LDN Video Interviews and Presentations

Radio Show interviews, and Presentations from the LDN 2013, 2014, 2016, 2017, 2018 and 2019 Conferences

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"The Game Changer" - LDN & Cancer - Low Dose Naltrexone - Serbian Subtitles (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

If you were to ask me does low dose naltrexone kill cancer cells, I would say it supports the actions of your classic cancer-killing drugs, such as your platinum; such as your radiation. These drugs and these modalities do work, and they work well in a lot of patients. However, there are a small fraction of patients that don't respond as well, and what low dose naltrexone can do, is that it can open up to these patients that are non-responsive. The whole idea that yes, you can use these treatments in your case, which  I think is fantastic. And if you were to say, do these patients see that as a cure to their cancer, in that situation, you must say it's helped them, and the help it's given them means the world.

I had a patient who I really thought their advanced cancer should be progressing and was delighted and surprised that she hadn't progressed in a certain time. And I asked her if she was taking anything else that I didn't know about because lots of patients do take all sorts of things, and she told me she was taking low dose naltrexone, and this is well over 12 years ago, if not longer. And I asked her where she got it and the whys and the wherefores, and I learned she was getting it from Dr Bihari in New York. And she told me a bit about the background and said that I should go and visit next time I was in New York, which is essentially what I did. And I realized he came from a proper clinical background, that he had been a narcotics expert and was weaning people off morphine heroin, which is how he knew about naltrexone and had been convinced that at low doses and not at high doses, that a lot of chronic conditions seem to improve.

So that's how I got interested, and I became more interested in it the fact that it might have a role in cancer when I noticed that other patients were doing very well on it. And at the end of that, often when there were no therapeutic options, I started prescribing it myself and being impressed that there seemed to be more to it than a placebo or smoke and mirrors, which is what many doctors regard something at a low dose.

Well, what really excited us is that I've taken the clinical observations from this seriously and because some of the results I saw are being really quite remarkable. For instance, I had a patient who had very serious melanoma of the head and neck, and he'd been on a vaccine program for about four years.

And when he started to progress, he wouldn't take any chemotherapy, but I did discuss with him about my suspected properties of low dose naltrexone. And he did agree to take that and rather than be grateful for taking the low dose naltrexone, he came and complained to me two weeks later that he had broken out in vitiligo, which means you get white patches all over.

And often just in the arms sometimes subtly on the face. In fact, about 5 to 8% of people have some form or other of it, except this appeared quite dramatically a few days after taking the low dose naltrexone. He didn't like the cosmetic aspect of it. I basically said I was delighted because it was a sign that the immune system's responding and had targeted the melanoma, and that's exactly what it is. It is due to the killer T cells recognize a major component of melanoma and the normal melanins taken out and bystander a friendly fire as it were. Well, he is still here. I mean, he had a dramatic clinical response to this. And what that showed me was that low dose naltrexone had to be stimulating part of the immune receptor pathway. And that was the start of our research. I said to the guys in the lab, this strike, isn't just working through opiate receptors, it's working through immune receptor pathway, and we sat down and worked out how to do it, did a strategy, and actually hit gold, and we found a very important, immune pathway was indeed heavily interactive with low dose naltrexone, which explained the clinical observation I think. With vitiligo being switched on; there's no defined time period, it can occur at any time, but with an effect of immunotherapy, this usually takes some weeks, months to occur. And we found out with the new checkpoint inhibitors, we basically don't really look to see if you're getting a response for a couple of months, because it is that slow. So, the fact that the vitiligo was induced very quickly suggested it had just flicked that switch which was already programmed, but the vaccine hadn't done it for four years, it just took the LDN, and it flicked it. Well, obviously we're going to be very focused on researching it; doing it properly. I mean, LDN is being used, anecdotally and off-license for a long time. There are fantastic results out there, but it ought to be taken forward; it really wants to be put it into proper clinical trials and getting it to the right niche. And because there are so many possibilities, we would like to do everything properly; get it properly approved by the FDA, EMEA, et cetera, and then go for a condition that we know the chances of working are very high and don't take very long, and of course, two of the conditions it's effective in are Multiple Sclerosis and Crohn’s, which are very difficult studies to get approval for. They're very hard and expensive trials to do. And you mention about taking it with something; this is what we've found with all of immune modulators, that they're much better in combination with other agents than by themselves. One of the things that we have been researching independently and it fits beautifully is that it is great, with what I would call an endemic, epidemic of a low vitamin D in the population. and it's particularly in the winter months and the further North you go. And this is one thing that we are looking at very carefully because we think that there is a positive interaction here, but that's not a big surprise, because if you're low in vitamin D, you don't respond to a whole range of things, like chemotherapy or whatever, so that's one particular thing. Combining it with another immune modulators/vaccines is the next obvious way to go, as is enhancing the anti-inflammatory aspects of it.

So, all of these things we have been looking at in our research, both in the lab and taking it forward into the clinic. Given how non-toxic it is and how relatively cheap it is compared to other interventions could be applied to, I would say the vast majority of people who have incurable cancers where you can't cut them all out because the anti-inflammatory aspect for most cancers is now well established and the need to boost the immune system when you have cancer. In fact, one of the pieces of research that we did early on, that  I’m most proud to have done, was we showed that even patients with very early colorectal cancer have a major suppression of the immune responses. And we proved that this was due to the bowel cancer patient group we use, because we repeated the assays a month after the tumour had been completely removed, and the immune system all bounces back into the normal range. So after that, and the colleagues elsewhere showed that they got the same sort of thing with other solid tumours, lymphomas, gliomas et cetera. So it means that tumours immune suppress, and if you can't cut them out you want to go some way to correct it.

There are some very fancy, toxic, expensive ways of doing that, but low dose naltrexone provides a lot of those properties without any of the toxicities, et cetera. So as a universal supplement, as well to be an anti-inflammatory, immune booster, I can't see why it would be limited to any particular tumour type.

Low dose naltrexone works on a number of processes in cancer cells. So, if a patient has cancer at whatever stage, if that cancer exhibits the same malfunctions, the same profile for one of the better term, then naltrexone prefers or low dose naltrexone likes, then you should see some kind of responses.

Like the first thing is that there is no drug in the world, and that would include LDN, that is active in everybody. But, if you’ve got advanced cancer and basically don't want to take anything else, but you’re happy to try something that might help you feel better, then to my surprise, I have seen the LDN is very effective in that scenario.

It shouldn't be looked upon as a cure again, to work on everybody, but I'm impressed with people who do have their disease stable after finishing chemo, having given up, and they take LDN, and they feel much better on it, and they request for repeat prescriptions that basically provides the evidence that they're doing really well just on this treatment.

One thing we did, first of all, was to explore the effects that low dose naltrexone had on immune cells, as well as on cancer cells. And I suppose one thing that people tend to forget is that drugs that you give to patients will have an effect on immunity as well as on cancer cells.

So, these so-called indirect effects versus the direct effects, and the beauty of naltrexone, especially at low doses, is that it can have an effect both on the cells in your body, as well as on the cancer cells. So it's like a double-edged sword, I suppose, one edge that kills cancer directly, and one effect which modifies the body's own natural ability to kill cancer cells. So, this drug naltrexone being a potential agent, or at least a semi-synthetic, we could then explore that further. And we showed that in addition to the effects on immunity, which made it a fantastic stimulator of immunity, which allows the body's cells to be re-educated to re-engage cancer cells, low dose naltrexone was also capable of targeting cancer cells directly. How does it do that? And that's the exciting thing. There's lots of data to suggest that it binds to certain proteins on the surface of the cancer cell and in doing so can manipulate the cancer cell to make it much more sensitive to the treatments.

There's also other trains of thought that suggest that it might enter the cell independently of these receptors, but nevertheless what we're finding is that the mechanisms that control cancer, the mechanisms, in fact, that makes a cancer cell, a cancer cell, is being turned off. it's been tweaked in such a way to make that cancer cell much more sensitive to cell death.

So, if you were to go along or come along, treating patients with low dose naltrexone, in addition to other drugs, which are focused on killing, then we have a fantastic partnership where one prime the cell and the other does the killing. And that's, what's exciting about low dose naltrexone.

So it was in about 2007, 2008 that I first discovered LDN, and we started using it immediately as a cancer treatment because there was some promising data presented by Dr Bahari. So, when we started using LDN for patients with stage three or stage four cancer with low disease volume, in other words, small tumours, or patients who had had surgery already but were not completely cured, we started seeing better results. One of our earliest patients that we used LDN on was a 65-year-old gentleman with bladder cancer. He had a tumour in the bladder, which was treated by conventional means, which means surgery, so they would go in and removed the tumour; they would burn where they had removed it from with a cautery and inevitably the tumour would return some months later.

So this gentleman had a few surgeries and the doctors had told them it was an aggressive type of cancer, which is called high grade, and that because of the depth of the growth of cancer into the bladder wall, it was growing into the muscle, they felt that he was at risk of cancer spreading in a short time.

So, this fellow was offered an aggressive surgery, which meant the removal of the entire bladder, and he declined that. At that point, he came to us and we started him on LDN. And he did very well on it, he had a little bit of sleep problem, but that was easy, we just gave him a little sleeping pill with that, and he did very well. And at the same time, his conventional doctor gave him a single course of an immune therapy called BCG. It's a bacteria that they instil into the bladder, and it can trigger an immune response. So while he had the one course of BCG, he was on LDN, and he took LDN for about four months, and then he had gone back to see the surgeon; they took a look in the bladder, and the cancer was completely gone. So, this gentleman continued LDN for about a year. He had no further conventional therapies, and cancer remained in full remission, and it's been about seven years now, and this gentleman is still in full remission. So, in his case, he did extremely well, and I believe that the LDN and the immunotherapy worked in unison, and one synergized with the other in order to give him an excellent result, which in this case would be considered a cure.

Another one of our earlier cases that really intrigued me was a 58-year-old gentleman that came to see us for rare cancer that was present in the base of his tongue.

He had about a three-centimetre tumour in the tongue, which was an adenoid cystic carcinoma; that's just the type of cancer, but it's an unusual type of cancer of the mouth. So, this gentleman went to see his specialist and he was told that in order to cure his cancer, the entire tongue would have to be removed surgically, and because of the location, in order to really give them the best chance of cure, they would have to remove his voice box as well. And then there was discussion about possible chemotherapy and radiation after all that surgery. So naturally, this gentleman was upset because of the dramatic change in his quality of life that would follow after cancer treatment.

So, he declined conventional therapy. He came to see us requesting a therapy that had no side effects. So, the first thing I told them was there's no such thing that has no side effects, however, immediately I thought of LDN because it's one of the gentlest therapies I know. So, he ultimately started LDN, and he combined it with vitamin D because that's considered to be a medicine that can potentially enhance other cancer therapies. It can work on the immune system and improve anti-cancer immunity. Vitamin D can also change the behaviour of cancer cells into more harmless behaviour so that they don't grow and aggressively spread. So, this fellow has started taking the treatment with the LDN combined with vitamin D, and within a few months he felt that the tumour was shrinking, and so continued therapy, and we didn't hear from him for a while until about two years after he started treatment., and he sent us a new MRI report, which is a scan of the tongue that showed complete disappearance of cancer. So, he continued on LDN and vitamin D and he has now over five years cancer-free. His specialist is quite surprised and pleased, to the point that he no longer repeats his scans frequently, and he just sees him once a year for a regular checkup.

A couple of years ago, a 53-year-old gentleman came to see me requesting treatment for bowel cancer. It was present in the sigmoid colon, and it was believed that cancer formed as a result of his inflammatory bowel disease called colitis.

So, this fellow was offered surgery by his specialist that would have been the standard treatment and potentially curative. However, he was afraid of surgery. He was afraid of the complications. So, as a result of his concerns, we offered him a few treatments, and he ultimately chose LDN. So, he started LDN, and we were monitoring him with a blood test for colon cancer called CEA, and in addition, we also monitored him with colonoscopies. So, his specialist would have a look within the colon and see what was happening with the tumour. It took about four months to see some improvement. We actually started to see the CEA, the cancer blood test numbers fall, and it was falling progressively over about a period of about three to four months subsequent to that.

And then it was maintained at a steady value of about 30% below the original value. In addition, he did have a follow-up colonoscopy, which confirmed that the cancer was stable or smaller, and his symptoms of bleeding in the bowel actually improved as well. Now this fellow did decline traditional surgery, which was not exactly what I had recommended either because I thought that cancer could potentially be curable.

However, the case does demonstrate that in cases where let's say a patient refuses surgery, or if surgery were to be too risky, then LDN could be an option for patients to try, especially if the cancer is non-aggressive.

In addition to using LDN, we almost always recommend vitamin D. The dosing of vitamin D is very controversial, but there's adequate research now that supports using high doses of the vitamin. So, that's what we're doing: we're using typically in the range of 5,000 to 10,000 units per day of vitamin D3, preferably in a liquid form because it's easier to take, and so patient compliance is high. Sometimes we even need upwards of 15,000 units or 20,000 units of vitamin D per day. As an aside, I personally take 15,000 units of vitamin D myself, and I've been taking that for about a year now. I take it from my allergies, and I find it to be highly effective.

So I became acquainted with Naloxone and Naltrexone, the drugs, in my training over 20 years ago in emergency medicine, and early in my career in general medicine began to explore the use of low dose naltrexone for a variety of illnesses, including auto-immunity, pediatric disease and then cancer. As the years of practice went on, we developed more and more cancer patient care where we were using the low dose naltrexone as an integral part of the patient's therapy.

We began adding low dose naltrexone with a variety of cancers, not knowing for sure which ones would be more or less responsive. And back at that time, the data was very sparse, so we were basically asking patients if they were okay with us trying it, So, many would come in with articles they had read, and we would start the therapy with them.

We have had a number of responses that run the gamut from—stabilizing disease, to being very supportive of other therapies that were being done, both natural and standard chemotherapy and radiation in some cases. And then one of the most beneficial uses we have seen is in the patient who has come back from the oncologist, and there is the report there's no more we can do for you. So, we use it in our program for stabilizing those patients where the standard of care has run out. I think the persistence of our using the low dose naltrexone as therapy is owed to the fact that we see positive results frequently enough, that we keep using it with many therapies that are nonstandard. You'll find that they work in a very narrow margin or for only certain types of cancer or certain types of illnesses, and so we'll reserve those for those certain type things. Low dose naltrexone at this point, as they say, eight or more years has impressed me enough that I keep it at the beginning of treatment when I'm working with patients all across the board with cancer.

So, the results are quite varied. We have had some patients, especially elderly patients, where they're very sensitive to medications. They've been told by their oncologist that they are not a candidate for standard therapy, because they're too elderly or frail. We have had a few of those patients where their disease, their cancer, has stabilized with basically the addition of low dose naltrexone on its own.

We don't expect that in everybody, but it's been curious to me to see one agent do that in cancer, which is very unusual. Most people, what we see is, it is a very good synergist with the rest of the care, and sometimes what will happen is, a patient will stop taking it and not tell us, they'll come back and they'll have some regression or some addition of symptoms from their cancer, we'll find out they've gone off low dose naltrexone. They'll go back on, and often those symptoms will go back away. So, we do see it as an integral part of care. I would say the number of patients with cancer that we have prescribed low dose naltrexone for in the last seven or eight years amongst myself and my colleagues at my clinic would probably reach a number between 250 and 350 patients.

As I said, we've seen a wide spectrum of response all the way from it was the only thing that they could tolerate, due to age or frailty, and we saw a stabilization of their disease, meaning it didn't progress, which is a very positive finding, to the person on multiple therapies where it's being used as part of a team approach, and as I mentioned, it being withdrawal caused a reversal of the positive. So, I would say in at least 30% of people, we have some verification, either based on it being the only drug used or it being taken away from their therapy, and them having regression that we could really point to clinical success. The rest of the patients, it's not that it made or broke their therapy, but we definitely left it in their therapy and never withdrew it to see if that was part of the success or not. But we definitely have seen, and as I say with either on standard oncology or natural therapies, I've seen it to be useful and positive in cancer cases, more than most other therapies I've used.

I would say that of all of the integrative and standard therapies that I have seen both in chronic illness, but especially in cancer in the last 20 years, low dose naltrexone has been one of the top treatments that have impressed me as far as outcomes. Improving the quality of life and stabilizing disease.

For patients, it's largely letting them know that it has a very low incidence of side effects and downside., and the most we can do is share case reports with them that match their cancer, and normally we have some positive ones. Of course, you can't guarantee anything in cancer, but to me, it's a low downside, low cost, and high-value therapy.

 

So low dose naltrexone isn't the cure to cancer, unfortunately, and I suppose there's no such thing as a true cure to cancer, but what low dose naltrexone will do, is it will support the actions of other drugs that are out there, which have been shown to have an effect. For instance, chemotherapies are efficacious in lots of patients, but they could be boosted. Irradiation is also effective in lots of cancers, but again, they can also be improved, and these agents that can support the activities of other drugs, these so-called agents, is a class of agent that low dose naltrexone will sit-in, which makes it an incredibly exciting piece of the compound.

So, what we did with all this genetic data, we went on to see if these cancer cells that we brought into lab could be sensitized or could be affected upon by naltrexone. So, we use in vitro experiments, experiments performed in a lab to see if we could kill these cancer cells.

And the disappointment was, that by using naltrexone at low concentrations continuously, we were having no effect on a number of cancer cells. However, the genetic fingerprint told us that it should work. So, by changing the schedule in the way that we gave this, this treatment to the cancer cells, based upon our understanding from the genetic fingerprint, we could actually cause these cancer cells to undergo cell death.

So, to summarize all that, we have a situation where if you were to use low dose naltrexone continuously you'd have no effects or effects will be minimal. However, if you were to use a schedule that involves slightly different aspects, you would end up killing those cancer cells. And that's something that armed with, we can take forward to the clinic and convince clinicians to start using low dose naltrexone, not on its own, possibly in combination with other therapies such as these chemotherapies, as I alluded to, as well as other newer drugs, such as the immunotherapies. So, the results of our studies that have allowed us to understand the action of low dose naltrexone much, much better than we did a while ago. And armed with this knowledge, we can design new treatment regimens, these new, different strategies that can be used in patients. And in that regard, it’s a game-changer. We now know how best to use naltrexone. In the past, we used to think naltrexone should be used continuously, and that would induce some effects in the number of patients. However, the data that we've generated very recently, suggests that we can actually improve on that. And it's these small step changes that will lead to a situation where these patients with cancer will benefit. We've worked on a number of cancers in our lab-based studies, and these cancers have involved cancers of the colon, of the breast and also of the lungs, and in these cell lines, we've shown that the effects of other drugs can be enhanced by using low dose naltrexone. And we are yet to find cancer that doesn't respond in this positive way, but we've only just started very recently and in the three cancer cell types that we've used, we've had a response that's always been positive.

Our results suggest that doctors who prescribe naltrexone need to be very wary of the way it's given. We've shown that depending on how the drug is given, you may get responses that are not optimal. Indeed, our results specifically showed that by giving this drug continuously over four days, would result in effects, although good on its own, was inferior to if you were to use the naltrexone on a different schedule altogether. What our data suggests, is that low dose naltrexone effects can be improved if you were to modify the schedule to involve breaks in treatment.

 My hope for low dose naltrexone is that it's incorporated in treatment regimens, in treatment strategies in patients with cancer. Naltrexone, especially low dose naltrexone, will enhance the actions of a number of chemotherapies in a number of cancers, and my hope is to see it being included in treatment.

Well, in a word, with the findings that we've captured here, gives a complete scientific justification for taking this forward into the clinic and giving evidence to the commissions, and the regulatory authorities and say look this does this, that, and the other, it should be incredibly useful in these conditions, and here you have this enormous amount of anecdotal evidence that it is. So basically, we want to go forward and capture it so it can actually be used and prescribed in the clinic on the NHS.

Our data gives us a better insight into low dose naltrexone, but better understanding, low dose naltrexone, we can better understand the ways that you can treat patients with cancer. So, I suppose the take-home message would be, we need to know how this drug works to maximize its uses in cancer patients. Patients are not interested in how the drug works, they are more interested in whether or not the drug works or not.

What our data suggests is that we have the best understanding. And by understanding the drug better, we can design better treatments that will benefit patients.

Well, the NHS and the government say, and various people say, that they would basically like drugs which are non-toxic cheap.

The current drugs being used to treat cancer are coming in at an average of about 5,000 pounds a month. And when you finish one, there's another one, so these costs are totally unsustainable. Whereas the advantage for a drug like this, that's a cheap, non-toxic can extend life, possibly, we don't know until we try that, but you can see it's a doctorate. It does improve the quality of life in a lot of people; that's an enormous potential that could save I believe you know, millions and all the treatments that we currently use to try and improve the quality of life and extend, et cetera.

