LDN Video Interviews and Presentations

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

They are also on our    Vimeo Channel    and    YouTube Channel

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

LDN Research Trust on Vimeo.

Dr. Igor Schwartzman is from the United States. He first heard about low dose naltrexone (LDN) around 2011 when learning about small intestinal bacterial overgrowth (SIBO), a gut flora imbalance and changes in gut motility. Treating SIBO includes treating gut motility secondly. Many of his patients have Hashimoto’s thyroiditis, which is autoimmune hypothyroidism; and a large number also have SIBO. LDN can be used as a prokinetic (pro = for, kinesis = movement). 

He also learned about other autoimmune conditions LDN can treat. In addition to Hashimoto’s thyroiditis, Dr. Schwartzman treats patients with multiple sclerosis and other autoimmune conditions, gastrointestinal disorders like irritable bowel syndrome, and Crohn’s disease. He treats SIBO in stages: managing overgrowth, which may include herbal or conventional antibiotics, fasting, appropriate diets; and focusing on motility, which involves herbal treatments, LDN as a prokinetic, and continuing dietary intervention. He sees food as medicine, and where things begin.

Typically, patients with gastrointestinal or endocrine disorders including Hashimoto’s thyroiditis, etc., generally have various food sensitivities or allergies. Patients with SIBO generally are on an individualized blend-specific carbohydrate diet with low FODMAPs, using anti-inflammatory foods. Once the gut and the barriers in the mucosal membranes heal, other food can be reintroduced, but it is a slow process.

The usual side effects of LDN he notes include vivid dreams, for which he recommends taking LDN in the morning if they do not enjoy those dreams. Most patients feel benefit during the first month, commonly describing a sense of wellbeing, and improved tolerance and distress resistance. He estimates 75% of patient see benefit, and the others don’t necessarily see any change.

About 85% of Dr. Schwartzman’s patients have Hashimoto’s thyroiditis, and at least half are on LDN, 100+ patients. People are even coming in requesting LDN – some have read LDN Research Trust’s  The LDN Book, so come educated. Dr. Schwartzman spoke his appreciation of Linda Elsegood, for all the work, heart, and soul she puts into bringing awareness to LDN.

Dr. Schwartzman can be reached at Whole Family Wellness Center in Portland Oregon. The website is http://wfwcenter.com/, and the phone number is 802-490-5009. He has patients contact him by phone, or email through the website.

Summary from Dr. Igor Schwartzman, listen to the video for the show.

Keywords: LDN, low dose naltrexone, small intestinal bacterial overgrowth, SIBO, Hashimoto’s thyroiditis, hypothyroidism, irritable bowel syndrome, Crohn’s disease, autoimmune, diet, The LDN Book

Dr David Borenstein, LDN Radio Show 28 Dec 2016 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today we are joined by Dr. David Bornstein.  Thank you for joining us, David. 

Dr David Borenstein: Thank you for having me. 

Linda Elsegood: For those people who haven't heard of you yet, could you tell us how you got involved in LDN? 

Dr David Borenstein: Absolutely. I'm an integrative physician. My office is in Manhattan, right here in New York; and about ten years ago, I had a patient come to me who was interested in being put on this medication known as LDN, low dose naltrexone.

Now the first thing I said was, like many people who do not know about LDN is, “Oh, we use naltrexone for drug addiction. What's this LDN?” And he said to me that he would give me literature, and I said, you know what, let me take a look at it; and on your next visit, we can talk about prescribing it.

I did some research. I made a few phone calls. And I said, okay, let me give this a try. And the patient just wanted it for general health. They didn't want it for any particular disease. So I prescribed it, and he was happy. No side effects; work beautifully. And then I had patients come in with various different abnormalities or diseases: Crohn's, MS. So I decided to try it for these patients; and lo and behold, two, three, four, five patients, they're doing okay. The patients with MS weren’t progressing, the Crohn's patients are getting better. I put a few patients who had cancer on it, and I started using it, gaining experience with it. And now it's a very big part of my practice. All thanks to that patient who came in ten years ago. 

Linda Elsegood: I can see on your website a list of conditions.  There’s thyroid, autoimmune, menopause, andropause, hormone imbalance, adrenal fatigue, chronic fatigue syndrome, fibromyalgia, chronic pain, polycystic ovary syndrome, insomnia, sleep disorders, metabolic syndrome, obesity, Crohn's disease, irritable bowel, yeast overgrowth, candida, and allergies. That is quite some list. How do you go about assessing patients to see whether they are suitable for LDN? 

Dr David Borenstein: Well, first of all, any patient who comes to see us gets a complete history and physical examination, and then we evaluate their condition.

We go over the lab work. At that point, I can discuss with them if LDN would be something they would want to consider. Now, remember, when they're coming to see me, they have many different symptoms: fatigue, weight gain, hair loss, dry skin, constipation, depression, mood swings, irritable bowel. They can have a laundry list of different symptoms. So what we first need to do is just evaluate, and treat these different symptoms. And then, especially on the first visit, it's a very long visit and we have to go over many things. I generally don't bring LDN up at the first or second visit. I usually wait until a couple of visits down the road, especially to monitor their response.

I mean, I don't want to use it initially for a first-line unless there are other things we can treat.  At that point, a couple of visits later, we see how the clinical condition of the patient is improving or not improving, and then we can throw in LDN. And now remember, most of these people coming to me have no idea what low dose naltrexone is. A few do; I’d say less than 10% of my patients know exactly what I'm talking about. The other 90% have a natural inclination. And what did they tell me? I will Google it. It's the first thing:  I will Google it. I say beautiful, Google it. I give them a couple of websites, give them your website. I give him some keywords to use, and 90% of the time they come back and say, “I want this.” 

Okay, what conditions do we popularly treat with low dose naltrexone Crohn’s, any inflammatory bowel disease, irritable bowel disease, multiple sclerosis; Parkinson's is very popular; fibromyalgia, and chronic fatigue - it's a biggie now, and we have a lot of that, as well as certain types of malignancies that a lot of patients come in for, for LDN. As you can see, we can treat a wide variety of diseases. But we generally have either autoimmune disorders, or malignancies, or certain neurological disorders. Those are the most common reasons for me to put patients on LDN.  

Linda Elsegood: We have a caller here, called Christina, who would like to discuss LDN with you. Would you like to ask your question, Christina, yes? 

Patient: Hi. Thank you. Can you guys hear me? 

Linda Elsegood: We can; or I can, yes. 

Patient: Yes. So, doctor, I have a few things. I have postpartum thyroiditis, I have hypothyroidism, I have pericarditis. And I have Sjogren's syndrome. I started LDN, and I was on it for about a month, and I got very sick. I got flu-like symptoms, a burning feeling in my stomach, and all of my symptoms came back. I also have vertigo, so they think it's autoimmune, inner ear disease. So my chest pain came back, and my vertigo came back, and I went off of it because it got intolerable. I've read a lot that starting off on a very low dose and working slowly can be beneficial. My doctor doesn't want to do that because he feels that it isn't a therapeutic dose unless it's at least 1.5 mg. So I've read a lot of posts in forums, about LDN, where people have had to try three or four times before they can successfully be on LDN; and that they could have a Herxheimer reaction. And, I did the very sensitive test for Lyme, and I am negative for Lyme. So I'm wondering, is a Herxheimer reaction something that does often occur with LDN? And have you found that people have had to go on it several times before they can successfully be on it? And is a low dose, very low dose, like 0.5 mg beneficial?

Dr David Borenstein: Well, it's a very good question. The first thing I would tell you to do is before you even consider the LDN, is you seem to be having some reaction. I think you need to clear up some of the other issues that you're having. For example, you mentioned to me the Hashimoto's. I think that when I hear Hashimoto's, I hear autoimmune. The first thing I would strongly recommend, way before taking LDN, is cleaning up your gut: I can't stress the importance of gut health. You have to clean up your gut. And what do I mean by that? I mean, adding things like probiotics, digestive enzymes, gut change to improve your gut function; looking to see if you have any parasites, bacteria, any sort of viruses.

Gut health is extremely important in treating autoimmune disease. I'd also recommend some treatments possibly for candida, yeast overgrowth. Looking to see if you have leaky gut, and if you have an autoimmune disease, by definition you probably do have leaky gut, and treating the leaky gut with a gluten-free diet, cleaning it up with adding things like L-glutamine and zinc and aloe, and all these sorts of things. So I think the first approach is, before you even consider going on LDN, is cleaning up the gut. Now, that's a lot harder to do than what I just said. I mean, it takes a lot of work; and you would probably need to find some sort of practitioner to help you with this. But again, cleaning up the gut is key to success with LDN. That's number one. Now, starting LDN, even at a very low dose after that's done, I think the issue is not so much the therapeutic effect. You need to build up your LDN tolerance. So even if 0.5 mg may not be very therapeutic, I don't think that matters. I think you just need to build up the dose so you can get up to a therapeutic dose, and I agree you're probably not going to get very much benefit below 1.5 mg. Maybe not, but I think you just have to have the ability to grow tolerance. So the quick answer is clean up your gut, to start slow, work your way up, and you'll get there.

Patient: All right. Thank you, Doctor. Do you notice that you see a Herxheimer reaction, or flu-like symptoms in patients that maybe start to build up too quickly? 

Dr David Borenstein: It's very rare. You know, when I start patients off at 1.5 mg, and then I go up to 3 mg; and after that, it depends on their condition. For example, with MS I don't try to go up above 3.0 mg unless I have to, because there are issues with spasticity; and remember, we always talk about doses. We have to remember these are doses, but it's going to be different for every person. A person who is 250 pounds is going to need more than someone who's 150 pounds. So you give them the same dose, okay; when you go per kilogram, it's a very different dose. So we have to also remember that. In all the LDN pages, and on the Facebook pages and the Yahoo groups, they will talk in doses. And the problem is it's not the most accurate way of dosing, because you need to consider the weight of the patient as well. So 1.5 mg for me is going to be very different from 1.5 mg for you or another person. That's also another important point to remember when prescribing LDN. Also, some of the practitioners like to go up to 4.5 mg.  I like to keep it a little bit below that. We're finding that you're getting the opioid blockade at around 4.0 mg, and after that, it's not as effective. So recently, in the past year, year and a half, I've been keeping my maximum dose to about 4.0 mg; and I don't really go above that unless the patient has been on LDN 4.5 mg for many years. I don't want to touch it. I leave it alone. 

Patient: Okay, and thank you. I appreciate it. Could I just ask one more quick thing? I do a lot of great things for gut health, the L-glutamine and probiotics; and I stay away from gluten and dairy completely. Could you explain a little bit about how one would go about testing for parasites, bacteria and viruses? 

Dr David Borenstein: There is a test called the CDSA 2.0, from a company in North Carolina; I'm trying to remember the name of the company. I use it all the time, I can see the box. But these are special stool kits you can get, and actually, insurances will help pay for a part of the test. You collect a stool sample for three days. The test looks for parasites. It looks for your digestive enzymes. It looks to see how well you're absorbing food. It looks for bacteria and other viruses. It's a very good test. It's called a CDSA 2.0.

Patient:  Great. Thank you so much, doctor. 

Dr David Borenstein: My pleasure. Thank you. 

Patient: Bye-bye. 

Linda Elsegood: Well before we go to the break, I have another question here that's come in. It's from Susan, and she says, “When do I need to stop taking LDN prior to a minor medical procedure which requires anaesthesia?”

Dr David Borenstein: Excellent question. We know that LDN and its metabolites have a half-life of approximately 59 hours. So 60 hours; you know, technically it's two and a half days. I would at a minimum do probably a week before, and that would be a minimum I would do. Yeah, I'd say two and a half days; or at least about a week before you'd play it safe. And that would be  a good thing to do, especially if you're receiving any sort of narcotics before or after the procedure. So I just say a good solid week would be a good number. You know, you can do a little more. Wouldn't hurt, but I think to keep it safe at least a week. 

Linda Elsegood: And how long would you say to wait after you'd had narcotics before you restarted LDN 

Dr David Borenstein: Let's see, two and a half days. So I would say at least five days afterwards would be a good number. From the last point of taking a narcotic. 

Linda Elsegood: Okay. Thank you. We'll just have a quick break. If anybody would like to call in with their questions or email them, and we'll be back in a moment. 

The LDN research trust is very proud of the LDN book, which was launched at the LDN 2016 conference in Orlando, and it's been a great success, not only for the medical profession but for patients wanting to learn more about low dose naltrexone. Full details can be found on the homepage of the LDN Research Trust. Discounts are available on bulk orders of the book, which is ten or more. The details: Contact us, telling me how many copies you wish and where you live. I will then be able to get Chelsea Green Publishing to contact you.

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Okay. Welcome back. I have a question here for you, David, from a  lady in Turkey or a gentleman. They have a five-year-old son who was diagnosed with nephrotic syndrome at age three. He takes 4 mg of steroid every other day. They would like him to try LDN, but the doctor said no. And through a year, they've looked for a doctor who would prescribe LDN, without success. They say their son's on steroids, and it's very troublesome. He becomes very sick easily at home, and next year he starts school. So they would like to find a permanent solution. The question was, can LDN be prescribed for a child who takes 4 mg of steroids; and do the steroids affect the LDN.

