LDN Video Interviews and Presentations

What the Bleep Can I Eat?! Making Sense of Conflicting Autoimmune Diets (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Improve gut microbiobes to heal leaky guts, to prevent or halt autoimmunity. Help low dose naltrexone (LDN) via adequate Vitamin D, good nutrition. Difficulty adhering to diets being studied, resulting in practical strategies.

Laura Dankof, MSN, ARNP, FNP-C 26th June 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today, my guest is Laura Dankoff, who is a functional medicine nurse practitioner, speaker, and author. She has her own practice, which is a path to health and healing. Thank you for joining us today, 

FNP Laura Dankof: Linda, thanks for having me on. I'm looking forward to this. 

Linda Elsegood: Now, we interviewed you about three years ago, and as you well know, so much can change in a period of three years. What has been happening in your practice? 

FNP Laura Dankof: Well, I've noticed in my practice over the last three to five years, that the interest and number of people seeking out LDN as a treatment option has increased. And that's certainly been mostly due to word of mouth, but also some people have actually found me through your website as well.

Many have travelled to meet with me to determine if LDN is an option for them, as they are really frustrated with their healthcare. Sometimes they are not getting answers, or perhaps feel that there's another path that they could be exploring, and they're wondering if low dose Naltrexone is an option for them. 

Linda Elsegood: And we didn't say where your practice is did we?

FNP Laura Dankof:   That is correct. My practice is located in a little town called Westcliffe, Colorado. I used to practice in Iowa for several years in internal medicine, and so I still am licensed both in Iowa and in Colorado. And, I offer virtual and in-person appointments. 

Linda Elsegood: Oh, that's very interesting. All right, so then what would you say your patient population consists of?

FNP Laura Dankof: My patient population is a lot of people with autoimmune disease, digestive issues, hormone issues---et ceteria. Quite frankly, they're generally people who have already been through the conventional healthcare system with a traditional workup, and either has been handed a laundry list of medications or been told that there is nothing wrong with them, and there's nothing that can be done.

And they, of course, are looking for answers. They don't want to settle for that conventional diagnosis and treatment. They want to figure out, with functional medicine, what the root cause is that is preventing them from feeling well. And so, this is where we start to look at lifestyle and what's happened along their life timeline.

And in the process of that, particularly people with autoimmune conditions, such as Hashimoto’s, and other conditions such as fibromyalgia, chronic fatigue, and even severe depression, people have come to me wondering if LDN would be something that could help them.  And a lot of times I also learn from my patients, and so will look to find what research is available out there and to determine that there is no contraindication, say, for example, them being on narcotics.

Then I would tell them, it's not going to hurt us to try LDN, to see if it helps you. 

That certainly has been true with a couple of cases of severe depression that came to me.  I had never really used it in that way, and so that was one of LDNs use that kind of surprised me, that it did seem to help anecdotally, just from my experience with these patients.

 With one patient Debbie, LDN did seem to help some with her depression.  I used it in one patient with Lyme disease, a lot of cases of Hashimoto's, where we looked at and monitored their antibodies, along with other things, that can certainly contribute to Hashimoto's. You need to look at gut health, hormone balance, detoxification pathways, and a lot of other things.

So it's just not using. Low Dose Naltrexone alone. You certainly want to look at all these other things, and for people that have fibromyalgia and chronic fatigue, one of the things that I'm looking for is if they've had evidence in the past, of exposure to various viruses. That can be a possible indication of one of many contributing factors to their condition.

 For these patients, I may try anti-virials on them.  If that doesn't work, we move on to Low Dose Naltrexone, and for some, I do a phenomenal type of response to it, and I'm always amazed by this result.

Linda Elsegood: Well, it's interesting because there are so many people with autoimmune diseases that suffer from depression.

I always think if you took a healthy person who never had depression, and gave them all the symptoms and the quality of life that some of these people have, you're going to feel depressed by having to cope day after day with these symptoms. So for the people that are listening at home, who might be feeling hopeful that their depression can be helped, in several different ways, what is the first thing that you do if somebody comes to you suffering from depression? 

FNP Laura Dankof: So there are a few things that I'll do. First, I want to get an extensive history on them. Things like, does depression run in the family? What emotional or physical traumas have they had? What's their nutrition like?

Though many people do not know this, gut health is so important to our mental health. So if we don't have a healthy gut, we're not going to have a healthy brain. I may also do a few genetic tests on them looking for MTHFR, and other gene mutations and deficiencies.  The reason for this type of testing is that those mutations and deficiencies can play a role in how people process their nutrients, particularly like folate.  We need to take a really comprehensive look at things.

We also need to know what things have they previously tried that did not work.  And from that, you really need to take a thorough history from each patient and make sure you've ruled the possible contributing factors to their depression, and then decide the suitable treatment.  We need to know if they are using natural herbal remedies in combination with Low Dose Naltrexone, or in combination with their prescription medicine.

I would never just pull anybody off a prescription antidepressant if they are on one, but I may add Low Dose Naltrexone or other nutrients, and nutrients such as B12 and folate and things like that if needed to, but would cross that bridge at that time, and see if that's an opportunity to work in conjunction with those things.

I may be that they will be able to wean down to a lower dose or even off of these medications? So you basically just have to take an individualized approach in each case. 

Linda Elsegood: And how long would it take if somebody came to you that had been suffering from depression for quite a while, and we're currently not taking any medication, for you to do all the testing and begin implementing a treatment plan, such as herb's and supplements, LDN, whatever, before they could start to feel an improvement?

FNP Laura Dankof:  First, I would do the evaluation and workup, and then I’d certainly look at their hormones, gut health and test for the MTHFR gene.  Then after I get results, I will create a treatment plan based on my experience in the few cases of depression that I've had, and see if they maybe want to try that.  In my experience, patients see a difference within the first month of taking it.   Now, I know in some cases, with other conditions, you need to give them a longer time, but generally speaking, when I'm seeing them back in a month, they're starting to notice a difference. Well, then they're excited about it. 

Linda Elsegood: Yeah, I bet. You know, there are people that think if you start LDN, by the end of the first week, you're going to feel better. But anything takes time, doesn't it? And you have to be patient. What dose do you normally start your patients on?

FNP Laura Dankof: I will start them on anywhere from 1.25 to 2.5 milligrams of compounded LDN.  If a patient tells me that they're very sensitive to things I will adjust the dose.   I had one person one time that was concerned about that, and we started her a little bit lower. The maximum is usually around 4.5 milligrams.  I would say that the average range is 3 milligrams of LDN.  I maybe have a few higher, a few lower, but I'd say the majority seem to have best results in the 3-milligram range.

Linda Elsegood:  Oh Okay. And what age range are your patients? 

FNP Laura Dankof: Previously to starting the path to my health and healing practice, I was working in internal medicine. So I would see people generally age 18, you know, on up to the end of life. But I would say people that were generally seeking LDN and other treatments for their autoimmune would be anywhere from age 20 to the mid-fifties.

Linda Elsegood:  Oh okay. And what about now in your new practice, will you do any consultations for children? 

FNP Laura Dankof: Yes. I am trained as a functional medicine nurse practitioner and family nurse practitioner, so I can see the whole life span. So I do see some children as well.  

Linda Elsegood: And what's your experience with LDN in children?

FNP Laura Dankof: I have not used LDN on children yet. I'd say the youngest patient that I have used LDN on was around 17, and that was prior to starting my current practice. So I have not started any children on it in my practice as of yet, not I wouldn’t consider it.

Linda Elsegood: Exactly, that's what I was going to ask. If there was anybody there with a child, close to you, would you be able to do it for them?  So that's very good. Okay. So what about pain? Have you noticed LDN has been a good source of helping with pain? 

FNP Laura Dankof: Yes, it can be.  I would probably say that my greatest experience using it for pain, would it be in helping people with fibromyalgia and their pain symptoms? But certainly, as we know, we must not use somebody on a narcotic. I've had some people come in and asked me to prescribe it, and they were on a narcotic, and I said, well, you've got to be weaned off that first before we can start that. I don't want him to have any kind of withdrawal symptoms, so you just have to be careful about that.

But otherwise, I'd say my primary experience with chronic pain symptoms, is in patients with fibromyalgia.  

Linda Elsegood: And have you seen any people with skin conditions that you've used LDN on? 

FNP Laura Dankof: No, not that I can recall right now. I think I maybe had one gal that had idiopathic urticaria, which is an itchy skin condition. And what I would say there is that a lot of times when somebody comes in with a skin condition, I'm looking at their gut microbiome, and they may have small intestinal bacteria overgrowth.  I know LDN can potentially help in that way as well to help support the immune system, so I have prescribed it for that. So yes, if we're looking at skin conditions, a lot of times those conditions can relate back to a digestive condition so then we may use LDN in that way.   

Linda Elsegood: Yes, I mean, there were a lot of people who use LDN for psoriasis, with very good results, but that isn't a quick fix either.  I've had people tell me that their skin has stayed just as flaky and patchy for six months, and then they start to have fresh skin appearing, and all the scaly bits go, which is just totally amazing. But it is very hard if you've been taking LDN for months and you haven't seen any benefits. It must be hard to continue having faith that it's going to do something for you when you've been taking it long-term.

FNP Laura Dankof: Yes, and I would say that what I generally tell people is that I recommend they stick with it for six to nine months, to see if they begin to see some benefit if they aren't somebody that responds quickly. And I would say the majority of people; they do want to stick with it because they have kind of come up empty-handed from other directions.

And this is—an avenue of hope for them, to see if this is something that will help them. 

Linda Elsegood: Hmm. And it must be very satisfying to be a nurse practitioner where people have been to so many other doctors, nurses, whoever can prescribe for them and have come up with nothing. You know, to actually be able to help these patients, you must get quite a buzz from it.

FNP Laura Dankof: It's very rewarding and humbling as well. You know, as a functional practitioner; you really care about helping people. And of course, trying to get them the answers that they deserve and that they're looking for, I don't take that mission lightly at all.

And I try to do my best to try to help them in any way that I can, and as naturally as possible, to support their bodies in a healthy way.  Certainly, LDN is just one of the tools in my toolbox to do that, and I will forever be grateful to the first person that brought LDN to my awareness, who is no longer with us.

She was a woman with stage four breast cancer, who came to me asking me if I would prescribe it. At that time, this was many years ago, I didn't know anything about it. And I thought, well, I need to look more into this. And so, had it not been for her, I might not have ever known the benefits of LDN and what it can do, and to see how many people have benefited from it, 

Linda Elsegood:  It's really so rewarding to hear that you are able to listen to one of your patients. It’s “kudos to you” for listening to your patient. You know, there are so many doctors that are so busy. I'm sure patients always recommend different things they would like to try, but doctors don't always listen and act upon what the patient says, so that's really good. 

FNP Laura Dankof: Oh, thanks. I think 90% of figuring out what's going on with the patient is listening. If there's something we don't know about, that doesn't mean it's not true and doesn't have value, and it's up to us to hear them, and for us to look into what they're saying, and see if there is merit and value in what they're bringing.  This day and age, with the internet, people are searching everywhere, so it's up to us to try to figure out and decipher what is relevant or not. 

Linda Elsegood:  Yes. So here in England, the doctors have 10 minutes per patient, and that includes getting up from the waiting room, walking into the doctor's exam room, and coming out.  So if you've got somebody who has an autoimmune disease which has a myriad of different symptoms, what can the doctor actually achieve in 10 minutes?

I mean, 10 minutes is nothing, is it?

FNP Laura Dankof: Very little. That's why quite frankly, many of us that have worked in the conventional medical setting, know that the healthcare system is broken, and you cannot begin to figure out anything and listen to a patient in that amount of time. So it's like, what are your top symptoms, and how are we going to either run a lab or give you a medication in that short amount of time and out the door?

I've never. I've never practiced that way.  I've just kind of bucked the system a little bit, I guess, and kind of flew under the radar. And now, now that I have my own practice, as many functional practitioners do, I don't take insurance because it dictates too much of that. And it allows me to spend a lot more time with patients as well.

You know, my initial visit with a patient is going to be 90 minutes. And follow-ups, depending on the situation, could be 30 to 60 minutes or more. So, that's the beauty of having your own practice and don't take insurance. And that's why a lot of functional practitioners don't, because it dictates those very things about the volume of patients you need to be seen in a day.

Linda Elsegood: Well, that's pretty good. So you really work it out and give the patient the amount of time that you feel they need. 

FNP Laura Dankof: Absolutely, because I always worry if I don't give them the time to tell their story, what am I missing, and are we going to go down the right path with their healthcare if I don't hear their journey there?  You know, like what has happened to bring them to this point that they're sitting in front of me now.  And so it is important that I hear that because there are so many clues that help put the pieces of the puzzle together. 

Linda Elsegood: And how long of a waiting list do you have? 

FNP Laura Dankof: Currently people can get into my practice pretty quickly because I just started my virtual practice in the last six months. I had been working in internal medicine, large corporate healthcare system for many years prior to that. So right now, it’s pretty easy for people to get in to see me for a consultation. 

Linda Elsegood: Well, that's really exciting, isn't it? So, the telephone consultations that you give, if they need lab work done, how do you go about doing that?

