LDN Video Interviews and Presentations

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

They are also on our    Vimeo Channel    and    YouTube Channel

 

Finding Relief: Jannie's Journey with CRPS and Low Dose Naltrexone (LDN)

Jannie, a 74-year-old from Canada, developed Complex Regional Pain Syndrome (CRPS) in 2016 after a severe foot injury and surgery. She began using Low Dose Naltrexone (LDN) after researching its benefits and, with her doctor’s support, became one of the first in her area to try it. LDN significantly reduced her nerve pain and allowed her to live an active life. After needing recent surgery to remove old hardware from her foot, her CRPS briefly returned when she had to stop LDN—but quickly improved once she restarted it. Janie encourages others with chronic pain to research, stay hopeful, and actively participate in their recovery.

 

Debbie's Journey: Managing Chronic Pain with Low Dose Naltrexone

Today, we had the opportunity to hear Debbie's Chronic Pain story, a patient from the United States who is using  Low Dose Naltrexone (LDN) for chronic regional pain syndrome (CRPS).

Debbie recounted going back to when she was seven years old and suffered a knee injury, leading to a series of medical interventions. Despite numerous surgical procedures, the chronic pain persisted, and she endured multiple operations without finding relief.

Eventually, Debbie was diagnosed with CRPS, marking the beginning of her battle with persistent pain. In her treatment process, Debbie started LDN with an initial dose of 1 milligram, which later required adjustment due to stomach-related issues. After starting on a lower dose and gradually increasing, Debbie noted an improvement in her condition. It took approximately six months for her to fully appreciate the benefits of LDN, which has helped manage her pain levels, albeit not without fluctuations.

Debbie's account emphasizes the potential efficacy of LDN in alleviating chronic pain, and her testimonial underscores the importance of individualized dosing and gradual titration to mitigate adverse effects. This insight highlights the significance of personalized treatment strategies in managing chronic pain. Overall, Debbie's experience serves as a valuable anecdote for healthcare professionals and patients alike, shedding light on the complexities of chronic pain management and the promising role of LDN.

Dr Richard Nahas, LDN Radio Show 2014 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr Richard Nahas is an LDN prescriber from Ottawa in Canada specialising in Brain Function and Brain Health.

Dr Nahas practices in Ottawa, Canada at the Seekers Centre. He was an ER doctor for 5 years and in 2004 was involved in dealing with the SARS outbreak. He traveled extensively to other countries to observe the varied medical systems. 

For the past 12 years he has specialized in brain function and brain health. He explains how he does functional brain assessments through QEEG tests combined with observations of other neuropathic complaints. 

He has utilized LDN for a decade, and describes the various ways brain and nerve damage affects our health. This interview touches on Chronic Regional Pain syndrome, Neuroplasticity, and pain thresholds. He explains how pain is related to sleep disorders, inflammation, mood, injuries and diseases.

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

Pharmacist Tarek El-Ansary, LDN Radio Show 10 July 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: My guest is Tarek El-Ansary. He's the owner of Carmel Valley Pharmacy. He's also a doctor of pharmacy. Thank you for joining us today. Tarik 

Dr Tarek El-Ansary: yes, my pleasure. Thank you for having me. 

Linda Elsegood: Could you give us your background, please? 

Dr Tarek: Yes, certainly. I've been a pharmacist for almost 21 years. I graduated in 1998 from the University of Pacific School of Pharmacy with a doctorate in pharmacy. I worked in different chain pharmacies for the first eight years. And then I went on to purchase my first pharmacy, an independent pharmacy, and it was retail on need. We barely did any compounding.  I went on to buy a few more pharmacies. And we had a lot of success with that. And then about five years ago in 2013, I started Carmel Valley pharmacy and I wanted to do something different, and, start with compounding and learn all about integrative and functional medicine that goes along with compounding. And that has really opened me up to many, many more opportunities and tools in the treatment options that are available, and it's just been, it's just been an amazing ride and process.  

Linda Elsegood: wow. How would you describe your pharmacy now? 

Dr Tarek: So my pharmacy now is really just focused on customer service and patient care. We do, we're a hybrid pharmacy, which means we do both compounding, and then we also do the retail commercially available pharmaceutical products that are made by the pharmaceutical company. So we do both. And it's a walk-in. People can come in, and we do also offer delivery and mailing, and a lot of consultations. We spend a lot of time, between myself, the pharmacist and the patient, and also interacting with the doctor, getting them involved. And we really do practice the triad of medicine, which is the relationship between the doctor, the pharmacist, and the patient.  

Linda Elsegood: We are moving towards a pharmacist in the UK playing a role. Normally if you wanted any medical advice, you got it from your doctor. You didn't get it from your pharmacist, but it's still not working. How it is working in the States because you there, you just go to the pharmacy and speak to the pharmacist, but the pharmacist doesn't relay that back to the doctor.  So we don't have it working.  It's a bit dysfunctional. Really. It's not as good as what you do so 

Dr Tarek: well, It doesn't work that often unless it's a type of pharmacy like I have when other pharmacies I've been at, which just retail me, it's still, we're still really behind on that also. 

Linda Elsegood: Okay.  

Dr Tarek: Yeah. It's just the type of practice I have now is different, and so now that triad works really well. 

Linda Elsegood: And it's so good that you look into supplements and lifestyle and things that maybe the doctor wouldn't have the chance or time to go through. 

Dr Tarek: Absolutely. You know, with the seminars I attend, I've learned so much about supplements, and unfortunately, the pharmacy schools and the medical schools are just not getting into that and teaching anything about supplements even to this day.

And so with the seminars, I'm learning a lot and doing them on myself, starting them on myself and my family members, and seeing a significant difference in our own health. And so it's giving me the firsthand knowledge to recommend for my patient. And the feedback has been really good and positive, which further reinforces, you know, an ???  to be able to carry on a message to patients who need supplements and specific areas of problems that they have.

Linda Elsegood: When did you first hear about LDN? 

Dr Tarek: Uh, I think it was a seminar I attended. I go to PCCA And a A4M seminars, at least a couple of times a year just to learn the new things and keep up on my knowledge. And, probably about three or four years ago, the first time I heard it brought up at a seminar and in it was, it just sounded, it's really exciting and amazing.

At the same time, a few prescribers in my area started prescribing it and then I was able to spread the word to other prescribers that were open to doing compounds and new things that they hadn't heard about. And so we've seen it really spread since then.  

Linda Elsegood: and you're in California. So I was just thinking about the supplementation.

Do people in California need to take Vitamin D, or do they get enough sunshine? 

Dr Tarek: I would say they still need to take vitamin D. I would say just about everybody. The average level of an American, even including California is 15 and anything below 50 is considered deficient in vitamin D. Actually if you're not above 80, you're not considered optimal. And so you don't get a lot of the preventative effects of vitamin D like preventing cancer and stimulating and really helping to have a healthy immune system. And so by just being at 50, all you're doing is helping to keep your bones healthy, but you're not really helping with the immune system.

