in conjunction with LDN?

Paul Battle PA-C: I think they can be done. I have patients, I just had one last week.  The ketamine works in a different way. it's a dissociative anaesthetic and it works by blocking the NMDA (N-methyl-d-aspartate) receptors. That's the receptor that transmits the pain to the brain and so what it does is it blocks that and so that really doesn't have any interaction with the LDN because the LDN works on opioid receptors, endorphin receptors. I think they can be used synergistically.

Linda Elsegood: And what conditions would you use the combination to for?

Paul Battle PA-C: That would be Complex Regional Pain Syndrome. When I used to operate on people putting in spinal cord stimulators, I would put it routinely. First I would give  IV magnesium prior to surgery and that has been shown in several studies that it can reduce pain 50%. That magnesium also naturally blocks the NMDA receptor, which the ketamine does so that works with ketamine. And then I would give an infusion during surgery and then after I would give an infusion for overnight to blocked the NMDA receptors so that the surgery would not precipitate an exacerbation of the Complex Regional Pain Syndrome or what's known as RSD, or Reflex Sympathetic Dystrophy.

That's only a diagnosis that I've ever used it for and I don't know of any other diagnosis that you would use Ketamine for. Ketamine is a tricky drug. Adults can have a miserable experience whether they can have nightmares and side effects from them can be hypertension, tachycardia, hallucinations, things like that.

So with adults, you do have to be careful with it. There are low dose ketamine infusions, and there are high dose ketamine infusions. Dr Kirkpatrick at the RSD Research Centre in Tampa, Florida, does a high dose. I've been there, and I watched him do his technique there. So that's the only diagnosed I can think of.

Linda Elsegood: Well, thank you very much. We'll just go to a quick break, and we'll be back in just a moment.

To listen to individual radio shows and interviews go to www.mixcloud.com/lldnrt.

This show is sponsored by Paul Battle PA-C. He is a well-respected physician's assistant. He takes a physiological approach for your optimal health using traditional and nontraditional treatments for autoimmune diseases and bone health, using hormone replacement therapy and low dose naltrexone. He has patients throughout Colorado and other states.

Visit www.pabattle.com or call 720 773 9041.

We have a question here, Paul, which you can sympathize with. Amy has a 17 year old daughter got Crohn's disease diagnosed four months ago. She says," Are the children taking LDN with success? What can I expect to see as an improvement besides better sleep, which assist with pain and improve quality of life?

And by that, she means more energy and able to go through a normal school day. Will LDN take her pain away?

Paul Battle PA-C: You're right. That is dear to my heart because that's how I got started with my son. And for her to know, my son was diagnosed with severe Crohn's as he hits at age 10. I think it started at age 9.

He had to have a good part of his small bowel resected that time, 3 years later, he had another severe exacerbation going into hypovolemic shock and so that is a time where I started researching by myself. And that's when I read Jill Smith's article in 2007 about LDN and Crohn's and she's an excellent and respect gastroenterologist who did excellent studies on LDN and Crohn's showing a remission. So if she wants to know if it works within 8 weeks, 69% of the people in her first study, showed that they went into remission, 89% of them showed that they had a significant reduction in the Crohn's index scores.

And what are those? The index scores are more symptomatic scores on a number of stools per day. Cramping, bloody diarrhoea, fevers things like that. Those, that 89% of them had significant reduction scores, so she can't expect a very good possibility that she would have less pain because the inflammation is causing the spasm, which is causing the pain.

So reduces the inflammation. Those symptoms will improve. They also will reduce the diarrhoea if she is having diarrhoea. You can get Crohn's in any section of your GI tract from the oesophagus to the anus. My son now, he's been on LDN for 8 years. He is a weight lifter, a bodybuilder.

He's doing really well. He has a strict diet so the one thing I would tell people that you don't depend on LDN alone. It's multi-system, multiple approaches to solving the Crohn's problem and if you do these other techniques such as dietary control and supplements, probiotics, things like that, you can expect to get good control of it.

As I said, I had a 14-year old that really pretty much doesn't have symptoms anymore. Inflammatory markers are gone, so you can expect chemical markers for inflammation to be reduced when she's on the LDN and yes, they had children on certainly had my own son on it. Dr McCandless treated many thousands of people with autism with LDN, and so it's proven to be very safe with children.

Linda Elsegood: Thank you. That was an ideal question for you, wasn't it?  Robin has asked the question. She's got Multiple Sclerosis. She's had been taking LDN since 2005 and in that time, she's had no new lesions and no active ones. She's had MRIs. She says that she's no better, but she's no worse.

MS has been stable in all that time. She uses a cane away for balance away from home and uses a scooter in large stores. Now what she would like to know is, does she need to continue taking LDN for the rest of her life, or is there a period of where she can stop?

Paul Battle PA-C: That's a good question. I wouldn't because she's been stable now for almost 12 years, I would be very hesitant to stop it. There are not many people with MS that are stable for 12 years. He could have 5 or 6 years where you have this up and down cycle but that's a long time to be stable.

She has no new lesions and the cost and the risk of LDN is so low. I don't know why she would want to consider stopping it. The other thing is the benefits of LDN with your immune system in general. It upregulates many of the things that help protect you from infections. It upregulates the natural killer cells and with the new research and cancer and the old research in cancer with doctors Aegon? it may help. I can't say for sure, but there are no studies on preventing it cancer. But certainly, we've seen the action clinically and how it benefits people with cancers. I would really recommend that she stay on it for the rest of her life.

Like I said before, there are people thought: " There's no benefit here. I stop it." And they paid the price. And MS is not something you want to have an exacerbation, it can be quite devastating for some people.

Linda Elsegood: Exactly. Yes. I certainly wouldn't want to come off the LDN.

We have an interesting question from Kat and, she says that she takes baking soda in water for reflux before she goes to bed, but she also takes her LDN before bed. And will the baking soda stop the LDN from being absorbed?

Paul Battle PA-C: It might. I wouldn't really recommend that because of the baking soda itself, could inhibit the absorption of LDN.

It'd be best if you could take the LDN maybe an hour after that. By then, the baking soda should be out of her stomach and into her small intestine. So that's why we don't recommend compounding pharmacies to put calcium and other minerals in with the pills because it can disturb the absorption.

If she really needs the baking soda then she might consider doing LDN in a topical form with the oil or cream or something like that. If she has that much trouble with reflux she might have eosinophilic esophagitis, which LDN can be helpful for, since it's also an immune-based problem and that seems to be a more common diagnosis. So in the end, I wouldn't recommend her to take it at the same time.

Linda Elsegood: Just on a personal note, I used to have to take an anti-acid every night for acid reflux, which was really bad. It used to burn the back of my throat and absolutely awful. But have changed my diet and not eating gluten or dairy, the acid reflux has gone on.

I no longer have to take that medication, so I'm quite pleased.

Paul Battle PA-C: Excellent. That's the way to do it. Glutamine also was another nice thing to do. It's just an amino acid and that helps with reflux also. That's what most of the intestinal cells are dependent on for energy and also helps with restoring the intestinal cells so that's another thing she could try, but you're right, Linda, that's the best thing to do is just get away from those triggers.  Gluten and dairy are the two most common triggers for many of the diseases we're talking about. We are not used to those kinds of proteins.