FNP Laura Dankof: If they're in Iowa or Colorado where I'm licensed, we can either run it through Lab Corp with their insurance, or I use a discounted lab called Ulta Labs. The discounted lab charges a fraction of what patients would pay running their labs through LabCorp.  So, if you have a high insurance deductible, or it's not covered, you're better off going through a discount lab. And if they are in another state other than Iowa or Colorado, we can use Alto labs where they can do some testing. They can even order it themselves.  If they need a prescription for LDN, I have to see them face to face once a year, if they're in a state other than Iowa or Colorado where I'm currently licensed.   They certainly could come to see me face to face, even if they live in a different state.  Otherwise, I would be talking to them more in a consulting role, I could not diagnose them in another state.

Linda Elsegood: Well, that's really interesting. So would you like to give us all your details? 

FNP Laura Dankof: Yes, of course. If people want more information, they can find me at wwwdotpathtohealthandhealing.com that's “path to health and healing.com” and there you'll find more information. I write a health blog there. You can kind of read my story, and why I'm so passionate about taking a functional or natural medicine approach to healthcare, along with the different kinds of conditions that I treat, and how to schedule an appointment or contact me directly. 

Linda Elsegood: You've got me intrigued. Now tell us why did you go down the path of functional medicine? 

Laura Dankof: Okay. So for many people who go into functional medicine, there was a health crisis in them or a family member, and that was certainly true in my case.  I had a daughter born with a hereditary blood disorder.

And she was very sick when she was young.  She ultimately had her spleen and gallbladder removed, and they put her on antibiotics for an extended period of time, which then led to skin conditions, eczema and so forth. So, I took her off the antibiotics, against medical advice, because of what it was doing to her.

And we healed her gut, and healed her body, through natural medicine, because the answer conventional medicine wise was to give her steroids and immunomodulating agents that would have increased her risk for cancer. And it was just going down a very deep, dark rabbit hole with her at a very young age.

And then on myself, I had thyroid and hormone-related issues when I was in graduate school and did not want to go down that pathway either. And so I started really diving deeper into functional medicine throughout that whole journey with her and with myself.  

Linda Elsegood:  Wow. I’m sure all your patients are really pleased, not that you had those obstacles, but that you chose to become a functional medicine nurse practitioner. It has been absolutely amazing speaking with you today Laura and I hope you continue with your practice and success, and we wish you all the best.

FNP Laura Dankof:  Well, thank you very much, and I've enjoyed talking to you again Linda.

Linda Elsegood: Okay, thank you. 

FNP Laura Dankof: Thank you. 

Linda Elsegood: This show is sponsored by Mark Drugs, who specialize in the custom compounding of medications, assuring that the client gets the proper prescriptions for their unique needs and conditions. They work with practitioners, integrating knowledge and treatment of experts to create comprehensive health plans.

Visit Mark drugs.com or call Roselle (630)-529-3400. Or Deerfield (847)419-9898.

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

Dr. Anna Cabeca - 8th May 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr Anna Cabeca is a board-certified gynaecologist and obstetrician from Georgia in the United States. She trained at Emory University, Atlanta, Georgia, then went on to also be boarded in integrative medicine, as well as anti-ageing and regenerative medicine. She is a pioneer for women's health, to solve the problems that so many women suffer with as a part of hormone imbalance; to do it naturally, and to regain control of our health to the best of our ability.

As many women age, muscle flexibility decreases and fascia tightens, with the result of discomfort with intercourse. In 2000 Dr Cabeca started using low dose naltrexone (LDN) in topical form for such patients, and developed a formulation of LDN, arginine, and pentoxifylline, that she calls “Joy Gel”. The vasodilators in it improve blood flow, moisture, etc.  It is applied to the pelvic floor prior to intercourse; or on a daily basis for relief from pelvic pain syndromes, vulvodynia, vestibulitis. Joy Gel includes LDN 2.5 – 3.0 mg per 0.5 ml and is measured into a syringe. A large pea or dime-sized is about 0.5 ml.

Dr Cabeca also uses LDN in capsule form for clients with difficult insomnia, typically with a very slow titer-up to 4 mg; and those with Hashimoto’s, autoimmune diseases, or suffering from toxic mould syndromes.

At around age 38, Dr Cabeca underwent menopause, looked for answers, that reversed menopause completely, and she conceived at age 41. At age 48 she and her family underwent a traumatic incident, and despite being on hormones, she became menopausal again. At that point, she tried a ketogenic diet but had side effects. She studied and hypothesizes that as protective neurotransmitters decrease with age, eg estrogen and progesterone, the ketogenic approach is not complete.  In her book The Hormone Fix, she writes about the keto greenway and the greens; adding on the alkalinizers, the high micronutrient-rich micro foods, and microgreens, like broccoli sprouts, and alfalfa sprouts; and using kale, beet greens, chard; lots of deep dark, deep leafy greens. Using the best to get the body into ketosis, thus using ketones for fuel. And checking urine to get an alkaline urine pH. She has developed a test strip to urinary pH and ketones, to help understand what’s working and what’s not.

In the book is a 10-day quick-start detox, a 21-day menu plan, chapters on stress and vaginal health and hormones, and functional testing, and quizzes, and inventories to do. She has programs and menus on her website as well. Once stabilized, clients may be able to reduce the medications they take.

In The Hormone Fix, she notes that it’s insulin, cortisol, and oxytocin are the major hormones that give the quality of life. Stress reduces oxytocin, and depression follows; healing comes through nutrition (25%) and lifestyle (75%). The book has a chapter on stress, developed through personal experiences and traumas. When cortisol’s up with stress, it lowers oxytocin; and you get into a critical phase of low cortisol and low oxytocin - and that feels like burnout.

The Hormone Fix is available from Dr Cabeca’s website: https://book.thehormonefix.com/get-the-book and that link includes a bonus offer.  The book also is available wherever books are sold – Barnes & Noble, Books-A-Million, and others; and on Amazon, where it’s #1 in menopause.

Summary from Dr. Anna Cabeca’s LDN Radio Show from 08 May 2019. Listen to the video for the show.

Keywords: LDN, low dose naltrexone, vulvodynia, vestibulitis, hormone, insomnia, Hashimoto’s, autoimmune, toxic mould, ketogenic diet, The Hormone Fix, insulin, cortisol, oxytocin

Dr Pamela Smith, MD - 6th March 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: I'm joined by Dr Pamela Smith, who is an MD from Michigan. Pamela has written ten books, and she has just released the 10th book, and the 11th book is going to be coming out next year. Thank you for joining us today  Pamela could you tell us about your new book that has just come out?

Pamela: Absolutely, and thank you so much for inviting me on the program. My new book is called "What you must know about vitamins, minerals, herbs, and more". And it really is an anthology of looking at all of these kinds of nutrients. And the whole idea is choosing the right nutrients that are right for you.

We have different sections of the book. We have vitamins as the first part of the book. So we do look at vitamins A, D, E, K, etcetera. We have a section on minerals, one on fatty acids, one on amino acids. We have section number five, which is on herbal therapies. 

Section six of the book I loving call it "other nutrients" because it covers things like Coq10.

Alpha-lipoic acid, probiotics and other things that really don't fall into a traditional category. And then part two of the book is on a health concern, meaning we actually go through different disease processes like hypothyroidism, low thyroid function: hair loss, insomnia, dry eyes, all these different things.

And we make suggestions from the medical literature: which nutrients work better for those clinical conditions.  

Linda Elsegood: So, do you test people of their minerals and vitamin levels, or do you, increase vitamins anyway for certain conditions? How does it work? 

Pamela: Well, basically, that's an excellent question.

You can do many things. You can measure 28 vitamins in someone's body. There's a test called the nutrient testing available worldwide, where literally you can measure all of those levels. You can go by eight. As long as people have normal kidney and liver function, for example, starting at the age of 50, most people make less of some of their vitamin sources.

They make less coenzyme Q10, less lipoic acid, et cetera. So you can make some generalities as well.

Linda Elsegood: Okay. So, once you decide which path you're going to take to treat a patient, what is the next step? Do you titrate them up or do you work out what would be the appropriate dose?

Pamela: Oh, my favourite way is obviously the measure.

I'm a physician. I'm a scientist. We'd like measuring people. So for example, if you measure vitamin D, vitamin D is a fat-soluble vitamin. That one should always be measured because vitamin D you can get toxic in. So we try and measure that, but we want the patient to have optimal levels and not just normal. Vitamin D is so, so, so important.

But the question is: What does perfect mean? So, when you look at vitamin D in American units, which are what is used most commonly internationally when you look at vitamin D, you want the revenue to be 55 to 80.  44 is normal, but it's not optimal. So you want that patient literally to have perfect levels because then vitamin D decreases the risk of developing breast cancer, colon cancer, Parkinson's, ms diabetes, high blood pressure, and really a number of different disease processes if you get the right amount of vitamin D. I mean, we can go through and talk about each vitamin. It is so important to have vitamin K adequate bone mineralization, so you don't get bone loss. It's very important for heart health.

It's very important for blood clotting, and so each different nutrient plays a very important role in the body. 

Linda Elsegood: You mentioned probiotics. Now I've had so many doctors tell me that when I've asked what are the top four nutrients, vitamin supplements that you would always rate highly and probiotics. It's usually maybe number one and in your book, you said that you're talking about probiotics. It's a bit of a nightmare, isn't it?  When I was looking to find out, which was the best for your money because you can pay a ridiculously high amount of money for a very good brand where you may be paying for the name as well.

But how do you assess when you are looking to buy a probiotic, which is the best one that you should be taking? How do you navigate your way around that?

Pamela: That's an extremely good question because first of all, new literature is showing for most people, not all, but the general population, we probably should rotate probiotics.  May mean that they shouldn't take them all the time, the same one. So for most people, take one really good for six months. Then the next six months alternate into another one. A good doctor has prescribed a particularly probiotic for you. Otherwise, for the general population, it's good to rotate them. Most of the really good probiotics do require refrigeration, and so we do keep them in the fridge.

I usually like to take my probiotics separately, so they're not taken with other things because sometimes nutrients interfere with that. So it's nice just to take them by themselves. 

Linda Elsegood: Okay. I didn't know that. And how do you go by the different strains. What we should be looking for?

Pamela: Well, you want a good general probiotic so that it carries a number of different things, and you also want something that's what's called pharmaceutical grade.

Nutrients come in different grades, and pharmaceutical grade means two things. Number one, it means that it's bioavailable meaning it gets into the body and does what it's supposed to do. And it is also, pharmaceutical-grade means that it's guaranteed to be 100% sure with outside verification. When you look at the idea of probiotics, you want a well-mixed probiotic for overall health because probiotics improved digestion. They help the immune system function as well, your gut, your GI tract.  70% of the immune systems is right in the gut. So the gut has to have that good bacteria and also people don't think about it, but probiotics help manufacture biotin, folic acid and niacin so that they're all in the right amounts.

So, if you asked me: Are there three things I suggest for every single patient in the world? There are.  Anybody who's an adult:

1. a probiotic

2. a multivitamin, and then 

3., it may be somewhat variable with people and depending on where they live, most people do need additional vitamin D, unless they're out sunbathing.

Okay? But the third one that everybody else needs otherwise is Omega fatty acids, otherwise known as fish oil. Most people don't get enough Omega 3's. So, I do take two fish oil tablets a day, every day, because I don't eat fish every day so it gives you really good fats.

Linda Elsegood: And there are so many people, patients, that I speak to who will tell me that they have a very good balanced diet. They don't need to supplement it at all. But as you were saying that once you reach 50, your body is lacking in certain vitamins, minerals, supplements, and is this something that you discuss in the book?

Pamela: Absolutely. It is something I discuss in the book. We look at things on what happens with age. Absolutely. There are also interesting things that happen when you combine food with medications. For example, grapefruit. I discussed this in the book. Grapefruit increases caffeine levels, and so, some people, if they eat grapefruit and they drink a cup of coffee, they're going to get nervous.

Great food also can increase the levels of different medicine like warfarin, which is a blood thinner. In fact, there's even a trial showing the grapefruit can cause hives if taken with Naprosyn, which is a nonsteroidal drug. So interestingly, even foods can have an effect on what happens in the body. And we do discuss all of this in the book.

There's a whole chapter looking at mixing supplements, drugs, and food. 

Linda Elsegood: Hmm. Well, I was mixing my probiotic with yoghurt. Is that allowed or not?

Pamela:  You should be taking it by themselves? 

Linda Elsegood: That's interesting. Very interesting. So what else do we learn in the book?

Pamela: Well in the book you're probably going to be surprised to realize that most people cannot eat their way into health. Believe it or not, in today's world, because things get genetically engineered, and we don't always replenish the ground with nutrients, almost everybody does need to take a least a multivitamin.

People tend to be surprised about that. Other things that people tend to be surprised about, and they look in the book, but there are actually many medical trials showing that if you look under health conditions, there are studies showing ways that we can all look at things to prevent cancer. There are studies showing that Chlorella taking a teaspoon a day decreases the risk of developing cancer. Not eating a lot of sugar decreases the risk of developing cancer, eating too many bad fats and salt—just some common sense things. And then again, a lot of it depends on what you're interested in. So, for example, if you're interested in the prevention of cataracts, then, believe it or not, there are medical trials showing that alpha-lipoic acid, B vitamins, bilberry, carnosine, which is an amino acid, N-acetylcysteine, glutathione, your basic vitamins,  Selenium. Those things help prevent cataracts, so a lot of it is prevention as well. It's always best to prevent the disease.

