LDN Video Interviews and Presentations

Sherry - 1st Jan 2020 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today. I'm joined by Sherry who uses LDN. Thank you for joining me today, Sherry. 

Sherry [00:01:07] Thank you for inviting me. 

Linda Elsegood: [00:01:10] Could you tell our listeners what is it you take LDN for?

Sherry [00:01:16] I have the autoimmune disease, lupus. I have degenerative arthritis and fibromyalgia. These are three of the main concerns in my health, which has caused chronic pain. And it's really brought me to a place of disability, not being able to work and to enjoy life. And my health just kept deteriorating. And so a few months ago I was introduced to the alternative medication of low dose naltrexone. 

Linda Elsegood: [00:02:08] Can we just stop there for a minute? Let's find out first of all, before you found LDN, what was it like, and how long did you have all these conditions? I mean, have you had them all your life? Have they only been the last few years? Start at the beginning of your journey. 

Sherry [00:02:28] probably about 25-30 years ago I started having issues of where I would get a rash all over my body and then begin just feeling really bad and tired, and everything on my body hurt. It would happen maybe two or three times a year, or if I had gotten a virus or a urinary tract infection, I would get these symptoms. And it took several years for it to progress to where I was having these symptoms every month, every two weeks. And it took quite a while for doctors to diagnose the condition as lupus. And it is a progressive type of illness, not like it happens once and then you get better.

It just continued to get worse as I aged, and I developed more degenerative arthritis in my spine and my hands, which also inhibited me from being able to do a lot of physical activity. I was a nurse and you use your hands quite a bit. And that became very difficult to do. And then I started with the chronic muscle pain and fatigue of fibromyalgia that impacted more of my lifestyle. As time went on, I ended up taking early retirement from a job so that I could rest for a little while, and maybe reduce the stress level in my life to see if that would help. I found a job that I could do sitting down and using my computer, but still having to deal with the symptoms of chronic pain, fatigue and then flare-ups from any types of stress or viral illnesses or bacterial illnesses. So it really inhibited my life quite a bit. In 2018, I was awarded a disability determination, and that same year I couldn't do my job anymore even though it was a sit-down job. I just got to where I couldn't do full-time work. It just affected every part of my life, even my extracurricular activities within the community or with church or friends. 

I went to see a rheumatologist, and a couple of years ago and a new drug called Benlysta came out that was the first, uh, treatment for lupus; and I've been getting infusions every month and that has helped tremendously. It's cut back on the number of flare-ups I have with lupus. But degenerative arthritis and the fibromyalgia still had a great impact. And it was to the point where I could not even walk a mile. Or if I had to go to the grocery store and I had to walk around the big shopping centre, I'd make sure to hold onto the cart if I had pain in my back and my legs, and it would just make me have to sit down or, at times lie down. If I had family meals, a holiday celebration where I would do a lot of food preparation, after a short period of time, I just had to go lay down. The pain was just so tremendous in my body because of arthritis.  

Linda Elsegood: [00:07:53] can I just ask you, Sherry, how difficult was it to be diagnosed with fibromyalgia because it hasn't been recognized as a condition for that many years?

Sherry [00:08:03] That's very true. It is difficult, because as far as being recognized, and even lupus, it is the great disguise there. It was hard for them to finally put a diagnosis on me. And you find in your mind that you question whether you are going crazy or something, and what's going on with me? I know I have these feelings. So you finally find other people who are experiencing the same thing you are, and you realize you aren’t the only one that felt that way. And so yeah, it is a very difficult thing going through a disease process that is not truly recognized. 

Linda Elsegood: [00:09:28] And then you, of course, we're told about LDN. I mean, how easy was that to get a prescription and have it filled.