From what I've learned, it's for every thousand units you supplement per day, you bring that level up by ten, so if you're at 15 and you take 5,000 units a day, you're going to be at about 65 so you're going to be above the 50 Mark, but you're still not going to be optimal. So that kind of gives an idea of where it is, and we do see people getting tested when they are taking and it kind of, it really does follow along those lines. 

Linda Elsegood: So how long have you been compounding LDN?

Dr Tarek: We've been doing it for probably about four years now. We opened about five years ago, a little over five years ago, and we've been doing compound LDN for the last four years.

Linda Elsegood: What forms do you compound in?

Dr Tarek: Oral,  topical and transdermal. 

Linda Elsegood: Okay. So. When you say oral, is it capsules, tablets? 

Dr Tarek: Yeah, 99% of the time we have done it as a capsule. There are a few that we've done in liquid for small children that can't swallow capsules. And then also if we want systemic absorption, we can do it in transdermal effect, where we put in a light that's on base. So it gets absorbed really well into the systemic circulation. And then topically, we've used it for scars and, and, or itching type skin reactions. We've seen great effects because usually scars and itching and like psoriasis or, or rash, that's part of the immune response. And since we know LDN has a significant effect on our immune system. We’ve been seeing it having a great effect.  

Linda Elsegood: let's 

Dr Tarek: use topically. And then with transdermal always seen it used when we want to insist into the systemic circulation, especially with small children who are on the autistic spectrum. They're getting it absorbed really well and seen great effect. 

Linda Elsegood: So do you have any case studies?

Dr Tarek: Yeah. Yes, I do. I had seen them when they were presented at some seminars. I do not have them handy. I have seen case studies done specifically just as an example, I think it was the glutathione 20% mixed with LDN, 0.5% in a transdermal cream if used with autistic children on the spectrum, and a significant effect that was. That had just by applying that each night by the parents and just rubbing it between the shoulder blades and giving the child a message at nigh with the cream and the parents, the feedback has been really good. And we have about five or six small children who get on a regular basis at our pharmacy and the feedback and the parents had, they tell me that it's made a huge difference in their children's behaviour and their life.

Linda Elsegood: So how old are the children when they starting at the end? What age are they diagnosed normally with, with autism? 

Dr Tarek: It definitely ranges and we've seen as small as four or five years old. I would say probably the most common age is around 10. I think there is a level of confusion and denial on the parents' part of not understanding what is going on with the child's behaviour when they start to present with autistic behaviour around the age of four and five that I think there are a few years where they're just not understanding what's going on and to actually take them to a physician who can make a correct diagnosis.

Linda Elsegood: Yes. I knew a little boy who was autistic. A terrible shock for the parents, I must say. 

Dr Tarek: We have a nephew in our family that is dealing with it and there were a few years of just not understanding what was going on before the diagnosis was made. 

Linda Elsegood: Yeah. I just have to tell you, we, in the first documentary, we did the LDN story, we interviewed a little boy called Jacob, and he's a piano protege. He can just play Beethoven just without looking at music, and he's so talented, but he was all. I would say it was, but of course, he still is, but he doesn't show signs of it anymore. But when he was small, he wasn't responsive to his parents. He didn't want to be hugged. He didn't want to be cuddled. And as he grew older, he just used to fight them the whole time, and regularly he used to smack his mum across the face.

And one day after he'd been on LDN, she was always saying to him, you know, I love you, Jacob. I love you, Jacob. And he just didn't respond, apart from slapping her. But this particular day she said, I love you, Jacob. And he looked at her, and I think he was three or four, and he said, “I love you, mommy.”

And she called her husband, and she said, quick, quick, get the video camera. I want to ask him again, you know, say it again and see if he'll do it, and we will record it because he may never in his life. Say it again. You know, I want to catch it. And he just went from strength to strength—a totally different child. Absolutely. Amazing story.

Dr Tarek: I think there's many like that with LDN.

Linda Elsegood: Yes. Exactly. It gives you hope, but like you were saying, it's the confusion to start with, isn't it? To get that correct diagnosis. So, yeah. Is important. So with your capsules, what filler do you use? 

Dr Tarek: There are two different fillers that we use. Typically we started with avicell, which is just very clean a filler that has no side effects, no inflammatory or reactive effects on, especially specifically to patients who have sensitivities. So we never compound with anything that would contain lactose or gluten or corn starch as a filler. But now there's been a few naturopathic doctors who. They loved the idea of compounding using the filler ginger root, because of its properties, especially with the gut health and just a soothing effect it has on the gut.

So that has been one of our common fillers now with the LDN, and other meds that we compound is using ginger root as a filler. 

Linda Elsegood: Wow. Do you know, I've not heard of that before. How interesting. Sorry, ginger. Tell, make a note of that. Wow. I love ginger. 

Dr Tarek: Yeah. Yeah. It's a great idea to mix it with their LDN.

Linda Elsegood: but of course, being a capsule, you swallow it so you wouldn't notice anyway.

You would use that. It was ginger. 

Dr Tarek: Yeah. You don't get the bad taste. Yeah. 

Linda Elsegood: Oh, bad taste. I love the taste of ginger. 

Dr Tarek: Well, it can, it can have some good tastes, but I think the ginger root powder that we, you know, that we're using its a clean powder, but it does have a little bit of a bitter taste.

Linda Elsegood: does it?

Okay. So what would you say your main patient population is that use LDN? Would you know that? 

Dr Tarek: Yeah. Uh, I would say it's adults over the age of 18 mostly getting it in capsule form. The most common dosing that we see is 2.3 or 4.5 milligram where the, you know, the vast majority is definitely below 4.5 milligram due to the fact that most studies show that the modulating effects of the receptor happen below 4.5 milligrams and we just, I don't think there are enough studies out there to know what happens when we go above 4.5, and I think the consensus is there's not really a need to go above 4.5 for most uses and that we see the effect, the response we want below 4.5 without the side effects. And so that's what we mostly see and the uses, it just ranges significantly between just gut issues, any autoimmune issue, neurological issues and pain. And on and on, it just seems like they keep coming up with a medical diagnosis that they try it on and they see good effects and the side effect profile, even though it's listed as sleep disturbance or vivid dreams. In speaking to my patients, and we have a few hundred different patients getting it each month. The feedback has maybe been one or two has actually told me that they thought they had a, it affected their sleep, but then again, you know, there's a lot of things that could affect our sleep.

So it could have been a coincidence. 