Linda Elsegood: Absolutely. You mentioned multivitamins there. And again, it's a bit like the probiotics. There are millions of different multivitamins, you know? Where do you start? What is a good multivitamin? What should you be looking for?

Pamela: You always want to look for pharmaceutical grade and a broad spectrum. And those are the two things you look for, and the trouble is that you usually if you're in my age group and you're over 60 you will only usually end up with a multivitamin where you have to take a number of them.

It's not like when you're 20, and you may just take two multivitamins in a day, that's enough. I really do have to take a number of them because you want to prevent disease and treat things. I have high triglycerides so I personally take Omega 3 fatty acids, which many studies have shown help lower triglycerides.

So, you know, my goal is that I may still have a heart attack because I inherited high triglycerides from my dad, but I'd like to be 95 when I had that heart attack and not my current age of 64. It's also important to have nutrients to keep the body going well. So, for example, the thyroid gland has to have enough iodine.

So if you'll never,  ever eat any fish, then you probably want to see your healthcare provider, have your iodine levels measured and see if you need iodine. If you're not eating your way into it.

Linda Elsegood: Oh, that's interesting.

Pamela: I think a fascinating one in the book has to do with high cholesterol. Everybody thinks high cholesterol is, I ate too much, this, that, and the other. Of course, it can be, but people don't realize that high cholesterol can be due to buy it to the deficiency.

Biotin is made in your gut. So if you've got reflux, IBS, GERD, all those things you've got, it's not healthy. You're not going to make enough biotin. You have to have carnitine. You have to have some of these nutrients in order to lower cholesterol, including vitamin C. So there's nutritional things that are important for the body but I think sometimes people don't realize So that's part of the reason why I wrote the book. I want people to have a good idea of vitamins, minerals, herbs, and more. More of a personalized approach to them, and it's called a concise guide to better health and longevity and that's what we want people to be, as healthy as they can be.

Linda Elsegood: Well, that's interesting that you talked about high cholesterol. I suffered for many years with acid reflux. My mother had a heart attack in 2000. Well, Christmas 1999, just before the New Year, and she had what they called hereditary high cholesterol, and they wanted to check me and my two daughters.  My cholesterol level was so high that I could have had a heart attack or a stroke at any time.

My eldest daughter's cholesterol level was fine. My youngest one was borderline, so they put me on a statin, and I had to see a consultant. And I said to her: " I would rather not take anything.  Ultimate diet Is something I can do so I don't have to take this statin?

And she said: "If you were to live on a glass of water and a lettuce leaf, you would still have high cholesterol." 

Pamela: Exactly. You have inherited that pattern. That is correct. 

Linda Elsegood: So I altered my diet. I have to say,  listening to doctors, Tom O'Brien. I'd stopped eating gluten and literally in days of stopping the gluten, the acid reflux stopped, and I was able to stop taking the anti-acid tablets. So that was amazing. So that's not a problem. But would I still be able to reduce that level of cholesterol naturally, or even if I have to still take the statin,  I don't care, but I would like to try and bring it down. So because the doctor had said to me, as I get older, I might have to increase the amount of starting I take, and if I can do something new and I'm 62,  I may not have to take a higher dose. Do you see what I'm trying to say? 

Pamela: I can absolutely see what you're saying. The goal is that you take the right dose of a statin drug and so side effects do go up with any drug.

The higher the dose you take. So number one, anybody taking a statin drug, they get deplete on important nutrients. Coenzyme Q 10. So they need Coq10 if you're on a Statin drug. So for you, for example, you're over the age of 50, so you need a 100 mg of CoQ10 and another 100 mg because of the Statin drug.

Are there other ways that come over cholesterol? There are pages and pages in my book. My personal favourite is bilberry. I absolutely love bilberry. Bilberry, 200 mg, twice a day is a great place to start. You can go all the way up to 500 mg,  3 times a day. Very effective to lower cholesterol, even coenzyme Q 10. Gugulipid. People may not be familiar with that one.

It's G. U. G. U. L. I. P. I. D. 50 mg,  twice a day, lowers cholesterol. Policosanol works very well for those out there. If you haven't heard of that one, it's P, O, L, I, C, O, S, A, N, O, L, 20 mg,  once a day or 10 mg, twice a day. Another one of my favourites is tocotrienols. It has a special kind of vitamin E, 400 to 800 international units a day. Very good to lower cholesterol. So, all of these can be very effective, and most of them do mix with a statin drug. Not all, but many of them do. 

Linda Elsegood: It is like a foreign language or hasn't heard of these.

Do you have to take all of those or just one or a combination? 

Pamela: For most people, I suggest starting, like for you, for example, you're on the statin drug, make sure you are on Coq10,  start a little bilberry, 200 mg,  twice a day. As long as you have normal kidney and liver function, that would be great.

Linda Elsegood: okay. Wow. This is really educational, isn't it? And it's all in the book. So people who are listening to this can follow your recommendations, and I'm sure they would get a really good idea of the guidelines of what you're suggesting now. 

Pamela: Absolutely. They'll have all of us in the book and more.

I mean, we didn't talk about amino acids. The body produces amino acids, eat your way into some of the amino acids. They're very important for memory and energy. So yes, we hope everybody picks up a copy of what you must know about vitamins, minerals, and more because there's a lot in here and it's written in bullet style format so that it's easy to read.

Linda Elsegood: Well, that's good because if you see chapters and chapters of text It's hard going, isn't it? But you can pick it up and put it down easily if it's in bullet points and it's easier to remember, I think as well. 

Pamela: I do too. I think people learn in bullet style format now because of computer systems. So it does make it easier.

Linda Elsegood: As we said, this will be the 10th book you've written. What other books have you written? What have they been about? 

Pamela: Well, I've written two books on hormones. My most recent is: " What you must know about female hormones". Let you know about women's hormones. Has done very popular.

Probably my most popular book is: " What you must know about memory loss and how you can stop it."

Linda Elsegood: And of course you're going to be a speaker at the 2019 conference in June, so we will actually get to meet you. So that's really exciting. 

Pamela: I'm very excited myself. 

Linda Elsegood: So, all the things that you talk about in the book, do they complement LDN?

Pamela: They do. They absolutely do. I have the world's best editor. She is so fabulous, and she makes sure, but they all complement each other.

Linda Elsegood: Oh, that's wonderful. And where can people buy your book? 

Pamela: People can buy my book at almost any major bookstore. You can order online from Amazon or any major outlet and online worldwide.  

Linda Elsegood: And do you have a website? 

Pamela: Actually, the website for this is going to be changed as the book is coming out because they're updating it.

So that part I'm not going to give to you because that one would be difficult, but if people can't find my book, they can always email me at faafm63@yahoo.com, and we can give you that new website as it comes up next week. 

Linda Elsegood: Fantastic! Well, absolutely amazing talking to you! But if patients want to see you, do you have a website for that?

Pamela: Yes, people can absolutely come to see me or any of my partners. And probably the easiest way of accessing that is to literally call as opposed to get on the website. But we are, if they want to be on the website and look at us, we are the Centre for Personalized Medicine. So if you type that in, then everything will come up.

If you're going to go on the web. 

Linda Elsegood: And what numbers should they call if they would like to make an appointment?

Pamela: as I'd like to make an appointment. (313) 886-4060  

Linda Elsegood: And are you, not just yourself, but your partners in the clinic there too?  Do you have a long waiting list too? Do people have to wait to see you?

Pamela: Well, our goal is there's not. I do have four partners, so I'm very blessed to have great partners that are all fellowship-trained and metabolic, an anti-ageing and functional medicine. They've all done an entire fellowship, so we hope that people will be happy seeing any of us. So we tried for there not to be a long wait.

Linda Elsegood: Well, thank you very much for joining us today and speaking about your fantastic new book. I mean, I've made so many notes here. I'll certainly be getting a copy and checking it out. 

Pamela: Good! I hope you enjoy it and I hope everybody in the audience enjoys it as well. It truly was a labour of love, but I'm very happy with how it turned out.

Linda Elsegood: Fantastic! And just where we go, you said there was another book to come out. What is that one going to be about? 

Pamela: Yes. That one is scheduled to come out November 2019, and it's called "What you must know about autoimmune diseases." But believe it or not, there are 105 autoimmune diseases. Certainly, all of them are not going to be covered in the book, but the major ones are.

There's more and more to know about autoimmune. So yes, that will be November 2019. "What you must know about autoimmune diseases."

Linda Elsegood: Well, we'll have to have you back talking about that because obviously, LDN works amazingly for autoimmune diseases. Not saying it works for everybody, but it does seem to work really well.

So that would be a really interesting topic as well. 

Pamela: I would be honoured to do that, truly.  There are three things that I do for every single patient with an autoimmune disease, and one of those is to put them on low dose naltrexone, LDN. There's not a single patient in my personal practice with any of the autoimmune diseases that is not on LDN.

Linda Elsegood: The million-dollar question that people will ask is: How long would I have to take LDN before I noticed an improvement? What would your answer to that be? 

Pamela: 30 to 90 days.

Linda Elsegood: That's amazing! So a short period of time, isn't it? 

Pamela: Yes, it is a short period of time.

Linda Elsegood: Awesome! Amazing!  Well, we have to go. We've come to the end, but thank you very much for being with us today, Dr Pamela Smith, and we'll have you back again. 

Pamela: Well, thank you so much! Everybody. have a great day! You as well have a happy rest of it, of everything because I just love this time of year and spring is about to blossom.

It's such a happy time. Thank you. Bye-bye. 

Linda Elsegood: This show is sponsored by Dickson's chemist which are the experts in LDN at associated treatments in the UK. Dickson's chemist, the most cost-effective for LDN in all forms within the UK and Europe maintaining safety standard of what is required. Why would you choose to get your LDN from anywhere else?

Call 01414046545 today to speak to an LDN experts 

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

Dr Harpal Bains talks about Low Dose Naltrexone and her new clinic (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: I'd like to welcome back Dr Harpal Banes from the Harpal clinic in London. Thank you for joining us today. Harpel. 

Harpal Bains: Thank you. Is it lovely to come back again. 

Linda Elsegood: So I know that you've been doing lots of amazing things and you're opening a new practice.

Harpal Bains: Yes, about three times the size of our current ones, so it's very exciting. 

Linda Elsegood: Wow. So what would you be doing in this new practice? 

Harpal Bains: Basically it's off the feedback that I've been getting from a lot of my patients. We get a lot of very chronically ill patients, including cancer patients and the rest of them.

And we find that a lot of them were coming asking or talking about things like hyperbaric oxygen chambers and infrared saunas for detox of a heavy metal detoxing and cryo chambers and the rest of it. And I started getting more and more interested. And then when you go to a lot of these conferences, especially within the functional medicine world, you see a lot of these all around, and the idea came to my head that what if I had a premises that were big enough to house all of these things? Because it's not really a case of one size fits all. You'll find someone saying that cryo is the best, don't even bother with the rest because that's the best.

And another person will say the same thing about the sonars. And so I don't think there's a one size fits all. However, I do believe all of them help in different ways, in some cases, and they actually help towards the same end in some cases. And so why not just have it all within the same place? The difference being is that here, I would have taken the trouble and done the homework so that I know the machines that I have are amongst the best.

Out there within what we can get in the UK and therefore they don't have to run around and try to figure out, is this inferior? Is it on the right one? Is it radiating EMS, rays?  Is that cryo cold enough or is it one of those, you know, so the idea is basically if we have someplace that is trusted and that they can use all of them at the same time, that'll be great. And so in terms of how we intend to move forward with that is once I get all these things and us, we thought that maybe one good way of going about it is to do it on a subscription basis where you could actually use any one of these machines within the same subscription, for the month or that part.

We have yet to completely identify how to do it. But I think that's really the best way forward. So, someone who decides to come in, they will be able to try each one of the machines and I suspect there'll be one machine, that they will prefer more than another, or they might find that they work in different ways and to actually have a one-stop centre I don't think any exists in the UK at the moment, so it's quite exciting. But we need big enough premises for that. And we found one.

Linda Elsegood: Wow, that's, that is truly amazing. And we interviewed your brother a few weeks ago, and he's working alongside you now. What would you say are the main conditions that you're treating. 

Harpal Bains: Within a setup that we want, initially as I would have mentioned before I started out with wellness medicine for someone who's fairly well, but feeling the signs of ageing and wants to maintain it for as long as they can.

That's how we started out. However, what we found was that we were getting people who want at home once, and we're starting to, and they were ill. And before I know it, all I'm seeing is chronic—diseases, autoimmune and the rest of it. And for me, that's of course, extremely interesting. And therefore it has been guided by my patients in a way, by what they feel they want.

The demand has been created by our patient population. So anything that's a chronic disease, it comes to the point where it doesn’t really make a difference what it is for me that they come in with, most likely that something we can do for them because most of it sort of have a similar basis and for us, because we see so many different types of cases, I can start to see patterns very easily as can my brother, which for the person and they go it, they can't. Or with someone who doesn't have that level of experience, it will be harder. So it's chronic diseases, higher type syndromes, autoimmune, anything within that area.

Linda Elsegood: and of course, it's rather like being Sherlock Holmes, isn't it? Is to try and find out what exactly is causing those symptoms rather than treating the symptoms. So if a patient comes to you with multiple complex conditions. What's the first thing you do. 

Harpal Bains: So at our clinic, basically the approach we have is very hormone and nutrition based and antioxidant based.

