LDN Video Interviews and Presentations

Dr Carrie Jones, LDN Radio Show 16 June 2016 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr Carrie Jones shares her Low Dose Naltrexone (LDN) experience on the LDN Radio Show with Linda Elsegood.

Dr Carrie Jones is a naturopathic doctor who specializes in women's health, particularly in hormone, adrenal, and thyroid conditions. She found out about Low Dose Naltrexone six years ago through a compounding pharmacist friend, and discovered how effective LDN was for a multitude of conditions. 

In this interview she explains how she introduces many of her patients to LDN straight away with confidence, knowing it is safe and effective.

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

Nutrichem's LDN Book Event with Dr Adam Livingston (Low dose naltrexone) from LDN Research Trust on Vimeo.

Dr. Adam Livingston, PharmD, BSc., RPh.

Low-dose Naltrexone (LDN) Prescription Basics

Dr. Adam Livingston packs a huge amount of information into a 29 minute presentation on how Low Dose Naltrexone works to control inflammation and many autoimmune conditions. As a compounding pharmacist, he know the dangers of many of the drugs on the market. LDN does not have those dangerous side effects or addictive problems. He explains clearly how LDN works in our system and covers the benefits of combining LDN and .... You will learn much during this interesting presentation.

Review by Ken Bruce

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Adam is a compounding pharmacist that works extensively with bio-identical hormones, thyroid compounds, low-dose naltrexone, and customized pain creams. He is also a clinical pharmacist with NutriChem Biomedical Clinic.

As a clinical pharmacist focusing on medication deprescribing, Adam believes that prescription drugs can be a useful tool in a healthcare provider’s toolbox. However, for many chronic conditions, they simply aren’t that effective and can be quite unsafe and difficult to discontinue. Adam helps to guide appropriate patients away from harmful drugs such as proton pump inhibitors, benzodiazepines, opioids, and sleeping pills through NutriChem’s Deprescribing Program.
 

Pharmacist Kent MacLeod at the LDN Book Event 2020 (Low dose naltrexone) from LDN Research Trust on Vimeo.

Kent MacLeod, RPh., B.Sc., Owner & CEO of NutriChem Compounding Pharmacy & Clinic

Low-dose Naltrexone (LDN) & The Gut Microbiome

Kent MacLeod, RPh., BSc.Phm., is a pharmacist, as well as the founder and CEO of NutriChem Compounding Pharmacy & Clinic in Ottawa, Ontario. He is an international thought leader and award-winning pharmacist, with over 35 years of clinical experience delivering patient-centered healthcare. He is globally recognized as a hormone health and nutrition expert, has lectured at many health conferences, published research, and developed course materials for many professional clinics based on NutriChem’s success. He is the author of the book, “Biology of the Brain: How your gut microbiome affects your brain,” and his focus is on the relationship of the gut microbiome to mental health and immune function.

Pharmacist Kent MacLeod owns and is CEO of NutriChem and held this event to highlight and share information about LDN (Low Dose Naltrexone). He shares his vast knowledge about LDN as a valuable tool in healing the gut and autoimmune system. He gives a thorough explanation on the importance of maintaining good gut health, which is the key to overall health. He shares many other factors that improve our well being and health. 

Review by Ken Bruce

NutriChem's LDN Book Events with Shannon Kenrick-Rochon, NP (Low dose naltrexone) from LDN Research Trust on Vimeo.

Shannon is a nurse practitioner with a focused practice in an integrative approach including hormone management, weight management, and LDN-associated disorders. She also has a focused interprofessional concussion care clinic and does a considerable amount of teaching with post-secondary institutions in Northern Ontario.

During an LDN Book Tour, Shannon Kenrick-Rochon gave a presentation on Low-Dose Naltrexone (LDN) & Autoimmunity. She is a Nurse Practitioner who has done extensive clinical research on the topic. She discusses the many mechanisms of action involved with LDN. She also talks about the numerous conditions this off-label drug successfully treats as an adjunct. There is much valuable information packed into this 30 minute presentation.

Review by Ken Bruce

Dr Tara Thompson, 22nd July 2020 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Tara Thompson, PharmD shares her Low Dose Naltrexone (LDN) experience on the LDN Radio Show with Linda Elsegood.

Tara Thompson obtained her Doctorate from the University of Houston College of Pharmacy in 2012, after receiving her Biomedical Science degree from Texas A&M University. She joined Innovation in 2012 to advance her clinical mindset by focusing on women’s health and pursue her love for compounding. 

Tara collaborates with providers and patients across the US who are interested or presently using compounded medications to treat women’s health. Her areas of expertise and extensive research include Female Sexual Dysfunction, Pelvic Health, and Hormone Replacement Therapy. She currently serves as the Vice President of Clinical Services at Innovation Compounding.

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

Dr Harpal Bains on the LDN Radio Show 2020 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr Harpal Bains specializes in hormone therapy and discusses the many situations where it is most effectively applied. She describes how testosterone levels are tested and how they can be increased along with Low Dose Naltrexone. She is one of those open-minded doctors who will research and utilize new methods versus sticking to what is taught in medical schools.

Shivinder Deol, MD - 27th Nov 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today, my guest is Dr Shivinder Deol, who's an MD, certified in family medicine and anti-ageing and regenerative medicine. Dr Deol has served at Bakersfield, California community as medical director of the anti-ageing and wellness centre for over 35 years. He specializes in integrative preventative and family medicine as a primary care provider.

Thank you for joining us today, Dr Deol.

Shivinder Deol: Thank you for having me. 

Linda Elsegood: So could you give us your background? Where did you train?

Shivinder Deol: Sure. I studied in a private school in India, one of the top leading medical schools for some medical college. Graduated from there in 1975 and then I came. I did a course a year off a residency in India, and then I came and joined a University of Tennessee, Memphis and did my training in medicine, psychiatry, and family practice.

And then, I've been in practice, since 1982 in Bakersfield, California. I've taken extensive courses in regenerative medicine and anti-ageing. So my training, even though it was initially more family practice, and I'm board-certified three times and family medicine, but my interest went towards more integrative medicine and functional medicine. For the last 15, 20 years I've been doing more of that. 

Linda Elsegood: When did you know you wanted to get into medicine? Were you very young?

Shivinder Deol: No, I wanted to be an army man. My family is a strong army. But my mother wanted someone to be a doctor. So my older sister, then my brother, passed out and did not go into medicine. So my mom said:" You got to do it." And I said: "okay". I got into medicine, but I'm so glad I did because I think it was my calling and I really had an incredible journey.

You know helping people, learning and growing myself with medicine.  