One of the issues with LDN being a generic drug is that if it has been proven to be effective as a treatment for a disease like cancer, it could certainly prove to be challenging for the pharmaceutical industry. The reason is that this very cost-effective medication could potentially compete with branded drugs that are out there already.

So, I think that there is going to be a bit of a challenge moving LDN forward as more of mainstream therapy because it would likely be opposed by the pharmaceutical industry. Well, at the current rate of growth of cancer around the world, and looking at the cost of cancer therapies right now, it’s pretty clear that in a short number of years, the treatment of cancer is going to be unsustainable, so we actually desperately need more cost-effective therapies. Now with the current research model, there's really no motivation to conduct large formal scale clinical trials with LDN, because it is not a profitable drug. So, what we really need is a different model for researching LDN. One in which there should probably input from the government, in order to fund large scale trials to finally put to rest the idea that LDN is in fact, a valuable therapy and potentially from the insurance industry there should be funding because they're probably going to benefit greatly from the reduction in the cost of cancer therapies.

Low dose naltrexone increases what's called the OGF and OGF receptor. These are little peptides, basically proteins, that when connected together inside the cell, they give a signal to the nucleus that inhibits the cancer cell production. The amazing thing that they found is this is present in 90% of the human cancers, over 47 different lines of cancer, they've shown that this mechanism is present, and after reading their papers regarding this, I found the science to be good enough to be legitimate to try for people who have cancers that really have no other choice; stage three, four cancers that really are done with their therapy. It also increases what's called the P16 and P21 pathways, that are the key components to inhibiting the cancer cell division, and what they found interesting enough is in the cancer cells, they don't have a lot of OGF and OGF receptors. So, what it does is it boosts the body's own way of inhibiting cancer cells. We don't know that it really destroys tumours., it just inhibits cancer cells from dividing. So, in doing so, I took it upon myself to do research on it before it would use it.

You know, I'm a scientific type of person. I like the science to be there. Dr Zagon published articles regarding ovarian cancer cells specifically with naltrexone and OGF, and since ovarian cancer’s, the fourth leading cause of cancer mortality with women, and it's the leading cause of gynaecological cancer; this is a tough cancer and it’s critical to understand the cancer mechanism. And they found that the OGF receptor mechanism was present there. They showed it reduced cancer cell proliferation, and he's had a number of other articles showing the same thing.

So, I have a patient who is 2004 had initial ovarian cancer, and as Dr Zagon points out in his articles, 65% of the patients with ovarian cancer recur within two years. Well, she went six or seven years, and then she had stage four metastatic ovarian cancer everywhere. Her spleen, liver, colon, she had the surgery, she had some chemo, and then she heard about me through a friend, and so I started her on low dose naltrexone in 2011. And as a matter of fact, I just talked to her two days ago. She's doing very well. Her liver metastases have stabilized, and she's now in a stable state, and this is four years, four and a half years later, which is significant, because I was anticipating that she wouldn't have lasted more than four or five months with metastasis through her whole abdominal wall cavity, and the other areas I mentioned.

I had another patient who at 38 years old had a discovery that he had stage four squamous cell carcinoma of the tonsil. And he was treated with the usual chemotherapy, radiation; he elected not to have a radical neck dissection. He just said I'm not doing that. So about eight months go by, and he's just not doing very well.

He was tired, fatigued, and so I said, well, come to my clinic. I did a bunch of body chemistry tasks; hormone levels and found that the chemo and radiation destroyed all those, which is very common. Once I got those balanced, he was feeling better now, and he's doing great, but I also put him on LDN and Squamous cell carcinoma that tonsil does not do very well when you're stage four. This is four years later now. There are no signs of cancer. His oncologist says we really don't even have to follow the PET scans anymore because there's really no evidence of any recurrence. And he now is doing very well. He's doing worldwide trips, working two jobs, and he takes the 4.5 milligrams every day and hasn't had a problem since. In regards to how well he's done, well, maybe half the people last five years with that diagnosis, he met two other men who had the same diagnosis, same exact diagnosis when he was at MD Anderson, they have now both passed away a couple of years ago, so as long as he lives, it's another telling sign that LDN could be very positive for people, you know, long-term, and maybe preventing the recurrence by inhibiting any other cancer cells that are residing or starting to rise again.

I'm a stickler for facts. I want facts. I want proof. I want black and white. I want to know this is how it works. It increases the endorphins in the body, we know this. We know what endorphins do to the tumour cells; they block those tumour cells, and they block the receptors on the tumour cells. They cut down the inflammation around these tumours because this inflammation around the tumours helps it to grow, helps it to get blood vessels to grow out of those tumours so you can get more metasticies et cetera. So low dose naltrexone plays a role directly there at the tumour surface at the tumour cell.

However, it has another mechanism. This is what's also fascinating. And that was, as I said before, it down-regulates some of the T suppressor cells; the ones that are the most important in suppressing the immune system, it blocks those. So, the immune system can go up, and you can get the immune system up by down-regulating these T suppressor cells it's called foxp3, for those who are in biochemistry or studying this area. The foxp3 cells are blocked by low dose naltrexone, and so you're raising your immune system, you're working directly against the inflammation at the tumour cells, and you're helping the patients to be able to reverse their own tumours,  but not as one drug alone, but in combination with other things. If any of my cancer patients have cancer, they should all be on low dose naltrexone, because of the fact that it is helpful for them in every area of cancer therapy…period. If I had it myself, I would be on low dose naltrexone, and I'm a physician and a pharmacologist and a former FDA official, and I would recommend it to any and every one of my patients. It's imperative, as far as I'm concerned as a support measure, and we need to realize this. We need to realize this is not a cure. We need to realize that this is something that is an agent that will help tremendously, and that when patients are in remission, it will help to keep them in remission. The fact that low dose naltrexone cannot do any harm, and we've been showing efficacies in autoimmune diseases as well as cancer, it's something that I think the FDA is going to have to recognize this as a support measure for many of these illnesses.

A very diligent radiographer went back through all my medical notes and said, perhaps we should look at the pathology of the spots you had removed from your leg seven years ago. And sure enough, it showed that there were some suspicious cells there that hadn't been removed. So, it was then decided that it was probably melanoma, and I had my lymph glands down my right leg removed. And then I was having a few spasms in my right arm and my right hand. My GP, my same GP, suggested that I was just anxious about my golf swing and that I shouldn't be too worried at my age. So, off I went on holiday and while I was walking on holiday, I had the most amazing spasms in my right leg, and I knew something was wrong. Thinking I'd got a trapped nerve, I went straight back to the doctor when I returned home. By the afternoon, I was seeing a neurosurgeon. He sent me for an MRI, and the result came back that yes, I had I think five-centimetre tumour in my left side of my brain. So, I had a pet scan, and it revealed I had a tumour on my adrenal gland and tumours in my lungs.

My name is Annette Manabi, and I'm a physician in Illinois. My background is in osteopathic medicine, and I have two board certifications, family practice, and neuromusculoskeletal medicine. I was diagnosed in December of 2014 with cancer, and at that point, it was a stage one endometrial cancer and the initial treatment plan is always surgery, which I asked to defer in an attempt to hopefully avoid surgery. And so they were willing to work with me. I said, you know, there are a lot of options that they do with women who are still trying to have children, and once you're menopausal, they just want to go straight to surgery. So, I said give me a chance to try some of these things. I, unfortunately, wasn't able to find a practitioner in my area who was versed in using LDN in cancer patients, and so I was having to navigate a lot of that on my own, but I worked up to the four and a half milligram dose, and over the course of six months incorporated a lot of integrative holistic treatments as well into my cancer treatment regimen. During that time, my tumour markers continued to rise. So ultimately, I did have surgery in June of last year. However, at the time of the surgery, what was of note to me, and I feel assigned that the LDN and the supportive treatments I did were helpful is the tumour itself did not invade systemically. So at the time of the surgery, it was still only a half-centimetre into the wall of the uterus. It didn't go into the lymph nodes. It didn't go into the circulation or metastasize anywhere. It did grow into the uterus. So, the tumour itself increased in size, but not into my own tissues, and so I feel had I got it sooner and had I caught cancer when it was much smaller, I may have had success in actually avoiding the surgery, and I'm continuing on the LDN at this point to prevent any recurrence or continue to boost my immune system because we don't really understand all the mechanisms of why cancer occurs and there's still a risk for recurrence or metastasis, and so I'm trying to boost my chances, and there's so much promising research coming out, showing it is effective in fighting cancers of all types and all stages. And so, I have no qualms in continuing to use it to support my own immune function.

So, I went away and I followed a very strict diet, then I was very conscious that I needed to rebuild my immune system and really fight cancer through my immune system. So, I followed that for the whole of that year. In July of that year, there were some more slight spots on my brain. So, the gamma knifed it again, and then I had seven sections of my small intestine removed.

So it wasn't until mid-2007 when I collapsed and was taken into hospital, ended up in Hammersmith Hospital. And I had a ruptured tumour on the outside of my liver, which caused me to bleed internally. And I was very seriously ill. You know they basically resected my the liver at that stage and shut everything down and that was the start.

So, Professor Dalgleish said, well, I wanted you to have LDN anyway because I think it's going to be good to build your immune system. He also advised me at that point to take vitamin D3, 25 UGS, high dosage every day. I was having B12 injections because I had so much that my intestine removed and I was trying to drink a lot of green tea.

So, he put me on green tea extract at that point, which was much easier.

So, it was about that time that I have an old school friend and his wife plays tennis with Professor Angus Dalgleish, and she said, why don't you go and talk to him? He's a top oncologist. And so I did, ‘cause I really didn't know what I should be doing at that stage.

So, I thought, well, I've got nothing to lose. And I went and spoke to him; had a consultancy session, and what he did tell me, he said, look, you know, it's just not quite my field, but he said, I can tell you, he said, I can't recommend it, but I can tell you that I have a dozen or so patients who are self-prescribing low dose naltrexone for malignant melanoma, and remarkably they've been symptom-free for 18 months, and he said, that's very interesting.

So here I am, just over seven years with, I hate to say it, but at the moment…good scans. And that’s really about where I am now. I suppose I love it, that's all I can say. My lungs are completely clear and that's only happened since I took the LDN. Up until that time, it was still growing. So, from my point of view, that's very positive. It's had no impact on my life whatsoever.

When I initially started taking the low dose naltrexone, I started at one and a half milligrams worked up to four and a half. I'm currently still on four and a half milligrams of the low dose naltrexone.

Initially, I did notice an improvement in my energy and an overall sense of feeling better. And aside from the initial disruption of sleep, which took place, my quality of sleep improved dramatically on the low dose naltrexone. And that persist, like if I miss a night or during the surgery, when I had to stop because of the pain medications, I could see a difference when I was off the low dose naltrexone than when it was back on the low dose naltrexone. So, I find overall, it's helping my overall wellness and state of health.

So, following on from that, I got more information from him and I didn't do anything about it immediately. I don't know why. I think it was because I'd been around the alternative market, and I was talking to all sorts of odd people. One of them selling mistletoe therapy.

I consider the impact of low dose naltrexone on myself and potential negative side effects. I did experience initially some of the sleep disruption that is commonly reported, where I was a little bit more awake at night, or I woke up a little more frequently.

And after about two weeks that passed and the quality of my sleep actually improved. Other than that, I've not had any other types of side effects from it that I'm aware of, and in general, I am feeling much better in how I feel my sleep energy and I haven't noticed any other specific side effects.

And so I was a bit sceptical about following Professor Dalgleish’s advice at that time, so I didn't do anything about it for 18 months. Anyway, within that timescale, I had two further recurrences of. HCC, which is hepatocellular carcinoma. It's a tumour in the liver. It doesn't spread in the body, but all the same, it destroys your liver.

When I came out, I did a bit more research, following up on what Angus Dalgleish had told me, and I researched  Dr Buhari in New York, and I thought, well, this is very interesting. And it kind of supported what Professor Dalgleish had said to me. And I also got to know about Dr Berk Berkson’s books and who's in Las Cruces, New Mexico, who was doing very interesting work as well with LDN and also using antioxidants, in particular, alpha-lipoic acid and some other things, and so, based on my research, I thought, well, I mean, I've got nothing to lose so I'll give this a whirl.

I have in terms of ways to take the low dose naltrexone, I am taking the capsule form that I obtain from a local compounding pharmacist. In terms of the future of LDN in the US I think in the ideal world, I would wish that all the major cancer centres would incorporate it into their treatment regimens immediately. Unfortunately, change in medicine is very slow, and it's challenging, and because it's already a patented medicine, there's not a lot of profit to be made. It's inexpensive, and so that becomes a barrier I think, in realistic means, the integrative medicine and holistic medicine community will be embracing it as the word gets out, as conferences are held, they will be the ones to hold the torch and get it available, as the patients also demand access, it'll be, I think, through that population of physicians who offer it to their patients. I would like to see it as a frontline for anyone who's got a suspicious diagnosis that's potential cancer. They should be started immediately.

So, I started without any expectation. I started taking the LDN and hey presto, miraculously I went into remission for three and a half years. Three and a half years. And that in itself was remarkable. And I was being treated then by someone at Hammersmith Hospital who was a bit dismissive about LDN. He'd never had great faith in it. And what he said to me was he said, look, your liver is recovering,

I don't think your recovery and your remission has anything to do with this low dose naltrexone you're taking. So, he was so dismissive I discontinued it, and I rue the day I listened to him basically. So, I discontinued it, and then within nine months, I'd had another recurrence of another tumour in my liver. But after I’d had this news, I decided I'd go to America to see Dr Berk Berkson, because I'd heard about him. And I thought, well, I'll go and talk to the guy. So I went out there and started on the LDN again with him, and I came back to the UK again with no expectations, and when I got back to the UK, I'd only been on the liver register for six weeks I think it was, and I  just sitting at home one day and I had a phone call saying we've got a liver for you. And I almost fell off my chair and we had to make a sort of an instantaneous decision about where to go. So, I said, yes. Interestingly, when they removed my liver and replaced it with a new one when they sectioned the old one, they said, oh, that's interesting, all your liver cancer has disappeared. Your tumour has completely necrosed. So, I don't know how to explain that, but since that day, that was over three years ago now. So well, I shouldn't really judge, but I suppose in my mind, I know that what did LDN do for me? Well, it gave me three and a half years of remission from the time when the doctors were actually saying, he's going to have another recurrence in three months time and it doesn't look very good, to basically getting me through that period. It's gone very well indeed, and I have no recurrence of any sort. So, do I believe in LDN? Yes, I do. I know, I know it worked for me.

So, more commonly we are getting many inquiries from patients who have been diagnosed with various types of cancer for low dose naltrexone. And it's quite important that if you are going to look at using low dose naltrexone for your cancer therapy that you talk to your individual GP and your oncologist first, because you may be on certain types of pain medication, which are contraindicated initially unless they're very carefully handled. A lot of people have come to us because they've gone onto the internet, and they’ve found something that they can buy. A lot of those are not real, or they are fake medications, which are dangerous, and you should not randomly decide to treat yourself for cancer by buying naltrexone tablets on the internet. I know it sounds very simple, but we find out the great number of people who do that.

So, looking at the possible side effects you can have from taking LDN along with cancer chemotherapy, that's extremely individual, dependent upon the type of cancer chemotherapy that you have. So, for example, there is a growth in biologics and vaccines, versus original chemotherapy drugs, like the platinum and things like gemcitabine, which has a slightly different mechanism of action. So, if you are taking, or you’re being prescribed many different types of cancer chemotherapy drugs, and each individual cancer is specific; cancer is not one disease, it uses multiple different types of treatments for different types of cancer, and the guidelines are always changing.

So, there are biological drugs that are chemically drugs called the plantains, and there are also drugs which can change your immune system, like vaccines. So, it's going to be very individual when and where you're able to take LDN in your treatment cycle or your treatment pathway. Now, there has been some information that we are aware of, which has not yet been released.  And I think over the next year we're probably going to hear more about that along with vitamin D. So, I’d certainly say, if you have been diagnosed with cancer and you're looking at using LDN, the first thing you should do is start taking vitamin D, and the dose for that, you can decide with your practitioner, but really it would be aiming for between five and ten thousand units per day, and LDN seems to work much better when it's being used with that, but LDN itself should not be taken when you're on any strong painkillers without direct medical supervision. So to speak to your doctor or pharmacist, and before embarking upon this journey and make sure that you get someone who is very qualified, who is capable of reading the most recent research and keeping you up to date and make sure that your treatment pathway works as well as possible.

Linda Elsegood: Thank you for listening to this presentation. All past conference presentations can be found on our website, https://ldnresearchtrust.org/

Dr Yusuf Saleeby - 19th Feb 2020 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

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

Dr. Saleeby is a 1991 graduate with a medical degree from the Medical College of Georgia in Augusta Georgia. Upon completion of post-graduate training at East Carolina University School of Medicine in Greenville, North Carolina, he had a two decade career in Emergency Medicine serving Emergency Departments in NC, SC and GA. He held leadership positions as medical director in his career. In addition, he pursued training in functional and age-management medicine since 1998. 

Currently, he practices holistic integrative and functional medicine in North & South Carolina at Carolina Holistic Medicine. From 2000 until 2006 he was appointed as co-medical director of the Emergency Department at Liberty Regional Medical Center, Hinesville, GA. In 2007 he was promoted to medical director of the Emergency Department at Marlboro Park Hospital in Bennettsville, SC until 2010.

With over 400 patients being treated in his practice currently, he has around 60 currently on Low Dose Naltrexone (LDN). In this interview Dr Yusuf Saleeby explains his interest in Chronic Lyme Disease and how LDN can help to combat the disease.

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

Dawn Ipsen, PharmD - 4th Dec 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today I'd like to welcome my guest pharmacist, Dr Dawn Ipsen, who is not only the owner of one compounding pharmacy but two confounding pharmacies in Washington State.  Thank you for joining me today, Dawn.

Dawn Ipsen: [00:01:35] Well, thank you Linda so much for having me. It's an absolute pleasure.

Linda Elsegood: [00:01:39] Great. So tell us, we're all interested. What made you decide you wanted to be a pharmacist?

Dawn Ipsen: [00:01:47] Oh, yes. So I knew at a, pretty early on that I wanted to be in healthcare on some aspect and pharmacy was very intriguing to me and started on that path and lucky for me, I got an opportunity to be a compounding pharmacy intern while I was in pharmacy school in a compounding pharmacy and immediately fell in love.

And so that was my path. I loved how personalized it was, how unique it was, how I was doing things that none of my classmates and colleagues was doing and so that started my journey. This was in the Seattle area. I went to the University of Washington School of pharmacy, and it was almost 20 years ago now and got my doctor and pharmacy degree there, and I've enjoyed it thoroughly.

Linda Elsegood: [00:02:43] So how did you get from pharmacy school to owning to compounding pharmacies?

Dawn Ipsen: [00:02:50] So I've always been an entrepreneur and really loved business sides of things and kind of had this long term goal that someday I was going to own a pharmacy and it definitely happened earlier in my career than I expected.

I had been working for the Kusler's family at Kusler's compounding pharmacy and had always told them: "When you're ready to do something else, keep me in mind." And got that call. Became owner of Kusler's compounding pharmacy. And  Linda, that was almost six years ago now and was just minding my own business, running my pharmacy, helping my community, doing great work.

And a couple of years into that, I received a call from another owner, the owner of Clark's compounding pharmacy in Bellevue, and he was looking for a buyer. He wanted to retire and he'd done his research and determined that he thought I would be a good fit, that I did the kind of pharmacy work that he liked to do, and I help people the way that he felt was the best way.

And so I've owned now Clark's compounding pharmacy in Bellevue, Washington for three years and even the pharmacies are only 25 miles apart. They kind of do similar, but yet different things or both, compounding, online pharmacies, Sterile. Kusler's does contract with some insurance plans, so we do help patients with that.

And Clark's is licensed in nine states, so we work with patients and not only Washington state, but Oregon, Idaho,  Arizona and Nevada. And we have Colorado and a couple of other States as well. So that's been really wonderful, great, fun and challenging. And it's just really neat that I get to use my really strong chemistry and biology background and help people really solve medication problems, for people and pets.

We helped the whole family. So that's intriguing and fun.

Linda Elsegood: [00:04:59] Wow. We never know.  It is been three years. You might get another phone call from another pharmacy.

Dawn Ipsen: [00:05:07] You never know. However, my staff might call crazy people if I do that, but no, I enjoy it, and I love the challenge and I think that it's something that, we're really successful at. We pride ourselves in the quality and in our teamwork and how we take care of patients and that we treat our patients like their family, and how we would want our family to be treated and very personalized with that care.

Linda Elsegood: [00:05:36] So with all your compounding, what forms do you compound LDN into?

