LDN Video Interviews and Presentations

Dr Scott Zashin, LDN Radio Show 2017 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

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

Doctor Zashin from Dallas, Texas, is a Rheumatologist who is Board Certified in Internal Medicine. 20 years ago he changed his practice to specialize in autoimmune conditions which required more time to evaluate and treat. 

Unlike most Doctors who allow only 10 to 15 minutes per visit, he spends an hour or more as necessary to get a firm grasp of the patient's problems. He discusses the many autoimmune conditions he treats and how LDN fits in, and why diet and exercise are very important.

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

Dr Sally Boyd Daughtrey, LDN Radio Show 2016 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: This evening. I'm joined by Dr. Sally Boyd Daughtrey, who's a licensed naturopathic doctor from Hawaii. Thank you for joining us. 

Dr Sally Boyd Daughtrey: Aloha. Thank you for having me. This is a great opportunity to share my experience with naltrexone. 

Linda Elsegood: Could you tell me when you first heard about LDN? 

Dr Sally Boyd Daughtrey: Well, this is a very interesting question, because it just sort of - I don't know if you know the word grok, but it just sort of grokked towards me from the universe and just different layers. There's not a particular time that I went, Oh wow, naltrexone is amazing. It just sort of became clear to me. But the first time I prescribed it for a patient, it's something I will never forget. It was astonishing. I'm sitting in my office, and I hear this banging on the wall of my waiting room, just this thump, thump, thump; and my receptionist was at lunch. So I was alone; what is that? So I am flying out to the waiting room, and there's this lovely waifish ill woman laying on the floor of my waiting room, and she was trying to drag herself through the waiting room to get to the reception desk by banging, by grabbing a wall, literally dragging herself through the waiting room; and it was amazing. So I reached out and I picked her up, and I put her in a chair, and I took her in the back and started doing her interview. She was an MS patient who had been through everything and couldn't walk because of the MS, and had no money, low-income, literally stumbled into my office off the street. There was very little I could do for her because I do private medicine, I don't take insurance. But I remembered naltrexone. Someone had told me about this thing called naltrexone. This is about 2007, 2008. I managed to find a compounding pharmacist that knew what the heck it was and prescribed it for her. And within two weeks she walked into my office. Two weeks, and all I had done for her was naltrexone and some vitamin D, because that's all she could afford. I saw her for two years when she could come in and see me. She had no relapses. One more thing we did, I gave her a grounding mat. I don't know if you know what those are. It's just a very simple device that helps connect you to everything, helps you connect to the earth and reduce EMF exposure, basically.

So those were the only things that we really did. And in those two years, she had no relapses at all. And I know people say, Oh, well, MS has spontaneous relapses, but really come on, the chance of that happening was so low. And the only reason I lost track of her is that she got well enough to get married and moved to a different state. So that was the pretty astonishing start and my exposure to naltrexone.

Linda Elsegood: So where did you go from there? 

Dr Sally Boyd Daughtrey: As you can imagine, I was pretty impressed, so I started using it specifically for autoimmune conditions at first. But as you know, autoimmune conditions are epidemic everywhere, and the more you look for autoimmune conditions in a wide variety of symptoms, the more you find them. So I started going with a lot of my Hashimoto's patients next. And it's sort of becoming my go-to if someone has thyroid symptoms; there are hundreds of thyroid symptoms. I have a thyroid questionnaire that's 2-3 pages long, with symptoms and overlapping with other conditions, symptoms, and whatnot. If someone shows a lot of thyroid symptoms I run antibody tests on them, and if they're high at all, then it's pretty much an automatic thing now that I put them on naltrexone. And what I love about running antibodies is because, especially with thyroid patients, you can get a baseline antibody level, and you can put them on the naltrexone, and you can watch that number drop like a rock. I had one person come in with 1200 antibodies, and three months later, they're something like 30 to 60. That's not uncommon, to have those antibodies go down that fast. And ANA and anti-TPO and TBG are well-accepted tests.

And it's a good thing to actually have something they can take to their MDs, who tend to be more in the medical establishment. So there's good about that and bad about that. One of the bad things about being in that system is if you're entrenched in that system, it's harder, there are more social stigma and financial stigma for them to break free of that dogma. So it's really refreshing for me to be able to say, here are the baseline autoantibodies when my patient walked in the door, and here are their antibodies ten times lower three months later, what do you think of that? And the more forward-looking of these that my patients also see, because most of my patients see an MD as well because their insurance covers it now - I use that as an educational tool for, for them to help increase exposure to this treatment. 

Linda Elsegood: So, do you have any other stories? 

Dr Sally Boyd Daughtrey: I can tell you my own story. I've had Hashimoto's thyroiditis for 25 years. I got it in medical school and I remember the reason for getting it, in my mind, was cadaver lab, being exposed to huge, massive amounts of formaldehyde in a high-stress environment, and then autoantibodies started going up from there.

And it was presented to me, even as a naturopath where we treat a lot of things outside the box that isn't supposed to be treatable; even in that context, it was presented as well, we can manage this, but you're always going to have gluten sensitivity and weight problems and fatigue, and we'll check your autoantibodies every now and then, but there's no need to really redo them again because now we know you have this disease and it's not treatable.

So basically the plan that was presented to me - I'm in my early twenties - was here, they'll give me this thyroid medication, and when it stops working, we'll give you more. And then when it stops working, we'll give you more. And then when you reach the max, we'll just keep you on that. And good luck with that. And you think, okay, I'm swimming against the stream by becoming a naturopath, so the things that aren't treatable are supposed to be treatable with our medicine. And you're telling me that this is not treatable, or it's something super elusive like - maybe it's your mercury exposure or something like that. And then 20 years later, take one little pill at bedtime and have that condition dramatically improve, it was amazing. And to be able to actually track that on lab work, and say it's not just me, it's not a placebo effect. I can't really see how a placebo effect would reduce an autoantibody level on a lab consistently. Yes it could take a little bit, but that's obviously not all that's going on here. 

So myself starting to take it resulted in my being able to go from a part-time practice to manage my condition, to a full-time treatment centre. So now I have staff, and I have ancillary services, I have an associative MD, and I have all these things that I'm able to manage now because that condition is successfully - I wouldn't say cured because to me cured means you don't need to take anything to not have your symptoms. So I would say that naltrexone has created the ability for me with a wide range of conditions to successfully manage them, and moderate or eliminate the symptoms. 

I would say maybe 20-30% of my patients that come into this clinic get naltrexone treatment. Part of that's a reflection of the fact that I treat recalcitrant patients in the first place, meaning I treat patients that have pretty much been through regular medical care and have not been fully resolved with that or satisfied with that. So that population is somewhat self-selected to be a more difficult treatment population in the first place, and that's part of what naturopaths tend to do in this country. When you have a success rate that is high with a population that already has failed conventional treatment, you know you're doing really well. It's a very gratifying profession in that way.

I would say it's an appropriate fit for about a third of my patients. Of those patients, about 60 to 80% stay on the therapy and self-refer themselves to stay on it. Meaning I'm not sitting there wondering how to track compliance. They're calling in to get their prescription refilled. They're choosing to stay on it because they perceive that they feel better when they're on it, and that's pretty quick too. 