Linda Elsegood: And we have a question here from Heidi and she says she's got resistant depression. "I've been on every type of antidepressant and been in counselling on and off for years, and nothing works. I currently attend CBT I am suffering from crippling anxiety, depression, and insomnia. I've read that LDN can help.

I'm very desperate for help. I wish to try what would work"

Paul Battle PA-C: That's a good question. Some of the psychiatrists on our meetings are saying it can help. I mean, it certainly, increases the endorphins or at least the endorphin function. So that in itself can help depression. I don't know if it'll help the anxiety. The cognitive behaviour therapies he's doing is helpful but newer research is showing that many people have depression. It is an inflammatory condition. For example, people who have had a heart attack, the highest risk for reinforce, and that is, another heart attack occurring is depression and it's not an accident because of inflammation from depression. Inflammation in the presence of coronary artery disease can cause the plaque to be released from the wall of the artery causing a coronary thrombosis. So I think it would be worthwhile. There are studies, and I think Sweden and Japan, are showing that people who didn't do well on the medications, did well responding with high doses of fish oil. It is also an anti-inflammatory, and I'm talking large dosages.

For example, 5 to 10 grams per day of fish oil. Because DHA, which is in the official, makes a good part of the brain weight, about 20% of the brain weight so in the studies that Purdue University with children on anyway, so that most of the kids with this kind of psychiatric diseases, 85% had low DHA.

So fish oil is another anti-inflammatory, another option for people with depression. And the other thing that's important, since I do a lot of hormone work is to make sure that the thyroid is optimized. I don't mean in the range or normal. I mean optimized at a good level, healthy level, not just in the range, like 95% of the population and that has been shown in psychiatric journals to be just as good as antidepressants for depression therapy.

Linda Elsegood: I know many people who are using LDN for depression and anxiety, and I found that it really does help. Certainly got nothing to lose by trying it.

Paul Battle PA-C: Right.  It's a great economic thing with really minimal if any side effects.

Linda Elsegood: Exactly. We have a question here from Robert who's got CFS/ME, and he said, "I was originally taking LDN at 4.5 mgs daily.

Now I'm taking it every other day based on an article which I have read recently, which is recommended, taking it every day or every other day.

Paul Battle PA-C: We have all, traditionally been prescribing it every day because the blockade is four hours and the immunological benefits that had been described byDr Dagan and Dr Bihari himself show that the immunological benefits last for about 20 hours. For that reason, I usually do a daily dose. Now for this person, if it's benefiting him every other day, his receptors may be more sensitive, and he does not need the 4.5 mg. What he might try is take half of the tablet and take two 2.25 milligrams a day versus every other day. But then, the pharmacokinetics, that is how the drug works and how long it lasts, it would be generally recommended to be on a daily basis. Now,  you got to understand how LDN works. It is an opiate receptor blocker, and if somebody has more sensitive receptors, they may need a lower dose or not as frequent to make their immune system actually, most beneficial.

That's true. We find with cancer. We don't like to go too high on the dose. Anything above 4.5 I don't think is a good idea because then you're blocking the benefits of the opiate growth factor that Dr Zagon has described in the past. So he just may find a level that's good for him, and that's perfectly fine, but the pharmacokinetics usually indicated it should be a daily dose.

Linda Elsegood: Thank you. We'll just have one more quick break, and we'll be back in just a moment. The LDN research trust has an LDN Vimeo channel. I have interviewed over 550 LDN prescribers, researchers, pharmacists, and patients from around the world for many conditions. You can find the link from the LDN Research Trust website. If you'd like to be interviewed, sharing your experience, these email, linda@ldnrt.org

 I look forward to hearing from you.

This show is sponsored by Paul Battle PA-C. He is a well-respected physician's assistant who takes a physiological approach for your optimal health using traditional and nontraditional treatments for autoimmune diseases and bone health using hormone replacement therapy and Low Dose Naltrexone. He has patients throughout Colorado and other states.

Visit www.pabattle.com or call 720 773-9041

Welcome back. I wonder if you could tell the people listening, Paul, the benefits of attending the LDN conferences, either in person or the live stream.

Paul Battle PA-C: Well, I've my personality. I think I've been to now 4 or 5 of them and the benefits certainly I get as a practitioner, but he can also apply as a patient or interested individual, is that you hear people from all over the world and the different applications that they're using it for. When I look at myself, I'm only one practitioner in my own experience, and I certainly haven't treated everything so it gives me a great advantage to listening to other speakers from anywhere around and what they're using it for, some of which I really never thought of.  The psychiatrists are talking about how it might help depression and may help sexual function, for example.

I certainly never thought of that so I think the biggest advantage is you're seeing some of the top people around the world who've been using this for a while and all the different indications so that if you have a disease that has not been a common one that we told about LDN, like Multiple Sclerosis and Crohn's, but it's one of these more rare diseases, you then can say: " This might be an option for me." And then try to find the LDN prescriber to try it. It's such a low-risk treatment. It certainly would be worthwhile for a lot of different diseases. I think you've counted over 200 autoimmune diseases now that I think we had the experience. It is a lot of diseases to cover and it's great to hear from other people around their experiences.

Linda Elsegood: And this year we're getting case studies and some prerecorded presentations because there was so much information there that we wanted to present to everybody. It would have taken like two weeks just to sit there and watch. So you're limited to what you can do in three days, but there is going to be a lot of extra material there.

But the Q&A sessions I find amazing because not only do people in the room get to submit questions, but the people who are listening online as well, and there are some amazing questions that come up, and it's really interesting to see all these people that have been prescribing LDN for so long.

Some of the questions are very complex and answering them can be tricky. We had feedback last year from one doctor who said she thought the Q&A sessions were amazing, and she had all her questions answered. She had some questions answered that she would have asked herself if she thought of them and the whole thing was unbelievable. She said, because some of the questions that were asked, I think there are only a few where nobody on the panel knew the answer, and they just shook their heads and said, no, I don't know that one. So for her, that meant every time somebody answered a question, they didn't answer it to give an answer.

They answered it because it was a fact. So for her, that made the whole thing believable. So, that was good. But I always find that the conferences, the atmosphere is electric. You've got all these people that are so for LDN. It's just amazing, isn't it? The actual feeling in the room.

Paul Battle PA-C: Well, it is. It's a great comradery because it's still not a well-known treatment and if it doesn't have salespeople doesn't have commercials on TV.

So it's really been pretty much up to people like you, Linda, who's been one of the leaders in promoting LDN around the world and that's been my mission since it says my thumb's life is to speak at international conferences sponsored by you and sponsored by other organizations. I'm going to be speaking at the Age Medical Management conference in Florida in April about LDN and that's a whole different group of practitioners that will be hearing about LDN from myself. It's a nice, progressive movement that's helping thousands of people around the world in a very economical way. I just wish there was a way we can spread it a little bit more, but commercials are expensive, so it depends on all of us to be together.

That's where I feel a real brotherhood and sisterhood about LDN movement. We don't have a lot of help other than us volunteers or in your organization.

Linda Elsegood: And this is where the good thing is in sharing case studies and people getting together to discuss different ways of treating different conditions with LDN.

It's a good way of everybody learning. We do have another question has just come in and it's for Rheumatoid Arthritis. The question is, "How long should I take LDN to treat my Rheumatoid Arthritis?"