Dawn Ipsen: [00:05:44]  So Low Dose Naltrexone is expanding. Actually had been working with Odell style Trek zone for roughly 10 years now, and kind of decided to become a state expert Low Dose Naltrexone about five years ago. And back then it was very primarily capsules only, and that's what we saw and actually five, 10 years ago it was even the doses were very structured at certain doses, not a lot of variability to it.   And we've learned so much, right?  Over the research and over the years. Now we're doing a much wider array of doses. Everything from ultra-low or micro-dosing for maybe patients who

are on pain therapies already and need some extra help with their immune system to even much higher doses, more frequent doses for mood situations or post-traumatic stress or depression.  And along with that, we're also helping patients who maybe there's an autism spectrum situation going on and they don't want to or aren't willing to take capsules in which we're able to make flavoured liquids and we're able to do now LDN in a transdermal.

And a transdermal is very different than just a topical. This is a cream-based that's very special and it's designed to drive the drug into the body,  but it's a great way to go when you have a patient who won't participate or can't participate in taking an oral medicine. And on top of it, we've started doing a lot of topical LDN treatment for skin conditions specifically for  psoriasis, eczema, things of that nature. So those are primarily the most dosage forms we see. So different ways to do oral, different way to do a transdermal, and then we have the topicals as well.

Linda Elsegood: [00:08:03] If I could just ask you, the topical cream or lotion, what do you call it?

Dawn Ispen: [00:08:11] It's usually a topical cream for the skin dermatology conditions.

Linda Elsegood: [00:08:17] So if you've got eczema or allergies or psoriasis and the other skin conditions like backtracked syndrome, Haley Haley's disease, applying that directly to the skin, what do you see? Does it take away the itchy, flaky redness? What do you see when people use it?

Dawn Ispen: [00:08:45] Definitely, so what we were noticing is, in psoriasis patients that were just on oral low dose naltrexone that they would typically get to effect at some point.  But it took a very, very long time. And it was, as you can imagine, hard for patients to be patient, so to speak, and wait for that. Because I mean, we all know how miserable it is to have skin that's irritated. It's red, it itches, it burns, it stings, all those things. It's very difficult to have any sort of quality of life. So we started doing both. We would help doctors with the normal oral therapies that we would be used to seeing, but then we would start making a customized cream for them, naltrexone being one of the ingredients. And we would put it in a cream base that actually had nutraceutical components to it that would help calm the skin already on its own with no drug in it. So yes, they often risked with the naltrexone and that cream base would find relief of redness and inflammation, and we'd start seeing the healing of autoimmune skin disorders much faster than if they were doing the oral alone.

On top of that, we could work more closely meeting their direct needs. So if it was causing pain, we could add an ingredient to help with that. If it was a histamine reaction, we could add another ingredient to help with that. And so it gave us a lot more flexibility to be very, very specific and customized with the treatment they needed on the skin that was bothering them.

Linda Elsegood: [00:10:31] So my question would be, Dawn. If, for example, 3 mg, the highest dose that you could tolerate orally and you're putting a topical lotion or cream on, does it matter how much naltrexone is in that cream? Does it get absorbed into the system? How does it work? Do you see what I'm saying? If three is all you can take and you've got three in the cream, does it matter?

Dawn Ispen: [00:11:03] Well, it depends. So if we are doing the topical cream base, there's a slim chance you could have some added absorption, but then we may want to go back and talk about what does it mean they couldn't tolerate more than three? Was it directly affecting their stomach and they were having nausea or cramps or something like that?

Or was it affecting sleep or why was it three their oral stealing number, right?  So when we go topical or even transdermal, a lot of times we can go higher than one would have thought than they could do orally and still avoid the side effects because they're avoiding that, what we call it in pharmacy, the first-pass effect. When a drug is swallowed it goes to the stomach and then it goes to the liver, and that's sometimes the portion of the system that's causing the side effect. And if we're avoiding that, we can get away with that. The other thing is that, given in these dermatology conditions, if we're doing Naltrexone  and it is just topical, we're not getting the systemic absorption that we would be getting in oral or transdermal delivery.

So in that sense, the amount probably doesn't quite matter, but also the amount of drug that's in that cream, they could put quite a bit on and not be getting a significant dose directly into the bloodstream. 

Linda Elsegood: [00:12:34] okay. And then would it be exactly the same as oral LDN and that if it kicks into the bloodstream, it would be the, and then go quite quickly.

Dawn Ispen: [00:12:44] Righ, so if it did go into the bloodstream or it was a transdermal delivery, what was driven in intentionally, you would expect to get the same effect as if they were on oral. You may avoid side effects of the stomach directly because again, you're not putting that drug directly in their stomach, and that can be helpful for some patients for sure.

Linda Elsegood: [00:13:09] okay. Now, patient feedback. What has been the outcomes of your patients taking LDN?

Dawn Ispen: [00:13:21] The feedback has been very, very positive. It definitely seems to be a drug that Is extremely safely tolerated with very few side effects, if any, and if there are side effects, they're typically dose-related and things that can be managed by proper titrations and proper dosing.

The benefit can be anywhere from subtle improvement to very profound improvement with a huge direct link to a much better quality of life. Even on my more subtle improved patients, they often find that their improvement was way more than they anticipated because they'll sometimes take a vacation or a holiday from LDN and realized symptoms are coming back.

They are not feeling as good,  more fatigued, on and on. And then when they restart low dose naltrexone they can then more clearly see how much benefit it was providing to them.

Linda Elsegood: [00:14:23] And what conditions would you say patients are taking LDN for? Do you know that?

Dawn Ispen: [00:14:30] Yeah. I often do know that. Of course, we have our longterm patients that have been on it for five, even five-plus years at this point that had the Fibromyalgia, Multiple Sclerosis, Crohn's disease, of course. We're seeing even more though conditions that are just in general inflammation-based and in which we're trying to control the body's autoimmune system. So Hashimoto's and Graves', Lyme disease, Rheumatoid Arthritis. We have patients that are using it, as I mentioned, for psoriasis specifically. And then, more recently in the last couple of years, we're seeing patients who do have post-traumatic stress disorder or depression that is been not responding to normal therapies and even cancer conditions that have been very helped by low dose naltrexone.

Linda Elsegood: [00:15:30] So do any of your doctors around your area prescribe LDN for infertility issues?

Dawn Ispen: [00:15:41] We don't have too many in our area that is doing naltrexone for infertility. However. there ts definitely known, it's definitely talked about. There's pretty good literature on its use  and it just might be that I'm not right next to where the infertility clinics are that are working with that.

Linda Elsegood: [00:16:09] What about mental health issues?

Dawn Ispen: [00:16:13] Yes, we definitely have doctors who are using this for mental health issues and are really trying great because they're trying to bring to light the whole topic of mental health and how important it is. And they become so much more open to other ways of thinking, other treatments, other modalities for these patients. So we're seeing things like the use of ketamine for depression. We're seeing the naltrexone being used for depression and PTSD. And I mean, I can honestly say that had patients who had been very concerned about their wellbeing and that once they work with these types of providers, down the road, their quality is just so much better and they're doing great with it.

Linda Elsegood: [00:17:02]  And of course, so many mental health issues with antidepressants, etc can make people feel a bit sluggish, drowsy whether naltrexone actually makes you feel brighter and better, and it's not addictive either.

Dawn Ispen: [00:17:24] Right. You get that endorphin release, which is so important to our wellbeing and how we feel in our motivation and our willingness and desire to interact with others in our community and those are all such important things for being part of this world.

Linda Elsegood: [00:17:45] Do you have any patient case studies you could share with us?

Dawn Ispen: [00:17:49] I'm sure. A couple of my favourites is one, she's a younger patient. Actually, she's only in her 20s, and she comes into the pharmacy and she's been coming in a long time getting naltrexone. At this point, it's usually just a quick pickup: " Hey, how are you?" And out the door, we go. And I was at the counter with her and I literally had to stop and scratch my head and I couldn't.  She looked just so great, so normal, so just young and vibrant. And I honestly couldn't remember why she even has started low dose naltrexone. And so I asked her. I was like, can you remind me why do you take the naltrexone?

What is it doing for you? And, and she's actually multiple sclerosis patients, which we actually have a lot of in Washington state because where we're located in our sunlight exposure and vitamin D levels and all that. And it has hot her completely in remission with her vitamin D and other things she's doing as well.

But she looks just so normal.  Is the only way I can describe it. And how cool is that? They here we have a twenty-something who, who is able to be a vibrant member of the community and have a well-rounded life and do what she wants to do. So she's one of my favourites because thank goodness you're staying on it to help slow any progression of the disease process that might occur later on.

And then I do have one psoriasis patient that I've ever seen psoriasis-like this before. She actually had it even on the back of her calves, which is an unusual location. And started naltrexone. Did that for about a month, just the naltrexone orally itself. And then when we added in the cream.

And when she would come back for refills, I just couldn't get over it, how fast it was healing and we marked it.  I actually took pictures of when she first picked up and then when she came in for refills and then now there's nothing left. So it's been really awesome to see somebody who had been dealing with this for most of her life, who now is doing great, well-controlled.

Her immune system is just functioning properly.

Linda Elsegood: [00:20:05] How long did that take before her skin looked normal again?

Dawn Ispen: [00:20:12] Yeah. So skin is always slow. I mean, that's with patience is a virtue. It's on any skin condition as you have to allow for the full all derm cycle, which usually is right about six weeks on average.

And so, you start in with treatment knew at the beginning or just trying to get the treatments on board and help with any symptom relief they might need. And then usually, like in this particular case, it was really about at the three-month mark that she was coming in happy that the condition was starting to reverse and go back to how the skin was supposed to be.

And then of course for full healing, it's another month or two after that. And then he'd go into maintenance mode at that point.

Linda Elsegood: [00:21:00] Well, that's amazing, isn't it? I mean, psoriasis, if you have it, and I know somebody with psoriasis, how embarrassing it is. People look at you when it's really bad. I'm not comfortable either, is it? So something that can heal and clear that up It's amazing.

Dawn Ispen: [00:21:26] Yeah, it's wonderful because it can be, like you said, not only visibly unappealing and they will often try to hide it if they can with clothing and coverage, but it hurts, it clot cracks, it bleeds, it burns, it itches.

It's just horribly uncomfortable and unrelenting, you know, it doesn't just stop. It continues.

Linda Elsegood: [00:21:50]  Do you have many children as patients?

Dawn Ispen: [00:21:53] We do. We actually work with some doctors who are very in touch with the pediatric population and that's their speciality. And they use naltrexone usually in the kids that they have some sort of a spectrum disorder where they're noncommunicative and they aren't interacting as we hoped they would be able to.

They're a great population to work with and that's where we get to become very creative and work really closely with the family itself on determining how does this child want to receive its medication and is it as simple as custom dosing and maybe they want the capsule a certain colour because it might be more appealing visually to them. Fine, perfectly great with that. Or do they need a liquid and do they want it to be flavoured a certain way or do they need a lozenge? And then for the most difficult of patients, we can do the transdermal cream delivery that I even have a couple of families that they actually apply it to the child's back, back skin area at night when the child is sleeping. So they can receive their dose that way. 

Linda Elsegood: [00:23:25] Wow. So what else do you know about LDN that you haven't shared with us?

Dawn Ispen: [00:23:35] With LDN there are lots of things can augment the therapy of LDN and getting the most out of it. And it's really looking at the patient at a whole and trying to discover what ways can we reduce inflammation load in that patient's body along with optimizing the dosage form and the regimen, the strength and the timing, it should be taken.

 I do work a lot on talking with patients about the importance, especially in Washington,  of vitamin D,  the importance of good gut health and probiotics. We're working more with patients on using full-spectrum C-- to help with pain and anxiety as well,  antioxidants and organic diet and how important all of these things are to get inflammation loads down, to get the best effect out of it.

Linda Elsegood: [00:24:32] Yes. Diet is a big one, isn't it? People do notice a big difference by changing their diet.

Dawn Ispen: [00:24:42] Diet is so huge, and you know, us living in a suburban area, gardening and farming is not simple, right? And our seasons make that challenging too, and just really encouraging our community to buy from the farmer's market get organic as much as you can, grow your food when you can yourself and just eat well, take care of your body, you're worth it. You know? It's like you are worth the extra effort in doing that.

Linda Elsegood: [00:25:14] And sugar is another big thing, isn't it? If you can't cut it out, at least cut it down.

Dawn Ispen: [00:25:21]  Right, and look for good alternatives that are natural and if you do have to have that sweet because, you're right, it's in everything and it's hidden often it's hard to even know it's there.

Linda Elsegood: [00:25:36] It surprises me when you look at a tin food.  Dugar is in pipe beans, it's in..Just trying to think of something else. It's gone. Slipped my mind. But...

Dawn Ispen: [00:25:52] Ketchup, salad dressings.

Linda Elsegood: [00:25:55] Exactly. Sugar, sugar, sugar, sugar. It's not easy, but it's, it's similar if you're buying foods and you read the labels, gluten is in so many things.

Dawn Ispen: [00:26:13] Absolutely.

Linda Elsegood: [00:26:14] I mean, when I first started to be gluten-free, it took me ages to do my shopping because I was looking at everything and trying very hard not to get anything with gluten in it.

But it becomes easier because you know which things you can have and which things you can't have. Once you've gone through reading everything, it does become easier and you do find alternative things. I use honey as a sweetener and I use coconut sugar but it's brown colour so I can still make cakes and waffles occasionally, but there isn't a different colour but if you close your eyes you don't know, you can't see that it's a different colour. You can be creative. It's very expensive to eat organic here, and I should think it's pretty similar in the US isn't it?

Dawn Ispen: [00:27:18] It is. It definitely can be challenging to be able to do that and hard for some families to make that happen. And I always like to refer to the dirty dozen as they call it, of if you really have to pick and choose which product is most important to purchasing, organic versus maybe you could save the finances on something else.  That's at a nice way to integrate or ended up the pathway. Lucky for us in our area, at least, we do have a substantial number of farmer's markets that are all close by and available different days of the week but that can be an option for patients that are really trying to do those things, but maybe not able to get it from the grocery store all the time.

Linda Elsegood: [00:28:16] And the thing is, with organic food, it doesn't last as long as a non-organic without us being sprayed with things to keep it fresh longer.

Dawn Ispen: [00:28:28] And it sometimes doesn't look as pretty, does it either? There are more bruises and changes in how it grows and things like that.

But it's funny how our minds have that used to be the normal, right? That produce always looked like that. And then we've changed to think that that product should look perfect in every instance and that's not necessarily the case. It comes back to what you're saying with the sugar.

Linda Elsegood: [00:28:59] We have a supermarket here that sells half-price vegetables from the supplier, and they're all packaged and they're called wonky vegetables. So the carrots, parsnips, that probably got deformed but they're perfectly fine. There's nothing wrong with them. It's just as they call them wonky,  they're not perfect and I think that's great.

Linda Elsegood: [00:29:34] We've come to the end of the show so we could have carried on talking for ages. We'll have you back again another time and until then, stay well and we will speak to you again soon.

Dawn Ispen: [00:29:48] Wonderful. Thank you. Have a great day.

Linda Elsegood: [00:29:50] Thank you. Bye-bye. This show is sponsored by Kusler's compounding pharmacy and Clark's compounding pharmacy. They are more than a drug store. They are highly trained, compounding pharmacy experts, combining the art and science of preparing personalized medications to meet your specific needs, improving lives by solving medication problems for people and pets, creating solutions to medication challenges.

Visit www.kuslerspharmacy.net

Any questions or comments you may have, please email us 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.

"The Game Changer" - LDN & Cancer - Low Dose Naltrexone - Spanish Subtitles from LDN Research Trust on Vimeo.

If you were to ask me does low dose naltrexone kill cancer cells, I would say it supports the actions of your classic cancer-killing drugs, such as your platinum; such as your radiation. These drugs and these modalities do work, and they work well in a lot of patients. However, there are a small fraction of patients that don't respond as well, and what low dose naltrexone can do, is that it can open up to these patients that are non-responsive. The whole idea that yes, you can use these treatments in your case, which  I think is fantastic. And if you were to say, do these patients see that as a cure to their cancer, in that situation, you must say it's helped them, and the help it's given them means the world.

I had a patient who I really thought their advanced cancer should be progressing and was delighted and surprised that she hadn't progressed in a certain time. And I asked her if she was taking anything else that I didn't know about because lots of patients do take all sorts of things, and she told me she was taking low dose naltrexone, and this is well over 12 years ago, if not longer. And I asked her where she got it and the whys and the wherefores, and I learned she was getting it from Dr Bihari in New York. And she told me a bit about the background and said that I should go and visit next time I was in New York, which is essentially what I did. And I realized he came from a proper clinical background, that he had been a narcotics expert and was weaning people off morphine heroin, which is how he knew about naltrexone and had been convinced that at low doses and not at high doses, that a lot of chronic conditions seem to improve.

So that's how I got interested, and I became more interested in it the fact that it might have a role in cancer when I noticed that other patients were doing very well on it. And at the end of that, often when there were no therapeutic options, I started prescribing it myself and being impressed that there seemed to be more to it than a placebo or smoke and mirrors, which is what many doctors regard something at a low dose.

Well, what really excited us is that I've taken the clinical observations from this seriously and because some of the results I saw are being really quite remarkable. For instance, I had a patient who had very serious melanoma of the head and neck, and he'd been on a vaccine program for about four years.

And when he started to progress, he wouldn't take any chemotherapy, but I did discuss with him about my suspected properties of low dose naltrexone. And he did agree to take that and rather than be grateful for taking the low dose naltrexone, he came and complained to me two weeks later that he had broken out in vitiligo, which means you get white patches all over.

And often just in the arms sometimes subtly on the face. In fact, about 5 to 8% of people have some form or other of it, except this appeared quite dramatically a few days after taking the low dose naltrexone. He didn't like the cosmetic aspect of it. I basically said I was delighted because it was a sign that the immune system's responding and had targeted the melanoma, and that's exactly what it is. It is due to the killer T cells recognize a major component of melanoma and the normal melanins taken out and bystander a friendly fire as it were. Well, he is still here. I mean, he had a dramatic clinical response to this. And what that showed me was that low dose naltrexone had to be stimulating part of the immune receptor pathway. And that was the start of our research. I said to the guys in the lab, this strike, isn't just working through opiate receptors, it's working through immune receptor pathway, and we sat down and worked out how to do it, did a strategy, and actually hit gold, and we found a very important, immune pathway was indeed heavily interactive with low dose naltrexone, which explained the clinical observation I think. With vitiligo being switched on; there's no defined time period, it can occur at any time, but with an effect of immunotherapy, this usually takes some weeks, months to occur. And we found out with the new checkpoint inhibitors, we basically don't really look to see if you're getting a response for a couple of months, because it is that slow. So, the fact that the vitiligo was induced very quickly suggested it had just flicked that switch which was already programmed, but the vaccine hadn't done it for four years, it just took the LDN, and it flicked it. Well, obviously we're going to be very focused on researching it; doing it properly. I mean, LDN is being used, anecdotally and off-license for a long time. There are fantastic results out there, but it ought to be taken forward; it really wants to be put it into proper clinical trials and getting it to the right niche. And because there are so many possibilities, we would like to do everything properly; get it properly approved by the FDA, EMEA, et cetera, and then go for a condition that we know the chances of working are very high and don't take very long, and of course, two of the conditions it's effective in are Multiple Sclerosis and Crohn’s, which are very difficult studies to get approval for. They're very hard and expensive trials to do. And you mention about taking it with something; this is what we've found with all of immune modulators, that they're much better in combination with other agents than by themselves. One of the things that we have been researching independently and it fits beautifully is that it is great, with what I would call an endemic, epidemic of a low vitamin D in the population. and it's particularly in the winter months and the further North you go. And this is one thing that we are looking at very carefully because we think that there is a positive interaction here, but that's not a big surprise, because if you're low in vitamin D, you don't respond to a whole range of things, like chemotherapy or whatever, so that's one particular thing. Combining it with another immune modulators/vaccines is the next obvious way to go, as is enhancing the anti-inflammatory aspects of it.

So, all of these things we have been looking at in our research, both in the lab and taking it forward into the clinic. Given how non-toxic it is and how relatively cheap it is compared to other interventions could be applied to, I would say the vast majority of people who have incurable cancers where you can't cut them all out because the anti-inflammatory aspect for most cancers is now well established and the need to boost the immune system when you have cancer. In fact, one of the pieces of research that we did early on, that  I’m most proud to have done, was we showed that even patients with very early colorectal cancer have a major suppression of the immune responses. And we proved that this was due to the bowel cancer patient group we use, because we repeated the assays a month after the tumour had been completely removed, and the immune system all bounces back into the normal range. So after that, and the colleagues elsewhere showed that they got the same sort of thing with other solid tumours, lymphomas, gliomas et cetera. So it means that tumours immune suppress, and if you can't cut them out you want to go some way to correct it.