I'm reading the LDN Research Trust website, which is super useful by the way, this is a great website, and there are all kinds of things on there that I didn't know, that's useful. I've been expecting people to have a significant symptom change within two weeks, and then I'm reading on here that a lot of the chronic pain patients can take three months to have a significant benefit. So I am able to condition people to wait that long to see a benefit. And still I'm seeing 60 to 80% of people staying on it and reporting improvement.

Part of that might be me encouraging them to notice an improvement is having a positive mental effect for sure. Everyone that comes here is paying cash to see me and is paying cash for the therapies because insurance doesn't cover what I can do. So if you're going to keep paying for something, you definitely perceive a benefit from it. 

Linda Elsegood:  On the flip side, has anybody told you that they experienced any negative side effects? 

Dr Sally Boyd Daughtrey: Well, the sleep change, sleep disturbance, insomnia effect is definitely a factor. And for that, I would say maybe 20-30% of people will report that. There are some people of course that come here, see me once to try something and then I don't see them again. I don't know what happened to them. They don't follow up. It's not the right kind of care for them. So I can't say what those people are doing if they have the insomnia effect or not. But people that come in and are consistent and do the therapy, it seems to me like there's a certain subset of patients that have that symptom. I haven't quite pinned down who they are, except that they tend to be more sensitive and more anxiety-prone, more reactive. I do see a lot of chemically sensitive people, canary in the coal mine kind of people, and  their dose-response rate is very individual. So I have people on 0.5 milligrams and I have people on 12 milligrams. That's a huge range, and I've come to that with people through very specific trial and error. 

A lot of my patients are very intelligent too, they're very motivated and follow instructions well, and can do some self experimenting. Which is a wonderful thing about being a naturopath too, that that population kind of seeks you out. So I'll start them on say one milligram for a week and then have them try 1.5 and then try 2, and change the dose, and keep a log and ask, how did I sleep last night? Did I have vivid dreams? Were they pleasant or unpleasant? Were they disturbing? A lot of autoimmune people have disturbed sleep, so they're not used to dreaming at all, or they're not used to remembering their dreams. So they find that startling at first. But then if you take the time to inquire and ask if it was a bad experience, they say no, actually it was a good dream. Well, maybe that's okay. That's not a bad thing. So part of it's how you see it, but definitely, people will have restless or disturbed sleep the first few nights, but I haven't usually found it to last more than three nights. 

What I do now just for simplicity sake is to start them on, let's say three milligrams, but the first night I'll have them open that capsule and pour nearly all of it out. And then the next night I'll have them pour all but a quarter out, and then stay on that for about three nights. And once they're sleeping through the night, then I'll slowly start adding back a quarter of the capsule at a time until they're taking the whole three milligrams without any problems. And that works 99% of the time.

Linda Elsegood: I would say that there are many doctors that actually swapped to morning dosing for people who find sleep is an issue. And it seems to work just as well in the morning. 

Dr Sally Boyd Daughtrey: And they're not noticing any downwards depressions spike at any time after taking it? 

Linda Elsegood: No. And there are some people who have been taking it in the morning, swapped to the evening and feel that actually taking it in the mornings they have less fatigue. I take it for MS, and I've swapped from night to morning and it didn't make any difference. And there are some doctors that prescribe LDN for chronic fatigue syndrome, double dosing, so the dose that they take in the morning they take in the evening as well because the body doesn't see it as double. So if you were taking 4.5, the body doesn't see it as nine, it sees it as 4.5 twice, because at the time you take the second dose, the first dose has been gone. I tried that as well. That didn't give me any more energy either, but I at least gave it a go.

Dr Sally Boyd Daughtrey: That's a really great idea. And I actually just had someone who just on his own decision, started taking it in the afternoon because he was afraid. We have lava here, this volcano that tends to threaten to cover the town every now and then. So he has severe anxiety and he lays awake at night and worries about the lava covering his farm, which I can't say is an unrealistic worry. So he started taking it in the afternoon and reported an immediate improvement in mood within 20 minutes. And thinking about the path of how it's supposed to work in the body, I don't understand how exactly that's happening, but I can't discount this experience. It's a consistent experience and who am I to say to stop doing that, you're doing it wrong; because for him, it's right. So I just put him on doing it in the afternoon and then trying a very small dose in the evening to see if it helps. 

And the wonderful thing about this stuff is that at these doses, it seems so safe that allowing people to experiment with it and find what works best for them, and then tracking their results and making sure that their lab work is in order and they’re progressing in all aspects. I do regular physicals and I can see people's physical parameters improving.

I don't do just naltrexone. In this kind of setting, I'm doing naltrexone and nutrition changes and counselling and lifestyle modification, and I'm doing all of these things together, and it doesn't really serve my patients to just do one thing so we can test it. Now that's a very difficult sell, right? So that's the whole problem with holistic medicine, with testing holistic medicine in general, that it's the sum of its parts and it's a synergistic sum of the parts. So if you try to reduce that down to what's just naltrexone effect versus what's this lovely whole food B-vitamin that I've switched to them too, and taking them off their synthetic kind that was causing anxiety, for example. 

That's challenging for the standard medical paradigm to accept as a real therapy. I don't really know what to do with that, except to compare people that get that holistic treatment with it with people who choose not to have naltrexone because some of my patients are against all pharmaceuticals. I have a subset of the population who are seventh day Adventists or Amish or someone like that. And they will not do a conventional pharmaceutical of any kind. Even this one, even this very benign one. So the only way in my mind, can ever really extract what naltrexone is doing individually is to compare the progress of those people in general, with those other people who do all of that plus naltrexone. I've been doing that admittedly in my own head, keeping a tally in my head, since 2007 or 2008, so that's 30 years, and a lot of people. My overall very strong impression is that the people that do everything plus naltrexone do significantly better than the people that choose not to do it for whatever reason they're choosing not to do it.

Linda Elsegood: And if we have people listening to you in Hawaii and they'd like to come and see you, how did they contact you? 

Dr Sally Boyd Daughtrey: Our practice is called Vitality Integrative Medicine, and we are a comprehensive integrative clinic in Pahoa, Hawaii. Our phone number is 808-965-2233. Our website is http://www.vitalitymedicine.org/

Linda Elsegood: Is there anything else you'd like to add before we finish? 

Dr Sally Boyd Daughtrey: I guess one thing that I'm thinking of doing now is expanding who qualifies for this therapy. What are other doctors finding results with this that are beyond cancer, autoimmune, pain syndrome? That's something that I'm really interested in because it seems like... 

Oh, PANDAS, I had an amazing PANDAS. It's a cross - one of the things that we're seeing more and more now is cross-reactivity is in the human body to past infection. So someone who's had an infection in their childhood, say strep, or staph, or Lyme; then their body will mistake the antibody for that bacteria to a piece of their own body, their own tissue, and then they will have chronic problems with that particular organ. I'm having some really interesting results with people like that. They don't even always know that they have an autoimmune condition. They feel like they have a heart condition or a skin condition; or in this case, a mental, emotional psychosis condition. And naltrexone seems to be helping - kind of in layman's terms, it's helping the immune system be happier and calm down, and recognize what’s a friend and what's foe more accurately. The implications of that are huge.