Paul Battle PA-C: Well, I'm not sure if he's asking how long should he take it before he notices a difference, or how long should he take it to treat it. I would stick with it at least three or four months before he would expect any dramatic results. Just give it that much time. If he does have a good result in the end, if you can get 70 or 80% improvement then he used to just stay on it the rest of his life. Rheumatoid Arthritis is not one that goes away. I would want to make sure though that it is Rheumatoid Arthritis. I had a patient in my clinic who was told by the rheumatologist she had Rheumatoid Arthritis, and so for 3 years, she's been thinking she had rheumatoid arthritis and I checked her for Lyme disease, through Armin labs, the German lab that we have come to our conferences, and she was positive for Lyme Arthritis. So the question is always make sure you have the right diagnosis also. But if he gets a good relief, Dr Bert Berkson in New Mexico has a great presentation on his patients with Rheumatoid Arthritis showing the serological markers improving dramatically on LDN. Many of the people were able to get rid of most of their rheumatoid medications of which a lot of them have side effects.

Linda Elsegood: Yes. We've had the lady Mary, who's been listening to the show, and she's talking about Complex Regional Pain Syndrome, and her daughter is 15 years old. She says: "Is it safe to take LDN at the same time as Gabapentin". Her daughter is currently on 2,700 milligrams a day, and she'd love to get her daughter off the Gabapentin but it's the only thing that takes the edge off the pain.

"Is it necessary to go gluten-free to find relief?" She said: "I know she should, and I'm gluten-free myself." But her daughter is not ready to accept. That's what she needs to do. "Are there any studies out there on the longterm effects of using LDN in adolescents?" She often searches for weeks and finding studies difficult.

What is the most normal dose for CRPS? She's 5,11 foot and weighs 140 pounds. Thank you for your help.

Paul Battle PA-C: Well, that's interesting she brings that up because I had that exact patient in my office about an hour ago. She's the CRPS patient on Gabapentin, and she's been trying to get off Gabapentine.

I believe the Gabapentin may have been helping her a little bit because Gabapentin can work with the LDN as it helps attenuate the nerve transmission. It's a class of drugs, like anti-seizure drugs, so she can certainly use them together. And is there any studies? There aren't any longterm studies on kids.

We just know that like Dr McCandless had kids on the LDN for years and there's never been any problem longterm. My son's been on it for 8 years without a problem. We have the OB-GYN doctors in Ireland who use the larger dose Naltrexone, 50 mg for infertility during pregnancy, and they have not had any problems.

So I really can't think of any other safer drug and  I've been a PA for 35 years and a lot of different medicines that I prescribed over the years. I can't think of a safer drug then Naltrexone at  3 mg, 4.5. For her at that size, I think the 4.5 milligrams would be the appropriate dose, but I would titrate it up, and regardless of the gluten-free, I think when you have any kind of immune dysregulation gluten-free is a good idea. The gluten proteins are not ones that we have been designed to digest. Dr Tom O'Bryan, who comes to our conferences, is one of the experts on gluten, said to me last year that, even a person without gluten intolerance or the Celiac disease still has inflammatory changes in their intestinal track when they do biopsies 30 minutes later.

So my recommendations would be yes to have her do gluten-free. I know my son with his Crohn's took a while, but when he finally realized, this is his body, this is this future, now he's gluten-free, dairy-free, all that. So I would highly recommend that she go on a gluten-free diet.

Linda Elsegood: Appreciate what she's saying though.

Having a 15-year-old daughter who wants to socialize and go out and be part of the crowd, and then you can't go out for a pizza because you can't eat it. It's difficult, isn't it?

Paul Battle PA-C: You have to do a gluten-free crash. A lot of pizza parts and an Italian place have gluten-free pasta, gluten-free crust. I was just had that last night, as a matter of fact so it's workable now. It's much easier now for gluten-free meals and diet, and she can always bring your own food. That's what my son's done for years, is just pack your own food and have salads and things like that.

Linda Elsegood: Well, it's not very easy in England to find anywhere that is gluten-free.

You'll find that when you come over. When I went to travel and, we were hungry, and I just wanted to grab something. I went to the supermarket, and I said to the lady because I couldn't find it," Do you have a gluten-free section?" So she said: "Yes, but it's not very popular."

We're going to stop it and we've only got what's left on the shelf. And there were like six things, and it was like, then you're going to get rid of all the small section. You do have. I thought that was quite amazing.

Paul Battle PA-C: They need more education there because the Northern Europeans, as I understand it, have a little higher incidence than other population.

That is 1% of the population so I'm surprised at that. That's unfortunate.

Linda Elsegood:  We took our grandson to the cinema last week, and we were looking at menus outside to see what was gluten-free. Many places don't have menus, and we were looking at TJ TG Fridays, and we went inside and they actually have a gluten-free menu. And it was like," Wow, a whole menu of gluten-free!" You can choose it. This is it! Take it or leave it! There was actually a choice. That was very good. I had a gluten-free burger and a gluten-free bun, and it was very tasty.

I was going to say to you, Paul and anybody else out there who's listening, if there are any conferences coming up where you're a speaker, or you're attending a conference, and LDN is going to be one of the topics, let us know. We actually have on our website now an events calendar for talks and lectures so that people can read and have that as a resource available.

So you would have to give me the details, Paul, and we'll put that on there in the event calendar.

Paul Battle PA-C: We can spread the word. I love doing it. If we can help a couple of hundred people. And mostly what I really like doing is teaching the practitioners because I figured each practitioner has 1,000, 2000  patients in his practice. You've helped that many thousands of people at least be exposed to the LDN, by teaching the practitioners that, I think has a big impact on l.

Linda Elsegood: And word of mouth. Taken hold, hasn't it? People are telling friends and social media. I must admit I didn't want to join Facebook. I don't know how many years ago now. Reluctantly thinking that suggest another thing I don't have time for, but I think we have about 18300 members now.

I'm on there and I'll take this opportunity to thank all the wonderful admin people that we have who answered all the questions and help and steer people and give them advice on how to find an LDN prescribing doctor. Without them, Facebook wouldn't continue, but the number of people that pass through, who come, who go, who take the information, go to their doctors and get LDN prescribed It's a wonderful tool.

Paul Battle PA-C: It would just have to educate more people, more practitioners.  Some people may not be open to things that they're not trained in, and certainly the lack of a lot of clinical trials that do make the practitioners a little hesitant to prescribe it, but if you educate yourself, I've read a lot of it, all doctors papers and convinced that it's definitely a good thing for my patients.

I do certainly not hesitate to do that, but you do have to get educated, and that's what we're doing.

Linda Elsegood: Well, I'd like to thank you very much, Paul, for being with us today. We've just about run out of time and you've been amazing. So thank you. And I look forward to meeting you in September, but I might meet you when you come over later in the year.

Paul Battle PA-C: Yes in summer. That'd be great! Okay, Linda, I appreciate it and a really great time. I love helping out.

Linda Elsegood: Thank you very much.

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.

Linda Elsegood is interviewed by Dr Jess Armine, 2014 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr Jess Armine: Good evening everyone. This is Dr Jess Armine here at the bio individualized medical centre in South Eastern Pennsylvania. We have a very exciting show for you tonight. And we have a very special guest. We're going to be talking about LDN or low dose naltrexone, which is being used for the treatment of chronic illnesses.

We have the honour of speaking with Linda Elsegood hope I pronounce that right. And she is the leader in the movement to educate patients and doctors about LDN she'll tell you her story and what she's been doing. You realize that she is the epitome of the tireless individual, the indefatigable individual that is required to get this type of information out to people.

