LDN Video Interviews and Presentations

An interview with Teresa, who has been dealing with multiple health issues, including mold and hormone problems. Teresa's symptoms were severe, and she had been struggling with them for over two years. When she was at her sickest, Teresa had histamine intolerance, gut problems, and neuroinflammation. She also experienced hot flushed red faces whenever she worked out, endometriosis-type symptoms, diarrhea, increased heart rate, weakness, and jumbled thoughts. Teresa sought help from multiple doctors but found no relief. She had to go to functional medicine and naturopathic medicine to get the help she needed. The doctors prescribed her supplements, herbs, and homeopathics, among other treatments, to improve her health. However, it took her some time to feel better despite adopting a healthy lifestyle and following protocols. She learned about how to eat properly, take care of her mitochondria, and improve her nervous system and relaxation through meditation. Teresa describes her typical day when she was at her sickest, and it is a poignant story. She would wake up feeling either nauseous or sweating and had to move her bowels frequently. Within two hours of waking up, her heart rate would increase, and she would feel weak, forcing her to sit down. Teresa had to work as an online therapist and tried to see clients despite feeling unwell. She couldn't be around intense smells, go outside, or eat without feeling sick or nauseous. Her life was limited, and she was essentially homebound. It wasn't until Teresa started taking LDN that things started to improve drastically. Her functional medicine doctor prescribed her LDN, which was initially a source of hesitation for her. However, as she saw her roommate getting better after taking LDN, Teresa decided to give it a try. LDN is a promising treatment option that has been used for various health conditions, including autoimmune diseases, chronic pain, and cancer. It works by boosting the body's natural immune response, reducing inflammation and pain. Teresa's LDN treatment was a turning point, and she started to feel better. She felt less sensitive to smells and was able to tolerate more foods. She started to gain weight, have more energy, and exercise again. It took her a while to feel better completely, but LDN was the key that unlocked her health. It is a testament to the power of functional medicine and the importance of finding the right treatment for each person's unique health condition.

Today, I had an insightful conversation with Michelle, a physician assistant, who recently opened her own integrative health practice. Michelle focuses on optimizing her patients' health and treating each person uniquely, addressing issues such as sleep quality, thyroid function, and hormone balance. She also prescribes LDN (Low Dose Naltrexone) for many of her patients and has seen positive results in improving their overall well-being. Her approach to personalized care and empowering patients in decision-making has been rewarding and successful. 

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Today we're joined by pharmacist Dr Dawn Ipsen who's the owner of two pharmacies in Washington State, Kuslers Pharmacy and Clark Pharmacy. Could you tell us what it was that inspired you to become a pharmacist? 

I knew early on as a high schooler that I wanted to have a doctorate degree in something and was sort of a little bit torn between pharmacy and optometry and with long heartfelt discussions and soul-searching I became a pharmacist and very early on in my career not only was I trending towards being a pharmacist but I had an opportunity to intern at a compounding pharmacy and just absolutely completely fell in love. It was the art and the science and the way of being able to help individual patients in manner of which no other pharmacist in my area was able to do so, of providing very personalized therapies. I was able to really listen to patient needs and work with their doctors, to formulate the exact therapeutic tool that they needed to improve their quality of life. That is really what has driven me in my career. 

When did you open your first pharmacy? 

I had been a pharmacy compounding lab manager for about 10 years for the Kusler family. When they were ready to go do other things in their life I was given the opportunity to purchase Kusler's Compounding Pharmacy. It had been a pharmacy I had worked at as a staff member for 10 years and took over as the owner and I've now owned that pharmacy for almost 10 years. In January it will be 10 years. That was my first pharmacy. I was doing all my good work up at my Snohomish Pharmacy and suddenly had a random phone call on a Friday afternoon in which the Clark family was looking for a new owner for their pharmacy. They were ready to retire and go do other things as well. I've also owned Clark's Compounding Pharmacy down in Bellevue Washington for six years. I've been an owner for almost 10 years total and have had multiple locations now for about six years. We service not only the entire state of Washington but we also work within nine other states as well. Our boundaries go quite deep and it's a really great way to help all types of patients all over the nation. 

What would you say is the most popular form of LDN that you use the most? 

I would say primarily we use the most customized strengths of capsule formulations of low dose naltrexone (LDN). It gives patients really great consistency yet opportunity to get the doses titrated in appropriately where they need it to be. What's really great about how we approach our making of capsules: we use hypoallergenic fillers. We're also able to work specifically with patients who have sensitivities. We can customize what that filler might be and I think that's really what sets our pharmacies apart and why doctors and patients choose to work with us. We are experts in autoimmune and chronic inflammatory diseases and therefore we're very used to working with patients where the normal just isn't what they need and isn't what's best for them. We can customize that to be appropriate for them. Along with capsules of course, we are able to do transdermals. That's really popular in pediatrics, especially for patients with an autism spectrum disorder. We are able to make flavored liquid tinctures of it so patients are able to use various small doses to titrate up doses. We also make sublinguals. I would say capsules are pretty popular for us. 

What kind of fillers are you asked to use? 

Most of the time I will steer a patient towards microcrystalline cellulose (which is a tree-based cellulose). It is very hypoallergenic for a lot of patients. However, some patients know they have tree allergies and those patients primarily prefer rice flour. I do have a couple of patients, but very very rare, that actually do better on lactose filler. They tend to not be my autoimmune patients. They tend to be patients in the chronic pain spectrum area. We have also worked with other fillers, like tapioca flour. We can be very customized into our approach of how patients need it. I've got one patient that comes to mind that loves magnesium as their filler and that's very relaxing for their muscles. I've also seen probiotics being used. There is not one right answer to how we do things. We are that pharmacy that is able to have a conversation with a patient. We talk about what their needs are and customize it based on that approach. 

From the prescribers that you work with, do you have many consultants that you fill scripts for? 

We definitely do. That's also kind of a little side thing that I do. I've always been very passionate about teaching. I'm on faculty at University of Washington School of Pharmacy and also Bastyr University, which is one of the top naturopathic doctor schools in the nation. I teach there during summer quarter. I teach nationally to providers continuing ed-based content that is often LDN in nature, or ties into LDN. Especially with autoimmune and chronic pain and chronic inflammatory conditions. We consult a lot with doctors. I probably work with three or four hundred functional med type providers on any monthly basis, even on being able to customize therapies for their patients. We are really big in the post-COVID syndrome arena of helping patients that are really struggling and LDN. We're finding it pairing quite nicely in that condition as it's very inflammatory based. We work quite heavily within the MCAS arena for patients who have a lot of mast cell instability and need other therapies. LDN is one of the tools that is used quite frequently by those types of providers and for those specific kinds of patients. 

Do you work with any pain specialists, dermatologists, rheumatologists, gastroenterologists? 

We do. Honestly, I’m quite proud of our little Seattle area of Washington because we do have MDs that are pain specialists that are now really turning towards using LDN in their toolbox of things they have available for patients. They're getting quite savvy at it. They're doing a really great job. It is super exciting. I have some dermatologists. I consult a lot with my functional med providers that are seeing dermatology conditions like psoriasis. I have an email I need to work with a doctor on after this to help them with this patient with a psoriasis case. We are seeing it in the GI world as well for Crohn's and irritable bowel disorder. Those chronic inflammatory conditions. I would say the MD pain specialists are really turning around over here. Obviously with the opiate crisis that has occurred in our nation I think most doctors of any type of credentialing or medical training or experience are quite interested in what LDN is doing for their communities and what opportunities it affords for patients who are trying to make sure they aren’t addicted to opiates but yet have something to improve quality of life and their day-to-day living. Low dose naltrexone has been an amazing tool for that. 