Linda Elsegood: Yes. It seems to be a drug that is well tolerated. I'm must say from my fifteen years of experience of talking to doctors and pharmacists and patients. The people who mainly tend to notice side effects are people that are ultra-sensitive to drugs, and it's usually people who've got fibromyalgia or chronic fatigue syndrome. Those people seem to be so ultra-sensitive that they have to start very, very low and increase very, very slow. People get there if they're patient. But yeah, if you find it is too much for you, it's definitely an idea to have a very low dose and increase slowly. 

Dr Tarek: Yeah, and that's a great point. And the patients who do require the slow titration up, we do the 0.5-milligram capsules, and it's anywhere from every three to seven days. They start to increase from one capsule a night to the second capsule to go to one milligram, and they slowly increase as they can tolerate it, so they get their desired effect, and then we stay at that dose.

Linda Elsegood: I mean, there are some doctors who prescribe up to six milligrams, some even go higher, but there are quite a few that try six. And with the chronic fatigue, there are some doctors who actually use double dosing, night and morning. And it's reported that those patients get more of the boost of energy, which is very helpful in those cases. What about thyroid patients? Do you have many of those on LDN? 

Dr Tarek: We do, specifically when they have autoimmune, when the underlying cause of their thyroid issues is autoimmune, which I think that the large majority of them, and you know, specifically Hashimoto's. When the doctor OD is open and familiar with the uses of LDN, and they do use that on those patients, we're able to see a reduction in dose and their thyroid medication and supplementation, and we're seeing thyroid antibodies reduce just by initiating LDN. 

Linda Elsegood: That's amazing, isn't it? How that happens.

Dr Tarek: about, do you use more often in the ones that said it is helping, 

Linda Elsegood: but I mean, the people are using it for Hashimoto's, hypothyroidism, hyperthyroidism, Graves' disease, Sjogren's syndrome. I mean, they're all thyroid, aren't they? And there was a paper written on Sjogren's syndrome last week, which was interesting.

Yeah. So, yeah. And then you get people who think, how can LDN work for so many different conditions, but it's to do with the autoimmune component. We didn't realize 15 years ago how well LDN worked for pain. It doesn't have to be a condition that is all autoimmune, which causes the pain for the LDN to work. Yeah. And neuropathic pain, especially in diabetics, it works really well for phantom limb pain as well is, another quite new thing that I've learned about, but there is always something happening with LDN. I don't know whether it's common knowledge yet in California, but. pain specialists are using ultra-low-dose naltrexone alongside opioids and weaning patients off the opioids.

That's very exciting. We're actually going to be filming a documentary on LDN and pain because there are so many patients who are addicted to pain medications through no fault of their own. You know, they haven't been buying drugs on a street corner. These are prescription drugs, and it's still the same, isn't it? To try and get off those medications. You still go through the awful withdrawal symptoms, but by using ultra-low-dose naltrexone where you. I'm starting on a microdose and increase that slowly, decrease the opioid and the people that I've spoken to who it worked really well for. It's amazing. Totally amazing.

And quite quickly, because I thought you'd have to do it over a long period of time, but it doesn't seem to be as long as I would think. 

Dr Tarek: Yeah. And those ultra micro low doses, are generally very low. So it's really important for anybody who wants to try it. They really need to be careful and, and understand instead of the dosing we've been talking about thus far, which is 0.5, up to 4.5 milligrams, uh, with, with people who are on opioids, we currently, we want to go start at 0.001 milligrams, so a very ultra-low dose. And because we don't want to throw them into withdrawal and cause them more harm, we want to try to help them.

Linda Elsegood: Exactly. And it's something that you would never, ever try and do on your own. It has to be under medical supervision because you could become stuck.  Definitely. 

Dr Tarek: Yeah. 

Linda Elsegood:  What pain conditions have you your patients been using LDN for?

Dr Tarek:  I've seen it used for some fibromyalgia patients. And some neuropathic pain patients we've asked. We've also included it in our transdermal pain creams, so we are starting to add that into there and seen a lot of, a lot of great results with it. I wish we could use it with, uh—complex regional pain syndrome. The problem is those patients are generally all already on high doses of opioids, so we can't use it on them. But we have seen that it's really effective for those patients. But the patients that we have at our pharmacy, they're already on really high doses of opioids, so they just can't be on it. 

Linda Elsegood: Well, maybe they could try the ultra-low dose. 

Dr Tarek: Yeah, they could. You know, we were just starting to learn about it.

And that’s the exciting thing about LDN is we're constantly in a learning phase with this. And so we're learning more and more uses and more and more types of doses and, and, that's something that we, we want to try to communicate to those physicians that are treating those patients. And. hopefully, we can get an open ear that's open to learning more about it.

Linda Elsegood: Yes. I mean, Dr. Deepak Chopra wrote a paper long while ago now, probably 2015 on complex regional pain syndrome and LDN, not a very interesting paper, but there are more and more pain specialists looking into LDN for pain. And I have spoken to many patients who are not on just morphine or fentanyl patches, but a cocktail of medication and they say that their pain is still on a score of one to 10, 10 being worst, nine on a daily basis.

And it's awful to think that people have to suffer like that, isn't it? 

Dr Tarek: Yeah, I agree.  Yeah, I have a young lady who comes to our pharmacy regularly who has the condition and, when it's acting up, and she comes in, you can, she's just kind of , bent over and walking very slowly, and you can tell that her pain is definitely at a ten on a scale of one to 10 and even though she is currently on high doses of opioids, it's just no stopping it. The pain is at a ten and, and she can't seem to find any relief at that point. Very, very hard to see someone suffer like that.

Linda Elsegood: Unless you've witnessed it and experienced what pain can be like. You think that you know you've got a headache, you take two paracetamol, you feel okay, but there is pain out there that does seem untreatable, doesn't it? Yeah, I can remember. Yes. Dr Samyadev Datta, he's also a pain specialist, and he was telling me how he has a practice, but he also works in the hospital, and he will get a phone call in the middle of the night that there's a patient, you know, screaming out in pain, the pain levels that are a ten and he will go in, and he'll say, okay. This patient is on 14 painkillers on this cocktail. They’re on too many pain medications. It's not going to work. You've got to take them off this, this, this and this, and sorting it all out. But he's very for LDN and ultra-low-dose and there is so much more coming in this in the next year, I am sure because. The PCCA, talking about LDN, more other conferences or talking about LDN? We have an LDN conference not that far from you really, is it? California? Portland in Oregon. 

Dr Tarek: Yeah. Great.

Linda Elsegood: Hopefully, we will be able to get you there. Because meeting all these people and actually being able to put your questions to them. It's an amazing tool. Amazing tool. Well, if you would like to tell our listeners how they can contact you and what your website addresses, that would be good. 

Dr Tarek: Yes. So the name of my pharmacy is Carmel Valley Pharmacy. The website is CarmelValleyPharmacy.com. And the phone number is (858) 481-4990. And lastly, my email, and if you go to the website, you can find my email, but just to mention it, it is, CarmelValleyRX@yahoo.com and I can be reached at any of those ways and I would be happy to receive any more questions or orders for prescriptions or any needs that you have with compounding or regular prescriptions 

Linda Elsegood: Thank you.