Sherry[00:09:38] That was another story. I had been referred to pain management because the doctor said, well, there's nothing else we can do for you. Go to pain management. And that was getting injections and getting on opioids. For some reason, it did not work on me. I guess maybe I'm just different. But the steroid injections didn't work. And as part of pain management, you also are sent to a psychiatrist to be able to find better ways to deal with chronic pain. And it was through that - that psychiatrist had dealt with other patients whose opioids and injections and all did nothing for the pain. And she said, they were put on a drug, it's off label use, but maybe this will help you. And so I started to do some research on it and talked with my pain management doctor asking if she knew about this use of naltrexone. She had never heard of it before. Then I talked with my rheumatologist and he said he had heard of it, but he's never used it for any of his patients, but he was willing to try it on me. And luckily there was the LDN Research Trust website and all the information that's for providers and patients.  He was able to be directed to that, and as he's educating himself with the use of this drug, he sent my first prescription to my pharmacy. I had no idea that it had become compounded, and my pharmacy didn't know either. So they actually made a mistake and gave me 50 milligrams of naltrexone. I'm thinking it was because I was on opioids at one point. So that was a farce. And then I finally found a pharmacy that did compounding for naltrexone, and that pharmacist was extremely helpful. He directed me to some more LDN research, information so I could educate myself and become part of the lupus support group of those who use LDN. He was an immense source of education and comfort, so I finally was able to get the medication through a compounding pharmacy in our area. 

I even talked with my primary care physician, telling her about the experience that I've been having with low dose naltrexone, and she says, this is what we need to hear. We need to hear about treatments like this, and they're not hearing it. And so anyway, my little part, I'm sharing the website information.

Linda Elsegood: [00:13:30] at what dose did you start on when you started, Sherry

Sherry [00:13:34] He started me on 4.5 milligrams right away, so I was taking that at bedtime, and immediately for the first couple of weeks, I saw no difference in the pain. I did start sleeping and dreaming, and I hadn't dreamt in quite a while, and sleeping through the night was very restorative.

It was about maybe six weeks of taking the 4.5 milligrams at bedtime that I started noticing in the day time that my pain level was decreasing. It wasn't as bad. It was tolerable. I had been where I would be from a six to eight pain score level every day, and at times more when I had to overdo things too much on my feet, or too much physical activity. I just had to go to bed and there was nothing that really helped me to take the edge off. After about six weeks, I noticed it's starting to work for pain and I was just full of joy about it. I just felt new. I felt renewed. My pain level about six weeks into LDN has gone to a three to a five every day, and that's for me, that's tolerable. That works. And I'm just overjoyed with that. And because of that, I've been able to walk for more than two miles, and hold on to a thing, or lie down, or use some other pain medication to help take the edge off. Those were the first experiences. I was just really just thrilled and told my doctors about it and they were extremely happy about it. Yeah. It set a whole new outlook on life. I don't expect that I would be 100%  a new body, a new person, but my life is definitely tolerable now in my body. 

Linda Elsegood: [00:16:49] And do you have a virus? Would you like to explain what happened when you had a virus? 

Sherry [00:16:57] Yes. It's now six days ago, I started having a respiratory virus, the cough, the congestion and all that. Usually, with lupus, those are triggers to a lupus flare-up. I didn't really know what was going to happen, but when it triggers a lupus flare-up, I get a rash over my total body and my skin becomes very painful. I have increased muscle and joint pain, fatigue, headache. It's not very nice.  It's bad enough you're not feeling well because you have a virus, then you have that on top of it. So six days ago I started with this virus then two days later I woke up and I had a lupus rash all over my body, the same type of experience that I would have prior, with the pain and fatigue, and all that went along with it. I called my rheumatologists and I reported to him what it was. Usually, he would prescribe a taper of prednisone over one to two weeks and my symptoms would be gone, the rash would be gone. And when the rash leaves, 10 days later my skin starts to peel off. The prednisone helps with the pain and the fatigue, but it usually takes about one to two weeks for me to get through an episode of a flare. 

I called my doctor as I was beginning this flare up and he didn't want to start any prednisone. He wanted to be sure that I did not have any type of infection, and afraid of it suppressing my immune system and then the virus really taking over. I agreed and I said I will call back and be reevaluated, so no prednisone next time. And then the rash and the fatigue and the pain exacerbated. And by that evening, ready to go to bed, I took in my LDN, as a backup.  We decided to give me the doses of one-milligram capsules so I could play with the dose and see if I could have a good reaction on just three milligrams of naltrexone, or if I really needed five or six milligrams of Naltrexone tab That's when I found that when I was on the three milligrams I had more disruption in sleep and more discomfort in my muscles and joints. So I went up to five milligrams and I was taking that pretty regularly and I was feeling good. And then I got the virus when I was on five milligrams of LDN. So when the flare started, that night when I went to bed, I took five milligrams of LDN. And when I woke up the next morning, my rash was almost gone. I mean, I could barely, barely notice it. I mean, it was just a shadow of it. And as the day went on the pain and the rest of the rash were totally cleared up. All the symptoms were diminishing. I still had the cold symptoms, cough and stuffy nose and all that, but the lupus flare was fading without prednisone. And that just is another surprise, to be able to do that without having prednisone. It’s just a miracle that that could happen. And every night I still continue with the five milligrams of naltrexone.