Linda Elsegood: I mean, things have changed, haven't they? I mean, you must have seen it from when you first qualified. What was it? 1975 where you went to the doctors, you told the doctor what was wrong and they, I remember it well.

I got married in 76 that people had their symptoms treated. But they never actually had the root cause treated in those days, which then eliminated the need to treat the symptoms. So, you know, what is it you actually do in your practice? If a patient came to see you with complicated symptoms, why would you start?

Shivinder Deol: You know, we would just, you know, and it was a great business for physicians and all patients came in, they got better and it was just an ongoing process, drug after drug after drug, and then treating.

So no one really was treating the whole body or looking at the real cause of a disease. It was taking care of symptoms now and we'll worry about the things later. 

Linda Elsegood: Yes. So what do you do now? 

Shivinder Deol: Now my focus is changed more.  When a patient comes in, my focus is more nutritional based, first and foremost supposed thing I'm really interested in finding. So this to me, the most important thing anybody can do is improve their nutritional status because a body is constantly working and regenerating itself.

So we estimate we have close to 30 trillion cells, but out of that, almost 700 billion cells are being built every single day of life. And we have hundreds of nutrients and the food that they're eating, which is processed, and with cold storage and with cooking, microwave, we've destroyed a lot of the nutrients that the body does not get all the raw material it needs for all its needs that all the regenerative and repair needs on a daily basis.

So my focus is nutrition and then I do a lot of things with detoxification, removing chemicals, toxins, poisons, reducing inflammation in the body through Iv therapies, chelation, all kinds of different things, hyperbaric. And then we do more stuff at balancing hormones and neurotransmitters to optimize health, brain health, heart health, and overall, you know, endocrine help.

So we do a variety of things to help the body improve rather than just fixing. A sore throat, some,  my aim is if I can prevent a single heart attack, a single stroke, single cancer, we do a lot of protection for breast cancer, for instance. So, basically, if we can reduce any of these massive major diseases, it's far better than, you know, treating the simple sore throats and colds and allergies that most people will have, but they don't really affect on lifespan with these scans.

Linda Elsegood: Okay. What kind of testing do you do when you're probing the patient to find out the wrinkles? 

Shivinder Deol: Yeah. So basically, you know, the insurance companies, of course, we are all kind of stuck with insurance companies to some degree. So the standard blood work that insurance companies cover, I do that but for instance, in a standard blood test, a lot of doctors will do as a free T4 and a TSH. But the key hormone and thyroid, for instance, is there a free T3 which is the active hormone and not T4. So unless we look at three-T3   and reverse T3, you really know what the thyroid function is.

So I look at more in the functional way of looking at health and so we do a lot of hormone testing, but the best way to test hormones are either through a saliva test or a comprehensive urine analysis. And typically insurances don't cover that. We do testing for heavy metals and for chemical toxicities.

So there's a really nice chemical toxicity test that looks at literally hundreds, if not thousands of different chemicals that we have been exposed to. We do food allergy testing, again, not the one that's covered by insurances, which is an immediate food has to be, but more a delayed food sensitivity test.

We look at a comprehensive digestive stool analysis. Look at gut health, gut inflammation, and see if there's an imbalance between the good and the bad bacteria in the gut. So a variety of other specialized tests that we do that can look at the body in a more natural matter. So trying to hit the cause rather than just the symptoms or repair.

Linda Elsegood: And you mentioned hyperbaric oxygen there. For people that are not familiar with hyperbaric oxygen, could you tell us what it is and how it works and what results you have seen?

Shivinder Deol: Sure. So hyperbaric oxygen is basically,  you're in a large chamber, which we are pumping in oxygen under pressure and under the, if you have some, some people remember the physics, the Boyle's law.

They've been, we put pressure, any of the gases are absorbed deeper and greater into the tissues. So when we pump in the oxygen, it goes into every joint, every fluid in the body, including the spinal CSF (cerebral spinal fluid). And so this increase oxygenation. It helps you the healing process in the body.

So if you can put oxygen into any tissues, the body starts to repair process and also discourages cancers, infections of all kinds of any chronic diseases. If we can put the oxygen, the body will start the repair process and use, any of the toxic effects off infections or, other pathologies.

So it's a great way to treat strokes or heart disease or traumatic brain disease, injuries of any kind, surgeries of any kind. So, for any surgery, if you were to get a hyperbaric treatment one before and two or three treatments after surgery, you cut down healing time in half, you cut complications in half.

So it's a very nice way to help repair the body. Also, injuries of all kinds, helps repair, very, very nice treatment, and very safe. I've been offering that for over 20 years. 

Linda Elsegood: Is it covered by insurance in the US?

Shivinder Deol: Unfortunately not. There only seven indication for which a Medicare will pay for and things like diabetic ulcer are non-healing ulcers, but you know, severe diseases they are willing to pay.  For minor issues, you know, they will not pay.

So it is typically a cash payment.

Linda : Elsegood: Is it very expensive?

It depends. So in our office, we charge to believe by the $150 to $200. There are some places, where they are in the three, $400 range. And some places, if they are using a smaller chamber, low pressure, they even offer it for like $125 a soul. But if you use a high-pressure chamber, you know, it's going to be about 150, $200, at least, if not more.

Linda Elsegood: Hmm. It's that for an hour?

Shivinder Deol: That's for an hour. But by the time you get in and out, it's going to almost be an hour and a half. So it takes about 10 minutes To get the pressure optimized in by us, then to brings the pressure down. So it's almost like an hour and a half a treatment. 

Linda Elsegood: I actually had hyperbaric oxygen when I was first diagnosed but it took me about an hour to get there and an hour to get back. It was very, very tiring because fatigue was bad. But I have claustrophobia and I was not really thinking about it, but it was quite a big tank and I think it sat about eight people. So I sat in this tank and I was thinking how am I going to feel when they close the door?

I'm really nice. And then they came out with these masks you had to put over your face. Oh, that was a testiness itself. But I, I have kind of got used to.

Shivinder Deol: We don't use a mask for this reason because it is so much closing feeling and our chamber has three different windows that you can look throughout.

So yeah, there is some claustrophobia, but it's really not that bad. 

Linda Elsegood: This small porthole but they are up high. So you couldn't actually see out. You could just see the other people who were in there with you for that.  Was quite an experience but unfortunately, it was run by a charity and it closed down many, many years ago now, which is a shame because I think they did some really good work though. So with the testing, one of the things that people quite often ask me about is Candida. Do you do Candida testing? 