Linda Elsegood: At the conference in February, we had two psychologists talking about post-traumatic stress. But it seems to work for cravings and all sorts of problems that people have. So the more we are using it, the more conditions are coming along that doctors are treating with it. We now have a list of I think 204. Normally, if there's an altered immune component, LDN could well work; and then there are all the different pain conditions, there are these mental health issues that it's helping with as well. So it's very interesting. We're learning all the time. 

Dr Sally Boyd Daughtrey: One that I also am treating for - I don't have a large population of people partially because they're self-reporting is poor, there are some shame-based issues with the self-reporting, but the euphoric drugs of abuse like ecstasy and Molly and MDNA. Those kinds of drugs. I think people that use those and use them and use them and use them, end up depleting not only dopamine but endorphin and enkephalin as well. They tend to present with this sort of chronic low-grade apathy, dysthymia, hopelessness, lassitude. The only thing that seems to make them happy is when they're actually on that drug. So, although it's not technically “an addiction or an addictive drug” by classification, their life ends up being cycled around the use of that drug. When I can get them to take naltrexone and stop taking that drug of choice, it seems to make them feel normal. And it makes me feel hope for these people because they're self-medicating in a way. If their endorphins are chronically low and they don't know that, but they know that they get to actually have an experience of having normal or high endorphin levels for a few hours, you can see how their life would then end up revolving around wanting that feeling of actually feeling normal. Here we are saying for the first time in your life, you can feel good, not high, but good every day. And that can be your baseline reality from now on. That's incredibly powerful. That's a life-changing experience. 

I've had a couple of patients who have been able to tell me this is the cycle they’re stuck in, and I've been able to say, well, if you can commit to weaning off that drug, not doing it every three nights or every week and/or living for it, and instead, do this because I would think that they would contradict. So I don't want them doing naltrexone and that drug at the same time; I don't know what that would do. So then we actually make a contract: you do naltrexone. If you want to keep doing your illegal drug of choice, don't do naltrexone that day, please. And they find that they need that drug, whatever their drug is, less and less. So that's very successful; that's very satisfying.

Linda Elsegood: Thank you very much for sharing your experience with us. 

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr Michael Arata, LDN Radio Show (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

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

Dr Michael Arata from the United States first heard of Low Dose Naltrexone around 2010 when one of his Multiple Sclerosis (MS) patients asked about the drug. Luckily due to his connections with other physicians, Dr Arata was able to begin prescribing LDN to his patients swiftly.

In the first few years he found LDN to be particularly successful in the autoimmune patients from his practice, including patients with chronic fatigue and fibromyalgia, chronic Lyme, etcetera. 

In this interview Dr Arata explains how LDN works in the body against autoimmune disease and declares his optimism for LDN’s possible future for being adopted into mainstream medicine.

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

Pharmacist Mark Mandel, LDN Radio Show (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr. Mark Mandel, owner of Mark drugs, compounding pharmacy in Illinois, United States shares his experience in prescribing and compounding Low Dose Naltrexone.

I first heard about LDN in the mid 1990s. One of my patients husband was using LDN, for a couple of conditions that he had at that particular time.

He had been diagnosed with cancer and with autoimmune diseases.

We compound LDN the simple way. LDN one compounded alone with lactose sugar is the most readily absorbed available source.

For those patients who are sensitive to lactose, the only other modification or alteration we do was we put it in combination with probiotics, and that seemed to have a beneficial effect for many patients as well.

We have the ability to put chemicals into any dosage form that was effective.

We do ship LDN all across the domestic United States.

We help patients with Cancer,  Multiple Sclerosis, Chronic Fatigue Syndrome, Fibromyalgia, Rheumatoid Arthritis prescribing LDN with success.

Dosing on the Low Dose Naltrexone can vary anywhere from a minimum 1.5 milligrams at bed time to the maximum effective dose, approximately 4.5 milligrams at that time. And then it's actually the 4.5 milligram dose is typically the most common dose.

There's a variety of different patients have different response rates.

And depending on the condition that's being treated, different concentrations at different dosages may be appropriate for different patients.

We probably have about 2000 physicians who are ordering Low Dose Naltrexone (LDN).

We have physicians in the Chicago land area in central Illinois, and in Northwestern Illinois. We also work with physicians in Wisconsin and Indiana, which are the States surrounding Illinois surrounding the Chicago area.

Talking about LDN side effects, the majority of patients that report any, would be the very vivid dreams. The dreams are typically not disturbing. However some of them can be quite disturbing. Some can cause some anxiety, if the patient knows in advance that their dream cycle may be effected.

We found from a server that we carried out that only about 5% of people experience side effects at all.

We find that we're able to give the patients a lower price with a larger quantity of Low Dose Naltrexone, or they tend to get three to six months supply at a time. As you get to a three month or greater supply, the price of the LDN dropped to less than $20 a month.

So other medications that are available to treat these autoimmune conditions have awful toxicity, from simple nausea to complete fatigue, which is some of the things that you're trying to combat with conditions such as Multiple Sclerosis, Rheumatoid Arthritis.

I've been amazed since I first learned about Low Dose Naltrexone, which was quite some time ago, at the positive results and the positive benefits that our patients have seen. I've had patients have been diagnosed with breast cancer, who decides to use Low Dose Naltrexone in conjunction with other treatments who've seen a reversal of the breast cancer, colon cancer and prostate cancer.

I encourage patients to contact me if they have questions. I can be reached through our website at Marc drugs or you can email us through our website@infoatmerckdrugs.com.

Summary from Dr. Mark Mendel interview. Listen to the video for the show.

Dr Kat Toups, LDN Radio Show 15 March 2017 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr. Kat Toups is an MD from California in the US,  a functional medicine doctor and a psychiatrist.

After graduating, being a psychiatrist I ending up working in a research centre, found trials and studies on psychiatric medications, and came to see the answer really wasn't in a pill. The kind of illnesses that my patients had could not be fixed just by giving them a medication.

They were multifactorial reasons and that the pharmaceutical route was not the answer. Maybe some of the medications did help relieve suffering for people, but they didn't solve the problem of why they were sick.

So like many people that have come to the functional medicine table, I came into it with my own illness. I had immune problems sort of on and off most of my adult life and finally crashed and burned with some serious immune illness. As a physician, I knew the limitations of what traditional medicine had to offer me.

They could give me steroids to suppress my illness, but that wouldn't cure things. And so I started learning functional medicine at that time. And I suspect a lot of your listeners are familiar with functional medicine, but the basic idea of functional medicine is that we want to understand the root cause of why someone is ill, and it usually causes are plural.

 And then as we address all of those factors and bring those things into balance, we can restore health and get people well.

I went through all the training courses with the Institute for functional medicine and subsequently became certified there.

I would say in my practice a large majority of people have immune type illnesses or infection type illnesses. Many with Chronic Fatigue and then, of course, all kinds of mood symptoms that go along with immune illness.