And every day, the lupus symptoms, the flare-ups, have diminished. I'm still working through the virus. You could probably tell, I sound probable still a little congested, but to me, it's a miracle. I  called and reported to my doctor and said, I know it's hard to believe, now I don't have the symptoms anymore and I didn't take any kind of prednisone. So that's where I am today. 

Linda Elsegood: [00:23:47] Well, What, amazing story. Truly truly is, and I'm sure those people listening who have lupus or degenerative arthritis, fibromyalgia is going to be so inspired by you, and thank you so much for sharing your story. Sherry. 

Sherry [00:24:08] Oh, I appreciate you giving me the opportunity. I hope this can help someone. I know it's so discouraging for some of these diseases, not getting the help you need.

Linda Elsegood: [00:24:21] Well, thank you for having been our guest today. 

Sherry [00:24:25] Okay. Thank you very much. 

Linda Elsegood: [00:24:29] This show is sponsored by our members who made donations. We'd like to give them a very big thank you. We have to cover the monthly costs of the radio station, software, bandwidth, phone lines, and phone calls to be able to continue with our Radio Show.

And thank you for listening.

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

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Her immune system is just functioning properly.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Visit www.kuslerspharmacy.net

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Turning Down the Volume on Fibromyalgia Pain (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Cases of fibromyalgia are discussed. Using opiates and LDN for fibromyalgia pain.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

I mean, 10 minutes is nothing, is it?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Linda Elsegood: Okay, thank you. 

FNP Laura Dankof: Thank you. 

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

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

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

Lauren - 1st May 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Lauren is from the UK, and uses low dose naltrexone (LDN) for chronic fatigue syndrome (CFS), myalgic encephalomyelitis (ME), fibromyalgia, and Ehlers-Danlos syndromes (EDS).

Before starting LDN she was housebound for about 2 years. She lost mobility in her legs; and had constant migraines and dizziness, and a myriad of other symptoms. She was only 20, and rates her quality of life as a 2 at that point. Having no quality of life, she was on suicide watch. One day she decided to do some research, and came across LDN, and found Clinic 158 in Scotland, which arranged for a consultation with a doctor, and the prescription. Within 2-3 weeks on LDN 0.5 mg she was cleaning the house; and as the dose increased, she felt like a new person, with her independence back. She was able to return to work, and has her own home now, although she does have some bad days.

Her fibromyalgia began at age 13. She was a champion Irish dancer, and suddenly her fibromyalgia symptoms began, and soon she was wheelchair bound. It took 5 years to get a diagnosis. Living with fibromyalgia was very traumatizing, not only because of the chronic fatigue, but also the pain in her body. She was told her leg muscle mass was pretty much gone. Because of the fibromyalgia in her joints, at age 22 she was preparing to have a shoulder replaced because of loss of her rotator cuff and frequent dislocation. Now on LDN she only suffers a dislocation maybe once a week.

A couple months after being diagnosed with fibromyalgia she was diagnosed with chronic fatigue syndrome (CFS) and myalgic encephalomyelitis (ME). A year later she was diagnosed with Ehlers-Danlos syndrome type 2, the hypermobility EDS. Things like cold weather, or a temperature her body wasn’t used to, would cause her shoulder to pop out. Her whole body was affected, but it tended to show most in her shoulder joint.

Now on LDN her pain is not gone, but it’s down to minimal, and a level she can cope with. She coped with excruciating pain daily for years, and now on LDN, having slight twinges here and there over her body is manageable. She is able to enjoy her life as a 23 year old.

 Summary of Lauren’s interview, please listen to the video for the full story.

Keywords: LDN, low dose naltrexone, chronic fatigue syndrome, CFS, myalgic encephalomyelitis, ME, fibromyalgia, Ehlers-Danlos syndromes, EDS

Dr Annette Johnson from Germany - 27th March 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda: Today, my guest is Dr Annette Johnson from Germany. Thank you for joining us today. 