There are some very fancy, toxic, expensive ways of doing that, but low dose naltrexone provides a lot of those properties without any of the toxicities, et cetera. So as a universal supplement, as well to be an anti-inflammatory, immune booster, I can't see why it would be limited to any particular tumour type.

Low dose naltrexone works on a number of processes in cancer cells. So, if a patient has cancer at whatever stage, if that cancer exhibits the same malfunctions, the same profile for one of the better term, then naltrexone prefers or low dose naltrexone likes, then you should see some kind of responses.

Like the first thing is that there is no drug in the world, and that would include LDN, that is active in everybody. But, if you’ve got advanced cancer and basically don't want to take anything else, but you’re happy to try something that might help you feel better, then to my surprise, I have seen the LDN is very effective in that scenario.

It shouldn't be looked upon as a cure again, to work on everybody, but I'm impressed with people who do have their disease stable after finishing chemo, having given up, and they take LDN, and they feel much better on it, and they request for repeat prescriptions that basically provides the evidence that they're doing really well just on this treatment.

One thing we did, first of all, was to explore the effects that low dose naltrexone had on immune cells, as well as on cancer cells. And I suppose one thing that people tend to forget is that drugs that you give to patients will have an effect on immunity as well as on cancer cells.

So, these so-called indirect effects versus the direct effects, and the beauty of naltrexone, especially at low doses, is that it can have an effect both on the cells in your body, as well as on the cancer cells. So it's like a double-edged sword, I suppose, one edge that kills cancer directly, and one effect which modifies the body's own natural ability to kill cancer cells. So, this drug naltrexone being a potential agent, or at least a semi-synthetic, we could then explore that further. And we showed that in addition to the effects on immunity, which made it a fantastic stimulator of immunity, which allows the body's cells to be re-educated to re-engage cancer cells, low dose naltrexone was also capable of targeting cancer cells directly. How does it do that? And that's the exciting thing. There's lots of data to suggest that it binds to certain proteins on the surface of the cancer cell and in doing so can manipulate the cancer cell to make it much more sensitive to the treatments.

There's also other trains of thought that suggest that it might enter the cell independently of these receptors, but nevertheless what we're finding is that the mechanisms that control cancer, the mechanisms, in fact, that makes a cancer cell, a cancer cell, is being turned off. it's been tweaked in such a way to make that cancer cell much more sensitive to cell death.

So, if you were to go along or come along, treating patients with low dose naltrexone, in addition to other drugs, which are focused on killing, then we have a fantastic partnership where one prime the cell and the other does the killing. And that's, what's exciting about low dose naltrexone.

So it was in about 2007, 2008 that I first discovered LDN, and we started using it immediately as a cancer treatment because there was some promising data presented by Dr Bahari. So, when we started using LDN for patients with stage three or stage four cancer with low disease volume, in other words, small tumours, or patients who had had surgery already but were not completely cured, we started seeing better results. One of our earliest patients that we used LDN on was a 65-year-old gentleman with bladder cancer. He had a tumour in the bladder, which was treated by conventional means, which means surgery, so they would go in and removed the tumour; they would burn where they had removed it from with a cautery and inevitably the tumour would return some months later.

So this gentleman had a few surgeries and the doctors had told them it was an aggressive type of cancer, which is called high grade, and that because of the depth of the growth of cancer into the bladder wall, it was growing into the muscle, they felt that he was at risk of cancer spreading in a short time.

So, this fellow was offered an aggressive surgery, which meant the removal of the entire bladder, and he declined that. At that point, he came to us and we started him on LDN. And he did very well on it, he had a little bit of sleep problem, but that was easy, we just gave him a little sleeping pill with that, and he did very well. And at the same time, his conventional doctor gave him a single course of an immune therapy called BCG. It's a bacteria that they instil into the bladder, and it can trigger an immune response. So while he had the one course of BCG, he was on LDN, and he took LDN for about four months, and then he had gone back to see the surgeon; they took a look in the bladder, and the cancer was completely gone. So, this gentleman continued LDN for about a year. He had no further conventional therapies, and cancer remained in full remission, and it's been about seven years now, and this gentleman is still in full remission. So, in his case, he did extremely well, and I believe that the LDN and the immunotherapy worked in unison, and one synergized with the other in order to give him an excellent result, which in this case would be considered a cure.

Another one of our earlier cases that really intrigued me was a 58-year-old gentleman that came to see us for rare cancer that was present in the base of his tongue.

He had about a three-centimetre tumour in the tongue, which was an adenoid cystic carcinoma; that's just the type of cancer, but it's an unusual type of cancer of the mouth. So, this gentleman went to see his specialist and he was told that in order to cure his cancer, the entire tongue would have to be removed surgically, and because of the location, in order to really give them the best chance of cure, they would have to remove his voice box as well. And then there was discussion about possible chemotherapy and radiation after all that surgery. So naturally, this gentleman was upset because of the dramatic change in his quality of life that would follow after cancer treatment.

So, he declined conventional therapy. He came to see us requesting a therapy that had no side effects. So, the first thing I told them was there's no such thing that has no side effects, however, immediately I thought of LDN because it's one of the gentlest therapies I know. So, he ultimately started LDN, and he combined it with vitamin D because that's considered to be a medicine that can potentially enhance other cancer therapies. It can work on the immune system and improve anti-cancer immunity. Vitamin D can also change the behaviour of cancer cells into more harmless behaviour so that they don't grow and aggressively spread. So, this fellow has started taking the treatment with the LDN combined with vitamin D, and within a few months he felt that the tumour was shrinking, and so continued therapy, and we didn't hear from him for a while until about two years after he started treatment., and he sent us a new MRI report, which is a scan of the tongue that showed complete disappearance of cancer. So, he continued on LDN and vitamin D and he has now over five years cancer-free. His specialist is quite surprised and pleased, to the point that he no longer repeats his scans frequently, and he just sees him once a year for a regular checkup.

A couple of years ago, a 53-year-old gentleman came to see me requesting treatment for bowel cancer. It was present in the sigmoid colon, and it was believed that cancer formed as a result of his inflammatory bowel disease called colitis.

So, this fellow was offered surgery by his specialist that would have been the standard treatment and potentially curative. However, he was afraid of surgery. He was afraid of the complications. So, as a result of his concerns, we offered him a few treatments, and he ultimately chose LDN. So, he started LDN, and we were monitoring him with a blood test for colon cancer called CEA, and in addition, we also monitored him with colonoscopies. So, his specialist would have a look within the colon and see what was happening with the tumour. It took about four months to see some improvement. We actually started to see the CEA, the cancer blood test numbers fall, and it was falling progressively over about a period of about three to four months subsequent to that.

And then it was maintained at a steady value of about 30% below the original value. In addition, he did have a follow-up colonoscopy, which confirmed that the cancer was stable or smaller, and his symptoms of bleeding in the bowel actually improved as well. Now this fellow did decline traditional surgery, which was not exactly what I had recommended either because I thought that cancer could potentially be curable.

However, the case does demonstrate that in cases where let's say a patient refuses surgery, or if surgery were to be too risky, then LDN could be an option for patients to try, especially if the cancer is non-aggressive.

In addition to using LDN, we almost always recommend vitamin D. The dosing of vitamin D is very controversial, but there's adequate research now that supports using high doses of the vitamin. So, that's what we're doing: we're using typically in the range of 5,000 to 10,000 units per day of vitamin D3, preferably in a liquid form because it's easier to take, and so patient compliance is high. Sometimes we even need upwards of 15,000 units or 20,000 units of vitamin D per day. As an aside, I personally take 15,000 units of vitamin D myself, and I've been taking that for about a year now. I take it from my allergies, and I find it to be highly effective.

So I became acquainted with Naloxone and Naltrexone, the drugs, in my training over 20 years ago in emergency medicine, and early in my career in general medicine began to explore the use of low dose naltrexone for a variety of illnesses, including auto-immunity, pediatric disease and then cancer. As the years of practice went on, we developed more and more cancer patient care where we were using the low dose naltrexone as an integral part of the patient's therapy.

We began adding low dose naltrexone with a variety of cancers, not knowing for sure which ones would be more or less responsive. And back at that time, the data was very sparse, so we were basically asking patients if they were okay with us trying it, So, many would come in with articles they had read, and we would start the therapy with them.

We have had a number of responses that run the gamut from—stabilizing disease, to being very supportive of other therapies that were being done, both natural and standard chemotherapy and radiation in some cases. And then one of the most beneficial uses we have seen is in the patient who has come back from the oncologist, and there is the report there's no more we can do for you. So, we use it in our program for stabilizing those patients where the standard of care has run out. I think the persistence of our using the low dose naltrexone as therapy is owed to the fact that we see positive results frequently enough, that we keep using it with many therapies that are nonstandard. You'll find that they work in a very narrow margin or for only certain types of cancer or certain types of illnesses, and so we'll reserve those for those certain type things. Low dose naltrexone at this point, as they say, eight or more years has impressed me enough that I keep it at the beginning of treatment when I'm working with patients all across the board with cancer.

So, the results are quite varied. We have had some patients, especially elderly patients, where they're very sensitive to medications. They've been told by their oncologist that they are not a candidate for standard therapy, because they're too elderly or frail. We have had a few of those patients where their disease, their cancer, has stabilized with basically the addition of low dose naltrexone on its own.

We don't expect that in everybody, but it's been curious to me to see one agent do that in cancer, which is very unusual. Most people, what we see is, it is a very good synergist with the rest of the care, and sometimes what will happen is, a patient will stop taking it and not tell us, they'll come back and they'll have some regression or some addition of symptoms from their cancer, we'll find out they've gone off low dose naltrexone. They'll go back on, and often those symptoms will go back away. So, we do see it as an integral part of care. I would say the number of patients with cancer that we have prescribed low dose naltrexone for in the last seven or eight years amongst myself and my colleagues at my clinic would probably reach a number between 250 and 350 patients.

As I said, we've seen a wide spectrum of response all the way from it was the only thing that they could tolerate, due to age or frailty, and we saw a stabilization of their disease, meaning it didn't progress, which is a very positive finding, to the person on multiple therapies where it's being used as part of a team approach, and as I mentioned, it being withdrawal caused a reversal of the positive. So, I would say in at least 30% of people, we have some verification, either based on it being the only drug used or it being taken away from their therapy, and them having regression that we could really point to clinical success. The rest of the patients, it's not that it made or broke their therapy, but we definitely left it in their therapy and never withdrew it to see if that was part of the success or not. But we definitely have seen, and as I say with either on standard oncology or natural therapies, I've seen it to be useful and positive in cancer cases, more than most other therapies I've used.

I would say that of all of the integrative and standard therapies that I have seen both in chronic illness, but especially in cancer in the last 20 years, low dose naltrexone has been one of the top treatments that have impressed me as far as outcomes. Improving the quality of life and stabilizing disease.

For patients, it's largely letting them know that it has a very low incidence of side effects and downside., and the most we can do is share case reports with them that match their cancer, and normally we have some positive ones. Of course, you can't guarantee anything in cancer, but to me, it's a low downside, low cost, and high-value therapy.

 

So low dose naltrexone isn't the cure to cancer, unfortunately, and I suppose there's no such thing as a true cure to cancer, but what low dose naltrexone will do, is it will support the actions of other drugs that are out there, which have been shown to have an effect. For instance, chemotherapies are efficacious in lots of patients, but they could be boosted. Irradiation is also effective in lots of cancers, but again, they can also be improved, and these agents that can support the activities of other drugs, these so-called agents, is a class of agent that low dose naltrexone will sit-in, which makes it an incredibly exciting piece of the compound.

So, what we did with all this genetic data, we went on to see if these cancer cells that we brought into lab could be sensitized or could be affected upon by naltrexone. So, we use in vitro experiments, experiments performed in a lab to see if we could kill these cancer cells.

And the disappointment was, that by using naltrexone at low concentrations continuously, we were having no effect on a number of cancer cells. However, the genetic fingerprint told us that it should work. So, by changing the schedule in the way that we gave this, this treatment to the cancer cells, based upon our understanding from the genetic fingerprint, we could actually cause these cancer cells to undergo cell death.

So, to summarize all that, we have a situation where if you were to use low dose naltrexone continuously you'd have no effects or effects will be minimal. However, if you were to use a schedule that involves slightly different aspects, you would end up killing those cancer cells. And that's something that armed with, we can take forward to the clinic and convince clinicians to start using low dose naltrexone, not on its own, possibly in combination with other therapies such as these chemotherapies, as I alluded to, as well as other newer drugs, such as the immunotherapies. So, the results of our studies that have allowed us to understand the action of low dose naltrexone much, much better than we did a while ago. And armed with this knowledge, we can design new treatment regimens, these new, different strategies that can be used in patients. And in that regard, it’s a game-changer. We now know how best to use naltrexone. In the past, we used to think naltrexone should be used continuously, and that would induce some effects in the number of patients. However, the data that we've generated very recently, suggests that we can actually improve on that. And it's these small step changes that will lead to a situation where these patients with cancer will benefit. We've worked on a number of cancers in our lab-based studies, and these cancers have involved cancers of the colon, of the breast and also of the lungs, and in these cell lines, we've shown that the effects of other drugs can be enhanced by using low dose naltrexone. And we are yet to find cancer that doesn't respond in this positive way, but we've only just started very recently and in the three cancer cell types that we've used, we've had a response that's always been positive.

Our results suggest that doctors who prescribe naltrexone need to be very wary of the way it's given. We've shown that depending on how the drug is given, you may get responses that are not optimal. Indeed, our results specifically showed that by giving this drug continuously over four days, would result in effects, although good on its own, was inferior to if you were to use the naltrexone on a different schedule altogether. What our data suggests, is that low dose naltrexone effects can be improved if you were to modify the schedule to involve breaks in treatment.

 My hope for low dose naltrexone is that it's incorporated in treatment regimens, in treatment strategies in patients with cancer. Naltrexone, especially low dose naltrexone, will enhance the actions of a number of chemotherapies in a number of cancers, and my hope is to see it being included in treatment.

Well, in a word, with the findings that we've captured here, gives a complete scientific justification for taking this forward into the clinic and giving evidence to the commissions, and the regulatory authorities and say look this does this, that, and the other, it should be incredibly useful in these conditions, and here you have this enormous amount of anecdotal evidence that it is. So basically, we want to go forward and capture it so it can actually be used and prescribed in the clinic on the NHS.

Our data gives us a better insight into low dose naltrexone, but better understanding, low dose naltrexone, we can better understand the ways that you can treat patients with cancer. So, I suppose the take-home message would be, we need to know how this drug works to maximize its uses in cancer patients. Patients are not interested in how the drug works, they are more interested in whether or not the drug works or not.

What our data suggests is that we have the best understanding. And by understanding the drug better, we can design better treatments that will benefit patients.

Well, the NHS and the government say, and various people say, that they would basically like drugs which are non-toxic cheap.

The current drugs being used to treat cancer are coming in at an average of about 5,000 pounds a month. And when you finish one, there's another one, so these costs are totally unsustainable. Whereas the advantage for a drug like this, that's a cheap, non-toxic can extend life, possibly, we don't know until we try that, but you can see it's a doctorate. It does improve the quality of life in a lot of people; that's an enormous potential that could save I believe you know, millions and all the treatments that we currently use to try and improve the quality of life and extend, et cetera.

One of the issues with LDN being a generic drug is that if it has been proven to be effective as a treatment for a disease like cancer, it could certainly prove to be challenging for the pharmaceutical industry. The reason is that this very cost-effective medication could potentially compete with branded drugs that are out there already.

So, I think that there is going to be a bit of a challenge moving LDN forward as more of mainstream therapy because it would likely be opposed by the pharmaceutical industry. Well, at the current rate of growth of cancer around the world, and looking at the cost of cancer therapies right now, it’s pretty clear that in a short number of years, the treatment of cancer is going to be unsustainable, so we actually desperately need more cost-effective therapies. Now with the current research model, there's really no motivation to conduct large formal scale clinical trials with LDN, because it is not a profitable drug. So, what we really need is a different model for researching LDN. One in which there should probably input from the government, in order to fund large scale trials to finally put to rest the idea that LDN is in fact, a valuable therapy and potentially from the insurance industry there should be funding because they're probably going to benefit greatly from the reduction in the cost of cancer therapies.

Low dose naltrexone increases what's called the OGF and OGF receptor. These are little peptides, basically proteins, that when connected together inside the cell, they give a signal to the nucleus that inhibits the cancer cell production. The amazing thing that they found is this is present in 90% of the human cancers, over 47 different lines of cancer, they've shown that this mechanism is present, and after reading their papers regarding this, I found the science to be good enough to be legitimate to try for people who have cancers that really have no other choice; stage three, four cancers that really are done with their therapy. It also increases what's called the P16 and P21 pathways, that are the key components to inhibiting the cancer cell division, and what they found interesting enough is in the cancer cells, they don't have a lot of OGF and OGF receptors. So, what it does is it boosts the body's own way of inhibiting cancer cells. We don't know that it really destroys tumours., it just inhibits cancer cells from dividing. So, in doing so, I took it upon myself to do research on it before it would use it.

You know, I'm a scientific type of person. I like the science to be there. Dr Zagon published articles regarding ovarian cancer cells specifically with naltrexone and OGF, and since ovarian cancer’s, the fourth leading cause of cancer mortality with women, and it's the leading cause of gynaecological cancer; this is a tough cancer and it’s critical to understand the cancer mechanism. And they found that the OGF receptor mechanism was present there. They showed it reduced cancer cell proliferation, and he's had a number of other articles showing the same thing.

So, I have a patient who is 2004 had initial ovarian cancer, and as Dr Zagon points out in his articles, 65% of the patients with ovarian cancer recur within two years. Well, she went six or seven years, and then she had stage four metastatic ovarian cancer everywhere. Her spleen, liver, colon, she had the surgery, she had some chemo, and then she heard about me through a friend, and so I started her on low dose naltrexone in 2011. And as a matter of fact, I just talked to her two days ago. She's doing very well. Her liver metastases have stabilized, and she's now in a stable state, and this is four years, four and a half years later, which is significant, because I was anticipating that she wouldn't have lasted more than four or five months with metastasis through her whole abdominal wall cavity, and the other areas I mentioned.

I had another patient who at 38 years old had a discovery that he had stage four squamous cell carcinoma of the tonsil. And he was treated with the usual chemotherapy, radiation; he elected not to have a radical neck dissection. He just said I'm not doing that. So about eight months go by, and he's just not doing very well.

He was tired, fatigued, and so I said, well, come to my clinic. I did a bunch of body chemistry tasks; hormone levels and found that the chemo and radiation destroyed all those, which is very common. Once I got those balanced, he was feeling better now, and he's doing great, but I also put him on LDN and Squamous cell carcinoma that tonsil does not do very well when you're stage four. This is four years later now. There are no signs of cancer. His oncologist says we really don't even have to follow the PET scans anymore because there's really no evidence of any recurrence. And he now is doing very well. He's doing worldwide trips, working two jobs, and he takes the 4.5 milligrams every day and hasn't had a problem since. In regards to how well he's done, well, maybe half the people last five years with that diagnosis, he met two other men who had the same diagnosis, same exact diagnosis when he was at MD Anderson, they have now both passed away a couple of years ago, so as long as he lives, it's another telling sign that LDN could be very positive for people, you know, long-term, and maybe preventing the recurrence by inhibiting any other cancer cells that are residing or starting to rise again.

I'm a stickler for facts. I want facts. I want proof. I want black and white. I want to know this is how it works. It increases the endorphins in the body, we know this. We know what endorphins do to the tumour cells; they block those tumour cells, and they block the receptors on the tumour cells. They cut down the inflammation around these tumours because this inflammation around the tumours helps it to grow, helps it to get blood vessels to grow out of those tumours so you can get more metasticies et cetera. So low dose naltrexone plays a role directly there at the tumour surface at the tumour cell.

However, it has another mechanism. This is what's also fascinating. And that was, as I said before, it down-regulates some of the T suppressor cells; the ones that are the most important in suppressing the immune system, it blocks those. So, the immune system can go up, and you can get the immune system up by down-regulating these T suppressor cells it's called foxp3, for those who are in biochemistry or studying this area. The foxp3 cells are blocked by low dose naltrexone, and so you're raising your immune system, you're working directly against the inflammation at the tumour cells, and you're helping the patients to be able to reverse their own tumours,  but not as one drug alone, but in combination with other things. If any of my cancer patients have cancer, they should all be on low dose naltrexone, because of the fact that it is helpful for them in every area of cancer therapy…period. If I had it myself, I would be on low dose naltrexone, and I'm a physician and a pharmacologist and a former FDA official, and I would recommend it to any and every one of my patients. It's imperative, as far as I'm concerned as a support measure, and we need to realize this. We need to realize this is not a cure. We need to realize that this is something that is an agent that will help tremendously, and that when patients are in remission, it will help to keep them in remission. The fact that low dose naltrexone cannot do any harm, and we've been showing efficacies in autoimmune diseases as well as cancer, it's something that I think the FDA is going to have to recognize this as a support measure for many of these illnesses.