So the way I would do it versus some other practitioners who have a slightly different angle, I think I mentioned this the last time I spoke, is that the biggest, biggest thing I find with homework is the speed at which I get results.  In the same way, and one reason why I really love LDN is the endorphin rush.

The moment you start feeling better, you get an endorphin rush. The moment you get that endorphin, and the rest of these feel-good neurotransmitters and hormones within your body, you start to heal in ways which you could not really anticipate and a speed that you couldn't get doing it—using purely functional medicine.

This is my opinion. Of course, and when we put that together with things like nutritional interventions, once again, not outsourcing it, but at the same practitioner actually doing that, which means now this practitioner has to understand that side of things as well. Get rid of all the heavy metals, uh, the detox side of things.

We actually get quite a lot of results. And at that point, I find that it works for about 70 to 80% of my patients. And then I get the remaining, with the remaining. I'm a member of a BSCS, which is. British society of environmental medicine, that's sort of the next area start to look at. So that's when you start to look at things like mould, heavy metals, exhaust fumes and anything and everything, which could give rise to, basically, these environmental issues.

And they are quite frequently forgotten. Not many people think of them, but they're highly, highly relevant. However, the way I practice, I tend to leave that to the last, unless it's blindingly obvious that that's a problem. Someone who just moved to a new house and then finding they're facing all kinds of problems, it could be fumes from the carpets, let's say, or brand new furniture. Even the fire retardant material they use for furnishings that's an issue as well. Or in a really, or they move into a really old damp house and then the issue with mould and the rest of it, that's a huge area of study, which I would say maybe 20% there.

I've got a long way to go, but then, you know, if the issue is really that, and if I don't feel like I handle it there, there'll be other practitioners I can refer them on to. 

Linda Elsegood:  I interviewed Dr Tom O'Brien, who talks about all the effects of the toxins, not only that are in food, you know, in crops that are sprayed.

A piece of furniture, and as you said, that retardant material, but something he said, which struck me, that something that everybody can do very easily is when you're filling your car up with fuel, can you smell it? If you can smell it, move. Stand the other way so that the fumes don't blow in your face. And I thought I've never thought of that.

Harpal Bains: I've just thought, Oh, I smell this smell. They probably go closer.

I mean, that's a good thought. 

Linda Elsegood: Diet is important. I mean, there are so many children that you can just see that if they can, you know that they're overweight and they if they carry on eating as they are doing, you know they're going to be a type two diabetic before they need school. 

Harpal Bains: Yeah. 

Linda Elsegood: But how do you educate people when they come to see you, to recommend healthier eating and maybe supplements, because obviously you did blood tests and things and if you find that they are low in certain vitamins or minerals, how do you go about trying to educate them to change the way in which they're living? 

Harpal Bains: I give my patients a lot of homework. Most of them have to go home with homework. So it's one of those things, I think if they don't understand what they're doing, they can listen and do some things for maybe a month or two months, and then that's it.

They'll forget, and they won't do it. And then you lose the benefits of it. So until, and unless they understand why they're doing what they're doing, it's not really for compliance is really important here. So it’s a comprehensive consultation that works out to be two and a half hours in total of the doctor's time.

Initially, it's one and a half hours as a lot of teaching that goes on there as well. Some things are frankly, blindingly obvious to us, will immediately know what's going on in other people. It's a little bit hard because they're doing everything right and it's hard to tell where they’re going wrong, but on top of that, when they get their eventual report, that has dietary advice as well within the report, and we allow them time to read and digest it, and then they come back for their final half an hour with us. So it's, as I say, it's two and a half hours split into two sessions, really with the report sent to them in between so that they have time to read, absorb, come up with all the questions they want. We stayed then come back and see us. I really like doing it that way because, at the back of their heads, they are not having to keep paying up for every time they see us, which is not a nice thought, but it's all-encompassing. They come in once, and they know they're going to get this management further on moving forward.

Linda Elsegood: And I think engaging people into their own health, giving them responsibility, you can advise as much as you like, but if they don't take it on board, it's not going to work. Is it? So having them working with you, it's a partnership, 

Harpal Bains: Yeah. Not only that, I mean, another thing that we have recently introduced and we had going to develop further is something like a health coach, not quite the health coach, but something like that.  Someone who's actually going to pick up the phone and ask you after you've been with us for a month, how are things, because from experience, what I find is that if they come across problems, most of them just stop the medication, or they stop doing that certain thing and they forget.

And so by having someone there slightly nagging them, it's actually a really good thing. And at some point maybe in the next two or three years, I don't see it happening this year, is to come up with an app where with prompts and the rest of it. But I think that's another level up.

Linda Elsegood: We have an LDN app remember, that you can monitor patients and check and do graphs and charts and things. Perhaps you can have a look at that, 

Harpal Bains: which is on my to-do list, 

Linda Elsegood: which I'm sure is growing all the time. 

Harpal Bains: Yes. Oh, yes. So, but that's only, that's in the pipeline via creating software for the whole clinic, as we speak. So there's the number of changes, a lot of changes. A lot of the new premises is actually devoted to office space because we needed it.

Linda Elsegood: Whereabouts, are you located? 

Harpal Bains: The current clinic is in Margate, which is between Liverpool street and bank. And the new one is about two minutes walk from St Paul's Cathedral, its a stunning location, really nice. And the good thing about the new place is that we are building, uh, we have the disability access.

Linda Elsegood: Right Okay. 

Harpal Bains: So we have disabled access and the rest of it, which we can't have in our current premises. 

Linda Elsegood: Oh, I see. Okay. So both of them are accessible if people are coming into London by train.

Harpal Bains: Oh, yes. Very, very easily. Yeah. I mean, because St Paul's a tube station about a five-minute walk away. The cathedral's right there, you've got the river so you could make a whole day out of it. We have a lot of patients who come from either abroad or outside of the outside of London. I know you could make a whole day out of it. It's really beautiful. That area. 

Linda Elsegood: I'll have to come and check it out. Come and see you.

I don't go to London very often but there we are. But it's a beautiful place. And especially if you're outside of England and you haven't been before this, there's a lot to see.  

Harpal Bains: The architecture is stunning. 

Linda Elsegood: Yeah. 

Harpal Bains: It's really beautiful. Yeah. And so this is a pedestrian street as well, so there's, that's a lot of nice things about, it's one of those really, really nice streets.

Linda Elsegood: So we talked a little bit about diet and supplements. What about sleep? The people that have problems with sleep, I mean with all the iPads and smartphones and this kind of thing, if people are having difficulty sleeping, and especially children who are staying up later and later because they're being pinged by friends on all these different platforms that they use.

What is a recommended time to shut down before you go to bed, ready to go to sleep? 

Harpal Bains: I think in an ideal world, sort of like five, six o'clock, but you'll have a lot of people doing beyond that. I would say if you could do it or two hours before you're in a particular place. Ideally more, but I mean, most people did not really get an idea to it.

And on top of that, simple things like having the night mode on it. Uh, right. It's called an M flux wait, turns the screen yellow, so you don't have the blue light, which is the one that affects sleep so that's one thing you can do. There are also these glasses that you can wear, which cuts out those lights as well.

So there are quite a few things you can do to mitigate it, or despite the fact that they are still going to do a bit, children are going to be quite hard to make sure they actually listen to you. So these would be the things that you can do because you just put it into the computer and automatically switches into night mode and things like that would help. But sleep is a huge, huge problem. It's becoming increasingly big. It was actually on my list of things to do to work alongside a dentist who would be able to deal with the jaw to create these little, what do you call it? These things, which pulls the jaw forward and therefore it doesn't have the weight on your neck. You don't have sleep apnea. Oh, so yeah, it's absolutely brilliant. Once again, you have to go to the US to get trained. And initially, I was hoping that my new premise was there'll be enough of a space for a dentist, but I don't think that's going to be, but it's, it's within a few years I was thinking perhaps, you know, To do sleep studies and the rest of it because once again, what's in NHS, it's not quite, I don't really agree with the way they assess it. Like for them, if you're snoring a little bit, you have a mile, and therefore it's okay, and I don't, I disagree with that. I think any sleep apnea it's waking you up because your body can breathe and there are things that you can do, but it's not a very big area yet. Not in this country.

Linda Elsegood: I have a problem with my jaw. When I go to the dentist, open my mouth wider, it keeps dislocating. So it is so painful, opening the jaw. When they say open wide, then they're trying to get at the back, and it goes clunk, click and I grind my teeth, but I was, I bought a gum shield that I put in, but because I couldn't shut my jaw completely, that I think the thing I had at the dentist was just as bad. So I tried desperately hard not to wear it because it hurt too much and try not to grind your teeth. I mean, how do you know when you're, when you're asleep? 

Harpal Bains: I see patients like that all the time. Botox is one of the best things out there for it.

Linda Elsegood: Really, how does botox do that?

Harpal Bains: Absolutely brilliant. It relaxes the muscles. It relaxes the muscles that cause us grinding. I have patients coming in for like, in fact, wonderful that someone's face. I can usually tell if they're grinders, they have these huge hypertrophic muscles on the side of their face.

They have quite square faces because that muscle is taking out. In quite many. You find that after a series of Botox injections the shape of the face changes, it becomes more rounded, the grinding at night stops. Your headache stops. So many problems go away, and this is grinding down the enamel, which will cost you tons and tons of money further down the line.

Such an easy solution, such an easy solution. Basically, Botox, what a lot of people don't understand about Botox is a, I've got a blog on my website actually, on how to do Botox so that it's very effective. What you're basically trying to do is making the body lose its muscle memory. So I don't want my muscle to remember how to grind, so it lasts about three months, so I'm going to inject some into my jaw before all the action comes back before it comes out completely I want to go in and inject it again because after not doing it for, in my experience, 12 to 18 months of regularly doing the Botox. That's it. You don't remember to grind anymore just because you've forgotten how to do it, so if you want to grind, you can, but you just don't do it anymore. It's amazing. No headaches now, and you're going to save a lot of money long term because you don't, you won't have all the dental issues moving forward.

Teeth grinding. That's an easy one. Yeah, very easy. 

Linda Elsegood: I've never heard of that before. Do you inject similarly to a dentist if he was giving you a local anaesthetic, is that how it works? 

Harpal Bains: Oh, no, no. Much easier. Much easier. Just on the outside. Basically. The way I do it is I, Oh yeah. You don't have to go in at all.

Yeah. So on the outside, I will get the patient to clench and then I will draw it out because everyone's got different musculature. It's fascinating when you start having to draw, and then I will inject the Botox basically on your jaw. You're already on the outside, right below your ear around that area.

So, but I will draw it out, and I will actually inject it in the right areas. And um, yeah, if you go somewhat conservative, you get really good results, we'll still be able to eat and rest of it. It's brilliant. You, I'm not many dentists seem to know about it, but I get people coming back to me again and again and again for the same thing.

No headaches, no more grinding, nothing. They come to me for that. And the small number of people come because they want a slimmer face. And then that's fairly cultural but no, it's brilliant. Definitely consider it. I think your whole jaw is dislocating as well, it's probably due to you've got some muscles which are possibly stronger than other muscles. That's another thing you could consider. 

Linda Elsegood: All right. As soon as we're finished, I'm going to go and look in the mirror and see what shape my face is.  

Harpal Bains: basically put your hands underneath your ear and clench your jaw. You could probably feel the muscle clenching. Yeah, just it. And then have both hands on each side of your face just next to your ears, and you'll feel the muscles.

Yeah, and that's the one that we inject into.  It's easy. Go. Go on YouTube, look, look for videos on it. It's easy. I love doing it. It's such an easy procedure, and you get great results. 

Linda Elsegood: Well, I mean, I've seen some people have Botox and it looks really fake and really horrible and ends up with funny lips and things.

It doesn't have any. Adverse effects do, it doesn't change you in any way, 

Harpal Bains: This is the bit that’s really, really sad because once again, that's media. That's a media presenting Botox in such a terrible way. Do you know that? Uh, and this one that the documented evidence was out there, uh, for someone who does their frown lines, they actually become more pleasant, to be around because they cannot frown, therefore, the signals to the brain that tells them to frown and be angry. It is, does this look to them? I have because we do aesthetics as well, and I've got mothers coming to me saying that I know it’s wrong because my kids think I look angry on it. And it's pretty funny.

But if you think about how it came up, it was discovered by ophthalmologists because they used to treat ticking of the eyes and these patients that came back you know, telling the doctor that this is great. I don't have wrinkles on that side that you've been injecting, but how about the other side?

And that's how it was discovered. So it's used for things like anal fissures, a lot of urinary problems. It's useful—so many different things. But people just think of it. Migraines. Migraines is a big one. People think of it as this beauty thing, which, you know, everyone looks fake, but done properly it’s beautiful. And lots and lots of benefits, especially headaches, is a big one. And I am not looking angry. I'm telling you, that goes every aspect of your life. 

Linda Elsegood: And I suppose you would need an experienced doctor to do the procedures. 

Harpal Bains: In an ideal world, I mean, there are a lot of very good nurses out there as well, while very experienced, definitely do not go to any beauty therapist who claims that they do it.

Not at all. Then quite a few dentists have started doing it as well and it's one of those things. It really is. You know, down to the practitioner, but a good practitioner will do a really nice job and you quite frequently, you can't even tell someone has had it done, and that look is getting more and more popular. Really. People don't like that overdone, that's fake. Yeah. Not many people like that, but that's what's portrayed in the media. There'll be so many people who would have had it, and you wouldn't even know. And once again, that's endorphins. That's like LDN. You like what you see in the mirror. You're going to be a happy person. That's endorphins. 