Annette Johnson, MD: Thank you for having me. 

Linda: Could you tell us how you got into medicine? Was it something you wanted to do as a child? 

Annette Johnson, MD: As a child, I wanted to go to Africa to help children that are not in a wonderful position as we are here in Europe, in Western countries. In the beginning, I thought it's only in Africa where they have problems and we don't really have problems in Europe, only luxury problems. Then I found out that's not true. We have lots of problems in Western countries, such as chronic diseases and the suffering that nobody cares about anymore because we tell our patients they are not curable at all. I wanted to help and change things.

Linda: When did you hear about LDN? 

Annette Johnson, MD: Actually I was so much into fibromyalgia and other patients that I was searching all over the world to find solutions for my patients. I am caring for about 700 fibromyalgia and around 600 Borrelioses patients and around 500 Hashimoto patients. 

I was very happy to hear about your radio show and your book. To start with, some other doctors in the area are pain specialists and who were experienced in this therapy.  

Linda: How long ago was that? 

Annette Johnson, MD: I think this is three years going by now but already I would say I can see success after some weeks, sometimes after the first week also. I also found a good psychological effect on the mood of my patients. So I'm really very positive about using this on patients who are so chronic. Sometimes I find them to improve very fast.

Linda: All right. You said that you have 700 patients with fibromyalgia. How many of those have you now got on LDN? 

Annette Johnson, MD: I don't want to disappoint anyone but I would say around 50 patients on LDN. Some patients do well only with diet changes with meditation techniques, plus therapy and private practical interventions. So I'm sort of doing my worst cases and that is why it's only around 50 from 700 because it's such a good help in the hard cases, in the difficult cases. 

Linda: Okay, so from those 50 patients, what have the outcomes been in the percentage?

Annette Johnson, MD: I did some research before our interview. I think it would be a 90% success. I'm separating my patients to those who best fit the criteria, which may be why my success rate is higher.

Linda: How do you prescribe LDN? Are you using capsules, or sublingual or cream? And how do you titrate the dose up? What is the starting dose? 

Annette Johnson, MD: Yes. I use a compound pharmacy that you recommended in Ireland off into South of Germany, and my first recipe is a 0.5 milligram, one milligram and two-milligram capsule on one recipe.

That means that the patients only have to come to me twice and then can proceed through. After they ask all their questions after they have understood the system, after they have read your book and then we keep in contact every two weeks by telephone or personally and then they increase.

The dosage until the four or 5.5 milligrams, if they use it if they need it, or they can stop if they don't need such high doses. Many of the myalgia patients only need very low doses to get a quick improvement. I have found with speaking to fibromyalgia patients and LDN prescribers that people with fibromyalgia and chronic fatigue syndrome, are very sensitive to all medication and LDN, even though it's a very low dose, is still a prescription drug.

Linda: Do you find you have to start very low and do you find they react to it negatively initially?

Annette Johnson, MD: I think they react very well if we start with 0.5 milligrams and I remember two cases who couldn't even tolerate that. So we made them buy empty capsules and divided into two pieces so they could start with 0.25 milligrams. This worked out very well. In the end, when they started it and then they increased the dosage over four weeks instead of two weeks, they could in the end or come to two around two milligrams. That's really interesting because we have some patients who want to give up, saying the side effects are a problem. Pharmacists and prescribers who say that they can get success with all patients, providing you use a very low dose and increase it very slowly. Some people need a longer gap to let the body get used to that dose before you increase it further.

Linda: Some people never have a higher dose than say, two milligrams. It's really individual to each patient, don't you think? 

Annette Johnson, MD: Yes. 

That's so wonderful, isn't it? We can give them the confirmation that in the end they'll find their individual doses and they can increase it if they just take their time. Also,  I tell about 10% say it didn't work well, then later say it did work and I didn't notice because  I did so many other things.  I didn't notice that I was so well, and this is a new effect and we want to go back on the medication. Isn't that interesting?

Linda:  It is very interesting. When I was really ill and every week I had a new symptom, I knew I had a new symptom. The numbness went from my toes to my ankle, to my hip, to my shoulder, and you noticed every single thing that was going wrong. But when things start to improve, it's certainly a case of, oh, my left side isn't as numb as it was before. The pins and needles aren't this bad, but you don't remember it daily like you do when things go wrong, and I think you probably think I'm okay now and you don't think about it.