A very diligent radiographer went back through all my medical notes and said, perhaps we should look at the pathology of the spots you had removed from your leg seven years ago. And sure enough, it showed that there were some suspicious cells there that hadn't been removed. So, it was then decided that it was probably melanoma, and I had my lymph glands down my right leg removed. And then I was having a few spasms in my right arm and my right hand. My GP, my same GP, suggested that I was just anxious about my golf swing and that I shouldn't be too worried at my age. So, off I went on holiday and while I was walking on holiday, I had the most amazing spasms in my right leg, and I knew something was wrong. Thinking I'd got a trapped nerve, I went straight back to the doctor when I returned home. By the afternoon, I was seeing a neurosurgeon. He sent me for an MRI, and the result came back that yes, I had I think five-centimetre tumour in my left side of my brain. So, I had a pet scan, and it revealed I had a tumour on my adrenal gland and tumours in my lungs.

My name is Annette Manabi, and I'm a physician in Illinois. My background is in osteopathic medicine, and I have two board certifications, family practice, and neuromusculoskeletal medicine. I was diagnosed in December of 2014 with cancer, and at that point, it was a stage one endometrial cancer and the initial treatment plan is always surgery, which I asked to defer in an attempt to hopefully avoid surgery. And so they were willing to work with me. I said, you know, there are a lot of options that they do with women who are still trying to have children, and once you're menopausal, they just want to go straight to surgery. So, I said give me a chance to try some of these things. I, unfortunately, wasn't able to find a practitioner in my area who was versed in using LDN in cancer patients, and so I was having to navigate a lot of that on my own, but I worked up to the four and a half milligram dose, and over the course of six months incorporated a lot of integrative holistic treatments as well into my cancer treatment regimen. During that time, my tumour markers continued to rise. So ultimately, I did have surgery in June of last year. However, at the time of the surgery, what was of note to me, and I feel assigned that the LDN and the supportive treatments I did were helpful is the tumour itself did not invade systemically. So at the time of the surgery, it was still only a half-centimetre into the wall of the uterus. It didn't go into the lymph nodes. It didn't go into the circulation or metastasize anywhere. It did grow into the uterus. So, the tumour itself increased in size, but not into my own tissues, and so I feel had I got it sooner and had I caught cancer when it was much smaller, I may have had success in actually avoiding the surgery, and I'm continuing on the LDN at this point to prevent any recurrence or continue to boost my immune system because we don't really understand all the mechanisms of why cancer occurs and there's still a risk for recurrence or metastasis, and so I'm trying to boost my chances, and there's so much promising research coming out, showing it is effective in fighting cancers of all types and all stages. And so, I have no qualms in continuing to use it to support my own immune function.

So, I went away and I followed a very strict diet, then I was very conscious that I needed to rebuild my immune system and really fight cancer through my immune system. So, I followed that for the whole of that year. In July of that year, there were some more slight spots on my brain. So, the gamma knifed it again, and then I had seven sections of my small intestine removed.

So it wasn't until mid-2007 when I collapsed and was taken into hospital, ended up in Hammersmith Hospital. And I had a ruptured tumour on the outside of my liver, which caused me to bleed internally. And I was very seriously ill. You know they basically resected my the liver at that stage and shut everything down and that was the start.

So, Professor Dalgleish said, well, I wanted you to have LDN anyway because I think it's going to be good to build your immune system. He also advised me at that point to take vitamin D3, 25 UGS, high dosage every day. I was having B12 injections because I had so much that my intestine removed and I was trying to drink a lot of green tea.

So, he put me on green tea extract at that point, which was much easier.

So, it was about that time that I have an old school friend and his wife plays tennis with Professor Angus Dalgleish, and she said, why don't you go and talk to him? He's a top oncologist. And so I did, ‘cause I really didn't know what I should be doing at that stage.

So, I thought, well, I've got nothing to lose. And I went and spoke to him; had a consultancy session, and what he did tell me, he said, look, you know, it's just not quite my field, but he said, I can tell you, he said, I can't recommend it, but I can tell you that I have a dozen or so patients who are self-prescribing low dose naltrexone for malignant melanoma, and remarkably they've been symptom-free for 18 months, and he said, that's very interesting.

So here I am, just over seven years with, I hate to say it, but at the moment…good scans. And that’s really about where I am now. I suppose I love it, that's all I can say. My lungs are completely clear and that's only happened since I took the LDN. Up until that time, it was still growing. So, from my point of view, that's very positive. It's had no impact on my life whatsoever.

When I initially started taking the low dose naltrexone, I started at one and a half milligrams worked up to four and a half. I'm currently still on four and a half milligrams of the low dose naltrexone.

Initially, I did notice an improvement in my energy and an overall sense of feeling better. And aside from the initial disruption of sleep, which took place, my quality of sleep improved dramatically on the low dose naltrexone. And that persist, like if I miss a night or during the surgery, when I had to stop because of the pain medications, I could see a difference when I was off the low dose naltrexone than when it was back on the low dose naltrexone. So, I find overall, it's helping my overall wellness and state of health.

So, following on from that, I got more information from him and I didn't do anything about it immediately. I don't know why. I think it was because I'd been around the alternative market, and I was talking to all sorts of odd people. One of them selling mistletoe therapy.

I consider the impact of low dose naltrexone on myself and potential negative side effects. I did experience initially some of the sleep disruption that is commonly reported, where I was a little bit more awake at night, or I woke up a little more frequently.

And after about two weeks that passed and the quality of my sleep actually improved. Other than that, I've not had any other types of side effects from it that I'm aware of, and in general, I am feeling much better in how I feel my sleep energy and I haven't noticed any other specific side effects.

And so I was a bit sceptical about following Professor Dalgleish’s advice at that time, so I didn't do anything about it for 18 months. Anyway, within that timescale, I had two further recurrences of. HCC, which is hepatocellular carcinoma. It's a tumour in the liver. It doesn't spread in the body, but all the same, it destroys your liver.

When I came out, I did a bit more research, following up on what Angus Dalgleish had told me, and I researched  Dr Buhari in New York, and I thought, well, this is very interesting. And it kind of supported what Professor Dalgleish had said to me. And I also got to know about Dr Berk Berkson’s books and who's in Las Cruces, New Mexico, who was doing very interesting work as well with LDN and also using antioxidants, in particular, alpha-lipoic acid and some other things, and so, based on my research, I thought, well, I mean, I've got nothing to lose so I'll give this a whirl.

I have in terms of ways to take the low dose naltrexone, I am taking the capsule form that I obtain from a local compounding pharmacist. In terms of the future of LDN in the US I think in the ideal world, I would wish that all the major cancer centres would incorporate it into their treatment regimens immediately. Unfortunately, change in medicine is very slow, and it's challenging, and because it's already a patented medicine, there's not a lot of profit to be made. It's inexpensive, and so that becomes a barrier I think, in realistic means, the integrative medicine and holistic medicine community will be embracing it as the word gets out, as conferences are held, they will be the ones to hold the torch and get it available, as the patients also demand access, it'll be, I think, through that population of physicians who offer it to their patients. I would like to see it as a frontline for anyone who's got a suspicious diagnosis that's potential cancer. They should be started immediately.

So, I started without any expectation. I started taking the LDN and hey presto, miraculously I went into remission for three and a half years. Three and a half years. And that in itself was remarkable. And I was being treated then by someone at Hammersmith Hospital who was a bit dismissive about LDN. He'd never had great faith in it. And what he said to me was he said, look, your liver is recovering,

I don't think your recovery and your remission has anything to do with this low dose naltrexone you're taking. So, he was so dismissive I discontinued it, and I rue the day I listened to him basically. So, I discontinued it, and then within nine months, I'd had another recurrence of another tumour in my liver. But after I’d had this news, I decided I'd go to America to see Dr Berk Berkson, because I'd heard about him. And I thought, well, I'll go and talk to the guy. So I went out there and started on the LDN again with him, and I came back to the UK again with no expectations, and when I got back to the UK, I'd only been on the liver register for six weeks I think it was, and I  just sitting at home one day and I had a phone call saying we've got a liver for you. And I almost fell off my chair and we had to make a sort of an instantaneous decision about where to go. So, I said, yes. Interestingly, when they removed my liver and replaced it with a new one when they sectioned the old one, they said, oh, that's interesting, all your liver cancer has disappeared. Your tumour has completely necrosed. So, I don't know how to explain that, but since that day, that was over three years ago now. So well, I shouldn't really judge, but I suppose in my mind, I know that what did LDN do for me? Well, it gave me three and a half years of remission from the time when the doctors were actually saying, he's going to have another recurrence in three months time and it doesn't look very good, to basically getting me through that period. It's gone very well indeed, and I have no recurrence of any sort. So, do I believe in LDN? Yes, I do. I know, I know it worked for me.

So, more commonly we are getting many inquiries from patients who have been diagnosed with various types of cancer for low dose naltrexone. And it's quite important that if you are going to look at using low dose naltrexone for your cancer therapy that you talk to your individual GP and your oncologist first, because you may be on certain types of pain medication, which are contraindicated initially unless they're very carefully handled. A lot of people have come to us because they've gone onto the internet, and they’ve found something that they can buy. A lot of those are not real, or they are fake medications, which are dangerous, and you should not randomly decide to treat yourself for cancer by buying naltrexone tablets on the internet. I know it sounds very simple, but we find out the great number of people who do that.

So, looking at the possible side effects you can have from taking LDN along with cancer chemotherapy, that's extremely individual, dependent upon the type of cancer chemotherapy that you have. So, for example, there is a growth in biologics and vaccines, versus original chemotherapy drugs, like the platinum and things like gemcitabine, which has a slightly different mechanism of action. So, if you are taking, or you’re being prescribed many different types of cancer chemotherapy drugs, and each individual cancer is specific; cancer is not one disease, it uses multiple different types of treatments for different types of cancer, and the guidelines are always changing.

So, there are biological drugs that are chemically drugs called the plantains, and there are also drugs which can change your immune system, like vaccines. So, it's going to be very individual when and where you're able to take LDN in your treatment cycle or your treatment pathway. Now, there has been some information that we are aware of, which has not yet been released.  And I think over the next year we're probably going to hear more about that along with vitamin D. So, I’d certainly say, if you have been diagnosed with cancer and you're looking at using LDN, the first thing you should do is start taking vitamin D, and the dose for that, you can decide with your practitioner, but really it would be aiming for between five and ten thousand units per day, and LDN seems to work much better when it's being used with that, but LDN itself should not be taken when you're on any strong painkillers without direct medical supervision. So to speak to your doctor or pharmacist, and before embarking upon this journey and make sure that you get someone who is very qualified, who is capable of reading the most recent research and keeping you up to date and make sure that your treatment pathway works as well as possible.

Linda Elsegood: Thank you for listening to this presentation. All past conference presentations can be found on our website, https://ldnresearchtrust.org/

David Borenstein, MD - 17th July 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today I'd like to welcome back Dr. David Bornstein from New York. Thank you for joining me today. David. Now I know you've been prescribing LDN for many, many years, but first of all, could you tell our listeners your medical background, please? 

Dr David Borenstein: Sure. Well, I initially trained in medicine at the Technion, Israel Institute of Technology in Haifa Israel.

I came back to do my internship in Staten Island hospital in New York, and I did additional training in radiation oncology and rehabilitation medicine at the State University of New York at Stony Brook. And then I opened up a private practice here in Manhattan. And I've been working here in Manhattan ever since.

Linda Elsegood: So tell us a little bit more about your practice, what you actually do there. 

Dr David Borenstein: Sure. I have an integrative medical practice and I do various different sorts of integrative approaches in functional medicine, approaches to issues such as, um, we work with a lot of patients with chronic fatigue, fibromyalgia, autoimmune diseases like MS and Crohn's, hormone replacement.

Dr David Borenstein: I work with patients who have issues with their guts. And we also do a lot of work with patients who have chronic pain. We do a lot of work with STEM cells, platelet-rich plasma, uh, and prolotherapy. We also do intravenous drips for our patients. So we offer a wide, wide variety of options for people looking. 

Linda Elsegood: I haven't had anybody explain about STEM cell treatment and possibly you could get in England, but it's not something that's been on my radar. Could you tell us a bit about the STEM cells? 

Dr David Borenstein: Sure. Basically, a STEM cell is by definition, the cell that can become any other cell in the body, so it's a very primitive early-stage cell that eventually can become lung tissue or hard tissue or bone. So what we do is we obtain, um, cells from either adipose fat tissue or we use umbilical cord, um, cells from other people, and we use it primarily to treat orthopaedic conditions. People with neck, back, shoulder, knee pain, hip pain, and we do a lot of work, uh, with that, uh, with that regard.

Um, we used to do some more work with Crohn's and autoimmune diseases, but we're primarily focusing now on orthopaedic conditions with a good amount of success and saving a lot of people from joint replacements, which is a good feeling. Wow. Yes. But you were saying. That the STEM cells can help replace all these different things.

How does the STEM cell know what you want it to do? The mechanism of action is poorly understood. We think that it either listens to a homing signal and does repair of the cell, or it actually may differentiate into that particular tissue. The mechanism, again, is poorly understood. Um, but you know, the basic science researchers are looking into that.

Dr David Borenstein: We do know from people doing STEM cell deployments for many years, that there is a good efficacy in treating orthopaedic conditions, and it's promising for treating things like cardiopulmonary diseases, neurological conditions, and um, and various other chronic medical conditions. The potential is unlimited, and this is like a very exciting field of medicine today.

Linda Elsegood: So if somebody needed a hip replacement. How would you treat that with STEM cells? 

Dr David Borenstein: Well, we would do is we initially evaluate the patient, have them come to our office, um, do a complete history, physical examination, look where the tender points are, looking at their range of motion, look at any scans, CAT scans, MRIs or x-rays.

And we will see if the patient is a candidate for having STEM cells for the hip. We generally like to use patients who are younger, uh, because. You don't, you know, the older patients, they're also candidates, but you don't want to put an artificial hip into patients who are in their thirties forties or even in their 50s because chances are because people are living into their eighties and even their nineties they're probably going to require revision of that.

And that's something you probably don't want to do. And what we would then do is we would inject. Either adipose-derived cells or umbilical cord cells into the hip joint, as well as all the attaching ligaments around the hip to make sure that the hip is nice and stable and roughly success rates depending on the age, depending on the severity of the disease, roughly in the high 70th percentile success rate, which is pretty good for, uh, having to avoid a hip replacement.

Linda Elsegood: Oh, definitely. Um, a friend of mine, his sister had problems, um, birth and she had to have a hip replaced, I think when she was. Like 15. She was very, very young. Uh, cause she couldn't run. One leg was longer than the other, and it just wore the hip. And she had another one. Uh, when she was thinking was about 35 and then another one just before she was 60.

So if she was able to have saved herself from having all these surgeries. I mean, that would just be amazing, wouldn't it? How long does it take for those STEM cells to do their work? 

Dr David Borenstein: It can take anywhere from several weeks to several months, and sometimes I have to have the patient come back. A few months later and we can boost the area where we treated with either something known as platelet-rich plasma, which are platelets we extract from, from blood, whichever, a lot of growth factors or another procedure known as prolotherapy, which is the oldest.

The oldest regenerative medicine technique will use sugar, water, dextrose, and lidocaine, and we can add some other things there. It causes localized inflammation. Okay. And it causes growth factors to come to the area and help tighten up the ligaments and, um, help improve the, um, and repair, uh, the local tissue in the joint.

So it's exciting stuff. It is, isn't it? Very, very exciting. And of course, the injection into the joint is far less traumatic for the body than having surgery to replace a hip, isn't it? You know? Not only is it less traumatic, now that's way less traumatic. It's done under local anaesthesia. So the risk goes down tremendously.

You don't have to be in a hospital. You can return to work in a relatively short period of time. I mean, if you're doing a desk job, for example, if you're getting a procedure done on a Wednesday, you can go back to work on Monday. Obviously, if you're doing, if you're working, you know, as a lineman on the, uh, for the electric company, you probably want to, you know wait a little bit longer to go back to work, but most people with desktops can go back within five or five to six days, and they don't have to be in an inpatient hospital, do any outpatient physical therapy. Now in the future, you know, two or three months, four months down the line, they may, we may need to give them some physical therapy, but it's not the inpatient type where you're stuck in a hospital or a subacute facility and you have to be there for a while.

Linda Elsegood: So it's, you know. It's nice because it allows you to go back to work in a relatively short period of time.  and when you were saying you prefer younger people, I'm just wondering if I'm in the age group. Older people.

Dr David Borenstein: Let's put it this way. Well, let's, we have a couple of ways we can, we can look at it for patients. We're using adipose-derived cells. You know, usually, I like.  If their patients are in there anywhere from the 30s too, let's say their early seventies they usually should have enough cells for doing the job.

But for patients who are in their mid to late seventies eighties even nineties I prefer sometimes to do the umbilical cord cell because I know well, they're not coming from the patient. I know they're probably going to have a high level of cells as you get older. The number of stem cells in your body are going to come down and they, they will drop.

There's no question. Someone who's, you know, 20 is going to have more STEM cell than someone who's 50, and someone who's 50 is going to have more STEM cells than someone who's 70 on, on average. So, um, usually I find that if the patient is going to be, you know, past your mid-seventies I may want to, you know, use only the umbilical cord cells because they know they have a, a good number in them.

Now, some patients will say, you know what, Dr Bornstein, I don't care. I want to use my own cells and I'll respect that and I'll use, I'll use the adipose. Fine. But you know, I have to give the patient the option. Of course. Yeah. No. 

Linda Elsegood: You have first-hand experience and knowledge about LDN? When did you first start prescribing?

Dr David Borenstein: Oh, at least 15 years ago. And the history is very interesting because I had a patient come in, and this is well before there were LDN websites, well before LDN research. Well before the information that we had, and a patient came into me and wanted LDN and I said, well, let me look into it. I was a little sceptical.

I didn't know much about it, so I did my research and said, uh, all right, let me give this a try. And I tried it on this patient. I think it was for, I believe it was either for Multiple Sclerosis or Crohn’s and, um. I got some very, very good results. So I, um, discussed LDN with a number of different compounding pharmacists, uh, one here in New York and one in, uh, one in Florida.

And I learned more about it. I did some research on it, and I started using more and more LDN in my practice. And I got some really amazing, amazing results and it just mushroomed. That has continued and we’re using it for the vast majority, everything that people are using today. I was using LDN for, you know, at least, you know, almost 15 years ago and great, great success stories, uh, multiple different, uh, conditions, and I just never looked back.

Linda Elsegood: Could you share some of those success stories with us? 

Dr David Borenstein: Oh yes. I said, for example, a number of different people with Crohn's disease, and for some reason I find the inflammatory bowel, Crohn's disease respond beautifully to LDN. I have had maybe two or three patients who really did not respond the way I wanted to, but they were very severe cases, but the vast majority of my Crohn's patients did beautifully on LDN, and this is, you know.

This is my early experience. So the vast majority of my patients were either Crohn's or MS and the MS patients also experienced quite, um, quite great results, lack of progression of the disease, some improvement in their fatigue and optic neuritis. The patients many times tried the, you know, the ABC, uh, medications, you know, and just didn't do well on them and didn't want to take them. So he did the LDN and they've never ever looked back again. So. Those are the two biggies. We also started using LDN for patients with various sorts of malignancies. I had a patient with a lung tumour, for example, and we put on LDN and it was just stable.

Didn't go anywhere. It was just sitting there, you know, and she was on it for many, many years. I lost contact with her after a while. I think she moved out of the country, but from a number of different years, she had a very stable, um, um tumour in her, in her lung, didn't, didn't do very much for it. And also we've been using it more and more since the studies came out from Stanford University on fibromyalgia.

And we've got some, you know, some positive results. I mean, I work with, in my practice, we incorporate LDN. We also use it in conjunction with other treatments. I find for fibromyalgia, it definitely takes the edge off. And, but you have to, you know, do a vast, um, uh, treatment option, um, working with their hormones, their sleep and infections.

I also find it's beneficial for Lyme disease. I do some, some work with Lyme disease, but overall, it's primarily MS, uh, autoimmune-related diseases that I use LDN for.  

Linda Elsegood: Do you ever use it for mental health issues? 

Dr David Borenstein: Yes. We've been getting more requests for that. Uh, primarily with the osteoarthritis, uh, conditions.

And I do have patients who swear up and down that it does improve their pain. Again, have patients who do not get any sort of relief. Um, I find that works better with the osteoarthritis and it does with the rheumatology conditions, but I, the number of rheumatoid patients that I have been a little bit more limited in that regard.