Shivinder Deol: Of course, and Candida is almost like cancer. So candida basically get thin, and it's very hard to clear Candida out of the body. So yes, we do quite a bit of testing for candida because I think of candida as a very severe, but just to be insidious, it's very quiet, a low-level infection that can just, go on for years causing a lot of damage. But people not even, sometimes be aware of it, and in the long run, can lead to greater complications in losing potentially cancer.

We made it, we believe that it may be a cause of.

Linda Elsegood: Well, so many people have asked me that they do a saliva spit test in a glass of water or something and I don't know how accurate that is. But people tell me that they try these remedies to get rid of it and they can't, and they've been to doctors and they've still got it. You know, if you have a persistent Candida problem, how do you go about fixing it?

Shivinder Deol: Well,  basically that is several things. But candida loves sugar. In fact, every bad bug cancer loves sugar. So to treat any chronic infection, the first thing you have to do is cut out the sugar, cut out the carbs, and remember all carbohydrates except fiber break down to sugar, all of them. So people will cut out sugar, but they don't reduce the carbohydrates, and it's still on getting sugar in the body.

And as long as you're getting sugar, the candida is going to be almost impossible to kill. So the diet, again, comes in really important on a low carb diet. And then we may want to make the environment on hospitable for candida. So whatever the candida likes, we would cut that.

So keeping the body made more alkaline, keeping the body more oxygenated. So using oxygen and ozone therapies. And really helped clear it up candida. But Candida will generally require a prescription medicine plus several strong probiotics, Saccharomyces, and several antifungal herbal supplements to help fight the candida.

And it's a longterm treatment. It's not a quick course of treatment that'll help clear it. 

Linda Elsegood: Wow. 

Shivinder Deol: It requires a long process treatment. Yeah. 

Linda Elsegood: I didn't realize that it was so difficult to get rid of. 

Shivinder Deol: It is. 

Linda Elsegood: So how long ago was it when you first heard about LDN? 

Shivinder Deol: I think it's been, well, over ten years or even longer than that, that I've been using and that I heard about LDN.

And I think, I'm not sure if I heard it in a conference or if one of my patients came to me originally initially and asked me about it, but I think it was over ten years that I used it and the first patient that I actually use it on happened to have such a dramatic result that kind of opened my eyes.

So this lady had severe Hashimoto's thyroiditis and her tilters were in several. And so we treated her with the LDN plus a few other things, lifestyle changes, iodine, cut out gluten and so on. And her tilters started coming down dramatically, and about a year, year and a half or titers were back to completely normal.

So we had cured her now, Hashimoto's, and this was, I believe, strongly related to the use of LDN. And, so that was a very strong eyeopener for me on this, on LDN and its potential efficacy. And since that time, I've used it on a whole bunch of other patients for a whole variety of other conditions. But fortunately for me, that I had, my first patient responded so well that, it really made me a believer.

Linda Elsegood: You said that you've treated in lots of conditions with LDN. Do you have any other case studies that have been remarkable in your practice? 

Shivinder Deol: Yeah, a few others. So I have a patient with severe ms. Was very fatigued, but she's got severe tremors and she was extremely fatigued, and so I put her on LDN, and within days she could tell the improvement in energy level and the fatigue had improved very, very nicely. But unfortunately, I did not see, or she did not see any improvement in her tremors. But as far as the energy level and a mood, she comes in smiling every time. Poor thing is shaking a lot, but she's smiling. And so it improved certain parts. I had another patient who came to me from New York and stayed with me for one week.

She was on heavy pain medicine, fentanyl and morphine for 30 plus years for back pain. I got her detoxed completely within one week, and I use an IV, NAD, which is an incredible nutrient to help with the detoxification, increasing energy level and then up, put her on LDN. And this lady wrote to me about a couple, three weeks ago saying she felt so wonderful and that she has not had a single pain medicine.

In fact, she said, I don't even take Advil orTylenol but rarely for pain now. And she was really grateful that she had done so well and all for 30 years, her life was all around pain, medicine, pain medicine, and so that was a very nice response. 

Linda Elsegood: Oh, that's amazing because if you're in constant pain the whole time, it must make you feel a little bit irritable and short with people because you have to deal with that level of pain. You can't live your life normally in pain. It's not possible. Is it? 

Shivinder Deol: Right. But see, unfortunately, that reality is, what people don't realize is that acute pain and chronic pain are not the same pain.

And it's a completely different set of effects, a completely different disease, acute pain. So somebody has an acute practice, acute injury, acute surgery, that's a completely different, set of effects in the body versus somebody who's had chronic bad back pain or neck pain or whatever for 10, 20, 30 years.

 There our need for pain medicines are different. They are now just dependent on getting that  pill, of course, rather than the true pain itself. So it's become more of a withdrawal-type pain and not a lot of ease. Opioid receptors are tight, are doubted out, and so the effectiveness goes down.

But when we use something like LDN, we recharge our opioid receptors. We reactivate them. We produce a resounding amount of receptors so that we are having much better, pain relief without the need for any external medicines.  

Linda Elsegood: It always amazes me how such a small amount of naltrexone can actually be more powerful than the fentanyl and morphine.

It's hard to understand.

Shivinder Deol: It really is. But you know,  I'm a true believer of this. The body is a true miracle. And the ability of the body to repair and regenerate itself is just incredible. Our challenges that we have, that our diets are horrible. We are living in a really toxic lifestyle. And then we have all these other stresses that are influencing neuro-transmitters and our chemicals and our hormones.

The body doesn't get the opportunity to repair and regenerate itself. So when the state garbage out of the body on necessity, medicines and toxins out, we balance some of the nutrients. We helped the body produce its own good nutrients and endorphins. The repair process becomes really dramatic and the body can pretty much heal anything.

So I see a lot of miracles, but it's really not a miracle. That's what the body is designed to do is to help. He looks healthy all the time, regardless of what's going on. So we are great healers.  

Linda Elsegood: And you were going to give us another case study before I butted in.

Shivinder Deol: I did not understand. 

Linda Elsegood: You were going to tell us of another case study. Another patient. 

Shivinder Deol: Oh yeah.  A cancer patient. Basically patient comes to me with metastatic cancer. LDN is great in supporting cancer. You can literally help stop cancers from spreading.

So this patient basically the doctors told him that just go home and die and he's a relatively young guy and he doesn't want to die. You know, who does? So he came in, you know extremely tired, extremely tired, and just basically depressed, no energy and kind of giving up. But the wife is wonderful.

Wife is so supportive of him. And so we've started him on a high dose, intravenous vitamin C, 75 grams three times a week. And he started feeling a little bit better. And then I added LDN to his regimen. I've got him on a lot of different things. So put him on a keto diet, very strict Keto diet.