Please understand that this particular interview is being prerecorded. So there will not be an opportunity for live Q and. A. But, uh, Linda tells me that we'll have the methodology of asking questions or getting more information that will cue you in towards the end of the lecture. So, welcome, Linda, how are you today?

Linda Elsegood: Oh, I'm fine. Thank you very much for inviting me. 

Dr Jess Armine: It is our honour. So please tell us your story. 

Linda Elsegood: Okay. My life was working full time. I had two children, so I ran the home, did the cooking, the cleaning, the gardening, the decorating and working. I was a wonder, woman. I thought I could do anything. I was a bank manager at the time, life was fine and I was healthy, which I took for granted. And one day I came home from work and my father phoned. Now my father never ever phoned. He didn't like the phone. And he said, your mother's had a heart attack. She's now going in the ambulance. And I literally just got in and took my coat off. I put my coat back on, to get to the hospital.

My father was in a wheelchair, and the ambulance people wouldn't take him with my mother because he had to have somebody to look after him when he got there. So I said, well, tell them to take you. I will be on my way. And this was Christmas 2000. And um. It's icy. It's been snowing. The roads were terrible.

It would normally take me about an hour and a half to drive that. It took a good two hours. Now my mother took some medication to keep her alive. It was a very major heart attack, and I sat beside her bed. I'm an only child. My husband came and took my father home because they wouldn't let him stay overnight in case there was a fire or whatever. But I had it in my mind that if I held my mother's hand and sat with her, she would be fine. If I went to sleep, she would go to sleep, and that would be it. So I kept myself awake for 48 hours, which is rather silly, but it did make sense to me at the time. And, my mother came home. She had to have somebody look after her. So. I had both my parents here with me. I had to go back to work. A friend of mine was a nurse, and she came and helped me look after my parents, and I was tired.

I was so unbelievably tired. And then I started to get ill. Different things were happening to me. My leg became numb. I had this awful fatigue. I didn't really have the energy to do anything. So what happened then I said to my husband, I'm just having fatigue, I had flu, I had gastroenteritis. I was just so sick I want to go away. I want to go have a vacation, come back, and I'll feel fine. He couldn't come he was working, so I took my youngest daughter and while we were on holiday. We went to Portugal, and it should have been hot. It was Easter time, but it was freezing cold, and it was raining. So we decided to stay in or walk out in the rain. So we went out in the rain, and the left-hand side of my face was numb, it was as if I'd had a filling.

And I couldn't understand why I had this numbness on the face, and the left-hand side of my tongue felt as though I had eaten melted cheese and burnt my tongue. So we managed, and luckily we were only away for a week. And when I came back, I went to see my doctor who sent me to see a neurologist and he thought I had to have a mild stroke or I had a foreign disease of some kind, or I got MS. I didn't really like any of those options.

Dr Jess Armine: I don't blame you. 

Linda Elsegood: Oh, a brain tumour. That was the other thing. 

Dr Jess Armine: that's even better. Yeah. 

Linda Elsegood: I just wanted something where I could say, you know, here's a pill. Go home, and you're going to be fine.

So it went on and on. I was just so tired. I couldn't cope with working five days a week. I went part-time, I only worked four days a week, but that didn't make any difference. And then I got double vision I lost my hearing in my left ear, and at which point I could not move. So I had to give in. I couldn't go to work, I couldn't move. I had an MRI, a lumbar puncture, and was told it was MS.

I had a three-day course of intravenous steroids, and six weeks later I was given another course of intravenous steroids because they thought I was going to lose my hearing and my eyesight completely, which made me put on so much weight on a pale person my face was like a red beach ball. It was unbelievable. I didn't look like myself, but the second course of steroids didn't work. But at that time I was so ill. When I say ill, I was on the toilet the whole time. I didn't have any bladder control and my bowels. I know it's not the done thing to talk about one's bowels, but... Do I explain 

Dr Jess Armine: all the time, the major subject all the time. 

Linda Elsegood: Yeah. It was like sneezing. You know how you feel a sneeze coming, and you go, ah, choo. But it was like that from the bowels, and there was no control at all. It would be a case of it's going to happen, and it would happen. So you don't want to leave the house until what happens, because it happens every day, but never at the same time. Which would have been more convenient, I had no balance. I had to do a furniture walk. People with MS will know what I mean by furniture walking. But I would trip, I would stumble over nothing. I had very bad vertigo, when I moved, everything would spin, and my legs became as though they were rubber bands.

So I used to bounce a lot. So when trying to move, I ended up on the floor most of the time through one reason or another, but the left-hand side, this numbness on my face and my tongue spread, and after a few weeks you could draw a line right down my face, half my, my nose, my tongue, my cheeks, my chest. The whole left-hand side was numb with pins and needles, but numb in a way that any clothing or bedding that touched me was really, really painful.

And on top of that, I had twitching muscles, and I had burning limbs. Like you had a sunburn, and I used to say to my husband feel my legs they are on fire. I don't want to feel your leg, I would say please, please just feel my leg. 

Dr Jess Armine: I know when you're dating, they want to feel your legs

Linda Elsegood: he would feel my legs and say, what are you talking about? Your legs are cold. But to me they were, you know, they were on fire. So, cognitively, Oh my goodness. English became a second language. I couldn't recall vocabulary. Everything was crazy I would try, and I would say, could you make me a cup of tea?

I never ever drink tea. I only drink coffee. So my husband says, well, don't you mean coffee? And I'd say, well, didn't I say coffee? It’s like saying can you let the cat out he wants to go to the toilet. Don't you mean the dog? Well, you know what I mean why do you have to keep correcting me, you're depressing me. Please don't keep correcting me. I think I'm saying it right. And it's really depressing. So he would say to me. I'm telling you, so you'll know for next time. We'll know it doesn't work like that because I think I'm saying it correctly anyway. You know, next time I could call the dog a duck and still think I'm saying dog. But it was depressing. So every time I spoke, he was correcting me.

And then I started to get where I was choking on my food. So every time I swallowed something, he'd come and hit me on the back, and it didn't really help either. The only way I could speak to try and make sense because everything was so muddled in my head. I had to speak slowly, so I sounded as if I'd had a stroke because it was such a struggle. It was so tiring to try and get together the information to make a sentence, which to me made sense, but it didn't to other people. And then I couldn't find my mouth, my daughter used to have to put the cup to my mouth because I couldn't find where my mouth was.

Only saving grace was I slept most of the time. I was asleep for about 20 hours a day. I was only awake for like four hours, which was marvelous because I didn't feel anything while I was asleep. But then I also had pains in my head, really bad pains, and I do believe the doctors thought I was making it up. It used to be a pain size of the top of the wine glass. Sometimes it would be at the front right, sometimes the back left. it would move, but the pain was so intense. It used to make me feel nauseous. So yes, I was taking some very strong painkillers, which made the pain bearable. It didn't remove it. It made it bearable, but the nausea was even worse and I had optic neuritis where I felt like somebody was sticking a pencil in my eye, to move my eyeballs up, down, left or right, really, really painful. And I was in a wheelchair. I could furniture walk in the house, outside of the house I had to use a wheelchair.

And moving forward with now. It was October 2003, and I went to see my neurologist, and he examined me. He sat down. He looked at me, he leant across the desk, held his hand out, shook hands with me, and said, I'm really sorry to tell you, you're secondary progressive; then got up, opened the door and said, there's nothing more we can do for you. And showed me out. 