I also, patients have been using it for reducing alcohol cravings, which we find has been, uh, more, and we're getting more requests to do, LDN for that as well.

Linda Elsegood: Have you been asked to use full-dose naltrexone, the Sinclair method for alcoholism? No, not at all. I haven't gotten any, you know, I'm aware of it, but I haven't gotten any requests for it yet. Okay. Because they have very good success rates with that, whereby you can continue drinking and you take the tablet.

I can't remember now, it was an hour or two before you start drinking, but it takes away the craving. So where you would probably. You know, have 10 pints of beer, you might only have two. And then gradually you get, so you can take it or leave it. You don't actually need to carry on drinking. That's really interesting for people who, um, they call it now, don't they?

Alcohol use disorder and it is, uh. Yeah. A bonafide condition. You know, it's not a case of saying to people, stop. These people can't just stop. So that is an alternative for, maybe you'll have more people coming to you asking you for that. Now. It's interesting because you know, you know, one of the side effects of LDN can be projectile vomiting with alcohol consumption, although I don't see too much of it.

Dr David Borenstein: I know we've had cases of that, and it is a known, um, side effect of taking LDN. So even that alone may discourage people from, uh, from trying to take alcohol. Uh, we've had, um. Probably one, two, three, four, maybe five or six patients who've used it for addiction. Um, and they're quite happy. Um, again, most people who take LDN for the condition that they want to be treated, tend to want to continue on, on the LDN for the condition. It is very rare for people to stop it. Very rare. I find most people just want to continue it for whatever condition they have. Well, it's also the boosts the endo endorphins, which is the body's own natural feel-good fight or isn't it? So that should really give you a boost anyway, shouldn't it?

Linda Elsegood: I know people say, and I've been taking LDN 15 years or over 15 years. That it protects them. They don't catch viruses or colds or become sick in any which way. I mean, LDN works amazingly for me. I'm not complaining whatsoever, but I still get colds and flu and whatever's going around, it doesn't protect me in that way.

Um, but there are many people that say that you know, they haven't had a cold since I've been on LDN, so I don't know why I'm different, but, uh, it can happen. Well, that's amazing. You mentioned that, cause I did a consult, uh, late last week and it was for an ms patient and the patient had ms and you know, we renewed her LDN.

Dr David Borenstein: But the comment always comes up that treating for MS, but they'll say, Oh, I haven't got a cold all winter. And I get that over and over and over again. So, people, it's very rare people come to me and say, I just want it necessarily to boost the immune system. I get that. But they usually have another condition.

They usually get colds and this season, last season, the season before they've, they've never gotten colds. So it's definitely a benefit to taking LDN and we see it all the time.

Linda Elsegood: Now people can come and see you and have a consultation face to face, but you also do telemed consultations. Could you tell us about that?

Dr David Borenstein: Sure we do, uh, telemed consultations all over the United States, and we do it all over the world. So we've had patients who we've done it in the UAE, Middle East, Mexico, uh, Europe. So yes, we have patients from all over the world. We're interested in getting, uh. Getting LDN. And um, many of them come to see me here in New York because I'm right in the middle of Manhattan, and they may come to see me first and then we can do everything over the phone and we do everything over the phone initially.

So yes, we can certainly do telemedicine anywhere. There's a phone connection. 

Linda Elsegood: So how does it work? I have people say to me. Do you know what happens if I need blood tests? Do you know what happens? So if somebody came to you today and said they would like a telephone consultation and there, I don't know, in France, how would you go about, um, finding out all their medical details, etc.

Dr David Borenstein: Well, many times they'll email me all the medical reports before the initial consultation, so I'll have all of their medical records sent via email, or if they want to fax it to me, they can. But today email's much easier. And we do a complete history over the phone. We get all the information we can.

The most important thing is, one thing about LDN is it's, it's really safe as long as you're not taking narcotics. Um, and it's only, you're not mixing the LDN with certain other medications that can. Um, go against LDN. For example, we know with MS there are certain medications you're not supposed to take with LDN.

Um, as long as you, you're clear with that, it's usually not a problem. I remember using medication at less than one 10th the prescribed dose. So long as you're not having any, um. Taking any narcotics, you stopped in narcotics before doing procedures. You know, you're not drinking alcohol at the same time, knowing you can have projectile vomiting.

We, you know, it's a pretty safe medication and then we can prescribe it. Uh, some people, um, will. Get it from pharmacies here in the United States or, um, that's usually, or they come to New York, um, and they can get it here in New York or any other pharmacy that can be prescribed here in the United States.

So it's usually pretty straight forward. Um, our dosing, you know, we can tell them how to dose. Um, I find that certain, you know, for example, certain patients, they want. The maximal dose all the time, but they don't understand is that the maximal dose for a person weighing 250 pounds is very different from a patient weighing 125 pounds.

And, um, even Dr Bihari when he was doing it, found that many times. You would. If you give too high of a dose, you can cause too much, uh, to prolonged blockage. You want to lower the dose. So every patient, it's not so easy. You just, you know, give the maximal dose and have a nice day. You also have to, uh, take, you know, take sex and weight into account when you are prescribing and take an account.

There are side effects, you know, difficulty sleeping, vivid dreams. So all of these have to play an account. Also, a patient has neurological disorders. Certain patients over a certain dose get increased specificity. So, you know, it requires, you know, some experience in prescribing. It's not, here's the medication, have a nice day.

And every, every, uh, disease, we're going to approach it from a very different perspective. For example, in patients with inflammatory bowel disease. I find giving a full dose at the beginning is a better way of treating them as opposed to stepping up the dose. With Hashimoto's, you've got to go very, very slowly and the blood tests have to be done just to make sure the antibody levels are dropping and that they're not getting hyperthyroid.

And that's where he gets a little bit tricky. But most of the patients do their blood tests. They do them locally with their local doctors. They send it to me with theirs, when we get their LDN prescriptions and you know, everything works out well. . 

Linda Elsegood: So how do they go about having the blood tests from you? Do you send them a kit or the information to take to their own doctor? How does that work? 

Dr David Borenstein: Well, generally, generally. Uh, with most cases, yes. For what we do, we don't need blood work. The vast majority of patients either have blood work from their local doctors, or for example, if they're having Hashimoto's, someone's prescribing their blood work and prescribing their medication, and we'll just get copies of that lab work just to make sure that the antibodies are going down and not becoming hyper.

We have to warn the patients that as the antibodies come down, you're going to need a dose adjustment and they should get blood work to reduce their dosage of medications. Um, and you know, the antibody levels can drop quite dramatically. And you know, if you're, if you're having a good dosage, it can actually make you a little bit hyper.

So you have to warn the patient about that and just check the, have them check their blood levels locally. And usually, everything's fine.  and people always want to know. 

Linda Elsegood: How soon would you say in your experience that patients notice an improvement on LDN? 

Dr David Borenstein: It varies. I find that inflammatory bowel disease patients usually notice an improvement quite quickly.

I think some of the other autoimmune diseases may take a little bit of time. It all depends. Um, people react differently. We're all bio-individual. None of us are exactly the same. We're not all Toyota Corollas, so it can be anywhere from several days to several weeks, even to several months. I usually recommend that the patient be on the LDN for at least four to six months before you even think of discontinuing it because it can take that long in order to see if they're responding or not.  

Linda Elsegood: Exactly. I mean, I've had some people say to me. Um, I'm taking liquid LDN and I've nearly finished the bottle. I've been on it nearly a month. Uh, it hasn't done anything, you know, I'm thinking of stopping, you know, it's not a miracle that it's going to happen. You know, just like that. You've got to give it time, haven't you? 

Dr David Borenstein: Exactly. As you were saying. Well, several things are sort of, you got to give it time and you have to make sure that you're getting it from a place that's reputable, that you're using a good quality LDN. And I only use, you know, a number of different pharmacies that I use. Sometimes I'll change the patient from an oral to a, say, a transdermal, just to see if there's going to be any difference in the way they're, they're feeling. Remember a lot of patients with severe, for example, inflammatory bowel disease, they may not be absorbing the LDN, so doing it transdermally may be beneficial.

I find many times in kids, for example, it may be more beneficial to do a transdermally then than orally, and sometimes they have other cofactors. They have just poor absorption. You've got to say, Oh, well, why aren't you absorbing it? Maybe you have low stomach acid, so. The vast majority of the time, the patients are quite pleased.

But, um, and this would make the difference between someone who, who does LDN and someone who does LDN is knowing if there's a problem, what do you do? What's the next step? What do you have to look for? And that's the that makes all the difference in the world. 

Linda Elsegood: So if somebody would like to have a telephone consultation with you, is there a waiting list.

Dr David Borenstein: We can always accommodate patients if they, um, depending on the day, the month of the year, uh, you know, typically you're very busy, sometimes very slow if they are interested in having a telephone consultation, they can just call our office. The number is 212-262-2412 or 212-262-2413. And if they want to learn more about the practice, they can go to my website at www.davidborensteinmd.com and they can look at the website and see what we offer and if they're interested in making a telephone consultation, just call the office and we're more than happy to schedule them at the earliest possible time.

Linda Elsegood: Well, thank you very much for having been our guest today. 30 minutes went very quickly. Oh, thank you for having me.

Dr. David Bornstein is New York's leading integrative and functional medicine physician. His patients are diagnosed and treated in an integrative manner to promote recovery and continuing good health. Call 212-262-2412 for an appointment. Telemedicine appointments are available for LDN prescriptions.

Any questions or comments you may have pleawse email us 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.

“The Game Changer” - LDN & Cancer (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

If you were to ask me does low dose naltrexone kill cancer cells, I would say it supports the actions of your classic cancer-killing drugs, such as your platinum; such as your radiation. These drugs and these modalities do work, and they work well in a lot of patients. However, there are a small fraction of patients that don't respond as well, and what low dose naltrexone can do, is that it can open up to these patients that are non-responsive. The whole idea that yes, you can use these treatments in your case, which  I think is fantastic. And if you were to say, do these patients see that as a cure to their cancer, in that situation, you must say it's helped them, and the help it's given them means the world.

I had a patient who I really thought their advanced cancer should be progressing and was delighted and surprised that she hadn't progressed in a certain time. And I asked her if she was taking anything else that I didn't know about because lots of patients do take all sorts of things, and she told me she was taking low dose naltrexone, and this is well over 12 years ago, if not longer. And I asked her where she got it and the whys and the wherefores, and I learned she was getting it from Dr Bihari in New York. And she told me a bit about the background and said that I should go and visit next time I was in New York, which is essentially what I did. And I realized he came from a proper clinical background, that he had been a narcotics expert and was weaning people off morphine heroin, which is how he knew about naltrexone and had been convinced that at low doses and not at high doses, that a lot of chronic conditions seem to improve.

So that's how I got interested, and I became more interested in it the fact that it might have a role in cancer when I noticed that other patients were doing very well on it. And at the end of that, often when there were no therapeutic options, I started prescribing it myself and being impressed that there seemed to be more to it than a placebo or smoke and mirrors, which is what many doctors regard something at a low dose.

Well, what really excited us is that I've taken the clinical observations from this seriously and because some of the results I saw are being really quite remarkable. For instance, I had a patient who had very serious melanoma of the head and neck, and he'd been on a vaccine program for about four years.

And when he started to progress, he wouldn't take any chemotherapy, but I did discuss with him about my suspected properties of low dose naltrexone. And he did agree to take that and rather than be grateful for taking the low dose naltrexone, he came and complained to me two weeks later that he had broken out in vitiligo, which means you get white patches all over.

And often just in the arms sometimes subtly on the face. In fact, about 5 to 8% of people have some form or other of it, except this appeared quite dramatically a few days after taking the low dose naltrexone. He didn't like the cosmetic aspect of it. I basically said I was delighted because it was a sign that the immune system's responding and had targeted the melanoma, and that's exactly what it is. It is due to the killer T cells recognize a major component of melanoma and the normal melanins taken out and bystander a friendly fire as it were. Well, he is still here. I mean, he had a dramatic clinical response to this. And what that showed me was that low dose naltrexone had to be stimulating part of the immune receptor pathway. And that was the start of our research. I said to the guys in the lab, this strike, isn't just working through opiate receptors, it's working through immune receptor pathway, and we sat down and worked out how to do it, did a strategy, and actually hit gold, and we found a very important, immune pathway was indeed heavily interactive with low dose naltrexone, which explained the clinical observation I think. With vitiligo being switched on; there's no defined time period, it can occur at any time, but with an effect of immunotherapy, this usually takes some weeks, months to occur. And we found out with the new checkpoint inhibitors, we basically don't really look to see if you're getting a response for a couple of months, because it is that slow. So, the fact that the vitiligo was induced very quickly suggested it had just flicked that switch which was already programmed, but the vaccine hadn't done it for four years, it just took the LDN, and it flicked it. Well, obviously we're going to be very focused on researching it; doing it properly. I mean, LDN is being used, anecdotally and off-license for a long time. There are fantastic results out there, but it ought to be taken forward; it really wants to be put it into proper clinical trials and getting it to the right niche. And because there are so many possibilities, we would like to do everything properly; get it properly approved by the FDA, EMEA, et cetera, and then go for a condition that we know the chances of working are very high and don't take very long, and of course, two of the conditions it's effective in are Multiple Sclerosis and Crohn’s, which are very difficult studies to get approval for. They're very hard and expensive trials to do. And you mention about taking it with something; this is what we've found with all of immune modulators, that they're much better in combination with other agents than by themselves. One of the things that we have been researching independently and it fits beautifully is that it is great, with what I would call an endemic, epidemic of a low vitamin D in the population. and it's particularly in the winter months and the further North you go. And this is one thing that we are looking at very carefully because we think that there is a positive interaction here, but that's not a big surprise, because if you're low in vitamin D, you don't respond to a whole range of things, like chemotherapy or whatever, so that's one particular thing. Combining it with another immune modulators/vaccines is the next obvious way to go, as is enhancing the anti-inflammatory aspects of it.

So, all of these things we have been looking at in our research, both in the lab and taking it forward into the clinic. Given how non-toxic it is and how relatively cheap it is compared to other interventions could be applied to, I would say the vast majority of people who have incurable cancers where you can't cut them all out because the anti-inflammatory aspect for most cancers is now well established and the need to boost the immune system when you have cancer. In fact, one of the pieces of research that we did early on, that  I’m most proud to have done, was we showed that even patients with very early colorectal cancer have a major suppression of the immune responses. And we proved that this was due to the bowel cancer patient group we use, because we repeated the assays a month after the tumour had been completely removed, and the immune system all bounces back into the normal range. So after that, and the colleagues elsewhere showed that they got the same sort of thing with other solid tumours, lymphomas, gliomas et cetera. So it means that tumours immune suppress, and if you can't cut them out you want to go some way to correct it.

There are some very fancy, toxic, expensive ways of doing that, but low dose naltrexone provides a lot of those properties without any of the toxicities, et cetera. So as a universal supplement, as well to be an anti-inflammatory, immune booster, I can't see why it would be limited to any particular tumour type.

Low dose naltrexone works on a number of processes in cancer cells. So, if a patient has cancer at whatever stage, if that cancer exhibits the same malfunctions, the same profile for one of the better term, then naltrexone prefers or low dose naltrexone likes, then you should see some kind of responses.

Like the first thing is that there is no drug in the world, and that would include LDN, that is active in everybody. But, if you’ve got advanced cancer and basically don't want to take anything else, but you’re happy to try something that might help you feel better, then to my surprise, I have seen the LDN is very effective in that scenario.

It shouldn't be looked upon as a cure again, to work on everybody, but I'm impressed with people who do have their disease stable after finishing chemo, having given up, and they take LDN, and they feel much better on it, and they request for repeat prescriptions that basically provides the evidence that they're doing really well just on this treatment.

One thing we did, first of all, was to explore the effects that low dose naltrexone had on immune cells, as well as on cancer cells. And I suppose one thing that people tend to forget is that drugs that you give to patients will have an effect on immunity as well as on cancer cells.

So, these so-called indirect effects versus the direct effects, and the beauty of naltrexone, especially at low doses, is that it can have an effect both on the cells in your body, as well as on the cancer cells. So it's like a double-edged sword, I suppose, one edge that kills cancer directly, and one effect which modifies the body's own natural ability to kill cancer cells. So, this drug naltrexone being a potential agent, or at least a semi-synthetic, we could then explore that further. And we showed that in addition to the effects on immunity, which made it a fantastic stimulator of immunity, which allows the body's cells to be re-educated to re-engage cancer cells, low dose naltrexone was also capable of targeting cancer cells directly. How does it do that? And that's the exciting thing. There's lots of data to suggest that it binds to certain proteins on the surface of the cancer cell and in doing so can manipulate the cancer cell to make it much more sensitive to the treatments.

There's also other trains of thought that suggest that it might enter the cell independently of these receptors, but nevertheless what we're finding is that the mechanisms that control cancer, the mechanisms, in fact, that makes a cancer cell, a cancer cell, is being turned off. it's been tweaked in such a way to make that cancer cell much more sensitive to cell death.

So, if you were to go along or come along, treating patients with low dose naltrexone, in addition to other drugs, which are focused on killing, then we have a fantastic partnership where one prime the cell and the other does the killing. And that's, what's exciting about low dose naltrexone.

So it was in about 2007, 2008 that I first discovered LDN, and we started using it immediately as a cancer treatment because there was some promising data presented by Dr Bahari. So, when we started using LDN for patients with stage three or stage four cancer with low disease volume, in other words, small tumours, or patients who had had surgery already but were not completely cured, we started seeing better results. One of our earliest patients that we used LDN on was a 65-year-old gentleman with bladder cancer. He had a tumour in the bladder, which was treated by conventional means, which means surgery, so they would go in and removed the tumour; they would burn where they had removed it from with a cautery and inevitably the tumour would return some months later.

So this gentleman had a few surgeries and the doctors had told them it was an aggressive type of cancer, which is called high grade, and that because of the depth of the growth of cancer into the bladder wall, it was growing into the muscle, they felt that he was at risk of cancer spreading in a short time.

So, this fellow was offered an aggressive surgery, which meant the removal of the entire bladder, and he declined that. At that point, he came to us and we started him on LDN. And he did very well on it, he had a little bit of sleep problem, but that was easy, we just gave him a little sleeping pill with that, and he did very well. And at the same time, his conventional doctor gave him a single course of an immune therapy called BCG. It's a bacteria that they instil into the bladder, and it can trigger an immune response. So while he had the one course of BCG, he was on LDN, and he took LDN for about four months, and then he had gone back to see the surgeon; they took a look in the bladder, and the cancer was completely gone. So, this gentleman continued LDN for about a year. He had no further conventional therapies, and cancer remained in full remission, and it's been about seven years now, and this gentleman is still in full remission. So, in his case, he did extremely well, and I believe that the LDN and the immunotherapy worked in unison, and one synergized with the other in order to give him an excellent result, which in this case would be considered a cure.

Another one of our earlier cases that really intrigued me was a 58-year-old gentleman that came to see us for rare cancer that was present in the base of his tongue.

He had about a three-centimetre tumour in the tongue, which was an adenoid cystic carcinoma; that's just the type of cancer, but it's an unusual type of cancer of the mouth. So, this gentleman went to see his specialist and he was told that in order to cure his cancer, the entire tongue would have to be removed surgically, and because of the location, in order to really give them the best chance of cure, they would have to remove his voice box as well. And then there was discussion about possible chemotherapy and radiation after all that surgery. So naturally, this gentleman was upset because of the dramatic change in his quality of life that would follow after cancer treatment.

So, he declined conventional therapy. He came to see us requesting a therapy that had no side effects. So, the first thing I told them was there's no such thing that has no side effects, however, immediately I thought of LDN because it's one of the gentlest therapies I know. So, he ultimately started LDN, and he combined it with vitamin D because that's considered to be a medicine that can potentially enhance other cancer therapies. It can work on the immune system and improve anti-cancer immunity. Vitamin D can also change the behaviour of cancer cells into more harmless behaviour so that they don't grow and aggressively spread. So, this fellow has started taking the treatment with the LDN combined with vitamin D, and within a few months he felt that the tumour was shrinking, and so continued therapy, and we didn't hear from him for a while until about two years after he started treatment., and he sent us a new MRI report, which is a scan of the tongue that showed complete disappearance of cancer. So, he continued on LDN and vitamin D and he has now over five years cancer-free. His specialist is quite surprised and pleased, to the point that he no longer repeats his scans frequently, and he just sees him once a year for a regular checkup.

A couple of years ago, a 53-year-old gentleman came to see me requesting treatment for bowel cancer. It was present in the sigmoid colon, and it was believed that cancer formed as a result of his inflammatory bowel disease called colitis.