And so we put LDN on, and his mood has improved a lot that he can tell, and he is now able to start to do a few things. So I don't know what the status of the cancer is. It's too early for me to do any scans on him, but I'm certainly hopeful that with his mood outlook, comparing his energy is improving that maybe we're going to get a decent result on his very widespread metastatic cancer.

...

Linda Elsegood: Well, I believe we've now come to the end of the show, so that has been amazing. When very quickly, would you like to tell patients how they can contact you if they wish to make an appointment? 

Shivinder Deol: Sure. My website is antiagingwellnesscenter.com. 

My email is support@antiagingwellness center.com and, the office phone is 661 325 7452.

Linda Elsegood: And do you have a waiting list? That's the other question.

Shivinder Deol: Do I have, what? 

Linda Elsegood: A waiting list? Do people have to wait to see you? 

Shivinder Deol: No, well we basically work people in. My philosophy always has been that we are in a service industry. We are providing a service. And  in the service industry, if you have, your electricity is gone, and you call the electrician, and he comes a month later, it doesn't work.

Or your car is broken down, you know? So if someone comes in that needs to be seen now, I'll see them the same date. I don't care. They may have to wait a little bit. We may have to work a little harder, but we take care of somebody who needs to be seen when they need to be seen. So I don't keep awaiting this for this reason.

Linda Elsegood: Oh, that's wonderful! Well, once again, thank you very much for having been our guest today, 

Shivinder Deol: Linda. Thank you very much and you take care.

Linda Elsegood: This show is sponsored by Dickson's chemist which are the experts in LDN at associated treatments in the UK. Dickson's chemist, the most cost-effective for LDN in all forms within the UK and Europe maintaining safety standard of what is required. Why would you choose to get your LDN from anywhere else?

Call 01414046545 today to speak to a LDN experts 

Any questions or comments you may have, please email me, Linda@ldnrt.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.

Dr Kirsten Singler ND - 4th September 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today, my guest is Dr.  Kirsten Singler, who's a naturopathic doctor from California. Thank you for joining us today, Kirsten. 

Dr Kirsten: Thank you so much for having me, Linda. 

Linda Elsegood: So first of all, can you tell us,  what made you decide you wanted to become a naturopathic doctor? 

Dr Kirsten:  I was in my twenties going to graduate school on a completely different life path and I got really ill. And I think this is common amongst other physicians that are really passionate and have that drive for good patient care and have that personal experience.

In my twenties, I got really, really sick. I wasn't able to go to my graduate program, and I wasn't even really able to leave the house. And I went to multiple doctors and at that time I only knew really about mainstream medicine. And so I would go from doctor to doctor, and no one could figure out what was going on.

 I thought that I was so healthy because I was a raw food vegan and was so conscientious of what I put into my body, but still couldn't function properly. And a friend of mine took me to a naturopathic physician who did acupuncture as well, and it was so phenomenal. The doctor that I saw, a Dr.Brennan McCarthy in Arizona,  told me I would be better within two days, and this was after two years of really being ill. And in two days I was better and after that, I was determined that this was going to be my life path. I was so struck by it and even to remember it now I get goosebumps that something that was so grievous in my life turned out to be maybe the best gift that ever came into my life.  

Linda Elsegood: if you don't mind sharing what’s the issue that you had what? What was, did you get a diagnosis. 

Dr Kirsten:  I won't go into too much detail because it was female problems but it did have to do with hormone imbalance so severe that  I was basically very, very anaemic and that's why I wasn't able to function.  Now that I look back on it within the mainstream, none of the physicians I saw really evaluated my iron, my ferritin, those main indicators that now, of course, I run on every female patient that comes in our office, but at the time, nobody did that workup on me.  

Linda Elsegood: okay, when did you qualify as being a naturopathic doctor?

Dr Kirsten: That was in 2015. I graduated from SCNM in Tempe, Arizona. Before becoming a naturopath, I did work as a nutritionist and a herbalist and did consultations for ten years prior to that.  

Linda Elsegood: so knowing that acupuncture works so well for you, do you do acupuncture in your practice? Is that a.therapy option?

Dr Kirsten: Absolutely. Currently, our practice is so busy that just this year really, I haven't been doing acupuncture on patients directly, because it's more time consuming for each patient. So I refer to another person too. I did do the acupuncture prior to that  I absolutely did perform it, and I love it as a therapy.  

Linda Elsegood: okay. So when did you hear about LDN? How long ago was that?

Dr Kirsten: So in fact, the first time I ever heard about LDN was due to your book, the LDN book, it was my first Hashimoto's patients in the clinic. So this was when I was a student, and I had my first autoimmune case and my supervising physician,  handed me the LDN book, which I poured over. And then tentatively started my patient on it and had such good success. Then it's been part of my toolkit ever since. 

Linda Elsegood:  So what conditions would you say you have seen to date.

Dr Kirsten:  I don't mean conditions, which is broad, you know, autoimmunity covers like Hashimoto's, rheumatoid arthritis, lupus,  autoimmune, hepatitis,  dermatomyositis. That's a skin condition, a case of polymyositis. And that's—kind of a muscular, joint pain type condition. Ulcerative colitis, Crohn’s of course and fibromyalgia. I use it a lot for those cases. I've had pain conditions like trigeminal neuralgia work successfully with that. Also undiagnosed chronic fatigue.  

Linda Elsegood:  Well, I know that you said it was one of the tools you have in your toolbox. You know, if a patient came to you with let's say, Hashimoto's, what therapies would you use?

Dr Kirsten: Well, we want to primarily work them up for figuring out what's their root cause, right?  And figuring out what are the obstacles that they're facing. And then also evaluate their basic function. So we want to always pull back. 

You can look at the big picture of their health, and it's kind of zooming out from what their symptoms are, like the trees in the forest, and we want to zoom out and look at the forest and evaluate them for external environmental triggers. Which for Hashimoto's I feel is almost always the case that they have some form of, and for autoimmune in general, some form of external stressor, whether it's a psycho-emotional stressor or a toxic exposure like heavy metals or chemicals or some kind of physical trauma. Or exposure to some kind of pathogen, like a mould or a viral or a bacterial thing going on.

So we want to assess them for what's going on externally and then treat that. Say a patient comes back with high Epstein. Bart titers. Then we're also going to accompany the LDN with an antiviral protocol and an immune-boosting or calming protocol. Then we also want to look at what's going on with them intrinsically. Such things as what kind of inflammatory or immune dysfunction is maybe inherent. Or could have been going on lifelong, like how intact is their gut function, were they breastfed his children, were they put on multiple antibiotics, what's their formative nutrition were they raised on condensed milk, sugar and formula? Or were they fed a nutrient-rich diet, or is there a genetic polymorphism going on right. These are snips, changes in their DNA that affect their enzymes. And that can lead to saying, an inability to convert something like selenium in food. The active form in a Hashimoto's patient, their thyroid needs the conversion to perform adequately.