It was awful. I sat in the car, and I said to my husband, he may as well as say, go home and die quietly; don't make a fuss, you are an embarrassment, you know, there was no plan B. There was nothing anybody could do to help me. It was awful. I felt totally alone, frightened because I couldn't live my life like that.

One day the doctor came out to see me and bought me some more painkillers. I was in the house on my own, and he very kindly fetched me a glass of water and he left. My neighbour was keeping his eye on me, as my husband was working, and I thought the thing that really got to me was the look in everybody's eyes, family and friends. They all felt helpless they all wanted to help me, and there was nothing that anyone could do. And to see that in their eyes was awful.

Dr Jess Armine: I'm sorry. Okay, good. Deep breath. So it's a tough story. I understand. 

Linda Elsegood: So I'd got the tablets, and I thought that the family would understand if I took them. They would know why, and at least that way everybody, once they got over the shock, could be able to get their lives back. I was just lying watching the days passing without me participating, I couldn't do anything. I couldn't achieve anything, anything I wanted to do, I felt a total failure.

Dr Jess Armine: Okay. Take a breath, kid. Relax. Relax. Okay. We really appreciate you sharing your story with us because I know how much this hurts.

Linda Elsegood: Luckily managed to think who was going to find me. Would it be my 15-year-old daughter? So I couldn't do that. The only option was to fight it, to get something so that I could actually live again.

Between my many toilet visits, I used to sit at the computer. I thought there must be other people out there. I couldn't be so unique that I was the only one who ever felt like this. And, I found LDN and, I found some people that were taking it. And luckily. Some of these people were willing to talk to me and everybody said the same, if it wasn't going to do me any good, it wasn't going to do me any harm.

I printed out all the information I had, and I went to see my own doctor, who had retired by then, I had a nice new young lady doctor who was very kind and understanding and she said she was going to give the information to the partners and would I go back in two weeks? I went back, and she said she wasn't able to prescribe it for me, but if it was me, if it was her, she would like to try it so I could find somebody who would prescribe it for me she would be happy to monitor me. Now I found a doctor who would prescribe it for me, and amazingly, in three weeks, this awful feeling in my head where I couldn't think was like living in a television set that wasn't tuned in. All that came back in three weeks, and it was just amazing. I was able to think clearly it was such a big deal. I wasn't talking rubbish anymore.

Dr Jess Armine: So you were speaking coherently. 

Linda Elsegood: Yes. 

Dr Jess Armine: Yes. Wonderful. Wonderful. Yeah, 

Linda Elsegood: but my husband still says, I talk rubbish  (laugh)

It was for three weeks, and that was totally amazing. Now, my daughter, when she was 15, spent the whole of the summer holiday looking after me. Washing me, feeding me, and washing my hair. It was role reversed. So, you know, put your head back, close your eyes, you'll be getting soap in them. 

And guess what: she is now a nurse.

Dr Jess Armine: boy, that's a surprise. Yep. 

Linda Elsegood: She’s worked on a stroke rehabilitation unit for 18 months, and now she would like to train to be a nurse practitioner. She was very good at looking after me, I gradually got my balance back. Now, if you think I'd been years of not being able to carry anything because of the furniture walking, I mean, carrying a glass with anything and it would have just been too dangerous. And one day she said to me, could you get me a glass of orange juice? And I thought I haven't fallen over for a while. I think I can do this. So it was all in slow motion, going to the cupboard, getting the glass out, putting it down, opening the fridge, bringing out the orange juice, then taking it to her. I didn't fill it right up in case I spilt it. But anyway, I took it to her, and I came back, and I said to my husband, I've just taken Laura a glass of orange juice, and I didn't spill it, you know, it was to be a really, really big deal that I did. I'd achieved something.

Dr Jess Armine: beyond a big deal.

Linda Elsegood: Yeah. She didn't know how cognitively I thought I was suffering from some form of Alzheimer's. I thought everything was going to go, you know, the only thing I've got left was my memory, and that was slipping away from me, and that was my biggest fear that I was just going to lose myself completely. She came in with the empty glass and put it on the countertop and said, it's very kind of you to bring me a glass mom, but you didn't put any orange in it. Now because my state of mind had been so bad, I believed her and not myself. I thought I had imagined putting that orange in there and I just burst into tears. I'm thinking, well, that's it. You know, I was afraid I had lost it, but she was joking. 

Dr Jess Armine: Beautiful. 

Linda Elsegood: Honestly, I believed her and not myself

Dr Jess Armine: Well, you have good reason to, and she had good reasons to play with you a little bit and make you giggle. That's great. 

Linda Elsegood: Yeah. So with the LDN I was getting better and better, and I carried on improving for 18 months.

What was I going to do after being told there was nothing more that could do for me in life wasn't worth living. And suddenly it was again, did I say, okay I’m one of the lucky ones. Or do I tell the people who have been told, there's nothing more that can do for you who are in that really deep, dark place who perhaps didn't have the strength to carry on as I did?

So I decided, I wanted to tell everybody, you know, that it's not a miracle drug. It's not a cure. It doesn't help everybody, but it's something that you could try. It took five months, to become a registered charity, the LDN research trust was established ten years ago. So that was a big milestone. And we've helped over 14,000 people around the world.

LDN can work for any condition that has an autoimmune component. And so far we know of 174 conditions that LDN has been used for.

Dr Jess Armine: Let's go back a little bit. If we could, Would you explain to our audience what exactly low dose naltrexone is? 

Linda Elsegood: Okay. Naltrexone in its full strength was used for heroin and drug addiction back in the late seventies, early eighties and not used in low doses. It helps - according to D. Ian Zagon, who did lots of studies of LDN back in the late seventies early eighties - it helps regulate a dysfunctional immune system.

And Dr Bernard Bihari was using it in his practice for AIDS. And the friends of his had got a daughter who had got MS, and he decided that he would try it on this young lady. And it worked very well, and she was on it for many years. She did actually stop after a while thinking that she'd been misdiagnosed and her MS wasn't really MS after all. And when she stopped, she relapsed. Dr Bernad Bihari had been using LDN for many conditions. Cancer too. But that's the problem with LDN. When you say it can be used for all these different conditions, it loses some credibility because it sounds like it's too good to be true. 

Dr Jess Armine: It sounds like a panacea. Anything that's considered a panacea has veracity problems. 

Linda Elsegood: Yes, exactly. So when it was trialed in its full strength and people were taking it 50-milligram tablets three times a day, so it was 150 milligrams, It was only harmful to the liver in doses of 300 mg a day. And with LDN, which stands for low dose naltrexone, people normally take around 3.0 mg to 4.5 mg. So it's a very low dose.

Dr Jess Armine: In your opinion. And not going to hold you to this cause, you know, I realized that in the research nobody really knows the exact mechanism on how this works. But in your opinion, what do you think it works? 

Linda Elsegood: It helps boost endorphins. And it also helps with the Toll-like receptors So there are two different mechanisms there. And there are many YouTube videos from LDN prescribing doctors and scientists explaining how they think that LDN works. But people start on LDN, on a very low dose usually around about 1.5 mg and titrate it up by 0.5 mg every two weeks if tolerated. But in 2005 people were starting on 3.0 mg, and 3.0 mg was too high for some people and was always going to be too high. Some people were dropping out, but by starting on the lower dose and increasing it gradually the fallout rate has really dropped.