So, this fellow was offered surgery by his specialist that would have been the standard treatment and potentially curative. However, he was afraid of surgery. He was afraid of the complications. So, as a result of his concerns, we offered him a few treatments, and he ultimately chose LDN. So, he started LDN, and we were monitoring him with a blood test for colon cancer called CEA, and in addition, we also monitored him with colonoscopies. So, his specialist would have a look within the colon and see what was happening with the tumour. It took about four months to see some improvement. We actually started to see the CEA, the cancer blood test numbers fall, and it was falling progressively over about a period of about three to four months subsequent to that.

And then it was maintained at a steady value of about 30% below the original value. In addition, he did have a follow-up colonoscopy, which confirmed that the cancer was stable or smaller, and his symptoms of bleeding in the bowel actually improved as well. Now this fellow did decline traditional surgery, which was not exactly what I had recommended either because I thought that cancer could potentially be curable.

However, the case does demonstrate that in cases where let's say a patient refuses surgery, or if surgery were to be too risky, then LDN could be an option for patients to try, especially if the cancer is non-aggressive.

In addition to using LDN, we almost always recommend vitamin D. The dosing of vitamin D is very controversial, but there's adequate research now that supports using high doses of the vitamin. So, that's what we're doing: we're using typically in the range of 5,000 to 10,000 units per day of vitamin D3, preferably in a liquid form because it's easier to take, and so patient compliance is high. Sometimes we even need upwards of 15,000 units or 20,000 units of vitamin D per day. As an aside, I personally take 15,000 units of vitamin D myself, and I've been taking that for about a year now. I take it from my allergies, and I find it to be highly effective.

So I became acquainted with Naloxone and Naltrexone, the drugs, in my training over 20 years ago in emergency medicine, and early in my career in general medicine began to explore the use of low dose naltrexone for a variety of illnesses, including auto-immunity, pediatric disease and then cancer. As the years of practice went on, we developed more and more cancer patient care where we were using the low dose naltrexone as an integral part of the patient's therapy.

We began adding low dose naltrexone with a variety of cancers, not knowing for sure which ones would be more or less responsive. And back at that time, the data was very sparse, so we were basically asking patients if they were okay with us trying it, So, many would come in with articles they had read, and we would start the therapy with them.

We have had a number of responses that run the gamut from—stabilizing disease, to being very supportive of other therapies that were being done, both natural and standard chemotherapy and radiation in some cases. And then one of the most beneficial uses we have seen is in the patient who has come back from the oncologist, and there is the report there's no more we can do for you. So, we use it in our program for stabilizing those patients where the standard of care has run out. I think the persistence of our using the low dose naltrexone as therapy is owed to the fact that we see positive results frequently enough, that we keep using it with many therapies that are nonstandard. You'll find that they work in a very narrow margin or for only certain types of cancer or certain types of illnesses, and so we'll reserve those for those certain type things. Low dose naltrexone at this point, as they say, eight or more years has impressed me enough that I keep it at the beginning of treatment when I'm working with patients all across the board with cancer.

So, the results are quite varied. We have had some patients, especially elderly patients, where they're very sensitive to medications. They've been told by their oncologist that they are not a candidate for standard therapy, because they're too elderly or frail. We have had a few of those patients where their disease, their cancer, has stabilized with basically the addition of low dose naltrexone on its own.

We don't expect that in everybody, but it's been curious to me to see one agent do that in cancer, which is very unusual. Most people, what we see is, it is a very good synergist with the rest of the care, and sometimes what will happen is, a patient will stop taking it and not tell us, they'll come back and they'll have some regression or some addition of symptoms from their cancer, we'll find out they've gone off low dose naltrexone. They'll go back on, and often those symptoms will go back away. So, we do see it as an integral part of care. I would say the number of patients with cancer that we have prescribed low dose naltrexone for in the last seven or eight years amongst myself and my colleagues at my clinic would probably reach a number between 250 and 350 patients.

As I said, we've seen a wide spectrum of response all the way from it was the only thing that they could tolerate, due to age or frailty, and we saw a stabilization of their disease, meaning it didn't progress, which is a very positive finding, to the person on multiple therapies where it's being used as part of a team approach, and as I mentioned, it being withdrawal caused a reversal of the positive. So, I would say in at least 30% of people, we have some verification, either based on it being the only drug used or it being taken away from their therapy, and them having regression that we could really point to clinical success. The rest of the patients, it's not that it made or broke their therapy, but we definitely left it in their therapy and never withdrew it to see if that was part of the success or not. But we definitely have seen, and as I say with either on standard oncology or natural therapies, I've seen it to be useful and positive in cancer cases, more than most other therapies I've used.

I would say that of all of the integrative and standard therapies that I have seen both in chronic illness, but especially in cancer in the last 20 years, low dose naltrexone has been one of the top treatments that have impressed me as far as outcomes. Improving the quality of life and stabilizing disease.

For patients, it's largely letting them know that it has a very low incidence of side effects and downside., and the most we can do is share case reports with them that match their cancer, and normally we have some positive ones. Of course, you can't guarantee anything in cancer, but to me, it's a low downside, low cost, and high-value therapy.

 

So low dose naltrexone isn't the cure to cancer, unfortunately, and I suppose there's no such thing as a true cure to cancer, but what low dose naltrexone will do, is it will support the actions of other drugs that are out there, which have been shown to have an effect. For instance, chemotherapies are efficacious in lots of patients, but they could be boosted. Irradiation is also effective in lots of cancers, but again, they can also be improved, and these agents that can support the activities of other drugs, these so-called agents, is a class of agent that low dose naltrexone will sit-in, which makes it an incredibly exciting piece of the compound.

So, what we did with all this genetic data, we went on to see if these cancer cells that we brought into lab could be sensitized or could be affected upon by naltrexone. So, we use in vitro experiments, experiments performed in a lab to see if we could kill these cancer cells.

And the disappointment was, that by using naltrexone at low concentrations continuously, we were having no effect on a number of cancer cells. However, the genetic fingerprint told us that it should work. So, by changing the schedule in the way that we gave this, this treatment to the cancer cells, based upon our understanding from the genetic fingerprint, we could actually cause these cancer cells to undergo cell death.

So, to summarize all that, we have a situation where if you were to use low dose naltrexone continuously you'd have no effects or effects will be minimal. However, if you were to use a schedule that involves slightly different aspects, you would end up killing those cancer cells. And that's something that armed with, we can take forward to the clinic and convince clinicians to start using low dose naltrexone, not on its own, possibly in combination with other therapies such as these chemotherapies, as I alluded to, as well as other newer drugs, such as the immunotherapies. So, the results of our studies that have allowed us to understand the action of low dose naltrexone much, much better than we did a while ago. And armed with this knowledge, we can design new treatment regimens, these new, different strategies that can be used in patients. And in that regard, it’s a game-changer. We now know how best to use naltrexone. In the past, we used to think naltrexone should be used continuously, and that would induce some effects in the number of patients. However, the data that we've generated very recently, suggests that we can actually improve on that. And it's these small step changes that will lead to a situation where these patients with cancer will benefit. We've worked on a number of cancers in our lab-based studies, and these cancers have involved cancers of the colon, of the breast and also of the lungs, and in these cell lines, we've shown that the effects of other drugs can be enhanced by using low dose naltrexone. And we are yet to find cancer that doesn't respond in this positive way, but we've only just started very recently and in the three cancer cell types that we've used, we've had a response that's always been positive.

Our results suggest that doctors who prescribe naltrexone need to be very wary of the way it's given. We've shown that depending on how the drug is given, you may get responses that are not optimal. Indeed, our results specifically showed that by giving this drug continuously over four days, would result in effects, although good on its own, was inferior to if you were to use the naltrexone on a different schedule altogether. What our data suggests, is that low dose naltrexone effects can be improved if you were to modify the schedule to involve breaks in treatment.

 My hope for low dose naltrexone is that it's incorporated in treatment regimens, in treatment strategies in patients with cancer. Naltrexone, especially low dose naltrexone, will enhance the actions of a number of chemotherapies in a number of cancers, and my hope is to see it being included in treatment.

Well, in a word, with the findings that we've captured here, gives a complete scientific justification for taking this forward into the clinic and giving evidence to the commissions, and the regulatory authorities and say look this does this, that, and the other, it should be incredibly useful in these conditions, and here you have this enormous amount of anecdotal evidence that it is. So basically, we want to go forward and capture it so it can actually be used and prescribed in the clinic on the NHS.

Our data gives us a better insight into low dose naltrexone, but better understanding, low dose naltrexone, we can better understand the ways that you can treat patients with cancer. So, I suppose the take-home message would be, we need to know how this drug works to maximize its uses in cancer patients. Patients are not interested in how the drug works, they are more interested in whether or not the drug works or not.

What our data suggests is that we have the best understanding. And by understanding the drug better, we can design better treatments that will benefit patients.

Well, the NHS and the government say, and various people say, that they would basically like drugs which are non-toxic cheap.

The current drugs being used to treat cancer are coming in at an average of about 5,000 pounds a month. And when you finish one, there's another one, so these costs are totally unsustainable. Whereas the advantage for a drug like this, that's a cheap, non-toxic can extend life, possibly, we don't know until we try that, but you can see it's a doctorate. It does improve the quality of life in a lot of people; that's an enormous potential that could save I believe you know, millions and all the treatments that we currently use to try and improve the quality of life and extend, et cetera.

One of the issues with LDN being a generic drug is that if it has been proven to be effective as a treatment for a disease like cancer, it could certainly prove to be challenging for the pharmaceutical industry. The reason is that this very cost-effective medication could potentially compete with branded drugs that are out there already.

So, I think that there is going to be a bit of a challenge moving LDN forward as more of mainstream therapy because it would likely be opposed by the pharmaceutical industry. Well, at the current rate of growth of cancer around the world, and looking at the cost of cancer therapies right now, it’s pretty clear that in a short number of years, the treatment of cancer is going to be unsustainable, so we actually desperately need more cost-effective therapies. Now with the current research model, there's really no motivation to conduct large formal scale clinical trials with LDN, because it is not a profitable drug. So, what we really need is a different model for researching LDN. One in which there should probably input from the government, in order to fund large scale trials to finally put to rest the idea that LDN is in fact, a valuable therapy and potentially from the insurance industry there should be funding because they're probably going to benefit greatly from the reduction in the cost of cancer therapies.

Low dose naltrexone increases what's called the OGF and OGF receptor. These are little peptides, basically proteins, that when connected together inside the cell, they give a signal to the nucleus that inhibits the cancer cell production. The amazing thing that they found is this is present in 90% of the human cancers, over 47 different lines of cancer, they've shown that this mechanism is present, and after reading their papers regarding this, I found the science to be good enough to be legitimate to try for people who have cancers that really have no other choice; stage three, four cancers that really are done with their therapy. It also increases what's called the P16 and P21 pathways, that are the key components to inhibiting the cancer cell division, and what they found interesting enough is in the cancer cells, they don't have a lot of OGF and OGF receptors. So, what it does is it boosts the body's own way of inhibiting cancer cells. We don't know that it really destroys tumours., it just inhibits cancer cells from dividing. So, in doing so, I took it upon myself to do research on it before it would use it.

You know, I'm a scientific type of person. I like the science to be there. Dr Zagon published articles regarding ovarian cancer cells specifically with naltrexone and OGF, and since ovarian cancer’s, the fourth leading cause of cancer mortality with women, and it's the leading cause of gynaecological cancer; this is a tough cancer and it’s critical to understand the cancer mechanism. And they found that the OGF receptor mechanism was present there. They showed it reduced cancer cell proliferation, and he's had a number of other articles showing the same thing.

So, I have a patient who is 2004 had initial ovarian cancer, and as Dr Zagon points out in his articles, 65% of the patients with ovarian cancer recur within two years. Well, she went six or seven years, and then she had stage four metastatic ovarian cancer everywhere. Her spleen, liver, colon, she had the surgery, she had some chemo, and then she heard about me through a friend, and so I started her on low dose naltrexone in 2011. And as a matter of fact, I just talked to her two days ago. She's doing very well. Her liver metastases have stabilized, and she's now in a stable state, and this is four years, four and a half years later, which is significant, because I was anticipating that she wouldn't have lasted more than four or five months with metastasis through her whole abdominal wall cavity, and the other areas I mentioned.

I had another patient who at 38 years old had a discovery that he had stage four squamous cell carcinoma of the tonsil. And he was treated with the usual chemotherapy, radiation; he elected not to have a radical neck dissection. He just said I'm not doing that. So about eight months go by, and he's just not doing very well.

He was tired, fatigued, and so I said, well, come to my clinic. I did a bunch of body chemistry tasks; hormone levels and found that the chemo and radiation destroyed all those, which is very common. Once I got those balanced, he was feeling better now, and he's doing great, but I also put him on LDN and Squamous cell carcinoma that tonsil does not do very well when you're stage four. This is four years later now. There are no signs of cancer. His oncologist says we really don't even have to follow the PET scans anymore because there's really no evidence of any recurrence. And he now is doing very well. He's doing worldwide trips, working two jobs, and he takes the 4.5 milligrams every day and hasn't had a problem since. In regards to how well he's done, well, maybe half the people last five years with that diagnosis, he met two other men who had the same diagnosis, same exact diagnosis when he was at MD Anderson, they have now both passed away a couple of years ago, so as long as he lives, it's another telling sign that LDN could be very positive for people, you know, long-term, and maybe preventing the recurrence by inhibiting any other cancer cells that are residing or starting to rise again.

I'm a stickler for facts. I want facts. I want proof. I want black and white. I want to know this is how it works. It increases the endorphins in the body, we know this. We know what endorphins do to the tumour cells; they block those tumour cells, and they block the receptors on the tumour cells. They cut down the inflammation around these tumours because this inflammation around the tumours helps it to grow, helps it to get blood vessels to grow out of those tumours so you can get more metasticies et cetera. So low dose naltrexone plays a role directly there at the tumour surface at the tumour cell.

However, it has another mechanism. This is what's also fascinating. And that was, as I said before, it down-regulates some of the T suppressor cells; the ones that are the most important in suppressing the immune system, it blocks those. So, the immune system can go up, and you can get the immune system up by down-regulating these T suppressor cells it's called foxp3, for those who are in biochemistry or studying this area. The foxp3 cells are blocked by low dose naltrexone, and so you're raising your immune system, you're working directly against the inflammation at the tumour cells, and you're helping the patients to be able to reverse their own tumours,  but not as one drug alone, but in combination with other things. If any of my cancer patients have cancer, they should all be on low dose naltrexone, because of the fact that it is helpful for them in every area of cancer therapy…period. If I had it myself, I would be on low dose naltrexone, and I'm a physician and a pharmacologist and a former FDA official, and I would recommend it to any and every one of my patients. It's imperative, as far as I'm concerned as a support measure, and we need to realize this. We need to realize this is not a cure. We need to realize that this is something that is an agent that will help tremendously, and that when patients are in remission, it will help to keep them in remission. The fact that low dose naltrexone cannot do any harm, and we've been showing efficacies in autoimmune diseases as well as cancer, it's something that I think the FDA is going to have to recognize this as a support measure for many of these illnesses.

A very diligent radiographer went back through all my medical notes and said, perhaps we should look at the pathology of the spots you had removed from your leg seven years ago. And sure enough, it showed that there were some suspicious cells there that hadn't been removed. So, it was then decided that it was probably melanoma, and I had my lymph glands down my right leg removed. And then I was having a few spasms in my right arm and my right hand. My GP, my same GP, suggested that I was just anxious about my golf swing and that I shouldn't be too worried at my age. So, off I went on holiday and while I was walking on holiday, I had the most amazing spasms in my right leg, and I knew something was wrong. Thinking I'd got a trapped nerve, I went straight back to the doctor when I returned home. By the afternoon, I was seeing a neurosurgeon. He sent me for an MRI, and the result came back that yes, I had I think five-centimetre tumour in my left side of my brain. So, I had a pet scan, and it revealed I had a tumour on my adrenal gland and tumours in my lungs.

My name is Annette Manabi, and I'm a physician in Illinois. My background is in osteopathic medicine, and I have two board certifications, family practice, and neuromusculoskeletal medicine. I was diagnosed in December of 2014 with cancer, and at that point, it was a stage one endometrial cancer and the initial treatment plan is always surgery, which I asked to defer in an attempt to hopefully avoid surgery. And so they were willing to work with me. I said, you know, there are a lot of options that they do with women who are still trying to have children, and once you're menopausal, they just want to go straight to surgery. So, I said give me a chance to try some of these things. I, unfortunately, wasn't able to find a practitioner in my area who was versed in using LDN in cancer patients, and so I was having to navigate a lot of that on my own, but I worked up to the four and a half milligram dose, and over the course of six months incorporated a lot of integrative holistic treatments as well into my cancer treatment regimen. During that time, my tumour markers continued to rise. So ultimately, I did have surgery in June of last year. However, at the time of the surgery, what was of note to me, and I feel assigned that the LDN and the supportive treatments I did were helpful is the tumour itself did not invade systemically. So at the time of the surgery, it was still only a half-centimetre into the wall of the uterus. It didn't go into the lymph nodes. It didn't go into the circulation or metastasize anywhere. It did grow into the uterus. So, the tumour itself increased in size, but not into my own tissues, and so I feel had I got it sooner and had I caught cancer when it was much smaller, I may have had success in actually avoiding the surgery, and I'm continuing on the LDN at this point to prevent any recurrence or continue to boost my immune system because we don't really understand all the mechanisms of why cancer occurs and there's still a risk for recurrence or metastasis, and so I'm trying to boost my chances, and there's so much promising research coming out, showing it is effective in fighting cancers of all types and all stages. And so, I have no qualms in continuing to use it to support my own immune function.

So, I went away and I followed a very strict diet, then I was very conscious that I needed to rebuild my immune system and really fight cancer through my immune system. So, I followed that for the whole of that year. In July of that year, there were some more slight spots on my brain. So, the gamma knifed it again, and then I had seven sections of my small intestine removed.

So it wasn't until mid-2007 when I collapsed and was taken into hospital, ended up in Hammersmith Hospital. And I had a ruptured tumour on the outside of my liver, which caused me to bleed internally. And I was very seriously ill. You know they basically resected my the liver at that stage and shut everything down and that was the start.

So, Professor Dalgleish said, well, I wanted you to have LDN anyway because I think it's going to be good to build your immune system. He also advised me at that point to take vitamin D3, 25 UGS, high dosage every day. I was having B12 injections because I had so much that my intestine removed and I was trying to drink a lot of green tea.

So, he put me on green tea extract at that point, which was much easier.

So, it was about that time that I have an old school friend and his wife plays tennis with Professor Angus Dalgleish, and she said, why don't you go and talk to him? He's a top oncologist. And so I did, ‘cause I really didn't know what I should be doing at that stage.

So, I thought, well, I've got nothing to lose. And I went and spoke to him; had a consultancy session, and what he did tell me, he said, look, you know, it's just not quite my field, but he said, I can tell you, he said, I can't recommend it, but I can tell you that I have a dozen or so patients who are self-prescribing low dose naltrexone for malignant melanoma, and remarkably they've been symptom-free for 18 months, and he said, that's very interesting.

So here I am, just over seven years with, I hate to say it, but at the moment…good scans. And that’s really about where I am now. I suppose I love it, that's all I can say. My lungs are completely clear and that's only happened since I took the LDN. Up until that time, it was still growing. So, from my point of view, that's very positive. It's had no impact on my life whatsoever.

When I initially started taking the low dose naltrexone, I started at one and a half milligrams worked up to four and a half. I'm currently still on four and a half milligrams of the low dose naltrexone.

Initially, I did notice an improvement in my energy and an overall sense of feeling better. And aside from the initial disruption of sleep, which took place, my quality of sleep improved dramatically on the low dose naltrexone. And that persist, like if I miss a night or during the surgery, when I had to stop because of the pain medications, I could see a difference when I was off the low dose naltrexone than when it was back on the low dose naltrexone. So, I find overall, it's helping my overall wellness and state of health.

So, following on from that, I got more information from him and I didn't do anything about it immediately. I don't know why. I think it was because I'd been around the alternative market, and I was talking to all sorts of odd people. One of them selling mistletoe therapy.

I consider the impact of low dose naltrexone on myself and potential negative side effects. I did experience initially some of the sleep disruption that is commonly reported, where I was a little bit more awake at night, or I woke up a little more frequently.

And after about two weeks that passed and the quality of my sleep actually improved. Other than that, I've not had any other types of side effects from it that I'm aware of, and in general, I am feeling much better in how I feel my sleep energy and I haven't noticed any other specific side effects.

And so I was a bit sceptical about following Professor Dalgleish’s advice at that time, so I didn't do anything about it for 18 months. Anyway, within that timescale, I had two further recurrences of. HCC, which is hepatocellular carcinoma. It's a tumour in the liver. It doesn't spread in the body, but all the same, it destroys your liver.