Dr David Borenstein: Well, the second question first. Yes, it can, and that's why I like to keep the steroid dose as low as possible.  In adults, I like to keep Prednisone below 10 mg per day as a rule, and that's just an arbitrary number. I just find that it works best below 10 mg a day. Many of my patients have a lot of autoimmune immune disease and are on much higher doses. So what I do is I start them on LDN, and I have them slowly taper their Prednisone while the LDN is kicking in, in the hopes that, as the LDN dose increases and the steroid dose decreases, the LDN will start working. So far, it's worked pretty well.

Now with kids, you have to be very, very careful, especially for nephrotic syndrome. And you would need a physician to really keep on top of this. But you could, in theory, try the LDN, 80 micrograms per kilos. You do depend on the weight. He's probably gonna need a lot less than most adults would. And with a child, they tend to like to use the transdermal  - just easier to use. And you can certainly give it a try, but again, you're going to have to be under very close care of a physician when you're doing this, to make sure that everything is being watched. This is very different from a patient who's just taking it for fibromyalgia or for Crohn’s. You can have some flexibility. But with a child, you have to really keep on top of them. I definitely think it's worthwhile to try it and see if it has an effect; but remember, you have to keep on top of this, and finding a physician who's going to do that is not going to be easy. People have had a lot of trouble finding physicians prescribing LDN, just to get it for whatever disease they have. But for a child, needing constant watching, that's going to be a little bit tricky.

Linda Elsegood: Especially in Turkey where I think it's very, very difficult to get LDN prescribed anyway. 

We also had a question from Taja, and she says that she was diagnosed with rheumatoid arthritis in December 2015 and she started LDN in March. Her questions, she's got three. The first one is, do anti-inflammatory drugs have an effect on the efficacy of LDN?

Dr David Borenstein: They generally don't. The main issue when you're taking low dose naltrexone is going to be high dose steroids. Not so much the nonsteroidal anti-inflammatories, generally not. But here's the problem. When you're taking a lot of NSAIDs or nonsteroidal anti-inflammatories, it's not good for you.

It's not good for your liver, it’s certainly not good for your kidneys, and certainly not good for your stomach. So LDN would certainly be of benefit to try to help reduce your need for these anti-inflammatory medications, but they're not going to interfere with LDN. 

Linda Elsegood: And the second question is, have you seen any difference in how LDN works on patients following an anti-inflammatory diet?

Dr David Borenstein: Yes, no question, diet is key to helping patients with rheumatoid arthritis and other autoimmune diseases. Now, what do I mean by that? I mean, I always talk about LDN being a tool, not a cure of disease. It's a tool that one can use to help treat disease. Now, if you can approach disease in multiple different ways, then, of course, there's going to be a much better response. So diet is key, especially in rheumatoid arthritis. With diet, we want to make sure that the patient, especially with rheumatoid arthritis, keeps away from nightshades - tomatoes, potatoes; working on fixing the leaky gut we are treating, having a gluten-free diet. These are very key components for fixing the gut. Probiotics, digestive enzymes, stomach acid. And again, looking for parasites and bacteria in the gut. Treating the gut is extremely important in rheumatoid arthritis and other autoimmune diseases. That in combination with low dose naltrexone is a very powerful tool for treating rheumatoid arthritis and other autoimmune disorders.

Linda Elsegood: Okay. And her third question was, I take 4.5 mg of LDN. Should I change the dose if I feel my symptoms increasing? And if so, in what direction? 

Dr David Borenstein: Well, I don't know the patient's weight or their age, so I really couldn't give a super-accurate answer. That being said, you're not going up.

I mean, that's it. 4.5 mg is the max. As a matter of fact, I would probably recommend the patient lower the dose down to 4.0 mg. I wouldn't be surprised if the response improves, because if you lower the dose to 4.0 mg there may be a more effective opioid blockade. So I would probably give a trial of lowering the dose to around 4.0 mg, not 4.5 mg and see if that works a little bit better, especially if the patient is low weight. 

Linda Elsegood: Thank you. And we have a question from Jen, and she says she has MS, and she has taken LDN for three months with some improvement to her bladder.

She said she started at 1.5 mg, then increased to 3.0 mg.  Should she increase the dose or wait longer, because she's only had some improvement to the bladder? Nothing else. 

Dr David Borenstein: Okay. Well, here's the thing with MS. You have to be concerned about spasticity. Many times we have patients with MS, they have spasticity, but if spasticity is not getting worse, then you can experiment with going up at very small doses - 3.25 mg try that for a little while. Then go up to 3.5 mg, and you can go up a little bit till the spasticity increases. And that's probably the max you want to take.

So yes, that would probably be a way to go. Now, remember, although we've had patients who felt better, the goal in low dose naltrexone for MS is more to prevent exacerbations and to keep disease stable, rather than actually feel a little bit better. So if you had numerous exacerbations in the past, LDN in many cases would prevent exacerbations. If it prevents exacerbations, then LDN has done its job. Okay. So it's more for preventing the disease from coming back and halting in its tracks rather than feeling better. So three months is a little bit short. We'd have to see over a longer period of time. I don't know how many exacerbations this patient has. So the answer will be if the patient has fewer exacerbations than she did, we know the LDN is probably doing its job.

Linda Elsegood: Okay. Thank you. We have another question from Paula, and she asks if LDN is a problem with candida? She took <a medication> to help and it allowed her to get up to 4.5 mg. She stopped the <medication> several months later and some of her old autoimmune symptoms have returned. She says, “Am I getting symptoms of candida, and what would you suggest I do?” 

Dr David Borenstein: Well, the first thing I want to do is, and sometimes patients with severe candida can have problems with LDN. I think the thing you have to do is just clean out your gut and especially with candida. The same treatments that we have getting gluten and dairy-free diets, keeping away from fruits that can contribute to candida, and we all know what they are.

Anything that tastes good or isn’t good for you, it's probably good for candida. And some doctors give a course of Diflucan for a period of a month or two, that may be beneficial. It's not a cure, but it can give what I call an artillery barrage to at least lower the symptoms and then change your ability to do with the candida, with dietary changes and other supplements, cilantro, oregano, garlic, all very good for treating candida.

And just one more, which. I have a little bit of a mental block, but it also works - berberine, berberine-containing substances are very good for treating candida. Treat the candida for a month or two, even three, and then try and restarting the LDN and you'll probably get a better response.  

Linda Elsegood: and we have a question here from Alec. She says, “Could LDN help with prostate cancer and other prostate issues?” 

Dr David Borenstein: We've had patients with prostate cancer who've taken LDN. However, again, when you're treating cancer, you have to use a very combined approach. I've had patients who basically have prostate cancer, but they're not treating it because it's either low-grade cancer or its small cancer, and they don't want treatment yet, but it's certainly worth a try. And as long as your PSA doesn't go up and there are no changes in a digital examination, it's certainly something to consider. That being said, if the patient has received hormone treatments, those who are in a later stage or towards the end stage of receiving hormone treatment, we’re finding the LDN really doesn't work too well with that subset of patients. But as a rule, it's certainly worth a try, as long as you follow the rules, keep away from opioids and do the proper dosing. I think the question is, do you tell your oncologist about it? People ask me this all the time, and you know, I would, and just explain to your oncologist, or your urologist that you're on it and just give them a five-minute debriefing. Bring them some literature. But a lot of the time, urologists and oncologists are not crazy about it. But there'll be someone understanding at least in 2016, 2017. Ten to fifteen years ago, forget about it. Everyone’s mind was closed. I think we're living more open-minded today. So, again, short answer, you should always use LDN with the knowledge that your attending physician, your oncologist, your primary care doctor, whoever's treating you should probably know about LDN and that you're taking it, and just make sure that you don't only use LDN if it's something serious, a more serious disease. Because again, there are other treatment options available for more serious disease.  

Linda Elsegood: And we have a question from Leanora. She says, “What are your thoughts on LDN and a person's genetics, SNPS, and methylation pathways. Are you familiar with MTHFR, COMT, or SNP called CYP-2-D-6?” 

Dr David Borenstein: Well, here's the thing with the MTHFR and the other genetic mutations, there's no problem using LDN with that. You do have to treat the issues of those particular mutations. For example, I'm going to use MTHFR, because that's certainly by far the most common that we see. How do you treat the MTHFR? Even this is controversial, and I think this is going to change, so this is not in stone. When we have MTHFR gene mutations, you have to first evaluate to make sure homocysteine levels are normal. This other test you can use, I'm not allowed to use it in New York state, but there are better ways of checking homocysteine levels than just measuring homocysteine, but that's the tools we have, we have to use it. And making sure that you have the B-6, B-12 and methyl folate - make sure that in all your vitamins there is methyl folate - and use trimethylglycine and cleaning up the gut to detoxify.

So that's the best you can do. That being said, if you do all that and use the LDN, there shouldn't be any issues.

Linda Elsegood:. Okay. And she said, “Would know a person's genetic hiccups help determine the dose of LDN.”

Dr David Borenstein: Not really. We've been dosing LDN well before MTHFR became popular, well before. And I know Dr. Bahari when he was doing it, I, I speak with his wife from time to time also, who is in New York; and again, in the eighties and the nineties, we didn't really use MTHFR, and nothing changed. I mean, the dose is going to be basically based on the disease you have, your weight, and your tolerance. MTHFR and other genetic mutations are really not gonna make a big difference in the way we dose you. 

Linda Elsegood: Okay. And she has another question, and she says” Have you seen success with LDN and endometriosis?”

Dr David Borenstein: I generally don't use LDN for endometriosis. Remember, endometriosis by definition, in most cases, is an excess of estrogen: estrogen dominance, as opposed to anything LDN would treat. So when I have endometriosis, I have to look for estrogen dominance and balancing the hormones. So I really wouldn't be using LDN for that.

There are many other things you can do to improve your hormone balance, like measuring the hormones, either through salivary testing; you can do urinary testing; in some countries, all you have is blood testing. And you have to do it on certain days of the month, balancing the hormones. And in most cases, the problem is either too much estrogen to too low progesterone or both. So balancing the estrogen, treating insulin resistance, and that's a biggie. And once you do that, that tends to be some sort of improvement in the endometriosis. So I would do that before throwing LDN at the problem. 

Linda Elsegood: Okay. And she has one more question, and it says, “LDN might not always help or improve a person's condition, but are you aware of any conditions that are known to exacerbate, or worsen, a condition or disease?

Dr David Borenstein: I have not seen that. I've only seen certain side effects from taking LDN - the vivid dreams, the difficulty sleeping, the increasing candida, and Herxheimer reaction. But I've never seen a condition get worse from the LDN. Now, of course, diseases do progress naturally, and if you don't treat them, they tend to get worse, not get better. So many times, this is the natural course of the disease. But as a rule, no, I've never—seen any detrimental effects from LDN. 

Linda Elsegood: Okay, lovely. Well, we'll just have a quick break, and we'll be back in a moment.

The LDN Research Trust has its own forum, which can be found at forum.LDNresearchtrust.org, or via our website. The forum is divided into sections, so it's easy to navigate and find what you're looking for. You can share your experience, ask questions, keep a journal, etc. Unlike Facebook, the posts are always easy to find and don't get buried. We have a private medical professionals only section. To find out more, please Contact Us.

Belmar pharmacy is a nationally respected compounding pharmacy. They compound low dose naltrexone, LDN; bio-identical hormones, and custom amino acids and mineral blends. They're based in Colorado and ship nationwide. That goal is better patient outcomes through quality compounding, combining effective communication between practitioner, pharmacist, and patients. Call +1 800-525-9473 or visit Belmarpharmacy.com.

Welcome back. We have some questions here from Dr Leonard Weinstock, and he says, “Have you measured pre and post LDN antithyroid antibody levels?” 

Dr David Borenstein: Well, the answer is yes, we have, because anytime I have a patient who has Hashimoto's and hypothyroidism, I always measure their antibodies. So, and as a rule, they come down, and they can come down sometimes quite quickly. And you have to be very careful with these patients because if you have them on thyroid medication and their antibodies come down, and the amount of medicine they take may be the same, but their antibodies come down. That can actually cause them to become hyperthyroid. Think of it as driving a car and all of a sudden you're driving with the accelerator halfway down and the brakes halfway down, right?

So all of a sudden you're lowering the antibody, so the brakes, you're reducing the brake and what happens - the car zooms forward. That's exactly what happens. So you have to watch it, and watch it closely. Now here are some of the problems we have in monitoring the antibodies. Many of my patients’ antibodies are through the roof and the lab that I use, which is a very common lab that most integrative doctors in the New York area use, if it's above a certain level - if the anti-TPO is above a thousand and an antithyroid globulin is above 3000, it just says greater than a thousand, greater than 3000. So if the antibodies dropped from 5,000 down to 3,500, I have no way of knowing that. All I'm seeing is that it's above 3000 or when it gets below 3000, and I can see if it's dropping or not. But as a rule, LDN is a very effective tool for treating Hashimoto's, and the antibodies can drop, and it can drop quickly, so you have to watch these antibodies very closely to make sure the patient does not become hyperthyroid. Now, if the patient's not taking any thyroid medication, then it's a very different story than if it drops, it drops, and then you have to still watch them make sure that they're not becoming hyperthyroid, but it's less of a concern because they're not taking any thyroid medication.