I'm always excited to meet different LDN prescribers and nurse practitioners who are providing lots of scripts. When you get an MD or a DO that is prescribing LDN and it is completely out of their comfort zone, I always think yes, you know we've got another one on board. We're making it right. We're getting it. MDs are already working outside of the box. That is normal for them to look into LDN; it's not normal for MDs to look at LDN but as you know, I've interviewed so many people and so many MDs when they have a patient that they can't help, and fix their issues. They've tried everything and they feel as if they've failed this patient, and then they try LDN. Once they have had amazing results with the first person it's then so easy for them to look into prescribing, not only for other patients with that condition but for any autoimmune disease, chronic pain, mental health, etc. 

I mean it's really amazing and this is where people like yourself come into play. The hand-holding with doctors because a lot of them haven't got time to do the homework. They're very busy and they need somebody to tell them exactly what it is, how to prescribe it, what to look for, what to do and have somebody on hand to say, like you said, I've got a patient with psoriasis. What do I do? Can you help me? That is the way to get more doctors involved is the pharmacist doing the hand holding. 

There is a local psychiatrist in our area that works with younger adults with substance abuse disorders and teenagers that are having a lot of trouble with mental health. I had an opportunity to get him thinking about LDN and his patient population. I love when I get to reconnect with him every few months because he just raves He finally has a tool that actually does something. He felt the antidepressants and all these other things were not really fixing any of the issues or fixing the symptomatology. We still have the same abuse issues, we still have the same addiction issues and we still have the same levels of depression and suicide risk. But with LDN he's finding that he's actually causing positive change in his patient population, and that's the only thing he really changed within his practice. We're really affecting the health of our community in a very positive manner with something that's really safe and low risk and not expensive. It doesn't get any better than that. It's the best compliment I could ever have. 

It's really nice when patients take all their information to the doctor. Once you've got a doctor really hooked on prescribing LDN they can change the lives of hundreds of patients. Dr Phil Boyle uses LDN in his fertility clinic. He also uses it in women's health for things like endometriosis, polycystic ovary, painful periods, heavy periods. Right across the board he uses LDN. He gets patients coming to see him with women's health problems who also have Hashimoto's or long COVID etc. I refer to his work all the time. He gets questions a lot from local providers such as we have somebody who wants to become pregnant, or they did become pregnant and they're on LDN and they want to know what the standard of care is and can we continue, and what's the risk and benefit are. It is so great to have providers like him out there that have been doing this work for so long that we can very confidently share those case experiences and history of using the medication long term for those patients. 

There have been so many of our members who were skeptical about using LDN during pregnancy. Doctor Boyle is always very generous with his time. I will send him details and he will answer the patient and share his experience. You know we used it once up until birth rather and breastfeeding, etc. We have those people who have done two or three pregnancies using LDN who are happy to talk to other people. This is my experience with 20 years as the charity next year, which is totally amazing, but I’ve found that word of mouth and with the education it is just spreading. 

Linda, you've done an amazing job with the LDN Research Trust and I thank you for that. You have made the Research Trust, its website, resources and its books into a trusted referral point that I can use with our doctors and our patients who are wanting that next level of information beyond what I'm able to say to them. They want to go see those studies themselves. They want to go read the book themselves and I know that without a doubt I can send them to your resources for them to receive complete in-depth and correct information. Thank you Linda. You're doing amazing things and this is all because of you. 

How can people contact you? 

We have two locations in Washington State. We have Kusler's Compounding Pharmacy in Snohomish Washington and the website there is www.Kuslers.com; and then we have Clarks Compounding Pharmacy in Bellevue Washington. That website is www.clarkspharmacywa.com. The WA stands for Washington. We are happy to help patients all over and talk with doctors that need guidance and assistance in learning more. I love being an educator and I love being here to support my community. 
 

 

George Yiachos, MD, FACC, FASNX: How to Treat Chronic Inflammation to Help Prevent Heart Disease (LDN; low dose naltrexone)

 

 

The LDN 3: To Purchase with discounts before 1st September 2022 Go to ldnresearchtrust.org/ldn-book-3 for full details

 

 

Carol Petersen, RPh, CNP - Discussing Healthcare, LDN Radio Show 13 July 2022 (LDN; low dose naltrexone)

SUMMARY
Pharmacist Carol Peterson is most interested in successful aging, working with bioidentical hormones. Along with a manufacturer of advanced nutritional systems, they developed a carrier solution with phospholipids for topical medications, that greatly enhances absorption. Another focus on aging is Beta 1,3 Glucan, which has a very positive effect on the immune system, important in autoimmune disease. She also discusses hormones and hormone testing. Her website is www.thewellnessbydesignproject.com, and she offers a free 15 minute get acquainted conversation to see if people are interested in what she can offer.

TRANSCRIPT
Linda Elsegood: Welcome to the LDN Radio Show brought to you by the LDN Research Trust. I'm your host, Linda Elsegood. I have an exciting lineup of guest speakers who are LDN experts in their field. We will be discussing low-dose naltrexone and its many uses in autoimmune diseases, cancers, etc. Thank you for joining us.

Today we're joined by pharmacist Carol Peterson, who's going to explain the new exciting things she is embarking on in her life. Thank you for joining us, Carol.

Carol Peterson: Thank you so much Linda. I'm not so directly involved with compounding LDN anymore, but I do follow this. I'm really interested in the most successful aging we can have, and so I spent many years directly with bioidentical hormones, which I think are a huge piece for people. And I'm continuing that work. You might find this interesting: I'm working with Quicksilver Scientific, and they've developed a dosage form that has phospholipids in it. Depending on whether the substance is water soluble or fat soluble, you can do a nano emulsion or a nano liposome, depending on your substance. And we're about to reach out to pharmacies to compound with this for hormones. One of the first pharmacists I talked to about this does a lot of compounding with LDN, so his question to me was, wouldn’t this be adaptable to LDN? Probably yes! We haven't done that yet, but it would be a phospholipid dosage form that you could use under the tongue. And in this case, it's going to be extremely well absorbed. We have really excellent data that using only tiny amounts of hormones will give you good blood levels and good function. So this could open up a whole wide area for a new dosage form for LDN, and maybe if we talk in a year, it'll be out there everywhere, I hope. Another potential would be to use it on the skin, because phospholipid dosage forms go through the skin very well, so it may be that tinier and tinier doses of LDN would be appropriate. It was kind of exciting for me. I'm also working with another two companies joined together, and they are US Enzymes and Master Supplements.

All my years of working with hormones is such a big pillar of having a successful aging process. I've added another two pillars. I think this is so important. A column of what's going to hold you up for your aging, and I think this is quite phenomenal, and just yesterday we've introduced, with Master Supplements/US Enzyme, a beta glucan. Why this should be interesting to anybody who uses LDN is, it's such a major stimulator of your immune system. This company has gotten Beta 1,3 Glucan, which has a linear, and they say has the most positive effect on your immune system, and should be applicable to any autoimmune disease. So that's kind of exciting for me. There's all these bridges from one place to another, and what else can I say. I'm doing some consulting online, I have a Facebook page and I've named it the Wellness by Design Project. I have a website, and I do individual consultations. If people want to work with me, they can. And this is not a big part of what I'm doing. I'm more interested in getting information out there. I have a blog I've been writing for the A4M website, worldhealth.net, and this gives me a huge voice that I was actually missing before. And I really am interested in helping a huge amount of people, and really Linda, that's exactly what you've done. I am just in awe of what a person can do when they're determined and what they can build. You are such an inspiring person to follow. So that's where I am right now.

Linda Elsegood: Wow, it's really exciting, isn't it? You've got your platform, and now you're going to go for it, which is amazing. Tell me a bit more about the carrier that you can put on the skin for LDN. Not being medical or having any pharmacy background. What is the difference between what you're talking about, and liquid or topical lotion?