Linda Elsegood: Well, we have five minutes left, so if you could tell us what your views are on LDN. 

Harpal Bains: It's one of the most mind-blowing things I've come across. It's like I'm trying to get everyone on it. It's wonderful. My own immunity has gone up tremendously.

It's like the amount of stress I've had at the moment is severe with two renovation projects going for the past few months. New staff, lots of rents to pay. No, I haven't fallen sick. Really so something else. And all my patients tell me the same thing. And the biggest, biggest part is the small things disappear.

And this is where I, this is why LDN will never be that well studied because everyone will come back and tell me something different that's now gone away that they've completely forgotten about. But I've reminded them because it's in my notes. It's all about the small things, and therefore that really adds quality to life. It’s wonderful. 

Linda Elsegood: And if you can hold a progressive disease, you know, even if it doesn't help with the symptom relief, which it seems to do for many people, but even if it just halted progression, how amazing is that you know? 

Harpal Bains: And the pain. Mm. 

Linda Elsegood: Yeah. So if people come to you, they can expect to be told about LDN and diets and supplements and if they grind their teeth, 

Harpal Bains: I do recommend, yeah, I do recommend Botox cause I'm telling you, it's so good for that problem. It's amazing. They keep coming back again and again and yet I'm telling them 12  to 18 months, the moment your body forgets that action. You're good. After that, you probably need just a top-up once or twice a year after that, and that's about it. It's well worth the money, I would say because if you think of it as saving against future dental work, that's not worth it.

Linda Elsegood: No, that's right. But this gum tooth guard or whatever they called, it was really, really expensive. It wasn't cheap, and I couldn't use it. So it sits in a drawer. 

Harpal Bains: Okay. Well, there you go, you’ll have to research it. You'll love it. 

Linda Elsegood: Well, thank you very much for having been on the show today, talking to us about just about everything.

Harpal Bains: Thank you for inviting me. 

Linda Elsegood: Well, we hope that people come along and see you and your website. Where would they find your details? 

Harpal Bains: It's  https://www.harpalclinic.co.uk/

Linda Elsegood: wonderful. And a question we're always asked is, do you have a waiting list? 

Harpal Bains: I personally do. My brothers is shorter.

I'm hoping to bring that number down, and we are also hoping to maybe get another doctor in as well at some point. 

Linda Elsegood: Wonderful. Well, we wish you every success with your, your new premises and your renovations on your existing one. So if anybody is in a wheelchair, they need to go to St Paul’s clinic? 

Harpal Bains: Yeah, most likely we will have that as the main centre because that's where all the buzz will be. 

Linda Elsegood: Okay. Yeah. Well, thank you very much.

Harpal Bains: Thank you.

Linda Elsegood: This show is sponsored by Dixon's Chemist, who are the experts in LDN at associated treatments in the UK. Dixon's Chemist, the most cost-effective for LDN in all forms within the UK and Europe, maintaining standard safety standards far in excess of what is required. Why would you choose to get your LDN from anywhere else? Call 01414 046545 today to speak to the LDN experts.

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

Dr Baldeep Bains MD - 23rd Jan 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today, my guest is Dr Bains, and he is the younger brother of Dr Harpal Bains, who you may have remembered we had on the show a few months ago now. Thank you for joining us, Dr Bains. First of all, can you tell us your background and about you and all the wonderful things that you've done to date. 

Dr Baldeep Bains: I grew up in Malaysia as my sister did, but then I was educated in the UK. I then went to university in Scotland and went to med school in Scotland. While I was in medical school, I had this mad idea that I wanted to join the military and before I knew it I’d signed on the dotted line and probably half of my life to the military. Upon finishing university, I'd spent a bit of time in Virginia. I joined the Navy, the general Navy. Upon finishing the officer's training, I spent about three years getting deployed in nice places, some not very nice places. As a Navy doctor, I’d look after old Marine commanders.

For the first five years after graduation, I spent most of my time doing the two operations. Upon completing them, we have to decide what you're going to do. I initially thought of a surgeon. I started off training to be an orthopaedic surgeon. I spent about four years doing orthopaedic surgery. I enjoyed it up to a certain extent. Then I realized that I was reaching a point where I wasn't passionate about surgery. I think I was passionate about something a bit more so I decided to quit surgery and joined general practice. I did my GP training and I qualified as a GP in 2009. 

My wife got pregnant in 2014 and when I was deployed for six months and I got back just in time before she gave birth. I think reality struck me that I can't continue with military life, I was having a family.

So I left the military in 2015 and then worked as a GP for a short while before my sister suggested that I should join her practice which is where I am now. So I've been at my sister's coming close to a year and a half now and working alongside her is where I heard about LDN. 

I've got to say it was quite a paradigm shift for me because when she first spoke to me about what she was going to do, I thought she was absolutely bonkers. I'm not going to lie to you all. We use nice guidelines and when she was talking to me about functional medicine... we had many arguments about how she was practising medicine and I was like, what are you doing? Are you crazy? Are you mad? Are you dead? I've got to say that we didn't see eye to eye initially with what she's doing. I think fortunately she persevered and she agreed. Even if I could see the way she does things and the way functional medicine works. I’m by no means trying to criticize the general practice. She’s done a fantastic job and I actually appreciate what my colleagues do but there's a certain extent to which we can actually help them and they're quite stuck with the reason I didn't blame them because they are guided by guidelines. A lot of the people who sit in the committees of guidelines are people who've got some vested interests elsewhere. I'm not gonna mention names, but I can understand the restrictions they have and why they can't. 

Yeah. It's quite hard for them to go explore other avenues. That's another way of doing things. I'm really glad I can introduce it as well because had I not been introduced, I think I would have been missing out on a lot, I love my patients. So I'm actually finding it harder and harder to be a GP now because of what I do know.

Linda Elsegood: What would you say are the main conditions that you are treating in the clinic?

Dr Baldeep Bains: I see the lion's share of the male patients. A lot of the male patients that we come across do come in with quite prominent symptoms of testosterone deficiency. That's one of the things, but I'm seeing a lot of patients with some degree of autoimmunity as well. I've seen patients with Hashimoto’s thyroiditis, chronic fatigue, Crohn's disease, bowel issues, etc. Increasingly I'm seeing more patients with autoimmune and bowel type issues. 

Linda Elsegood: When a patient first comes in to see you, how long is the initial consultation? Do you do lots of form-filling, questionnaire-answering with all of them? What's the procedure?

Dr Baldeep Bains: Most of the patients, we're looking to get one of their main symptoms, what their diet’s like, how their condition is affecting their activities of daily living. We can be asking quite a lot of questions. We spend anywhere between 1-2 hours with the patients. We try to read the evidence in order to find the root cause. Again, we will see a patient and we will treat the symptoms and the majority of the time that's what we do. But they keep pulling back the same issues again and again. If you don't look into food it takes time to look into a root cause, you can't just expect to spend five minutes with a patient talking about their history and find the root cause. You need to go into a lot more detail, which is what we try to aspire to do; just get into the nitty-gritty and hope to find what might be the root cause for a lot of these symptoms. 

Linda Elsegood: What other testing do you use? 

Dr Baldeep Bains: The majority of the time we will carry out a comprehensive blood panel. It’s one of the baseline things we do. So in a certain comprehensive blood panel, it would include the likes of a full blood count. You carry out a comprehensive biochemistry analysis looking into things like your liver function, kidney function. In our practice we do quite an in-depth hormonal evaluation, looking into quite a few different hormone levels and trying to see if anything that needs to be addressed. Beyond that, if a person does have a lot of bowel type symptoms, we will potentially do something along the lines of a comprehensive, thorough analysis, which is not a simple as microscopy. It gives you a lot more information. We would offer that if your bowel symptoms are quite prominent. I think we might do as well if something known as SIBO testing, small intestinal bacterial overgrowth, complaints of quite significant gut symptoms. We'll do something along those lines. We do allergy testing as well, and we use Cyrex. Personally, I feel it's one of the best kits out. I think it has been extremely comprehensive and they will probably them give us an overview as to what is going on, to keep eating the same foods and which is stimulating an inflammatory response. I think that that's the first few stages. Plus, I would normally offer a test when I first see a patient.

Linda Elsegood: When you ask patients about diet, are they honest with you as to what they eat or drink or do they tell you what they think you would like to hear?

Dr Baldeep Bains: That's a tricky one. I like to think my patients are honest with me. I think the majority of the patients we have are quite honest because by the time they come to see us, they're quite desperate. They've tried everything. I think they like to be as open and honest as they can with me. I think they are honest because of how they're feeling and their determination to get better.

Linda Elsegood: I was only asking because my mother lived with us for a few years. Unfortunately she, she got cancer and died. Before that, we would go and see the doctor and the doctor would say, “have you taken salt out of your diet?” I used to hide the salt because she was at the age where she used to use lots of lots of salt. I would sit there and I'd say, “you put so much salt on it, mom. It looks like snow, doesn't it?” And butter. “Have you cut down on the butter?”, “Oh yes. I don't use it as much.” “Mom, you use as much butter. It looks like cheese because it's so thick” but she didn't want to upset them. She wanted to please the doctor by letting them think she had done what she was told, but she didn't use, to tell the truth. I now have to hope that when I get older, my daughter doesn't come with me,

If we just continue treating symptoms and not the root cause, that root cause could be creating a lot of damage. It's vital to find out what that is. That is what's so good with functional medicine.

Dr Baldeep Bains: I completely agree with her. I think we actually have the luxury of time, which is what a GP doesn't have. I've got 10 minutes per patient, and in that time I've got to get a history from the patient, I’ve got to sort dates, I've got to get ready for my next patient. It’s especially complex with complex patients and complex patients are increasing in numbers. I've seen more and more patients with more and more complex problems coming in. I don't think treating symptoms is the answer to that. 

Linda Elsegood: You're seeing more and more people who have chronic conditions. What would you say is the difference between now and 40 years ago? Is it because we're eating different, or due to the fact that food is treated differently? When I was a child, everything was cooked from scratch. There were no additives. I hardly know how to pronounce some of them, let alone know what they are. What do you think is the cause? 

Dr Baldeep Bains: Reverse back 40-50 years ago, you're not seeing the problems that we had in those days. Compared to the number of solid issues we have nowadays it is just phenomenal. I've got no doubt it's to do with our diet. It's all about the fast food, and then you can get your hands on processed food, anything that's microwaveable, low phosphate and nothing else. No one has time to do things, you want everything in an instant. The busy lifestyle, the stress... life is a lot more stressful now because we've got a lot more demands and you've got everything in your face due to social media. I think stress has got a much more significant influence and the fact that we are actually doing less as well. Spending huge amounts of time in front of computer screens and TVs. Get yourself out, playing, get some sunlight, get exposed to sunlight. I can say my childhood is very different from the childhood experience now. 

Linda Elsegood: You were talking before we started and I'm sure you're quite an outdoorsy person, but what is your diet like? I mean, are you gluten-free, dairy-free? Are you a vegan? What is your diet? 

Dr Baldeep Bains: I am none of those, but I am quite careful about what I eat. I limit the amount of processed food I have. My kids have significantly reduced their intake of sugar. I use just for taste, such as half a spoon in my tea or in my coffee. I don't have any fizzy drinks. I drink water or milk. I'm quite fortunate in the sense that I don't really have many intolerances so I can actually cope with gluten. I've got a very narrow relationship to gluten. If I'm going to define myself, I've significantly reduced them on process over refined carbs. If I do have carbs, it traditionally would be half a plate or a quarter. I do love exercise and I need energy. So I still have carbs. Probably half my plate is protein. But I'm currently 43 and I feel fantastic. I train hard and I can sustain my mind. A craving I've got no real issues. I don’t have any fatigue issues, I'm not obese. I’d like to say that I'm in quite a decent shape, I think it's working for me. I don't eat junk. I've read a lot about intermittent fasting and I probably do that about two or three times a week. I try to fast for 16 hours and then tried to eat in the daylight hours which has been shown to be quite effective. I suppose if you say any dietary routine, but that's been quite recent, probably 2-3 weeks ago. I don't find it too hard to do.

Linda Elsegood: We’ve nearly run out of time, but very briefly, for parents who want to make sure that their children grow up as healthy as possible, what would you recommend to do diet-wise with children? Because it's very difficult with all the crisps and sweets and biscuits and advertising on television, how do you go about trying to establish healthy habits?

Dr Baldeep Bains:I think you get a vibe from them whilst they’re a baby. You've got to introduce them to good food and fruit and vegetables. We try to make everything from scratch, making home-cooked fruit. 

Linda Elsegood: You don't buy Robinsons or anything along those lines?

Dr Baldeep Bains: Nothing whatsoever. They drink water. That's the only thing they seem to pick. Once in a while, my daughter has fresh fruit juice, but apart from that, it's water and milk. That's all they have. I think trying to develop habits from the start and you're trying to give them a good breakfast. I try to avoid sugary cereals. I think even a traditional English breakfast as well, they'll have sausage, which I do try to get good quality sausage just for kids. Try to make a lot more home meals and try to get them less processed food. It's not easy on junior kids, even seven done. Life's extremely busy at that time. Everyone's quite time poor. It doesn't take a lot to make a decent kitchen. We know what we need to be doing and we should practice it. 