Linda Elsegood: Just out of interest, how often do you check the levels if they're on thyroid medication? 

Dr David Borenstein: It depends. If they're on LDN and I'm starting it, I probably would do it every four to six weeks, and I tend to be very, very conservative in the way I give the LDN. I like to start off at 1.5 mg, and then after a month go up to 3 mg and then go to 4.0 mg. However, sometimes I'll do it a little bit slower than that. Especially when I know the antibodies can drop quickly and they're on a high dose of thyroid medication. So you do it very, very slowly. Sometimes I'll just put them at 1.5 mg and have them come back in two months to see how the levels are. And then, all right, they've dropped, we're going to put you on 3.0 mg. But you know what? We're going to change your medications a little bit. Drop your medications a touch, come back in two months. But when we do it that way, you require a lot of constant monitoring. That's the best way to do it. And the safest now, thank goodness, no problems, but you know, there's a theoretical risk of hyperthyroidism, which you have to watch out for.

Linda Elsegood: Okay? And he also says, “What are your thoughts on using low dose oral methylnaltrexone for systemic inflammatory conditions without CNS pain?”

Dr David Borenstein: You know, generally I don't use it. Most of the time I use straight LDN, and I treat those other conditions other ways. As I said, I don't use the LDN only for treating pathology. I use various different ways to reduce inflammation, and there are many different ways we can reduce inflammation in outpatients. Obviously diet is very big. We know that certain foods are more inflammatory than others. High fructose corn syrup is huge. Red meats, certain nuts are huge. Dairy is huge. All inflammatory foods, so you want to change that. Use of anti-inflammatory supplements like fish oil, curcumin, Boswellia, bromelain; there are many different supplements you can take to reduce inflammation. One of the least evaluated, but very, very commonly associated with inflammation, believe it or not, is insulin. Insulin - you have to be very careful with insulin. We know that people who have hyperinsulinemia are very inflamed, and a lot of doctors aren't aware. Physicians treat blood sugar. They look at glucose. They never look at insulin. And while there is a relationship between the two, it's certainly not direct. You can have perfectly normal blood sugar and very high insulin, and that insulin can be very inflammatory. So I like to treat inflammation, look at the root cause of the inflammation, and then I add the LDN to help for any other issue that we're treating.

Again, not the primary treatment for what I do. But it's just a tool that aids in helping me treat disease. 

Linda Elsegood: And he had one more question, “Did Dr Bihari compare measurements of enkephalins with PM versus AM dosing of LDN?” 

Dr David Borenstein: I believe he may have, and it's usually about a third. As I remember, about a third less in the afternoon than in the evening. So, for example, let's say 2:00 AM in the morning is when you have the peak. It's probably three times as much at two in the morning than it is at two in the afternoon, at least three times, maybe a little bit more than that. That's why we don't recommend taking LDN in the morning. I have this question asked all the time because you don't have anywhere near the amount of endorphin peak at 2:00 PM in the afternoon than you do at 2:00 AM in the morning.

Linda Elsegood: Okay. We have another question here. Can you explain how LDN effects and regulates Th1 and Th2 rather than boosting either one?

Dr David Borenstein: Here's the thing. I've seen the charts on them, and it's probably better to explain visually. I think theTH-1 and TH-2, you know, the humoral immunity versus cellular immunity, I think a lot of this is overblown. But basically, the answer is it does affect the relationship between the two. But there's a huge chart that has all this stuff, and I probably have to do a more of a visual presentation than I can explain over the radio. It would be a very visual thing, but there are charts out there that will explain how LDN may affect the Th1 versus Th2 immunity.

Linda Elsegood: Okay. Thank you. And how does LDN affect allergy testings? 

Dr David Borenstein: Well, in theory, it really shouldn't. I have patients on LDN get allergy testing and they certainly still come up positive, so we've never seen it. I mean, it could very well be, I've never done a study, but just from anecdotal evidence, I don't see how it affects the IgE modulated immune response.  

Linda Elsegood: Another question: we're always being asked, while we're talking about testing, people say if I have to have a drug test for my work, would LDN show up? 

Dr David Borenstein: No. Remember, it's not an opioid, it's an opioid blocker. So there's going to be no problem with you going in and taking LDN and having issues at work. 

Linda Elsegood: And does LDN right serotonin levels in the brain? 

Dr David Borenstein: As far as I know, the relationship is not proven. There may be some relation to that because remember, it's working more on the opioids and met 5-enkephalin. The met 5-enkephalin somehow may have some effect on serotonin, but I haven't certainly seen that in my patients. But that would be something that research can definitely look into.  

Linda Elsegood: And we have a question from Kirsty, and she says, a week ago she started on 1.5 mg of LDN for lichen sclerosis, and she’s curious about at what point should she expect to see some relief of symptoms, and when should she increase the dose? 

Dr David Borenstein: Well I think it's still very early, but I would certainly recommend the next couple of weeks trying to go up to 3.0 mg and see how that works, and then moving up a little bit higher. And if you're not getting any results for a few months after that, it's probably less of a chance that it will work. As a rule, I think after three or four months if we’re not seeing results, either you have to clean your diet out and change what you eat, or it's probably not gonna work for what you're trying to use LDN for.

Linda Elsegood: What is the protocol that you suggest to your patients? I know you have said LDN is just one of the tools that you use and it doesn't always work for everybody, but if we were a new patient coming into you, how would you describe LDN to them if they weren't going to go off and Google it. 

Dr David Borenstein: Well, here's the thing. Usually, if I'm going to prescribe LDN, we'd have a specific reason for doing that. So maybe give me a scenario, which type of patient - one with MS, a patient with Crohn's. You tell me, and I can give you better answers. 

Linda Elsegood: Let’s say Crohn’s.

Dr David Borenstein: Perfect. Perfect. Well, most of the time, people with Crohn's maybe on Humira or other medications that would impair the immune system.

So I would explain to them it's very simple. I tell them that there's this medication that mostly integrative doctors use. It has very good success in treating Crohn's disease. It is inexpensive. A dollar a day on average. It has minimal side effects, and it works in most cases really, really well. So they say, doctor - the most common question I have for this - is, “How come my gastroenterologist didn't tell me about it?” This is the most common question I have. Why are you doing this and they're not doing it. So then I have to explain it again: most integrative doctors use this; this is compounded, not pushed by their pharmaceutical representatives. That, and explain the mechanism of action, that we know that opioids have a very important part of regulating the immune system. Then explain to them what opioid blockade is and the increase in met 5-enkephalin and how that can modulate the immune response. Now we also have to educate the patient that this is not a narcotic, because they think naltrexone, and they think drug addiction, so we have to educate them about that. 

Now, especially with Crohn's, not only do I use LDN, but I also use some of the other techniques I mentioned: treating the gut, the inflammation. But here's some good news about LDN and Crohn's. A lot of my patients don't keep to their diet. A lot of my patients don't do what I tell them. All they do is just take LDN, and that's it. And you know what? They do really well despite not having to change their diet; despite not having to do anything I tell them to do; and they respond really, really well. So that's kind of a good thing. At the same time, patients who don't respond well, we may want to have them change their diet and follow my instructions for cleaning up the gut and taking the proper supplements and diet, and then they tend to respond as well. One thing about Crohn's that works so well in our patients. A lot of the patients don't even - that's it - I want my LDN and goodbye. And it works as they come periodically to see me get their refills, and they're the happiest people in the world. 

Linda Elsegood: I have a question here that always comes up. Now, some doctors, pharmacists, think Tramadol is an opiate. Others will say it's a synthetic opioid and can be taken with LDN. Where do you stand on that? 

Dr David Borenstein: It can be taken with LDN. Don't believe anything they say. If you're in pain and you need a painkiller while taking LDN, Tramadol is what you're going to take. It works. How do I know? I've tried it on myself. You know, it's not a problem. 

Linda Elsegood: Okay. Any particular dose. 

Dr David Borenstein: You know, it’s individualized. But the point is, the question is more in general, will Tramadol have a problem working with LDN, and the answer is no. The dose is as you need it. Every pain situation is different. Certain pains, you don't really need Tramadol, you just need Tylenol or Motrin. But other pain, heavy narcotics. In that case, that's where the Tramadol comes in. That being said, in many of our patients who need high dose narcotics, you may want to just get off of LDN for a little while and hope for the best. And then when your need for narcotics goes away, restart the LDN

Linda Elsegood: So would you say with Tramadol there has to be a gap when you take LDN or can they be...

Dr David Borenstein: No, no gap at all. Just use it as needed. But sometimes Tramadol will not be enough for the pain. You may need opioids, and that's when you're going to have to go off the LDN.

Linda Elsegood: Oh, that's good. Thank you. We have people ask us about weight. We know that LDN is used in some weight loss clinics; and some people say when they start LDN, they gain weight. Do you have any experience of weight with LDN? 

Dr David Borenstein: Usually not. Usually, people don't gain weight. It's usually very well tolerated. I wouldn't use it, again, as a primary weight loss medication, although some patients have claimed that they have lost weight on it. Maybe they sleep better after a while on it, and that improves the metabolic rate. But weight loss is an entirely huge separate issue. We can have ten seminars on weight loss because it's such a complicated factor of hormones, adrenals, thyroid, lecithin, insulin. It's a huge, huge topic; and growth hormone; there are so many things that are involved in discussing weight loss, and that's just hormonally, and obviously, we have diet issues and exercise issues that we can discuss as well. But I think, for the most part, it may be a pleasant, side effect. And if you lose weight, that’s great.  

Linda Elsegood: And does LDN help with sensitivities to fragrance or chemicals.

Dr David Borenstein: Here's the thing. It's certainly worth a shot, but chemical sensitivity, and I've seen a lot of chemical sensitivity in my life; it's a very, very, very difficult thing to treat. First of all, many physicians, if not most physicians in the United States, I don't know how it is in the UK or the EU, but most physicians here don't even think that it even exists. It just doesn't exist. Okay. And I think when we're treating chemical sensitivity, we have to work on detoxification of the body. Working on building the methylating pathways, detoxing with things like charcoal or other things. Also, when I hear fragrance sensitivity, when someone has a problem with perfume, the first thing I think of is candida. Candida is the first thing I think of. Look for yeast. Many times it's a very close clinical association. Now, if you want to try LDN that's great, but I don't think that's gonna cure the issue. I think we have to look at the root cause of the problem and address it. And the LDN may be a tool in fixing, addressing that issue, but I don't think it's a cure-all, but certainly worth a shot. Again, we have a medication that's cheap, little in the way of side effects. It may have good therapeutic potential. Why not use it?  

Linda Elsegood: And another question that's always coming up, and I know you were saying about missing doses for a period of time before and after an anaesthetic. Some people say that skipping a dose is good on a regular basis. Some doctors will say once a week, some will say once a month. What is your view on that? 

Dr David Borenstein: Well for the first few years, I don't think it's necessary to skip a dose, but we're finding probably after a number of different years, and patients who've been taking LDN for many years, it certainly wouldn't hurt to skip a dose maybe once a week. First of all, it saves you a few dollars if that's a concern. But if you can skip the dose once a week. Okay, now I wouldn't do this in the initial couple of years. It's just more people that have been on it for a long period of time. Skip a dose once a week and see how you feel, and see if your clinical symptoms change. We do this, believe it or not, in Parkinson's disease, we take as a drug holiday, and it works really well when the medicine for Parkinson's disease doesn't work very well. We take a drug holiday, and it's kind of like what you're doing here. It wouldn't hurt. I don't think there's an exact protocol. I think this is very anecdotal, and every patient is different, and everyone is different. But you know, 5-6 years of LDN - try stopping it one day a week and see what happens. What's the worst-case scenario? You have to go back on it every day. That's the worst thing that's going to happen.  

Linda Elsegood: And you were saying about Parkinson's - we've got many members that are taking LDN for Parkinson's. What has been your experience with that?

Dr David Borenstein: Pretty well. Now I've been doing a lot of work with Parkinson's, and right now in my practice I've been doing a lot of work with Stem cells, and I find that Stem cells are very beneficial. And what I find is that I get the Stem cells to improve the symptoms of Parkinson's and then the LDN to keep it stable. So I've been using LDN and those patients recently with some good results too. We just keep the disease stable. So they may get a big boost in the way they function with the Stem cells, and we use the LDN to keep them that way. So I think it's a very powerful tool for treating Parkinson's and MS, and some other neurological diseases.  

Linda Elsegood: We have a question for Mary, and she says, “Have you found LDN to be beneficial for Alzheimer's?” 

Dr David Borenstein: I have not used LDN for Alzheimer's. The problem is you have a patient who may not have the best memory, and you have to be very careful with the medication. If there's a provider there with the Alzheimer's patients, you can certainly give it a try. I think there are many other things you can do for Alzheimer's patients: treating their vitamin deficiencies, B12, folic acid, lots of fish oil, making sure their thyroid is okay. And look for other deficiencies: low levels of vitamin D, look for MTHFR mutations, high levels of homocysteine. These are things that - aluminium toxicity is the thing that I would look for in treating patients with Alzheimer's. Again, if you have a physician who can work with you, this is very low risk. And very inexpensive. It's certainly worth a try. That being said, look for the other things that you need to address with patients with Alzheimer's and address those, and you'd be surprised just by giving some B12 shots, a little thyroid, and little fish oil - you may actually see some improvement.