When I came out, I did a bit more research, following up on what Angus Dalgleish had told me, and I researched  Dr Buhari in New York, and I thought, well, this is very interesting. And it kind of supported what Professor Dalgleish had said to me. And I also got to know about Dr Berk Berkson’s books and who's in Las Cruces, New Mexico, who was doing very interesting work as well with LDN and also using antioxidants, in particular, alpha-lipoic acid and some other things, and so, based on my research, I thought, well, I mean, I've got nothing to lose so I'll give this a whirl.

I have in terms of ways to take the low dose naltrexone, I am taking the capsule form that I obtain from a local compounding pharmacist. In terms of the future of LDN in the US I think in the ideal world, I would wish that all the major cancer centres would incorporate it into their treatment regimens immediately. Unfortunately, change in medicine is very slow, and it's challenging, and because it's already a patented medicine, there's not a lot of profit to be made. It's inexpensive, and so that becomes a barrier I think, in realistic means, the integrative medicine and holistic medicine community will be embracing it as the word gets out, as conferences are held, they will be the ones to hold the torch and get it available, as the patients also demand access, it'll be, I think, through that population of physicians who offer it to their patients. I would like to see it as a frontline for anyone who's got a suspicious diagnosis that's potential cancer. They should be started immediately.

So, I started without any expectation. I started taking the LDN and hey presto, miraculously I went into remission for three and a half years. Three and a half years. And that in itself was remarkable. And I was being treated then by someone at Hammersmith Hospital who was a bit dismissive about LDN. He'd never had great faith in it. And what he said to me was he said, look, your liver is recovering,

I don't think your recovery and your remission has anything to do with this low dose naltrexone you're taking. So, he was so dismissive I discontinued it, and I rue the day I listened to him basically. So, I discontinued it, and then within nine months, I'd had another recurrence of another tumour in my liver. But after I’d had this news, I decided I'd go to America to see Dr Berk Berkson, because I'd heard about him. And I thought, well, I'll go and talk to the guy. So I went out there and started on the LDN again with him, and I came back to the UK again with no expectations, and when I got back to the UK, I'd only been on the liver register for six weeks I think it was, and I  just sitting at home one day and I had a phone call saying we've got a liver for you. And I almost fell off my chair and we had to make a sort of an instantaneous decision about where to go. So, I said, yes. Interestingly, when they removed my liver and replaced it with a new one when they sectioned the old one, they said, oh, that's interesting, all your liver cancer has disappeared. Your tumour has completely necrosed. So, I don't know how to explain that, but since that day, that was over three years ago now. So well, I shouldn't really judge, but I suppose in my mind, I know that what did LDN do for me? Well, it gave me three and a half years of remission from the time when the doctors were actually saying, he's going to have another recurrence in three months time and it doesn't look very good, to basically getting me through that period. It's gone very well indeed, and I have no recurrence of any sort. So, do I believe in LDN? Yes, I do. I know, I know it worked for me.

So, more commonly we are getting many inquiries from patients who have been diagnosed with various types of cancer for low dose naltrexone. And it's quite important that if you are going to look at using low dose naltrexone for your cancer therapy that you talk to your individual GP and your oncologist first, because you may be on certain types of pain medication, which are contraindicated initially unless they're very carefully handled. A lot of people have come to us because they've gone onto the internet, and they’ve found something that they can buy. A lot of those are not real, or they are fake medications, which are dangerous, and you should not randomly decide to treat yourself for cancer by buying naltrexone tablets on the internet. I know it sounds very simple, but we find out the great number of people who do that.

So, looking at the possible side effects you can have from taking LDN along with cancer chemotherapy, that's extremely individual, dependent upon the type of cancer chemotherapy that you have. So, for example, there is a growth in biologics and vaccines, versus original chemotherapy drugs, like the platinum and things like gemcitabine, which has a slightly different mechanism of action. So, if you are taking, or you’re being prescribed many different types of cancer chemotherapy drugs, and each individual cancer is specific; cancer is not one disease, it uses multiple different types of treatments for different types of cancer, and the guidelines are always changing.

So, there are biological drugs that are chemically drugs called the plantains, and there are also drugs which can change your immune system, like vaccines. So, it's going to be very individual when and where you're able to take LDN in your treatment cycle or your treatment pathway. Now, there has been some information that we are aware of, which has not yet been released.  And I think over the next year we're probably going to hear more about that along with vitamin D. So, I’d certainly say, if you have been diagnosed with cancer and you're looking at using LDN, the first thing you should do is start taking vitamin D, and the dose for that, you can decide with your practitioner, but really it would be aiming for between five and ten thousand units per day, and LDN seems to work much better when it's being used with that, but LDN itself should not be taken when you're on any strong painkillers without direct medical supervision. So to speak to your doctor or pharmacist, and before embarking upon this journey and make sure that you get someone who is very qualified, who is capable of reading the most recent research and keeping you up to date and make sure that your treatment pathway works as well as possible.

Linda Elsegood: Thank you for listening to this presentation. All past conference presentations can be found on our website, https://ldnresearchtrust.org/

Russell - 29th May 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today, my guest is Russell from the United States who takes LDN for hypothyroidism, Graves' disease, a non-Hodgkin's lymphoma.

Thank you for joining us today, Russell.

Russell: Hi, Linda. It's a pleasure to be speaking with you 

Linda Elsegood: So could you tell us, when did you first notice there was something wrong? How long ago was that?

Russell: So first for me, it was with the non-Hodgkin's lymphoma. The cancer was back in 2016. Um, well that's when I got diagnosed, but I, I had a, uh, a lump on my arm near my elbow and, um, I had seen a lot of, uh, or I saw my primary care physician for it.

And I'm fairly young. I'm 29. Just turned 29. Actually. You know, a couple of weeks ago in February 1st and uh, so, you know, no one thought that it was cancer at the time, as I call it. It's a rare chance that it could be, but you won't know until you get it taken out or get a biopsy or anything like that.

At the time, I was busy working and. Uh, I kind of, you know, drug my feet a little bit to actually get, get it, uh, you know, get the imaging studies that were requested, you know, those types of things done, you know, just being busy with work. So it turned out to be about, uh, it's about 14 months later when I actually got diagnosed and, um, and I, that's when I got the cancer diagnosis and non-Hodgkin's lymphoma.

It's a. Caught 'em anaplastic large cell lymphoma and it's a T cell lymphoma, and it's highly aggressive, and it's, it's, you know, they diagnose it as systemic cause I had a lymph node and, um, it can end up anywhere and everywhere in the body very quickly. And, uh, you know, by the grace of God, at that time, I was diagnosed with stage one.

So that was surgically removed, and I'm kind of taking a step back. So that was surgically removed. That's how I actually found out what was. And so then they referred me to an oncologist. And, uh, so I saw an oncologist and, um, you know, they recommended to chemotherapy. So I did the chemotherapy first-line therapy, 

And, um, so that, so that, and then in that context, it was an adjuvant therapy. From what I understand. Based on the terminology, because you know, I had pet scans, CT scans done, you know, after that biopsy. And there was no other detectable disease at the time. So it was stage one, and they said, Oh, since this is stage one, and you know, we think we, uh, you know, can, you know, take care of this with the first-line therapy.

And it was like they said, a 90% chance of longterm, durable remission or cure with chemotherapy. Then ten months later. Um, I, uh, started to get skin lesions that were just popping up. And I'm saying that now cause I know what they are now, but at the time they just look like, like little bumps and um, you know, they started on the legs and arms and they'd get on the back and had some on the face and not a whole lot on my face, but mostly on the, you know, the limbs and trunk and stuff like that as a body.

And it's like, what should go in and get this checked out? So I had told my oncologist about it, and he saw some of them, and he's like, Oh, this is kinda, you know, it looks, you know, it doesn't look like anything cancer-related, but then we'll recommend you to the, you know, the lymphoma, dermatology, ontological specialists.

So, and that was kind of a little, what am I seeing? This guy where I'm in? This doesn't look like him, but they just want to make sure. So I saw him. And, um, you know, he's used to seeing these types of things. And you know, it was kind of shocking to me when I saw his face because he was puzzled. He was kind of like, or not puzzled, I should say, but he was concerned that this was cancer.

And so I did some biopsies there, and they started checking lymph nodes, and they found the lymph node and the growing. And I was like, Oh, we need you to go, you know, and get this a lymph node biopsy as well. So those biopsy results came back. So it came back as a recurrence for the primary, uh, lymphoma that large anaplastic cell in the groin.

And then I had metastasis to my skin and with that, of that same primary lymphoma, then there was one of the other skin biopsies that were done. It was suspicious for. Another type of skin lymphoma called mycosis fun goatees. But they were kind of going back and forth cause it kind of looked like the primary, um, anaplastic large cell lymphoma and this other type.

So then the recommendations, you know, back for all those fines reflected and met my primary colleges. Again, I was like, well, we have the second-line therapy. We still believe it is a high chance. To, uh, to cure this. And those were the terms they used. And, um, so I went through that, and I did four rounds of a targeted drug.

It's called an upper and Tufts and bad. So my client will make antibody. And, um, within two cycles, I got another emission. All the skin lesions, you know, went down at the lymph nodes in the groin were gone. And then, um, the oncologist said, well, in order for us to cure you, we need to get you into, um, high dose chemotherapy with the STEM cell transplant.

So this is not just the normal chemo. I mean, this is like, you know, high dose. They give you enough chemo where they wipe out everything that's in your bone marrow, and they rescue you with a STEM cell transplant. So. Uh, so I was like, you know, at the big, you know, kind of against that, because I looked into a lot of, uh, you know, the side effects and longterm stuff is associated with that.

And there's just a lot of risks with me being young. And I, I was never in favour of doing that. And, um, so my plan then was after I got through a mission, you know, which the mission was done about that, maybe the second cycle. And so I did two more additional. Then after that, my plan was to try to, you know, pursue some holistic type treatment and, um, to, to sort of try to keep it away or whatsoever.

But, you know, look, uh, shortly after that, maybe two to three weeks after I was done with that chemo, I started to get skin lesions again. So, I mean, that kind of shocked me as well. That was pretty quick. I was like, Holy cow. Um, you know, I just got off of the chemotherapy, so I went back in and got some more biopsies, and sure enough, it was the same, you know, stuff in my skin again, this with this lymphoma.

I was like, well, now it's insight, you know, it came back so rapidly. They were like, well, you know, if you don't go into this, you know, high dose chemotherapy with the STEM cell trust that we wouldn't expect, you know, Chris, your condition and with relapse and stuff like that to live past six months.

So that was kind of, I was like, Oh, wow. Yeah. So then, you know, this was, that was in January of 2018 so, I mean, I was, I wasn't convinced that that was gonna cure me because the data that they supply for me, um, you know, the bone marrow transplant team and my primary oncologist, I mean, the data was showing a 30% chance of survival for three years.

You know, and they were saying that secure. I mean, I, and, and I was trying to be objective as possible. And I mean, it just didn't pan out to me. I mean, I have a three-year-old, and I'm thinking to myself, it's like, well, how is this going to cure me? You know, there's no data showing ten years, 20 years, or 30 years.

But I don't know. That's what they told me. And that's what the data said. So that's when I decided to, um, you know, not pursue any more conventional therapy, you know. So I stepped outside of the standard of care, and I went to a, uh, a clinic down in Mexico, ships the hospital, and I got some, um, you know, uh, treatment down there and some natural therapies and some immune therapy, um, called Cooley's toxins.

And this is how we're just starting to get him to the point where, um, I started my LDN. So after, you know, all those treatments and stuff I did down there. Actually, I responded pretty well. Um, you know, a lot of the skin lesions, I had probably about 95% of those was gone when I came back home though, right before I left Mexico.

Um, they had tested, uh, just normal thyroid panel testing and my T, um, TSH was like really, really low. It was like, I think it was like 0.05, and so then I got back here, I got the results, and they sent it to me an email, and I saw my functional medicine doctor, and he was like, Whoa, this looks like graves' disease.

So I'm like, Oh my gosh, you're, this is, you know, I've got another condition. You know, trying to deal with cancer and, and, um, so he did some more tests and some thyroid antibody tests and TSI, those tests like that. And, um, my TSI came back. It was elevated positive for graves' disease. So then that's when he had recommended for me to take, um, LDN low dose naltrexone.

So I started taking that, and he started me off at 1.5 milligrams, and the plan was to escalate that dose over a, you know, go up 1.5 milligrams every two weeks. But what I found is that I wasn't able to do that initially. I mean, I somewhat explain that a little bit. I went from, I think it was what, 1.5 to three and in two weeks, and I tried to go.

Oh to 4.5 then the next weekend, I did have some side effects. I was like, Whoa. I had to, I just felt so exhausted the next day, and you know, really, you know, really tired and fatigue, muscle aches and stuff like that. So I, you know, took a step back and I went back to three. And, uh, took that for a little bit longer than asked my doctor, you know, if it would be okay if I just went to force.

I did that for probably a couple of weeks then. Then I finally went to the 4.5, and that's where I'm at now, taking, taking that every night at bedtime. And, um, some of the side effects that I've experienced. Um. I mean, this is very low. And that's one of the things I like about LDN. There are very low side effects, but I did call sleep services for me in the beginning, and every once in awhile I'll have an issue where I'll find myself, you know, awakened and, um, you know, two or three o'clock in the morning or something like that.

But I started, um, taking some magnesium. With that, because that's been shown to help with sleep and stuff like that. So that's, that's actually been helping me quite a bit here, uh, over the last couple of months. And, uh, so I've been taking it, so I, I haven't, I mentioned when I first started it, I started it back in, uh, was in April of 2018?

So I'm coming up to about a year and, uh, on the LDN. But other than that, I think those were all the side effects that I experienced. And one other, uh, interesting. Um, synergy I think I experienced with LDN because I'm, I'm doing this, this holistic protocol, Gerson therapy, those two different types of therapies for just the maintenance and to keep cancer from coming back.

And I'll kind of, um, I'm not jumping over the place here, but I'll kind of come back to the cancer part a little bit too because I believe it's helping there as well. But, um, yeah. So all the therapies I mentioned, I was doing this Coleys talks and this immunotherapy, so mixed bacterial vaccines, non-infectious, and this is a dead bacteria, but I won't go too much into the details or the history behind that, but it's a very old, um, you know, Dr. William Coley was the father considered the father, you know, therapy. And he actually formulates, came up with the formulation for this mixed bacterial vaccine and found out that, uh. What he, what he saw is that a, a patient that, uh, had sarcoma and of the, I think it was a bone sarcoma, and this patient was not supposed to survive this disease.

And he actually, you know, coldly found him alive and well, you know, long after he was supposed to be gone. And he, uh. They looked into the records and found out what actually happened to him. But this man was breaking out into high fevers and chills and, you know, shake. So he had this, uh, uh, air syphilis infection and, and, you know, dr Coley believed that that caused the tumour regression, and he, you know,

A scientist actually tried to reproduce that, and he was able to do that by infecting people with live bacteria. But he killed a lot of people. And this is doc, well documented in the medical literature, you know, would dr Kohli and his results. But, uh, so then he actually, you know, you can't kill people giving them something to treat a condition.

So he actually, uh, you know, thought that, Hey, what if I heat-killed this bacteria and gave it to people? And, you know, he didn't cause any mortality associated with it, but he did have, uh, some tumour regression. And um. But anyway, so that's a little bit of history behind this vaccine, but there's some literature out there that shows that LDN has the potential to, um, help the maturation of dendritic cells and, you know, Coleys this vaccine actually.

Um, it, it works through your dendritic cells. And, and, um, from my experience when I started taking LDN and continuing my, uh. Immunotherapy vaccine, I notice more the reactions from the vaccine were more intensify. And, uh, and it, that didn't happen before. Like, actually I responded better. Like, one of the metrics for this vaccine is it does cause you to have high fevers.

And, you know, I, I, I didn't really get them consistently and, um, but once I started, you know, using LDN and the vaccine, I mean, it actually. You know, I would get getting consistent, you know, high fevers in some record temperatures and stuff like that. But, um, so I thought that was pretty interesting. So my, all my doctors were kind of on board with me using that.

So I was working with my doctor. I just wasn't, you know, doing experiments and stuff like that by myself. But, um, so kind of, uh, I think that's the gist of. With the, with, with the vaccine, but back to, um, with Gray's disease, as I mentioned, I started taking it in April of last year, and about three months after that, um, in July, I had more thyroid testing done and my graves' disease would, it's remission, you know, just in those three months of taking LDN.

So that was pretty, I was pretty sold on using it. And, uh, as I said, I still use it to this day, so, and, and, um, but my, so regarding cancer, um, so like I said, I've been taking it and, um, you know, also for cancer, but in doing all these other things, but. You know, as I mentioned that my doctor mentioned in January of last year that I wasn't expected to live past six months without that high dose chemotherapy and STEM cell transplant.

And so now I'm actually, you know, it's almost a, it would be going on like 13 months since that, um, prognosis and I had a pet scan back in September of last year, and that actually showed that I didn't have any, you know. Evidence of any tumours or anything like that. So was a clear pet scan.

Linda Elsegood: Yeah. That's amazing.

Russell: So, um, so I'm, uh, you know, and I believe that LDN has helped as well. You know, as I said, especially with the vaccine and, you know, and, uh, so I'm, I am, you know, going to continue to take that and. And, um, and another thing that's pretty interesting that from that I came across is, you know, there's a lot of talks now about cancer STEM cells and circulating tumour cells.

And, you know, the literature is saying that this is what causes a person to relapse. And, you know, what I found highly interesting is, um. No. From some of dr his work and, and some of the, uh, the information that's out there regarding some of the people that he gave LDN after they had, you know, successful cancer treatment.

You know, even if it was conventional or whatsoever surgery, and that people tended not to relapse after taking LDN. And the connection here, and this is some of the conclusions that I've been drawing just from some of the research that I've been doing, but I'm coming out of a university of Michigan, dr max, which I mean, they have one of the leading STEM cell cancer STEM cell research laboratories, and they're kind of leading building this.

But one of the. Cytokines and these are just inflammatory cytokines. It's called interleukin six is what causes these cancer STEM cells to go into the proliferation cycle. And that's kind of what they found from their, their research and the connection with LDN is I've seen some of the data that they looked at some of these cytokines that LDN effects.

And, and this is in particular, I believe you probably though the doctor, I think you've, I've heard you interviewed him, he did some clinical trials with fibromyalgia

Linda Elsegood: Jarred Younger

Russell: Yeah. That, yes, that's his name there. And, uh, one of the tops of the, uh, on the top of that list, my memory serves me correctly, I believe it was to where necrosis factor out was, which is another, you know, uh, typical transcription factor or a cytokine.

I forget. Specifically, but interleukin six is like the second one on that list. So LDN, um, inhibits that. So I meant, I know, as I said, these are some of the conclusions I'm drawing from my research. But, so, I mean, maybe that's by one of the mechanisms by which, you know, LDN may keep a person in remission.

And, uh, so, and I, I've heard a couple of testimonials of people. You know, having, you know, in remission from cancer, especially if LDN, you know, bought them, but that person in remission, you know, and they stopped taking it and have a relapse again. And there's a guy, I believe, I think his name is Kevin. I think he had liver cast.

And I believe you interviewed him and he mentioned the head in an interview, uh, with you regarding, uh, the, the, you know, after he stopped taking ODN and liver cancer came back, I believe his name, Kevin, but, um. But anyway, so I just thought that was interesting in some other, you know, functional medicine doctors have kind of reported some of the similar, um, similar, you know, things happen.

Linda Elsegood: well, you know, it's totally amazing, and I'm sure people find you an absolute inspiration. Definitely.

Russell: Yeah. So, uh, yeah, I'm just very, yeah, I've been blessed in it, you know, I thank God for. You know, everything and you know, the success I'm having, and you know, being in good health right now. And so that's a

Linda Elsegood: yes.

Well, long may you continue in the way in which you are and lead a normal, healthy, happy life.

Russell: Yes.

Linda Elsegood: Thank you, Russell.

Russell: Okay, great, great. And uh, you had the great day and thank you for all that you do. And uh, that's great. 

Linda Elsegood: This show is sponsored by our members who made donations. We'd like to give them a very big thank you.

We have to cover the monthly costs of the radio station software and with phone lines and phone calls to be able to continue with their idea of the show. And thank you for listening.


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

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.

Stephanie Grutz FNP (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Stephanie Grutz, FNP shares her Low Dose Naltrexone (LDN) experience on the LDN Radio Show with Linda Elsegood.

Stephanie Grutz is a Board Certified Family Nurse Practitioner, specializing in Integrative medicine. After practicing as a nurse for over 6 years, she went back to school to become a Family Nurse Practitioner. Her first job was in an acute rehab care setting. 

At that same time, she was also battling a chronic autoimmune disease and felt that Western Medicine wasn’t fulfilling her desires. She branched out into holistic living & Integrative Medicine. She saw great results and decided to open up her own clinic to help patients on similar journeys.

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