Annette Johnson, MD: It’s just something that happens. It's only when you stop, as you say, and all these things come back that you remember. That's why I encourage them to have a little book, where they write down their everyday symptoms in a good way. We don't call this a pain book, but we call these recurrent feelings.

We'll see. Then they can go and read how bad they were years before or months, or even weeks before. Because patients with fibromyalgia and fatigue syndrome are often not very good at remembering things. So it's really necessary to write things down and then to go back and look at how many symptoms have already resolved.

Linda: We do have an LDN app for those people who are English speaking. You can have a journal, but you can also record sleep, mood, diets, supplements, exercise, set alarms, do graphs and charts and printouts. It's amazing, but it's in English. So if you have any members who are English speaking, they might find that as a value and help. It's on our website so they could look into that. 

Annette Johnson, MD: These days, they want to take their health in their own hands and they come with ideas.  I just had a patient who was suffering from fibromyalgia for 30 years. She had to do the suggestions to her doctors, what they could do to help her. This is so wonderful that we now understand pain and psychology effects much better than we used to.

As a doctor, you always need some patients that bring you on the way. You need nice colleagues that support you and give the support that you will manage and they will happen. There will be nothing difficult or illegal behind it and the doctors are very busy.

They don't have the time to look at everything themselves and to find out. If you have a doctor who's willing to listen to the patient, giving them new information, that is the way to educate them, isn't it? The busy doctors, when they don't have to search for it to be given the information is a big help.

This is so wonderful and I'm always asking the patients once they'll be better if it's allowed to then call their old doctors. That's what I do once they are better.

I go and call very nicely. They're all doctors and just tell them in a very collegial way how we managed to bring the patients back. It's the insurances that send me patients because they notice they don't have to pay for them anymore because they're going back to work after months or weeks.

So this is wonderful to see that in Germany. That government insurance ascends patients to my office because they know they'll be helped with LDN or other methods. I'm in close contact to Amin who also did lectures at the conferences for Augsburg for calming labs, and it's around 80% of my fibromyalgia patients who actually are triggered.

Borrelioses is a tick-associated diseases. So astonishing if isn't that bad that we are not finding the Berlioz if we don't use the right tests.

Linda: So would you say the Barrios SIS is Lyme disease itself, or would you just say that's a co-infection.

Annette Johnson, MD: I would say it's, it's triggering to see if you have the genetics that for example, you cannot get rid of, phosphates, which professor Paws and Amanda in Los Angeles found. And then you have a tick infection, then everything will compensate and everything will be bad. And you'll start to get autoimmune. And bad reactions. And that's where the LDN comes in. It doesn't replace the antibiotics or the plants that we use or the therapies that we use but it's keeping us from getting all these other diseases like Hashimoto or like other autoimmune diseases from infections.

And I find it very useful. I've had lots of prognosis patients. The Borrelioses and fibromyalgia are really so common in South  Germany. We have a lot of patients who have Lyme disease who have been told by their medical professionals that it's all in their head.

Linda:  They're just depressed. There's nothing really wrong with them. So that automatically makes them very depressed, not being believed when they can't get out of bed, they can't function. Do you have patients who have chronic Lyme disease that you treat because they are getting fibromyalgia from borreliosis?

Annette Johnson, MD: They're coming with fibromyalgia symptoms. And then I find very high numbers.  Actually, I had very bad Borrelioses last year.

It was 16. Unbelievable. And then I could just help myself with some physical therapies,  some foot photons to appease and some electric therapies. And I took LDN in the end after that, I just wanted to try it on my own. And I found that it was very useful and that I'm not having nightmares or something, but I have very nice dreams. it's really interesting and it's nothing scary about it, but it's wonderful to dream. And also it helps with my Parkinson patients who are not dreaming anymore. It helps with my dementia patients if they're not dreaming anymore because a deep sleep would DRI with dreams is so important to heal your disease.