Dr Tarek: It was my pleasure. Thank you for the invite.

Linda Elsegood: Carmel Valley Pharmacy is a family-owned independent pharmacy with a mission to provide the best pharmacy experience possible with exceptional customer service, access to knowledgeable pharmacists and cost-friendly prices. Cool. (858) 481-4990.  Call Carmell Valley pharmacy.com the friendly store for their state of the art compounding lab and waiting to help you.

Any questions or comments you may have. Please email me. Linda, 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.

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

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

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

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

Paul Battle PA-C:  Since 2008 I believe.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Can it really have such opposite effect."

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 I look forward to hearing from you.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Linda Elsegood: Appreciate what she's saying though.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Linda Elsegood: Thank you very much.

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

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

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

Dr Steven Richeimer primarily uses Low Dose Naltrexone (LDN) for neuropathic pain diagnosis, including fibromyalgia which closely relates to complex regional pain syndrome.

In this interview he stresses the importance of the patient researching LDN thoroughly, particularly if it's compatible with any current medication you may be taking. Nevertheless, LDN is highly compatible with a number of treatments and can often compliment your current plan and improve its benefits on your health.

Dr Richeimer mentions that often the longer a patient is off their opioids, the more likely the patient is to see the benefits of LDN.

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

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

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

Dr Samyadev Datta was first introduced to Low Dose Naltrexone (LDN) in 2012 by Dr Pradeep Chopra, who explained the myriad of benefits LDN has in boosting the body’s immune system in order to combat diseases.

In his practice, Dr Datta primarily specialises in pain, particularly patients with Complex Regional Pain Syndrome (CRPS) and has found LDN to be very successful in these patients. 

In this interview he explains the complex relationship LDN has with opiates and painkillers, while providing an interesting insight into some cases in his practice.

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

Dr Richard Nahas, LDN Radio Show 12 April 2017 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

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

Dr Richard Nahas is an LDN prescriber from Ottawa in Canada specialising in Brain Function and Brain Health.Dr Richard Nahas practices in Ottawa, Canada at the Seekers Centre. 

He was an ER doctor for 5 years, and in 2004 was involved in dealing with the SARS outbreak. He traveled extensively to other countries to observe the varied medical systems. For the past 12 years he has specialized in brain function and brain health. 

He explains how he does functional brain assessments through QEEG tests combined with observations of other neuropathic complaints. He has used LDN for over ten years, and describes the various ways brain and nerve damage affects our health. 

This interview touches upon Chronic Regional Pain syndrome, Neuroplasticity and pain thresholds. He explains how pain is related to sleep disorders, inflammation, mood, injuries and other diseases.

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

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 John Kim, LDN Radio Show 07 Dec 2016 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today we're joined by Dr John Kim. Thank you for joining us, John.

Dr John Kim: Well, thank you for the invitation, Linda,

Linda Elsegood: For those people that haven't heard you on our Vimeo channel, would you like to tell us what it is you actually do in medicine?

Dr John Kim: I'm actually in-between transition, as some people may know. For the last ten years, I've been working in Georgia where 50% of my practice is in pain management, and then the other 50% is solving complex medical puzzles; especially autoimmune conditions. I actually discovered LDN as a part of the second part of the practice, and the second part of the practice actually came about because I had wonderful techniques to help patients with chronic pain, except for patients with autoimmune disease pain. Those pains just were harder and tougher, and I had to change my paradigm and look for other tools other than what I had, and kind of open the door through LDN to treat the whole bunch of other conditions, especially autoimmune conditions with a great deal of success.

Linda Elsegood: Would you like to tell us what it is you have trained in?

Dr John Kim: So the original training in medicine began with family medicine, and I chose that because it was the most holistic of all areas. But I wanted to train more, so I actually changed my career to a speciality; to preventative medicine, and then from there I learned medical acupuncture, and then went on for a fellowship in integrative medicine with Dr Andrew Weil as a residential fellow. That kind of sums up my traditional training, but I've also done extensive basic science research in biochemistry and pharmacology.

Linda Elsegood: What would you say the outcomes have been for the patients that you have prescribed LDN for?

Dr John Kim: LDN for me hits even closer because the LDN originally was brought to me by one of my favourite patients. I'm not supposed to have favourite patient, but the patient is a favourite because she one day said, ‘Hey,I have this condition called Hashimoto's thyroiditis, and the prognosis is really depressing. I get to take medication and as Hashimoto's thyroiditis destroys more of my thyroid I get to take more and more, and you never get off it’. And she said, ‘I found something interesting called low dose naltrexone, and would you please do research?’ And I said ‘sure’ and when I did research about it, that was about ten years ago, there were fewer research articles, but even then, it really looked like the risk-benefit profile, meaning how much risk is there and how much benefit is there, was very, very limited; small, and the benefits sound so incredible. So, I prescribed the medication and what happened was that her disease went into remission, full remission, and did not require any further use of hormone treatment. Then what had happened was that within several years she got pregnant and, retained her baby, because before she was having issues with, I think miscarriage, and then she gave birth. And then after the birth, her disease returned, almost like Graves and we again used low dose naltrexone very successfully and helped the illness to go into remission as well. 

Linda Elsegood: And did she take the LDN throughout her pregnancy?

Dr John Kim: Yes. LDN through pregnancy is a very interesting topic and I had them talk to their doctor, but you know, part of the acupuncture practice I have, a small part of it is fertility. And I've noticed that LDN helps patients to get pregnant. For those I think who have issues with their ability to get pregnant it’s often coming from an autoimmune condition, and I think that LDN can reverse that.

Then I've seen LDN reverse endometriosis, and again, I think that a lot of the illnesses that we have seen have an autoimmune basis. We don't use the word autoimmune, what I like to use is the dysfunctional or stunted immune system. The immune system is no longer being intelligent, and I think the LDN corrects it.

That's why I think that LDN is such an interesting drug because LDN seems to be what we call an adaptogen, which means that it brings a system into balance. So if it's too much, it brings it down. If it's too little, it kicks it up. And I think that's how LDN works for from everything. From autoimmune diseases to HIV, to cancer.

And LDN, I think is like almost a class of its own, because it does so many nifty, therapeutic actions with some limited side effects. 

Linda Elsegood: What side effects have you noticed with your patients?

Dr John Kim: There are at least two people that I've seen that had a severely depleted state of endorphin.

They’d been ill for a long, long, long time, and their resilience is very, very limited. And for those people, I've noticed that even with one microgram of low dose naltrexone, they have a hard time taking it. And. If there was a homoeopathic pharmacy, I wondered if they could make a nanogram dosing of low dose naltrexone for these people, but these people are few and far between.