Carol Peterson: Whether it's your mucous membrane in your mouth which, except for the mucus, it's skin too. And your whole esophagus is skin too, if you turn it inside out. But what happens is that you get an enhanced absorption with the phospholipids, and these are actually good for you too. Your skin, every cell in your body needs those lipids, the phospholipids, to put in their cell membrane. It actually could be used as a supplement all on its own. Therefore, I'm really excited about this, because you're feeding the body also, with the dosage form, instead of introducing chemicals, which I'm really against. I think there's a danger in the compounding world, and I think people should pay attention what their stuff is put into. I had a call from a woman, had a nice conference with her, and she called me because that was her number-one concern with a bioidentical hormone product, and she finally looked at all the ingredients in the cream base that she was getting, and she was horrified as she looked up every single one, one by one. That's 100% of what I'm concerned about. If you're using something that you're going to be using all the time, you shouldn’t be introducing things that could be potentially harmful or accumulate. We've got to consider our poor livers, because we're asking a lot of our livers in this toxic world, so there's no sense in adding to that toxicity. I guess we want to be using some things to help us, but don't introduce unhelpful things along with it.

So it's just phosphatidylcholine and different assorted similar molecules, and there's I think there's a little MCT oil in that. Lecithin has a phosphatidyl choline and associated molecules, so it's kind of an interesting thing, and I'm certainly going to going to plant that bug into your compounders’ ears when we get it out there. I think this dosage form has much more applications than just hormones.

Linda Elsegood: Would it be a case of using less LDN, which would make it more effective in that way, or would the dosing remain the same?

Carol Peterson: Probably the first thing to do would be to try equal dosing and see what happens, but potentially you need less. I'll use a hormone analogy like progesterone. I'm really against using the low-dose progesterone over-the-counter creams where they deliver 20-30 milligrams of progesterone, and women actually do have a hard time with this. They stimulate estrogen, and yet can't fill in all the things that progesterone needs to do with that little amount. They're miserable and they hate progesterone, that woman who is so anxious and can't sleep and irritable, has water retention, breast soreness. She needs like 200-300 milligrams, maybe in a cream. Then when you think about the rate of absorption through the array of creams available in compounding, you may have only 10% to maybe a maximum of 80% absorption. That's a thing that people don't understand. But with the phospholipid progesterone, Dr Shade, who is the owner of Quicksilver Scientific, said that he was able to get a luteal phase of 20 nanograms per deciliter. This is high-level phase level with only 20 milligrams of progesterone, whereas I just said it might take 200-300 milligrams to do that adequately. For a woman a lot of the times in conventional medicine, those low-dose progesterones are poo poo because you can't see it in the in the blood, and of course you can't see it because it's so tiny. It's just too weird, so I'm a real advocate of making sure there's enough. Probably there'd have to be some adjustment with people, and what's working, what's not; or maybe something's not working so well. Maybe it really is an absorption problem with some people who are not getting the results they could be from LDN. Changing the dosage form might be just the key.

Linda Elsegood: That's interesting. For people listening who think that you'd be able to help them with their issues with hormones and so on, how do they get hold of you? Could you give us your website address?

Carol Peterson: It's www.thewellnessbydesignproject.com. I chose it. It's rather long, but this was my web designer's idea. “Project”, because I used to be more black-and-white and think people should be able to be on a path and be an advocate for what they they're talking about. I was pretty judgmental. Now I realize that we're all in a path to make our health better, to make our whole lives more vital, and we're not going to get to perfection. But we can be on the path and get there, and that's why I said I want to help people with the project of themselves, and help them get better, get as much better as they can. As far as that's concerned, unless you're dead, I think you can improve, would you agree?

Linda Elsegood: Absolutely! So once people contact you for a consultation, how long is the consultation?

Carol Peterson: I'm offering a free 15 minutes so we can get acquainted and see if people are interested in that interaction. Why I think that's important is, whenever you're offering the gift of information, or you're the messenger, it might not be the right person at the right time, and I don't take that personally. I just feel that I've put a piece in the puzzle, and maybe it's going to help later on with somebody else. But if that person is ready to work with me, we can figure that out in 15 minutes. Then I offer our consultations, and then I offer a more extended program that would last over six months with more intense coaching.

Linda Elsegood: And does that involve any testing?

Carol Peterson: I like to see some testing. So much of the results, it's always clinical, whether it's LDN or whatever, you can't measure specifically very well. What your outcomes are, if you don't have the clinical outcomes, if you're not getting the results you want, testing makes no difference at all. What are you testing for? You can't measure what the person tells you about how they feel, how they're able to operate in the world. That's like 99% of what you're doing. But if I have somebody who's really rather complicated, I do a life extension panel. I like the elite panels for men and women. They measure the pituitary or growth hormones, thyroid hormones, adrenal hormones, sex hormones, Vitamin D. You have this whole measure, plus the blood chemistry, plus the blood differential, plus all the lipid stuff. It takes a lot of vitals of blood, and patients can order this themselves, unless they're from New York. It's self-directed. You can get your own test. I love it because you get a bigger picture. If you just go in and have your sex hormones measured, like people will do, it doesn't place it in the whole realm of all the endocrine system.

I have a hierarchy of hormones. The insulin - glucose is the most important, the most primitive of our hormones, and that makes so much difference. What we are going back to: we're going back to our nourishment, what we eat, how we eat. If that step isn't taken, you could be messing around with sex hormones all day long and not get whatever you want. Then adrenal hormones: if you don't have good adrenal activity, this is like life or death. This is quality of your life. Plus, if you need thyroid, thyroid becomes impossible to take if your adrenals aren't supporting that thyroid activity. Then finally, sex hormones. A lot of people know they have a hormone problem, but they'll think I know it's my sex hormones because I'm menopausal, but you really need the whole picture to do that justice. So, I like that more comprehensive test. If somebody is really not understanding what's going on with their body, and there's a lot you can get there, a test is no good if it doesn't give you direction. I was really happy: I arranged for a test for a young woman with difficult periods, a lot of pain, and putting on weight and acne, and I chose a panel. I was so happy, because a lot of the things were abnormal, and if you don't have a test that shows you where the abnormalities are, you can't do anything about it. You have no direction. How many people go to the doctor and have a test and they say oh, everything's normal. No, you haven't looked at the test results well enough, or you haven't picked the right test to use for that patient. So that's another piece of things that are going on.

So many people are told, especially with the thyroid, that it's fine, your levels are great, there's nothing wrong, when people are feeling really ill. You know yes, there is something wrong. I myself have secondary hypothyroidism, and that is my pituitary TSH, which is what they measure all the time, is simply always low. It's low if I use thyroid, it's low if I don't. I think my pituitary was poisoned. It came from an area of a country with the biggest amount of atrazine in the ground water, and atrazine is a pituitary poison. I've been working on that. But what do you do when your TSH is so low, and your other pituitary hormones are low? You treat what follows. You treat the thyroid, you treat the adrenals, you treat the sex hormone function. That's how I've been managing myself. But interesting enough, a doctor can look at you, and you have every symptom of hypothyroidism, and they would take a look at a very low TSH, and say you're hyper, and that's that, because they haven't even thought about the pituitary actually producing that hormone, and being unable to. It's shocking to me how many times they see this.

I follow a lot of Facebook pages. I do follow one on LDN, and I follow menopause and osteoporosis, and <perry>. There are so many people out there that are suffering needlessly, and sometimes they write about their pharma experience. One drug after another. And their lives are devastated. I want people to know I'm a pharmacist, and I would say renegade pharmacist. Drugs do not return you to health, never ever. To go down that pathway, as soon as you start it, the drug is going to cause damage, and create more symptoms of discomfort. You're going to add another drug, and another drug, and you are doomed to a marginal existence, and none of this is necessary.

Linda Elsegood: Well, that's amazing.