And there are different forms in which you can have LDN. Now, initially, it was just capsules. But some people had problems with their stomach. They could get very bad nausea, diarrhoea, especially people with Crohn's and ulcerative colitis. So there is now the capsules and we have a liquid, and there are sublingual drops, which is relatively new. I think the first was about August last year, and that's absorbed differently, which bypasses the stomach. So for those people that had problems with them, stomach issues, that's now no longer a problem.

Years ago it was told you could only take it at night because that's when your body makes more endorphins. But so many doctors have found that it did cause sleep issues with some people, and they tell their patients to try it in the morning, and they still get very good benefits. But full studies and trials are needed to find out.

With LDN it isn’t the case of height, weight ratio, we have many men that can't take 3.0 mg, and these are big men, and you get a very small lady who can take 4.5 mg, no problem. It is what dose suits you best.

Dr Jess Armine: I'm getting the impression that this can support or be effective in a myriad of autoimmune conditions, in your experience in talking to people. And again, I know we're, you know, we have our limitations of what we can talk about, only because we have to be careful about the men in black going to show up at our doors. Okay. But, in raising awareness about LDN, people are still asking I have X. What can you do for it?

What are some of the things that, in your experience and what you've seen, you interacted with a lot of people, obviously, what have you seen? I know it doesn't work with everybody. So with all of those caveats, okay, what are the things that you've seen that works best for.

Linda Elsegood: Okay Crohn's is a really good one, psoriasis, amazing, But with psoriasis, people have to be patient. I mean, there are people who will say that they noticed improvements after the first week, but normally with psoriasis, I would say it takes about six months. And do you know how angry psoriasis looks and red and scabby after six months, normally it starts to look like skin colour and then just all fades. It, to me, just is amazing. It's like normal skin.

Banking was my thing, I wasn’t medical, I had a first-aid certificate that was my whole knowledge of medical conditions. But this lady had alopecia. She also had Crohn's type symptoms and she was a mess. She was a young girl, very, very pretty and she had a high powered job. She has a little small velvety spot that she used to rub that she thought was quite cute, but the small spot spreads and slowly all the hair was just falling out. And her consultant said to her that there were some very pretty scarfs out there these days, she was in her early twenties she was horrified. She lost her eyebrows and her eyelashes, and she said that she'd lost her whole identity. She'd look in the mirror, and she'd gone, she wasn't there. And she thought everything she had was probably autoimmune, she found LDN and started it, and slowly her hair came back. Can you believe her hair came back? 

Dr Jess Armine: I believe anything you tell me 

Linda Elsegood: And, her hair came back black and white or black and grey mottled, even though she was young. People thought she'd had this really expensive colour job done on her hair, and she thought it was quite trendy, and left it as it was. It didn't come back the same texture. It was finer, more like baby hair but she had a full head of hair.

Dr Jess Armine: as you have with chemotherapy, it comes back 

Linda Elsegood: But she got her hair back and to her, that was just absolutely life-changing.

Dr Jess Armine: It sounds to me that if you have a chronic illness, especially in the immunological range, like autoimmune or whatever, LDN sounds like it might be worth a try. What are the risks, benefit factors? Are there any risks using LDN? 

Linda Elsegood: As I say, it was only found harmful if you took 300 milligrams a day of Naltrexone. So it's a safe drug. 

Dr Jess Armine: In low dose. 

Linda Elsegood: Yes. It's not toxic. And it's, of course, it's very inexpensive. People in the States pay around about $26 a month. It's not an expensive drug, but it's out of patent. So. drug companies are not interested in trialing it because there's no profit. But there is a company set up now called TNI  biotech, and they're planning some trials and studies to get LDN out there, and they have promised that LDN would never be more than a dollar a day.

Dr Jess Armine: Wow that's pretty amazing for anybody in the pharmaceutical industry to even say. Here in America, the more, the better. Yeah. More money they can charge for it, the better. 

Linda Elsegood: And we have a new medical advisor called Dr Pradeep Chopra, and he's from Rhode Island. Amazing man he's a pain specialist who uses LDN. You can listen to the interviews on the LDN research trust video channel. Very amazing. 

Dr Jess Armine: I was saying you were very kind to send me a bunch of links that we'll be putting on my website. Is that link included in there?

Linda Elsegood: It should be, he has patients come to him, he's usually the last in the line—people with fibromyalgia, neuropathy, regional pain syndrome. People that have been on morphine and fentanyl patches and that pain is still in between a nine and a ten every day. These are people that have to cope with such bad pain, and there's nothing, and a narcotic. 

He was told that they weren't working anyway, so he weaned them off, which is quite a complex thing. And nobody should ever stop taking any painkillers without medical supervision.

So he got them off these medications and started them on LDN, and he said to me, they came back and the feedback he got was that the pain was bearable. It was still there, but it was bearable, or it had reduced from what it was and for some, it hadn't gone. So he wanted to know whether it was a placebo, so he told these people that he was going to stop the LDN.

So he would know whether it was actually the LDN or mind over matter. So he said to them, okay, you've been on LDN now for this many weeks. Um, I'd like you to stop taking it. And he said, without exception, every single one said, you're not stopping. The LDN is the only thing that's ever worked for me. And he's done one small pilot study on, um, LDN, which he presented.

At the LDN conference in Chicago, he spoke and it was absolutely amazing that something so minuscule can have a better effect for these people than they were having with morphine? Absolutely unbelievable. And I had one doctor I met, and unfortunately, both he and his wife and daughter had MS, and he wanted them to try LDN, he was also a diabetic and had neuropathy. He had no feeling any toes, apart from pain which was awful, he tried LDN. And I think he said in 30 years, the pain that he'd experienced had virtually gone. It was no longer a problem for him. And that was the first time that I'd actually spoken to somebody. This was in around about 2008.

I didn't finish completing my story the numbness and pins and needles went, vertigo went, the balance problems went. I had my bowel and bladder control back. Cognitive, things cleared,  my eyesight is not as good as it was, but it's, it's okay. The hearing in my left ear is back probably 75% of the time, and it's amazing. I can achieve things. I know I've got MS. I'm not back to how I used to be, but if I plan things and pace myself. I can do anything, which is amazing. 

Dr Jess Armine: having a life, isn't it? 

Linda Elsegood: It is called having a life, 

Dr Jess Armine: And, I am so impressed I really am. You got tears in my eyes, right. 

Linda Elsegood: I set up the charity in such a way that nobody would ever get paid. So I work without any pay. But my payment is when people get LDN who's found it very difficult and they've been on it for a while, and they come back and say, thank you so much I feel like me again, or I feel I've been given a second chance, or I feel I've been given my life back. That is just so rewarding.

Dr Jess Armine: Absolutely. If your suffering was to have any meaning, that you've taken that suffering and served your fellow human beings is in this particular and, very expensive manner. You know, I always tell people, when I meet people like you, as I always say, that God has a special place roped off in heaven for you guys. You know, because it's true. 

Uh, I know the questions are going to be, excuse me. Is this a prescribed drug? Does it need to be prescribed by a medical person?

Linda Elsegood: Yes, it's a prescription-only drug.

Dr Jess Armine: Is there a listing of physicians that people can access, whether it's in the UK or United States or Canada? Is there a listing of physicians who are willing to work with people with LDN?