Linda Elsegood: We've come to the end very quickly. If patients would like to come and see you, how do they get in touch with you?

Dr Baldeep Bains: They can visit our website, www.harpalclinic.co.uk We have two practitioners there: my sister and I. I have a lot of patients with her too. You get the benefits of two practitioners and hopefully, when you come and see me, you can appreciate the frustrations and a lot of patients as well. I can understand what's going on and I can sense the limitations that they face and be able to give them a bit more of a balanced view. I think one thing we pride ourselves on is ongoing support. Most of my patients have an open email conversation. They can email me anytime and I will get back to them and I would advise them. I think on a lot of occasions patients find that quite reassuring. At the end of the day, I do things which are not very conventional. They didn't think their potentially own GP should be asking them, why are you doing such a thing? A good example is I prescribed LDN to one of my patients and I had a bit of a nasty email from a Polish GP asking me, what am I doing now? I think once the people are educated, once the GPs are educated, then you can get a GP alongside the patient and the GPs can work together with a patient and ultimately what we're doing, what we're looking for is to make the patient feel better. That's the aim. 

Linda Elsegood: That's fantastic. We'll have to have you back another day and thank you very much, Dr Baldeep for being our guest today. 

Dr Baldeep Bains: Thank you, Linda.

This show is sponsored by Dixon Chemist, who are experts in LDN at associated treatments in the UK. Dixon Chemist is the most cost-effective for LDN in all forms within the UK and Europe, maintaining safety standards far in excess of what is required. Why would you choose to get your LDN from anywhere else? Call 01414046545 today to speak to LDN experts. 

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

Dr David J Zeiger, 26th Dec 2018 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today, my guest is Dr David Zeiger, who is a D.O. in Integrative Medicine and a practitioner from Chicago, Illinois. He treats both chronic and acute illnesses as well as neuromuscular pain. Thank you for joining us today, David. 

Dr David Zeiger: Thank you for having me. I'm looking forward to talking to you. 

Linda Elsegood: First of all, could you tell us about you? Who is David Zeiger?

Dr David Zeiger: I have originally boarded in family medicine over 30 years ago, and I recently got boarded in integrative medicine as a speciality about two years ago. I've been practising family medicine, functional medicine and for the past 30 years as well as doing things in neuromusculoskeletal medicine, including osteopathic manipulative medicine and using techniques called prolotherapy or neural therapy to treat chronic pain syndromes. So, a variety of different therapies in my practice gives me a large toolbox to work from as I work with my patients.

Linda Elsegood: So what is the age range of the patient population which you treat? Do you do from the cradle to the grave or do you do adult medicine? 

Dr David Zeiger: It's primarily adult medicine, but I occasionally do see some adolescents, some pre-teens. I mostly see patients from about 20 to about 80. I've had a couple of 90-year-old patients in my practice, it varies. I would say more it sways more towards a female population than a male population because I do a lot of hormone therapy in my practice for menopause, premenopause, infertility, fibromyalgia, chronic fatigue, et cetera.

Linda Elsegood: Out of interest, I know you prescribe LDN, and this is why I'm interviewing you, but do you use LDN for your patients with fertility problems? 

Dr David Zeiger: I haven't been using it in that direction yet. I've got a few patients who are interested in that and once they get back to me and I will. I have found LDN to be useful for a lot of autoimmune conditions: Hashimoto’s thyroiditis, Rheumatoid arthritis and lately I've been seeing a lot more patients with what's called small intestine bacterial overgrowth and with people who have a variety of different gastrointestinal dysbiotic syndromes, leaky gut syndrome, the inflammation thereof, I found LDN to be very useful in those patients. 

Linda Elsegood: You were saying about mainly females, I think it's usually the female population that has the most autoimmune diseases as well. I think with MS, it’s three women to one man. So that is probably why as well. When you find a patient who is suitable for LDN, how do you go about treating that patient?

Dr David Zeiger: What happens is I generally spend about a good hour with a new patient to get a complete history, do a very thorough physical, literally from head to toe. There's a variety of baseline laboratories that I may use to try and find out what are some of the targets that I'm to go after, be it dysbiotic, guts, the hormonal imbalance, inflammatory markers. I will then put everything together for the patient to explain, “these are the targets that I feel are probably the most significant avenues for therapy and using various different tools, LDN being one of them, I will then broach the patient with the information. I like to refer them to the LDN network, websites and other sources of information. I think that in the States there was a company that used to sell men's clothing and the owner of the company would say, “our best customer is an educated customer.” I feel that the best patient is an educated patient. I feel that as a physician. It's my responsibility and my calling to help, educate and guide patients towards the therapies that I think that are probably the most beneficial to them and answer all the questions I possibly can.

Linda Elsegood: What dose do you start your patients off at? 

Dr David Zeiger: I usually like to start at around 0.5 milligrams and then slowly increase to around 4.5 over a period of about 14-21 days, depending on how they respond. I haven't had the use of microdose. I have a few patients that are currently in my practice where I think it’s worth considering LDN as a beginning point for their therapy.

Linda Elsegood: You said that you have patients that take it for thyroid conditions, and we have learned that some patients who are on thyroid medications have to reduce the thyroid medications because the LDN makes it work more effectively. Have you found that in your patients?

Dr David Zeiger: Most definitely. I have had a number of patients who’ve had Hashimoto's thyroiditis for 15-20 years and they have been to a variety of different practitioners, including integrative practitioners and their antibody levels have been like in the thousands and what I've often found with many of the patients with autoimmune conditions, and I'll specifically talk about how she noticed for a second, is that about 70-80% of the patients with Hashimoto's have a dysbiotic issue, or they may have parasites, they may have protozoa worms, which is what I found in one patient, and by going after these organisms and then treating the results as an inflammatory condition, using LDN as well as other nutraceutical tools, I have been able to lower the antibody levels of these patients and, to improve this as an analogy, decrease the dependence on medications for thyroid over a period of several months. I have several patients where I've actually normalized levels, they have no antibody levels anymore in their thyroid, their TSH has gone down to normal. Their stamina and energy have significantly improved and many things that were tied into that, clinical wise, have also simply improved.

Linda Elsegood: To come off medications, it’s a box with a big tick in it. To achieve that, it's really something. Have you found, in any autoimmune condition, how important do you regard gluten in the diet? 

Dr David Zeiger: Well in SIBO, Dr Mark has been doing research on SIBO for around 25 years and they have published some of the most seminal articles on this, that diet is one of the hallmarks of therapy and when we look at what the components of that are, it revolves around the antigen load from things like gluten and casein from dairy, iron from corn and those are the things that can be major autoimmune triggers in many of these patients.

Linda Elsegood: How long would you say it takes for your patients to notice any improvement? 

Dr David Zeiger: Generally when I start working with the patient, if I had the lab tests and I like to use what is commonly referred to in functional medicine as the 4R program where you remove, replace, reinoculate, rebalance, et cetera. As well as helping the parenchyma of the gut or the gut lining to repair itself. I find that I can usually start seeing results in patients anywhere between 6-8 weeks within a program. They start to notice things like stamina, energy, less gas, less bloating, improvement in brain fog, inflammation in joints improving. I had one fellow who had been suffering from chronic urticaria for years and we're resolving after about six weeks for the first time in years. 

Linda Elsegood: How many new patients notified you of any adverse side effects? 

Dr David Zeiger: You know, that's definitely a case by case basis. I would say the major adverse effects that I see in LDN is a couple of things. Number one, vivid dreaming. Sometimes patients will say, I've never really remembered my dreams, or now I'm remembering my dreams and these are really intense, or they're in colour. The other thing is that sometimes some of our patients suffer from a lack of sleep. Sometimes a spillover into the next day where they might feel kind of groggy. But that usually is short-lived. Gastrointestinal side effects are usually very minimal and those are usually the people where I recommend to them to have a snack at that time with a good eight ounces water, with any sort of medication to mitigate the problems. Some people may have a hypochlorhydria where they’re not able to take tablets. Aside from that, I haven't had any other major problems like headaches or some of the other symptoms some people complain about simply because I really try to warn my patients ahead of time what to expect and if they had any issues, I tell them to give me a call right away. I can usually handle any minor things and address those issues right away. 

Linda Elsegood: What would you say the average dose is? I know you said you try and get them up to 4.5, but do all your patients get up to 4.5 or do some stick at a lower dose? 

Dr David Zeiger: I've had a number of patients stick around 2-2.5 milligrams and they seem to benefit quite well at that dosage. Well, that’s exactly what we found. It's not the higher the dose, the better the benefit. It's really unique and individual per person because some people do really good on two and then they begin to take 3 milligrams and they don't feel as good. Then, by going back they, they feel fine. 

Linda Elsegood: Have you treated any cancer patients?

Dr David Zeiger: I haven't had any cancer patients in my practice at this time. There are a couple of practices out there that have been dealing a lot more with integrative approaches to cancer and so generally what happens is that I will get a patient, they will come in and say they want a sort of functional medical approach to some relative nutritional deficiencies and they may have some other issues, some musculoskeletal issues that I may treat. Then what I may say is, “if you want more of an integrative and well-balanced program…”, I'll refer them out to these other practices that specialize in integrative cancer therapy.

Linda Elsegood: If you had to pick a condition, would you say thyroid is the condition you treat the most in your practice? 

Dr David Zeiger: It’s very interesting that you mentioned that. I would say 70% of my patients have Hashimoto's thyroiditis. It's very rampant.

Linda Elsegood: That's very high. What do you do in order to lower that number of patients? 

Dr David Zeiger: I came onto the Hashimoto's scene probably around 20 years ago and I remember when I was in medical school, we were taught that this was a very rare condition but when I got into practice, I found that it was much more common and actually close to 20% of the patients that have hypothyroidism and the reasons for that were always something that I was curious about. One of the things that I started looking into were things like what are the possible autoimmune triggers. We know from the human genome project that only 12-18% of diseases are actually genetic in nature. The rest of the diseases are due to epigenetic causes. So what are those epigenetic causes? We're looking at things like different pathogen infestations, microorganisms like Blastocystis, hominins, certain protozoa. Another factor in there is stress on the immune system. Diet and nutrition, nutritional deficiencies, another, another factor. Unfortunately, over the past 60-70 years or more, the population has become more and more exposed to these kinds of pathogenic factors and I think this is what is causing a lot of the autoimmune conditions that we see today. 

Linda Elsegood: Do you think people seek you out through word of mouth that you're the man to see if you have a thyroid condition? 

Dr David Zeiger: That's what I hear. So there are people with thyroid conditions, then, of course, those with chronic fatigue syndrome. 

Linda Elsegood: How do you find people with chronic fatigue syndrome compared with the thyroid? I have found people with fibromyalgia and chronic fatigue who are ultra-sensitive to all drugs. LDN included.

Dr David Zeiger: What I've come to see is that many of these conditions have a lot of things in common. I guess the rubric that I would use since I'm also trained in homoeopathy is inflammation, which causes this inflammation, and as I mentioned a moment ago, there are many epigenetic triggers for this. So, depending upon the person's individual biochemical makeup, they will be more prone to the manifestation, all various different diseases, be it thyroid or be it adrenal or be it SIBO. What I find is that when I work with a patient, I look for those factors that will create an inflammatory condition, and then based on their family history, based on the physical findings, I can then hone that into various different subsystems or organ systems that I need to focus my attention on. Be it the thyroid, be it the adrenal, be it hormone imbalances between estrogen, progesterone, et cetera.

Linda Elsegood: With regards to the neuromuscular pain that you treat, and as you were just saying there, how inflammation plays a big part in these conditions, what techniques do you use to treat neuromuscular pain? 

Dr David Zeiger: Well, I'm an osteopathic physician. So I have been trained in medicine so using osteopathic manipulative therapies, I use that modality. I was also trained in medical acupuncture. I use that from time to time. If there are other certain other kinds of, say ligamentous instabilities, I will use a technique called prolotherapy, which is an injection technique to regenerate the ligaments. The interesting thing is that we talk about autoimmune conditions, one of the things that we find with SIBO patients or some of these other conditions is that you may have a variant of a syndrome, which is genetically inherited weakness of the ligaments. It can also be related to certain inflammatory factors in the body that can be triggered by various different things I've just mentioned. So looking at all these different kinds of moving parts, you try to get a picture of what is the most impactful on the patients and health then focus on those things that you can start to build a foundation of health for them.

Linda Elsegood: You were saying that you are an osteopathic physician, and I have seen a chiropractor. What is the difference between the two? 

Dr David Zeiger: That's, that's a very good question. Chiropractic actually evolved from osteopathic medicine. Andrew Taylor Still, who was the founder of osteopathic medicine in the 1800s hundreds, developed osteopathic techniques. A fellow by the name of Palmer was a student of Still. He was also at that time was a hypnotist and he went off and founded a chiropractic practice. So the evolution of the two professions sort of had a certain amount of parallelism between the two of them. The difference between chiropractic and osteopathy is that osteopathic medicine is basically maintained, all of official allopathic medicine. As a matter of fact, osteopathic medicine was the first medical professional to incorporate x-rays. As an osteopath, I have an unlimited license to practice medicine and surgery, whereas a chiropractor has a limited license to practice, basically manual medicine. They cannot give injections. They cannot deliver babies. They cannot do ICU medicine. Although some chiropractors now are trying to become what they call internal chiropractors, internal medicine chiropractors. It's more of functional medicine, but they cannot prescribe hypertensive and I happen to take medication. They can't prescribe antibiotics, those kinds of things that I, as an osteopathic physician and surgeon can. 