Carol Peterson: Everybody is aiming for their optimal health, right, and it's achievable. Always, the people with the most trouble have the greatest gains to be made. I'm reading an old book by Andrew Saul called Doctor Yourself. I love the philosophy, but he is really making a point, over and over and over again: things that we consider illnesses are most often deficiencies in something, and we know enough about biochemistry now, and in physiology we're able to target certain nutrients for certain things. The more you know about that, the more tools you have to help yourself. That's what you have to do in the end, when you go to a doctor with whatever you have, you should be in charge. You are the person who is the buyer, and the seller is trying to sell you information, or a protocol, or something to do. You have to keep that in mind. You would spend a lot more time comparing cars than you do comparing what that doctor is able to offer you. And doctors have forgotten that they are a seller, partially because they offer you a pathway, and they're not allowed to deviate from that pathway they're offering. We've got our medical system so entrenched in, like, flow chart medicine, that doctors can no longer develop a patient-doctor relationship, where they're interested in the patient, and go right along with the patient, and examine the information out there. When you think about it, we have a whole world of smart people in country after country after country. We have no database that we could really touch into for finding that person, say in South Africa, who's gotten wonderful results doing a certain thing. We have no way of knowing that. In this age of information, not having access to the world's information on how to keep healthy and at optimal health, it's sad really, We should be able to do that.

Linda Elsegood: Well fingers crossed that you're laying the foundations for that.

Carol Peterson: Okay!

Linda Elsegood: Any questions or comments you may have, please email me, Linda, 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.

 

 

LDN Webinar Presentation 18 May 2022: Dr Mathewson - LDN as supportive care for Oncology and Autoimmune patients: Case Reviews

Sponsored by Innovative Compounding Pharmacy https://icpfolsom.com/

 

 

LDN Webinar 18 May 2022 (LDN; low dose naltrexone)

LDN Questions Answered Live by

Pharmacist Dr Masoud Rashidi - LDN Specialist
Dr Sato-Re
Dr Mathewson

Sponsored by Innovative Compounding Pharmacy icpfolsom.com

 

Sakina Davis, MD - Hashimotos and LDN (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr. Salina Davis practices Functional medicine and knows the heartache of Hashimoto’s as does her daughter. She describes the testing process and the various treatments for it. She prescribes LDN (Low Dose Naltrexone) to her patients and utilizes it herself. During this interview, she gives great suggestions on diet and nutrition and life style changes.

Review by Ken Bruce

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A fellowship-trained physician, Sakina Davis MD, FAARM, ABAARM, provides outstanding care to her patients. At Woodlands Wellness and Cosmetic Center in The Woodlands, Texas, Dr. Davis delivers a wide range of medical spa services. She takes pride in helping patients achieve each of their medical and aesthetic goals.

Dr. Davis graduated from the Medical College of Georgia in Augusta, Georgia. She completed her internship in internal medicine at the University of Florida College of Medicine –Jacksonville. Later, Dr. Davis performed her residency in family medicine at St. Vincent’s Medical Center in Los Angeles, California.

For many years, Dr. Davis specialized in family medicine and general practice. But she always held a passion for functional medicine and anti-aging care. In 2005, she established Woodlands Wellness and Cosmetic Center so that she could help patients prevent illness and achieve optimal health.

Dr. Davis believes that hormone balance is the key to wellness. At Woodlands Wellness and Cosmetic Center, she specializes in hormone optimization like hormone pellet therapy. Hormone-balancing treatments can help stimulate weight loss and boost energy levels. Dr. Davis is also proud to offer a wide range of weight-management services to help patients feel their best.

Dr. Davis takes pride in delivering a cutting-edge approach to functional medicine and healthy weight management. She’s fellowship-trained in metabolic and nutritional medicine and board-certified in anti-aging and functional medicine. Dr. Davis has also developed her own skin care line, available at Woodlands Wellness and Cosmetic Center. Sanavi skin care products use natural, botanical ingredients to deliver exceptional results.

When she isn’t assisting patients, Dr. Davis enj oys spending time with her family and giving back to the Woodlands community. She is involved in the Montgomery County Food Bank, Interfaith of The Woodlands, and CASA Advocates for Children. She has also chaired the American Heart Association Luncheon.

Please visit our website ldnresearchtrust.org which is packed with information on Low Dose Naltrexone (LDN) for Autoimmune Conditions, Cancers, Chronic Pain, Women's Health, Children's Health etc, plus we have a very active FB Closed Group facebook.com/groups/LDNRT/

Dr Yusuf (JP) Saleeby, LDN Radio Show 08 Feb 2017 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Thank you for joining us today, Dr Saleeby. 

Dr Yusuf Saleeby: It's very good to be here, Linda. 

Linda Elsegood: Wonderful. I wonder if you could tell us first of all, about yourself and how you got interested in medicine. 

Dr Yusuf Saleeby: Well, that started at a very young age, while I was living in Beirut Lebanon. I was very close to the AUB hospital. My father worked for a pharmaceutical company, so I always had an interest in medicine and science. And then I had a very pivotal moment in high school with a fantastic biology botany teacher who got me really ramped up about the sciences and about biochemistry and botany and biology.

And all through high school and undergraduate I always had my eyes on medicine. At the time I was in Atlanta, Georgia and went to premed at Georgia Tech, Georgia State University, then onto medical school in Augusta, and I did my postgraduate training up in North Carolina and then kind of settled into the Southeast, covering the Carolinas and Georgia. Mostly the first part of my career was in emergency medicine. So I had a very traditional conventional medicine career as an ER doctor. 

Linda Elsegood: Okay. So how did you get involved in therapies such as LDN? 

Dr Yusuf Saleeby: Well, in my 20 plus years in the emergency room, I saw on a daily basis, the ravages of chronic disease, a lot of which I perceived as being completely preventable. And so during my last 16 years in the emergency room, I sort of developed a curriculum to learn about what I could possibly do for patients before they reach that end-stage of chronic disease, whether it's cancer, congestive heart failure, autoimmune diseases.

It was terrible. It was depressing seeing these folks come into the emergency room. So for 16 years, I developed a curriculum where I looked at other options outside of allopathic medicine, in the integrative field and functional medicine. So I kind of built on that, with members of different organizations and going to different conferences, I kind of developed a passion for functional and integrative medicine. And that's what I've totally dedicated the latter part of my career to. I retired from emergency medicine five years ago, and I do strictly functional medicine now. 

Linda Elsegood: And how long would you say you've been prescribing LDN? 

Dr Yusuf Saleeby: Well, I've read about it peripherally, heard of it in some of the conferences I attended, but nothing until about three or four years ago, when a patient of mine who was suffering from Hashimoto's brought it to my attention and passed along a big stack of papers that she acquired doing research online.

So I've also learned from my patients. I'm never afraid to learn information from my patients. So I decided this was interesting enough for me to go after and learn more about it. A good friend of mine a couple of years ago - he's a PharmD, a pharmacist,  and does some research in North Carolina. I attended last year's conference in Orlando and came back with a wealth of information, and he was very excited. So that actually ramped up my prescribing. I dabbled in it for a couple of years, but then as about a year ago I started writing heavily for LDN and implementing it in some of the programs and protocols that I have established for my patients, especially with Lyme disease.

Linda Elsegood: And you were telling us before we came on air, where you practice from, and you're going to have a new centre soon. Would you like to tell us about that? 

Dr Yusuf Saleeby: Sure. So my first centre - I'm kind of headquartered in a little coastal town just North of Charleston, South Carolina - it’s called Murrells Inlet, and we opened up a second satellite office in the Raleigh-Durham area of North Carolina. That was about two years ago. And last year we opened a small satellite office in Charleston, South Carolina, a little area called Mt Pleasant. 

I was approached by another holistic provider and also a licensed acupuncturist and TCN specialist about a year ago about collaborating on an effort in Savannah, Georgia. So I'm happy to announce that in March of this year we'll open up another office in collaboration with another integrative healer for functional medicine practice. 

Linda Elsegood: Could you tell me what's the satellite centre? 