So some of my patients kind of have the double whammy. They have immune illnesses, and they have a brain component, either psychiatric or cognitive problems.

So I would say that I've ended up with a pretty complex set of patients and I really enjoy working with very sick people because it's so much fun to help them on that path to getting better and getting their health back.

The first thing that I look at is a timeline. So I have patients fill out quite detailed questionnaires that I can start to see what has been happening. So I start back with when your mother was pregnant, did anything happen? You know, did she have illnesses?

What happened at the delivery? Was it a vaginal birth? We know that people who are born by C-section and subsequently are not breastfed may have lower levels of healthy probiotics.

We know that the gut microbiome and our healthy probiotics are what controls our immune system in great part. So if we don't have a healthy gut microbiome, then we can predict problems with chronic illness down the road. So then I'll look at the factors all through their life. What happened in early childhood? Did you have your infections? Did you have allergies? Did you have colic?

And then I look at the stressors happening and all those various factors. What were your teenage years like? Was it pleasant or was it a time of struggle and conflict and what was happening in your family? Was somebody a drinker?

Was somebody impaired by psychiatric disorders? Did a parent die or abandoned the family? We know now that when people have a lot of those factors, we can see immune disorders developing at higher rates like 20 or 30 years later.

So the notion of PTSD Post-traumatic Stress Disorder, you don't have to be beaten or raped.

I'll ask about tick bites. I'll ask about mould exposure.

Those were, of course, things that can affect the brain and the immune system.

 And testing, of course, testing is a big part of what I do.

I also test for SIBO, Small Intestinal Bacterial Overgrowth, and people with SIBO have a lot of GI issues. They typically have a lot of bloating and a lot of gas and people can have a lot of Irritable Bowel Syndrome, either constipation or diarrhoea or both. And what happens with SIBO is we have a lot of bacteria in our colon, and that is normal, but we shouldn't have such a high level in our small intestine, but when the bacteria get out of balance they can grow into the small intestine and overtake that. And so when you eat certain foods that are fuel for those bacteria, that will just have a little party with all that food, and they give off gas and bloating, and some people can appear six or seven months pregnant with the magnitude of the bloating, with the SIBO.

And so, as a psychiatrist, it's very clear. When people have SIBO and  there's a disruption in the gut that causes leaky gut or increased permeability in your gut, that allows food particles to get through into our bloodstream and then sometimes bacterial or viral or parasite components and all those things activate our immune system. And so when that immune system gets activated, it release's these inflammatory chemicals called cytokines and they'll travel around, and they freely cross the blood-brain barrier, and they turn on the immune system in the brain.

And when there are these inflammatory cytokines turned on in our brain, it causes psychiatric symptoms. And kind of the first thing that I'll see is anxiety.

 And then it can have depression ramifications. It can have cognitive ramifications and even people who never had ADD can have ADD symptoms with trouble paying attention and being distractible and can't focus.

 SIBO is where I learned about LDN. As part of the regimen for SIBO treatment, LDN is used theoretically as a prokinetic agent. And so the thinking was that you probably have some kind of GI infection.

Your immune system turns on to fight that infection. And so the thinking with LDN is that it somehow settles down that immune reaction so that people can quit suffering from constipation or diarrhoea.

I use LDN  in a variety situations. It's been probably best studied with immune disorders and Cancer. Cancer is really kind of the ultimate failure of your immune system. So cancer is certainly one place that I have used it.

And I've used it for Hashimoto's thyroiditis, unfortunately, a condition we're seeing so much more of these days. For some people, it can help the Hashimoto's so quickly that I always warn my patients that are on thyroid medication. If they start feeling hyperthyroid, like they're on too much medication, you can feel jittery, heart racing.

Then, when you're on too much thyroid medication I advise them to let me know immediately, and I give them blood lab order to get their thyroid tests right away because what I find is for some people they can reduce their thyroid medication because of treating with the LDN. And I've had people that have completely resolved their thyroid antibodies.

I've used it for psoriasis and I started taking LDN myself because I have psoriasis and I would say within days, I stopped needing to use topical steroids on my scalp, which is where I have the worst symptoms.

I've used it with Parkinson's patients, multi-system atrophy, with a lot of Fibromyalgia's patients and Fibromyalgia is one area where people say you should watch the side effects of LDN that sometimes it might flare it up in the beginning and you might have to go start lower and go slower.

And I really haven't seen much of that. I usually let my Fibromyalgia patients know that that's been reported but I still go ahead and start with my standard dose titration.

I use it for pain conditions. We know that when you, take a dose of LDN that, it's reported that it temporarily blocks your own opiate receptors, and that causes your own brain to make opiates.

So your own brain is reported to make six times more opiates with a dose of LDN. Of course, there are feel-good hormones and that is also the component of narcotics that helps the pain. So LDN can be quite useful for pain conditions.

I spoke with one woman who told me she had been on high doses of narcotics for many years, for Regional complex sympathetic.

It's a neurologic pain disorder that can be quite disabling. And she told me that by using LDN, she was able to get off of her high doses of narcotics because it had controlled her pain.

I've seen it really help people's depression and anxiety.

I have used it with veterans with PTSD or post-traumatic stress disorder and typically we've given it at night time because that's the time when you're sleeping that your brain reportedly makes a lot of opiates but some people end up moving the medication to the daytime because of vivid dreams although they are temporary side effects. So we have the idea of giving this a couple of times during the day to see if we can get that endorphin increased during the day when these patients are really stressed and triggered by the PTSD symptoms. So they started splitting the dose and they have some very lovely results with that so I learned that I had shifted a lot of my patients who do have anxiety or PTSD symptoms to taking it in the daytime.

Lyme disease and the co-infections with Lyme are another areas that LDN is definitely put that on the first line. What I think because it happens with Lyme disease is it shuts down the immune system.

And so LDN then becomes a mechanism to help support the immune system so that it can detect and clear that infection.

I've had some discussions with one of my friends and colleagues who works with pandas, and that's the pediatric autoimmune neuro-psych disorders. Typically it's been reported in children that they'll have an infection most often strep, but it can be caused by mycoplasma.

It can be caused by other infections that trigger that child's immune response. And then the immune system starts attacking the brain and these children can develop the pretty acute onset of severe obsessive-compulsive disorder and behavioural problems. And I had recently worked up a 12-year-old for his pandas and discovered that he had an infectious source with active mycoplasma. I had started that child on Low Dose Naltrexone.

The thing about infectious diseases we have a beautiful design that is supposed to work for some kind of acute infectious diseases with a short course of antibiotics that may knock things out. The problem that we get into is with the people that have chronic infectious diseases. That is chronically triggering their immune system. And those are some of the kinds of patients that I see.

And they come in, when I take their symptom history, they have, 20 or more active symptoms that are troubling them. A traditional doctor will look at that many symptoms and say, "Oh my God, there's your neurotic, you're a psychiatric patient." I am the psychiatrist, so from my perspective, I can say you have all these symptoms. This is not in your head. It's in your body. There's something happening in your body that is triggering the symptoms. The answer for me isn't giving the psychiatric meds because those don't get them well.