Linda Elsegood: I have MS and before I was diagnosed different things kept going numb and I saw a chiropractor, but he had this way of running his fingers down my spine and would say, does it hurt here? He would press really hard with his thumbs. But then he would also get a hold of your neck and twist it to the side until it cracked. I didn't like that. That put me off osteopathic medicine. 

Dr David Zeiger: The palpatory techniques are highly developed. Being able to feel for joint mobility, tissue texture changes, is this inflamed? Is this boggy? Is this hard? I can tell you that when we are assessing a patient. Structurally, those are the skills that we use with our hands because we're talking in that way. Also we use our visual perception of like, how a person walks, how they stand, how they sit and then listen to the patient. Are they talking? So we're basically incorporating all of these other skills of palpation percussion, auscultation, which is hearing. As any other doctor does, any other physician does. Then we understand the biomechanics of the body. So when we look at how the shoulder moves or the hip moves, and then getting into finer detail within the cranium. Osteopathy, which has been around for 80 years or more, it's where we can actually palpate the very subtle motions of the movement of the cranial bones. These things don't fuse until death or certain disease states. Cranial osteopaths are able to determine how well they are functioning, how the different bones are functioning in relationship to one another. If you were to look inside the head and you look in the brain and you see the brain sitting on top of what they call the tentorium, which is like these membranes, all the nerves. I come off the brain and go through the membrane, which is all the ligaments, and then go down through like little holes in the skull down into these cranial nerves that go into the eyes and the nose or down to the neck, and if there is head trauma, surgical trauma, inflammation or infection, then these membranes can then become twisted, inflamed, boggy and cause basically a restriction of flow and thereby affect the end-organ tissue. So train cranial osteopaths to look at this when they're treating, children with cerebral palsy or children with autism, or people who have had PTSD or people who have had chronic headaches, migraine headaches, et cetera. 

Linda Elsegood: We've come to the end of the show, but for people who are in Chicago or the Chicago area in Illinois, how do they get a hold of you? Where do they go? 

Dr David Zeiger: You could call my office at 312-255-9444 and the name of the practice is Healthworks Integrative Medical Clinic. 

Linda Elsegood: Do you have a website for that?

Dr David Zeiger: Healthworksimc.com

Linda Elsegood: Do you have a waiting list?

Dr David Zeiger: I do but if somebody calls me up and they say “I really need to see you”, I will get them in somehow. 

Linda Elsegood: Thank you very much for being such an amazing guest today. I do appreciate it. 

Dr David Zeiger: Well, thank you for the opportunity to talk to you and thank you for your time. 

Linda Elsegood: This show is sponsored by Mark Drugs who specialize in the custom compounding of medications, ensuring that the client gets the proper prescriptions for their unique needs and conditions. They work with practitioners integrating knowledge and treatment of experts. To create comprehensive health plans, visit markdrugs.com or call Roselle at (630) 529-3400 or (847) 419-9898.

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

Dr Melissa Coats, LDN Radio Show 14 Nov 2018 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today my guest is Dr Melissa Coats from Arizona in the US. She is a naturopathic oncologist. Thank you for joining us today, Melissa. 

Melissa Coats: Thank you for having me. 

Linda Elsegood: Well, could you just give us an idea of your background, first of all, please? 

Melissa Coats: Sure. Initially growing up, I always knew I wanted to be a physician, I think, or in medicine. And when I went to school far away from home in Lynchburg, Virginia at Randolph-Macon Woman's College I focused on biology. And then after that, I didn't exactly know what part of medicine I wanted to do. So I decided to get a Masters in bioethics while I was deciding, and when I discovered bioethics, I stumbled across naturopathic medicine. Once I read the philosophy and what it was all about, I knew that was where I needed to be. Once I finished my Masters at Midwestern University, I went on to the Southwest College of Naturopathic Medicine, which was in Tempe, Arizona. And I didn't even realize it was in my native state. And so I learned all about naturopathic medicine and went on to school there, and ever since, here I am.

Linda Elsegood: Wow. And when were you first introduced to LDN? 

Melissa Coats: I believe my first introduction was through my mentor and colleague, Dr Daniel Rubin. He had co-written an article about low dose naltrexone, I think back in 2006, for its use in pancreatic cancer. And Dr Berkson who uses it a lot at his clinic, where he does a lot of hepatitis C treatment, also was very interesting to me So I learned a lot from both of them. And from then on, I've been doing more and more research and just using it in a multitude of ways with different types of things beyond cancer. But cancer is obviously one of the bigger ones that we focus on here at our clinic.  

Linda Elsegood: Could you give us an idea of your protocols for treating cancer patients, and which cancers you've actually treated with LDN?

Melissa Coats: Probably one of the bigger ones we typically put people on it for are those who have breast and colon and pancreatic cancer. Those are some that we definitely do, but we know there's some efficacy with ovarian and neuroblastoma and glioblastoma and even squamous cell carcinomas. Pretty much because of the natural killer cell and the immune stimulation that it gives.

We've found it is a very nice adjunctive thing to add on to most treatment protocols, so we utilize it quite often, usually starting with a lower dose. Depending on the sensitivity of the patient, maybe 1.5 all the way up to 4.5 milligrams, depending on what's going on and making sure that we're not conflicting with any pain medication use, of course, if the patient's had surgery or things like that.

We also, me particularly in the clinic, like to use it for other things as well. One of my very first patients actually wasn’t an oncology patient that I utilized it in - it was a person who had undiagnosed celiac disease for 25 years, and her gastrointestinal system was just a giant mess, and she was miserable. It was one of the things that I decided to introduce to a kind of calm her autoimmune issues that were going on, including her thyroid. And it really seemed to calm her gut. And she said it was like a miracle to her, and we even tested going off of it briefly to see if that was truly what was happening. And it was definitely the low dose naltrexone that was helping calm things for her. And so that was one of my first introductions to the power of it. And from then on, I've been utilizing it in many ways since  

Linda Elsegood: What are the therapies you use alongside LDN?

Melissa Coats: Currently, here in Arizona, we have the ability to give IV nutrients, so we use IV alpha-lipoic acid alongside the LDN. Sometimes it's vitamin C, IV. We utilize other supplements, as well, to focus on different parts of what the person needs as far as support if they're during chemotherapy or radiation or other treatments who may have anything going on.

We also utilize sometimes another natural killer cell stimulator, which is mistletoe, but we only give that in a sub Q injection versus IV here in Arizona. There's often a combination of things that we utilize with LDN to help the patient get the best for their immune system and whatever other issues they're having.

...

Melissa Coats: Sometimes, most of those patients are already on LDN, so it's definitely a good part of the mix. We definitely like to make a treatment plan very individualized to each patient, and so there's often quite a multitude of things going on at once, whether it's ... LDN, IVs, a diet plan, whatever it is. We like to bring it all together for them so that they can feel their best. 

Linda Elsegood: And you mentioned a diet plan there. Of course, with cancer, sugar. Is a no, no. What kind of a diet do you suggest patients follow? 

Melissa Coats: A lot of our suggestions as far as diet are either to focus on a very anti-inflammatory or a Mediterranean style diet. The ketogenic diet is obviously big news right now. So that is definitely utilized depending on if the patient's in a good place to do that or not. If they're in a very cachectic state or their weight is very low, we may or may not utilize that, but if they're in a place where it looks like they would benefit greatly from the anti-inflammatory effect of being on the ketogenic diet, we definitely introduce that. Definitely a big part of our consults with patients is spending a lot of time on the diet because we believe food is one of the greatest medicines you can put in your body if you're utilizing it properly.  

Linda Elsegood: And what's the age range of the patients that you treat? 

Melissa Coats: We have little tiny babies all the way up to, I think one of our patients right now that we have that I also believe is onLDN is 89. So we have quite the age range going on here in our clinic. I would say the majority of my patients range in their mid-twenties to like in the seventies and eighties. So we have quite the group. 

Linda Elsegood: And you were saying that you treated the lady with celiac disease. Have you treated any other autoimmune diseases? 

Melissa Coats: Yes. Of the ones that I've seen some benefit, a few patients who have lupus who've seen some benefit; in rheumatoid arthritis we have definitely seen some help in calming some of that; a lot of Crohn's and colitis. I definitely really see a lot of benefit with LDN when you bring in GI issues that are very inflammatory and sometimes immune-mediated. So it's definitely been helpful. I also have utilized it quite often with Hashimoto's thyroiditis to kind of calm the thyroid antibodies, and they seem to note that their thyroid works more efficiently and we see better numbers on labs when they're on the LDN, and less need for medication, which is nice.

Linda Elsegood: So the patients that you know are on LDN for thyroid, do you taper up slowly? How, what is your protocol for that? 

Melissa Coats: The patients mostly have been able to start at three milligrams, and I haven't really had to taper them per se, up or down. Sometimes we just watch the numbers and kind of see how they're feeling, and I may start them at three and just have them check-in with me about how they are feeling, whether that's too much, too little? It hasn't seemed to cause any major side effects, which is why I love using it so much because most people have a great response. 

I forgot about one case that I specifically wanted to tell you about. I have two patients that have autoimmune hepatitis that has been very difficult for them to wean off their steroids. And we have been utilizing LDN probably for the last year and their numbers as far as their liver markers, their AST and ALT have definitely decreased significantly since starting the low dose naltrexone, and I have finally been able to taper to a much lower dose of their steroids, which is wonderful because they hadn’t gotten to a low dose before without the LDN. And we found that using the LDN has made them much more successful and they're very excited about that. The thyroid becomes more efficient with the use of the LDN. They definitely need less medication, which is wonderful. So I usually check thyroid labs when I'm changing things up, every four to six weeks. And so definitely I've had many patients have to reduce their dose because of the LDN, which has been great.

Linda Elsegood: So when a patient comes to see you, let's just say a cancer patient, how would you go about putting that plan together? What is the procedure you follow?

Melissa Coats: When we meet, we initially have at least an hour consultation. We have really extensive forms that they fill out ahead of time, so that I have a really good understanding of their history, and we try to request records so we’re already in the know of what's going on so that we can spend a lot of time talking with each other about goals and where they want to begin.

While we're in consult, we actually type up a protocol so that they leave with a piece of paper that says what labs they are going to get., what treatment plans and treatment options we are interested in doing, whether that's IV or starting low dose naltrexone or some supplements. And then we make sure that there's a clear understanding if we need to check-in and get a diet diary, or what changes should be made immediately.

So they leave with that protocol in their hands so that they feel like not only did we meet and get a good understanding of what's going on, but we have a plan in action that first day, which I think is very powerful in making a patient feel empowered about taking control of their health. And we also kind of keep updating that protocol each time we meet so that if a supplement doesn't work out or we need to add something, they know exactly what's going on and can keep track, which is helpful to everybody involved.

Linda Elsegood: I was speaking to Dr Berkson, and he taught me that alpha-lipoic acid is to be taken intravenously, that it wasn't as effective in tablet form. And the other day somebody was telling me that no, the tablet form works just as well as the intravenous. So I'm now confused. Has it changed? What's your take on it? Exactly. 

Melissa Coats: My understanding is with IVs, you're bypassing the GI and you're getting full absorption; whereas orally you'd have to take a lot more, and obviously the doses are different. The IV amount we go up to is about 600 milligrams, whereas orally we're giving someone up to 1200 milligrams a day. Typically we use both, so when they're not here, they're on it orally. And then when they're in an office, they don't need to take their oral dose that day because they're getting the IV version of it  But from a strengths perspective, and I'll have to check the latest studies, I guess now that you say that, my understanding from Dr Berkson and his protocol that I've been utilizing for a number of years now, that the IV seems to be pretty vital.

Linda Elsegood: That's what he told me, so I've just wanted to check that. 

Melissa Coats: We haven't changed our protocols yet as far as I know. When I can't get numbers to move from oral dosages of things, I definitely bring in the IV protocols, and that seems to make a difference. 

Linda Elsegood: And what about vitamin C taken intravenously? Is that really effective that way? 

Melissa Coats: For absorption issues and things like that? I would say yes, because, from the standpoint of orally, most people can't handle maybe roughly above six to eight grams because it causes a lot of GI distress, even if it's buffered, whereas IV we give people up to a hundred grams, which is way past what anyone could take orally. We know that that creates a different type of stress on the cells, that it can help with reducing vascular endothelial growth factor and other inflammatory markers related to cancer.

Linda Elsegood: And if you read about vitamin C and it talks about water-soluble fat-soluble and it's flushing out of your system if you take too much, or you take too much intravenously.

Melissa Coats: It’s pretty much individualized as well. Some people can't handle certain doses. There are some patients that feel great at 40 grams, and others that can take a hundred grams and feel just as great. So it kinda depends on the person. There are tests to check also whether their plasma level of vitamin C, so that's something that we have utilized in the past.

And then based on our clinical knowledge from using it for a long time. We have kind of figured out where people tend to do well. Yes, it doesn't stay in you forever. It is leaving the body, and there's a lot that's going through the kidneys and being voided out, but for the time that it is in the body and doing what it's doing to the cells.

And if you come on a fairly regular basis, you are creating an environment that is, less available for cancer to grow. So you're creating an environment that is not what they will utilize. So that's why we use it so often. We also use alpha-lipoic acid because it's a powerful antioxidant. And then some of the other nutrients that are out there too. 