For most of the other people who have side effects, they find it easier to handle. Like some people, instead of it helping them to sleep, it has the opposite effect. So, if that's the case, it's pretty simple, they just take it at dinner time or in certain cases, I just tell them to take it with lunch or even at breakfast time.

Linda Elsegood: Well, we did have a question, which fits in quite nicely with what you're saying, and it's from Deb, and she has her own thyroid group with LDN, and she says, ‘have you seen a patient with a genuine allergic reaction, not just a side effect on  1.5 milligrams of LDN?’

Dr John Kim: So I think that the allergic reaction if they're talking about an anaphylactic reaction, that's probably due to the filler, not necessarily to do with LDN. As I said, the two people that I have seen a reaction, even one microgram, those people, I think probably had the reaction that they're describing, which is closer to an allergy, however, I've not seen the typical, what they call anaphylactic or IgE mediated response to naltrexone, and it's theoretically possible, but I just haven't seen it at this point.

Linda Elsegood: We have a lady called Lynn from Australia who has been using LDN for two and a half years for graves' disease in kidney neuropathy, and it’s inactive now, but she does have small, reoccurring, low-grade bladder cancer.

Her naturopath suggested that she should take a test to show nutrients, which would affect the cell line of cancer patients, so she's asking ‘would this test be worth having in regard to bladder cancer and LDN?’

Dr John Kim: I think that's a wonderful question, and it also happens to be a complex question. And the reason why I say this is that the low dose naltrexone effect on cancer, I think that is very beyond theoretical. I think that we are beginning to have case series of studies that would be the basis of one day doing a randomized control trial using LDN to use either as an augmented complementary to the conventional therapy or standalone agent. In terms of the nutrition testing, which is very popular we call this approach ’functional medicine’, within the integrative medicine spear. And in that philosophy of testing everything that you can pass on, or micronutrient testing, or even testing of the agents that are a part of the Krebs cycle, and testing those intermediate, biological functional markers to be useful.

And I think that to be honest with you, that the research just is not yet fully there. Spectracell is one company that will basically test different types of antioxidants and vitamins, and I think that it's a reasonable thing to do for cancer patients.

I would not recommend it for everybody who is in good health, but for cancer patients, if you asked me six months ago, I would say, I'm not sure, but I think that because cancer is such a debilitating and life-threatening illness because the conventional medicines alone don’t have full control over cancer.

Because even with LDN, looking at Dr Biharis’s study, that wasn't a hundred per cent. I mean, he did not get a hundred per cent either. So, I think that we have partial answers, but with cancer, we have room for improvement. I think that some types of micronutrient testing for cancer patients makes sense.

Again, that’s not recommended on a healthy person, but for cancer patients, because the stakes are so high, and because of the latest protocol by Dr Berkson, who combined alpha-lipoic acid with low dose naltrexone to help stage four cancer patients to go into remission.

So, if you look at that, then, all of a sudden what else are we missing? I mean, are there systematic studies? No. So then if there are no systematic studies, then you have to become a study of one. And how do you do that? Just like what the natural path is suggesting. I think that it is reasonable for cancer patients, but unfortunately not for everyone.

I think there's part of us that can be narcissistic and say, I want to test everything on you; genetic markers and nutrients, but I think that moderation is often a good way to go, but with cancer, I think that my answer has changed in the last year; the more I think about it, and the more I read, and the more new studies come out.

Linda Elsegood: Okay, we have a question from Christina, and she says ‘I have postpartum thyroiditis from pregnancy in 2011. My thyroid has never recovered and is very large with hypothyroidism. I do not have Hashimoto's. Should I start off at a very low dose because of my thyroid issues?’

Dr John Kim: So that's the wonderful thing about low dose naltrexone. Like I think I've shared earlier, the patient who introduced me to LDN, in the beginning, had Hashimoto's. But then she had postpartum hypothyroidism and LDN works for both, and some people would think, how can that be?

How can LDN increase the function of the thyroid and also decrease the function of the thyroid? If you look at it as LDN is an adaptogen for the immune system, meaning LDN restores the balance of the immune system, then everything makes sense. It's because the low dose naltrexone can increase the overall balance of the immune system that it can help with hyperthyroidism. It can help with hypothyroidism because the mechanism in both cases is exactly the same. Decrease the abnormalities within the immune system, and it does this it seems through glial cells binding through glial cells to There is a certain type of receptor that is responsible for releasing pro-inflammatory molecules. So, LDN binds to that site and does not allow for the release of inflammatory molecules. So, I think that the answer would be yes for somebody in that area, who is capable and is familiar with using LDN for those circumstances. And the other thing is that in such circumstances, I think aggressive testing makes sense.

So for me, if I had patients like that, I’d keep a very close eye on them, and I would test them even monthly to see what their labs are doing.

Linda Elsegood: Oh, she then goes on to say that she's actually been on LDN 1.5 milligrams and she had to take it every other day in the morning because she got very jittery.

She said she built it up to 1.5 milligrams daily and felt better. But then, after three or four weeks, her symptoms suddenly came on strong. She says, ‘does LDN bring out the disease and make you worse before you get better? Should I increase if I start to feel worse? And how long should I expect to feel worse before I start to feel better?’

Dr John Kim: I think that it's very rare. With my patients, I have seen or heard of those reactions. And I think that in one of the emails you sent me, I think that person had a similar reaction, were that there seemed to be a sudden release of catecholamines, which means molecules like epinephrine norepinephrine get released. And in such cases, you really have no choice but to go slowly, and to utilize incremental increases. I think whenever people have like a complex reaction, I will recommend them to consider having more than the standard use of LDN. I would say, you need to use more of a shotgun approach and utilize multiple assets. And I think that seems to be a good example because she's having a complex reaction; it's not a typical reaction. And so, for that, more diagnosis is needed, to see if there are any kind of issues of catecholamines being higher in her body than they should be. There's a test that they can do over 24 hours of urine collection. They can measure the overall amount of catecholamines in the body, and that indicates other problems that can be present. But if she wants to solve the issue, I think the best thing to do is branch out to other tools, and that's where I really love having more than just one tool. So, for example, I would use the LDN, I would use acupuncture because it also increases endorphins and decreases inflammation. Supplements that can also reduce inflammation, as well as immunotherapy that I talked about and those five things are what I recommend people to try before going to the conventional medications. In some cases, I see that even combining all those is not good enough, and then they have to use number six, which is conventional medications and conventional approaches. I think that it's just important that conventional medicine is not our enemy. It is neither a friend nor an enemy.

It's supposed to be our servant. We don't want it to be a master. We don't want it to be a dictator and create all kinds of problems.

Linda Elsegood: Okay. Well, we'll get ready to go into a break. If anybody out there would like to phone in and ask your questions to Dr John Kim, if you want the numbers, just go to www.ldnradio.org.