So if they have those kinds of polymorphisms and we want to be moving forward and making sure they get the right form of the vitamin and then evaluating them for other intrinsic type conditions like what's going with food intolerance. Do they have some kind of lactose intolerance or a food sensitivity that's affecting their gut that may be leading to an inflammatory cascade that's affecting their whole body or inhibiting their ability to absorb nutrition?

So it's really zooming out and figuring out what are the areas that need addressing and creating a pretty comprehensive plan for them. And then just taking baby steps with that plan wherever the patients are, you know if they're, say, a mechanic in a garage and they're getting lots of chemical exposure at their profession. And  I'm thinking, Oh boy, this guy's got to get out of that garage. Also, I'll start them on a detox plan and educate them about learning how to make better food choices. So at least he's reducing his toxic burden in his food. And then with the goal of figuring out how he can still maintain his profession without having so much exposure. 

Linda Elsegood: You mentioned heavy metals. How do you treat somebody who's been tested for having had? 

Dr Kirsten: So there are chelation protocols. And for the most part, naturopathic doctors are trained in this. We all take classes in environmental medicine and it's required, at least it was required in my program, to have an environmental medicine shift.

And the chelation can range from oral chelators (those are substances that will bind up certain metals, like bind up, lead, bind up mercury, and pull it out of the body through the alimentary canal).  There are other chelators, more aggressive, like IV solution. Now I don't do IV chelation.

If a physician is going to do IV chelation, that's all they should do because there can be so many side effects and patients have varying degrees of tolerability, especially when they're sick. But, the oral chelators are slower going and keep the body more in a state of homeostasis.

Linda Elsegood: Okay. How long does it take if you do it orally?

Dr Kirsten:  It varies on the vitality of the patient, the severity of their condition. You know, if, if they have like a severe Parkinson's and are wheelchair-bound versus mild exposure to lead that was stored when they were children. And then they don't have a current exposure and don't really have symptoms. So the vitality of the patient matters. The severity of pathology matters and then the degree of exposure. So has it been like lifelong, for example, you know, were they raised with it? Out on the dock here in California, we have a lot of dockworkers and there's a lot of pollution from the ships coming in, you know, a lot of inhalants.

Were they always there, out there on the docks, since they were kids up until adulthood and now adults, they're working on the docks or you name it. It really does vary based on the individual and their exposure. 

Linda Elsegood: Sure. Okay. So if you had a severe case, and they were on oral, would they have to be on it for a year or longer? You know, if it was a really bad thing. 

Dr Kirsten: If it was a really bad case. Okay. Say, somebody came back, and they had a severe pathology plus very high levels of heavy metals in their system. We would want to start figuring out where's the exposure coming in and remove that access. And second to that, take it really,  really slowly because it takes energy to detox. So when a patient's really sick, and they don't even have the energy to get up and walk around, perform daily activities, you want to drive up their vitality. So that could be starting with doing IV therapy, like IV vitamin C so that you're boosting up their immune system, boosting up their vitality, and then  build them up while you are slowly, intermittently, chelating them. So for a severe case, I guess the rule of thumb is for every disease a patient has, you're spending a month of active therapy. So if somebody has been ill for 20 years, you want to anticipate 20 months of active therapy. 

Linda Elsegood: Wow. 

Dr Kirsten: Okay. 

Linda Elsegood: Yeah. I'm just thinking of the age that I am. If you went back it would take 

Dr Kirsten: forever. It depends on vitality too. So some people inherently have phenomenal vitality. I had a Parkinson's patient, and she was wheelchair-bound and she had a full manifestation of Parkinson's and her medications were not adequately treating it. That's why she ended up on my doorstep. She was looking for something else. Actually, her children were looking for something else for her. She just inherently had such good vitality that as we started doing the IVs, it was really within three months that she was up out of her wheelchair. And walking around and could smile and could talk. And, you know, the first day I met her, she was mute, she couldn't smile or talk to me. So it does vary from patient to patient. Absolutely.  

Linda Elsegood: It's interesting that you said about Parkinson's patients. I have a friend who I went to college with who has Parkinson's and she came last week, and it's very difficult for her to get up.She's still walking, but when she goes to go through, or whether it's the stress of going through the door, I don't know, but she starts to do what she calls a dance, and she's popping up and down, and she can't get her legs to move. And it's every door that she goes through. Where would you start with somebody like that? Do you think maybe she has some of these conditions cause it's not that easy in England to see a naturopathic doctor. So that is a challenge in itself. 

Dr Kirsten: In England, do you all have evaluations? Do they evaluate for heavy metals and chemicals? Do they have tests like that? 

Linda Elsegood: I wouldn't know. I've never had a test. I have multiple sclerosis, but as far as I know, I've never been tested 

Dr Kirsten: There is a lab company that we use a lot. It's called great Plains labs and, I think that they are available internationally and their evaluation is through either urine,  stool, and saliva evaluations.And I think that that might be a place to start. She could look into that lab company and see if one of her physicians would be willing to run that lab and find out what kind of chemicals are going on. If there's heavy metal exposure, usually heavy metal testing is within the mainstream, you know, it's like a urine evaluation. I could look into it further and find out resources in your area. I can always email you. 

Linda Elsegood: Okay. That would be really interesting. That's good. We will have to have a look at that. She certainly could use some help. So have you found that your patients that take LDN and thyroid medication that they have to be very careful and reduce their thyroid medications?

Dr Kirsten: Well, yeah. Thyroid in my experience is ever-changing.  I've had patients that reduce their thyroid script just based on removing inflammatory foods from their diet.  So the better the gut functions, obviously the amount of inflammation is going to go down, which calms the autoimmune response. Number two, they absorb their medications more efficiently. So, a good rule of thumb that I always follow is I  run my labs every six months on the patients, and I'm always expecting them to change. Every once in awhile patients will come back stable. You know, these are people that have already seen naturopaths for years. They know their body. They're on a really good health program. But when people are first starting out, I am expecting to modify their scripts.  

Linda Elsegood: now you talk about the guts, and you did say at the beginning that you used to be on a raw vegan diet.  Is that the diet you're still on. 

Dr Kirsten: I'm not, but I do really subscribe to a philosophy of eating a lot of vegetables.