Linda Elsegood: That's good. Well, we have time for one more quick question.

Debbie has bipolar, and she wants to know if LDN would help her. 

Dr David Borenstein: I have not treated bipolar in my practice, and I have not had any patients who would be treated with, let's say, Crohn's or MS or cancer, and also have bipolar and have any change in their symptoms. So I honestly couldn't give you an answer to that.

Linda Elsegood: Well, that's us just about over David, and thank you very, very much for taking all these questions and for your time. It's been amazing. So thank you very much. And next week we're going to be joined by Dr Mark Shukhman, who's a psychiatrist, so maybe he'll be able to answer our question on bipolar. But thank you once again, David.

Dr David Borenstein: Oh, my pleasure. Thank you.

Linda Elsegood: Belmar Pharmacy is a nationally respected compounding pharmacy. They compound low dose naltrexone, LDN; bio-identical hormones, and custom amino acids, amino blends. They're based in Colorado and ship nationwide. Their goal is better patient outcomes through quality compounding, combining effective communication between practitioner, pharmacist, and patient. Call +1 800-525-9473 or visit Belmarpharmacy.com.

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.

 

Linda Elsegood: I'd like to introduce Darlene from the United States who takes LDN. Thank you for joining me, Darlene.

Darlene: I had lupus for many years and started back when I was raising my young children, and I felt fatigued and feel all the time. So I found the LDN.

Linda Elsegood: Before we start Darlene, what are the conditions do you have?

What autoimmune conditions that you use LDN for?

Darlene: Well, I use it for Myasthenia Gravis also, another autoimmune disease.

Linda Elsegood: And do you said about Raynaud's syndrome?

Darlene: I couldn't take it for that. I haven't really seen any results from that.

Linda Elsegood: And do you have IBS as well. Is that right?

Darlene: Yes. They said I would need a lower dose for that, but I've tried the lower dose, and it helps the IBS. I don't get the benefit for Lupus.

Linda Elsegood: Ok. So how old were you when you had the Lupus?

Darlene: It started when I was about 29 years old.

Linda Elsegood: And what symptoms did you have at that time?

Darlene: Just feeling ill and weak like you had the flu or fever but didn't run a fever.

Linda Elsegood: That must've been very difficult with young children.

Darlene: Oh, it was terrible.

And I would go to the doctor, and he couldn't find anything wrong with me. "Oh, you're just feeling bad." Everybody would try to blame it on nerves, depression and it took ten years for them to find a diagnosis.

Linda Elsegood: And what were you offered once you had your diagnosis?

Darlene: They said it was Lupus, Systemic Lupus and put me on the Prednisone and all different drugs,

which didn't really help or do any good for me.

Linda Elsegood: And how long were you before you had these other autoimmune conditions?

Darlene: So my opinion? It was about 20 years then I had Lupus.

So I really didn't respond to anything else.

Linda Elsegood: And how many years was it from first being ill to having heard about LDN? How many years in between?

Darlene: Oh, I didn't hear about LDN until 2009, and I started with Lupus in 1989 when I was diagnosed. So that would be 20 years.

Linda Elsegood: So in those 20 years, what was your health like just before you found LDN?

Darlene: If I planned anything, I would get sick, and my family thought I was just sick all the time, but I would feel well some days, and then other days I'd feel sick.

So every time we'd plan something, we'd have to cancel because I'd get a flare of the Lupus. And I didn't feel well. So we had to cancel our plan. I went around like that, just raising my kids and living that way for 20 years.

Linda Elsegood: And what would you say your quality of life was like at that point with ten being the best?

 Darlene: Probably two or three. And then when I got the Myasthenia Gravis, it got even worse. The weakness was worse. I had some days where I couldn't get out of bed. I couldn't walk. I had to use a wheelchair. Couldn't walk distances at all. And some days I would crawl to the bathroom from the bed would be so weak I couldn't lift up a fork to eat.

And that was also in Myasthenia Gravis when that came. So then I had two diseases. I did get the thymus removed for the Myasthenia Gravis because I ended up getting a fibroid cancer to make a long story short. They said they would remove the thymus then along with the fibroid because I had wanted to find this out because they say you improve and it helped them somewhat, but not a whole lot.

Then after that, I still had flares of Lupus and the MG, whatever it was because they just called it the lupus syndrome because I didn't know which one it was bothering me. I tried to treat Lupus with all the lupus medicines and none of them worked for me. None of them helped. Then one day I got an email about the LDN and so I thought: "Wow, check it out."

So I started looking on the web and saw that people were really getting well with MS. And there were a couple of Lupus patients on there. So I said, "Well, why not? I haven't got anything to lose. Try it."

Linda Elsegood: How easy was it to get the prescription?

Darlene: Well, it wasn't too bad. I talked to Crystal on the internet to find a doctor in my area.

And of course, my Rheumatologists didn't know anything about it, but I went to the doctor in my area. He was a regular internist, and he gave me the prescription right away.

Linda Elsegood: And when you first started, did you notice any introductory side effects?

Darlene: I noticed no side effects at all for me, but I did notice a great difference in my energy.

I was helping to move my mother. She was moving, and I had lifted boxes and all that. And everyone thought I'd be fit because, with Lupus, you can't do that. And you'll pay the next day, I guess, just like MS. And the next day I wasn't sick. I kept feeling good and kept helping her pack and lift boxes the whole week.

I never got sick. I just felt more energy. It was great, like a miracle overnight for me.

Linda Elsegood: Wow. So how long has he been taking LDN now?

Darlene: I've been taking since 2009. So about five years.

Linda Elsegood: Amazing! So how long did LDN continue to improve your condition?

Darlene: Well, it just kept working, and I haven't had any flares for the six years.

I even went through a lot of stress with my son because he had leukaemia and was hospitalized since his treatments. It was very stressful, but he came through it, and I came through it without any medicine taking it.

Linda Elsegood: And what would you say your quality of life is like now on that score scale of one to 10, 10 being the highest?

Darlene: Mines at 10. I'm like the difference between night and day. My whole family tells me that. I am a different person because I've been doing things I've never done before. I'm able to do the things a normal person does and I am so thankful for that.

Linda Elsegood: Well, amazing testimony, isn't it?

Darlene: And that's just one email sent to me really changed my whole life to get that drug.

Linda Elsegood: So, what would you say to other people who are thinking about trying LDN, but maybe are a bit sceptical?

Darlene: Well, I can't guarantee it works for everyone. I have heard some people say it didn't work for them, but I don't know the situation or if they tried it long enough or any of the particulars. If I can say it's worth a try because it has little side effects and it doesn't hurt to try it. If you're as sick as I was, you have to try something. I couldn't go on like that.

Linda Elsegood: Well, that's one amazing story! Thank you very much for sharing with us Darlene!

Any questions or comments you may 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!

Angela - Ireland: Alopecia Universalis (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Angela from Ireland shares her Alopecia and LDN Story on the LDN Radio Show with Linda Elsegood.

Angela first noticed her loss of her when she ran her hand through her hair and found a small patch of hair was missing at the back of her neck. In the following weeks, she noticed that upon showering, she would be seeing considerable amounts of hair on the floor beneath her.

In search of new alternative treatments due to the failure of conventional methods, Angela came across Low Dose Naltrexone (LDN) and began her prescription in late 2009. Within 18 months, she had 90% of her hair back.

In this interview she emphasises that she owes her recovery to LDN and recommends it to all who are interested.

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

Katie gives an update on taking LDN for Fibromyalgia, Interstitial Cystitis, GERD, IBS (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Katie from the US gives as an update on taking Low Dose Naltrexone (LDN) for Fibromyalgia, Interstitial Cystitis, GERD, IBS.

Katie suffers multiple autoimmune conditions including Fibromyalgia, which caused pain, extreme fatigue, and foggy brain. She eventually learned about Low Dose Naltrexone (LDN). After experimenting with various doses, she found her sweet spot at around 4 mg. She is excited about her new energy and pain relief. She is thankful to be thinking clearly again!

Review by Ken Bruce

Berglind from Iceland talk about LDN and Hypermobile Ehlers Danlos, IBS, Allergies (LDN, low-dose Naltrexone) from LDN Research Trust on Vimeo.

Berglind had suffered many years with her Hypermobile Ehlers Danlos, IBS, and allergies. At long last she found out about LDN on Facebook, and her doctor was LDN knowledgeable. He prescribed it for her. Within weeks her pain was reduced and she could finally get a good night’s sleep. It solved her IBS and allergy problems quite quickly. You will enjoy this interview and learn much in the process.

Teresa shares her Fibromyalgia, CFS, Thyroid disfunction, Spondyloarthritis, IBS and LDN Story (low dose naltrexone, LDN) from LDN Research Trust on Vimeo.

Teresa is from Portugal and suffers many autoimmune conditions. The worst is Fibromyalgia which doctors don’t recognize easily and don’t have a treatment for. But she did her research and tried LDN. She suffered many years but has an improved quality of life thanks to the Low Dose Naltrexone.

Michelle Resendez FNP-C - 15th Jan 2020 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Michelle  Resendez is a certified family nurse practitioner. She combines her love for alternative and natural medicine alongside traditional medicine.


She has successfully treated patients with a diverse range of health conditions that have not responded well to conventional medical treatments.

She said" I first learned about LDN about 10 to 12 years ago, first learned about it from a naturopathic medical. The first patients I treated had thyroid conditions, Hashimoto's, Graves thyroiditis. And so I was really using it to try to the modulator assist the thyroid in functioning better. And from that point, it really expanded and opened the horizons, treating other things.

So we found that people with thyroid conditions, if they're taking thyroid medication, usually have to reduce the amount of thyroid medication.

When I start someone on Low Dose Naltrexone (LDN), easily around 0.5 to one milligram at night, and I will either reduce their thyroid medication in half, or I will just reduce, if they're on a T three medication, I'll reduce that down.

 A lot of times, their autoantibodies will start going down, and that will help the thyroid function better.

Sometimes you'll get some adverse side effects like tremors or palpitations, or just feel a little bit more excitable than her used to feel.

I have a lot of patients start noticing the effect almost immediately within a couple of days. Depends on what condition I'm treating.

A osteoarthritis type pain or structural type pain people usually notice the effects within a week of taking that.

Once they move out to one or two milligrams, they start feeling some relief.

Antibodies are a little bit more resistant, and it might take, two to three months to see antibodies go down with LDN. And that's because of the treatment approach for that is really multifactorial.

And the LDN is just an adjunct to that. And usually, we do lifestyle modifications and diet and, and other interventions to help those antibodies come down as well.

Anyone starting Low Dose Naltrexone (LDN) can experience negative side effects. The most common would be that when they get a rebound effect it at night with those endorphins kicking up, they can get some anxiety. They can get some insomnia.

Patients that we treat for viral conditions or reactivation syndromes like Chronic Fatigue Syndrome, they can actually get more severe adverse side effects such as sweating, fevers, flu like symptoms, feeling sore throat, things like that.

All of that is expected and typical. I don't like to stop treatment if they're experiencing those side effects because that's telling you that it's working. We're getting the endorphin release that we're looking for, and we're getting the immune system enhancements that we're looking for.

Those side effects are what I would consider good responses.

I haven't had anyone had any side effects that  I would consider to be adverse like hives—rashes, vomiting, anything so severe that I'd have to stop them on it.

I treat GI conditions as well. I've had probably the most success with gut issues. It's one of my top responders. Some of my earlier patients were Crohn's patients.

LDN seems to work pretty well for the exhaustion, the fatigue and the pain.

The conditions that I treat teenagers for could be anything from Attention Deficit Disorder, Depression, pain conditions, allergies, sleep issues.

Some of my kids are on the autism spectrum, so I do treat that as well.

I do have quite a few teens and young children on LDN. And I'll actually have them on liquid if they're too young to swallow a pill or won't tolerate a gummy or a sublingual lozenge.

I do have a traditional medical doctor referring to me, Neurology, Cardiology, Rheumatology. Dermatology because there's a lot of dermatologic conditions that can be treated very successfully with both topical LDN called Xeno top and then oral LDN.

The skin conditions I am treating it for it would be the Legos, Psoriasis, Rosacea, Eczema. Those are probably the top of all the skin conditions that respond really well to it. It takes normally 3 months to see results.

There's trials to find if there are some food triggers associated with that.

A lot of it is when they're having fires and because it's triggered by something and I want to find out what that trigger is.

And then the LDN just helps the body heal itself. So it's keeps them in a remission state.

When I first see a patient I typically wll do labs tests first that looks at allergies, hormones, thyroid, inflammatory markers, genetics, things like that. I try to find triggers if I can identify any and remove those before then starting on LDN. I like to see how they respond first to that.

I like to do things in stages so we can really see how impactful each thing is at each stage. So I'll take away the food triggers first if I can identify them and then add LDN onto that at some point.