Linda Elsegood: Now we will take a call. Hello? Can you hear us?

Caller:  I can hear you, yes. Can you hear me?

Linda Elsegood: Fantastic. I can indeed. Yep.

Caller: Getting that somehow, right. Well, I refer to the guy that Dr John said had had a cancer diagnosis three years ago, bowel cancer. I haven't been using naltrexone yet, and I've had some chemotherapy, but on-base occasions I had Capecitabine to start with, and then I had Fluorouracil, and both of them threw me into A & E, so I've gone off the idea completely of conventional, well, what's it called? Chemotherapy. I'm just looking for alternatives. We've changed our diet. We’ve done all sorts of things and are feeling very positive, but just want to find out from you whether you think that I can be helped by LDN.

Dr John Kim: May I ask you what stage of cancer you were diagnosed with?

Caller: Oh, I think it was one.

Dr John Kim: So, then you are cancer-free at this time?

Caller: No. I had a CT scan a couple of weeks ago in November, and that showed that the tumours that they found, that showed up in April, have actually got bigger on my liver and in my right lung. I did have an operation to remove tumours from my left lung. So, I had the left upper lung removed and also I had about 30% of the liver removed.

Dr John Kim: So, when cancer that starts in one area goes to different areas such as liver and lung, it’s considered metastatic or stage four cancer. So the use of low dose effects for cancer that I've read about and that inspired me to use it actually are twofold. One is the original physician who made it popular or known to use LDN. Dr Bihari used low dose naltrexone for treating cancer very successfully and he had documented it. Now there's a second physician. Dr Berkson, who is in New Mexico, who is utilizing low dose naltrexone and alpha-lipoic acid, and in his case he does injections very successfully. So both parties have written about it. Dr Berkson has published his work. So, right now, all of my patients that have cancer, who come to me, pretty much, I recommend them a protocol of low dose naltrexone as well as alpha-lipoic acid, as well as other supplementation.

Now as for stage four cancer, fighting it just using low dose naltrexone generally, you know, I don't recommend it. I recommend using all the tools that you have because of the grade of the diagnosis. Using all the tools is what I recommend. Now, having said that, Dr Berkson does have documented patients who have used low dose naltrexone, and alpha-lipoic acid and the other protocols that he utilizes.

And my recommendation is to find someone near you who has utilized that protocol to success.

Caller: Wasn’t it Professor Dalgleish in the UK?  He's been fairly active I think in the LDN and cancer field. Have you come across him?

Dr John Kim: There's also Professor Liu, with whom Linda has connected me with. And you are part of the LDN research trust on Facebook, right?

Caller: No, I don’t do Facebook.

Dr Kim John: I'd like to highly recommend you to join. It's a really wonderful community to ask other people, especially in your circumstances. In general, I recommend for patients for fighting cancer for integrative medicine, low dose naltrexone, to use all the tools that make sense to them at their disposal. Because really, in my experience at least with stage four cancer, it's really difficult to make peace with stage four cancer. Cancer wants to grow, continues and there is no 99%, it has to be a hundred per cent because if you leave even 1%, it's alive.

It will double, and double. We call that tumour burden, and after the tumour has grown to a certain size, it puts a tremendous amount of burden in or way.

Linda Elsegood: The next caller now, if not, we won't have a chance to get through the queue.

Caller: Oh, sure.

Linda Elsegood: Okay. Thank you. Thank you for your call.

Caller: Thank you very much, Dr John.

Dr John Kim: Yes sir.

Linda Elsegood: Okay. I think we have another question here that may be cancer. Hello? Hello? Are you there?

Caller:  Hello? Are you talking to me?

Linda Elsegood: Yes, I am.

Caller: Okay. This is still us. No, this one wasn't cancer-related, but I can probably find one if you want.

Linda Elsegood: No, that’s fine.

Caller: This is about mast cell activation disorder, and if Dr Kim has ever prescribed or treated anyone with that condition. Has he prescribed LDN?

Dr John Kim: I have not seen one prescribed as such, but I've seen many patients who have the symptoms of this, and I think mast cell activation disorder is closer to what the physician's call IGE, mediated allergic reaction. You know, the mast cells release histamine, and some of the interesting things about that are the speed at which it can occur. It’s very rapid. In some people, you just have to scratch their skin, and you can see a welt developing very quickly.  Is your symptom like that?

Caller: This is a question and from a group member. Not me personally.

Dr John Kim: The answer is that yes, I have utilized LDN, but the utilization of LDN in such cases is an excellent question. I think LDN is a wonder drug for autoimmune diseases, but I don't think LDN, in many cases, should be utilized alone; like the previous caller wanted to use LDN for stage four cancer.

I think that of course, it can be done, if he can find a physician willing to do it, but I think that the better approach in this case and I’ve had patients with similar symptoms, is that LDN combines wonderfully with another immunotherapy, which is more common in Europe. It's called allergy drops, and what you do is you test the person for offending agents from the environment, as well as food. And mostly if IGE with food IGG can also be included. And the wonderful thing about is once you are armed with information, what things can trigger them, you can utilize allergy drops and LDN together to allow the immune system to be reeducated.

So, I'll give you an example. One patient came to me with a mast cell activation, and hers would begin with eating fruit, whatever kind of fruit, she would just not be able to breathe. And she loved fruit, but for ten years, she couldn't eat fruit. And so, I put her on LDN, and it made her symptoms a little bit better. In a year of allergy drops plus

LDN she was able to eat fruits again, and she has no reaction. So in that case, can you get that reaction just by using allergy drops? I think it's possible, but usually allergy drops alone it takes five years. Whereas in this case, within less than a year with both LDN and allergy drop, we were able to get that rapid reaction.

So, I think that LDN is a wonderful tool. Anytime the immune system is not behaving, if it’s hyperactive or sluggish, I think LDN is a wonderful tool, but I think there is this idea, a temptation almost, to view LDN as a single agent for everything. I think that everything has a tool and for some of the patients that have had severe symptoms, I'm not afraid to use LDN and Montelukast, which is also sold under the name of Singulair, and is a prescription medication, or some of them I ask to take Zyrtec and then the allergy drops. And the wonderful thing about LDN is that it seems to re-educate the immune system, so it's almost like an intelligent approach, and it compliments the allergy drop because that is also an intelligent approach.

Caller: Understood. I guess this question probably has the same answer. I’ll just ask it in a different way. Can LDN work to help histamine inflammation? So, would that basically be the same answer?

Dr John Kim: Well, I think the answer is, I think, that I would be more careful to use histamine because what we’re talking about is that what happens after the mast cells have released histamine. So, in this case, what you're looking for is rapid response. Can LDN be used to stop an anaphylactic reaction? I don't think anyone has done the study, but I don't recommend that clinically. If someone is having an acute reaction, I think the proper response would be either Benadryl shot or Benadryl liquid.