I get most of my nutrition and most of my food from vegetables. But they're going to be cooked and varied. And I'd say I'm definitely omnivore.  I think everybody should get most of their nutrition primarily from a vegetable source. 

Linda Elsegood: Now looking in supermarkets, and especially people that have several children to eat healthily,  it's very expensive.  I would think it's out of the reach of a lot of families where they have several children, you know, do you think in years to come, we're going to get rid of this high sugar, high salt, snacky type food? Do you think we will be able to educate people? You know what you eat, you know what goes in the gut really does affect your health.

Do you think that is likely to happen or is that just me being in cloud cuckoo land and you know, cheap food is going to always be there, and it's going to be full of sugar and salt, and people are going to continue to become type two diabetics because they are upsetting their immune system and having autoimmune diseases and thyroid problems and the like, you know, what's your opinion?.

Dr Kirsten: You're right. Similarly, I might be too idealistic, but I think that as they're teaching in the schools, and they're teaching children how to grow vegetables and cook,  that it all comes down to being able to cook for yourself. So I'm going through school. You know, when I was too broke to even buy toothpaste, right? I put myself through medical school and worked full time during that time and definitely knew financial pressures. Even during that time, I still cooked for myself. And you know, what I cooked was a lot of beans. I cook rice, and I cook a whole grain and actually did grow vegetables in my little garden in Arizona.I was successful in that way, but that all comes down to education. You know, cause I was raised in a family, that taught me how to grow vegetables and taught me how to cook beans and sprout seeds and like that. So for me, it comes as like second nature. I know it very well, but I think that with education, that will change.

And that's what I'm really hopeful for and excited about out here in California. There are lots of programs,  to educate kids on how to grow food and cook and changing the food systems within the school districts. And I hope that it just spreads throughout the United States, everywhere.

Linda Elsegood: Yes. And you know, if you went to buy, if you've got four children and you went to buy four apples, you know, the mother might go for the cost of the four apples of buying what we would call biscuits. You call them cookies and crisps, which you call chips and could end up with a basket full of snacky foods for the same price as for apples.

Which would be gone in minutes, you know? And that's what I find really hard. You know children are being given the wrong foods when money is a problem, which then causes lots of other issues further down the line.  I don't know if we can get healthier food at a more reasonable price. Yes, that might be an answer, but of course, it all costs money too for the farmers and things to supply the supermarket chains that also have to make a profit. And so it goes on. But it would be nice if all the snacky foods became slightly healthier as we go on, we have the sugar tax here. I don't know whether you have that yet, and they're trying to reduce the amount of salt that's being put in pre-packed food. So that's the style. But I think things have got to go a lot further. I mean, we were far healthier. I'm 62. My mother, when she was growing up, she grew up post-war, and they were very limited to what they had.  I think she was quite old when she had her first banana. She'd not seen a banana or an orange.But they lived on a farm. Had a pig, and a cow, and then when they slaughtered one of them, all the neighbours had bits and pieces, and then when they slaughtered something else, everyone got some of those, it was all similar to a barter type system. And they grew vegetables, so she only grew up with fresh meat, fresh fish, and vegetables. And  I think they as a generation were far healthier than my generation where, you know, fast food came in, you know, all of these prepacked foods, which I mean, in my mother's day, they didn't have, 

 I think we need to, instead of carrying on the path we're doing is to revert. Act how it was years ago in that eating your own vegetables. But for some people, that's still not an option if you live in a flat.  And you've got no way you could, you could grow things, but that's really interesting, What do you say about, if you had to give me the names of four top supplements that you mostly use. What would they be? 

Dr Kirsten: Oh, that's a great question. The pharmacist that I talk to the most, I send a lot of the patients to our compounding pharmacy and he was teasing me that I use magnesium for every single patient, which I have. I would say, okay. Magnesium is definitely on the list. I do think that people benefit from magnesium and commonly vitamin D. I've run a vitamin D lab on every patient, and they almost always come back in the deficient category. You know, I don't think it has to do with sun exposure. Everybody's either using sunblocks or staying out of the sun, and not eating vitamin D rich foods.  I almost always prescribe vitamin D3.  I would probably put some B vitamins in that cluster of supplements too,  so many of our patients, again, are compromised with their absorption. So either they're having issues, they're on like a. Proton pump inhibitor or there's something going on in the gastro system, and their B vitamins are deficient. Whether it's a B6 or a B12.  So I'd maybe put a B complex for those. And, getting back to the gut, I put almost every patient on a probiotic eventually. So it might not be the first go-round that we meet. But most people I think are gonna benefit from a good pharmaceutical grade probiotic.  And then. I will eventually put most patients on a detox.

So that could be mild. I could be taking botanical teas that helped move their liver and get their liver to function better. Or it could be more aggressive, like a box kit,  like something like the Standard Process detox kits cleanse that takes them through a list of foods that they can eat, have a list of foods that they can't eat, and then supplements that are really going to be pushing their liver through the phases of detoxification. I think that that would be my general toolkit for most patients. 

Linda Elsegood: So with the box detox kit, how long would you have to eat certain foods and restrict. 

Dr Kirsten: Well, there's a low intervention kit, by a company called Metagenics. That's a ten-day cleanse. And I like that when patients that have never done a detox before in their life, it helps them get confidence, know what to expect and get results. So usually, it's a one week cleanse and usually they're gonna feel more clear-minded, have good energy, and almost always lose weight because that's another component. Patients are always tracking their weight. Usually. And, it bolsters them. So after they've done a ten-day detox, then they could graduate to, you know, the next time they need to do a detox. they could do a month-long,  a 28 day cleanse.  I like to start patients where they're at. You know, sometimes I get a patient that has done multiple detoxes and then we can go straight into month-long cleansing. But I usually am going to start where they are. 

Linda Elsegood: Well, it's been amazing talking to you. I'd love to have you back another day and find out more from you. 

Dr Kirsten:  I would love that. 

Linda Elsegood:  Well, thank you, Kirsten. Absolutely amazing talking to you, and thank you. 

Dr Kirsten: Oh, absolutely. It is so nice to get to talk with you, Linda. It really means a lot to me. I've admired everything that you've been doing for a long time. 

Linda Elsegood: Thank you very much. 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 Markdrugs.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 appreciate it. Until next time, stay safe 

Thyroid Autoimmunity: Causal Relationships & Novel Therapeutics (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Links between growth hormones, sex hormones and the thyroid gland; their effects on sexuality, musculoskeletal function and immunity. Gut repair protocol. Positive effects of LDN, including in diabetes.