Annette Johnson, MD: people talk about the vivid dreams with LDN., I feel robbed. I never had any vivid dreams, but I've heard so many people tell me about their dreams. I had vivid dreams, I wasn't scared. It was just interesting. It was like watching a video. It was not scary at all and I never felt that I should stop it or something. I think it's a wonderful thing and I want to take it one and a half years just to find out what it does with my body. I'm so convinced about this therapy I just wanted to take it. Just getting back to the Lyme disease patients, how long it takes to get better.

Linda: How long would you say that would take with using all your different therapies as well as LDN and the earlier they come, the faster they are healed, but already if they have it for a long time, we can help within half a year. Wow. Yeah, it is because it takes so long to initiate all the things and to get your vitamins on the internet and things.

Annette Johnson, MD: If people come from somewhere else very far away, you have patients from Egypt and from Portugal and from Scandinavia. So if, if they come from far away, I have to be very fast and I'm starting all things parallel because I don't care which of the things heals in the end. I just want to hear and. Then I'm faster.

Sure. The more they can do, in parallel, the shorter time they are here.

Linda:  Now, how do people get hold of you? What's your website?  And do you have a waiting list?

Annette Johnson, MD: Sure. https://www.annette-johnson.de/ But this is only three months, I think. Okay. So if anybody would like to come and see you, the sooner they can make that appointment, the better. If you have to wait three months. But if they come in the beginning of the week and they have had their massage already, then we could start, take the early spot LTT um, and know if it's Borrelioses triggered that why they are so fatigued or while they are so painful for, and then it would be just faster.

So we can take blood in the morning about vitamins and Borrelioses if it had their massage in the week before. And then. They don't need to come so often, but maybe three times or so. 

Linda: Well, thank you very much for being our guest today and sharing with us your experience. I appreciate it so much and thank you for your work.

Annette Johnson, MD: Take care. All the best. Thank you.

This show is sponsored by Dixon's Chemist, who are experts in LDN at associated treatments in the UK. Dixon's Chemist is the most cost-effective for LDN in all forms within the UK and Europe, maintaining safety standards far in excess of what is required. Why would you choose to get your LDN from anywhere else? Call 0141404654 five today to speak to LDN experts. 

Doctor Annette Johnson asked me to add, I may not have pointed out enough how important it is to start the titration with a compounded product instead of diluting tablets. Local pharmacies, unfortunately, suggest this in order to avoid the high costs of the raw material.

And the extra effort. Patients nightly believe that diluting a 50-milligram tablet is accurate doses of no 0.5 milligrams, which it isn't. I found incorrect fillers and self dilution. The reason why I initially didn't receive the results I do now, some colleagues are still not aware of this.

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

Michelle, Fibromyalga and ME - 9th Jan 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Michelle shares her Fibromyalgia (CFS/ME) and Low Dose Naltrexone (LDN) experience on the LDN Radio Show with Linda Elsegood.

Michelle first started having problems at the age of 12 or 14.  Her low energy, chronic migraines and pain were put down to puberty by her doctors. Later, in her twenties, the doctors blamed her problems on stress although she never felt that she was stressed.  Eventually in her thirties she was diagnosed with ME (myalgic encephalomyelitis) and Fibromyalgia. 

She is now 52 and has spent a number of years being bed bound. She felt she had a very limited life. In 2017 she was in bed from the end of September until march 2018 and felt her life was being wasted.

While researching the latest research on ME she found references to Low Dose Naltrexone (LDN). Michelle printed off the information she had found and took it to her Doctor. Michelle started to ask people on facebook where she could get LDN and was advised to contact Dicksons chemist in Glasgow. Since then she has had a miraculous recovery.

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

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

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

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

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

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

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

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

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

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

slowly tapering their opiates.

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

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

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

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

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

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

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

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

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

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

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

I can be found at www.georgeschatz.com,

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

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

Dr Sajad Zalzala - 4th July 2018 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

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

Dr Sajad Zalzala, commonly known as Dr Z, combines unique qualities of an experienced doctor passionate about disease prevention and longevity, and a serial entrepreneur. Sajad has been passionate about slowing down and reversing age-related diseases for 20 years. 

He decided to become a doctor after reading Ray Kurzweil’s books. He became interested in integrative and functional medicine as a medical student. He currently sits on the board of the International College of Integrative Medicine (ICIM).

For the last several years, he has run an online clinic dedicated to prescribing LDN to patients across the US and most of Canada and has treated over 1,000 patients with LDN.

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