I may use psychiatric medications in the short term as a bandaid.

The LDN definitely is one part of the toolkit to start helping support the immune system.

They are written about dental infections. This is a really tough area where people have a root canal because they've had an infection in a tooth and the dentist take out the roots, and they fill them up with material. What I've learned is beyond those roots stars, the infection can get into those microtubules and maybe it's a low-level infection, but it can be enough to keep turning on someone's immune system.

And some people with immune disorders just won't get well until they pull those root canal teeth, because it's triggering this chronic infection.

I took part in a Lyme disease documentary and they have so many different symptoms. And even though these people are really obviously very ill, unable to move, function, the pain, cognitively, etc and the doctor says "It's all psychological. It's in your head. "And how devastating when you feel that low to be told it's in your head and being offered antidepressants and things. I empower people and get them to believe that they can get well. And that these symptoms really are of a physiologic nature and that once we can find all the causes and support their nutrition and support their immune system, that they can get better.

My website has the information. My practices called Bay Area wellness.

So the website is www.bayareawellness.net. And my Facebook It's called Bay area wellness dash functional medicine psychiatry.

Summary of Dr. Kat Toups interview. Watch the YouTube video for full interview.

Dr Jill Cottel, LDN Radio Show 30 Nov 2016 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Welcome Jill! How does it feel to be our first guest on the new LDN Radio Show?

Dr Jill Cottel: Hello, Linda. It's very exciting.

Linda Elsegood:  Thank you! Isn't amazing? I mean, you're out there in the West coast of the US and I am in England. Amazing!

Could you give us an overview of your LDN experience, please?

Dr Jill Cottel: Sure. I've been prescribing Low Dose Naltrexone since 2008 and have had a lot of success with it. It's been exciting to watch patients as they respond. I have a general internal medicine practice, so I get to see a little bit of everything. And so I've had a chance to try LDN out on a number of different clinical situations. It's kinda nice to get that, the rounded experience and try it out for different things that aren't typically used. It's been interesting.

Linda Elsegood: What would you say the main conditions that you've seen?

Dr Jill Cottel: Well, let's say in the beginning mainly I was treating autoimmune arthritis just because that was where I was seeing the main focus and a lot of the reading I was doing, and a lot of patients that I had already in my practice had different types of autoimmune arthritis.

So that was where I started. And then those patients would refer to other patients, and then I started branching out. And then kind of, it's a mixed path that I have a lot of patients with fibromyalgia or just muscle type pain and then different types of chronic pain syndromes, and then just a wide variety of other things, asthma allergies and some neurologic issues.

Linda Elsegood: One of the questions that people like to know before they start is what are the side effects likely to be. Have you noticed any side effects?

Dr Jill Cottel: Well, it's, it's really well tolerated. When you compare it with just about anything else that a doctor would prescribe.  All-day long we write prescriptions for various things, for high blood pressure, diabetes and high cholesterol.

You look at any one of those numbers of things and plot the prescribing information. It can boggle the mind about the list of things that can happen. And so when you look at Low Dose Naltrexone, very, very minimal side effects are really good profile. I would say when people report a side effect, that usually has to do with sleep.

And I would say, in my practice, that's really only maybe 10 to 20% of the people will have sleep interruptions or vivid dreams. Sometimes that will pass and sometimes not. If it is an issue, they can always move it to dose at a different time of day. And that will usually clear up the problem.

And aside from that, pretty uncommon, I've had maybe in the past couple of years, a handful of patients who've had kind of a strange headache and that usually passed within the first week. And then some patients who their stomachs are very sensitive. In the beginning, they might get a little bit of loose stool.

But again, that tends to be just in that group of patients. Even that will generally pass after the first week. So not a lot of side effects to report.

Linda Elsegood: What drugs can't you take alongside with LDN?

Dr Jill Cottel: Basically it's the narcotic medications, Oxycodone, Hydrocodone, Morphine, those sorts of pain medications. Other medications for pain like Tylenol and ibuprofen are fine.

There's really a wide variety of things that can be taken with Low Dose Naltrexone and in the way of drug interactions I haven't seen any problems except with the narcotic type medications. 

Linda Elsegood: Because I know there have been people who've asked questions about Methotrexate, Interferon drugs, steroids, and I believe all of those can be used with LDN.

Dr Jill Cottel: Right. In my practice, I've not had any issues, and I know there are a number of other clinicians using them together and haven't reported any problems. so there's some good experience there.

Linda Elsegood: What would you say has been your greatest success with LDN?

Dr Jill Cottel: I would say, probably the autoimmune arthritis patients.

They respond really dramatically and quickly. That's exciting to see when that happens. With fibromyalgia patients, every now and then you'll get someone who responds really quickly and complete response. That's exciting too. It doesn't quite happen quite as often as the other ones.

Linda Elsegood: It's amazing, isn't it? That you can get people on very, very strong painkillers where elsewhere it doesn't control the pain. They come off then, try LDN and suddenly are playing free.

It always astounds me that such a small pill can do. It's like using a sledgehammer and it doesn't work, and you tickle it with a feather and It does.

Dr Jill Cottel: Exactly. One of my first patients came off large doses of pain medication a few years back. He was on almost a 100 mg of Oxycodone or something similar and wanted to try LDN. I thought:  "Well, this is just no way that this is going to work." And he tapered off on his own. And a hundred milligrams hadn't been controlling his pain. Then he was completely pain-free on 3 mg of LDN.

It was amazing! It worked! How can 3 mg of LDN work better than 100 mg of Oxycodone? There it was. He was pain free. That's amazing!

Linda Elsegood: Always amazes me too.

Dr Jill Cottel: Think about some of these studies showing that narcotic medications can actually cause hypersensitivity to pain and possibly central pain.

Look at it that way. Maybe it makes sense that patients are going to do better off of those medications and better on LDN.

Linda Elsegood: I've also been told that if you take a cocktail of pain medications, you can then take too many and then they don't work either.

So that's interesting as well.

Dr Jill Cottel: It's hard to sort out. Often a patient with chronic pain will come in, be on a lot of different types of medicines from different classes, usually off label, l because everyone's trying to help them and it's hard for those patients.

They've got a lot of side effects. I was getting them off of those medications slowly, then LDN may start responding. You can start weaning off some of these other medications. A lot of the medications that we use for chronic pain have many side effects, so people tend to feel a lot better being able to come off of them.

Linda Elsegood: That's good. Well, we'll take a break now, and when we come back, we'll take questions.

Today's show is sponsored by the Poway integrative medicine centre who take a holistic approach to provide the highest level of health care, combining internal medicine with alternative therapies, including acupuncture and Chinese medicine.

If you're in the San Diego area, they'd love to see you or if you're in the state of California, they offer secure video conferencing appointments when clinically appropriate. 

Go to www.pimchealth.com or call 858 312 1672. On Facebook, follow Jill Cattell MDs page.

Linda Elsegood: Welcome back! Now we've taken our first caller. Can you hear us?

Blanca: Yes. Thank you so much. I am here.

Linda Elsegood: Okay. What question would you like to ask Dr. Cottel?