Right now we've just moved into our new office. So my business partner and I have been here for three months. I'm at a two-month waiting list right now. Once we hire some more back-office staff, I'll be able to stack more appointments and that will trim down for maybe a month or two and then we'll probably get booked up again. I do keep appointments open early morning and sometimes I'll see patients after my last appointment for the day. If there's something urgent or somebody's not responding favourably to meditation or something.

I leave those time slots available for that so I can get people in if I really need.

I would say on average, patients see me every three months. That would be somebody who is stable, doing well on their regimen and not needing any further testing or imaging or interventions done.

So some patients I will see on a monthly basis if they have a lot more chronic illnesses and conditions because I like to do those steps, plan out, maybe CBO treatment, diet.

Also with hormones, thyroid continue to add things to optimize how they're doing and their quality of life.

I have some come in annually. They're probably not my patients on LDN. They're probably more. They're doing our mono treatments, pellets, injections. Yhey're doing other treatments other than just LDN.

Summary from Dr Michelle  Resendez YouTube interview. LDN Radio Show Listen to the video for the full interview.

Tom O'Bryan, DC - Gut Healing (2017 Conference) (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Autoimmune diseases are the third leading cause of getting sick and dying in the industrialized world surpassed only by cancer and heart disease. Three things in the development of autoimmune diseases: having the gene for that disease, the environmental trigger that that sets it off, and the loss of intestinal barrier function. How you live your life determines whether or not you get that condition. You can arrest the development of the autoimmune disease.

Dr Tom O'Bryan: Well. Hello everyone. This is Dr Tom O'Bryan, and it's a pleasure to be with you. And this is for the Low Dose Naltrexone Conference, September 21 through the 24th of this year (2017) in Portland, Oregon. And it's with a great deal of gratitude that I am presenting there.

I'm very grateful for the work that Linda Elsegood and the entire team is doing to bring out information about low dose naltrexone to the world and how remarkable a tool it is, to use with many, many different health conditions. And in our presentations in the past in 2016 at the LDN conference, which I believe that presentation is accessible to you if you go to the LDN conference website, we talked a great deal about how LDN is a benefit with autoimmune conditions. I referenced that. And how if a person has a sensitivity to wheat, whether they know it or not, it can diminish the effectiveness of LDN. And, uh, just as a segue last year in 2016, I presented at the Fourth International Oncology Conference in Abu Dhabi and showed the studies that if a person has a sensitivity to wheat, a number of different approaches of chemotherapy will not work the way they're supposed to and is for a similar mechanism. And that is that wheat will bind down to receptor sites that LDN also binds onto and that chemotherapy can bind onto. So this whole thing about wheat is worth exploring in more detail, and you can learn more about that by reviewing the presentation from the 2016 conference.

And that's just a little of who I am. I like to start with this slide. This is a display in the museum of science in Florence, Italy. This is Galileo's finger. And Galileo bequeaths in his will that all of his inventions could be on display for all of the posterity as long as they also displayed his finger.

And I like to put that up because you're going to hear her so much marvelous information in this conference. And when I've sat as an attendee in conferences like this, I take pages and pages of notes, and I'll write down, check this for this patient, or read this article or look more into this topic.

And I have pages of notes, and then I go back home and Monday morning back to work, and I don't have time to do any of it. That there is so much good information that we get. It's hard to implement. So I came up with the principle that if there's one thing, just one thing, that I walk away from a conference, a weekend conference with that goes into my lifestyle or my practice for the rest of my career, that weekend was worthwhile.

The thousands of dollars to travel and stay in hotels and pay the registration and be out of my practice. It's worthwhile, if I can just pick up one thing, I wish I could pick up ten things, but if, if I can pick up one, then it is a value. And so that's how I feel about this presentation, that if we all understand the concept of autoimmune disease and the message that I want to give you here today, this will stay with you the rest of your life. And it will not only help you in making more informed choices in your health care but also your children, your spouse, your family.

The first part of this autoimmune disease concept is that there are four circles to consider when thinking about autoimmune diseases. Genetics, and this is not a talk about genetics today, but let me just say with genetics, if you have a gene for a particular disease, that does not mean you're going to get the disease. It means that you're vulnerable to getting that disease. So the way I say it to patients is, Mrs patient if you pull it a chain, the chain breaks at the weakest link. It's at one end, the middle, the other end. It's your heart, your brain, your liver, your kidney, wherever your weak genetic link is, that's where the chain's going to break if you pull too hard.

So the goal in life is don't pull so hard on the chain because if your weak link is your brain, that's where the disease will manifest. If you pull too hard, if the weak link in your chain is your skin, you may get psoriasis. If the weak link in your chain is your joints, you may get rheumatoid arthritis, but it's the pull on the chain that allows the gene to express itself with the vulnerability that you have.

So genetics is important, but they are not a sentence that you're doomed to get a particular condition. It's how you live your life. That determines whether or not you get that condition. Notice that the genetics in yellow there is not covering everything. That it's only the part of the genetics that merges with the infections, the toxic chemicals, the dietary components.

Those are the triggers that will pull on the chain. And then if the link breaks, the gene gets activated and here come your kidney infections. If that's your weak genetic link, or here comes your Parkinson's if that's your weak genetic link. So the goal here is to learn how to not pull on the chain so hard.

To find out what it is in your life, in your body, with your genetics, where the weak link in the chain is. So the classical paradigm of an autoimmune development, the pathogenesis of autoimmune disease involving a specific genetic trigger and exposure to genetic makeup and exposure to environmental triggers has been challenged by the addition of a third element. There are three things in the development of autoimmune diseases. You've got the gene for that particular disease, whether it's Alzheimer's or Parkinson's or rheumatoid or ms or diabetes. You've got the gene, the environmental trigger that that sets it off, the straw that breaks the camel's back, when you're pulling on that chain too hard. And there's a third element, and that is the loss of intestinal barrier function. The technical term is pathogenic intestinal permeability. The slang term is leaky gut, and we're going to talk about that in detail, so you have a clear understanding of what the scientists are talking about when they're referring to the loss of intestinal barrier function.

So in this article in autoimmune disease, in the journal, autoimmune diseases, they talked about the environmental triggers, whether it's food or something in the air or something like in your clothing. If you get dry cleaning and you're inhaling those chemicals, those minute amount of chemicals, all the time, you can't tell, but you are inhaling them.

So the trigger. Causes a breakdown in oral tolerance. That means that you no longer can tolerate this food changes your gut microbiota. The technical term is dysbiosis, which enhances gut permeability. You get this thing called pathogenic intestinal permeability or the leaky gut, which causes large macromolecules to get into the bloodstream that isn't supposed to get into the bloodstream, which your immune system reacts to, to protect you, which then can trigger autoimmunity.

And in this article, it was neuro autoimmunity. So I'm going to go through these concepts in more detail so that they're crystal clear for you. Increased intestinal permeability is, and I underlined this, is an early biological change that often preceded the onset of autoimmune diseases. The intestinal permeability comes first.

By the way, the way that I do my presentations is that this is the front page of the article I read, and in the upper right side, you see the name of the medical journal, the issue, the volume number, the date, sometimes the pages. And then in the yellow box are exact quotes from the authors, exact quotes. I haven't changed a word.

If I've added anything, it's in parentheses, but these are exact quotes. This becomes your reference library, this presentation on this topic because these are the exact quotes. Such increased permeability could be due to environmental factors such as infections and toxic molecules and allergenic foods that possibly initiate the autoimmune disease.

Together with the gut-associated lymphoid tissue and the neuroendocrine network, the intestinal epithelial barrier with its intercellular tight junctions controls the balance between tolerance and immunity to non-self antigens. Non-self antigens mean, uh, environmental molecules you're exposed to, whether it's food or air or water.

It's not part of you, but it's inside of you. And when you lose tolerance to that thing and your immune system gets activated, now you have a non-self antigen. And this suggests the autoimmune process can be arrested if the interplay between genes and the environment is prevented by re-establishing intestinal barrier function.

This is the take-home point that you can arrest the development of rheumatoid psoriasis, multiple sclerosis, Parkinson's, or Alzheimer's, dermatomyositis. It doesn't matter—the autoimmune disease. Practically every autoimmune disease that we've ever looked at, we see this trilogy, which is a genetic vulnerability and the environmental trigger and intestinal permeability, and if intestinal permeability is the gateway into the development of the autoimmune disease when you take care of the intestinal permeability, you close the gates.

And when you close the gates, your immune system calms down. And I'm going to go through this in detail for you in this presentation. So if we take a look at autoimmunity, the National Institute of Health tells us the autoimmune disease coordinating committee that while many individual autoimmune diseases are rare, collectively, they are thought to affect about 8% of our population, about 24 million people. To provide a context for this, the impact of the impact on autoimmune diseases, cancer affects 9 million people. Heart disease, about 22 million people, but autoimmune disease, 24 million people. And Dr Jeffrey Bland went around the country, around the world, actually talking about autoimmune diseases, and he said, collectively, the autoimmune disease has been identified in about 24 million people in the US, but only one out of three are diagnosed.

That means there are about 72 million people out there with an autoimmune disease, and it's not looked for. Doctors don't look for it. Our system waits until the signs and symptoms are severe enough. With organ failure and organ can't function correctly anymore, and there's irreversible damage, and now you have symptoms, then we start to look for it.

Seventy-two million people, autoimmune diseases are the third leading cause of morbidity. That means getting sick and mortality. That means dying in the industrialized world surpassed only by cancer and heart disease. So this is what we're up against. Many times when you start looking at this world of autoimmune diseases, autoimmune diseases can affect any part of the body.

There's no part of your body that can not have an autoimmune mechanism going on. And it takes an inordinate amount of time and perseverance by the patient. Look at how many years it took on average for diagnosis of autoimmune diseases. In the last, uh, almost 20 years here now, 20, 21 years since 1996.

How many years did it take? How many doctors did the person have to see, and how many were told it's just in their head, and they're just a complainer—the years to diagnosis for different autoimmune diseases. The number of doctors seems to get a diagnosis for different autoimmune diseases. The per cent that was told, their diagnosis imagined, or that they were overly concerned that it was just in their head.

Half the people are told it's just in your head, and they've got a devastating disease that's killing off their tissue. These are not exceptions. These are the averages. Why so long and difficult is to correct, to get a correct diagnosis. Physician education was identified as a contributing factor.

The American Autoimmune and Related Diseases Association did a study of family practitioners, family doctors, and this is what they found when asked in medical school, how much training in autoimmune diseases did you receive? Look at the numbers here. 18.5% one lecture, 27.8% two lectures, 18.5% three to five lectures.

That means more than half the people. Half the doctors had some less than five lectures. Now, that's not courses. That's a lecture. This is just unacceptable. Would you agree that you received enough training to diagnose and treat autoimmune diseases? Look how many doctors feel they don't agree with that statement, that they did not get enough training.

What is the level of comfort in diagnosing autoimmune diseases? Half of the physicians interviewed were uncomfortable. Half of them because they just didn't get the training. They don't know how to identify this until it's so obvious that it's just staring you right in the face. So before I go onto this first premise, I just want to say it's not our doctor's fault that patients have to see so many doctors to get the right diagnosis.

They just weren't trained. They weren't trained in this. Now it is their fault. When they tell somebody, it's all in your head. Rather, an appropriate thing would be to say, you know, I just don't know what's going on here. I'm going to have to send you to somebody else cause I just don't know. I take issue with telling people it's in their head. Okay, let's move on.

Premise number one. Just how prevalent is the development of autoimmune diseases? Well, I'm going to introduce a new concept here about the true prevalence of autoimmunity. Autoimmune diseases are the third leading cause of getting sick and dying in the industrialized world surpassed only by cancer and heart disease.

However, if we think a little more closely about this, immune driven inflammation is key to the development of cardiovascular disease. We think the number one cause of getting sick and dying in the world is cardiovascular disease, but it is immune driven. Atherosclerosis is increasingly considered an immune system-mediated process of the vascular system.

Autoimmunity plays a major role in the development of dyslipidemia and atherosclerotic plaque formation. Atherogenesis the development of atherosclerosis has been proposed to be considered an autoimmune disease. Now, this is the World Journal of Cardiology talking to us. Thus, if the cardiovascular disease has an initiating autoimmune component, arguably what becomes the number one mechanism in the progression of getting sick and dying in the world today. If we think about it, and if cardiovascular disease is autoimmune in its initiating phases, then autoimmunity becomes the number one mechanism for getting sick and dying in the world, your immune system attacking your own tissue, and I'm going to show you why this happens, but whether it's number one or number three, it doesn't really matter. The point is it's in your practice every day. It's in your family every single day.

Premise number two, how can we identify people at risk for the development of autoimmune diseases? The National Institute of Health tells us that there are six potential mechanisms by which biomarkers can really help with identifying autoimmune diseases. They enable a diagnosis before the onset of symptoms. I'm going to explain this. They predict specific organ involvement. They predict disease flares.They identify clinically meaningful disease subsets, and they predict and monitor response to therapy and describe organ or tissue damage. So once again, if autoimmunity plays a major role in the development of dyslipidemia, atherosclerotic plaque, the next sentence in this article, what they said was the mechanisms underlying these changes include the interplay of inflammation and autoantibody formation. So the mechanisms underlying these changes include the interplay of inflammation and autoantibody formation. So we can predict organ involvement. We can enable diagnosis before the onset of symptoms. We can predict and monitor response to therapy. We can identify clinical, clinically meaningful disease subsets.