Linda Elsegood: Yes, some don't mind having that information out there, others chooses to operate under the radar. I do have a list ,and if anybody is interested and would like to find an a doctor in their area, if they email me - contact@ldnresearchtrust.org - I'm more than willing to help anybody wherever they live, to find a doctor. 

Dr Jess Armine: And I will, I will put that on during the show and I will have it on my website. It doesn't sound like it's expensive. It sounds like the risk-benefit factor is very low. It sounds like it handles the inflammatory portion of many, many different conditions, which a beautiful thing. There is an indication in what I've read, that there are conferences coming up tell us a little bit about that.

Linda Elsegood: We had one, as I referred to, earlier last year in Chicago, and for your listeners, if they would like to watch the whole conference in separate parts from each speaker, there are 12 parts, if they put in the search bar https://ldnresearchtrust.org/content/ldn-2013-conference

(Note: previously the LDN 2013 Conference was behind a paywall; it now is not.)

Dr Jess Armine: that's reasonable about how much is it? 

Linda Elsegood: It should be $40, but if they put in the code, Jess2014 They will get 25% off, so it will cost $30 instead of the 40

Dr Jess Armine: Thank you so much. You know that's going to be, a beautiful thing for people to listen to, and that's a reasonable price. And like you said, it's to cover costs. 

Linda Elsegood: Yes. We have Dr Pradeep Chopra talking about pain. We have. Dr Jill Smith. If anybody knows anything about the Crohn's, she's done Crohn's research, absolutely amazing work, where she's done an endoscopy and seeing what people's intestines are like. Crohn's is also absolutely awful. Five months later, absolutely clear, like the back of somebody's throat. We had Dr Deanna Wyndham from the Whitaker Wellness Center and she explained she herself had lupus, systemic lupus. She would have died if it hadn't been for LDN. But she uses it in her practice for many different autoimmune conditions, and with children as well.

And I forgot to say, LDN is also used for autism, and can be given in a cream applied to the skin, and that works really well. Dr Jacqueline McCandless did some studies with LDN for autism. She and her husband also did studies for HIV in Mali, which is also a very exciting project that was happening there.

Anyway, the survey should tell you that. So last year, the conference was very good. We had talked about cancer etc, and the air was electric. You could actually feel it crackle. It was a nice thing. And we have another one this year. It's going to be in Las Vegas, and be held over two days next time because we have so many great speakers.

Dr Jess Armine: There's a conference in Las Vegas.

Linda Elsegood: It's going to be November, and it will be the seventh and eighth, which is going to be a Friday and a Saturday. 

Dr Jess Armine: I'm going to do my best to come. 

Linda Elsegood: That would be a nice thing to have you join us.

Dr Jess Armine: Would be great to meet your guys. That is wonderful. So we have just a few minutes left. Believe it or not, the hour went rather quickly, didn't it?

Linda Elsegood: I told you I could talk!

Dr Jess Armine: No, it's good. You were worried about being able to cover stuff, and I said, no, no, no you'll just do it. Okay. Do you have any parting words, anything that you'd like to give as advice to someone out there who may have a chronic problem? How should they go about investigating whether LDN maybe a possible treatment; how should they approach their healthcare practitioner ,and so forth?

Linda Elsegood: Well, we have a doctor's information pack that we always say to people, print it off, take it to your doctor, they need to research it. I mean, there are some doctors that now have heard of LDN.

I think it's a case of if they specialize in a condition, like fibromyalgia or something. The patients are educating the doctors. You know, like you're the sixth person that's asked me for LDN, and they eventually look into it. But I would always say to people, don't take my word for it. Don't take anybody else's word for it. Do your own research. Read up as much as you can and find out if it's something that you think is right for you.

Dr Jess Armine: I want to reiterate the fact that this is a grassroots movement, the patients telling the doctors what they want; and what is that the doctors should learn is catching on. Let me tell you something. I have a lot of physicians who I mentor right now. It's because their patients have been arguing with them saying, you have to know this stuff. I'm getting better because of what Dr so-and-so is doing because he understands X, X, and X. How come you don't?

Six months ago, that doctor would have just said, that's not important. And then they learned that it was good. Doctors will look to train, other doctors will continue to ignore it, and you know, poopoo it away. In which case you change doctors, because let's face it, especially in most of the areas of the country, especially here in Philadelphia, they're not the only game in town. You deserve to be treated well and with respect and with knowledge, and you should demand that your doctors do the appropriate training. Okay? And this is how you bring them the information. Okay.

Such organizations like Linda's. Are invaluable because guess what? Now you have ammunition. Now you have information to say, Hey, this might work. Okay, there's no risk. There's only benefit. Let's try it. And if it's helping me, great. If not, you know, no harm, no foul.

Linda Elsegood: And I think people should try something sooner rather than later,  I've stabilized, and prior to that, I was deteriorating rapidly. It's a progressive disease, but it has halted the disease since I have now been on LDN. It was ten years on the 3rd of December last year. And honestly, I have had no progression since that time.. And I'm touching wood here.

Dr Jess Armine: And the bottom line truly is, if this particular substance gets you to a certain plateau point, and even if you had to take it every day as you said, it's about a dollar a day as opposed to some neuropsychiatric medicines that are better thousand dollars a month.

Okay. So. Again, even if it isn't the total answer and you have a chronic condition that can not be cured, it can be managed, it can be managed more effectively, and you can have a life rather than an existence  Linda, I want to thank you so much for being on our show tonight and sharing your knowledge and sharing your story, sharing your struggles.

You've given me several email addresses and links which will appear on my website. I can tell you that, giving of yourself in this manner, you're going to be helping hundreds and thousands of more people because this will spread the awareness of LDN. I learned a lot from myself tonight. I just want to take the time to thank you for your story. Thank you for you and thank you for all your hard work. 

Linda Elsegood: Thank you. It was my pleasure. 

Dr Jess Armine: Take care. We'll talk to you soon. 

Linda Elsegood: Thank you. Bye. Bye.

Dr Tom O’Bryan, LDN Radio Show 27 Sept 2017 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr Tom O'Bryan shares his Low Dose Naltrexone (LDN) experience on the LDN Radio Show with Linda Elsegood.

Dr Tom O’Bryan discusses his book, The Autoimmune Fix. Expect continual OMGs.The prevalance of autoimmune disease is the #3 cause of getting sick and dying in the world. Autoimmune diseases progress over years, till enough tissue is damaged that enough symptoms appear to get a diagnosis. For example, a very early sign of Parkinson's is loss of sense of smell, and can be predictive of death within 5 years.

Measuring our antibodies can predict illness in its early stages. Antibodies cause cellular damage, then tissue damage, then inflammation, and eventually organ damage. 

Getting this in control early is important. Most of us are bombarded with toxins every day, so learning how to avoid them is crucial to a good healthy life. LDN is helpful in bolstering and regulating our immune system so that it can naturally fight off these elevated antibodies.

This interview includes some valuable knowledge for all listeners concerned with how to combat autoimmune diseases, cancers etc.

This is a summary of Dr Tom O’Bryan’s interview. Please listen to the rest of Dr O’Bryan’s story by clicking on the video above.

Pharmacist Sahar Swidan, LDN Radio Show 2016 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr Sahar Swidan shares her Low Dose Naltrexone (LDN) experience on the LDN Radio Show with Linda Elsegood.