Dr Yusuf Saleeby: Well, we say satellite office - it's a smaller office, kind of a micro office. We don't have a large space nor do we have a large number of staff. It's actually a very personalized one-on-one, and it allows us to actually go to where the needs are. I find that with my practice I was getting referrals from all over the Carolinas because I'm one of the very few practitioners in ILADS members. So I had to kind of position myself to where a lot of patients were coming from, to make it more convenient for them. 

Linda Elsegood: Talking about Lyme disease, how many Lyme disease patients do you think you've seen in the last five years? Has the number increased? 

Dr Yusuf Saleeby: Hundreds. I think because it's been over-politicized and it's very difficult to make a diagnosis, I think there's a lot of misinformation and misunderstanding about Lyme disease. And I think a lot of people just don't get diagnosed. 

The CDC is saying within the last two years that the numbers are around 300,000 new cases in America alone. That was up from about 30,000 prior to 2013. So there's obviously some issues with their counting new cases, but ILADS estimates that there's anywhere between 800,000 to a million new cases of Lyme disease each year in America. Worldwide it’s much higher. That's pretty significant. 

So now with more recognition, there are the folks wearing green ribbons for Lyme awareness, there are people marching on Washington and Capitol Hill, and lobbyists trying to fix the wrongs that have been for so long with regards to diagnosis and treatment of Lyme disease. There's not even an ICD-10 code, which is a coding system we use to record a diagnosis for submitting claims to insurance companies. There's not even one for chronic Lyme disease. It's really quite a shame. And a lot of people have suffered for protracted periods of time. 

But with all this Lyme awareness, the floodgates have opened, and it's less politicized. The medical boards historically have gone after doctors who have practised on the fringe if you will, and taken on these patients, and have been reprimanded by medical boards. It still happens a little bit, but that's going away too. So now doctors are less fearful of losing their license and are able to treat and practice and take care of Lyme patients.

So to answer your question, hundreds and probably if it's exponential now. Three years ago, I'd get one or two patients a month. This week I've made three diagnoses of new cases of Lyme just this week. 

Linda Elsegood: Goodness. I know it's very tricky to get diagnosed. There are people that are telling us regularly. We have many, many, many members with Lyme disease, but they had such a hard time getting the diagnosis. If anyone is listening and they suspect they've got Lyme disease, how do they get a diagnosis? Who do they go to? Who do they turn to? 

Dr Yusuf Saleeby: Some resources, at least in the United States, and I know internationally, there are other resources, but in the United States, one of the premier organizations that advocates for Lyme awareness and also does some training to train doctors to be what they refer to with LLMD, which means Lyme literate medical doctors, doctors who are familiar with the caveats and the intricacies and the limitations of our testing. And can actually make a correct diagnosis. And then after that, correctly treat people, to put them in remission. I don't know that you can actually say there's a cure for Lyme disease if it's caught in the chronic stages, but you can certainly put it in remission so that people can regain a fairly normal life.

There are some that have flare-ups from time to time. So the organization that offers a lot of information and good information that's evidence-based and that's reputable, is an organization called ILADS. ILADS.org would be the website. And if you go to that website, there are the sections for some videos for patients to watch and there are videos by Dr Horowitz, a prominent doctor in the field of Lyme treatment. There's also a video by dr. Shor, who's the new incoming president of the organization. And there are some other video documentaries. Under Our Skin is a documentary that was filmed about 10 or 12 years ago. And that's a very good immersion for the average person to get a little exposure to what is involved with Lyme disease.

Linda Elsegood: How do you go about diagnosing somebody with Lyme disease? 

Dr Yusuf Saleeby: Well, it's a little tricky. There are no good direct tests for Lyme. It's difficult or impossible to culture out. So historically the Center for Disease Control has set up a one-two punch, if you will, on diagnosing. They used the Elisa test followed by a confirmatory Western Blot for a line for borrelia. However, that works great for the diagnosis and confirmation of HIV infections, but really falters when we talk about hunting down and detecting the spirochete that causes Lyme disease. The Elisa I don't even do in my practice. It is a worthless test. The Western Blot can miss up to 50 or 52% of positive cases. So we rely on other more sophisticated Western Blot technology tests that look at different bands in different species, not just one single species of borrelia. It's estimated there are about a hundred. 

And then there are other surrogate markers that we look at. Usually, if it's a chronic case of Lyme, people have immune dysfunction or a weakened immune system, and we can look at a particular type of T-cell or lymphocyte called a CD57. The CD57 test is a marker for the health and wellbeing of your T lymphocyte cells, and I use that in my practice to kind of help make the diagnosis, along with monitoring the therapy. So every three months or so we'll draw another, and hopefully, we see that number rising. The normal range is between 30 and about 300 for most reference labs. And I have seen patients coming in with numbers well under a 60. This week I had a patient with a level of 19 who was severely impaired and debilitated. So that is one tool we use. 

There is a relatively new test, that's a direct test called the Nanotrap LA - LA for line antigen. That's a direct test. In other words, it measures directly the antigens, which is independent of your body's ability to produce antibodies, which is where the Western blot falls short. So the Nanotrap LA iS a relatively new test, and it takes two large samples of urine to run. And I've had some success with ironing out a diagnosis based on this new test. 

I also use the Horwitz questionnaire. Dr Horowitz developed a fairly lengthy questionnaire that is a good diagnostic tool. An analogy would be the diagnosis of a headache. So you can have a normal spinal tap. You can have a normal CT or MRI, but a person still has a headache, even though there's no physical finding or test other than their subjective complaint. So in a way, a diagnosis of Lyme disease can sometimes be a kind of a subjective clinical diagnosis that confounds the testing for it. So the Horwitz questionnaire is something I use in my clinic all the time, along with some symptom scores, like the SSS-8 symptom questionnaire, and the FACIT questionnaire, which is for fatigue. So it gives me a way to quantify and put a number on their complaints. Instead of somebody saying they’re just tired or fatigued, I can put a number and then watch that number improve or not based on our therapies.

Linda Elsegood: How does one catch Lyme disease? 

Dr Yusuf Saleeby: Well, historically Lyme, of course, was named after the town in Connecticut where it was supposedly first discovered by a concerned mother who prompted the local health department to get the CDC to come up and figure out what was making all the kids in the neighbourhood sick. So it was named after the town. It was associated with a deer kick. We know now that there are other ways besides getting bitten by a deer tick that can transmit Lyme. There are researchers in Europe, the Netherlands in particular, who believe that the flea and the mosquito might also transmit Lyme.

And there are co-infections too, like the Babesia, Bartonella, Ehrlichia - there are about a dozen or so other co-infections that the tick can actually carry, so one bite from a tick can actually infect people with more than just one infectious organism. 

The other ways you can get Lyme is congenitally through the placenta. We do know, and it's been confirmed, that Lyme disease can cross the placenta and you get a newborn who can have Lyme disease because mother had it. And also we're finding out that very likely it is sexually transmitted. So you have partners who are sexually active who can actually transmit that spirochete from one to the other.

Again, there's a lot of research going on, mostly in Europe. Our research dollar is not very strong here in the United States because of the politics behind the diagnosis of chronic Lyme disease. And that's very unfortunate. So the researchers in Germany and the Netherlands have sort of taken it to the forefront of a lot of really good research.  

Linda Elsegood: Well, we will just have a quick break, and then we'll come back, and we'll discuss this further. To listen to individual radio shows and interviews, go to www.Mixcloud.com/LDNRT. Today's show sponsor is CareFirst Speciality Pharmacy. They are leading compounders of LDN and other custom treatments, servicing patients in over 18 states, coast to coast. They're widely accredited to provide you with the highest quality demanded by the industry, and the expert service you expect. To learn more, call (844) 822-7379, or visit www.cfspharmacy.pharmacy. Thank you. 

Welcome back. It's very interesting talking about Lyme disease, and I know many people will find this very interesting. You talked about it being sexually transmitted. If you think that you've caught Lyme disease from your partner, what is the first thing you should do? 