Let's begin with a cursory review of auto-immunity. Of course, many of us here understand all of this, but let's go through it as it specifically relates to thyroid. Thyroid autoimmunity begins with some form of environmental trigger. One good example is an antigen from food allergies, and we've been hearing a lot about that this weekend. An APC, or an antigen presenting cell, presents the antigen to a CD4 cell, and the cascade we see here is triggered. So classically, we believe Hasimoto's to be TH1 dominant. But this graphic, modified from an article published in 2002 in Nature Reviews Immunology, proposed that autoimmune hypothyroidism, or Hasimoto's thyroiditis, results from both B cell and T cell activation, which could be both TH1 or TH2 dominant. Both mechanisms are generally occurring. I think that's important. However, they do propose that for autoimmune hyperthyroidism, or Graves' disease, it’s largely B-cell and TH2 dominant.

We also have to appreciate the classic TH1 versus TH2 models being challenged. There are other discovered classes: we've got a less known TH3, there's another one called TH17 with its own chemotactic components which LDN has been proposed to influence and to modulate. The excellent thing about LDN is its ability to influence both TH1 and TH2 and TH2 dominance over other immune classes, due to overall immune modulation. This would be particularly important in Hashimoto's, as it seems to be both TH1 and TH2, and or some other immune class known or unknown. So again, immune modulation is the key to be achieved through all these multiple therapeutic vectors.

We've got four therapies here to consider, to create and reestablish immune modulation. There are others of course, as we all know, but these tend to be the most direct routes, at least for us at our clinic. So of course, LDN, as I just stated, one of the great things about LDN to wield as a therapeutic tool is this ability to sort of modulate the immune system. It's clinically forgiving, and the patient benefits. Also, the use of thyroid hormone product that contains both T4 and active T3. My particular practice focuses on comprehensive hormone replacement therapy that considers estradiol, progesterone, testosterone, cortisol, insulin, growth hormone. We know that estrogen, progesterone and cortisol tend to increase TH1, whereas testosterone, DHA, and androgens tend to influence an increase TH2. The balance of course is important. The consideration of all these hormones comprehensively will provide optimal immune modulation. And finally, the gut. We've been hearing a lot about that this weekend. We know that the gut is associated with immunity, and its dysfunctions related to opportunistic infections, food sensitivities, dysbiosis, and autoimmunity in general.

We've been tracking observational internal data on LDN and thyroid antibodies for the past about two years, the best we could in a very busy practice. Since Hashimoto's is far more common than Graves' disease, we placed our focus on Hashimoto's. We presented a total of 53 patients; they're replaced in two categories: LDN-only, and LDN with a gut repair treatment protocol. It's really important to note that the LDN-only group is also receiving comprehensive thyroid nutritional hormonal support - please don't think that it's just that. We deal with things very comprehensively in general, but what I'm trying to say is that there's a difference between the LDN-only group versus the people who were also on some kind of specific gut repair protocol that I'll explain in the next slide.

We simply calculated the average thyroid peroxidase antibodies and the average thyroglobulin antibodies, then we calculated the average values of each after a length of treatment. You can see the average there. We've got far more patients in our practice on LDN than this sample here, but we only included patients who had at least one follow-up lab to show a calculable difference in their antibodies, so we excluded some out. The LDN-only group of 39 patients with an average treatment time of about 13 months, showed a very significant antibody drop, particularly in anti-TPO, which is of course the most common autoantibody, but of course we always check both. Beginning average antibodies on gut repair patients was much higher and the change was also less significant. This is consistent with the general observation that significant gut compromise is related to autoimmunity; and as we'll see later, that compliance to gut modifications is significant.

The patients who chose to do the gut protocol in general had the most obvious outright symptoms of gastrointestinal distress, hence motivating them to want to do the testing and follow through with the diet and the supplement commitment. So again, compliance. We can see that the decrease in thyroid antibodies in the LDN plus gut repair group was not as significant as the LDN-only group. This could be due to compliance and adherence to the gut treatment protocol, and the very small sample size of only 14 patients versus the 39.

So why did we do this? Why did we track this? What was the motivation? One, we want to make sure that we're incorporating a treatment strategy that was indeed effective at lowering antibodies. We wanted to see. Two, at least to my knowledge, there's little direct evidence and research about the use of LDN and its specific effects on thyroid antibodies, at least by what I could find If I am wrong about that, I encourage someone to let me know at the end of this presentation. Then three, because I'm a dork and I genuinely like to play this game and I like to crunch the numbers and see what we can find. We seek to add to the body of knowledge about LDN, however humble and modest this observation and methods are. It is our hope that other prescribers of LDN do the same as we have, or at least inspire the call to other researchers to provide in-depth analysis and results about LDN specific to thyroid autoimmunity.

Here's the gut repair protocol, a little bit of detail. We start off with a serum analysis of IgG reactivity to 154 different foods. It's a standard industry test. For those with high suspicion of wheat and/or gluten activity, we'll add a different test as well. And that'll include glutenin, gliadin, and what I think is very important, non-wheat, protein fractions as well. All patients in our sample had at least 11+ foods that they were reactive to. That could have been wheat, gluten, or the other foods. They were then instructed to follow a diet that of course removes these foods, and they have to do that for at least 90 days. Our gut repair protocol can, of course, go longer, but we start them off with a three-month process. During that 90-day restriction, they follow the supplement regimen designed to repair and restore gastrointestinal integrity and function. You can see the gut cocktail here. This is a simple, relatively taste neutral beverage, and includes glutamine, fructooligosaccharides, Acacia senegal, and n-acetyl-d-glucosamine, the classic herbs slippery elm in a powder form, and good old aloe vera juice. They can mix this in water, or a juice of their choice. It's consumed twice daily. We also use a professional strength, broad spectrum probiotic. We start off with a loading phase of 300 billion times 10 days, and then we go to 100 billion daily for about two months after that, and then about 30 billion as maintenance after that. Finally, we used a dual phase digestive enzyme formula that includes hydrochloric acid, pepsin, et cetera, as you can see here.

Let's do a quick couple of case reviews here. Here's a great example of a patient from our sample who was prescribed LDN and diagnosed with leaky gut, and placed on our gut protocol. He presented with a strong history of irritable bowel syndrome diagnosed when he was very young. He goes through the normal testing. He had several loose bowel movements when he first presented, including uncomplicated hemorrhoids with some occult blood. He was routinely screened by a gastrointestinal specialist. His thyroid antibodies are elevated. He also presented as hypogonadal, and he was only 28. Aside from the gut repair protocol, he was prescribed natural desiccated thyroid, and of course LDN 4.5 mg. He was really compliant for those first six months. Stools largely normalized, and his hemorrhoids improved. He got better and you can see his antibodies really got better as well, lowered drastically. Because he improved and it was part of the typical 90-day protocol, he was less compliant. A lot of times once patients get better, they start to slip a little bit, as we know, and you can see that his antibodies slipped, but he was still on the LDN, but his antibodies went back up a little bit. So this is an example of how important comprehensive care is when treating thyroid autoimmunity or any autoimmunity. The food sensitivities and gut permeability are not always fully corrected after 90 days. Sometimes we have to continue to go much longer.