Blanca: Doctor thank you so much for listening to my question. Did you have any experience with Multiple Myeloma?

It's a bone marrow cancer. My husband has it, and he has been taking LDN every day for four months and we have seen these numbers stable. So I was just wondering if you have any experience with Multiple Myeloma?

Dr Jill Cottel: Not so far, but that's a great question.

I would expect, based on the positive results that other people are getting with different types of blood disorders, that LDN would be something that could be beneficial. And you said that his numbers had been stable over the past four months.

Blanca: Yes, stable., stable. He's not using any chemotherapy for now. He did chemotherapy in 2013. I heard about Low Dose Naltrexone, but actually I wasn't sure where to get it or which doctor will give it to me. So finally, back in April, we got a prescription from a doctor, and he's been taking, it six months already. He's stopped taking it for like three weeks because he developed some anaemia because and we were afraid of any interactions of any with supplements. So we stopped the Low Dose Naltrexone, and I've noticed that his numbers raise a little bit. So we went back right away to Low Dose Naltrexone, and the numbers went back to a little lower but stable. It's not a huge change, remission or something, but at least it's keeping cancer at bay.

Dr Jill Cottel: How does he feel on it? Can you tell the difference taking LDN now versus when he wasn't taking it?

Blanca: He has a sleep problem many years ago, sleep apnea and he's not having any episodes of apnea anymore, and I've noticed that he sleeps deeper. He wakes up because he has that problem from before, but it's not as acute as it was before. I think it's helping like to get more like deep sleep.

 Dr Jill Cottel: That's good. I've had some patients report they're sleeping better on it. Their quality of sleep improves.

Blanca: Exactly. I wasn't sure if he has a little bit of anaemia if it's okay to take Low Dose Naltrexone or with Tylenol, but I heard Tylenol is fine.

Dr Jill Cottel: That'd be fine.

Blanca: And so having anaemia, do you think there's a problem?

Dr Jill Cottel: No, I can't see any reason why that would be a problem with anaemia.

Blanca:  That wasn't all his concerns because he didn't, he his thinking about introducing other very, very lows that were chemotherapy capsule. So I wasn't sure if it has any interactions with chemotherapy or immunosuppressant.

 Dr Jill Cottel: I don't have any experience in patients specifically with Multiple Myeloma, but I've had other patients where I've used LDN in combination with immunosuppressants, and we haven't seen any problems.

Blanca: Okay.

Linda Elsegood: Thank you. We will get to our next call on now. Hello Sabba. What question do you have for doctor Cottel?

Sabba: I'm a pharmacy student. I just learned about LDN and how it works. I'm really interested to know more, and I just wanted to see if the doctor can explain to me the exact mechanism of action.

What's happening with this medication? And in pharmacy school, I learned that it's mostly used for alcohol dependency, but they never talked about other indications for Low Dose Naltrexone. So I just wanted to see if the doctor can explain more about the medication.

 Dr Jill Cottel: That's a great question, and I'm so glad to hear it. From the best pharmacology standpoint, this is a fascinating compound.

There's an article that was published in 2014 in clinical rheumatology, and the lead author is Jared, Younger. The title is "The use of LDN as a novel anti-inflammatory treatment for chronic pain." It outlines different pathways and receptors. Also in the LDN book, which just came out this year, the first chapter is by Dr Steven Dickson, and it goes over the pharmacology of LDN in detail. There are several different ways in which we think it works. This chemical is a mixture of both up left-handedness and right-handedness. A number of these medicines that we use are like that. The left-handed side does a number of things with different receptors that have to do with inflammation. The right-hand side has to do with the effects that it has with the opioid receptors.

Sabba: Okay. Thank you so much.

Linda Elsegood: We'll go to our next caller now, James. Hello,  what question do you have for Dr Cottel?

James: I've been taking Low Dose Naltrexone for 27 months now. I began taking it for a Non-Hodgkin's Follicular Lymphoma and I'm almost 70 years old. I feel like I'm 50 years old again. It cleared up my depression; my brain fog, my fatigue. I'm physically about twice as strong as I was.

I've always done heating, and air conditioning work and  I'm actually back doing it again now.

It cleared up the ringing in my ears that I had for years. Anyway, my question is, after taking 4.5 mg for 27 months, I was wondering if I should dosing and scheduling. In this last Research Trust documentary, they talked about different dosing protocols. And I was wondering if I should get off of it for a few days and then take it seven days a week. If I should skip a day now and then, or skip a couple of days every so often if it would help.

Dr Jill Cottel:That's a very good question. I know that Dr. Dalglish in London is looking at intermittent dosing and it seemed like when you were in the treatment phase of the disease, it was continuous, and then off, somewhere in the distant future if you were in remission, you would maybe fiddle with the schedule a little bit. But I would say that for lymphoma, I would probably continue taking it daily, but  I'm not the most experienced person for oncology with it.

James: Thank you so much for all the good work! LDN just really given me my life back and I feel great.

I really appreciate all you did.

Linda Elsegood: That's good to know. Thank you. Well, we'll go to our next caller  Harry. What question would you like to put to Dr Jill Cottel?

Harry: Well, I don't have a question. Mine is a real success story with LDN. I had Ulcerative Colitis onset 15 years ago. And for the first eight or ten years after that, I was being given everything you could think of, 5,600 mg a day of Mel Salomon Emeran?, 50 mg of Oxycodone day, which didn't solve my pain problems, which nobody could figure out. And we finally, through dr Julian Whitaker, we got some information on Low Dose Naltrexone and started reading up on it and finally found a doctor who would prescribe it. And basically with me, we went, no dairy, gluten-free, making probiotics and 4 mg of LDN a day.

And I had resulted in less than a month.

And doctors, all of them would admit that there was no way that LDN could possibly hurt me, but none of them would prescribe it.

They did want to take out my colon. They were doing colonoscopy on me literally every four to six weeks.

The last one I had here this last August, they again. The gastro doctors will say, no evidence of active disease Ulcerative Colitis. They just won't admit it's gone. Literally, at this point, I have no dietary restrictions at all. I just take my 4 mg of LDN every night, and I eat anything and everything and have zero problems.

So I would just encourage anybody who has not found a doctor where they can talk to them about these problems and can maybe get something to just quote off-label to do so. Because at the very least, if all of the doctors admit that the LDN can't hurt you, it would seem to me that it would be inventory just to at least try it for some of the more drastic things.

And they had me on all kind of stuff and none of it worked. And there are some really nasty side effects to some of those drugs they use, just like with chemo drugs. So mine is just a good story, and I realize that may not work for everybody, but it's certainly worth trying.

Dr Jill Cottel: I agree.

James: One quick aside on the pharmacology student that called a while ago. There is a video out to YouTube called "LDN, how it works." which talks very specifically about how this works. I take it with me to every doctor I go.

It's something that a normal person can understand.

We need to try and get as much information out to everybody we can about this because there are so many things that people are taking that are so terrible on their system, and then they don't work.

 That's all I had. I do appreciate the time.

Linda Elsegood: Thank you, Harry. Well, we'll go to our next caller, Theresa. Hello. Would you like to ask a question to Dr.?