Caller: You use the word inflammation. I don't know if that's different from a reaction.

Dr John Kim: The histamine inflammation is very rapid, and I would say if you're in that rapid phase of inflammation and the answer, I think it's similar when you're having rapid phase reaction of inflammation, I think that you have to use all the tools that are required, including steroids,  in case of histamine reaction, an anti-histamine, and then use LDN long term to get gain control. And we basically create another equation, change the equation because LDN can change the basic equation, but at the time, the house is burning down. You want to use everything. LDN is a wonderful tool to redesign the infrastructure so that the immune system just only has one response, inflammation, inflammation, inflammation. LDN can change that, and it's very interesting, because people who have a reaction, in that situation, often their immune system is actually depleted, so that means they get sick easier.

I tell them that's very similar to police being told by naughty teenagers twenty-four-seven that they can't do their job. Whereas the well-rested, police force can respond to emergency calls quite adequately.

Linda Elsegood: Okay. Yes.

Caller: Thank you.

Linda Elsegood: Okay. We're back. And what I would like you to do now John, is could you answer some of the emails that were sent in, please?

Dr John Kim: Absolutely. I really love the questions from your readers or your Facebook group members. They are just so intelligent and wonderful. One of the questions that I had was from a patient who was diagnosed with pancreatic cancer.

She's taking Tramadol for pain, and clinic basically is agreeable to put her on LDN. I'm sorry her or him. But the thing is that they want the person off Tramadol and the person is asking what do you do? I've often seen this sort of question regarding Tramadol or Ultram, which is a brand name and is basically a form of synthetic opioid that's not a full-on opioid. What I mean by that is that it's got two different activities. Number one is that it does bind to the mu-opioid receptor, but it also works as a serotonin and norepinephrine uptake inhibitor.

And I think that it seems to me that this has multiple answers. So, part of the answer is that if the clinic says no, you can't take LDN and Tramadol together, I would say that the person can explore a herb which is very effective, known as corydalis. Corydalis does not use opioid receptor but has high effectiveness for controlling pain.

That is my go-to herb to control pain. The secondary herb can be something like curcumin, and especially if they can find long-acting curcumin, it can be helpful for controlling pain. Another tool that I find exceptionally well-suited that works in conjunction with low dose naltrexone is what I call neuroanatomical approach to acupuncture and is a new way of using acupuncture using scientific principles. And it works on strengthening the endorphin system and reorganizing the neurological signals that are pain prosthesis. The underlying question to this is, can you combine narcotics and LDN? And I think the answer is yes.

I formulate this from research done using what we call the microdose, dosing of LDN. So instead of using the normal dose, LDN use is 1.5 milligrams to 4.5 milligrams, but in micro-dosing, you use microgram doses. A thousand times less than one milligram would be one microgram, and that, even in my clinical use when people are using narcotic agents, my to-go game is to utilize a microdose gram dosing of LDN, and it seems to actually help patients to get pain relief longer. Then what I do is increase the dose of microgram dosing of LDN to push it up. And then what happens is similar to them not taking the medication you're just doing backwards.

By increasing the inhibitor strength, you're basically taking down the amount of narcotic that is effectively available and just two different approaches. But I think that it's more humane and I'm not convinced, because the effective dose for the naltrexone to overcome narcotics is about 5,200 milligrams anyway.

I don't think adding 1.5 milligrams or five milligrams will make a difference in the majority of people. Now I have to say, that because I know that in literature, there are people who are exquisitely sensitive, that even utilization of anaesthetic during surgery didn't work. They had to use massive amounts, and then at the end of they said, what on earth is going on with you? Why is it that I have to use massive doses on narcotics? They say ‘oh, yeah, I'm taking the LDN’. And so in that case, you know that in those people the LDN, is working so well, or probably what is happening to those people is that their affinity; the LDN attraction to the receptor, is exceptionally stronger than the general population.

But in general, I think that LDN, especially micro-dosing naltrexone or very low dose naltrexone, is safe with utilizing narcotics. I think that was a wonderful question.

Linda Elsegood: Do you have time to answer another one?

Dr John Kim: Oh, yes. Oh, there was another question of RSD or the CR, complex regional pain syndrome. That is a really heartbreaking condition.

‘My neurologist started me on 3 milligrams, then 4 milligrams and then 4.5 milligrams. I had some pain relief for six weeks, but the burning pain has returned to the same level. Do you know? Is there a reason? Is this a typical reaction? Do you agree with my doctor’s opinion that I would get more benefits after five months?’

I think that it's, it's kind of interesting because 1.5 milligrams to 4.5 is like the standard, and that's written in stone, but if you really dig in and do the research, those response studies that were performed on low dose naltrexone was sort of a convention developed over time, accepted by researchers. But I think that there are multiple ways low dose naltrexone works, and one way of course, is that it works through the immune system, and I think that the dosing of 1.5 to 4.5 often works quite well.

However, there's another way that LDN and especially for CRPS and neuropathy that LDN can be helpful is that LDN also works as an anti-inflammatory agent for the central nervous system. What that means is that in that setting, the dosing of LDN is going to be more dose-response curve, what I call linear response.

What that means is that depending on who you are, you will need more than 4.5mg. I had patients who needed six milligrams, and who do very well on 6 milligrams or even 7.5 milligrams, and obviously, I don't start a patient on that. I titrate them. And if you look at the original dose of medicine being 5 milligrams, I think even 9 milligrams is not unreasonable for the minority of people, but I think that rather than waiting five months, what I would do is push the dose to 5 milligrams and then 6 milligrams to see or and 7 milligrams to see if that's helpful. The other part is that CRPPS is a nervous system disorder, so alpha-lipoic acid would be another tool that can be very helpful, also taking a very high dose of fish oil also can be helpful, but taking a high dose of fish oil can result in bleeding episodes or even bruising episodes. So, it would be better if you are under the care of a physician or a naturopath who is familiar with that. With alpha lipoic acid you also have to be aware that you can lower your blood sugar levels so that's another a thing you have to watch out for. 

Linda Elsegood: Something we were talking about before. How important is diet?

Dr John Kim: You know, I think that there is again a very romantic idea that you take LDN and it's like a magic bullet. It works for everything. I think that diet is important because of the way that that LDN works. You know, in my own practice, what

I do when I take in patients with autoimmune diseases, in the beginning, I just say eat well, and patients would not listen, and the minority wouldn’t.  So now I just do the full food allergy testing because that way, I can see, and show them, and then lead them to not eat these groups of food.

And second, we need to do allergy drops to normalize your response to that food because obviously it's not killing off our population, but I also would say that there's something that has changed, that our people are having autoimmune diseases. It’s like an epidemic. You know this is everywhere. Everyone is having an autoimmune condition. Why is that? I think it has to do with we're doing something different. Has our genetics changed in 50 years? I don't think so. What has changed? Our diet has changed, and our pollutant exposure has changed. So, I think that we will find more than a lot of the plastic exposures they were having, we’re going to find to be harmful to our immune system.