Linda Elsegood: A few years ago I had an operation, and as I came to I was in quite a bit of pain, and they gave me intravenous paracetamol, and I was thinking to myself, the pain was quite bad, and I was wondering why they are giving me paracetamol? You know, that's not gonna do any good. And it worked. I was absolutely pieced. I thought, paracetamol isn't very strong, but apparently, it's stronger if it's taken intravenously, as it goes through the metabolism by the liver. It just goes right in. I was surprised at that.

So, vitamin C, minerals, and supplements. Do you have any favourite ones? I mean, obviously, it's individually tailored to the person. But on the whole, what would you say? 

Melissa Coats: We utilize a lot in the oncology world, things that basically kinda change the terrain for cancers. So one of the things that I've utilized a lot is modified citrus pectin, which targets galectin-3, and by lowering that, you allow protection of good, healthy cells and keep other tissues healthy. So, for example, with a woman with breast cancer in one breast, you want to try and protect the other breast. So that we found that this can be helpful. And if she's going to be having surgery or a biopsy, having this on board can kind of help prevent the spread of the other rogue cells. In studies, that's what's been confirmed. So it's something that we've utilized a lot. 

And I use some mushrooms, a whole bunch of different ones. Coriolis mushroom, to help your white blood cells keep your immune system healthy. So that's a big one that we use. And then things that target vascular endothelial growth factor, which is basically kind of a signal for angiogenesis or blood vessels to grow around a tumour.

And so there are numerous things that target angiogenesis. One is a magnolia extract. There are other herbs as well that do that. So obviously vitamin C. And then there's some thought that if you stimulate things like the natural killer cell function with low dose naltrexone, that you may be inhibiting some of those other pathways in a roundabout way. So that's why it's a of things. Quercetin, resveratrol; and curcumin is a huge one, which is the active constituent found in turmeric. There's a lot. And that's why we constantly are trying to throw different curveballs at the immune system to help people fight cancer. And so that's why we utilize so many different things, because if you just use one agent, obviously the immune system and the cancer is going to figure that way around it. And so you want to make sure that we help. 

Linda Elsegood: Do probiotics play a role?

Melissa Coats: Oh, yes, definitely. The GI health and having a really good balanced flora of good bugs in the body is definitely key.

When I'm not focusing on cancer, I really do believe in the gut-brain connection. If your gut is unhealthy, so will your brain be unhealthy. And so making sure that you have good flora can definitely help people's mood and their anxiety and stress responses. It's pretty amazing. So I love probiotics and what they can do. 

Linda Elsegood: I was looking at probiotics, and you start off with what I would call a reasonably priced product. So I was reading the labels - this one has that many million and this one has got different strains in it. I was just lost. I didn't know what it was I should be behind. Which was the best? Is it a case of the more money you spend, the better the product you're getting, or should you be looking deeper than just the price you're paying? 

Melissa Coats: I think it's probably a combination of both. Hopefully, the more expensive products are good. If not, then they're just gouging you. But the main thing for us is it's good to get a variety of strains. So not just acidophilus always. You want to make sure you're getting lactobacillus and bifidobacterium, and you want multiple strains of those types of bacteria depending on what you're trying to work with, with the gut. Also, we're a big fan of billions versus millions because you don't know how much is actually lost or killed off into your absorption and what your stomach acid is doing to those bugs. Depending on how they're put into a capsule, there's always some that aren't going to make it. So the more, the merrier, hoping that you'll be colonizing the gut with some good stuff. I always tell people to rotate brands, and also research the brand and make sure that however they have them, they can prove that when they get their product on the shelf, that those bugs are still alive in there if they're supposed to be, and not been heat shocked in transit and are no longer anything other than a pill filled with nothing. So it may be that that is cost-prohibitive, but normally most of the products that are pretty good are similar in price. 

I think that there's some that are really high in the billions that are intensive protocols that you may only be doing for a week or two, that may be more costly. It just kinda depends, which is why we recommend you usually see someone who has done the research versus just buying a product at the grocery store that's just been sitting on the shelf for you have no idea how long. And so it's good to kind of find that out before you spend the money and then are disappointed.

Oh, vitamin D is another one. Yes, it also depends on the person's absorption. Sometimes I've switched patients from a capsule form to a liquid form and have them hold it under their tongue because they didn't seem to be getting anything from their capsule. And that could be a reflection of the way they absorb through their GI, or if it needs to be more sublingual in their case. And usually, the dose probably needs to be higher than they thought it needed to be. Based on our labs, if someone's our range - here for example, one of the labs we use the range is 30 to 100, and we like to see people between 60 and 80. And so that may take them taking 10,000 units a day for a while, and then they may be able to ramp back, or they may have to take more than that depending on their absorption status. But you kind of play with what seems to work for them. And yeah, there's a lot of different brands on the market. 

Linda Elsegood: What about omega-3s?

Melissa Coats: Yes. The key thing with omega-3s for me is making sure that it's a very pure product, that it's not from fish that are in a farm lot being fed dog food or something horrible like that. They need to be deep-sea coldwater fish, hopefully sustainably raised. And then the capsules themselves, when you're looking at it, you want to make sure that they're fresh. So hopefully the product has some sort of date on it that tells you that those haven't been sitting and becoming rancid.

The key is to look at the EPA and DHA content. If it's fish oil it'll typically show you EPA and DHA, and you want that to add up to over a thousand milligrams within just one or two capsules versus having to take ten capsules to get there because otherwise, you're not getting the benefit of the anti-inflammatory effect, the good healthy cholesterol effect and everything else that goes along with it.

Linda Elsegood: I was talking to a nutritionist a few years ago now. And she was saying if you had an inferior product, they usually have vitamin A in them. And the more tablets you take, the more vitamin A you're taking and you can overdose on vitamin A.

Melissa Coats: Yeah, you've really got to make sure it's a pure product. That could be bad. And that will give you a nasty headache and make you not feel good at all. But the one I believe that we carry here, as far as I know, is just really focused on the omegas aspect of it.

Linda Elsegood: Yes. And what about people who are vegans? Can you take flaxseed oil to do the same?  

Melissa Coats: You could do flax or chia seeds. Also just eating healthy oils like avocado oil, olive oil, coconut oil. You know, there's a lot of different ways to get in. Omega fatty acids that do not necessarily require a fish or krill.

Linda Elsegood: I was reading the other day an article on coconut oil where they were saying that previous research was incorrect and it wasn't as healthy as they made out. What is your stance on that?

Melissa Coats: I don't think it's the healthiest oil, but definitely, but I still see some benefit in using it, particularly the medium-chain triglycerides that come from coconut oil. Or we use MCT oil sometimes instead of just coconut oil. But if someone is just occasionally throwing a little bit of coconut oil into their smoothie, I haven't seen it detrimentally affect them and I've seen some good studies with Alzheimer's and Parkinson's research, that it helps the brain. So the MCT from coconut oil is helpful. 

I think it's also a matter of where you're getting it. If it's this big tub of coconut oil from a big box store, that may not be great versus actually getting small organic coconut oil, which might be a better option. With the ketogenic diet, they often mentioned using MCT oil does help supplement your fat content. And that's been a very pure product, and it usually doesn't have a coconut taste, but it's from coconuts. So people can use that if they don't like the coconut flavour. 

And it's nice because if you need to gain weight, it's a good way to add a hundred calories or more. Most people are not looking for that, but sometimes in the oncology world, we need to help people get more out of their meals. And because that doesn't have a taste like coconut oil, it's helpful. I don't think coconut oil is horrible, but I definitely don't recommend it to be someone's only source of fat for sure. And definitely, it is not an oil that cooks well at high heat. It will actually oxidize it and make it an unhealthy thing. So we usually recommend people use avocado oil for that. 

Linda Elsegood: Wonderful. The half an hour is up. It's gone very quickly. This was Dr Melissa coats and thank you so much. Before we go, can you tell people how they can contact you? 

Melissa Coats: Yes. You can contact us through our website at www.listenandcare.com, or you can give us a call at (480) 990-1111. And you can even have a 10-minute free consultation if you like.

Linda Elsegood: Oh wow, so we have nothing to lose and everything to gain. 

Melissa Coats: Thank you so much for having me.

Linda Elsegood: This show is sponsored by Dickson Chemist, experts in LDN and associated treatments in the UK. Dickson Chemist, the most cost-effective for LDN in all forms within the UK and Europe. They are maintaining safety standards far in excess of what is required. Why would you choose to get your LDN from anywhere else? Call 0800 027 6910 today to speak to the LDN experts.

Any questions or comments you may have, please Contact Us on our website at https://ldnresearchtrust.org/contact_us. 

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.

Tracy Magerus, NMD – 15th August 2018 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

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

Dr Tracy Magerus is an MD from Phoenix, Arizona. Having graduated in 2009, she has been in private practice for nearly ten years giving her a great depth of valuable experience. 

She had previously heard of Low Dose Naltrexone (LDN) during her studies in the late 2000s, but first prescribed it for one of her patients in 2012 where within weeks she noticed improvements in their overall health.

Dr Magerus currently has over 25 patients on LDN and considers it a vital tool in her naturopathic arsenal.

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

George Schatz, MD – 8th August 2018(LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr. George Schatz who's an MD from Tuscan in Arizona shares his experience with Low Dose Naltrexone (LDN).

I am a medical doctor and currently a third year and chief resident of our residency program at the university of Arizona for family medicine. I was born in Pittsburgh, Pennsylvania, and I did my undergraduate training in Ohio at a small college called Hiram college.

I decided to move down to Arizona for my residency training because of the world renowned university of Arizona center for integrative medicine, which I'm looking forward to being one of the residential fellows this year to further pursue training in integrative medicine.

I first heard about LDN trought a patient who came in, who had an Ulcerative colitis or Crohn's flare. I don't remember. I don't recall which, but he had an inflammatory bowel disease flare up. And he had to be admitted to the hospital for IV fluids and for monitoring and everything. He was very sick at the time. It was very early in my training, my third year at medical school. He told me  In two weeks, he was going to meet with a doctor in New York city that was going to start in on Low Dose Naltrexone.

I didn't spend much time looking into it. I had a million other things I was trying to learn at the time.

And over the past a few years and months really I've started to hear more about LDN and so I have a few colleagues here who use LDN very commonly and so talking to some of their patients and hearing about what they were taking it for and how it was working with them. And I got extremely interested just hearing the anecdotal evidence of how people's pain is getting better, how people are off of their thyroid medications or their immunosuppressive medications for their auto immune diseases. And I got intrigued. And that's really what led me diving into the research and then using it with my patients with success.

Mostly, I use it for pain, all sorts of different pain,Fibromyalgia or Chronic Regional Pain Syndrome, formerly known as reflex sympathetic dystrophy. Also just chronic low back pain had some improvements. But also Crohn's,  thyroid issues as part of a comprehensive and anti-inflammatory or immune treatment program.

A lot of them are on opiods medications for years. I start by

slowly tapering their opiates.

So if they're on a combination of long acting and short acting, we tape it the long acting first because once that's out of the system and they can control their pain with the short acting, we can stop quicker and start the LDN shortly after.

I usually say, "If it's a Sunday night, take your last Percocet on a Sunday night and then, either Monday night, depending on how you are or Tuesday night take the first dose of LDN."

 Some people come in, especially when you start at a higher dose, they have that initial endorsement rebound and they tell you that this is the first time they felt like this in years. Of course that's what this is all about. That instant gratification as a professional helps me to continue what I'm doing, but that's not always the case. And I'd say that is almost more the exception.

Typically it takes patients anywhere from two to four to six weeks.

There's a beautiful case study that I read recently on a 35 year old guy who had low back pain. And he had tried on opiates and anti-inflammatories and then the epileptics and trigger point injections and steroid injections.

No improvement in it, of his pain. Once they got them on the 4 milligrams of Low Dose Naltrexone, two weeks later, 30% reduction in pain by six weeks, he's completely back to work. Six months after starting it, when he was totally off of it for, almost four months and he was still having just minimal pain, it was still completely, fully functional back at work. And that's something that I totally see.

Some patients mention a bit of sleep disturbance. It's really not insomnia. It's just a change in their sleep habits that can be remedied quite easily by making sure that we optimize our sleep hygiene prior to initiation of LDN and also by just making sure that we take the proper steps when we're initiating it to not really start too high, but, if we do start at what we think is an appropriate dose and has some issues, we sort of drop it down and again, that take her upwards.

 I wanted to mention has a side effect, which I find extremely interesting is if the patients tell me their issues with binge eating have decreased and it doesn't surprise me knowing the mechanism with opioid growth factor and opioid growth factor receptor and beta endorphins.  Having that endorphin surge that's the reason why people binge eat for the endorphins to quell some sort of inner pain.

And so having your opioids inside your body or beta endorphin at a higher level which can actually satisfy those cravings and you don't need to binge it's something that is fascinating to me.

And actually that reminds me a formulation of a weight loss drug that's FDA approved in the United States for and that's a combination of anti depressant and Low Dose Naltrexone. It's called Contrave.

I have an integrative medicine practice that is  growing every day. Those are the patients that come to me either requesting help in, or having heard of LDN in some specific way.

I can be found at www.georgeschatz.com,

And that's the easiest, quickest way to get in touch directly with me and my team. And I can get you a schedule for appointments starting pretty soon or booking out a couple of months, but pretty soon.

Summary of Dr. George Schatz's interview. Watch YouTube video for the full interview.