And here's what I'm going to show you how. This articles by Arbuckle and her team and came out in the New England Journal of Medicine in 2003, and she went to the Department of Veterans Affairs hospital system,and looked for people with the autoimmune disease - lupus, systemic lupus erythematosus -and she found 130 people in this one VA centre with lupus. Now, if they're in the VA system, they're veterans. If they're veterans, they were in the armed forces. If they were in the armed forces, they had their blood drawn many times over the years when they were in the armed forces when they were healthy in the Army, the Air Force, the Navy. What most people don't know is that the US government has saved all of that blood since 1978. They've got tens of millions of samples of our service people's blood.

So Dr Arbuckle went to the VA and asked for permission to look at the blood of these people currently diagnosed with lupus from when they were healthy in the Navy or in the Marines, and she received permission to do it. And what did she find? She found that antibodies are typically present many years before the diagnosis of lupus.

That the appearance of these antibodies follows a predictable course with a progressive accumulation of the antibodies, you keep producing more and more and more before the onset of lupus, before the, while those patients are still asymptomatic, they have no symptoms. So this graph from her research article shows that with the antibodies in general, they were 50% above the limit of normal six years before the patient ever had symptoms, six years, and the average was six months after the start of symptoms before they got the diagnosis of lupus in this particular study. And these are the seven different antibodies of lupus. There are seven, and you can see every single one of them. Zero is normal. So if going from left to right, the zero lines are normal and every one of those antibodies was elevated years before there ever were symptoms and referred to as the first manifestation of SLE, systemic lupus erythematosus.

Years beforehand, the antibodies were elevated, and you can see how they kept climbing up every year, going up, going up, going up until they start to plateau. After you get symptoms, you've pretty much killed off enough tissue where you're getting symptoms now. So let's just back up. Let me just tell you something here.

Why is it normal to have antibodies to your own tissue? To your thyroid or to your brain or to your muscles or to your skin. Why is it normal? Because for most patients, we have an entirely new body every seven years. Entire new body. Some cells reproduce very quickly, like the inside lining of your guts—every three to five days.

Other cells are very slow, like bone cells are very slow. So every seven years you have an entirely new body. Right? So when cells get old or damaged, they get bruised from oxidation, bad foods, radiation when you fly in it in an aeroplane. There are many reasons why our cells get damaged. When that happens, the body has to make antibodies to get rid of the old and damaged cells, to make room for new cells.

That's how we create new cells. You've got to get rid of the old ones to make room for the new ones. So there's a normal reference range of antibodies. To your thyroid, to the myelin that wraps around your nerves, to the cerebellum in your brain, to the hypothalamus, in your brain, to your skin, to your joints.

We have a normal reference range of those antibodies, but when you have elevated antibodies, like in this slide here, you see all seven antibodies to lupus are elevated years beforehand, you're killing off more cells than you're making. And if the mechanism that's causing the elevation of the antibodies - remember environmental trigger genetics and intestinal permeability - if the mechanism continues, you keep making more antibodies, more antibodies, killing off more tissue, killing off more tissue, killing off more tissue until eventually, you've killed off so much tissue now that organ can't work right now, you start getting symptoms. Then it takes years to get the right diagnosis.

As you saw in the slides from earlier, it takes years to get the right diagnosis while you're still killing off tissue. So Dr Arbuckle refers to it as the prodromal period—that period before you have symptoms when you're killing off tissue. And the entire goal here is to identify the prodromal period for people before they've killed off so many tissues the brain can't work right anymore, or the heart can't work right anymore, and they get diagnosed with cardiomyopathy, or they get diagnosed with Alzheimer's or they get diagnosed with Parkinson's. So the goal here is to understand this prodromal period, and I'm going to talk to you about the testing to identify if people are in this prodromal period killing off cells.

So Dr Arbuckle drew this graph. You have normal immunity, a normal amount of a normal immune system. You get some benign auto-immunity. You're killing off a few cells to make room for new cells. Now you get pathogenic autoimmunity where you're killing off more cells than you're making, killing off your tissue, destroying your tissue, destroying your tissue until eventually, you get the clinical illness.

Now back in 2003, Dr Arbuckle did not know about the intestinal permeability part of this. So she's got two of the three, she's got the genetics on top and the environmental factors underneath. But the third one, the gateway that caused that allows all of this to happen is intestinal permeability. So immunologists all over the world said, well, that's brilliant what Dr Arbuckle did. Let's go back to the blood banks and look and see about other diseases. And there are many, many papers now published on the world of predictive autoimmunity. So look at this graph. If you have any antibodies to lupus, any of these seven antibodies elevated - the PPV stands for positive predictive value - you have a 94 to 100% positive predictive value. You're going to get lupus within 7to 10 years. For scleroderma, if either of these antibodies is elevated, 100% you're getting scleroderma within 11 years. Rheumatoid is 52 to 97% depending on the antibodies, within 14 years, you're getting rheumatoid Sjogren's; primary antiphospholipid syndrome is 100%. Now in this one, the bottom one, beta-2 glycoprotein 1, this is the antibody that's elevated for many women with unexplained miscarriages. It's an autoimmune mechanism causing a clot, blocking the blood flow into the uterus, into the placenta, and the woman miscarries.

So every woman, of childbearing age, in my opinion, that has a family history of miscarriages, should do this test to see if they have elevated antibodies to beta-2 glycoprotein 1 because it's such a very common trigger for the loss of a pregnancy, unexplained loss of a pregnancy, especially in the second trimester, but not exclusively in the second trimester.

If you have TPO antibodies elevated, especially postpartum, it's 92% you're getting Hashimoto's within 7 to 10 years. Primary billiary cirrhosis, 95% 25 years; type one diabetes, Addison's. 70% of Crohn's disease. Look at this. If you have sacharomyces or BCA antibodies elevated, that's ASCA antibodies. ASEA it's 100% you're getting Crohn's within three years.

The science has done on this. I mean, predictive autoimmunity is where we all want to go. We all want to include. What's cooking inside of me right now? What is it that I might be able to nip in the bud before it progresses by killing off enough cells that finally I'm now I'm diagnosed with dementia or Parkinson's or schizophrenia.

So this is a test that's available that looks at 24 different tissue antibodies in one blood draw. The top four, the grey ones are to the gut. The next two are to the thyroid, the adrenals, four for the heart, the reproductive system, three for the muscles and ligaments. Then the bones, a couple for the liver and the pancreas, and the bottom six are for the brain. You do this blood test, this single blood draw.

When I did this, I had three of the ones on the bottom elevated. I had myelin, basic protein, AGL, gangliosides and cerebellar antibodies elevated. I was 45 years old. I was at the peak of my triathlon career scoring in the top 10% of the 30 to 35-year-old. So I thought I was really healthy physically, but my immune system was killing off my brain, and I never knew. All outward appearances were that I was healthy.

I'll give you another example, a 44-year-old guy comes in to see me. His father died of a massive coronary at 44; his two older brothers died in their early forties of massive coronaries. He was 28 when his last brother died, and so he went to a cardiologist who put them on a statin right away, preventively. Now he comes to me 16 years later. He's been on a statin for 16 years, but he's the picture of health, really smart guy ,and learned the potential complications of statins. So he was taking a lot of nutrition to protect himself, including coincide Akutan. His diet was squeaky clean. He never ate junk, only good food, good healthy food. His body fat was 16%/ He had an excellent job. He was an executive. Happy family life. Everything looked great to doctors every year he got his physicals,. They said you're as healthy as a horse. When he came to me and said I want to do your tests, he wanted to do this test because he had heard about it. So we did this blood draw on him.

It came back: all four antibodies to his heart were sky-high, all four of them. He said, why is that really worrisome? And I said I don't know. Let's find out. It turns out that he was allergic to wheat and to dairy. When we did the right tests for him, he was allergic to wheat and dairy. I talked about those tests in last year's presentation at the LDN conference, on testing accurately for sensitivity to wheat. So he's allergic to wheat and dairy, and we put a wheat-free dairy-free. I didn't do anything else. He was already taking a bunch of good vitamins. All of his other markers were as healthy as could be. Six months later, he comes back, and then we retest—his heart antibodies are down to normal. The autoimmune mechanism killing off his heart had stopped. It was a reaction to the environmental triggers of some of the food that he was eating. And he said you saved my life. And I said, well, I don't know. You know, the doctors that did this work, they did all the research on this. That's really what we need to be grateful for. But this test is an introductory test to identify where is the pathology in your body right now. You know, no one gets Alzheimer's in their sixties or seventies. You get Alzheimer's in your twenties and thirties. It just takes decades of killing off brain cells before the damage is so extensive that it becomes obvious, and as you kill off more brain cells, the rate of the increase goes up, so you kill off faster as you go forward, as the antibodies keep going up and up and up and up.

Premise number three, what's the trigger to the production of antibodies to yourself? And the extremely important function of the GI tract is its ability to regulate the trafficking of macromolecules between the environment and the host through a barrier mechanism. What they mean here, Mrs Patient, if you could take a doughnut and just stretch a doughnut out, and if you look down that stretched out doughnut, looked down the hole, that's your GI tract from your mouth to the other end. It's one long tube. It's 20 to 25 feet long. Winds around inside your abdomen there, but it's one big long tube. So when you swallow food, it's really not in your body yet. It's in the tube. And it's gotta be broken down to go through the walls of the doughnut into the bloodstream.

We have to digest that food, break it down. Think of proteins like a pearl necklace. Hydrochloric acid made in your stomach undoes the clasp of the pearl necklace. Now you have a string of pearls. And the digestive enzymes that we make in the pancreas, in the gallbladder or in the microbiota., these digestive enzymes act as scissors to cut the pearl necklace into smaller clumps of the pearl necklace, and it keeps snipping them, snipping them, snipping them until you snip it into each little pearl of the pearl necklace.That's digestion.

Now you've got this long tube, the inside of the tube, it's got Shea carpeting, but the surface of it is lined with cheesecloth. The cheesecloth only lets really small molecules get through. If you remember your grandmother pouring gravy into the cheesecloth, only the liquid comes through the other side and all the clumps, they stay on the outside. They can't get into the gravy pouring dish. That's the way our system is. The inside of the tube is lined with cheesecloth, so only each little pearl of the pearl necklace can get through the cheesecloth and get in the bloodstream. Then your body uses these acids that are called amino acids to make new bone cells and brain cells and heart cells. That's the raw material you make your new cells from. But it's got to be in the form of the amino acids. As you're snipping down the pearl necklace, that 33 pearl clump, that 17 pearl clump, that 19 pearl club, they're not supposed to get through into the bloodstream. They can't get through unless you have intestinal permeability.

If you get tears in the cheesecloth, then larger clumps of the pearl necklace get through the tears in the cheesecloth. They're called macromolecules. They get through the tears in the cheesecloth into the bloodstream before they're supposed to be able to get through into the bloodstream. They're supposed to go further down the digestive tract. That's one reason why your intestines are 20 to 25 feet long, because prime rib takes a whole lot longer to break down than bananas. So you've got to snip, snip, snip, snip, snip. But if you've got tears in the cheesecloth, that's intestinal permeability.

If you've got tears in the cheesecloth clumps of the prime rib, clumps of that food molecule get through before they're supposed to. They're called macromolecules, big molecules. They're not supposed to get through, but they do. And when they get through your immune system says, Whoa, what's this? This is not something I can use to make new bone cells or brain cells. I better fight this. And your immune system makes antibodies to protect you from that food.

What we see here is what's called the healthy gut. And you can see the lining of the gut here. These are the shags in the tube, in the intestines, and the shags are all lined with cheesecloth. Now, and here's what it looks like. Those big molecules can't get through into the bloodstream. They can not get through. Only the little molecules get through, and doctors notice that the absorption of the small molecules is both between the cells, paracellular, and through the cells. That's really important when we talk more about high-fat diets later on. But this is normal. This is what a healthy gut is supposed to do. Only the small molecules get through, not the big molecules. Now when you have a gut that's been damaged, and you've got the tears in the cheesecloth, if you will, now you see the big molecules get through that big green mile. You'll know don't tell this chicken out. You're going to be allergic to chicken. Oh no, not beef. You're going to be allergic to cantaloupe. Any macromolecules that get through the tears in the cheesecloth into the bloodstream, your immune system then in an effort to protect you from  the macromolecule is going to make antibodies to that molecule.

Now you become sensitive to that food - and the people who do 90 food panels, IgG panels, look at 90 different foods - and it comes back they're sensitive to 25 different foods. They say, Oh my God, that's everything I eat. What am I going to eat? Well, of course, it's everything you eat. It's because your immune system's trying to protect you.

When you heal the gut, which we'll talk about how to do when you heal the gut, you wait six months and go back and check again. Now you're sensitive to maybe three foods. This is so critically important to understand because it's these macromolecules that get into the bloodstream. Your body fights these macromolecules, the immune system trying to protect you, fights it, and then there's this whole world of molecular mimicry, the antibodies against the food start attacking your own tissue.