Dr Sahar Swidan has had a busy career, traveling extensively to educate while running her own Compounding Pharmacy. She has witnessed many successes with the use of Low Dose Naltrexone (LDN) and also ultra-Low Dose Naltrexone. 

She is a humanitarian and is writing a book on opioid-free pain medicine in an effort to educate more people on the many other optional treatments. Many experts will add chapters.

In this interview she provides an interesting insight into pain management and how LDN can be used in its treatment.

This is a summary of Dr Sahar Swidan’s interview. Please listen to the rest of Dr Swidan’s story by clicking on the video above.

Dr Ronald Hoffman Interviews Linda Elsegood on LDN and The LDN Book (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood shares her Multiple Sclerosis (MS) and Low Dose Naltrexone (LDN) Story on the Intelligent Medicine Podcast with Donald Hoffman.

In 1969 at the age of 13, Linda had glandular fever (Epstein-Barr virus). She was seriously ill and away from school for six months. 

Late 1999 Linda’s mother had a serious heart attack and the trauma affected her badly. She was working full time, travelling two and a half hours every day and running the home. This excessive workload and stress began to take its toll on her health, and by May 2000 she had lost her balance, lost feeling in the left side of her face and her head, tongue and nose were numb with pins and needles.

In early December 2003 Linda started Low Dose Naltrexone (LDN), and the results were incredibly positive. By Christmas Linda was functioning again, and her liver tests were back to normal. She felt like herself again.

Linda founded the LDN Research Trust in May 2004. In this interview she says that it is the most exciting thing she has ever done. She is able to give many hours a week to the Trust, helping people to get LDN and trying to get it into clinical trials.

This is a summary of Linda Elsegood’s interview. Please listen to the rest of Linda’s story by clicking on the video above.

Dr Rajka Milanovic Galbraith, LDN Radio Show 16 Aug 2017 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr Rajka shares her Low Dose Naltrexone (LDN) experience on the LDN Radio Show with Linda Elsegood. 

Dr. Rajka is trained in functional medicine and specializes in nutrition and realises that most illnesses stem from inflammation throughout our systems. Her pathway into this career was inspired by her own pediatrician from a young age, instilling a desire to help others.

She herself has Hashimoto's and went gluten, dairy, and sugar free in order to heal herself. Many causes of inflammation begin in the gut and can be corrected with healthy eating habits and lifestyle changes. 

Dr Rajka describes her 8 point list of triggers for that inflammation and how to alleviate them. She prescribes Low Dose Naltrexone (LDN) as an adjunct to her other treatments with positive results. 

This is a summary of Dr Rajka’s interview. Please listen to the rest of Dr Rajka’s story by clicking on the video above.

Dr Pat Crowley, LDN Radio Show 18 Dec 2016 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr Pat Crowley shares his Low Dose Naltrexone (LDN) experience on the LDN Radio Show with Linda Elsegood.

Dr Pat Crowley is a retired GP from Kilkenny in Ireland, and he's been prescribing Low Dose Naltrexone (LDN) since 2004. He graduated from a university college in Dublin in 1968 and went on to have an extensive 40-year career in the pharmaceutical industry.

Throughout his career he has noticed the incredible benefits LDN has had to offer for not only his autoimmune patients, but also many cancer patients. Additionally, there has been instances which Dr Crowley has noticed where LDN has been effective in treating addictions such as Alcoholism.

This is a summary of Dr Pat Crowley’s interview. Please listen to the rest of Dr Crowley’s story by clicking on the video.

Pharmacist Neema Yazdanpanah, LDN Radio Show 07 July 2017 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr Neema Yazdanpanah shares his Low Dose Naltrexone (LDN) experience on the LDN Radio Show with Linda Elsegood.

Dr Neema Yazdanpanah has been a compounding Pharmacist for only a year, but is very knowledgeable and extremely enthusiastic about the effectiveness of Low Dose Naltrexone. He has done extensive study of LDN because it has been helpful to his patients with numerous autoimmune conditions. 

He did a survey of 62 patients for 3 months regarding side effects, effectiveness, and satisfaction of taking LDN. The average score was 9.12 on a 1-10 scale on effectiveness. Only 18% experienced minimal side effects which subsided after a week or two. This survey will be available on the LDN Research Trust site soon.

This is a summary of Dr Neema Yazdanpanah’s interview. Please listen to the rest of Dr Yazdanpanah’s story by clicking on the video above.

Dr Kathleen MacIsaac, LDN Radio Show 2016 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr. Kathleen MacIsaac is from Florida in the United States. She first heard about LDN around 2006 while researching a different topic. It made sense biochemically, so she started using LDN in her patients, to treat fibromyalgia, chronic pain, migraine, and insomnia. She noted great response in reduction in pain and increased quality of sleep in fibromyalgia patients. More recently she is using LDN for Hashimoto’s thyroiditis; and chronic neurologic disorders including MS (multiple sclerosis), ALS (amyotrophic lateral sclerosis), and PLS (progressive lateral sclerosis). While the neurologic issues haven’t had complete resolution, the patients’ quality of life has improved, and there has been improvement in coordination, articulation, and swallowing. She has a pediatric patient on LDN for autism.

Less than 10 of her patients stopped using LDN, because they didn't notice any improvement or because they did not like a side effect, such as vivid dreams, or nausea, or some GI side effect. Those patients tended to start with milder conditions, thus less motivation to work through the side effects than ones with more debilitating conditions. There is a gap of time it takes to adapt. Most recently Dr. MacIsaac will start very low and progress upwards in dose slowly. Rather than a common titration like LDN 1.5 mg, then 3.0 mg, then 4.5 mg, she has the compounding pharmacy prepare a suspension so patients can titrate up by 0.5 mg over a longer period of time. Some patients remain on very low doses of less than a milligram, and she found it interesting that that small amount is adequate.

Linda Elsegood commented on various approaches she is aware of to lower the dropout rate for LDN, such as starting very low doses, taking LDN in the morning if there are sleep issues, and sublingual drops that are absorbed and bypass the stomach for patients with GI problems.

Dr. MacIsaac has 3 recent patients using daytime dosing of LDN for smoking and alcohol dependency issues, and it’s as if LDN doctors the brain to have less craving for nicotine or alcohol. It’s a new method of treatment for Dr. MacIsaac, and she is pursuing it further.

Linda Elsegood added that LDN is being used to treat OCD, and PMS; and Dr. Phil Boyle uses LDN in treating infertility and other gynecologic issues. Linda is aware of at least one woman whose PCOS (polycystic ovary syndrome) was improved on LDN. Linda relates that she herself had many issues with endometriosis from age 11, and a surprise added benefit when she began LDN for her MS, was her endometriosis issues cleared up. Dr. MacIsaac has found the LDN Research Trust website to be a good resource, and is learning a lot more about LDN.

Dr. MacIsaac’s practice is Healing Alternatives in Orlando Florida, and the website is http://www.healingalternativesinc.com/. The office phone is 407-682-711.

Summary from Dr. Kathleen MacIsaac, listen to the video for the show.

Keywords: LDN, low dose naltrexone, fibromyalgia, chronic pain, migraine, insomnia, Hashimoto’s, multiple sclerosis, MS, ALS, amyotrophic lateral sclerosis, PLS, progressive lateral sclerosis, autism, compounding pharmacy, alcohol, smoking, nicotine, infertility, endometriosis, OCD, PMS,  PCOS, polycystic ovary syndrome