I think that research is just beginning on that, but diet I think, is important. Why? Because everything that happens in our body biochemically is predicated by what we eat, what we put in our body. Then if we eat anti-inflammatory food then our body will become anti-inflammatory. If we eat pro-inflammatory food then the end result is that we will be suffering from the high levels of inflammation in the body. So, I think that LDN is a wonderful tool: however, it does not give you permission to eat badly every day, smoke, and pursue an unhealthy lifestyle.

Linda Elsegood: We've just had a question come in, and it says ‘could you define allergy drops?’

Dr John Kim: So allergy drop is basically, I think that everyone has heard of allergy shots. When you have a severe allergy you give shots to people. It does work, but  I just don't like giving shots. My family members hate shots, patients hate shots.

So, what I've done, is looking for a solution that doesn't involve all shooting allergies. It makes sense to me that if it works by giving shots, it will make sense using the GI system because a big portion of our immune system is in our gut anyway. So, I've been looking for a solution to this problem for about five years. I found a solution.

I'm told that this is the more common approach in Europe to the use of allergy drops and allergy drop means that you, whatever your allergy, whether you're allergic to food or environment, you can create an antigen dose that corresponds to how much you're allergic to.

So, if you're allergic to huge levels, then you give them a minute amount of allergen, and then you systematically teach the immune system by exposure not to overreact. So, you can do that to peanuts, you can do that to wheat., you can do that to milk, you can do that for grass, fungus; the big thing that I see is yeast.

So that's the allergy drops that I talk about. I think that as I said, LDN and immunotherapy go hand in hand in my opinion, for autoimmune, and the reason is very simple; both of them are the intelligent approach to re-educating the immune system. And it seems the immune system is amazing because, that one patient I talked about that she was allergic to the fruit, what I found out was that she was allergic to grass. And grass, of course, is the cousin of fruit. So, I treated her grass allergy for about a year, and low and behold, she was able to eat fruits again, and I never went to even specific foods. I just treated grass, because that was the one thing that she was most allergic to.

So, it shows how intelligent immune system is. Of course, she was also taking LDN at the same time, which I think shortened the duration needed for her to go into remission.

Linda Elsegood: Well, I'd actually like to now talk about your LDN book that you've just managed to get published, and it's available on Amazon.

Could you tell us more about your book?

Dr John Kim: Yes, you know, it kind of began as my notes, because in the beginning, LDN was like magic. It would work. It would work. And I was almost thinking, why does it work? Why does it work? So, I started reading, and first, it was blogged on your website.

And then I just dug deeper, because of my research background I just went to the research databases and I would just read different studies, and understand better how low dose naltrexone would work. And of course, there are books already available. I think you were the editor in one of those books, but I wanted to go to the source and learn more.

And so this book is called LDN primer, and I call it primer because I feel like even after 15 years of using low dose naltrexone, I'm still a beginner. And in here I just talk about the history of LDN, and LDN as a noble anti-inflammatory agent for our central nervous system, which I don't think is utilized very often outside my clinic.

And then LDN for treating endorphin deficiency syndrome. Again, I'm looking at the conditions that LDN can treat as groups, so if you have an inflammatory condition for the central nervous system, LDN can be useful, even though it's not an autoimmune condition. LDN can be useful for people who have endorphin deficiency, and who knows if the bipolar disorder, depression, anxiety are a subset of endorphin deficiency syndrome, and I certainly treat it that way, and I have utilized LDN alongside an SSRI with great effect. And even a bipolar disorder with great effect. And then the other thing is LDN as Immuno adaptogen, and then I talk about atypical uses of LDN.

And then the last chapter I talk about clinical considerations of using LDN and share stories of my patients and my observations and ideas that I had, like dosing, you know, and how the dosing is determined. It's not scientific. It's been just supposition. I was just guessing. So then means we have the right to ask.

And what's really wonderful about your Facebook group is the interactiveness, and I see what they mean because some of the people start 0.5 and they think that's too much. I had to cut to 0.1 because.

Like in my practice, that's what I do. I look at a person and try to determine how much endorphin reserve do they have in their life.

If someone has high functionality, then I don't mind starting off 1.5 and then rapidly branch up, going up to 4.5. But if I get the sense that they are very depleted, I would start at 0.1 and then march slowly to get them to 4.5, but take my time doing it and looking for any side effects. So it's been a result of me wanting to understand LDN better and starting a blog and just continued writing.

And I kind of got caught in the web of interestingness of LDN, and I just couldn't stop writing and stop researching. And even preparing for this show, I found out there are more studies out now, and it's really a fascinating subject.

Linda Elsegood: I know a lot of people want to know how do they know how high to go if 4.5 isn't the sealing. How do they know that the dose is right for them?

Dr John Kim: Yeah. So, I think that again, understanding how LDN works is crucial. So, I call it two different dosings. One dosing is linear dosing, the other dosing is synergy dosing. So what do I mean by that? The synergy dosing; I'm referring to the LDN educating the immune system to calm down. So for most autoimmune diseases, I utilize LDN; the lowest amount of LDN required to put a patient into remission, or their symptoms into zero. So, in those cases, some patients are taking 0.5. if they're in remission. I don't want to increase it, because if their disease comes back, then I want to have a little bit of room left over to increase the dosing.

But if there are other people who have central nervous system issues, so I'll give you an example of what I mean by this. Neuropathy would be a great peripheral neuropathy. Diabetic neuropathy would be a great example. Or another example would be post-herpetic neuralgia, and LDN can do amazing things, but in those settings, we are not really counting on the LDN to reset the immune system, we’re using LDN as conventional medication, as an agent to create an anti-inflammatory effect in the central nervous system. And for that, I think that 1.5 to 4.5 dosing is a bit limited, and you have to look for ways to either make LDN work harder and then bring out the LDN synergy, and my to-go tool for that is acupuncture, especially the neuroanatomical approach to acupuncture seems to go very well with LDN. Another tool that I use routinely is alpha-lipoic acid. It seems it can enter the central nervous system with ease and works very well in synergy with LDN.

Linda Elsegood: I'm going to have to stop you there, John. We'll have to have you back on another show. And we really appreciate you being here with us today.

Dr John Kim: Thank you.

Belmar Pharmacy is a nationally respected compounding pharmacy. They compound low dose naltrexone, LDN bio-identical hormones. And accustom amino acids and mineral blends. They're based in Colorado and ship nationwide. Their goal is better patient outcomes through quality compounding, combining effective communication between practitioner, pharmacist, and patient.

Call +1 800-525-9473 or visit Belmarpharmacy.com.

Linda Elsegood:  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.