So a common initial autoimmune pathway and therapeutic target to the degenerative disease include the immune response to intestinal antigen presentation. That means, when these macromolecules get into your bloodstream, your immune system responds trying to protect you, which triggers intestinal inflammation from that antigen getting in, which triggers activating the tight junction proteins, which triggers antibody production to the barrier proteins, which triggers leaky or leaky gut, leaky brain, leaky bladder. Which triggers pathogenic intestinal permeability antigen and macromolecule translocation into the bloodstream and immune response to the antibody production, molecular mimicry, and other pathways that occur and the development of the autoimmune mechanism.

This is the mechanism that's responsible for so much of the autoimmune disease that we are suffering from today. Arguably, number one or two or three cause of morbidity and mortality in the industrialized world. This is the mechanism. When you understand this, and you start addressing this mechanism, you will find so many of your patients not only get dramatic results in a few months, but they're so grateful, and you extend the quality of their life and most likely the length of their life, but certainly, the quality causes you to calm down this inflammatory cascade.

The autoimmune process, once again, can be arrested if the interplay between genes and environmental triggers is prevented by re-establishing intestinal barrier function, you can arrest the development of the autoimmune disease by healing the gut. Most critical is healing the gut. Well, what? How do you heal the gut? Well, first you have to stop throwing gasoline on the fire. You have to find out what the person is sensitive to and reacting to, and then you heal the gut. We'll talk about that in a little bit.

Premise number four, can foods trigger pathogenic intestinal permeability. This is a great study that came out of Harvard a couple of years ago using confocal endomicroscopy. They took patients, I don't remember how many patients, 36; they took 36 patients at Harvard diagnosed with irritable bowel syndrome, IBS, who were complete failures to every protocol they had tried for a year. The minimum was a year of no results. Still suffering dramatically, and this is Harvard.

So they took these people - confocal endomicroscopy is taking pictures of the inside of the gut - when, they looked at the inside of the gut, they found that the microvilli were closely attached to each other without space between. This is what it looks like. That's confocal endomicroscopy on the left, and that's a scanning electron microscope picture on the right. With confocal endomicroscopy, you get much clearer pictures of what's going on. So they exposed these 36 patients to cows milk, wheat, yeast, soy, and sterile water to see was there any reaction in the gut when they were exposed to these common antigen foods, antigenic foods. Lots of people are sensitive to these foods, so they said, well, let's, let's try it on these failure patients and see what happens. Within five minutes of exposure to food antigens, intraepithelial lymphocytes increase, epithelial leaks and gaps form between the cells and the intervillous spaces widened. This is what it looks like. It shows that the villi are close together. They injected a white dye, and I think they injected it into the femoral vein. I'm not sure. I think that's where they did so that the dye would be flowing through the blood vessels in the intestines. And then when they expose the intestines of these people to these different foods, they look to see if they got intestinal permeability. Did the dye leak out of the blood vessels out into the lumen of the intestines? So it's kind of a reverse permeability, you know? But are there gaps? And this dye is leaking out and look at B, multiple eruptions represent breaks in the wall, and they put white arrows where these eruptions are. See, the white dye is out into the lumen of the intestines, now. This all occurred within five minutes, people. Within five minutes.

Now this one is really cool. This is a five-minute video, and if you scroll over the video, you'll see the arrow comes up, and if you click on it now the videos starts, and you'll see it looks the same for a moment. But notice that the white starts showing itself more on the surface here. Remember the dye's inside. Now you can see the gaps forming. See that gap on the right side there, and it's white. Watch what happens. This is intestinal permeability as it's occurring. Look at all the white that's coming in up. The gaps between the cells that are not supposed to be there. This is how macromolecules get into the bloodstream that isn't supposed to be there.

Aren't the video's cool? To see this. This is at Harvard, within five minutes of being exposed to these foods that the clinicians thought these people might be sensitive to. After food challenge, 22 of the 36 patients showed an immediate and dramatic mucosal response to these antigens. Increased permeability is an early biological change that often precedes the onset of autoimmune disease.

Now I've shown you a video of what permeability looks like. And that foods can trigger it. There are many things that can trigger it. We'll do another session on that. I've got a full day course that I'll be doing this year at the LDN conference, going into great detail on all of this. There's just not enough time to go into all the detail now.

Premise number five the more lipopolysaccharide or weed peptides that pass through a permeable intestine, the stronger the inflammatory response. So there's a correlation between the degree of systemic inflammation and the increase in intestinal permeability. The more permeability you have, the more systemic inflammation you have; the more systemic inflammation you have, you're pulling on the chain; the more wherever the weak link is and the chain develops.

I have a gift for all of you, and the gift is I'm giving you all 43 studies that I'm using in they're all available to you. Now, 31 of those studies were free. I got them for free, so I'm giving them to you. For the others, I'm giving you the link to the abstract so that you can read the abstract. So many of these studies that you want to learn more about and read the study here they are. All you have to do is go to my website, https://thedr.com/LDN17, and all of the studies are there for you. It's my gift to you because I want you guys to really get this. You really need to know this because it's a foundational platform of healthcare. This is so common in your practice. Every day you will find six, seven out of 10 people, when you check them, they've got elevated antibodies to their own tissue. They have an autoimmune mechanism going on. Obviously, if it's the platform for most of the degenerative diseases, including atherosclerosis and cardiovascular disease, it's got to be going on in most people. So you'll have the studies here. This is what your handout will look like, the scientific references from this talk.

Premise number six. So how do you arrest pathogenic intestinal permeability? How do you arrest this process? You have to put the fire out. If, if every degenerative disease, as far as I know, every degenerative disease at the cellular level is a disease of inflammation, you have to stop the inflammation, so you have to stop throwing gasoline on the fire and then put the fire out. So how do you do that?

The first concept is a pleiotropic concept. It's a good Scrabble word. Pleiotropic it means all roads lead to Rome. You know, there are many, many ways to heal intestinal permeability and put the inflammation out in your body. There are many ways, and because certain products like glutamine, it's a great product to heal the gut. Glutamine turns on certain genes, but vitamin D turns on genes in the gut that glutamine does not. Curcumin turns on genes in the gut that vitamin D does not. And so there are many different paths to get a comprehensive treatment protocol that's going to work in the vast majority of your patients. Here's an example for curcumin. These are all the inflammatory and anti-inflammatory pathways that are impacted by taking curcumin, and I'll talk more about that in a minute. So all roads lead to Rome. A pleiotropic approach to addressing pathogenic intestinal permeability.

There are three categories to consider. First, avoid inflammatory triggers. Stop throwing gasoline on the fire. Critically important. So the question about is gluten sensitivity really limited to just celiacs or is there's this thing called non-gluten sensitivity? This is about the world of non-celiac gluten sensitivity. So in this study, this is a study that Hollon and his team at Harvard did. They took celiac patients recently diagnosed, so they had villous atrophy and lots of inflammation. They took celiac patients who were in remission at least a year on a gluten-free diet, so their microvilli had healed, and the inflammation was greatly reduced. They took people who had a problem with wheat but didn't have celiac. They refer to them as non-celiac patients with gluten sensitivity. And then they took people that didn't have a problem with wheat at all, all four groups, and they exposed them to wheat. The peptide, the clump of the pearl necklace of poorly digested wheat called gliadin, alpha-gliadin. Their conclusion: increased intestinal permeability after gliadin exposure occurs in all individuals. And one part in there, they said in all humans, so any of you that is human, every time you eat wheat, this is what happens to you irrespective of how you feel when you eat it. This is what the science tells us. Well, I don't feel bad when I wheat. It doesn't matter if you feel bad. The lucky ones are the ones that feel bad. Then if they continue to eat wheat, that's their problem to deal with. But the unlucky ones are the ones that don't feel bad when they eat wheat, because you can't feel when you tear the cheesecloth. But remember, Mrs Patient, the fastest-growing cells in the body are the inside lining of the intestines; every three to five days, you have all new lining of your gut. So you eat toast for breakfast. You tear the lining of your gut, but it heals. You eat a sandwich for lunch. You tear the lining of your gut, but it heals. You have pasta for dinner. You tear the lining of your gut, but it heals. Croutons on your salad. Tear the lining of the gut, but it heals. A cookie tears the lining of the gut. But it heals. Day in, day out, day in, day out until one day. And that can be when you're two years old, 22 years old or 92 years old. One day you cross that line. You lose oral tolerance. You don't heal anymore.  Now you get tears in the cheesecloth that don't heal. That's called pathogenic intestinal permeability. You don't feel that now the macromolecules get into the bloodstream; that now your immune system produces antibodies against those macromolecules; that now because of molecular mimicry you produce antibodies against the weak link in your chain, your thyroid, your brain, your liver, your kidney. Now you're on the autoimmune spectrum. That's how it happens.

It's so cool when you look at this science, and you realize, wow, this is so very common. This is an underlying mechanism that we can identify years in advance. And that gives you a heads up to do something different. Well, what do you do differently? Well, first stop throwing gasoline on the fire and then heal the gut. So this is the book that came out in September of last year. This is 35 years of my, professional life. But it's all about this mechanism in great, great detail. And I think everyone should read this book, not because I wrote it, but because this gives you the clear, precise, step-by-step mechanisms and what causes the primary mechanism in getting sick and dying in the world.

The immune system is attacking your own tissue. The autoimmune mechanism. Alzheimer's is autoimmune, cardiovascular diseases autoimmune, cancers are autoimmune, and all the studies are in the book with explanations on how to explain it to patients. And when you see this, you go, my God, that's profound. I make $2.10 or something on a book, so this isn't going to pay for my grandchildren's college funds. I'm not saying buy the book because of some personal benefit. I'm saying buy the book because you're really going to learn so much. Or you can take my old day course at the LDN pre-conference in September. You learn so much about this, you'll really understand it, and you can apply it in your practices.

In the book, I recommend a three-week protocol for people to give up wheat, dairy, and sugar for three weeks. And we give lots of examples of breakfast, breakfast for your kids, breakfast for the family, lunches, dinners, snacks for three weeks. And just see how you feel. Just see what happens. Cause most people can't afford or don't have access to the tests. So just do this, and you say, Oh my gosh, my headaches are gone. Oh my gosh, I'm waking up, and I've got more energy. Oh my gosh, I'm sleeping better. Oh my gosh, my child's doing better in school. They're sitting still in school. You just see a condition after condition after condition that's better after doing or during this three-week protocol. So that's a recommendation that I give to people who can't have access to the tests for one reason or another.

The second category in the pleiotropic approach to pathogenic intestinal permeability is included foods that heal intestinal permeability. The first one, of course, vegetables, and one of the benefits of the vegetables is, as you know, the microbiota work on the fibres in vegetables, insoluble fibres, to produce short-chain fatty acids like butyric acid or butyrate. Mrs Patient, the past is growing cells in the body are the inside lining of the gut. Every three to five days, you have a whole new lining to your gut. The fuel for those cells to reproduce is called butyric acid or butyrate. That is why butyric acid is so critically important. If you don't have enough butyric acid, you make your house out of straw instead of brick. And you find so many studies, just go to Google and type in butyric acid and colon cancer. And when you have low butyric acid, you're at a much higher risk of developing colon cancer because you made your house out of straw instead of brick. So you need butyric acid . How do you get butyric acid? it's the good bacteria in your gut working on the vegetable fibres that produce butyric acid.

My good friend Terry Walls, who is a brain neurophysiologist, a professor of medicine, and she developed MS, and being a brain neurophysiologist, she knew all the cutting edge techniques of how to deal with MS and they didn't work. Within seven years, she was in a wheelchair, and her brain wasn't working very well anymore, and a friend said, wake up. What you're doing isn't working. Do something else. It's not working. And she did. She went back to the basic literature, and she found studies on animals that they had induced MS-like symptoms, and they changed their diet, and the animals got better. So she changed her diet to mimic what they did for the animals. She started feeling better. So then she went to functional medicine courses, and she learned about this, and she completely reversed her MS, and she has what she's called The Walls protocol. It's a great book on how to reverse MS. And Terry, applies these principles at the VA Medical Center in Iowa, where she's associated; and she's taking these veterans who are completely disabled. They'd lost a limb, or they've got PTSD, and they can't function in life. She's taken these bedrooms, and she's completely reversing them, getting their brains working normally again, getting rid of their chronic pains.And there are a couple of things that she's doing that I'll talk about here.

The first one, they have to eat 12 cups of vegetables a day before they eat any starches, like pasta and bread and stuff. What does that mean? It's kind of hard. There's no room for pasta after 12 cups of vegetables a day. Right? But that's how she gets them to do it. You eat 12 cups of vegetables a day, five different colours, then you can have some pasta or some toast or something.

Prebiotics, originally defined as nondigestible food ingredients, had beneficially affected the host by selectively stimulating the growth and/or activity of one or a limited number of bacteria in the colon. That's what these vegetables are. Some of these vegetables are prebiotics. Here's a study demonstrated the apple derived pectin could modulate gut back microbiota. Here's a study that shows that apple pectin treatment attenuated the level of lipopolysaccharides and reduced intestinal permeability. So what they did here on the left, you see high-fat diets, how it changes the gut microbiota, and it causes more inflammation. And the change in the gut microbiota is to microbiota that induces weight gain. So you get more of the formicilis's family (as I understand the family of G. formicilic (Geriger)) of microbiota that hoard calories, survival, survival, hoard calories. So you store more calories, thus you gain weight. Plus you get the inflammation. Then when they did the same high fat diet, but they added pectin from apples, you see the benefits that occurred from that suppressing weight gain and healing tight junctions of intestinal permeability.