Dr Yusuf Saleeby: Well, first of all, Lyme disease infection is the chameleon of infectious diseases. In the 17th, 18th century it may have been syphilis - in other words, it had different manifestations. And then I think the baton was probably passed to HIV.

So with HIV/AIDS patients, you had a plethora of symptomatology and presentations. And I would say today that baton has again been passed to Lyme disease. So Lyme disease can affect many, many things. It can affect the skin; you have dermatological manifestations. It can affect the heart - I actually lost a patient in the ER about 15 years ago, and that's what really sparked my interest in Lyme disease. She had a bullseye lesion, and she had complete heart block and died two days after she presented to the emergency room. I always remember that case in particular. The other manifestations are neuropsychiatric, and that's a big one because a lot of people when they get infected with the Borrelia species, will instantly have that organism burrow into their neural tissue, so they present with things like MS - Multiple Sclerosis, with plaquing around their brains and spinal cord. They will present with ALS type symptoms or Parkinson like symptoms or severe depression or bipolar or even schizophrenia. And unfortunately, years can go by before the correct diagnosis is made, and these poor souls will get put on all kinds of psychotropic medications, which often don't work.

They kind of maybe mask the symptoms, or are very minimally effective until such time as they're diagnosed with Lyme; and then the appropriate therapies are rendered and then their situation improves, the plaques go away. So their MS improves and their gait comes back, or their vision comes back. They stop acting crazy. The schizophrenia seems to just melt away, and they come off of their typical poly-pharmacy where they present on multiple medications - that can go away too. Once we get their Lyme disease in remission their symptoms clear up, we can pull them off of all their antipsychotic medication and antidepressants. So when one suspects it based on a plethora of weird symptoms that haven't been diagnosed, where conventional doctors can't come up with a reason for it, it's time to get checked out.

Linda Elsegood: I know after speaking to many patients with Lyme disease, there seems to be a wide range of treatments available. What do you normally have as a protocol, or does it vary from patient to patient? 

Dr Yusuf Saleeby: Well, I believe in very personalized healthcare. So almost every one of my Lyme patients doesn't get a cookie-cutter sort of prescription. I do align myself with the ILADS protocols and some that have been developed by Dr Horowitz and others, although I also embrace some protocols developed by Dr Cowden and Dr Buner, which utilize less of high potency antibiotics, synthetics, and more into some natural anti-microbial and immune-enhancing herbals and supplements.

And that's the big thing - immune enhancement. So all the heavy lifting that the body does to fight an infection, whether it's Lyme disease or anything else, is done by our immune system, our innate and humoral immune system. 90% of it is done by a healthy immune system. The additional five or 10% can be done and accomplished by antibiotics or herbals.

So my sort of philosophy as a functional medicine doctor is to get the immune system back in its optimum health so that it can be healthy enough to fight off and suppress the Borrelia microbes. That is not necessarily the philosophy of conventional doctors who like to blast away with high doses of antibiotics for protracted periods of time, leading to other issues like dysbiosis and overgrowth in the gut microbiome and things like that.

So LDN has found its way into my practice as an adjunct therapy for many of my Lyme patients, because I know it bolsters the immune system. I don't know how many of the people listening today know what and how LDN works, but obviously this drug has been around since 1963, I believe it was created, and FDA approved since the mid-1980s. And this compound binds to certain opiate receptors, the mu kappa and delta. Receptors. But it's the mu receptors where its usefulness was first recognized in treating people with opiate addictions, and then later alcoholism. But I guess doctors were finding people returning to their clinics for refills on this higher dose of naltrexone that had some of their symptoms and signs of other chronic illnesses dissipate or disappear. And so there were some researchers like Dr Bernard Bihari who noticed this and some researchers in Europe who said, well, let's look at lower doses because what lower doses of naltrexone do is they actually can upregulate certain opioid receptors. So there's this something called opiate growth factor and opiate growth factor receptor, which when upregulated actually has a very positive effect on the immune system on what they call T helper cells - T_h1 which is your cells that actually gobble up bad bacteria and viruses. And then also has an effect on the T_h2 cells, which are the ones that produce antibodies. So I'm using LDN aggressively in my Lyme patients who show up with the CD57, which is a surrogate marker for the health of their B cells or their antibody-producing cells.

And I'm using the LDN in conjunction with other therapies, to enhance it. I'm finding on a regular basis people who come in with subtherapeutic CD57 counts are returning to my clinic, even in one to three months, with a marked improvement. And then, of course, that correlates with a marked improvement in their overall health because now their immune system is healthy. Their T_h1 and T_h2 cells are reactivated. They're healthy, they're more focused and directing the battle against these invading spirochetes, these microbes, and there's less need for the use of really high doses and protracted courses of antibiotics, 

Linda Elsegood: Having fewer antibiotics has got to be good, hasn't it? I wonder if I could just ask you to answer a few questions and then we'll come back to Lyme disease. We have a question from Kim, and she says, does LDN directly or indirectly affect dopamine levels? I know it increases endorphins. 

Dr Yusuf Saleeby: Right. So Kim, yes the LDN can enhance dopamine. It does enhance endorphins and enkephalins just because of the nature of how it works on certain receptors. I think I previously mentioned OGF are receptors on the surface of cells, and that can actually lead to enhancement of the cells to fight off cancer, especially on the lymphocytes, on the immune system cells. But LDN actually plays a pretty big role in something called PONC, which stands for pro-opiomelanocortin. That's a mouthful. It's actually a big fat protein, a precursor to ACTH, which stimulates the adrenal glands. So you get your DHEA and cortisol amongst others. And also POMC is a precursor to the endorphins and enkephalins. So when you stimulate that system with LDN it binds and has a very positive effect on the release and production of endorphins and enkephalins, and also on the HPA axis, which encompasses your adrenal glands and also some neurotransmitters in the brain and even in the gut.

Linda Elsegood: That's a really good answer. Thank you. So thank you for your question there, Kim. We have another question here from Donna. She says, “I'm a CRPS patient with autoimmune disease, mixed connective tissue disease. I've been in remission. CRPS is extremely painful, and I started at 1.5 LDN two months ago. I've been at 4.5 for a month. I was taking it at midday. Dr Bihari said to take it at night, and so far it hasn't worked. My pain management doctor thinks it's a wonder drug. Do you have any suggestions?” 

Dr Yusuf Saleeby: Well, you know, in all, honestly, there's no magic bullet. There's no panacea for everything. I've seen LDN work very, very nicely and very well for folks. And then there are some people who don't tolerate it very well. Sometimes in dosing, I am very conservative, and my protocol is to start out low and go slow. I sometimes start out with one or two milligrams and then slowly, every month titrate up, and sometimes cap at around four and a half milligrams, although I do find that sometimes a lower dose actually works better than a higher dose of. For instance, I had a patient that did marvellously at two, and then as we started to escalate the dose, we hit three, three and a half, four. She didn't do so well so we backed down to two, and she did fine.

With Hashimoto's patients, I found that starting even lower is better, at maybe a half a milligram. I've had some mixed feelings about LDNs place with Hashimoto's in that I've seen PPO titers actually climb once people have been on it. 

But I think there are other factors involved. Some of it is genomics. There is a genetic mutation or variant of a particular gene that actually enhances the ability of this drug to work on people. So what I'm going to be doing in my practice is checking people's genomic profiles for their ability to tolerate naltrexone, and also if it's an effective therapy. So sometimes we can not just do trial and error on a patient, but actually look at their genomic profile and predict whether naltrexone is going to work better for you.

I have had complaints of things like headache, insomnia, feeling wired up, some nausea, and on occasion, some Herxheimer reactions, what some would call a healing crisis. A Herxheimer reaction is when there's a big die-off of Lyme bugs, people get feverish, chills, achy, and that's called a Herxheimer reaction. So, occasionally we have some of that going on when we have folks on LDN, and it's just a matter of titrating the dose up or down or sometimes discontinuing it for a while and making sure that it's not some other factor that's getting in the way and kind of falsely blaming LDN.