Now to speak to his hypogonadism, I recently presented in London at the International Congress on Naturopathic Medicine, and my presentation was on the global decline of testosterone and sperm in men. I presented research regarding all of this and what I had found, and it was only maybe about three weeks after that presentation that another large landmark study came out of Jerusalem that did really, in fact, confirm that sperm is lowering in men. Okay. Part of that presentation was the causal relationships for lowering testosterone and sperm, and what the functional medicine practitioner can do to help. There are all kinds of reasons for this decline, but we think of diet and toxin exposure, gut compromise, and maybe even autoimmune thyroid disease. And maybe that's relevant to this example. So, in this patient, a change in diet and improvement, all of this, it actually helped with his testosterone. It's also important to mention that he and his wife were trying to get pregnant for about a year before he came to see us. And they got pregnant. So coincidence? I don't know, maybe, maybe not.

Here's another example from our sample. This was a 37-year-old female with high expression of autoimmunity, in an LDN-only group because she didn't do anything significant with her diet. She had other things going on: vitiligo, vaginal lichen sclerosis; and we discovered Hashimoto's. Interestingly, she had already known about that to some degree. They had seen serum elevated antibodies, but her conventional doctor said, well, there's nothing really you should do about that. I think we've seen some evidence here this weekend that it is important to preemptively work with someone who has that, despite what they may or may not be presenting with clinically. This patient also had low testosterone and suppressed estradiol production from oral contraceptive use. Oral contraceptives suppress ovarian function, it’s just what they do. It also can lead to gut dysbiosis, nutritional deficiencies, particularly magnesium. I gave her a low dose estradiol, optimal testosterone using subcutaneous pellets, something we focus on, and a plan to slowly wean off of her oral contraceptives. She was also placed on a nutritional regimen, of course desiccated thyroid, and of course LDN 4.5 mg. When she returned, you can see it was pretty straight forward. In a relative very short period of time, about five months, her antibodies lowered, her symptoms drastically improved. She had less headaches, which was another big concern when she first came in to see me. She's off the birth control pill, and we were able to just get her off the estrogen. She just didn't need the estradiol anymore; but she maintained the testosterone - she liked the libido from that, so we maintained that.

Why did her antibodies lower? In this case it could be several variables. It could be just getting off of the oral contraceptives, it could be the use of the natural desiccated thyroid, the normalizing of her sex hormones, all of which have immune modulating effects in and of themselves. Or, at least these could be obstacles to cure, something we say in naturopathic medicine. But of course, it could just be the LDN.

We’re here at an LDN conference. We've gathered under the basic premise that we believe LDN is worth prescribing. I certainly do, but I'm seeing changes with its use in my patients. I'm not a fan of the statement that science is settled. I think it makes us intellectually sluggish. So I think we should continue to look deeper for the sake of our patients.

A final case review, another example from our sample, technically in the LDN-only group, but who did make specific diet changes I'll explain here. This is a 56-year-old menopausal female. A large percentage of our patients would fall into this demographic. She's on desiccated thyroid, estradiol, testosterone subcutaneous pellets with oral opposing progesterone. Her initial anti-TPO was 2315. It rose up a little bit after that. At that point, she got a little more motivated to get on the LDN. We gave her that, and you can see that it started to lower.

Hashimoto's presents with these flares. You can have up and down of the antibody response anyway. But about six months later, on July 8th, 2016, we discovered mild insulin resistance and suboptimal glucose; hemoglobin A1C, insulin, homocysteine levels, all being suboptimal. At that point, I'd given her 500 mg tid of Metformin, and a proprietary palladium alpha lipoic acid mineral complex that some of you may be familiar with. Those were an injection form. I reduced her net carbs at 125. That seems to be a very reasonable and effective number, and all this of course led to getting rid of a lot of her grain-based carbohydrates as well. You can see, in a mere four months after that her anti-TPO antibodies dropped to only 74, essentially normal. This was the lowest reading she had ever had.

Was it the LDN by itself? Perhaps. I've observed that LDN very often takes several months for the full impact on thyroid antibodies to be realized, yet the idea that she avoided, or at least limited excessive carbohydrates, particularly grain-based carbohydrates, that could be part of it. Her treatment for the insulin resistance included the use of Metformin and the low carb diet. Maybe that's the reason. There is evidence that overproduction of insulin leads to B cell stimulation, possibly potentiating the TH1 pathway.

Ultimately, comprehensive strategies help the patient to realize optimal results. That should be the perspective of any functional medicine practitioner who decides to use LDN. I believe it's important to approach thyroid management in this comprehensive fashion. Tolle causam, or treat the cause. This is another tenant in naturopathic medicine that is known within the functional medicine world. I believe that the use of LDN helps us to treat that core cause, that often is autoimmunity. Another saying in naturopathic medicine is to heal the gut and the rest will follow. And this is a generalized idiom that so often is true. It's almost always an excellent place to start.

The endocrine system is one, if not the most vital system within the body. We have hormonal influences and production within the womb before we ever develop a nervous system. So dare to balance the endocrine system and you help many things with your patients, including thyroid autoimmunity. A healthy immune system is also key to managing thyroid disease. LDN proves to be one of the most effective tools in doing this, particularly when it comes to lowering an antibody response, I believe.

And finally, one of the most overlooked possibilities in thyroid hormone diagnosis and management is the clinical measurement of metabolic rates. It's something that we look at very, I believe, somewhat uniquely. And certainly of course, we look at mitochondrial function, as thyroid hormone influences mitochondrial function, second to none. If we can look at things from that perspective and correct that. even above and beyond the conventional perspective of serum analysis, then the patient realizes optimal outcomes, the patient actually gets well.

I look forward to your feedback and input on this presentation. I hope that it helps to lessen the pain of at least even one person. Thanks for your attention. Thank you.

Keywords: low dose naltrexone, LDN, thyroid, Hashimoto’s, autoimmune, antigen, TH1, TH2, Graves', immune modulation, hormone, gut, dysbiosis, thyroid peroxidase antibodies, thyroglobulin antibodies

 Presentation at the LDN 2017 Conference

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.