Theresa: It has been wonderful. I have been taking it since May. It has helped me tremendously. Unfortunately, it hasn't 100%, maybe 80, 85% but I do understand that it doesn't correct things that have been of an old issue.

Maybe I didn't catch my problem in time, but I was able to find my doctor who wasn't familiar with the medication, but he did allow me to try it. And it's been wonderful ever since. But it hasn't corrected everything so I still look at a couple of things, and I'm looking at something called Sam-e, which is an amino acid and it does suppose to help with arthritis but my concern is with stiffness. And so I'm wondering. Will it affect that? I know it affects your brain. The Sam-e and the LDN also work in the brain and I don't know if that would be an issue with mixing those together or not.

 And there's the other issue, which is Wilson's Temperature Syndrome, which may be an issue with me.

Dr Jill Cottel: That's a good question because I often will have patients and taking Sam-me and then we'll start an antidepressant if we're treating them for depression. And then it's important to know, what herbs and supplements they're on because not everybody will bring that up. And so there are some interactions with Sam-e and different types of antidepressant drugs. We do know that Low Dose Naltrexone has some interactions with the different neurotransmitters, but it's so mild in terms of the effects with LDN that you should be fine taking it with LDN.

Actually, I do have one patient who is taking Sam-e with the LDN, and she actually did better with the combination than she did with the LDN by itself.

Theresa: That's great to know. Now my other concern is that we haven't looked into this part yet, but because my issues have been so evasive, Wilson's Temperature Syndrome, so we may be going down that road looking at certain protocols that may require some Cytomel for a small amount of time to regulate the body temperature. And this may resolve a lot of my issues. Is there any complication with using LDN and the Cytomel and maybe the Sam-e? I also use Ashwagandha.

So combining all those, I mean, I don't know what I'm doing, but I do know I feel so much better, but I don't want to pose another problem that may be worse down the road. So there would be the Cytomel and then the ashwagandha and the Sam-e.

 Dr Jill Cottel: So the Ashwagandha should not be a problem. The Cytomel I would just be very careful with that because some people will respond fairly dramatically Cytlmel just on their own when you're treating for low thyroid. And sometimes it's difficult to get the thyroid adjusted with that. So just, I would say talk to your doctor about dosing it very low and watch your thyroid numbers pretty closely.

I would say getting them checked, at least within the first six weeks of starting it. 

Theresa: He's, really unfamiliar with the LDN but my thyroid numbers are always fine, but with Wilson's temperature syndrome, the body temperature is always low.

So this is an indication of chronic infections so it can be mixed, but very, very cautiously.

Right. Well, I appreciate your time and thank you.

I heard about it about four years ago, and so lucky to have a compounding pharmacy online. Advertising it in my area, so that got the news out. So it's wonderful that the news is getting out and more people are going to be able to be a little bit less painful.

Linda Elsegood: Okay, well, we're going to have another break, and we'll be back with some more questions later. Today's show is sponsored by the Poway Integrative Medicine centre who take a holistic approach to provide the highest level of health care—combining internal medicine with alternative therapists, including acupuncture and Chinese medicine.

If you're in the San Diego area, they'd love to see you or you for in the state of California they offer secure video conferencing appointments when clinically appropriate. Go to www.pimchealth.com or call 858 312 1672

On Facebook follow Jill Cottell, MDs page.

Linda Elsegood: Welcome back and this time, which went by Cynthia. Hello, Cynthia. What question do you have for Dr. Cottel?

Dr Jill Cottel: I have PMR for the second time. I had been using LDN since July 2015, and when it came back again this July, it was significantly less pronounced than the last time. However, I'm not on steroids yet. I'm doing a low inflammatory diet, but if things get worse, is it alright if I do go into steroids? Also, there's a possibility I might be developing giant cell arthritis because I have a very painful jaw, sort of extreme tenderness on top of the head, but no headaches yet. Last time I was probable GCA, but,I had been in touch with my rheumatologists just yesterday.

Just in case they want to do a biopsy, but I really want to know where I stand beside the LDN and steroids.

Dr Jill Cottel: That's a very good question. If you were just dealing with the PMR alone, that would make it a little bit easier and it definitely, it would be fine to combine steroids with the LDN for PMR.

I've had patients do that. And you can generally get that away if you think less steroid and come down off of it more quickly. But if there's any possibility of the temporal arteritis, you have to be more careful about that because of having your vision affected. So I'd be more vigilant about that and getting your eyes checked frequently and making sure they are watching you closely.

Cynthia: Well, I'm hoping that I haven't got the GCA and I'm really hoping, but I up to what level can I take steroids because I know that with GCA they will often a GCA, sorry, start at 25 milligrams. The steroids, is that all right with LDN?

Dr Jill Cottel: It should be fine.

Cynthia: Oh great. I mean, I'm hoping not to because last time I was on steroids for three and a half years and then I was on methotrexate as well for the last year probably, and I didn't like either of them, like all the side effects combined, so I'm hoping to keep off the steroids. I just wanted to know where I was because I'm hoping to see my rheumatologist who will obviously know nothing about LDN.

Linda Elsegood: Sure. Well, good luck. with that. Bye-bye. Okay, next we have Linda. Do you have a question?

Yes, I do. I have severe Crohn's. I've had three bowel resections, and the last one I ended up with a hospital, a bug on a ventilator for two months and almost died. So it's very important that I take my LDN all the time. I've been on it for about six years, but here's my problem.

Now that they look in my colon and basically in remission I still can't control the bowel movements and diarrhoea all the time, but it's better than it used to be. I also have multiple pain issues, Fibromyalgia, myofascial pain, Stenosis and I've had to have my ureters replaced with tubes that have to be changed out every 90 days or so. I have not been able to let go of my pain medication. I worked out a plan for myself because I couldn't go off the pain medication. I don't take any pain medication after 3:00 PM in the afternoon and when I go to bed at 10 pm I take my LDN.

Do you see a problem with that?

Dr Jill Cottel: I don't.I mean if my patients are on pain medication and they're taking it so frequently that they've always got some in their blood it can be a problem. So even if their last dose, is it three, if they've already taken, a certain amount of medication that day already, it may not be completely out of their system by bedtime. But if you're on a small enough amount that you're getting enough space out from it, you should be OK. And if not you should know already because the pain would come back, and you get some withdrawal symptoms. There is the issue of course, while your chronic narcotics, the hyperalgesia of the central nervous system, pain effects from being on them.

It's risk versus benefit and with all the different pain type syndromes you're having if it's something that you aren't able to come off of you have to just do your best.

Linda: I have tried, and it just has been impossible for me. I ended up becoming homebound and in bed, and I refused to accept that, and I fight as hard as I can, so I take the minimal dose.

The earliest possible during the day and then just do the white knuckle teeth-gritting when it gets to be there in the day so that I can have my naltrexone at night. And I think it's working because my colon is still beautiful.

I so much wanted somebody to tell me if that was an acceptable way to combine them or not. So thank you very, very much. 