Linda Elsegood: Okay. I hope that answers Donna’s question. Then we have another one which fits in nicely with what you were saying. I don't know who it is, but they said, “I've been told by my doctor today that I'm now hypothyroid. I had a blood test yesterday. The last blood test in November 2016 showed that I was borderline as other tests done earlier in 2016. I've been taking 1.5 of LDN since April and had expected my thyroid levels to improve, but the opposite seems to happen. Do you have any idea why?”

Dr Yusuf Saleeby: Well, I have one question for clarification. Are they saying they are hyper or hypo?

Linda Elsegood: Hypothyroid. 

Dr Yusuf Saleeby:  So first of all, there may be other factors. One, we have to establish that they may have an autoimmune disorder, like Hashimoto's. So along with their thyroid function tests, they would need to determine their TPL, their thyroid peroxidase titers, and the thyroglobulin antibody titers. And if it's a hyper going to hypo like Graves' disease - you can cross over from hyper to hypo - the TSI test, the thyroid-stimulating immunoglobulins - might be helpful. So we have to quantify the type of thyroid disorder that patient has and not just throw LDN discriminately at them because there may be other things in place. There could be a selenium deficiency, an iodine deficiency, there could be a conversion problem where people are not converting the T-4 thyroid hormone to the T-3 active. They may be converting to their lazy brother if you will call the reverse T three. I used the analogy of their “lazy brother “ if you will, that sits at the dining room table, eats all the food and doesn't do the dishes. It's not something you want to have a lot of around, so one has to check for that because if they're feeling worse, subjectively, that must mean that there's something going on with their thyroid that maybe the LDN is not addressing. So if it's a Graves' disease or Hashimoto's thing, you would tend to think that the LDN would have a big part to play in that. But if it's another issue, there may be other therapies. 

It could be what type of thyroid replacement therapy you're on. If we're using Armour that might be a problem. If we're using Synthroid, which is T-4 only, that patient could actually be converting too much of the T-4 to reverse T-3, instead of T3. It could be a methylation problem, so methylation pathway analysis, looking at their genomics, looking at methylation testing panels to see where they're metabolizing things. Maybe the introduction of select adaptogen herbs can help with T-4 to T-3 conversion, and blocking down things like reverse T-3. Also, deficiencies and some of the B vitamins and also vitamin D. Vitamin D deficiency can lead to a problem with conversion and reverse T-3 being escalated or high.

So just because the LDN is not working, it could be that it's possibly the wrong therapy for you. Or again there could be many issues that need to be investigated. 

Linda Elsegood: Thank you. And the next question runs into the last really. Dana sent this question in and the question says, “I was diagnosed with Hashimoto's and AE. I was taking Synthroid for seven and a half years. And the current dose was 112 micrograms In March last year, I was diagnosed with AE, and I started the IV steroid protocol, which is very effective. I didn't believe the diagnosis and didn't think steroids were the best course of treatment. I saw a functional medicine doctor who ran tests and couldn't find any other cause for my symptoms. He prescribed LDN, but I didn't start it. The main reason was that the steroids really work to stop the symptoms I was having. My husband was concerned for me to try anything else as everything read suggested that untreated AE could result in seizures, coma, or death. I went to the Mayo clinic last year. The diagnosis was confirmed, and IV steroid treatment protocol was prescribed. It was very effective and mostly eliminated all of my symptoms. She's been taking a thousand milligrams of Solu-Medrol every three weeks, reducing every four weeks. The treatment will stop in mid-June. Steroids have cut my thyroid antibodies in half. And the last time I went to see the endocrinologist, I told him I felt my thyroid was becoming overactive and suggested that my Synthroid be reduced. He said the numbers looked good and he wasn't alarmed. It was possible the symptoms I was having were side effects from steroids: heart palpitations, sweating and sleep disorders. I started reading on LDN and see that many people are able to get completely off Synthroid after starting LDN. My question is, should I wait for the steroid treatment to be over before starting LDN? I stopped taking Synthroid last week because my heart rate was getting a hundred some days, and it would skyrocket with any activity at all. Normal for me is 55. The script I have is 1.5 milligrams, and I've read that people with Hashimoto’s should start very slow, very low. Any directions you could provide would be appreciated.”

Dr Yusuf Saleeby: That was quite a question. So a couple of things to address, first of all, steroid therapy. The Solu-Medrol, which is a potent corticosteroid, is downstream treatment. In other words, it is treating the symptoms of the underlying cause of the autoimmune disease and the other issues she has, and yes, while it is effective - we do use steroids in short bursts for symptom relief - you are not really addressing the underlying cause. There's no way to ever reverse what's going on with steroid therapy. It'll basically mask symptoms. It's like a paint job on a rusted car. You're still going to have rust underneath the paint unless you do do a full rehabilitation of a car. So by just masking it over, just by slapping paint over the top, it might look shiny and bright for a while, but it still has rust underneath. 

A same analogy for upstream. You have to use a functional medicine doctor to make a diagnosis of an upstream root cause reason for your symptoms or your disorders. I don't really care what you call it. You can call it lupus. You can call it MS. You can call it ALS. You can call it Hashimoto's. Essentially from a functional medicine perspective, autoimmune diseases are the same downstream. They may just affect different body organs or systems, but the root cause can be just a handful of things that can trigger this. An infectious disease, genetics, heavy metals,  overgrowth or dysbiosis of the gut microbiome.

So some very rudimentary, very basic things can actually trigger off the cascade that winds up as an autoimmune disease of different natures, of different flavours, if you will. So the steroid therapy is basically masking your symptoms. Yeah, you're going to feel better, but it can also lead to euphoria. It can lead to bone loss. It can lead to thin skin Cushingoid like fat retention and certainly you don't want it. And there are some very detrimental side effects from long-term steroid therapy. So is my advice to my patients to try to limit the amount and length of time they're on steroids and really find the root cause and address root cause issues for your autoimmune disorders and never try to let it go so long that it really becomes a debilitating disorder. 

So hopefully that answered some questions. There was a lot to that question, but I think she would be very well served by having a functional medicine doctor to look at her, and analyze her for antecedents, mediators, and triggers, uh, through what we call the timeline and the matrix, which tools we use in functional medicine to help our patients.

Linda Elsegood: Thank you. We'll just have a quick break, and then we'll come back with some Lyme disease questions for you. Thank you. The LDN Research Trust has an LDN Vimeo channel. I have interviewed over 550 LDN prescribers, researchers, pharmacists, and patients from around the world. For many conditions, you can find the link from the LDN Research Trust website. If you'd like to be interviewed, sharing your experience, please Contact Us. I look forward to hearing from you.

Today's show sponsor is CareFirst Speciality Pharmacy. They are leading compounders of LDN and other custom treatments, servicing patients in over 18 states, coast to coast. They're widely accredited to provide you with the highest quality demanded by the industry, and the expert service you expect. To learn more, call (844) 822-7379, or visit www.cfspharmacy.pharmacy.&nbsp;

Welcome back. We have a question from Chris, and he says he has Lyme disease and co-infections and does LDN work from 0.5 to 5 milligrams a day with Suboxone? He takes that at four milligrams a day. 

Dr Yusuf Saleeby: So he's on Suboxone as well as the LDN? I have very little, um, experience with the concomitant use of naltrexone and Suboxone. The mechanism of action is slightly different when we're dealing with opiate addiction. We're looking at a blockade of the mu and kappa receptors, and maybe to a lesser extent, the delta-opioid receptors. But when we talk about the use of LDN to treat Lyme disease, we don't want any interruptions or anything in the background to impede its ability to work. And it does work differently. Again, the lower dose works much more effectively on the OR receptors and what they call the toll-like receptors or TLR4s, in exacting their effect on the immune system. 