The next category here, or the next component of category two, is bone broth. And once again, Dr Walls with these vets, she has them drink one quart of bone broth a day, not a cup, a quart of bone broth the day. And how do these guys do it, because they don't have any money, they can't work because they're disabled. They can't afford to buy quarts of bone broth a day. They make their own. So these guys go out hunting. They harvest an animal, they make their own bone broth, and they're very proud to be so active in taking care of their own health in a way that they can relate to. They go hunting, they kill a deer, and they make bone broth.

Now about bone broth. Gelatin Tannet is in bone broth. It's a strong anti-inflammatory. Next fermented vegetables. And focus on diversity. Mrs Patient goes to the local natural foods store and buy five different types of fermented vegetables just to make sure they're not pasteurized because pasteurization kills bacteria. So get sauerkraut, get kimchi, get fermented beets, get kvass, get Italian flavoured fermented vegetables, curry flavoured fermented vegetables. Get five, six different types. Keep in the refrigerator. Every day, walk by, take one fork full of fermented vegetables. And somebody said, well, why can't they take more? They can take more. I'm happy, if they get a fork full, then they can take more. Do it twice a day. Why? Because every family of vegetables that ferment produces different species of probiotic bacteria, the good bacteria, and we now know it's not lactobacillus or bifidobacteria that are the commercial ones we've used for 20 years that change the gut microbiota. They help. But you really want the diversity of hundreds and hundreds of different species of good bacteria in your gut. And how do you inoculate for that? Eat fermented vegetables every day.

So you're changing the microbiota because if you have intestinal permeability, you've changed the microbiota to be more pathogenic. That contributes to more intestinal permeability. You take the nutrition and stuff to heal the gut, but if you still have dysbiotic gut flora, you're going to get more permeability. So you have to change the gut microbiota, and by doing the vegetables, doing the fermented vegetables, 12 cups a day, vegetables, bone broth and the fermented vegetables, you're going to change the microbiome.

Fermented foods and beverages were among the first processed food products consumed by humans. The ingestion of fermented foods potentially increases the numbers of microbes in the diet by up to 10,000 fold in one day. It doesn't take long to do this.Consumption of fermented foods may provide an indirect means of counteracting the hygienic, sanitized, Western diet and lifestyle. Many of these species found in fermented foods are either identical to or share physiological traits with species relevant to promoting GI tract health. You know, docs, so many of you just don't have time to talk about foods with your patients. That's understandable. Every office should bring on board a nutritionist or a registered dietician, or have one of your staff people trained, so that you can just prescribe what needs to be done, and the expert can sit down with the patient and walk them through how to change their lifestyle habits. They don't do it in a day by giving them a handout, you know it's going to take some time, and we talk about that in the full-day course, how to get the right people and how to train them, and all of that.

Next, the third category of the three categories, is nutrient supplementation. You want to do nutrient supply admin supplementation to address the inflammation, rebuild the microbiome and healing of the intestinal epithelial lining.

Vitamin D plays a role in the aetiology of autoimmunity. Vitamin D causes assembly of the adherence junctions. That's part of the control for intestinal permeability. Here is a drawing of the adherence junctions right there, and this is a drawing of two full cells, and on the outsides is the start of a third and fourth cell. Vitamin D plays a critical role in the mucosal barrier homeostasis by preserving the integrity of tight junction complexes and the healing capacity of the colonic epithelium. Vitamin D markedly enhances tight junctions by increasing junction protein expression at the kissing joints, and preserving the structural integrity of the tight junctions. Here's the visual, that's the tight junction strands. Here's the drawing of the whole thing. The upper left one is the one you saw previously. The letter B is a picture of a tight junction. Now when you see they blew up that tight junction in the lower-left corner, you see that it's looped the tight junction where food goes through, vitamins go through, its loot. Think of the Panama Canal. The gates open, the food comes down a little bit in between the cells, the gates close, the immune system checks it out. The next gate's open, the food goes down a little further. The gates close behind it, then another part of the immune system checks it out. The next gates open, the food goes down further, the gates close, the immune system checks it out. That's how we check out foods and things that we're being exposed to through the oral cavity coming down into the gut.

And then you see the drawings of these kissing joints. Now, that extracellular space, that's where the tight junctions are. That's the Panama Canal. You are going through that extracellular space. Now watch how much, and then on the right is the drawing of the kissing joint itself. And so you see the paracellular space, the extracellular space there on the right side of the drawing and the zonulin family of proteins are like shoelaces and the shoelaces, you untied the shoes, they open; you close, or you tie the shoelaces, they close the gates, open the gates, close. Now watch how much of this is controlled by vitamin D. All of those are controlled by Vitamin D. Vitamin D controls the gate opening the gate closing, the shoelaces opening the shoelaces closing, all controlled by Vitamin D.

Here are some recommended protocols that you can review. There are three main mechanisms of how probiotics contribute to human health. They shape the ecosystem by a competition for the resources and the adhesion sites. They decrease the local pH, and they produce specific antibacterial substances.

Probiotic strains can not only affect the intestinal microbiota directly, but also affect other organs by modulating the intestinal inflammation and permeability. Changes in gut microbiota modulator. Endotoxemia. By a mechanism that affects gut barrier function and increases intestinal permeability. Look at the journal diabetes metabolism that this is a critical, critical component of dealing with diabetics, is having a healthy gut and closing the intestinal permeability and rebuilding the microbiota.

Our findings that the human gut microbiome can rapidly switch between herbivores and carnivores. Functional profiles may reflect past selective pressures during human evolution. Consumption of animal foods by our ancestors were probably by little, depending on the season and forging success with readily available plant foods, offering a fallback source.

So that's why you eat meat. You change your microbiome in one day. Not saying it's bad, not saying it's good, just know it changes the microbiome. So you have to see what type of microbiome you have to determine what kind of foods you should be emphasizing more. We found that microbiota changes on the animal-based diet could be linked to altered faecal bile acid profiles and the potential for human enteric disease.

VSL Number 3 is a type of probiotic that you can use. There are some really good studies on SL Number 3, and its multi-species. You always want to go through varied species, not just take one type of probiotic, but the key is diversity.

Here are some recommendations on dosing. Fish oils exert much of their anti-inflammatory benefit by suppressing NF Kappa B, which is the major amplifier of inflammation in the body. The safety of fish oils is high, has been well established in numerous clinical studies. Drug interactions are extremely rare. A dose of up to three grams a day has been determined to be safe for general consumption.

Here are some dosing recommendations. Glutamine is the most commonly used amino acid in the gut. In a study giving 30 grams a day, every ulcerative colitis patient got better. It didn't matter how bad they were, even the really severe ones, but when they stopped the glutamine, the disease came back. And why is that? Well, it 's because the lifestyle was still throwing gasoline on the fire, and they didn't heal the gut, and they still have the microbiome of the altered lifestyle. You can't just give a pill and expect to heal the gut. We have to change the environment, the ecosystem of the gut. Glutamine is a very clinical, useful, useful tool. But it's also a substrate for lymphocytes and macrophages. So you gotta be careful, Mrs Patient. I give people, I call it the gluten sensitivity packs. There are six pills in a pack. MrsPatient, can you take one pack a day? Yes, they can. And so, okay, now if you have any reaction to the pack, you get a little bloated, you get a little cramping, anything like that, just stop that one pill. And that's the glutamine. Just keep them in a little container. Wait two weeks, take everything else to calm down the inflammation, and then you're going to be fine. Then you can take them again, because glutamine is a precursor for lymphocytes and macrophages.

Here are some recommendations. Tumeric is remarkable in its benefits. Tumeric is anti-amyloid. Orogenic. It's neuroprotective. It enhances cognition. It's a diagnostic marker. It's an antioxidant. It's an anti-inflammatory. Here are the dosings on all of these different studies. Just depending on what you're dealing with and what your target is that you know you, you can be aggressive with a tumour. It's extremely safe. And here, once again, are all the pathways. Inflammatory and anti-inflammatory pathways that are modulating to produce an anti-inflammatory effect. Here are all of the diseases that there are studies showing curcumin is of great benefit for, and how many of them are autoimmune.

Recommended protocols. Colostrum. High intestinal permeability is normal in newborns. Their guts are very permeable. That's one of the main purposes of colostrum. The first three days of mother's milk is not breast milk. It's colostrum, and one of the main purposes immediately is to turn on the genes in the gut. Say okay, baby, let's close these tight junctions now. Come on. Let's get these cells going. Close these tight junctions. Colostrum also says, all right, let's build the receptors for this good bacteria. Let's start colonizing this good bacteria that you just got washed through as you came down the birth canal. Let's start building these receptor sites. So colostrum helps to set up the environment of the gut for a healthy, well-functioning gut. It also promotes recolonization of the bowel by the friendly bacteria. It's the best remedy known for all-around gut help. Restores leaky gut to normal permeability, contains growth factors and hormones to repair damage to the lining and restore gut integrity. It's unmatched as an immune system stimulator and modulator. There are numerous note products lining the shelves of natural food stores that claim to stimulate the immune system. Only colostrum plays the entire symphony. Colostrum.

If there was only one product I was going to use, it would be this, and it would be this colostrum, produced by the author of this book, Andrew Keech. Dr Keech grew up on a dairy farm in New Zealand. He learned really early in life that you have to give these newborn calves colostrum, or they die in a week. They die. And he then learned that the humans, when they were sick, they drank the colostrum, they got better. So he decided he's going to devote his life to colostrum. So he went to Oxford and got a PhD in mechanical engineering, and I said to him, Andrew high five to you, high five Oxford PhD, way to go, man, way to go, but mechanical engineering, what is that? And he said, well, Tom, I knew I was going to make the best colostrum in the world, and no one is doing it. So I was going to have to learn how to build the equipment to do it. So he spent eight years getting a PhD in mechanical engineering to build the equipment to produce the best colostrum in the world—grass-fed antibiotic-free, hormone-free. Every batch is checked when it comes in, every batch, every time. It's the most powerful product that I know of. It's on my website. You'll see it there. My website is TheDr.com. The product is called GI Restore. It's really quite remarkable.

The two key developmental time points of the regulation of gastrointestinal tract help occur postnatally, the first few days after birth, when all the gut digestive functions are launched by first colostrum ingestion; and then the second when weaning, when the digestive system has to modify its function following a switch from mother's milk to solid food. Two critical developmental time points. The first time point is particularly relevant for all mammalian species since it's associated with a complex of dynamic changes in the gastrointestinal tract structure and function, leading to a temporary drop in gut permeability barrier. So when the guts on fire, the body's on fire. This is a protocol that will work for you. Eliminate inflammatory foods. Give prebiotics, give fermented foods, give probiotics, give Vitamin D, give glutamine, give fish oils, curcumin, colostrum; and I want to note there are many other beneficial anti-inflammatories that can be used to heal the gut, reduce inflammation. There are many. I'm not saying these are the best. These are just well referenced in the literature, and it's a safe protocol that everyone can do, and you'll get dramatic results when you do this.

So what did we talk about here in this little over an hour? Just how prevalent is the development of autoimmune disease. If the cardiovascular disease has an autoimmune component, what becomes the number one mechanism? That's how prevalent it is. Premise number two, how can we identify people at risk for the development of autoimmune disease? You do the test, and you find out. Number three, what is the trigger? in the production of antibodies to self. The addition of the third element, the loss of intestinal barrier function. Number four, can foods trigger pathogenic intestinal permeability? Yes, they can. Number five, the more LPs or wheat peptides that pass through a permeable intestine, the stronger the inflammatory response. Number six, how do we address pathogenic intestinal permeability?

Once again, we have a full day course. We'll be doing it as a pre-conference workshop in Portland in September. We guide you on all of the testing, the supplements. How do you diagnosis, how do you think about this? How do you talk to patients about it? You can find out more on the LDN Research Trust website about this. We also offer the online, you can do the course online, but I think it's better in person. You get all of my, visuals and my emphasis when it's live. For those of you that don't know, we did Betrayal, the Autoimmune Disease Solution. It aired in November and we're going to be launching it again in the very near future. I think by the time you're watching this, it will be launched again. You can find it at betrayalseries.com. I interviewed 85 of the world's leaders in autoimmunity, and the scientists, and then clinicians applying the scientist's principles, and then the patients who went through the protocols recommended by the clinicians. For example, Linda, talking about LDN, and it's really quite remarkable. And if you go to betrayalseries.com, you can find out more about that.

So take care of yourselves. Hope you have a wonderful time in Portland. Make sure to tell those important to you how much you love them.

And this is the last slide, a very good book to read about genetics The last paragraph in this book, throughout your life, the most profound influences on your health, vitality, and function are not the doctors you visit or the drugs or the surgery, the therapies you've done. The most profound influences are the cumulative effects of the decisions you make about your diet and lifestyle on the expression of your genes.

And with that, I would say thank you very much for your kind attention.

Linda Elsegood: Thank you for listening to this presentation. All past conference presentations can be found on our website, www.ldnresearchtrust.org.