Mary: I have been looking at LDN for a long time, and I haven't gotten a doctor to prescribe it for me. I had to ask a couple of doctors in the UK. We live in Sweden for three and a half years, and I went to the UK for treatment with finally identical hormones and I asked the doctor there to prescribe it, but she wouldn't, she just didn't think it made any difference. But she said she didn't believe there was any research that proved that it would help. I've gone to the seminar in Las Vegas and I thought that it would help me. I currently am not taking much pain medicine. I take Arthrotec now and then. I have Fibromyalgia,  Chronic Fatigue, and the fatigue is bothering me much more than the pain now. Do you think LDN would help me?

Dr Jill Cottel: I do. Well, based on my experience. With my patients who have Fibromyalgia and Chronic Fatigue, for the Fibromyalgia, almost all of my patients have had some benefit, and a very few have not.

Almost everyone has had some. And then I've had patients where they've had dramatic improvements with the Fibromyalgia, and same thing with Chronic Fatigue. Most of my Chronic Fatigue patients are feeling much better. We do have a good couple studies looking at Fibromyalgia with Low Dose Naltrexone and you should be able to find someone to prescribe that for you.

Mary: Now we just moved about two weeks ago to Austin, Texas. Do you have, do you know of any doctors in this area that is familiar with it?

Linda Elsegood: We have a list, and there are some doctors around that area. If you would like to send me an email, contact@ldnresearchtrust.org, and we will get back to you with some of the doctors that we know of that prescribe.

Linda Elsegood: And we will quickly get to the next person. So thank you very much, Mary, for your call. Next caller is Robin. Hi there.

Robin: Hi there. My question regarding Chronic Fatigue. You just answered part of my question about Chronic Fatigue Syndrome. But I wanted to be a little bit more specific. My son, who is 18 years old, has been suffering from CFS for about two years. He seems to be improving with, nothing, I guess He's on an antiviral that doesn't seem to be helping to me, but he's just gradually getting better and specifically, do you think that it would help his, like these setbacks and crashes that he has that we're trying to really put an end to? I mean, what specifically with CFS doesn't seem to help other than just the fatigue?

Dr Jill Cottel: I would say, probably energy improves. And also a lot of times mood improves.

And so patients, sometimes the symptoms aren't as much improved, but their ability to cope with the symptoms is better. Does he have any muscle type pain at all, or is it just the fatigue?

Robin: He really doesn't have muscle pain. He has suggested that his limbs feel heavy at times. He occasionally has a headache, but not often.

It really just seems this excessive fatigue. If he doesn't get enough sleep, it's stress and emotional stress or concentrating in school, that seems to cause these setbacks the most. And then he can't basically, get off the couch for a couple of days.

Dr Jill Cottel: I would think it'd be worth trying.

Robin: I agree. Okay. I just wanted to confirm because I hear it used more with pain and Fibromyalgia, but not strictly with Chronic Fatigue syndrome though.  Thank you very much. I appreciate your help. Bye-bye.

Linda Elsegood: Sarah on Facebook wanted to know if you'd had any success with LDN for treating Epstein-Barr.

Dr Jill Cottel: I have a patient who, she had had, illness with Epstein-Barr, and she just hadn't been able to bounce back from it.

And it had been, I'm going to say at least six months, and she started taking the LDN, and I want to say within about a month she was feeling much better and then it wasn't much longer after that she kind of felt back to normal.

Linda Elsegood: Okay. And Diddy said, can LDN be taken with high doses of Manganese?

Dr Jill Cottel: I don't see any reason why not.

Linda Elsegood: Does LDN help with adrenal insufficiency?

Dr Jill Cottel: That is a good question. I don't know the answer to that. I do have patients who've come in with the diagnosis of Adrenal Fatigue, which is kind of a nebulous sort of thing, and I'm not sure anyone knows why LDN helps those patients, but it might just be the endorphins themselves helping with energy food.

Linda Elsegood: Another question. Is endorphin buildup a real thing and should people occasionally skip a dose? And if so, how often?

Dr Jill Cottel: The patients that I've had generally when they skip doses, they feel worse. And sometimes not right away. But they can usually tell the difference sometimes after four or five days off.

I think in general, probably not skipping doses. And you figure it takes a while for the endorphin levels to decline anyway. So how much difference you're making just by skipping a day or two here and there, I'm probably not making too much of a difference.

Linda Elsegood: I must admit sometimes. I'm just drifting off to sleep, and I think, I haven't taken my LDN.

Do I get up and take it and wake himself up or just miss a dose? And I sometimes miss a dose, and it doesn't make any difference. I think sleep sometimes it's better than getting up and not going back to sleep. Another question here from Kaylyn. Does LDN stop the progression of the disease?

In her case, she's got Rheumatoid Arthritis?

Dr Jill Cottel: That's a good question. I don't know that anyone knows the answer to that for sure. I think that we look at terms like remission and how people are doing clinically. So, I mean, just matter of semantics, whether you say, stopped progressing or it's in remission.

We go by how the patient is feeling clinically.

Linda Elsegood: Okay. And another one there about dosing. The benefits of splitting the dose into two over a day for CFS/ME.

Dr Jill Cottel: So again, that's a very good question. I generally discouraged my patients from doing that just because that's not the way it's classically been dosed.

And it's not the way it's been dosed in the small studies that we've had. And the mechanisms of action is to briefly block those endorphin receptors. And it has to be brief, and it has to be in and out of your system. So what the implications would be of doing that again, only 12 hours later? We don't know and Naltrexone has metabolites that stay around in the body afterword. So I would tend to discourage it. 

Linda Elsegood: okay. We've got time for one more caller.

What question would you like to ask Joe?

Joe: I would like to ask for a group member who has been trying to get an answer to this question. If Dr Jill has ever treated or know of anyone treated for a condition called a Stiff Person Syndrome, also known as a Stiff-Man Syndrome and  I'll start there, and then there's a part two.

Dr Jill Cottel: That doesn't sound familiar.

Is there anything else that goes by?

Joe:  No. Those are the only two he stated and that I know of is the stiff person or stiff-man syndrome, but is, I'm pretty sure, I believe.

Linda Elsegood: It is actually on our list of conditions that LDN can treat.

Dr Jill Cottel: Okay. I'm looking at it just in front of the computer since I'm sitting here and it says a rare neurologic disorder of unclear cause with progressive rigidity and stiffness mainly affecting the trunk muscles with spasm. So no, I don't have any personal experience.

Joe: Okay.

Linda Elsegood: I'm really going to have to stop you there.

When the hour's up, we stopped. So I'd like to thank you very, very much for taking our calls. As always, Jill, the next Wednesday we'll be joined by doctor Jim, Dr John Kim, full details are on the website.

Thank you. We would like to thank today's show sponsor, Dr. Jill Cottel and the Poway Integrative Medicine Centre.

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.

Researcher Dr Jarred Younger, LDN Radio Show 08 March 2017 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

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

Dr Jarred Younger describes his continuing studies on LDN and has written papers on them. There is an interview with him in March 2017 where he explained his testing for pain levels. 

He concentrates his studies on Fibromyalgia women and measures the reduction of pain, fatigue, and inflammation with the use of LDN. His work will someday be recognised in the training hospitals for doctors. 

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