I don't have any patients in my practice that are on Suboxone. I usually wash out those kinds of drugs at the onset when I see folks. I try to take them off as many of the toxic drugs. I have very, very few patients who are taking any type of opiate, centrally acting medications. We get them off that fairly emergently so that we can open up the field of our herbals and some of our selected shortlist of good meds, if you will, to help them with their conditions. So I'm sorry, I don't really have a good answer about the interactions between Suboxone and LDN. 

Linda Elsegood: Okay. That was still a good answer. And we have a question from Kathy, who has got Lyme disease co-infections and chronic fatigue. Now she's rather concerned. She's going to go and have some allergy testing, and for food allergies as well. And she says, should she stop LDM prior to the testing? She says I ask because since taking LDN, her allergy reactions and sensitivity to food has much reduced. She's very glad about that, but she doesn't want it to affect the testing she's about to have. She wants it to be accurate. What should she do?

Dr Yusuf Saleeby: Oh, it sounds like she is looking for a big reaction for the food allergies. If she's looking to get the maximum reaction and she's found through her personal experience that while on LDN it has suppressed her allergic reaction to foods, that's probably by a mechanism of LDNs effect on the and also the T_h2 and also the T_h17, which has to do with allergy and autoimmune.

So if she stops the LDN and waits for a washout period, she could pretty much realize a stronger reaction to the food testing or the skin prick testing, if they're doing topical testing for allergies for pollen and environmental allergens. But what's the point? Is she trying to look for a bigger reaction, or is she trying to take something to help with her symptoms? So if she's trying to figure out what maybe are the offending foods or environmental allergens, yes, stop it for a bit to see if it would cause a more severe reaction. But again, she's throwing her T_h2 or T_h17, the T helper cells into chaos again. Because obviously there's something going on that's causing her to have these environmental allergens, whether it's the methylation problem, a vitamin deficiency, toxic heavy metal, an infectious organism, a smouldering infection causing her to be hyperactive. It could be her gut microbiome. She could have an obliterated crazy,  unbalanced gut microbiome that needs to be put in balance to avoid leaky gut and gastric permeability, which can lead to food allergies. So skin testing is a way to determine some of these things.

In my practice I don't do so much of the testing like IgG testing or skin testing for allergies, as I do more of an elimination diet. It's a less expensive, more comfortable way, in my opinion, to do things. And you can isolate certain foods that are problematic and eliminate them, try to eliminate them for a period of time where the antibody titers diminish, and you don't mount a response to these foods any longer. It's you sort of becoming desensitized if you will, to it. And when you are exposed to these antigens again, they don't necessarily cause the same kind of chaos or reaction. 

Linda Elsegood: One last question. Jack says that he's taking LDN and high doses of vitamin D and his question is, does LDN change the laboratory results of PTH in any way?

Dr Yusuf Saleeby: Parathyroid hormone, PTH? 

Linda Elsegood: He doesn't say what PTH stands for. 

Dr Yusuf Saleeby: Well, I'm going to assume that it's parathyroid hormone since he was talking about vitamin D and how high doses of vitamin D can certainly affect parathyroid hormone. I haven't had any issues with high doses of D affecting PTH or bone turnover markers for that matter. In my practice I check parathyroid hormone, calcium levels, and things like osteocalcin and Beta-Cross Laps, which is a CTx, a C telopeptide, which is a bone turnover marker, to assess if the thyroid therapy is appropriate. In other words, we don't want to overprescribe thyroid medicine because it can cause osteoporosis and it affects the bone turnover markers. Likewise too low thyroid can also, so you have to have the right amount. It's kind of the Goldielocks principle, where too much or too little can have detrimental effects. But I have not experienced in my practice, nor do I know anything in the literature necessarily, that LDN can affect the parathyroid hormone levels.

Linda Elsegood: That's very good, thank you. So people now know who you are, what you do, and where you operate from. How do they contact you? 

Dr Yusuf Saleeby: Well, we make it pretty easy. We have a very interactive, information-filled website. Our URL is carolinaholisticmedicine.com. So that would be one of the first, exposures. We're getting a lot of folks coming through IFM, the Institute for Functional Medicine website, ifm.org; and there's a physician finder. If they're in the area of the Carolinas or Georgia, they'll find me. ILADS also has a physician finder. So ILADS.org for anyone with Lyme disease should visit that website and they can send you to your closest Lyme doctor.

Then we have a toll free number in the United States. It's (800) 965-8482, and that again is on our website. For those calling from overseas, we do some consultation work for people outside of our region, and that number would be 843-651-9944. But the best way to get ahold of us is via our web presence, our carolinaholisticmedicine.com website.

Linda Elsegood:  That's interesting. My geography is getting better - you are on the east coast. If somebody on the west coast wanted to see you, would you do a Skype consultation, that kind of thing, if they couldn't travel to see you?

Dr Yusuf Saleeby: The laws in the United States are very different from state to state. Some have frowned upon telehealth outside of the state in which you're licensed. And we adhere to strict compliance with those laws in South Carolina and North Carolina and other states, too. Very often people come in for an initial visit, face to face with one of our providers, at our three different locations. Once that physical contact has been made, we can then comfortably meet the criteria of taking care of patients by the standard of care, at least having met them and examined them. We can do that via Skype. We use Zoom Meeting or Go To Meetings where we can screen share. So a lot of the followup is done even within our state and state of South Carolina. There are people that travel four hours to see me, and after their first encounter, we can sometimes do followups via telehealth.

There are people that come in from Buffalo, New York, from Fort Myers, Florida, that drive eight hours to come up to our office and see us. Once they make that initial contact, then we are okay. Some folks have done consultations for folks overseas, and one in particular in Brazil. We did this via telephone, and it was as a consultant only; I was not a prescribing doctor. I was only giving a second opinion on some things. The rule is at least a one-time physical encounter is required to proceed as an active patient 

Linda Elsegood: And at your practices, do you have a waiting list or can people get an appointment quite quickly with you?

Dr Yusuf Saleeby: We've built our infrastructure up pretty rapidly. I'm not the sole provider. I have a staff of highly trained - by me, and also focused on especially thyroid and now starting with Lyme - mid-level providers, a naturopathic doctor. So there's a group of us. We take a team approach. We're also bringing in health coaches to help people with remaining compliant and adherent to our programs and protocols. So to answer your question, we have positioned ourselves with keeping our infrastructure up and our staffing with very highly trained advanced providers and doctors so that there's not a huge waiting list. I know there's some practices that have a two-year waiting list and that's not us. We get people in pretty quickly. 

Linda Elsegood: Well, that's reassuring to know. Well, it's been an absolute joy to speak to you. I'm sure everybody has learned so much. I know I have, and it's really a shame that so many people are getting Lyme disease and the way it's spreading. But with more and more doctors like yourself who are helping people to find out they've got Lyme disease, and to help start treating them, surely has to be the way to go. 

Dr Yusuf Saleeby: Well, Linda, it was a pleasure speaking with you tonight, and yes, I think allied advocacy groups are making great strides and gaining ground on a lot of disinformation. And I think we see the politicization of Lyme disease kind of slowly melting away. And hopefully, the result will be more people getting this diagnosis and therapies they need, so they don't have to suffer. 

Linda Elsegood: And you've seen that starting to change already. Have you. 

Dr Yusuf Saleeby: I have, yes, I've felt it in my neck of the woods. And I know that on a national scale that's happening. There's much more awareness. It only takes a couple of celebrities to contract Lyme and write books about it to push it to the forefront of people's consciousness. 

Linda Elsegood: Indeed. And that's sad, isn't it? But a famous face really helps. Doesn't it?

Dr Yusuf Saleeby: Yeah. 

Linda Elsegood: Okay. Well, thank you very much, and we'll have to invite you back another time. 

Dr Yusuf Saleeby: My pleasure. Thank you. Bye. Bye.

 

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.